Darkness Visible

VII

IT WAS DR. GOLD, ACTING AS MY ATTENDING PHYSICIAN, who was called in to arrange for my hospital admission. Curiously enough, it was he who told me once or twice during our sessions (and after I had rather hesitantly broached the possibility of hospitalization) that I should try to avoid the hospital at all costs, owing to the stigma I might suffer. Such a comment seemed then, as it does now, extremely misguided; I had thought psychiatry had advanced long beyond the point where stigma was attached to any aspect of mental illness, including the hospital. This refuge, while hardly an enjoyable place, is a facility where patients still may go when pills fail, as they did in my case, and where one’s treatment might be regarded as a prolonged extension, in a different setting, of the therapy that begins in offices such as Dr. Gold’s.

It’s impossible to say, of course, what another doctor’s approach might have been, whether he too might have discouraged the hospital route. Many psychiatrists, who simply do not seem to be able to comprehend the nature and depth of the anguish their patients are undergoing, maintain their stubborn allegiance to pharmaceuticals in the belief that eventually the pills will kick in, the patient will respond, and the somber surroundings of the hospital will be avoided. Dr. Gold was such a type, it seems clear, but in my case he was wrong; I’m convinced I should have been in the hospital weeks before. For, in fact, the hospital was my salvation, and it is something of a paradox that in this austere place with its locked and wired doors and desolate green hallways—ambulances screeching night and day ten floors below—I found the repose, the assuagement of the tempest in my brain, that I was unable to find in my quiet farmhouse.

This is partly the result of sequestration, of safety, of being removed to a world in which the urge to pick up a knife and plunge it into one’s own breast disappears in the newfound knowledge, quickly apparent even to the depressive’s fuzzy brain, that the knife with which he is attempting to cut his dreadful Swiss steak is bendable plastic. But the hospital also offers the mild, oddly gratifying trauma of sudden stabilization—a transfer out of the too familiar surroundings of home, where all is anxiety and discord, into an orderly and benign detention where one’s only duty is to try to get well. For me the real healers were seclusion and time.