Just Like Someone Without Mental Illness Only More So (27 page)

No one is going to look at me and say, “Look at the bald
guy,” but I have less hair than I used to. When I saw a circular little bit of shiny skin showing through the top back of my head in a photo, I thought there must be some mistake, that the light must have hit my head in a certain way and made it look like a bald spot.

Once upon a time, my hair was not only thick but halfway down my back as well. I’m not sure my hair would even grow that long anymore. It gets lonely and wispy a few inches from my scalp. I used to have
hair
. Now I have these here and those over there. When I was younger, one place on my head was pretty much like any other. I’ve had more than my share of hair but had hoped for more than just being able to pass for not bald.

I wasn’t really accusing my barber of anything when I mentioned the “indicator strip.” I had suspected for some time that the hairs just to the left of the middle part became annoyingly long and unmanageable four or five weeks after a haircut so I would know I was supposed to go back and get another one. I thought it might be a small trade secret and was curious to see what Al would say about it.

Al had been cutting my hair for years, but he and I didn’t usually talk much. The lack of mandatory chatting is something I value in a barbershop. People do talk there. It’s banter about sports mostly, but if you don’t want to, you don’t have to talk. I tried some more upscale places to get my hair cut a long time ago, but even when I had an appointment and was on time there was something awkward about how I came through the door or checked in or said I had an appointment that led to my sitting awhile listening to the snipping and whispering while easier, more graceful people got their hair cut.

There’s no whispering at my barbershop. Al couldn’t whisper on a bet. We’d had some conversations before, actually
more like contests to see if we could remember the same things about old Red Sox teams and Elvis Presley.

We talk more now, and what broke the dam was my asking him if he deliberately leaves a lock of hair just to the right of my part that becomes unmanageable four or five weeks after a haircut so I know when I’m supposed to come back.

He was a little surprised.

“Not really. We don’t leave an indicator strip or anything like that,” he said after a pause, during which he just stood there with scissors and comb in his hand. I thought that that would be the end of it, but then he started talking. “This is really a Dorchester haircut I’m giving you, not a Hyde Park haircut at all. Your hair is thinning on top. Not bad. But it’s less noticeable if I leave a little more on the sides and shape it down. When you have a lot of hair it doesn’t really matter how you cut it.” He has a toupee.

We both agree that being in good health and looking good for guys in our sixties is better than the alternative, but that what we really want is to look good and be nineteen.

There was something wrong with me besides hearing voices and jumping through windows, besides schizophrenia or manic depression or schizoaffective disorder. What was wrong with me was that I couldn’t love or accept love.

Besides that, Mrs. Lincoln, how was the play?

It seemed unfair that someone who worked as hard as I did to be right about so many things should be unloved. There were people who liked me or seemed to like me, but what if I wasn’t a doctor, hadn’t published a book, wasn’t Kurt Vonnegut’s son? The truth is, I was terrified and wouldn’t have trusted or accepted
love if it came and sat in my lap—
especially
if it came and sat in my lap. I didn’t have the faintest idea who I was. Publishing a book, getting into medical school, and getting to be a pretty good doctor saved my life and kept me barely alive, but by the time I went crazy for the fourth and, I hope, last time, my soul was on life support.

I had a prayer that went, “God, whatever I am, let it be for good.” By my mid-thirties it had morphed into “God, what the f—— am I?”

Now I’m sixty-two. My first child is thirty-two. His son is walking and talking. If you don’t want to miss life, don’t blink. Somehow having my awesome willpower come up short against alcohol got rid of the three-inch-thick Plexiglas separating me from the rest of the world. I can now love and accept love.

I get to see people at their best. No one wants to be a lousy parent. I’ve seen hopeless narcissists become good parents and stop being narcissists. I didn’t think that was possible.

The best parents are poor people who have a little bit of money and rich people who have had a little bit of poverty.

By the time he is twelve years old the average child has heard about drugs, alcohol, and unsafe sex so often that the messages are blocked before reaching consciousness. He has also been told over and over that if he works hard and gets good grades things will go well for him, which is a lie. Drugs are a way to be dead but just for a little while.

I find I can sometimes break through the glaze of boredom by saying things like “If you’re having trouble making decisions,
maybe you should smoke a lot of marijuana.” Or “The great thing about not having a drinking problem is that you can drink yourself into a blackout whenever you like.” Or “Safe sex is better than no sex at all.” These can lead to useful conversations.

All you have to know about the power of will and choice is that most drug addicts can’t stop, even when they want to.

Not infrequently, a boy will hand me a cup of pee that couldn’t have come from him because there are vaginal cells in it or signs of a period or a urinary tract infection. The first sign of something wrong is often that the temperature of the pee is closer to room temperature than to 98.6. Another clue is when the person being tested tells his parent that he’ll go wait for them in the car.

“Go get John. I have to talk to him,” I say.

The parent knows better than to ask why and retrieves the invariably bristling, sullen “What is up with this lame doctor?” patient.

“It’s not your pee,” I say.

“It’s not my pee?” Shock, outrage, and denial.

“It’s not your pee.” This can go on for a while.

“How can you tell?”

“It’s too cold. And it came from a girl. If your parents think you need a drug test and you can’t beat the test with someone else’s pee, you don’t have a gift for getting away with things.”

“Are you going to tell my parents?”

“No, you are. I’d rather not deal with your parents directly.
The only reason for me to test your urine for drugs is to help you stay clean when you’ve decided that’s what you want. The fact that you’re fifteen years old trying to pass off someone else’s urine as your own means to me that marijuana is probably not your friend and might get in the way of whatever else it is you want your life to be about. Did you pay for this pee or was it from a friend?”

On the Internet you can buy fake pee to pass drug tests that comes in a realistic penis container so that when the test is strictly monitored, which means someone is in the bathroom with you and watches the pee go into the cup, you can squeeze the pee into a cup from the fake penis.

I don’t monitor my patients giving urine, mostly because my job is hard enough without hanging out in bathrooms with adolescents who are trying to pee. Partly I’m trying to give them a shred of privacy and dignity, and partly I’m curious as to whether, given the chance, they’ll try to give me someone else’s pee. Catching them at it, especially early in the process, especially when I’m not really trying, has led to conversations in which the patient actually ends up caring about whether or not he does drugs. Sometimes.

When the urine drug screens I send out are negative, sometimes it’s even because the patient involved isn’t doing drugs. Consider all the possibilities.

If I see someone and I don’t recognize him because all the softness and pinkness has melted out of his face, I assume he’s doing drugs. Addictive drugs take all your little problems, like having a difficult family or feeling insecure, and trade them in for one big problem, having to have drugs. Childhood isn’t fun
for everyone. One of the attractive things about drugs is that they give children a way to stop being a child. Bye-bye pain and fear; hello addiction.

If there is a last judgment, if there’s an outside chance of a last judgment, do you want to be standing there with someone else’s pee?

Parents tend to think that a negative or positive drug test accomplishes more than it possibly can. If their child has clean urine, all is not necessarily well. If the test is positive, very few children, confronted with proof of drug usage, will stop. They can’t. I care about the results of the drug test, but the real goal is for the child to have a life that doesn’t involve being in my office, handing me a cup of urine that might not be his.

A positive drug test is an opportunity for collaboration. If we can’t come up with clean urine, we’re going to have to keep doing tests that cost money and take valuable time out of our day. The easiest way to come up with negative drug tests is to stop doing drugs, but it goes better if you let the child think of that on his own. Then not doing drugs is no longer a moral issue but a practical, cost-effective way to deal with the annoying problem of having illegal drugs in your urine.