The Risks of Unraveling

Dec. 26, 2009

A few years ago, journalist Norah Vincent went underground as a gender spy, dressing and living as a man in order to write, Self-Made Man: One Woman's Journey into Manhood and Back. Her book garnered accolades and became a New York Times best-seller. But the emotional price of her 18-month experiment was a nervous breakdown. The experience led to her next book, Voluntary Madness: My Year Lost and Found in the Loony Bin.

Vincent launched her loony bin experiment getting off the meds her psychiatrist had prescribed -- Prozac, or Vitamin P, as she called it-- and voluntarily committing herself, first to a city public hospital, then a small private hospital, and finally, a holistic recovery facility.

Early on in her experiment, Vincent writes, "Being put away does a number on you very quickly, and very thoroughly, no matter who you are in the outside world." She also recognizes fairly soon that the brain -- unlike the kidney or other types of the body -- requires more than medicine in order to be treated. It requires empathy.

You have to marvel at Vincent's brazenness and willingness to go the distance. She informs her insurance company that she (not they) should foot the bill for her institutional stays, as she is a journalist doing research, and shells out $14,700 not once, but twice -- to the public institution, then to the private facility, both of which put her in a state of roiling anxiety about all the freedoms she's turned over. Vincent doubts whether she can recover in these places, where patients are over-medicated, and conditions, often inadequate.

Vincent becomes fascinated by the habits and prognoses of the patients she encounters in wards, but their colorful stories would be old news to anyone who's ever been in rehab or made the rounds of recovery rooms for group therapy.

Vincent writes with confidence and her quirky observations can be inspired -- as she depicts day-to-day life among the addicted and mentally ill, and particularly as she questions her own mind, her surroundings and the system into whose hands she's entrusted herself.

She asks, for example, "How does one exist as a self, as a discrete person in the world, and yet not inhabit one's own self?" While at a private hospital, where she finds herself spending too much time curled up alone on the tiles of her bathroom in order to avoid having to deal with the overwhelming pain of those surrounding her, she realizes this is how many sensitive people feel out in the world and how the homeless mentally ill and addicted especially feel, as they are forced to live without a break on the streets, bombarded by chaos, noise, pollution and fear.

Vincent also ponders, "What might happen if we as a culture took even the most minor responsibility for the lost among us, rather than consigning them, and quite possibly ourselves, to the ravages of the system? The indifferent system."

At St. Luke's, the name she gives to a private hospital, she is touched by the kindness and simplicity of Sister Pete, who prompts her to muse: Maybe "true goodness... in this fucked-up creation" is a "form of retardation. Not an avoidance of vice but an ignorance of it, a lack of acquaintance with it that cannot be willed after the fall, no matter how strong the intention."

By the time Vincent leaves St. Luke's, she is beginning to emerge from her depression, a depression complicated by the power struggles she encounters in the institutions in which she places herself. At St. Luke's, she realizes how much a private room can mean, providing as it does, healing space, even room for exercise.

By the time Vincent commits herself to Mobius, a place she determines is easily "within the reach of the middle class," she is back on Vitamin P, taking 20 milligrams a day, and holding. Unlike the previous two institutions, Mobius aims to heal mind, spirit and body. It's a place where Vincent is able to explore past traumas and experience deeper healing. She finds therapists there to whom she can relate as they freely share their own humanity. They inform her that she is not mentally ill after all.

Summarizing, Vincent laments the overcrowding, lack of fresh air, cleanliness and nutrition that she has experienced in institutions, noting significantly, that among all the patients she encountered during her hospital stays, she found very few willing to take responsibility for their own health and lives. The resistance of patients to change stymies many in the system who want to help and often turns them cynical.

At one point, a therapist at Mobius asks Vincent to consider the word 'compassion" as a means to heal. Unable to stomach the word, she opts for the idea of help instead. Vincent realizes, "I am not bound by my diagnosis. I can help myself, and I will," a perception that, once seized, could make all the difference to anyone suffering mentally, physically or spiritually.

Death and Laughter

Dec. 18, 2009

We're getting close to Christmas and the farthest thing from most people's minds is death, or so I'm assuming. But it's pressing on my mind this year. My father died last Wednesday, and today we are going to the funeral of a friend's brother, who died suddenly this past Tuesday.

One thing I've learned for sure is, try as you may, you can't plan death. The world is full of surprises, and death, even in the midst of a holiday that rains so much color and joy. Like holidays, life with all its color and vibrancy ends too. Throughout it all, you try to keep laughing. That's why, even in the midst of my father's passing, I wanted to read David Sedaris. I wanted to laugh.

I loved Naked, published a few years ago, and expected great things from When You Are Engulfed in Flames, which I picked up a few days before we heard the news that dad was in the process of dying. I wasn't altogether disappointed, although the dark humor and pointed quips struck almost too close to home.

The cover of Sedaris' book has a skeleton on it that appears to have a cigarette between its teeth. The cover is meant to be the death mask of Sedaris himself, who was, until fairly recently, a habitual smoker, and whose final essay, "The Smoking Section," refers to his process of quitting. There's also an essay in this collection about a skeleton that Sedaris once bought for his partner Hugh, who decided to hang it in the bedroom. Sedaris found himself looking at this dangling skeleton, which seemed to say to him, "You are going to die."

I can't say this struck me as particularly funny, just true, having recently stared at death straight in the face and recognized, sure as I'm sitting here right now, that this life, solid and real as it seems, is indeed ephemeral as a dream and quick as smoke to disappear.

My father was a strong, indomitable soul, full of enthusiasm for life, with a vitality so palpable it was intimidating to some. He lived a year and a half longer than he was expected to live, and no one, least of all the doctors who predicted his demise, could believe he could carry on so long, his heart being in the shape it was. He humored us, mugging till the very end, reminding us of his amazing resilience and also of his capacity for laughter and the importance of it. It has always been a balm and savior for our family.

Taking my dad's cue, the night after his passing, my siblings and I drank, smoked pot, and drove fast and furiously around Hilton Head, where my dad lived. I turned around to my two sisters and brother once and said, "How does it feel to be 15 again?" No doubt, each of us was filled with the intractable knowledge somewhere deep within that we are no longer 15 and will never again be, and are in fact now ourselves on death's list, however far into the future each of us may live.

Still, the laughter helps, and for us, for me, provided a much needed respite from our vigil with death, reminding us that good times can be there, sometimes even in the midst of heartbreak.