Authors: Susanna Kaysen
Our double-locked doors, our steel-mesh window screens, our kitchen stocked with plastic knives and locked unless a nurse was with us, our bathroom doors that didn’t lock: All this was medium security. Maximum security was another world.
The Prelude to Ice Cream
The hospital was on a hill outside of town, the way hospitals are in movies about the insane. Our hospital was famous and had housed many great poets and singers. Did the hospital specialize in poets and singers, or was it that poets and singers specialized in madness?
Ray Charles was the most famous ex-patient. We all hoped he’d return and serenade us from the window of the drug-rehabilitation ward. He never did.
We had the Taylor family, though. James graduated to a different hospital before I arrived, but Kate and Livingston were there. In Ray Charles’s absence, their North Carolina–twanged blues made us sad enough. When you’re sad you need to hear your sorrow structured into sound.
Robert Lowell also didn’t come while I was there. Sylvia Plath had come and gone.
What is it about meter and cadence and rhythm that makes their makers mad?
The grounds were large and beautifully planted. They were pristine as well, since we were almost never allowed to walk around. But now and then, for a special treat, we were taken through them on the way to get ice cream.
The group had an atomic structure: a nucleus of nuts sunounded by darting, nervous nurse-electrons charged with our protection. Or with protecting the residents of Belmont from us.
The residents were well heeled. Most worked as engineers or technocrats along the Technology Highway, Route 128. The important other type of Belmont resident was the John Bircher. The John Birch Society lay as far to the east of Belmont as the hospital lay to the west. We saw the two institutions as variations on each other; doubtless the Birchers did not see it this way. But between us we had Belmont surrounded. The engineers knew this, and they took care not to stare when we came into the ice cream parlor.
Saying that we traveled with a group of nurses does not fully explain the situation. A complex system of “privileges” determined how many nurses accompanied each patient, and whether a patient could leave the grounds in the first place.
The privileges started at no privileges: restricted to the ward. This was often Lisa’s condition. Sometimes she was bumped up to the next rung, two-to-ones. That meant she could leave the ward if she had two nurses with her, though only to go to the cafeteria or occupational therapy. Even with our high staff-to-patient ratio, two-to-ones often meant restricted to the ward. Two nurses could rarely be spared to take Lisa by the elbows and hustle her over to dinner. Then there were one-to-ones: a nurse and patient bound together like Siamese twins. Some patients were on one-to-ones even on the ward, which was like having a page or valet. Or like having a bad conscience. It depended on the nurse. A lousy nurse on one-to-ones could be a problem; it was usually a long-term assignment, so the nurse could get to understand her patient.
The gradations were Byzantine. One-to-twos (one nurse, two patients) led to group (three or four patients and one nurse). If you behaved in group, you got something called destination privileges: This meant telephoning the head nurse the moment you arrived at wherever you were going to let her know you were there. You had to call before coming back, too, so she could calculate time and distance in case you ran away instead. Then there was mutual escort, which was two relatively not-crazy patients going places together. And the top, grounds, which meant you could go all over the hospital alone.
Once these stations of the cross were achieved within the hospital, the whole circuit began again in the outside world. Someone who had mutual escort or grounds would probably still be on group outside.
So when we went to Bailey’s in Waverley Square with our retinue of nurses, the arrangement of atoms in our molecule was more complex than it appeared to the engineers’ wives sipping coffee at the counter and graciously pretending not to look at us.
Lisa wouldn’t have been with us. Lisa never made it past one-to-ones after her third escape. Polly was on one-to-ones, but that was to make her feel safe, not hemmed in, and she always came along. Georgina and I were on group, but since nobody else was on group, we were effectively on one-to-twos. Cynthia and the Martian’s girlfriend were on one-to-twos; this made it seem that Georgina and I were as crazy as Cynthia and the Martian’s girlfriend. We weren’t, and there was a bit of resentment on our part. Daisy was at the top of the chart: full towns and grounds. Nobody could understand why.
Six patients, three nurses.
It was a ten- or fifteen-minute walk down the hill, past the rosebushes and stately trees of our beautiful hospital. The farther we got from our ward, the jumpier the nurses became. By the time we hit the street they were silent and closed in on us, and they had assumed the Nonchalant Look, an expression that said, I am not a nurse escorting six lunatics to the ice cream parlor.
But they were, and we were their six lunatics, so we behaved like lunatics.
None of us did anything unusual. We just kept up doing whatever we did back on the ward. Muttering, snarling, crying. Daisy poked people. Georgina complained about not being as crazy as those other two.
“Stop acting out,” a nurse would say.
They were not above pinching us or giving a Daisy-like poke to try shutting us up: nurse nips. We didn’t blame them for trying, and they didn’t blame us for being ourselves. It was all we had—the truth—and the nurses knew it.
Ice Cream
It was a spring day, the sort that gives people hope: all soft winds and delicate smells of warm earth. Suicide weather. Daisy had killed herself the week before. They probably thought we needed distraction. Without Daisy, the staff-to-patient ratio was higher than usual: five patients, three nurses.
Down the hill, past the magnolia already losing its fleshy blossoms, the pink turning brown and rotten along the edge; past the paper-dry daffodils; past the sticky laurel that could crown you or poison you. The nurses were less nervous on the street that day, spring fever making them careless—or perhaps the staff-to-patient ratio was a more comfortable one for them.
The floor of the ice cream parlor bothered me. It was black-and-white checkerboard tile, bigger than supermarket checkerboard. If I looked only at a white square, I would be all right, but it was hard to ignore the black squares that surrounded the white ones. The contrast got under my skin. I always felt itchy in the ice cream parlor. The floor meant Yes, No, This, That, Up, Down, Day, Night—all the indecisions and opposites that were bad enough in life without having them spelled out for you on the floor.
A new boy was dishing out cones. We approached him in a phalanx.
“We want eight ice cream cones,” said one of the nurses.
“Okay,” he said. He had a friendly, pimply face.
It took a long time to decide what flavors we wanted. It always did.
“Peppermint stick,” said the Martian’s girlfriend.
“It’s just called ‘peppermint,’ ” said Georgina.
“Peppermint dick.”
“Honestly.” Georgina was revving up for a complaint.
“Peppermint clit.”
The Martian’s girlfriend got a nurse nip for that.
There were no other takers for peppermint; chocolate was a big favorite. For spring they had a new flavor, peach melba. I ordered that.
“You gonna want nuts on these?” the new boy asked.
We looked at one another: Should we say it? The nurses held their breath. Outside, the birds were singing.
“I don’t think we need them,” said Georgina.
Checks
Five-minute checks. Fifteen-minute checks. Half-hour checks. Some nurses said, “Checks,” when they opened the door.
Click
turn the knob,
swish
, open the door, “Checks,”
swish
, pull the door shut,
click
, turn the knob. Five-minute checks. Not enough time to drink a cup of coffee, read three pages of a book, take a shower.
When digital watches were invented years later they reminded me of five-minute checks. They murdered time in the same way—slowly—chopping off pieces of it and lobbing them into the dustbin with a little click to let you know time was gone.
Click, swish
, “Checks,”
swish, click:
another five minutes of life down the drain. And spent in this place.
I got onto half-hour checks eventually, but Georgina remained on fifteen-minute checks, so as long as we were in the same room, it made no difference.
Click, swish
, “Checks,”
swish, click
.
It was one reason we preferred sitting in front of the nursing station. The person on checks could pop her head out and take her survey without bothering us.
Sometimes they had the audacity to ask where someone was.
Click, swish
, “Checks”—the rhythm broke for a moment. “Have you seen Polly?”
“I’m not doing your job for you,” Georgina growled.
Swish, click
.
Before you knew it, she’d be back.
Click, swish
, “Checks,”
swish, click
.
It never stopped, even at night; it was our lullaby. It was our metronome, our pulse. It was our lives measured out in doses slightly larger than those famous coffee spoons. Soup spoons, maybe? Dented tin spoons brimming with what should have been sweet but was sour, gone off, gone by without our savoring it: our lives.
Sharps
Nail scissors. Nail file. Safety razor. Penknife. (The one your father gave you when you were eleven.) Pin. (That pin you got when you graduated from high school, the one with two small pink pearls.) Georgina’s gold stud earrings. (You can’t be serious! It’s the backs, see—the nurse showed her the stubby darts of the backs—they’re sharp, see.) That belt. (My belt? What’s going on here? The buckle was the culprit. You could maybe put your eye out with this part of the buckle, the pointy part.) Knives. Well, you could make a case for knives. But forks and spoons too? Knives, forks, and spoons.
We ate with plastic. It was a perpetual picnic, our hospital.
Cutting old tough beef with a plastic knife, then scooping it onto a plastic fork (the tines wouldn’t stick into the meat, so you had to use the fork like a spoon): Food tastes different eaten with plastic utensils.
One month the plastic-utensil delivery was late and we ate with cardboard knives and forks and spoons. Have you ever eaten with a cardboard fork? Imagine the taste of it, melting clotted cardboard in and out of your mouth, rubbing on your tongue.
How about shaving your legs?
Over to the nursing station. “I want to shave my legs.”
“Just a minute.”
“I’m going to take a bath now and I want to shave my legs.”
“Let me check your orders.”
“I’ve
got
orders to shave my legs. Supervised.”
“Let me check.” Rustle, rattle. “Okay. Just a minute.”
“I’m going now.”
In the tub, swimming-pool-sized, Olympic-swimming-pool-sized, deep and long and claw-footed:
Click, swish
, “Checks”—
“Hey! Where’s my razor?”
“I’m just the person on checks.”
“I’m supposed to shave my legs now.”
Swish, click
.
More hot water: These hydrotherapy tubs are really comfortable.
Click, swish
, my shaving supervisor.
“Did you bring my razor?”
She hands it over. She sits on the chair next to the bathtub. I’m eighteen years old. She’s twenty-two. She’s watching me shave my legs.
We had a lot of hairy legs on our ward. Early feminists.
Another Lisa
One day a second Lisa arrived. We called her by her full name, Lisa Cody, to distinguish her from the real Lisa, who remained simply Lisa, like a queen.
The Lisas became friends. One of their favorite activities was having phone conversations.
The three phone booths near the double-locked double doors were our only privacy. We could go in one and shut the door. Even the craziest person could sit in a phone booth and have a private conversation—though only with herself. The nurses had lists of permitted numbers for each of us. When we picked up the phone, a nurse would answer.
“Hello,” we’d say. “This is Georgina”—or Cynthia, or Polly—“I want to call 555-4270.”
“That’s not on your list,” the nurse would say.
Then the line would go dead.
But there was still the quiet dusty phone booth and the old-fashioned black receiver with its sharp dorsal ridge.
The Lisas had phone conversations. Each one got in a booth, folded the door shut, and yelled into her receiver. When the nurse answered, Lisa yelled, “Off the line!” Then the Lisas got on with their conversation. Sometimes they yelled insults; sometimes they yelled about their plans for the day.
“Wanna go over to the cafeteria for dinner?” Lisa Cody would yell.
But Lisa was restricted to the ward, so she’d have to yell back something like: “Why do you want to eat that slop with all those psychotics?”
To which Lisa Cody would yell, “What do you think you are?”
“Sociopath!” Lisa would yell proudly.
Lisa Cody didn’t have a diagnosis yet.
Cynthia was depressive; Polly and Georgina were schizophrenic; I had a character disorder. Sometimes they called it a personality disorder. When I got my diagnosis it didn’t sound serious, but after a while it sounded more ominous than other people’s. I imagined my character as a plate or shirt that had been manufactured incorrectly and was therefore useless.
When she’d been with us a month or so, Lisa Cody got a diagnosis. She was a sociopath too. She was happy, because she wanted to be like Lisa in all things. Lisa was not so happy, because she had been the only sociopath among us.
“We are very rare,” she told me once, “and mostly we are men.”
After Lisa Cody got her diagnosis, the Lisas started making more trouble.