Dr. K: Did something happen?!

—“Medical History #2,” The Bearable Slant of Light

In the first intake documents from my son’s first hospitalization, the attending psychiatrist wrote: “On examination, the patient presents as a very poor historian.” In other words, he couldn’t tell a coherent and accurate story of  what had happened that had led him to bolt from the therapist’s office that July afternoon and subsequently be transported to the hospital for psychiatric evaluation.  

Even now, ten years later, it is not clear that he is yet able to tell that story that reflects his truth about what his life is and will be. 

I have also tried to answer the question of Did something happen!? with a story that explains my son’s mental health challenges more times, and in more forms, that I can possibly recount.  But as someone who teaches in a graduate creative writing program, my accounts never actually feel like anything I recognize as a story.  There’s no inciting incident, there’s no protagonist, no identifiable conflict, and certainly no resolution.  

There are characters, sure: the wide-eyed young social worker who really wants to help; the weary but wise nurse practitioner who has seen everything; the eager resident who has a new idea about new meds; the harried doctor with 15 minutes to assess the case and then solve it all with a pill or five.

And there are plenty of settings: the suburban office of the first therapist where we sat nervously waiting for the results of the assessment, with no sound but the gurgling of a decorative water feature meant to inspire mindfulness; the waiting area of Emergency Psychiatric Services, shaking with fear for his life after a self-harm event; my bedroom in the middle of the night, when I am startled awake by the phone and questions from a social worker about his mental state; in the parking lot of his apartment explaining to emergency responders that he suddenly started shaking and then became unresponsive; late at night over too many glasses of wine with dear friends who sit on our back deck and listen patiently to the “story” of the latest failed hospitalization.

The only way to tell it, for me, is poetry. My conversation with Dr. K, quoted above, opens the first poem in my new collection, The Bearable Slant of Light, which documents my son’s struggles and diagnosis of bipolar disorder, as well as the contours of our anxious culture.  As the poem lays out from the start: 

The hospital happened    the involuntary happened   the injectables happened    they had to rip his shirt    the doctors the nurses the residents the techs happened       the other patients    some of them pacing in the hall      and loud     the first attempt happened   the one-on-one happened   the eeg  happened     the ambulance happened     none of this is in any kind of order you understand      the restraints and psychosis    the overdoses and noncompliance     the catatonia the mania happened        the loneliness the isolation happened      so many many different meds   the assessments and telehealth happened       more ambulances happened  the courts happened       the ect happened    the second attempt happened     the social workers happened        the intensive outpatients and treatment teams and therapists happened      seven years happened       he won’t get them back

I wrote this because I had to. Because the story that helps him and helps us, and helps everyone who loves and cares for him make sense of the last 10 years of his young life —the story that would be the foundational story of identity and acceptance — has not cohered. Did something happen? we keep asking ourselves. And if we understood what had happened, then perhaps we could answer the more important question:  What’s going to happen next?

As a writer, I am compelled to make it make sense, to build a narrative in which he achieves what he set out to achieve with this life though this was no more clear to him now than it was when he was a 20-year-old just beginning the journey into adulthood. That’s when a psychotic break first hit him.  And here, even the narrative implications of the word “journey” suggests that while there might be obstacles, there will be an end — whether for good or for ill. 

But storytelling devices never seem to add up to more than the sum of their divergent parts: the illness metaphors of struggle and sturdy survival (he beat the odds! he battled back!) or graceful acceptance; the predictable plot twists and turns of remission and flare-up; the clear successes and failures of any one treatment; the clinicians that don’t fall easily into categories of heroes and villains, each with their own story of motive and intent.. 

So it’s hard, if not impossible, to impose on my son’s story any kind of literary “sense.” As a writer and a mother both, this has been my challenge. 

The language of poetry can tell a different story

To be sure, there have been possible candidates for narrative subjects  — ways to spin a tale about “what happened.” 

There is, for instance, the story of medication. It began with an antidepressant and was told to him like this: You won’t really notice anything for a month or so, and then you’ll realize you just feel better. Instead, twenty minutes after taking the pill, a different story emerged of a laughing, crying, twitching, pacing, sleepless 72-hour freak-out. While this manic response to Luvox should have been a tip-off, he sort of stabilized at a lower dose and persisted for a while until finally abandoning it. Did it work? Was he better? Worse? Changed? Was this progress or decline? Surely, something worth telling had happened.  

What happened next, of course: hospitalizations and more medications. An antidepressant was the first drug, but it was hardly the last; a protocol of polypharmacy including meds to alleviate the side effects of other meds meant it was never clear which ones were providing what kind of relief, if any. I needed to shape the story of them (so many, many meds) as something entirely different, something that was more than just information about neurological receptors and physical side effects. Mark Freeman, in his discussion of the psychological humanities, points out how it is “… important to find a language to be able to speak to experiences that are not readily articulable, explainable, and so on. And that also means moving into a different register of language…”  

Here, the language of poetry can tell a different story of medications. For instance: 

Celexa

Hell no he wouldn’t take

it again. He knew 

it wasn’t right, felt it buzzing

in his veins like a trapped

fly. Wouldn’t take a pill

that sounded like the name 

of a goddamn luxury sedan, 

smooth over winding 

mountain roads, silent

into an inferno of fall colors,

flaming in a distant state.

And: 

Depakote

Might as well be

called dead-a-kote –

a dumb blunt of 

a drug dosed 

by the 500 mg

slug.  Thuggish,

old school knock-out.

Then there are the stories of the assessments, the inventories, and exams and bubble tests that are meant to measure. But my son was essentially unmeasurable. Freeman, in his interview again, refers to the “arsenal of instruments” psychology offers in its attempt to diagnose, concluding: “One of the faults of academic psychology is that through its vast arsenal of methods and techniques, scales, and measures, it has beclouded our own encounter with elements of human reality that precede all of that arsenal of instruments.”

Another way to say it, as I wrote in “The Results of the Assessments I,” a poem about the merry-go-round of psychological inventories and instruments: “What we observe is what we want to see.”

But I also looked to literature and history for representations and stories of mental suffering. In the most true of these fictional stories, there are rarely good ends: Quentin Compson’s psychosis spiraling into suicide in The Sound and the Fury; Holden Caufield telling the story of his breakdown from a residential psychiatric facility where he has been sent to recover; King Lear’s youngest daughter Cordelia remaining silent until her death. Though armchair diagnoses of fictional characters (the most famous being Freud’s analyses of Hamlet) can distract us from the beauty of the tale at hand, these characters were a way to refract the light of our experience through a different lens, and perhaps see it more authentically. My son is not Holden or Quentin or Cordelia, but there is a flash in what these writers have captured that invites more expansive thinking, ineffable language about what happened, and the emotional burdens of loss, anger, and despair these experiences carry.

Stories of who we are, how we got here, and what shaped us are perhaps now more than ever at the forefront of our cultural landscape. The rage for personal DNA profiles that will tell us our ethnicity and migration stories, and the celebrity gotcha drama of Finding Your Roots, all suggest how fundamental our “stories” are to understanding who we are.  

But for ten years, my son and all those who love and care for him have had no coherent story to tell. I have tried to tell a kind of story in my poetry because it is all I can do to save myself. If it is chaotic, unresolved, but with flashes of beauty — much like everyday life — then I will have succeeded. The false and partial stories of drugs and the “arsenal of instruments,” along with the hundreds of pages of intake and discharge papers, do not tell us — or him — what we need to know. 

He must fashion his own story with its own expansive narrative mosaic of chaos and beauty. He must become his own historian.

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