Theresa’s plan to go to Boston University changed when she cleared a waitlist at The University of Pennsylvania. The apartment in my parent’s duplex in Haddon Heights, NJ, the one I moved into, was suddenly convenient for a commuter student attending school in Philadelphia, so she made overtures for us to stay together. She’d cuddle up and intimate that maybe we should reconcile, but I just wanted her out. I was still drinking and cutting, and with her future set, it surprised me that she didn’t need to be free of the darkness of the pit into which I could drag all light. She discovered that the old friend from college she slept with wanted nothing more to do with her, and I held her as she lay there sobbing, feeling nothing except a vague sense of duty that I should care, reaching out as if inviting more abuse, both of us knowing no other options for survival. But she couldn’t study with me bleeding in the living room, so she wrote my family a letter detailing her pain, not mine, and fully turned over care for me to them and left. Somehow she had enough money to afford a new apartment on the Schuylkill River in Philadelphia. Somehow she had enough for a new car. Somehow she had enough for tuition. Certainly, she had enough of me, and somehow, all my money was gone.
I thought of suing her for divorce, getting back what might have been taken from me, but it wasn’t really the money that I was missing. Instead, we just waited out the period of time the law required, signed some papers, and parted. We would stay in touch for a while. I remember years later, at a party at a house she shared with another man. She had a room with walls covered with pictures of her and me. Crazy people latch on to each other like that and find it so hard to let go. So much passed between us, and a piece of that was displayed in another man’s house. I had copies of the same photographs but they were in a box in the back of a closet.
I used the money from the sale of my car to pay for a few months of COBRA – the personalization and extension of the group health insurance provided during my time at Schwab. But that was only made available for 18 months. It was expensive and temporary. With the time ticking on my insurance and my wallet I had to work, but I was in no real shape to interview or even show up every day. But I did have insurance, at least for a while, so I sought help.
At first, starting over with a new doctor seemed daunting, and I didn’t want to do it. Finding a psychiatrist to work well with is like dating. Slowly, I revealed myself as I tried to figure out the relationship and how the doctor and I would work together. Then, at some point came a decision of whether I wanted to continue with this person and get serious or dump them for someone new. Where it’s not like dating is that the relationship, the disclosures, and the discoveries, were completely one-sided. One can successfully see a doctor for years, reveal everything and make great breakthroughs, and know, after all that time and honesty, very little about the doctor that sat across the room for so long. As it was, I walked into the clinical practice of the University of Pennsylvania with a surprising openness, considering the experience I had with doctors to date. I met first with Dr Baldassano, and then with her and the chief resident, a man named Benoit Dube. As expected, they dove into my past and scoured me for early trauma, for apparently early childhood trauma can later trigger the onset of bipolar disorder. I gave them two incidences:
When I was 18 months old I fell while dancing to Happy the Clown and smashed my mouth onto a rocking chair. Years later, my Uncle still had the chair and it still had the indentations from my tiny teeth on the seat. After a series of bad dental work, my mouth became infected, leading to the removal of most of my baby teeth, root canals and spacers. My Mom says she was kept out of the surgery and sat listening to me scream down the hall. The doctor said, “Every doctor has his bad results. George is mine.” Pictures of me as a child show me smiling happily, front teeth missing, and I remember deep into summer having Mom cut the corn off the cob so I could eat it.
Another long hall kept my Mom and I separated. When I was very young she was stricken with plural pericarditis. At the end of the hall in our house was a door, and behind that door was my parents’ room. All I remember was that Mom was sick and down that hall and behind that door, and I wasn’t allowed to go in. It could have been days or weeks. I don’t know now, but to me then it was an eternity. Dad made soft boiled eggs for every meal. He tried to make burgers once, but they were terrible, and I resolved to take care of myself from then on. Mom recovered and I haven’t admitted vulnerability since, at least not until I told the story to Dr Dube.
These stories signaled a place for therapy to begin, and a short trial set us on to medicine that worked.
Theresa was gone, I finally had a good doctor to work with, and I began to study classical guitar. I bounced from the bottom of the pit into an elevated mood that left me wondering what held me down so long. Fueled and moving, I enrolled in an MPA program at Rutgers, Camden, to study health care finance. I had an opinion on everything, and I dashed off incoherent letters to editors of local and national periodicals, none of which were ever published. I wrote a chapbook of weighty, sinking prose poems that I forced on everyone I knew, not realizing how embarrassing the prose was. I practiced guitar incessantly, studying with my teacher, Bill, as much as I could. Way overestimating my talents, I played classical pieces at a gallery opening for an artist I knew. I was abuzz.
My mother offered me a job at her travel agency. I took it for the health insurance and the travel benefits. I flew to London and walked in the rain from the enthralling new Tate Modern across a bridge to a rare late-night place for bangers and mash. On Armistice Day I wandered through a growing crowd, lapel pin poppies everywhere, and stumbled upon an obelisk upon which the royal family laid wreaths. So close to a Prince, I felt his contemporary and peer.
I jetted to Israel during the 2nd Intifada and traveled with a group that included a born-again couple from Kansas. We saw the Chagall windows, Yad Vashem, and the Wailing Wall. The wife, overcome by the lack of Christianity around her, stood in the bus and shouted, “Star of David this! Star of David that! I just want to see a goddamned cross!” We did climb the hill from which, supposedly, Jesus fed the multitudes. I slipped off by myself and sat on a wall of crumbling stone overlooking downward sloping fields of mustard flowers dotted with donkeys, the hazy sea just beyond. For a moment I felt well inside of me feelings that were uncomfortably religious, and I was Catholic again. Later in the trip I went to a mass that was recited in Tagalog for the Philippine service workers who immigrated into Israel to replace the now banished Palestinians. I ended the trip in Tel Aviv on Purim and drank later than I should have been awake, trolling along the Mediterranean in a party hat and the idea that I fit in, when I didn’t.
Back home, music filled my time and my mind with hope and possibility, although most of what I listened to was moody and depressing, as I turned back to the guitar. To seriously study classical guitar gave me a measure of confidence and the discipline to believe that I could undertake something and stick to it. Discipline as a force for healing and accomplishment cannot be over-rated. Only through a measured, careful application of practice and work can an instrument be mastered, a career successfully guided, or a serious disease managed. When episodic, everything conspired to throw me off the path to health. Temptations or surrender beckoned, and the road too often taken was the easy, pleasant one, not the one paved with sacrifice. Guitar became the object of my discipline, and I learned to move onto the difficult road and persevere. I fell into the classical guitar world of Philadelphia, guided by Bill Newman, my teacher, and Linda Cohen, a performing artist and teacher at The Classical Guitar Store, where I studied. Bob Page, the owner of the store, took to me and welcomed me into his circle and his favorite wine and restaurants, and soon he offered me a job at the store. The dedication, creativity, and lightness I was surrounded with brightened me and led to a positive outlook, and the belief that I could heal.
Linda and I spent a lot of time together, although not always in the healthiest pursuits. Mostly, we drank and discussed books and big ideas, from Proust to Kundera to Fitzgerald, late into the night at a smoky bar or at her house on Delancey Street. She taught me the stability of principles and friendship, and, over the next few years, as I waivered from interest to role and back again, shifting wildly between what was important and what wasn’t, she would be the home base I could come back to and tag and re-find my center, for I was without a center for long stretches at a time. I’d get caught up in a book or an opinion and change or re-change what I believed and held, temporarily, to be true. Shifting from one position to the next, most influenced by the last convincing argument I read, I was exasperating, inconsistent, and full of myself. Actually, I was full of someone else - some author or pundit.
This shape-shifting was the result of the obliteration of my Randian ideal. I didn’t know what to believe in as I still pushed objectivism onto Linda and Bill, who thought Rand just silly and a lightweight, one whose ideas didn’t hold up under strict philosophical scrutiny. And they were right. But I held on to a worldview I could no longer defend, just as my life in the last four years was a demonstration of its failing. My self-direction came apart and I couldn’t function, or even survive, without the assistance of others: Assistance that ranged from the paid to the altruistic. I slipped into a leap for the past, and I flew to Ohio to see Kelly and drove to Richmond to see an old girlfriend and Paul and Margi. But the old girlfriends were unsettling, and Paul and Margi were divorcing and I lost them both in the split. There was a bad time when my mind was struck with the obsession that the 8th song on every CD held a special message just for me, and I laid in front of the player with headphones blaring, jewel boxes strewn across the floor, searching for answers. I was a devotee of reason and reason failed me. Again, the fabric of reality tore, and I was desperately trying to stitch it back together.
I was assisted in this attempt by my doctor, for I had finally found a good one. He diagnosed me as a challenging case of mixed-episode, rapid cycling, bipolar disorder 1, and Dr Dube and I worked hard to ameliorate my suffering. To me the answer was to work harder and take on more, and I added a third job selling subscriptions to the Philadelphia Orchestra. I sat in the bucket shop next to a Hasidic Jewish violin student, and when I pitched a Rabbi he leaned across the desk and whispered in my ear, “Don’t mention the Wagner.” Most of the money was going to medicines and doctor visits, but Penn offered me a hardship rate and my parents offered me the apartment rent-free. I asked American Express, with whom I was a cardmember since 1982, to give me one more month on a month overdue bill, but they told me the card was already cancelled and I was reported to collections. Seven years before I used it to buy a car and paid it off the next month. Money meant little then, but now, with so little, it meant an awful lot. A new century settled in, and I wasn’t a yuppie anymore. Creeping penury was new. I liked being a yuppie, and it bothered me.
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Then came August. As a kid, every summer, by August I developed a nervous tick: One year it was spitting, another year twitching my head, another blinking my eyes constantly. Maybe I spent too much time with my family over the summer. Maybe I was anxious about the upcoming school year. Whatever it was, the humidity would seep oppressive and the grass in the backyard would brown as the tree leaves just drooped around the perimeter of the property. I could escape the beating sun, but little else, by going inside. We had no air conditioning. Lying wet in bed uncomfortable, just in front of a roaring fan, consumed by some involuntary movements, I spent my late summers. Vacations would interrupt this discomfort, but I’d always come back to the searing heat and the melting heart of August. This August, 2001, left me full of malaise but not twitching, as I sat in my apartment on the 2nd floor of the house where I grew up, gazing across the yard at the squirrels scheming for seed in the bird feeder, everything hungry despite the bloom of summer all around.
9/11 happened, and like everyone else I was setback and dark for a time. The morning the towers fell I was home sick, not knowing, overcome with depression. My mother called and told me what happened and I rushed to her living room. I had no TV in my apartment to turn on and see the towers collapse. The next day I saw Dr Dube and said, “What can I say about myself with all this?” We sat in silence and stared at the tall buildings outside his window. Curiously, in my depression I was so self-absorbed that I felt little for the thousands lost. But I did feel the weight and the relevance of the time passing and the time past. I was of the 20th century, and I felt my potential behind me as the country clamped down and a new paranoia closed in and replaced the optimistic freedom I aspired to. All was different now.
I visited my friend Brian at his home in Colorado, the same place I hiked in the mountains with him and his dog when Theresa had her affair. He was in a rage over the attack and sent scathing emails protesting the quiet response of Arab leaders and calling for retribution and punishment. He gave me a life-size Mini Me doll, but I left it standing in a stall in the bathroom at the airport, sure to scare the hell out of some rushing commuter who just had to pee, and I lost the friendship by replying that maybe we should at least consider why those who hated our way of life hated it, and by extension, us. Perhaps we had some cultural responsibility in tempting the attacks.
My unquestioning call to capitalism faltered as I hung from the lowest rungs of the ladder of self-actualization and pulled myself up, needy. I never did give to charity, and now I felt loathe to accept any. But I did, and I considered the fact that the very system that enabled great donations was the system that created those in need of donations in the first place. Wealth and poverty were two sides of the same coin, and mine spun on the edge, barely wobbling, not yet fallen to decide heads or tails. My plan at this age had been to leave business for politics or academia, followed later by a stint in venture capital. None of that was likely to happen, and study became too much for my unfocused mind. I did not re-enroll at Rutgers despite the A’s and left another opportunity squandered.
I kept working, saw my friends, studied the guitar, took my medicine, and again felt better. I took a job at Theodore Presser Music, a sheet music store, and was able to move onto their health insurance and leave the travel agency. I kept the jobs at the orchestra in the evenings and the guitar store one day a week. My nights were still a bit wild, out with Linda or another friend, or someone I just met, but my moods leveled and I became symptom free. Stability was an unfamiliar feeling, but a good one. I wanted to stay there. I sold and played music and dove again into ideas and culture. That was it, and that was enough.
My relationship with my sister, Stacey, grew very close. We went out a lot, and I got to know her friends. We took a vacation together and hiked above Lake Tahoe, above the treeline, above the snowline, both getting colder and still alone. Then she met a great guy and moved into the world of couples. I saw her less and less and realized I hadn’t seriously dated anyone since Theresa left. By not considering it for so long, I startled myself by being OK with being alone. The self-loathing that led me to disappear into relationships either didn’t exist or ran very deep. I didn’t feel it.
My job at Presser Music was a good one. I studied the music we sold, and I sold it well. Students from the nearby Curtis Institute would come in looking for audition pieces, and performers from jazz to music-theater discussed with me everything from standards to new works. Touring musicians would frequent the store, and I introduced a couple to unfamiliar works they later used as encore pieces. As I established myself at the sheet music shop, I stopped working for the orchestra and the guitar store and settled into a good job with health insurance once again. Gone were the days of executive decisions or the excitement of stock trading, but I was getting by, and I even managed to save a little money.
Things were going especially well with Dr Dube. We hit on a regimen of medicines that was working, and our therapy sessions were uncovering things unspoken and unrevealed that at the very least agitated my unstable periods. I say we and our, because the doctor/patient experience is collaborative. The doctor develops strategy and the patient implements it, much like the marketing and sales dynamic I was familiar with. While the doctor draws on experience and research, the larger responsibility lies with the patient, who must be disciplined and vigilant in following the treatment protocols and mapping their moods. I failed a number of doctors who prescribed treatment regimens by not fully following them. Side effects, pining for higher moods, or the confrontation with myself, holding pills, in the mirror that revealed that it was truly I, not a system of my body, but me, myself, my soul, who was sick, all led to noncompliance with the doctor’s orders. I didn’t always come fully clean about this, and my ambivalence about and half-hearted attempts at following the doctor’s orders left past doctors to decide, “This treatment isn’t working. Let’s try another,” when the treatment not followed may have been the right one all along. I was fully compliant with what Dr Dube ordered. He wasn’t thrilled with my drinking, and I did lie about how much of that went on, but mostly I did what I was told to do and continued to improve.
Dr Dube is from Canada and came to the University of Pennsylvania for his residency. While his specialty was AIDS and Psychiatry, he kept me on as a patient as his residency turned into an associate professor position, and long after his time in the clinic we continued to work so well together that I came a long way back to health and temperate vitality. He is a thin, gentle man, balding young but attractive, with a sense of humor I can tickle. He gave up just enough information about himself to make me feel a part of the conversation, not the only subject. However, in 2002 his training came to an end and his educational visa expired. To stay at Penn he had to re-apply as an alien of exceptional ability and, in the post 9/11 world of immigration, that would take some time. Unfortunately, during this period of time, which could be as long as 6 months, he could not work at all. I was, for a seemingly long time, going to have to see somebody else, and see that doctor a lot less often.
Shortly after his hiatus began it became clear to me, as if I didn’t already know, how crucial my relationship with Dr Dube was to my recovery. Although I was assigned back to Dr Baldassano, the department head who I worked with before, the thought of again starting over and telling the story from scratch, even updating the little she already knew, left me exhausted before we even began. My mood plunged, and I returned to a world where days, if they begin at all, drag on with the intensity of a turtle crossing a busy highway - slow, and fraught with terror.
But with me it was never so simple. Mixed episodes, in which symptoms of mania and depression occur together, began to cycle through my days and my moods changed every few hours. Yet again I was a master at faking wellness, and managed to still work and fool those closest to me into thinking everything was fine. I could snow everyone but my father. He always saw through this faking, and knew something was wrong, but I assured him I was well treated and things would get better, soon. I assured him I was diligently working on it. Since I saw Dr Baldassano infrequently, it was even easy to convincingly fake wellness to her, and she bought it. She bought it even when I missed appointments. Things changed very quickly, and soon I stopped taking one medicine that made me gain weight, and started abusing another that made me calm down. On all fronts, every intimation of wellness was artificial.
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There was a jazz club called Natalie’s on Market Street, just where University City crept into West Philly, on a block where the east end was full of pirate taxis and smoking men and one still had the chance to turn down 40th Street and buy ice cream, and the west end, which was already too far into a neighborhood with too many uncertainties, where days were spent by men kicking the sidewalk with no job and nothing better to do, and nights were spent looking over shoulders and rushing back to safer ground and shelter from the threat of passing this way not knowing a soul or a secure destination. Natalie’s was right in the middle of the block.
I went there every Saturday evening after work. Lucky Thompson held a jam session from 5:00-9:00 where the jazz swirled with the smoke from ashtrays scattered about the bar. Natalie’s served no food, but you could bring something in from the Crown Chicken across the street, if you could stomach eating in the choke of cigarillos. The musicians were players finding their chops for gigs later that night, others who just came from social dates and wanted to play something they couldn’t for a wedding or a Bar Mitzvah, and Temple University students, looking very white against the backdrop of the curtain and under the dim lights that barely lit the stage, trying to fit in and play something worthy. The men at the bar wore hats and the women slinked close to them, brushing their breasts against the men’s long colorful suit jackets, and feigned surprise when a hand guided their butts onto a stool. There was no top shelf, and the labels on the bottles under the bar matched the ones in the gutter down the west end of the street.
I sat in a booth, usually alone. I felt more out of place when I brought a friend, and conversation only distracted from the inconsistent music bouncing off the walls. I took a glass of crap tequila and used it to chase a Klonopin, then set up for a night of snaking sax, jarred by the backbeat and chased by a walking bass. My head swam in the neon of a beer sign above the bar, and the women merged into one person who didn’t want to know me at all. One night as Lucky launched into a drum solo and the tom toms rumbled like the subway passing beneath Market Street, I laid a pill in front of me and crushed it with a highball glass, rolled up a dollar bill, and snorted the yellow powder. Some of it stuck in the back of my nostrils, and some of it found the capillaries I chose to stuff with bliss. Everything seemed calmer that night, and the mix of mania and depression was tempered by the mix of Klonopin and tequila, and I slid into a level mood. I headed back into Center City in a dented, unmarked pirate cab to grab a train home and sleep without bad dreams or hours spent awake. Soon I was sleeping like that every night, until I ran out of re-fills and knew I would be found out if I tried to get a new prescription from Dr Baldassano this soon. It seemed there was no other way to cope.