Monday, March 31, 2008

Beau Blue Calls; Bud #4

Last night I got a call from Beau Blue, aka Mr. Webb, regarding my recording difficulties. He generously invited me down to his place where he has a studio for recording. I hope to visit him someday, though it's not practical at present.

We had a freewheeling conversation about poetry and poets, living and dead, the evolution of the net and East Coast poetic prejudice. Beau is a fascinating man, and I encourage any who have not visited his Cruzio's Cafe to go and see what he's doing with poetry--he fleshes out the recitation of poems by fine poets with animation. He prides himself on choosing poems that "stand up off the page," poems with an immediate verbal impact. "Academic" poets need not apply, but he has recorded Ted Kooser, former poet laureate, among other notables. I'll be honored to join his production if I can just get my recording together.

The crying spell I had yesterday while canoeing I think is a biological marker, as today, around the same time, I teared up. Usually my crying jags come at around 11 AM and 4 PM, but of late it seems the early afternoon has supplanted those traditional times. It's strange the way crying spells attach themselves to certain times of day as biological markers for youknowwhat.


"Positively Bud" installment #4:

Larry stood by Bud's side expectantly. "You want to grab your bag, Bud?" he asked.

"Sure," Bud replied.

"Just follow me," Larry said, and led him through two pristine hallways of white tile and linoleum to a little room with two beds, one somewhat rumpled and one freshly made. "You have a roommate, which is part of the therapeutic process. Your goal is to encourage each other, not commiserate. He's been here a little while and may help show you the ropes. His name is Ken." With that Larry left him.

The room's single window looked out on a hillside where the early morning sun unearthed the violet from the silvery-green chaparral, and all the colors deepened and distinguished themselves, brown-gold tumbleweed, red sandstone, olive scrub oak, and one brilliant yellow sycamore. Bud looked around the room with the same indifference with which he greeted nature. Walls of mint green. Two electric lamps. Bathroom with shower, fresh towels. Thin green carpet. Green corduroy bedspread. He put his few clothes and toiletries away, one thing at a time, trying not to get ahead of himself. He had used up only ten minutes. If he lay down on the bed he might not get up so he sat on its edge. No sign of the roommate. After twenty-five minutes he slowly navigated the gleaming white hallways back to the interview room. He knocked, got no answer, found it unlocked, went in and sat down. He was early.

Troy bounded in a few minutes later with his tennis court enthusiasm. "Well Bud, you're early! That's great-- even better than punctual. How did you like your room?"

"It was OK."

"OK? Only OK?" His eyes went wide with mock shock. "Have you ever considered the luxury of indoor plumbing, something not even Roman Emperors enjoyed, or the pleasure of air conditioning, that even the imperial British lacked in India? And how about that lovely view of the hillside? And your room was just 'OK?'"

Bud almost felt bullied but noticed only a slight increase in his anxiety, if that were possible.

"The room is fine," he said.

"Fine? When you could be sleeping outdoors with the rattlesnakes and scorpions and ticks and mosquitoes? The room is just fine?"

"What more can I say?" Bud pleaded.

"Can't you think of anything better than 'fine?'"

Bud froze.

How about, "Better than fine?"


"How about, 'terrific!'"

"Terrific," Bud deadpanned.

"Somehow your 'terrific' doesn't sound 'terrific!"' Troy said. "Let me hear it again. How did you find your room?"

"Terrific," Bud said with just a little more energy.

"How was your room?"

"Terrific," Bud repeated, vainly trying to paint the word with an emotion he didn't feel.

Troy regarded him with sympathy. "I don't think you really appreciate your room yet, Bud. This requires a little lesson in gratefulness." He pressed a button on his desk and Larry appeared. "Larry, Mr. Rose doesn't seem to appreciate his room. Can you find an alternate room for him today?"

"Certainly," Larry smiled. "Come with me, Mr. Rose."

"But the room was fine," Bud mumbled.

"Only 'fine?'" said Troy. "Take him away, Larry."

Larry led him gently by the elbow down fluorescent corridors to a metal door with a small slot near its bottom and a ventilation grille above it. Larry unlocked the door and guided Bud in, then locked the door. "Enjoy," he said and left.

The heat was stifling. He paced out the dimensions of his room and found it to be six-by-six feet. The walls were of corrugated aluminum, hot to the touch, and he could barely reach the ceiling with his fingertips, which was even hotter. The only light came from the grille in the door, spreading a chevron on the floor. Sweat soaked his collar. He took off his shirt and squatted down on the smooth floor where it was cooler. Leaning against the wall he heard the rumble of the thin metal just as his skin registered a burn. Snapping forward to avoid it, he used his shirt as insulation to lean back against the wall.

Bud found the physical hardship not unpleasant, as the exigency distracted him from his inner ruminations. He was no worse off here than elsewhere. He was hot, uncomfortable and in near darkness, but he also had fewer choices and no social contact was required of him. Inside the box he had no sense of time. He only knew the heat was increasing with the approach of noon. The air was thick and hot as soup; he found himself taking slow breaths through his nostrils to compensate. Thirst assailed him but he repressed it.
He sat against the wall for hours, mind adrift, and thought about who he used to be before the darkness descended. But that was irrelevant now; he could no more imagine who he'd been than recollect his own conception. The former man was a mirage, a brief and ignorant exception to the universal rule of futility. "Vanity of vanities," saith the preacher, "All is vanity." But if all was futile, why did he pad the hot aluminum with his shirt to avoid a burn? If all was useless, why avoid pain at all?

"How long has he been in there, Larry?" Troy asked.

"Long time-- going on six hours now-- worst heat of the day."

"And you've heard nothing from him? No wall-banging, cries for water, nothing?"

"Quiet as a church mouse."

"Hmmm. He must have it bad. The better ones take action sooner. How long can we leave him in there without water?"

"You know what the director says: 'Depression is a life-threatening disease.' So policy says it's up to the counselor's discretion, provided the patient doesn't die."

"Yeah, right. So how long before dehydration begins to be serious?"

"I saw one go two days and we had to send him off for IV therapy. But I think twenty-four hours can be solved with oral fluid replacement."

"Alright, Larry. That gives us twenty-four hours to see if he's as helpless as he claims. After that we'll have to intervene."

"Right. Nick has night duty tonight, so if Bud asks for water he can give it to him."

"Then all we can do is wait. I'm going to catch up on some paperwork and maybe watch the ballgame."

"I may join you later," Larry said.

Sunday, March 30, 2008

Paddling Upriver; Bud #3

I continue below with the third installment of "Positively Bud." But first I want to brag about an outing I took today. I had invited Kathleen to go kayaking up Big River, something I've been meaning to do for two years. Kathleen decided she had more important things to do but I didn't let that stop me.

I rented a solo outrigger canoe instead of a kayak, at the guide's suggestion, and took it up Big River until my back hurt so much I had to turn around. I saw a great blue heron and remnants of logging docks from long ago.

Strangely, I had a crying spell near the end of my progress upriver, but I told myself "It's OK to be sad." Not everyone can be sad, so tears might be looked upon as a gift of sorts. Except in this case the grief was diffuse, with no particular focus, the equivalent of a hiccup. Actually, I did think about David's psalm, "This poor man cried unto the Lord and he delivered him from all his fears." I felt sad knowing that this poor man hasn't received such a happy result. Thoughts of God and faith, in my condition, routinely sadden me. I feel locked out of paradise, never mind what theology I embrace.

I asked a good friend of mine some time back what he would do if he couldn't "feel" the presence of God. He said he didn't know what he would do; he couldn't imagine such a deprivation. I'm happy that he's happy, happy that he can't understand my sadness.

The only difficulty in the trip was a strong wind blowing upriver from the ocean. It aided my progress going up, but it was very difficult to paddle through on the way back; I was even blown to shore on one occasion.

The main thing is, however, that I thought up an activity and carried it out. And it was pleasurable, the solitude and tranquility, the green river and greener forest, even the struggle over the last half mile to paddle through the wind. As someone suffering from youknowhat I can rightly take pride in such an outing--not the kind of behavior one expects from one affllicted with youknowwhat.


"Positively Bud" #3

Bud got up slowly to follow Martha out the door like a whipped dog. Hope. Another hope salesman. His wife would likely be glad to be rid of him for a month, and the terror of a new institution could be no worse than the terror of his next footstep on the linoleum. Suppose the floor collapsed? Suppose his foot stopped working? Why should it work, anyway? It seemed like some completely foreign appendage as he stared at it on the way to the parking lot.
Martha got in the driver's seat and opened the passenger door. "Well, what do you think, honey?"

"I don't," Bud replied.

"Well, if you did think, what would you think about this program?"

"I might think it was a waste of time. But since all I do is waste time, I guess it doesn't matter if I do it there or at home. At least there's no charge."

"I have a good feeling about this, Bud. I think these people may be able to help you."
Bud stared out the window at the passing greenery on the Pasadena boulevard, oleander in white profusion and palm trees towering above. Tears welled in his eyes. The thought of hope was crueler than anything.

Their drive to the institute was uneventful. Bud said nothing and Martha listened to talk radio. As they entered the San Gabriel foothills the winding road swept through silvery-green chaparral with pungent sage blooming in bunches of small lavender flowers. Yuccas towered on the hillsides with their yellow-white colonnades of waxy flowers. Bloom once and die. Such a waste.

They turned off on a dirt road where a small sign announced "Institute for Positive Living" and passed under a wooden archway branded with the motto, "Abandon despair all ye who enter here." But how could one abandon despair when despair was abandonment? Abandon abandonment? His head began to hurt as he ruminated, and his body swirled around the hollow in his chest while the grim razor of fear cut every waking moment like a fresh wrist. He felt he was being dissected by the blind eye of the universe minute by minute. He was scared, but no more or less than always-- here, at least, there would be new things to fear.
The Institute was a ramshackle affair of one-story ranch-style bungalows connected haphazardly. Weathered wood siding and worn, warped cedar shingles gave it a rustic air.



"We're here, honey. Why don't you grab your bag?"

He opened the door and smelled the sage, as if an accusation by a former olfactory pleasure, then lifted his bag by its shoulder strap and schlepped to the front steps. After the car's coolness he began to sweat in the dry mountain heat, which rising from the ground seemed to inflate his pants.

The double glass doors above the steps struck him as incongruous with the surrounding architecture and scenery. Martha pressed the doorbell and they waited in the half shade of an inadequate awning. Finally a man came to the door dressed in whites. Crisply he opened the door and said, "Bud Rose?" Bud nodded. "And Mrs. Rose, I presume?"

"Here," Martha said with forced cheerfulness. "Can I come in and see the layout? I'm a nurse, you know."

The man smiled. "I'm afraid that's not permitted, Mrs. Rose. You'll have to say your good-byes now."

Bud awkwardly set his faded blue gym bag down for the expected embrace. Martha hugged him and he responded stiffly. There was no melting reciprocity in his hug, only the mechanical deference of a lifeless homunculus. She kissed him on the neck and whispered, "See you in about a month. Get well!" Then she extricated herself from his wooden grasp and walked to the car. Driving away, she smiled and waved as if sending her first child off to school. She didn't start crying until she passed under the wooden arch forbidding despair.
Bud was ushered in through the glass door and was mildly relieved to note the air conditioning. He was led to a small room where a blue molded plastic chair with chrome legs faced a battered wooden desk. His escort told him that his counselor would be in momentarily, and to meanwhile make himself comfortable. Comfortable. A foreign word. He looked around the room, concentrating on the fine cracks in the plaster that reaffirmed his sense of universal decay. A new wall to stare at. The door swung open.

"Hi, Mr. Rose. I'm Troy. May I call you Bud? Good!" He shook Bud's hand energetically and sat behind the desk. "I will be your counselor for the next month. It will be my responsibility to see that you get every treatment advantage our program can offer. Any questions so far?"

Bud shook his head.

Curly blonde and blue-eyed, with an upturned nose and a chin dimple, nicely tanned, Troy looked like he'd stepped out of a fitness commercial. He was the antithesis of everything Bud felt himself to be. He would have preferred an old woman who appeared to know something of suffering next to this Love Boat refugee.

"By walking through the door your treatment has already begun. You have made a commitment to feeling better, no matter how impossible that may seem to you now. You may feel distant, hopeless, disenfranchised, even a ghost-- but none of that matters now. By the time you leave here you will be feeling better because you will have a positive attitude. This does not mean the experience will always be positive-- but that the result will. Our techniques are . . . how shall I say? Aggressive? Bold? But they are proven to work, and work they will. You will get better."

Someone knocked at the door.

"Come in," Troy yelled. A black man the size of a pro linebacker walked in. "Let me introduce you to your trainer, Bud. This is Larry." Larry extended his massive hand and his teeth shone yellow in the fluorescent light. His smile was as large as the ocean. It swept Bud up like a tide. His monk's fringe of frizzy hair, large eyes and broad nose all seemed to emanate goodwill like the smell of a neighborhood barbecue.

"Larry will be in charge of your physical regimen while I am in charge of your mental regimen. We work as a team in coordinating your daily activities. Are you comfortable with that?"

That word again. Bud nodded.

"Good, then. No sense in wasting time. Larry will show you to your room and I will see you back here in exactly thirty minutes. Clocks are posted everywhere and we consider punctuality extremely important, since it displays a positive respect for others' time. Am I clear?"

Bud nodded.

"Good, then. I look forward to seeing you in half an hour." Troy briskly rose from the desk and exited in a blur.

Saturday, March 29, 2008

"Positively Bud": Installment #2

Unless properly dissuaded, I intend to continue posting an excerpt from my story until it's finished.

"Positively Bud": Installment #2

The next morning Bud woke early, as usual, before dawn, to face a day like all the other days, when the terror of the bedroom finally drove him to the terror of the living room. After an eternity Martha's alarm went off. She reached over to hit it and Bud relaxed his desperate grip around her breasts.

"Good morning, honey," she said, yawning.

"Good morning, honey." It was easier for him to mimic speech than originate it.

Martha got up and began her morning pre-work ritual. Bud heard, in order, the coffeemaker, the shower, and the hair dryer while he lay on his back with the sheet up to his neck and stared at the acoustic ceiling, gray cottage cheese. He couldn't understand why these horrible feelings seemed to come from outside himself when in fact he generated them. Changing locations seemed as scary as staying still. Knowing his fear to be irrational did not change it in any material way: the bankruptcy of reason.

Martha came back to say good-bye and plant a perfunctory kiss on his forehead. "I'll call about that trial today," she promised.

"OK," Bud said and pulled the sheet tighter.


A young man hornrims sat behind a gunmetal gray desk and toyed with a pencil. His thin strawberry hair nearly matched the color of his scalp as he hunched over the extensive background history Martha had filled out. From time to time he would say "hmmm" and lower his glasses and look up for a moment, when his quizzical brown eyes wandered over Martha and Bud as if they were laboratory specimens. Sometimes his freckled nose wrinkled like a rabbit's, as if he could smell something about them even without the forms. After an interminable silence he set his glasses down and folded his hands.

"Mr. Rose, it seems you have tried all the conventional anti-depressant therapies, am I correct?"

Bud shifted in his seat, looked to Martha for support. "I guess so."

"More specifically, Mr. Rose, you have tried MAO inhibitors, tricyclics, SSRIs, and ECT without remission?"

Bud looked puzzled. "Yes he has," broke in Martha. "And he's also had psychotherapy, both individual and group."

"And what did that therapy consist of?"

Martha looked to Bud and gave him a nudge. "Talking," he said, "though I didn't much feel like talking."

"What did you talk about?"

"I don't really remember. One lady asked a lot about my childhood. Another guy kept telling me I had to change my thinking."

"I see." He leaned back in his chair and put his hands behind his head. "We have an experimental program for patients like yourself, Mr. Rose, but we cannot guarantee the outcome of the treatment. It would require at least a month away from home in a special institution. All costs would of course be borne by us. The program is designed for resistant depressives like yourself. Would you be willing to participate?"

Bud looked at Martha, who nodded, then turned to the interviewer and said, "Why not?"

"Good, good," the man said. "You seem a perfect fit for our protocol. You should know going in however that because the treatment is highly specialized no visits or outside contact will be allowed for at least a month, and we have the right to keep you under treatment for two months if necessary. Furthermore, not all of the treatment may be pleasant, as it is directed at changing your world and self-view quite dramatically. We aggressively attempt to reverse your negative thought processes by whatever means possible, and this challenge has produced psychosis in a few patients. Should that happen we will of course stop the treatment and release you on the proper medications. But all of our cautions are spelled out in the human research protocol here. Take a moment and read it over."

Martha took the brochure and began studying it, point by point. "The Institute for Positive Living is based upon a cognitive-behavioral approach to depression which utilizes both punishments and rewards to achieve optimal outcomes. The behavioral program for each participant is customized to fit their symptoms, age, and history. Although progress is slow the first several weeks, usually by the fourth week dramatic improvement can be expected. Seventy percent of the patients are discharged at that time."

Martha looked at Bud. He had only glanced at the brochure's cover and now held it loosely between his thumb and forefinger in pathological nonchalance.

"Bud, you need to know this doesn't sound like summer camp," she said. "It sounds intense and demanding and I can't be here to support you."


"So say something! Do you want to do this?"

Bud stared at her vacantly. "Why not?"

"Very good," the interviewer said. "We have an opening in two days. If you'll be so good as to sign these papers we can get you scheduled."

Bud signed the forms with painstaking slowness, then handed them back. The man took the papers and put them in a manila folder which he locked in a file drawer. He gave Bud a bunch of yellow triplicate sheets. Martha stuffed them in her purse.
"Very good, then. Here is a map to the institute. Please be there at 8AM sharp on Thursday morning. Do you have any questions?"

"Can he receive letters or packages?"

"I'm sorry, that's strictly forbidden. No outside influences are allowed. We cannot interfere with the study design, you see. Very unscientific. But you will be promptly notified before discharge, which will generally be between four to six weeks. Any other questions?"

Bud wagged his head in the negative. Martha put her finger under her chin and looked ceilingward but said nothing.

"Very well, then. We'll see you in two days. Pack what clothes you think you'll need as well as personal items like a toothbrush, soap, shampoo, etc. And, if I may so bold as to prognosticate, I think you will find the results positively amazing."

Friday, March 28, 2008

Positively Bud: A Short Story about Depression

I wrote a short story related to depression years ago and it remains unpublished, likely in part because of its 16,000-word length. But I was thinking: What if I serialized it here, say no more than 1000 words/day? Would people read it? I'm going to give it a try. Feedback welcomed--especially let me know if this is asking too much of my readers.

Positively Bud

Martha wove her gray Corolla through the 405 traffic under the overcast Los Angeles sky. She punched her radio buttons like a keyboard operator, deftly avoiding commercials without looking down from the road. The talking heads on KFI hotly debated school vouchers. Not that she cared about school vouchers, but the emotional pitch of the hosts could make the most trivial concern seem consequential, and that was the game: pretend to care about something, adopt an opinion like an only child, then defend it tooth and claw. The more outrageous the opinion, the more incensed the caller, the higher the ratings. Emotions sold soap.

When the next commercial break was introduced by the fading musical signature she was too tired to continue her manipulations, so she listened distractedly: "Home equity loans can give you financial freedom / Cosmetic surgery for the discriminating / We take credit cards, etc." Then: "Are you presently suffering from, or do you know someone who suffers from depression? You may be eligible for inclusion in our treatment trial AND receive up to $600 in compensation, as well as free physical exams, laboratory testing, and follow-up. Call 866-HELP for more information. Sponsored by California Medical Trials, Inc."

Did she know someone who was depressed? Sheesh! Over the last year her husband had devolved from an active (if not cheerful) computer consultant to a sedentary blob whose chief challenge was to rise out of bed and assay a chair. He no longer golfed. He spoke in monosyllables and only rarely watched TV. If she didn't feed him he wouldn't eat. He didn't drive anymore. Mostly he sat staring at a wall as if it might reveal, in its utter blankness, something even less present than himself.

He'd been to therapists and psychiatrists, had tried five different antidepressants, had even undergone electroconvulsive therapy, but nothing could wake him from his stupor. Something had transformed the man she loved into a blackening potato and she didn't know what else to do beyond gentle refrigeration. She memorized the phone number of the radio offer. The disembodied but engaging voices returned to their insincere arguments over nothing.

Arriving home, she hung her stethoscope on the hat rack and put her ID badge in the outgoing mail tray, pausing to look in the entry mirror. Her hair was nut-brown, though casually invaded here and there by white threads, and pulled back in a bun. The pouches under her green eyes had taken on more freight than she remembered and her cheeks were fuller. Her straight, no-nonsense nose called attention to their insidious plumping and likewise emphasized the beginnings of a double chin. Her lips were full, her teeth small and even. She eyed her nurse's uniform: too tight and bulging in places not designed for bulges. But altogether, at forty-five, she wasn't bad-looking. In her soiled whites she approached her silent husband, whose half-closed eyes seemed positively reptilian, cold-blooded, as he reclined in an easy chair.

Though a year younger than she, he looked much older. His sparse gray hair was combed straight back over his crown. It looked as if he hadn’t washed it in a week.. Extended by frontal balding, his high forehead gave the impression of a large-brained alien from an old science fiction movie, the hairless kind with big eyes. Rectangular black eyebrows arched upwards in something beyond grief; permanent puzzlement, perhaps? His red-rimmed eyes were dull, as if their deep brown had stopped reflecting light. And the folds in his skin from weight loss made his cheeks resemble the sagging skin of an elephant. He sat in the striped boxers and gray T-shirt he'd worn to bed. Three days' growth of beard clung to his immobile jaw like a fungus.

"Hi Bud," Martha said with forced enthusiasm, kissing him on his rough cheek.

"Hi, honey," Bud replied mechanically without returning the kiss.


"Yes, dear."

"I heard about a special trial for depression on the radio today. If I make an appointment would you be willing to go?"


"We're having pork chops tonight with fresh applesauce."


"It's your favorite."


She turned away and strode to the bedroom to shed her uniform for some light sweats, then returned to the airy kitchen to prepare a meal only she would enjoy, as Bud's "anhedonia" included food. She had tried explaining to her friends what it was like to live with a depressive. It was as if she dwelt on land and he was underwater, like a fish, and she couldn't share his world anymore than he could share hers. With a few of the drugs he had almost threatened to become amphibian, venturing out for dinner or a movie before he inevitably devolved, losing all interest in the shore. These failed glimmers of near recovery were hardest to take.
Depression was too tame a word for his condition. "Disensoulment" might work better; "Zombification," perhaps; or "Vegetosis," which turned humans into vegetables. She put the green beans on to steam. Somewhere she had read of a Roman punishment for murderers, where the criminal had the body of the victim tied to his back until he died as well from exhaustion. Sometimes she felt that way. It was getting harder and harder for her to carry Bud.

Bud stared out the window. The birdsong from the maples irritated him; each note was like a pinprick. The spot on the carpet made him sad as did the cobwebs in the ceiling corners, but he felt helpless to do anything about them-- they were too, too much.

He had tried to tell Martha what it was like inside the black hole, where attempts at contact with the universe were pointless, only worsening the inexorable gravity of self-absorption with a self long since absorbed. But she couldn't understand, she was too grounded in reality. She even clipped coupons. This seemed particularly miraculous to Bud; planning ahead for anything was beyond his imagination, would require hope. He barely existed (did he?) in the present. The future was unreal. Where did she get such strength?

"Bud, time for dinner."


He began with his right arm. If he believed he could lift it off the armrest, he could. Left arm. Good. Lean forward to the edge of the chair. Good. Deep breath. Hands on thighs. I can stand, I can stand. Slowly he rose, feeling momentarily dizzy. Passing out would be a blessing. Robotically he circumambulated the coffee table and made it to the kitchen, where he collapsed, exhausted, at the dinette. The smell of the food sickened him but one of his last remaining pretenses was to force feed himself and compliment her cooking.

"Let's pray, dear, shall we?"

Bud nodded passively. Martha grabbed his hand.

"Father we thank you for this meal and for this day, and I pray you will help my dear husband and that we won't lose hope. Amen."

Thursday, March 27, 2008

No reference to you-know-what

Here's a poem of mine that was just purchased by Sigurd Magazine:


Because I doubt my being
I drape you in words
like papier mache'
that when you withdraw
I have a hollow to inhabit.
Everyone is Jesus to me,
everyone who leaves
a space to occupy.
Notice how many hollows
letters contain
and the spaces between words--
I dare you to find me.

They had a submission policy of twelve lines or less for poetry, which made submitting a challenge. Glad I found something they liked.

I just found out from Cider Press that my poetry ms. did not even make the finalists, and Tony Hoagland chose a book by Stacey Lynn Brown as the winner. If you google her you'll find very few online references, nothing like mine.... but I never do well in contests, though magazine editors seem to like me. And of course, she is married to a poet and has an MFA, so is probably better connected with the poetry world.

(My poetry has always striven for depth, for meaning, and much of today's poetry seems chatty and trivial to me. But I have no MFA, so I speak out of turn.)

I bought a huge vegetarian cookbook today (World Vegetarian Classics) at Kathleen's urging, since the one I was using was limited. Even so, she wanted pork for dinner! (Should go well with my vegetarian chile.)

Now, Norm, I'll conclude this brief note with no reference to...youknowwhat.



Tuesday, March 25, 2008

The Distraction of Basketball

Ignoring my depression doesn't seem to be working, so I'll indulge in writing as therapy, believing it helps objectify my suffering. Suffering can never be compared; each of us has suffered to a degree we would be afraid to exceed, as one can only know greater suffering when the soul is stretched beyond its former capacity for suffering. With enough suffering comes a numbness, as in Holocaust survivors, the mind's defense mechanism against overwhelming grief and terror. Depression differs from grief and trauma in that it comes from the inside out instead of from the outside in. It is self-generating.

As a form of suffering I find depression to be one of the worst varieties, because it darkens everything, it makes one unable to experience pleasure, it robs you of yourself--with all the history and attachments that implies. The past seems meaningless and the future seems a terror, while you spend every spare minute accusing yourself of one failure or another. Today my mind chose to accuse myself of not doing enough to end my depression--this despite exercise, ECT, compliance with psychiatric meds, attempts at gardening and cooking, continuing occasional publication of my poetry, hiking, and yes, a lot of basketball watching.

Last night I watched my beloved Lakers beat the Warriors in overtime, and it was a sad victory because a referee handed the game to the Lakers in the last eight seconds with a charging call on Monta Ellis, when it was clear that Derek Fisher, who was guarding him, pulled him down after the initial contact. I don't like referees to decide a game, and I wasn't happy that the Lakers won that way.

My college team is my alma mater, UCLA, and they have just made the sweet 16 of the NCAA tournament. Overall I don't think we have what it takes to win the tournament; our perimeter shooting is suspect and other teams have superior athleticism. In our favor is a relentless defense that can shut nearly anybody down. But if we run into a high-flying team like North Carolina or Memphis, I expect we'll lose.

How do I enjoy basketball while being depressed? First, it generally comes on in the evening, when depression itself improves, as depression is usually worst in the morning and better at night. Second, it is essentially trivial. The fate of the chinook salmon or the arctic ice pack does not hang from a basketball rim. It's just a simple game with one ball and two hoops. When I was younger I could play it, which adds to my appreciation. Still the main reason I can "enjoy" (better "be distracted by") basketball is that it demands nothing of me except that I be a mindless fan, an illogical and irrational position and thus a relief from significance.

I will admit that I don't have enough to do. When my depression was less severe I spent a lot of time writing, but now that I've decided I'll never make it as an author I hardly have the heart to keep generating books that won't be published. My novel, "The Abomination," is so boring I can't finish it ( published one copy of it for my perusal when I entered their first novel contest; I think I mentioned that out of 5,000 entrants, I didn't even make the cut for the top 1000. But I do have the souvenir book!) I had high hopes for the novel to be a thriller, a page-turner, but I realize in reading it that the characters do not demand the kind of interest that makes for an interesting novel. I don't really care about the characters when I read it.

As for my poetry and literary criticism, I still have faith that some of it has merit beyond my lifetime, but I don't expect to be discovered any time soon.

I recently picked up a new collection of Charles Simic, our present poet laureate, and found no brilliance to envy. Why he is lauded above others I can only attribute to the usual East Coast Old Boys' network. His poems are workmanlike but underwhelming.

To be fair, my sense of failure as an author has not been properly earned because I haven't pulled out every stop and made every sacrifice to succeed. But I have become disheartened, and I don't know how to return to writing without confidence--a writer must have the conceit that he has something worth saying--lacking that at present, I don't write about anything, excepting the therapy of this blog.

So, how did I do today? I hit upon one thing that distracts me from depression: Basketball! I passed a small opinion on our poet laureate. And I confessed that my inner critic thinks I haven't done enough to come out of my depression; but what is enough? It doesn't get more serious than ECT, from which I'm still recovering in terms of memory and cognitive functioning. But what if ECT was a way of avoiding some other aspect of depression? The mind won't let up, the hook is set and the brain reels it in over and over again. That's a good metaphor for depression: having set the hook deep in your soul and afterwards trying to reel it in--you are the fish and the fisherman and therefore can never succeed. And the more you yank on the line the worse it gets. One of the best lines I ever heard about depression was, "If your car is stuck in the mud, don't spin your wheels, just wait for the sun to come out and dry the road and you'll be able to drive away." It's the waiting that kills us. I spin my wheels too much.

Monday, March 24, 2008

Clinical Confession

I think the objectification of the self as a patient under treatment qualifies as "outside," though the narrator may be biased.

Since I was begun on a new antidepressant last Wednesday I haven't cried, and have felt better in general--until this afternoon, when I began to feel fragile. This makes me suspect I should increase the dose of the antidepressant now lest I lose the effect, as I have so many times.... Oh, and I just remembered I forgot one medication this morning--Abilify!

That's not good, as one test of my sanity is remembering all the medications I am supposed to pour down my gullet. It's no secret and no shame, here: Lithium, Effexor, Prozac, Wellbutrin, Abilify, Adderall, Enalapril, Aspirin, Celebrex (and M.S. Contin on bad back days). Klonopin at bedtime.

Of course I am transitioning from Prozac and Wellbutrin to Effexor, the new antidepressant, why I am on three at present. I'll stop the Prozac and Wellbutrin on Wednesday.

I used to say to my patients that if they took no more than one pill per decade they could be considered healthy. By that criteria I can't be healthy, as I take two pills per decade. Still, an increase in medications also reflects a doctor's inability to properly treat a disease; doctors always add more in pursuit of the desired effect, whether it's to control seizures or blood pressure. But what is "mood?" And what are its normal variations? And are some destined to be lifelong melancholics like Eeyor?

Flowers for begin to come out of a depression and "smell the roses" when inexplicably, the normal mood retreats and you're left alone again in the shoddy outhouse of your mind. This is what I fear will happen to my Effexor response.

What must it be like for a person who's never seen a psychiatrist to read my blog? Monsanto coined the term, "Better living through chemistry." I can see a suspicion that people like myself just can't handle a little pain in their lives, and thus go running to the doctor for every little anxiety and mood shift. But it's not like that.

I didn't see a psychiatrist until I was 29, though I had suffered severe depressions since the age of 13. I had decided it was simply normal to be suicidal for six months at a time, that everyone must go through it.

I don't expect psychiatry to help me with grief over my daughter's death, or to give me the courage to take my former landlord to small claims court (which I'm doing). I just want to be normal, with normal sadness and anger and fear, the kind we all have. What makes me abnormal is my brain's ability to generate a persistent mood, whether the pit of depression or the peak of mania, for an extended time, a time long enough to damage my life and relationships. For a mood disorder to be worth treating, it must interfere with basic functioning. It must harm one's life.

How I do go on! So much for today's confessional. I'll end with a poem on depression, another objectification:

On the Left Brain

Sometimes I think my left hemisphere
swollen like some great infected testicle,
necrotic, convoluted and gray.
Its vein walls are thinner than the membranes
lizards use to shield their eyes
and inside blood flows so slowly
I consider it a miracle
that a single rational thought escapes.

The great vein of Galen sits
at the bottom of both hemispheres
like a distensible sewer line that eventually empties
through the superior vena cava
into the heart’s right chamber
where its effluent mixes with blood
from the bowels and extremities,
pools in the lungs, and, re-oxygenated,
races from the left ventricle
back to everywhere else.

I tell you this because
the dream engine that pulls the body
has no conception of itself,
and though dependent on blood
is blind as an infected testicle,
as my metaphors bear witness
and your brain understands

Not rated,


Thursday, March 20, 2008

Staying busy. with outside things....


I recently wrote here that I would try not to write about myself but about things outside myself.

I saw my shrink this morning and he changed my antidepressant. I couldn't help weeping in front of him, something I've tried to spare others in my latest strategy of ignoring depression.


It's the first day of spring and the raven in the tree outside is honking annoyingly. I love ravens, I love to watch them in flight, but I must admit their vocalizations leave something to be desired. Their calls remind me of those old brass car horns with the black rubber bulb. What does it mean that a bird calls at a lower register? I have no idea, but it is clear that larger birds tend to have lower voices, as the flock of wild turkeys outside demonstrates.

There are mountain lions in this area and we can't figure out why they don't make a quick snack out of this flock of wild turkeys. I'm tempted to wring some necks myself for a feast but can't face the boiling and plucking it takes to get the carcass ready to cook. These turkeys ought to taste good, though. The only food I see them eating are insects in the abundant grass, and they are definitely free-range turkeys. Who began this flock and when and why are questions we have yet to answer. But it is fun to see the turkeys line up at twilight near the eucalyptus grove, waiting for the precise moment to fly up into the branches to roost for the night. They tend to ascend one by one, occasionally two flying up together. And once they are ensconced in their protective grove, they know that they have succeeded in surviving another day.

Although it caused me great anxiety, I looked up six vegetarian dinner recipes and made a list of the required ingredients and went shopping for them. The anxiety might be normal, in that it's something I've never done before. Last night I made a swiss chard fritatta, which Kathleen truly enjoyed. Today I have made a mushroom-barley soup. I had to do it this morning because I won't have time when Kathleen returns from work, so I have it all done and refrigerated already.

Having something to do with my hands is a blessing. I recall prior to my ECT that I generally made Kathleen lunches and tried to make dinner, but just like my former exercise regimen, ECT seemed to amputate my past from my future. The threads of things I was doing before the treatments I have had trouble reconnecting with. There was a chapbook contest I intended to enter, for example, and I had the chapbook done, but I no longer know where to send it. And I found myself published in a journal I didn't know was publishing me. I think the entire experience of ECT resembles a major concussive syndrome, with selective anterograde amnesia and a general disconnect with one's former life. If I were to do it over again, and I never plan to given the recent results, I would take the time to write down in a notebook beforehand all my ongoing activities and goals in a detailed fashion, so that I would have a guide for resuming my life. As it is, things crop up--”I was going to do that?” “I had promised to do that?” “There's a deadline for what?” “I owe whom a letter?”

ECT is a great interruption in the flow of one's life. Naturally anyone considering it would not call their life normal. But even depressed, as I have been, there are connections and recollections that seemed to have been whited out by ECT.

Of course, underneath the inevitable progression of my bipolar disease lies the grief at the loss of my first-born daughter, Rachel, on July 29, 2007. At the time I welcomed the sad feelings because they were legitimate grief, and grief felt better than depression, but in the emotional economy of the human psyche one wonders if that great loss has not been feeding my depression at some level. Experientially I can't say so; theoretically it makes sense.

I've been worrying a lot about old age lately, where we might live, how we will afford to live and all the attendant worries. But I like what Bob Dylan said: “He who isn't busy being born is busy dying.” Also, T. S. Eliot: “Old men should be explorers.”

Fine quotes to live up to. Fear is the mind-killer. Once faith in yourself is undermined, faith in anything else becomes near impossible.

So, outside myself, I've shopped and cooked two meals. Tonight I will be playing a tune I wrote for a Spring Equinox ceremony. The performance, of course, fills me with fear. But the way around my basic fear of non-being, or global incompetence of my person, is to do the things of which I'm afraid. I know this and have done this many times in my approach to life. I even called the Medical Board about the status of my medical license renewal today. (They told me to call back Monday.)

Oh, I fed the cats and brought Kathleen coffee and provided her with a lunch today. Every little useful thing helps. I don't know how it is for others, but in my advanced mental illness I have so much trouble trying to inhabit my body. My body becomes a thing, not part of my person, and to heal my mind must slow down or speed up to the rhythm of my body, so that in washing dishes, for instance, my hands and mind can work in concert. This idea hearkens back to the “moral treatment” enlightened Christians first used on the mentally ill after saving them from asylums. Farming was a big part of that therapy. My capacity for abstraction puts me at risk of losing contact with the material universe and my necessary role in it.

I have tried to keep today's post from undue solipsism. This does not mean that I am necessarily better, only that I am trying to follow my own prescription for improved health.



Monday, March 17, 2008

Something outside myself....


Though repeated over and over
they sound equally urgent

as if a mad ventriloquist had placed a hand
in each feathered back, egging them onward,

desperate to pierce air the way
the meadowlark embroiders wind.

Some may be calls for mates, yes,
and some for territory, but I swear

most call because they are birds
and for no other reason.

The birds are mad with joy
but they don't know it.

It takes a human mind to parse
delight behind these repetitions,

each as urgent as the last.


Perhaps if I only wrote about things outside of myself, perhaps if I concentrated only on what is joyful, my mood would be better served than by the long analytical posts about how stuck I am. So I'll give it a shot, starting with today's little poem.


Friday, March 14, 2008

ECT Failure

The following was written over a number of days. I see little merit in posting it, then I see little merit in anything these days. I am not just a depresso; I am an ECT failure. It doesn't get much worse than that, does it (excluding all the evils one can think of)?

3/12 How am I doing? I was tearful when I spoke with my shrink today; he added another medicine to my collection of wonder drugs that aren't working. He also encouraged me to seize any activity I can, which I'm already doing. In blogging right now, for instance, I'm hanging out at a mini-mall with wireless service, because it's better to be around people than to be alone.

Craig cries when trying to explain how he feels. Even the smallest task or decision can burden Craig with anxiety, which often requires relief through tears. Craig feels that life is a wasteland, a desert devoid of succor or employment, a vast blank canvas on which he leaves no mark. But he's better than when he first finished his ECT treatments. Marginally, at least.

How does one get stuck in an emotional hell for two years? And does the very use of the word “hell” mitigate against healing? Perhaps I should call my feelings of worthlessness and hopelessness and all the rest just a “persistent dysphoria,” instead of tagging the experience with a negative value judgment.

This is always a conundrum in depression; you must accept it as your present condition but not as your permanent condition, because you have known better. Thus you cannot accept your present mood as normal, though you must accept it as your present mood in order to take the sting out of the condition.

I know my mood isn't normal. How? Because I've had a life. And because I've recovered from previous depressions, though I'll admit each one takes a big chunk out of me and leaves a large scar behind.

The great fear is that I will be like this until I die. I couldn't face that. But if it turns out that way, I will have to face it, just not yet—there's always something else to try (like Kromart, an herb from Southeast Asia one reader recommended).

3/13 For four days I have been unable to blog beyond the desultory remarks above. I sat in front of my screen yesterday and had virtually nothing to say, so I posted nothing, having written the last part when I got home. I'm looking forward to getting a new laptop, possibly this week, as this Acer bottom-of-the-line model is always gobbling text, and the screen is so dim I fear I shall go blind if I continue to stare at it. I have to play with the angle of the display screen to read the writing for many programs on my desktop. I got this machine as a hand-me-down, and trust me, it ought to be handed further down. Most irritating is the wandering cursor effect, where I am typing text and suddenly, without warning, the cursor pops up in another part of the text and starts inscribing there. Also, at times, large blocks of text have been lost that were irrecoverable for reasons unknown.

I think I said something important last night to Kathleen, and although not the cause of my depression, it does form a nice backdrop. I have not worked as a doctor since late 1995 other than some brief volunteer work in Mexico which my back could not endure. The reason for my not working was bipolar disease and chronic spinal pain. I took advantage of my enforced sabbatical from medicine as an opportunity to pursue my dream of being a poet and writer. I can't say how hard I've worked at my dream; of course I could always have worked harder. But since 1996, when I recovered enough to begin writing, I have written two book-length manuscripts of short stories, one mystery novel, two books of opinion columns, a book on the major poems of T. S. Eliot and another book on general literary criticism and a book of theology on the Holy Spirit. So much for the prose, not my main feature. As for the poetry, my chief ambition, I had one book published by Mellen Press but have failed to interest any publisher in a second book. Yet I have certainly written enough poetry for three additional collections, in order: Sine Wave, Unexpected Light, and Wear Me Like a River. And in paging through my files, my records indicate that I have published over 600 poems since 1996. That's prolific. To give you a touchstone for comparison, Yeats' collected poems number less than 500. So for twelve years, pretty consistently, I have averaged 50 published poems a year, and this does not include the many columns and essays I published, along with some short fiction. (Fiction is my most difficult genre.) The most I've been paid for an individual poem during this time was $100; the most I was paid for a group of poems was $250. I used to be on the LA reading circuit but despaired of the quality at the open mic venues and quit that scene years ago.

It's been said that if you can pay for your postage as a poet, you are successful indeed. I've done much better than that. Yet I have not done well enough to be a “name,” to be a somebody in the literary universe, somebody an editor will consider closely before rejecting simply on the basis of his name.

It's time to take a good, hard look in the mirror. My thriller, The Abomination, I've been re-reading and I don't think it is of marketable quality. The book on Eliot ought to be published, it's well-done, but I haven't promoted it adequately. My unpublished books of poems I consider better than my only published one; each book gets better, IMHO, and the book of love poems could really achieve some success if someone would publish it. But I'm getting into too much detail here.

Simply said, if I look in the mirror, in pursuing my dream of being a poet, I have not succeeded. I have not succeeded to the extent I wanted to succeed, namely to be fairly well-known and desired at conferences and readings and so forth, and published in the leading journals.

Poetry is not the kind of work you can measure in hours. Inspiration comes when it comes; the mind must be ready to receive it. You cannot compare the work of a poet to the work of a doctor. They differ in kind, not just degree.

Here's the thought I'm trying to work myself up to: Craig, you have not succeeded as a poet despite ample time and a workmanlike effort, of which your publications speak. Maybe it's time to pack in this ambition and take up work “by the sweat of the brow” once more. There was a time writing did occupy you sufficiently to say you were working, but here in this two-year depression you can, perhaps, see the writing on the wall. It would be better for you to be engaged in an outside, worldly endeavor than to continue on your interior journey, which is bankrupt at present in any case. You're only 53. Do you want to go on not earning money until you're 65? Wouldn't involvement in the world benefit you biochemically? You've had a good run as a minor net poet, why not be happy with that? But is this the right thing to do, to shut down the full-time pursuit of my dream in the interest of participating in “reality?” Remember, before I became depressed, I used to take my writing work seriously. Now I've lost faith in my work as a writer. Now I suffer from the summer syndrome, “What's there to do, Mom?”

When I'm healthy there is usually no shortage of things for me to do, gainfully employed or not.

And here, again, we have the question of what's good for Craig and what Craig is good for. There are many fine family doctors equal to or better than I. Practicing medicine would not be a special calling for me. It's not that I want to return to medicine per se as that I want to do whatever I need to do to get out of the clutches of my depression. Perhaps I can scare up enough volunteer work, provided my back can endure it, to keep me involved in the world, without having to desert my artist's world entirely for Mammon's arena. I do not claim the following is a good poem, only reflective of this meditation:

The Poet Bids His Muse Farewell

With the grace of a cat
you have patrolled my shoulders,
clawing me when I failed to see
the nimbus around
the blue-faced turkey
or the pink algae
spread like a holy blanket
on the brown stream.
If only I could see
what you see!
But that would be surfeit,
as in a Van Gogh painting.
There can be too much light;
a man can only take so much.

You also inspire by connections
that make all exceptional!
Hurrah for our interconnectedness!
That last bird that sang, what was it?
A meadowlark! I knew you'd know
I never tire of his song
but you can tire of mine,
yes, you can tire of mine.

To sum up: I am depressed. I don't have enough to do and I don't have a car during the week, which limits my options. I don't believe in my writing anymore as a viable pursuit beyond a hobby, so the main thing that had justified my continued existence and slaked my Protestant thirst for productivity feels as if it has been disqualified. Obviously no one should feel sorry for me, if I have the time to do what I want but fail to believe in the thing I was doing. Most would consider that an extreme luxury. The irony is, it is my bipolar disease that makes such freedom possible (through my disability), while at the same time rendering me incapable of enjoying such freedom. What good is freedom if you are too depressed to take advantage of it?

When they handed out the happiness glow sticks there must have been a hole in my bag. It's getting hard for me to remember ever being happy, but I know I have been, most memorably when Kathleen and I fell in love. And I'm always “happy” to be published. And I'm “happy” to see my close friends, but now I am using “happy” as the cliche' it's become. What would it be like to have an unshakable self-love and self-acceptance? In that case it wouldn't matter if you watched TV all day, you'd still feel good about yourself. You would not be haunted by the specter of self-justification, of Protestant productivity What you did would be acceptable because of who you are, not what you have done. And that includes doing nothing.

All this is making my head hurt.

But are you one of the blessed who accepts yourself regardless of situation or performance, one who embraces and loves the inimitable you through all its incarnations? If you are there, write me, or better, direct me to your blog.

A point about religion: When I get desperate I want to imagine some divine healing from God, so I go to churches in a near psychotically expectant state. This naturally makes my mental illness worse, though even today I'm tempted to go to some healing service. What could it hurt?

When I don't get well, then I can add God to the list of things I have failed or have failed me, and I don't want to do that. I must hold on to something apart from my illness, and my intellectual faith in Christianity, however battered, remains. If you have joy in your type of faith, consider yourself blessed.

5 kilorats,


Monday, March 10, 2008

Still Crazy After All These Amperes

March 9, 7 P.M.:

The blinding gold over the ocean makes writing hard. Seal that light off by adjusting the shutters and I'm still suffering after-flashes from the brightness.

Think about that: Every day we have the possibility of blinding ourselves forever by staring into the sun. How can we possibly leave such decisions to the mentally disabled? We're just risking our favorite wackos, not truly guarding them from imminent dangers--like exposure to the Craig Kilmer Show. These late-night less-than wits could prove toxic to the fragile scaffolding by which a depressed patient attempts to construct a sense of hope, even a sense of humor. Why not more protection in the name of the rights of the disabled, more restrictions on their freedom for their own good? How the ACLU frees us through restrictions, liberates us by encircling us, the kind of groveling freedom old-time liberalism produces. “Let us take care of you; we can't trust the great unwashed to care for themselves.” And yet, here am I, a mental patient with suicidal yearnings perfectly capable of blinding himself on a natural phenomenon anytime he likes. The last freedom is the right to suicide, but it may also be the first freedom. Even so, in our Western society it is frowned upon as the ultimate failure. Famously the Japanese have a different take on this.

Although it has been hard for me to admit in the past, I hereby publicly admit that for the present time and foreseeable future I am disabled, that is to say, unable to work in any normal capacity without an undue risk of being incapacitated. By imagining myself as someone else I can function, though I still fall victim to that 1000-yard stare. How I wish I were better grounded!

My dear friends have been calling me, and that shores up my sanity, because they treat me as fully human and in charge of my capacities, which makes me feel more and more competent as I talk with them. (There is something parasitic in all of us, something vampirish, in how we can, when we need to, suck a great bunch of energy from another person. Talking with close friends so energized me today, almost to the point of feeling normal. But what price did they pay?) The obverse of this experience is that by projecting myself as incompetent and disabled, I fulfill my own prophecy and encourage acquaintances to treat me as such.

If today's post, which will really be tomorrow's post when posted, seems directionless, it is. And here's why:

Kathleen raised the possibility that the self-involvement of blogging might be bad for my depression, and I countered that when I felt particularly dissociated, writing helped objectify my being, just as conversations on the phone with friends helps restore my sense of personality. Because of her point, however, I resolved to try to write comically from here on in. I know nothing is harder. But if I could succeed in making the reader laugh, wouldn't that be a gift? And now that I have burdened myself with humor, can I be humorous? Was anything up to here in this blog humorous?

What do you say to an ECT patient after his third treatment?

Anything you want, because he'll forget it after the fourth.

Why do they give depressed patients so many medications?

To insulate them from the reality they can't handle and enable them for the reality they can.

How do doctors tell the difference?

Why they get paid the big bucks.

Are you shocked that Craig needed electroconvulsive therapy?

No; it was Craig who was shocked.

It's hard to be humorous on command. Usually I have to be writing about a subject for humor to occur, as it does naturally in most stories worth re-telling, stories of extreme stupidity and disappointment (like our two-trillion Iraq War). When I think of all the other things we could have spent our money on, like flat-screen TVs, it makes me weep. Who's the candidate to turn the neocon hubris around? Who's willing to step down from being “The World's Policeman” and simply coexist without having to dominate? I don't know if any of the candidates get it. It's not a call to isolationism, it's a call to realistic expectations in a new global order.

At least I didn't fall for talking about me, here at the end. I know you wouldn't have minded. But I truly have nothing to say about myself except that I had another day and got through it, even hiking in the afternoon. Of the terror and sadness I will not speak.

I cannot properly rate myself in kilorats anymore because my psyche is not that simple. Nevertheless it is a handy shorthand, so I will return to it.

At -5 Kilorats (with quite the electrical hangover),

Dr. Chaffin

Friday, March 07, 2008

Poem: ECT

I wrote a long entry today that I just lost, and probably for the best, as it was a rambling piece of work, talking about the unintended benefits of ECT--how as in an acid trip I find myself returned from Planet Craig to Planet Earth. I'm still spaced-out and vulnerable, but I'm here. That's about it. Here's an old poem of mine that I think better captures the flavor:


“That’s me in the corner, losing my religion.”

Each day for years
I sacrificed my heart to God.

My smile got so tight
I had to nibble through a straw.

All my epiphanies were poison,
my thoughts hounded by sirens

until I was forced to recognize myself
inside the silver lenses of a policeman

and know that all the wanted posters
of Jesus were for me, so I peeled them off

like a bad paint job. Underneath
was a darkness more terrible

than a starless, starless sky,
the pupil of a salmon’s eye

fixed behind display glass.
After the electrodes and the gel

and four weeks at Hospital Hotel
it was enough to finger my own face.

Was that my mustache?
Will anyone recognize me on the street?

Prepare a face to meet the faces you will meet.

(published in Free Cuisenart and Conspire)

Wednesday, March 05, 2008

Finished with the Course of ECT

Tuesday, March 4, my first full day back home from treatment in the Bay Area, my last ECT treatment having been performed on 2/29. Kathleen and I arrived on the Mendocino Coast yesterday in the early afternoon, whereupon I was confronted with our new rental, as yet in shambles. The disorder was challenging to say the least. Kathleen, God bless her, had tidied up the kitchen and the bathroom as well as put her own wardrobe away in the new guest bedroom, but working full-time and being burdened, even long distance, by a sick husband, she hadn't had time to really straighten out the house. Besides, there are some things she'd rather leave for me, like where to hang which pictures.

If I were in any other state I would have tolerated the disorder fine, but in my present state of near dissociation, after ECT therapy, I found the state of our belongings daunting. Annie Lamott wrote a book called “Bird by Bird” in which the chief metaphor is an overdue school report on birds. Near the last day of the family vacation, her brother bemoans the fact that he'll never get all the birds he wants into his report, now that the time is short. “How can I ever do it?” he asks his family, holding the huge bird book in desperation. “Why, bird by bird,” his father says, simplifying the problem. And indeed, if I look at the disorganization of our new rental and don't know where to begin, if I look around and can't tell which boxes to open and what possessions to discard or donate to Goodwill, I will be overwhelmed and paralyzed, unable to act. But if I take one small thing at a time, I can make steady progress until the whole enchilada is cooked.

Still, there are other impediments to my progress than procrastination. I feel a bit like Charlton Heston in “Planet of the Apes,” as it feels as if I have landed on a totally new planet. Because far from grounding me, as far as I can tell, the ECT treatments splintered my consciousness into even smaller quanta, so that I must gather my thoughts up like dust in a shaft of light and try to cup them in my palm before their relations to each other disappear. All my clothes look new and unfamiliar, although there is a strange familiarity about them, as if I had worn them in another life. Even Kathleen and my stepson, Derek, look slightly alien. The fact that I have “returned” to a place I have never lived before is unfortunate, as it only aggravates the feelings of unfamiliarity. The rental is indeed what we had been long seeking, a place of light with an ocean view, and now we have it and a flock of wild turkeys to boot. But having just been discharged from what I consider a failed course of 10 ECT treatments, I experience what are called “dissociative” symptoms, where familiar objects and persons seem strange, as in “derealization,” and I feel as an object acted upon, not a person with a will who can change his environment, as in “depersonalization.” I don't know what it's like for a brain-injured or stroke patient to go home, but it must be something similar. A whole movie has been based on this premise, “Regarding Henry,” with Harrison Ford.

What dissociative states mean to the patient is hard to say, but it is as if the observing ego has been sheared off from the experiencing ego, as happens in times of great stress as when a mother, for instance, lifts a car off of her trapped child (and afterwards needs treatment for vertebral fractures). It's as if someone else is doing, experiencing, acting in your stead and in some cases it can lead to multiple personalities, created to cope with specific stresses—as when a woman becomes seductive around her pastor to flex her sexual power but becomes a prude at home because of marital unrest, each personality critical of the other.

How badly did ECT damage my memory? I lost whole chunks of people, places and things. The most curious phenomenon was my loss of visual memory. Normally I have a rather eidetic or strong visual memory, so that when I think of a sock in my drawer, I see the drawer and the sock in my mind's eye, and where the dresser is located before I pick out the sock. But after ECT I couldn't see the dresser; I couldn't imagine many of the visual clues that help me approach life's details. The question, “Where is the sock?” no longer took me on a brief physical journey. I could imagine the sock itself and presume it to be in the drawer, but I couldn't actually follow my visual memory down the stairs to the dresser and the proper drawer. This is frightening at first, and is worst at the end of the treatments, but if the treatments did you no good, it is a steep price to pay.

No doubt the reader wonders whether the treatments are painful. They are not, as the anesthesiologist puts you under before the current is discharged. Afterwards there is the equivalent of a temporal headache bilaterally, like a bad tension headache. But there's also a larger feeling of having the furniture moved in the apartment of your mind. Songs began playing in my head that I hadn't heard in years, including a lot of Simon and Garfunkel, as in “Sounds of Silence,” eerily appropriate.

But the most aggravating side effect of treatment, in my case, was how my visual library of recollections had many of its connections cut. A familiar name would be mentioned, for instance, and I couldn't imagine the face. Someone might say, “Remember when we went to Yosemite?” and I couldn't picture Half Dome or Bridal Veil Falls--they were just terms without visual correlation in the slide show of my mind.

I didn't forget how to brush my teeth or other rudimentary habits, and I knew who my family is, even if I could not visualize them in my mind, and I could give consent to the treatment while it was going on. Some seven shocks into the treatment I complained that I was getting worse, I was now tearful before and after my induced convulsion. I mentioned that my previous treatment, in 1983, employed bilateral ECT, and the doctors seemed to panic and put me on bilateral ECT, as well as loading me down with so many meds at once it was hard to keep track. In one swell foop they added lithium at 1200 mg./day, another Wellbutrin 150 mg. at bedtime, an antipsychotic named Invega in the morning, a new antidepressant, Remeron, for bedtime, and another antidepressant of the sedating kind, Trazodone, as needed for sleep. These were in addition to the 80 mg. of Prozac and 300 mg. of Wellbutrin I was taking daily, along with the stimulant, Adderrall. Truly the doctors seemed to overreact to my criticism that the unilateral treatment wasn't working by switching me to bilateral and loading my gray matter down with all of these new drugs. It's as if they were throwing good drugs after bad, just to let it be said that they had left no stone unturned. Had they been treating a stone it might have been appropriate, but here I was, tearful before ECT and after ECT, and especially affected by the Invega, which dropped me into a severe trough. It was a soul-killing medication much like Haldol for me; I feel that both lower me into some demonic world where I was at the mercy of evil and could not think for myself. I have naturally stopped the Invega and Remeron as I plan to speak to my psychiatrist tomorrow.

How am I doing today? I'm fragile and sketchy and and tear up talking to Kathleen of Derek about minor things, particularly things that may demand some action on my part that I feel helpless to provide. Just because I burst into tears doesn't make me quit talking necessarily; we wait it out until I can catch my breath and then move on. But it is difficult to describe the extreme vulnerability you feel after a course of ECT; in many ways you feel like a newborn with a tabula rasa for a brain. There is a sense of caution about what you should allow into your mind and what you should studiously ignore. I would very much like a handbook for recovering from ECT, telling patients how their humanity can best be restored. For ECT is a blunt and cruel treatment, one that tosses the baby with the bathwater, at least as it's been practiced on me. I was desperate enough to seek the treatment this time but I would not seek it again, ever. It can reduce you to a quivering mass of jelly, an Alzheimer's patient desperately trying to make sense of his surroundings (in the acute phase). It ought to be reserved for desperate cases, like me. Too bad I have not responded to it, though its long term effects on me remain to be seen. But I am not sorry I did it; it was the old “Hail Mary” play of psychiatry. And though Mary may be full of grace, the treatment did not impart that grace to me. I am presently in recovery from treatment, my last one having been on Feb. 29 (also my sister's birthday, “Leap Day.”) Again, whether we will remember it as “The Great Leap Forward” or “The Great Leap Back” remains to be seen. Early reports are not encouraging.

Unexpected Light

Unexpected Light
Selected Poems and Love Poems 1998-2008 ON SALE NOW!