Months had passed since my last significant episode, but as 2002 zipped by the balance could not hold and, fueled by too much time, too much risk, and not enough discretion, the disease came fully back. My sister was engaged and planning her wedding, and I saw her less and less. To make extra money and keep me in the city at night I went back to work for the orchestra a few evenings a week. I saw less and less of my friends. I went to concerts, went drinking, and occasionally took someone home. A certain numbness of settled non-thinking filled me like a liquid, its level rising like the mercury in a thermometer, as the weather heated and the summer came and dragged on.
On the train returning from Natalie’s to New Jersey one night I met a woman named Courtney who was a musician in the Philadelphia Orchestra. I told her I worked at Theodore Presser, and was fairly familiar with the repertoire, so we had some things to talk about. I didn’t tell her I sold subscriptions to her employer and snuck into the Kimmel Center at intermission to find an empty seat and hear the end of a concert every once in a while. A few days later I looked up her number. We went to an Italian restaurant in the small town I lived in and she brought a bottle of wine she made herself. When the check came she said we should split it. Nearly broke, I threw chivalry aside and jumped at the chance to go Dutch. I said, “That’s a good place to begin,” and inexplicably impressed her enough to get a second date. We went out two or three more times and I spent a night helping her bottle wine at her house. Then she left for a few weeks at a music festival.
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My sister Stacey was married. In the pictures from the wedding I look especially small. By then, I was at my worst. The weeks leading up to the wedding saw my mental state decay as I got hold of more Klonopin and plunged into the abyss of depression while simultaneously racing along the expanding self of grandiosity. I missed a day or two at the sheet music store and, again and for good, quit the orchestra. That was the only setback visible to others as I continued to play it normal and fool everyone. My father was suspicious, but not too insistent, in his drive to expose my weakness, and I saw Dr Baldassano, and she deemed me well enough. I was too far gone, too caught up in lies, too rapidly inconsistent, to admit to an episode now. Lying seemed easier than facing the truth of a full-blown, panicked, mess of a mind. In July I made out with a man outside my apartment and walked the beach, too hyped to sit on a blanket and bake in the sun like everyone else in Ocean City, NJ.
The night of Stacey’s wedding, in early August, I took a friend of hers home, and spent a disastrous night entwined in an act I had no desire to finish, no desire to even begin, with no chance of shaping it into an affectionate moment of caring or sensitivity or even lust. My virility was in chasing a quick high and I preferred Klonopin to company.
After a couple of weeks more of this self-abuse torched by a jittering, smoldering mind, I caught myself in the mirror and saw a need for help. On a Tuesday in mid-August I reached out to Dr Baldassano and came clean. I told her I was out of Klonopin. I told her I stopped taking everything else. I clutched the phone and cried that I was at wits end and didn’t know how to stop it. She assured me she could help, told me she was working intake at the hospital on Thursday, and arranged for me to meet her there that morning. I arranged for Mom to take me.
I passed Wednesday zombielike, unfeeling, all of the energy that drove my highs fizzled out and spent. Stacey had returned from her honeymoon and came to visit, and I scuffed downstairs to my parents’ floor of the house to eat roast chicken with the three of them. I mustered normalcy again, and even stayed to watch a sitcom and hear stories of Stacey’s trip to Alaska. Soon, tired, I left through the back door, walked up the stairs of the fire escape to my apartment, looked out into the night, and locked the door.
Almost immediately I began to write the note. At some earlier point I lived a year and a half largely symptom free, and now had good friends, held an OK job, and even faced a budding romance with this woman Courtney. At some earlier point I felt a little reborn. But now it was back in full force, category five, ripping through this new normalcy and knocking the home I’d built for myself to matchsticks. I couldn’t take it again, not another hospital, not another failure, not another day. “What the fuck?” taunted me with “Why the fuck not?” and I filled a couple large glasses of water and set them on the coffee table in front of me. I went into the bathroom and took the bottles from the medicine cabinet. I opened them and placed them on the table next to the water. Then I took them all, every pill, tablet, and capsule. A bottle of Klonopin, a bottle of Depakote, another of some anti-depressant, and a handful of aspirin. I burped, and the bitter taste of the medicine mixed with the chicken I had for dinner. The amount of water I had to drink to get it all down made me nauseous.
I stood up and took the empty bottles into the kitchen. I placed a new trash bag into the can, dropped in the bottles, then settled the old bag back in, on top of the pill bottles in the new bag. Double bagged, no one would find them and know what I took. In my bedroom I changed for bed, pulled back the sheets, and crawled in. I thought of saying a prayer, but thought that hypocritical and pointless, so I wearily closed my eyes. It was an impulse, a decision quickly made, and now it would be over…
If I had obtained the education I should have, I would have come across formulas and physics that cast free will as an enigma at best, and quite possibly a fallacy. According to the National Institutes of Health, between 35% and 60% of people with bipolar disorder 1 attempt suicide during their lives. So, over the years of unsuccessfully dealing with the disease, the probability that I would find myself on this couch in front of a coffee table littered with empty pill bottles was likely. My opportunity of choice in this action is debatable.
Every action in life that human beings take or confront can be plotted on a bell curve. On the average, we act a certain way. I was just doing what a large group of people with bipolar disorder do. Unlike most men, I didn’t choose a violent method, but as I lay down on my bed and tucked myself in I was certain that I had succeeded. But many people who attempt don’t succeed, so here I was another piece of data plotted on the axes of attempt and success. In the research that yields the treatment that seeks to heal the individual, groups of data within a standard deviation dictate the drugs prescribed, the insurance provided, and the outcome expected. And the outcome should be positive, as treatment for bipolar disorder has an 85% effective rate. That’s better than heart disease or diabetes, and certainly better than cancer. Most people with bipolar disorder who stick to treatment get better. Yet most people don’t stick to treatment. Noncompliance with prescribed treatment reaches 64%, eliminating treatment effectiveness and walking so many to the altar of poor results, hence the co-morbidity rate, 80%, so high, and the average life span, 56 years, so low.
The predictable likelihood that I would do what I just did made a mockery of my lifelong adherence to the concept of free will and the personal responsibility each must take for their own actions. I was just an average person with a severe mental illness, and, in attempting to take my own life, in some sense, I was doing what epidemiologists insist I was supposed to do. Free will aside, I was another statistic.
The decision I made as I filled the glasses of water and scribbled an incoherent note with a short will and a quote from Job made no sense given the pleasant evening I just passed with my family. I was not angry, there was no unvoiced “fuck you!” aimed at anyone. Possibly a little hopeless and definitely exhausted by the setbacks and surrenders of the battle with the disease, and physiologically unbalanced by varying my treatment regimen and abusing my medicine, with grave impulse I swallowed, passing several chances to stop and reconsider, and plummeted deep into a dark well that dropped through the floor of what I had been sure was the bottom. If any decision was made at all, it was simply, “that’s it. I don’t want to deal with this anymore.” As far as I can tell, I hadn’t planned, or even pre-considered this act. I just acted, with little thought or alternative. In a life of mercurial impulse it was the least thought out act I’d ever committed, and the most final. Little emotion followed the meal of everything that was in the medicine cabinet. I didn’t cry. I felt nothing but sore in the throat and bloated. I was cold and unfeeling and I still am as I write this. I entered the dead center of the bell curve and drifted off to sleep.
I came to in a rage on a gurney, a mess of bedpans and catheters; pumped with charcoal to neutralize the drugs still in my system. I thrashed angrily when I realized what I did and where I was. I was angry I failed, and wailed to the lights beating on me to let me die as I pulled out the catheter again. The doctor said, “belts,” and I was strapped to the bed, bucking against the buckles, arms stopped from hitting, and pulling, and grabbing, spitting into the tubes in my mouth, chewing on plastic. I noticed my parents, knew they must have found me unconscious, and cursed them for saving me. I ranted and blamed the problems of the world on the fact that Billy Joel was on tour performing with Elton John, as if that mattered to anyone at all. I railed against lucidity as I felt myself come back. A large black woman named Mary, an angel in nurse’s scrubs, said, “Release him. I’ll hold him down.” She held me in an embrace that drew the possibility of love, of life, back into my lungs and limbs, and I calmed down. Nine hours in the ICU is what it took to finally bring me back. Mary held me, and I settled. I felt in her soul the ineffable quality of human compassion.
Once the charcoal did its work I was moved to a private room where a 24-hour orderly, a young nun, sat by my bed. I was still disappointed to be alive – she would keep me from trying to end it again. I was ashamed and already guilty, so I turned away from her and said nothing. My throat was too sore from the tubes that were forced down it earlier, anyway. She switched on a reading lamp, and I heard her turn the brittle, thin pages of her bible. In a silence like the beginning of rainfall I slept. The air conditioner in the room hummed, and God and guilt let me be for the night. The next morning, a priest came in and asked if I wanted him to hear my confession. I did. They say that Catholics who regularly go to confession have lower rates of mental illness. Cause or correlation or selection bias aside, perhaps three weekly minutes of anonymous therapy followed by penance and forgiveness allow the healing of the small, emotional wounds that stress a mind to the point of breaking. My parents and siblings all visited, but too soon. I remained very quiet. I apologized, and some desire to live crept back into the shadows of my mind. On the second day the nun said something about Dios in Spanish and left. I was placed on 15-minute checks.
Back home the vomit on the bed sheets and pillows, and the vomit spewed up the headboard and walls, dried. Mom and Dad would clean what they could, and throw out all they had to, just trying to wash that day away. Thursday morning, Mom had come upstairs when I didn’t answer the phone or the doorbell, and she found me dead, for all she knew, in a mess on the bed. My body had tossed out all I dumped into it to kill it. The first officer who responded was a man I went to high school with, one with little promise expected only to do little things. Little things like save lives.
The ambulance squad were all volunteers too busy to judge or offer comment on a life wasted; perhaps a life that could be saved, if they did their work well. Mom and Dad sped after them to the hospital and found me in the ICU screaming. I wouldn’t feel the impact of what I did to those who love me for years. Just as I didn’t consider anyone else in taking the pills, I’d consider no one else in my recovery. I wouldn’t blame or misplace responsibility for my poor decision. I’d take it all on myself, as I should. I did it, and it was my fault. After confessing in the hospital I stopped wishing I had died, but stopped short of hoping to live. I was lost in the middle to breathe without will or regret, not yet ready to consider what I did or what was to come.
I was at Our Lady of Lourdes, a Catholic hospital in Camden, NJ, for three days. At some point two men who self-identified as psychiatrists came in with clipboards and asked me a few questions. That was the only psych consult I remember. I called Courtney, who was back from the festival, told her what I’d done and, surprisingly, she came right over to visit. She told me she was an evangelical Christian and asked me if I was saved. I lied and told her I was. She wondered aloud why someone who met the person he could spend the rest of his life with would try to kill himself. I wasn’t sure what she was talking about. We’d only been on three dates, but I didn’t want her to go away. She knew the future would be bright; it was predestined. I sat with her in a sitting room full of plants and light and I saw the angel on the roof of the hospital through the plate glass that stretched from floor to ceiling. For a moment, the thought of smashing the window and jumping to the sidewalk below entered my mind, but I held her hand and the urge passed.
On the third day, well enough, I was discharged to the street. No follow-up was scheduled. No one spoke of plans. I was just alive and it was time to leave.
I spent what seemed like days rollerblading along the roads that laced over gentle hills in Haddon Lake Park. A man did solitary Tai Chi on a flat above the amphitheater. His hips set and his knees went soft as he angled back and moved his arms in a gentle curve from left to right. The trees that surrounded him swayed in exactly the same way as he settled into the rhythm of nature I’d lost. I joined him and requested that he teach me. He asked for no payment but a donation so he could send money back to his master in China. In my time with him thoughts fell away and my body spoke, until the wind rustled the leaves as they gently turned their light undersides over, signaling a late afternoon thunderstorm. A haze of steam rose from the black top of the streets as the first drops fell. I thought of practicing Kendo again, but the closest club was in Princeton, and that was too far. So for days I practiced the gentler art with the man in the park.
I wanted to see no one, and my parents lay awake in struggle below me each night, listening for footprints or music in my apartment upstairs. My movements stilled. At three-thirty AM everyone in the house sat drowsy but awake; shadows fitful and alive. Mom kept my pills and dispensed what I needed, when I needed it. Unlike in the park, in my apartment I was captive to anhedonia and felt almost nothing.
Soon enough, Dr Baldassano called and asked where I was. She was contacted by Lourdes and that way learned about my attempt. When I told her I was home, alone, just kicking around, she insisted that I immediately go to Pennsylvania Hospital in Philadelphia and check in. I was not ready to be out of the hospital. There was a huge risk I would attempt again. I was due at the psych ward and this time I would go. My mood fell, I packed a bag, and Dad drove me across the bridge.
I became a man who failed at his most significant attempt to change. Ambivalent about that failure, I entered the hospital. Later, I might regret trying to kill myself, but at this point I was careless with the idea of living, left to feel little hope, little fear, and little remorse. The method I chose for this most violent of acts was peaceful and surely destined to fail, so perhaps I didn’t want to die after all. But again I tried something and again I failed at it, as if my lot in life was to fail and feel sorry for myself for even bothering, sorry for the effort wasted, sorry for being itself, and still going on.
In some sense it was all over. Something passed, something gave, yet something stronger still held. In the calculation to continue, to not immediately jump off a bridge or swallow Draino, I chose once again to give life a shot. I entered the hospital with a choice to live. A regrettable choice, yes, but still a positive choice. As I remembered from a different hospital years before, they gave me a bed and allowed me to go to sleep. I woke up and wandered into the day room, filled with the craziest people I ever met. But a quick survey revealed that I was the only one there who tried to take his own life. Who’s crazy now?
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“I chose once again to give life a shot.” Yes. Your words are keeping me up tonight in a good way. Survived one myself several years ago. Most days feel lucky and grateful to still be here. This is very good writing, George. Thanks for sharing.