Just Like Someone Without Mental Illness Only More So (19 page)

Somewhere in there I started painting after ten years off, at first with oils and then back to watercolors. I did it in the basement so as to not wreck anything. I bought a Yamaha digital piano and started working on jazz standards. I started writing a novel about a depressed pediatric senior resident who gets run over by the angry father of a baby who gets mistreated in the ER. When I wanted to take music-theory courses at the New England Conservatory, my wife became exasperated; surely there was something I could be doing to get back to work faster. Why wasn’t I taking a medical course of some sort?

“You’re a doctor,” she said.

Was I a drug addict or an alcoholic or just plain crazy? There were all those questions on the medical license renewal application to deal with. The chief of pediatrics at MGH knew I had been hospitalized. He liked me, so I more or less followed his lead when he described the problem as a drug problem that I had gotten into by taking drugs as prescribed for my sleeping problem. To me it seemed a little bit more complicated than that, but if I was going to have a shot at continuing to practice medicine, I had to give people a simple, easy package to swallow.

Because I hadn’t screwed up medically or acted out in a professional setting, I didn’t have to report to the Board of Registration of Medicine. In AA meetings I was an alcoholic who also used drugs, but mostly as prescribed. Purists said that if you were a drug addict who also drank, you were supposed to go to different meetings.

An earnest, bright-eyed young man at an AA meeting told me that to stay sober most people couldn’t keep doing whatever it was they had been doing for a living before they got sober but that perhaps I could work in a bookstore until I figured it out. I had to face the possibility that I could lose my profession, but it seemed like a terrible waste of all those premed courses and then medical school and then internship and residency. What was I going to do to pay the bills when the disability insurance ran out?

Two months after being hospitalized, I met with my partners and my psychiatrist to try to figure out when, if ever, it was going to be okay for me to come back to work. It was a tentative, very soft-spoken, slow-moving tea party. I tried to be dull without being too dull. Everyone was doing the best they could.

I was on lithium, which had been restarted during my hospitalization. Lithium is a mood stabilizer, yet my mood seemed anything but stable. I wanted to be stable and could have been stable by using the mood stabilizer that came in cases of twenty-four returnable bottles and tasted really good in chilled mugs or the more concentrated stuff in the bottle with
Jack Daniel’s
written on it. I could have been a lot more like Clint Eastwood and less like me and probably more popular.

It would have been almost logical to ditch the notion that alcohol was part of my problem. Alcohol had, in fact, been mostly
a comfort that had brought me safely through many bad times. Ninety-nine times out of a hundred I felt at least a little better with every drink. Except for maybe the seizure when I stopped, alcohol and I had gotten along very well, and maybe the real issue was Xanax.

With four psychotic breaks to my credit and a solid four-straight-generation family history of hyper-religiosity, voices, delusions, et cetera, I more than met diagnostic criteria for bipolar disease, formerly known as manic depression, which was why I was taking lithium. Why did I want to crud things up by bringing alcohol into the picture? If you’re an alcoholic, you don’t have to take lithium. You just don’t drink. If you’re bipolar and take your lithium, you can probably drink a little. It seemed unlikely, over the top, gilding the lily, and almost bragging to say that I could be an alcoholic and a drug addict and bipolar. Where’s Ockham’s razor
^*
when you need it?

But there was something about the intensity of the vision that alcohol was not my friend. I would have rather eaten putrid flesh off the bone than had another drink. Just because I could drink and be okay with it didn’t mean I had to drink.

The next Christmas I took a big bite of coffee cake that was loaded with bourbon and spit it out against the wall.

“Walnuts,” I said to the startled bystanders. “I can’t stand walnuts.”

At a certain blessed point you are able to just not drink without thinking about it all the time.

I wasn’t sleeping. There were times when I went several days with no sleep at all.

My mother was slowly relentlessly crushed from the inside and eaten up by her cancer. Together we wrecked two Christmases in a row.

“Uncle, uncle, uncle
, damn it. Didn’t anyone hear me call
uncle?”

I was acutely aware of a gritty stiffness twisted into every muscle of my body, as if I was on a spit being roasted over a slow fire. It came and went without there being anything I could do about it. I was painfully aware that I couldn’t drink, which is what anyone in his right mind would have done. God bless the moments when I felt all right.

After I’d been hanging out at home for a few months, a doctor who admired
The Eden Express
and ran a small psych hospital in Florida offered to pay an honorarium and for my whole family to fly down to Disney World if I would come talk to their staff and patients. I enjoyed being a professional and trying to give them their money’s worth. I didn’t tell them I had been crazy again and was just a few months out of the hospital.

I ate steamed blue crabs off of newspaper-covered picnic tables and liked that a lot. Maybe this was what Tigger does best.

Shortly after that, my partners let me come back part-time and then full-time. It was a huge relief to be doing something I knew how to do and could get paid for. Maybe in some sense I was and still am addicted to taking care of other people’s problems. Faced with sick children and worried parents again, I felt useful.

There was nothing to do for my mother except to be with her as much as possible while she was dying. When she looked around the Cape house, which she had treated more like a friend and co-conspirator, she was radiant and proud and whole. She had come from very little and created a great deal for many, many people. At the end, she toned down the “Aunt Jane” and acknowledged what my sisters and I had been through. She talked without rancor about Kurt and she said she was glad I didn’t drink anymore. Her initial response had been “Oh no, you’re not an alcoholic. You’re a nice boy.”

During the Bow Wow Boogie that year, three months clean and sober, in the ninth inning of the final game, I threw out a runner trying to go to third on a dribbler out in front of home to preserve the tie. Then I drove in the winning run with a single in the bottom of the ninth. It was no more or less likely than the Red Sox that same year going on their incredible run to get into the World Series and then blowing it with the soft grounder that went through Buckner’s legs. Baseball was something to count on in this crazy world.

With mental illness the trick is to not take your feelings so seriously; you’re zooming in and zooming away from things that go from being too important to being not important at all. So I was watching my thoughts in a detached way. I could zoom in or out to see how they looked without trying to change them. If I was lucky, I might find things that could be part of how I try to tell the truth.

The first truth is that none of the thoughts going by are worth drinking over.

Alcoholism and mental illness aren’t very different and I had both. When I believed that I was well because I worked hard and made good choices … when I believed I was well because I deserved it … I was living in a shoe box. My worries were my enemies, and my best tool was my ability to hold my breath. I was, in fact, a good doctor, and that seemed important, but the importance kept pleading for itself in a way it shouldn’t have had to do.

Amazingly, during or shortly after that last break, something broke through the thick plate-glass barrier between myself and the rest of the world. I didn’t have to stop and think anymore about what a good father or a good friend or good husband would do.

At the end of my drinking I had a baby-poop-brown underpowered Subaru that I picked out in the dark when my underpowered baby-poop-brown VW died. The three cars I’ve had since have been a sleek black Honda Prelude with four-wheel drive, a red pickup truck, and a red Mini Cooper S with racing stripes and the extra thirty-seven horsepower.

Sometimes when we’re stopped at lights, other drivers look at me, and I look back at them like “Who are you looking at?” before I realize it’s my car.