Darkness Visible

VIII

THE HOSPITAL WAS A WAY STATION, A PURGATORY. When I entered the place, my depression appeared so profound that, in the opinion of some of the staff, I was a candidate for ECT, electroconvulsive therapy—shock treatment, as it is better known. In many cases this is an effective remedy—it has undergone improvement and has made a respectable comeback, generally shedding the medieval disrepute into which it was once cast—but it is plainly a drastic procedure one would want to avoid. I avoided it because I began to get well, gradually but steadily. I was amazed to discover that the fantasies of self-destruction all but disappeared within a few days after I checked in, and this again is testimony to the pacifying effect that the hospital can create, its immediate value as a sanctuary where peace can return to the mind.

A final cautionary word, however, should be added concerning Halcion. I’m convinced that this tranquilizer is responsible for at least exaggerating to an intolerable point the suicidal ideas that had possessed me before entering the hospital. The empirical evidence that persuades me of this evolves from a conversation I had with a staff psychiatrist only hours after going into the institution. When he asked me what I was taking for sleep, and the dosage, I told him .75 mg of Halcion; at this his face became somber, and he remarked emphatically that this was three times the normally prescribed hypnotic dose, and an amount especially contraindicated for someone my age. I was switched immediately to Dalmane, another hypnotic which is a somewhat longer-acting cousin, and this proved at least as effective as Halcion in putting me to sleep; but most importantly, I noticed that soon after the switch my suicidal notions dwindled then disappeared.

Much evidence has accumulated recently that indicts Halcion (whose chemical name is triazolam) as a causative factor in producing suicidal obsession and other aberrations of thought in susceptible individuals. Because of such reactions Halcion has been categorically banned in the Netherlands, and it should be at least more carefully monitored here. I don’t recall Dr. Gold once questioning the overly hefty dose which he knew I was taking; he presumably had not read the warning data in the Physicians’ Desk Reference. While my own carelessness was at fault in ingesting such an overdose, I ascribe such carelessness to the bland assurance given me several years before, when I began to take Ativan at the behest of the breezy doctor who told me that I could, without harm, take as many of the pills as I wished. One cringes when thinking about the damage such promiscuous prescribing of these potentially dangerous tranquilizers may be creating in patients everywhere. In my case Halcion, of course, was not an independent villain—I was headed for the abyss—but I believe that without it I might not have been brought so low.

I stayed in the hospital for nearly seven weeks. Not everyone might respond the way I did; depression, one must constantly insist, presents so many variations and has so many subtle facets—depends, in short, so much on the individual’s totality of causation and response—that one person’s panacea might be another’s trap. But certainly the hospital (and, of course, I am speaking of the many good ones) should be shorn of its menacing reputation, should not so often be considered the method of treatment of last resort. The hospital is hardly a vacation spot; the one in which I was lodged (I was privileged to be in one of the nation’s best) possessed every hospital’s stupefying dreariness. If in addition there are assembled on one floor, as on mine, fourteen or fifteen middle-aged males and females in the throes of melancholia of a suicidal complexion, then one can assume a fairly laughterless environment. This was not ameliorated for me by the subairline food or by the peek I had into the outside world: Dynasty and Knots Landing and the CBS Evening News unspooling nightly in the bare recreation room, sometimes making me at least aware that the place where I had found refuge was a kinder, gentler madhouse than the one I’d left. In the hospital I partook of what may be depression’s only grudging favor—its ultimate capitulation. Even those for whom any kind of therapy is a futile exercise can look forward to the eventual passing of the storm. If they survive the storm itself, its fury almost always fades and then disappears. Mysterious in its coming, mysterious in its going, the affliction runs its course, and one finds peace.

As I got better I found distraction of sorts in the hospital’s routine, with its own institutionalized sitcoms. Group Therapy, I am told, has some value; I would never want to derogate any concept shown to be effective for certain individuals. But Group Therapy did nothing for me except make me seethe, possibly because it was supervised by an odiously smug young shrink, with a spade-shaped dark beard (der junge Freud?), who in attempting to get us to cough up the seeds of our misery was alternately condescending and bullying, and occasionally reduced one or two of the women patients, so forlorn in their kimonos and curlers, to what I’m certain he regarded as satisfactory tears. (I thought the rest of the psychiatric staff exemplary in their tact and compassion.) Time hangs heavy in the hospital, and the best I can say for Group Therapy is that it was a way to occupy the hours.

More or less the same can be said for Art Therapy, which is organized infantilism. Our class was run by a delirious young woman with a fixed, indefatigable smile, who was plainly trained at a school offering courses in Teaching Art to the Mentally Ill; not even a teacher of very young retarded children could have been compelled to bestow, without deliberate instruction, such orchestrated chuckles and coos. Unwinding long rolls of slippery mural paper, she would tell us to take our crayons and make drawings illustrative of themes that we ourselves had chosen. For example: My House. In humiliated rage I obeyed, drawing a square, with a door and four cross-eyed windows, a chimney on top issuing forth a curlicue of smoke. She showered me with praise, and as the weeks advanced and my health improved so did my sense of comedy. I began to dabble happily in colored modeling clay, sculpting at first a horrid little green skull with bared teeth, which our teacher pronounced a splendid replica of my depression. I then proceeded through intermediate stages of recuperation to a rosy and cherubic head with a “Have-a-Nice-Day” smile. Coinciding as it did with the time of my release, this creation truly overjoyed my instructress (whom I’d become fond of in spite of myself), since, as she told me, it was emblematic of my recovery and therefore but one more example of the triumph over disease by Art Therapy.

By this time it was early February, and although I was still shaky I knew I had emerged into light. I felt myself no longer a husk but a body with some of the body’s sweet juices stirring again. I had my first dream in many months, confused but to this day imperishable, with a flute in it somewhere, and a wild goose, and a dancing girl.