The Center Cannot Hold: My Journey Through Madness (33 page)

The thoughts grew more insistent; within minutes, I couldn't push
them away anymore. It was afternoon; I knew Steve's schedule, and I
knew it'd be hours before I could track him down. So I called Steve
Wizner in New Haven instead.

"Elyn!" came his voice on the phone. "How nice to hear from you!"

"How are you doing?" I asked. "I'm a her-o, not a him-o. Heroic
efforts. Put in one's time. Like prison. I see through the prism of life.

I've killed lots of people."

"You need to call your doctor, now," he said. He knew about
Kaplan; he knew that Kaplan had taken over my treatment at White's
recommendation.

"All right," I said, and called Kaplan's answering sendee. While I
was leaving the message on one coast, Wizner called from the other,
leaving an urgent message with Kaplan's sendee that my situation was
indeed an emergency.

Within the hour, Kaplan called me back. "Steve Wizner tells me
you're not doing too well this afternoon," he said. "So what's going
on?"

"On is a manner of speaking. Off may be more like it. I don't like it
at all, thank you very much. I refuse to be killed. I'll kill back. Are
people trying to kill me?"

"I'd like to meet with you at my office in an hour," he said. "Can
you come?"

"Yes, but it's Sunday," I said. "The Sundance kid. Bearded and
gray. With all the interferences."

"My office in an hour, OK?"

"OK," I said. "OK."
Only terrible patients must be seen on a
Sunday. Will Kaplan terminate me and make me get lost? He could
do better. Who is interfering with my thoughts? What do they want
from me? What will they make me do?

Kaplan was already in his office when I got there. "Come in, Elyn."

I sat down. I was holding myself, rocking and scared.

"You seem like you're having a hard time," he said.

"I'm doing hard time. For all the crimes. They're doing them
through me, though. The ones in the sky. I'm an instrument. An
instrument of the devil. Please don't let them kill me. My head is so
hot on the inside. I'm afraid it might explode."

"You're having psychotic symptoms now," he said. "The things
you're afraid of aren't really happening."

"I know they're real," I said. "They seem crazy to you, but they're
real. I'll reel them all in. Tell them to get away!" I was rocking and
grimacing, flailing my arms as though I were fighting interference
from the beings.

"White used to raise your dose of Navane when you were feeling
like this," he said. "So I'd like you to go up to thirty-six milligrams for a

few days."

"It's not a medical problem," I moaned. "It's a matter of good and
evil. Innocent children are being hurt. There's the store and what's in
store. Cries and whispers. Fear and trembling and sickness unto
death."

"Yes, I know you are in terrible pain," he said. "Do you have
Navane with you?"

"Yes."

"Then count out eighteen pills and take them right now, OK?"

"OK." I reached into my bag, fumbled for the pill container, and
carefully counted out eighteen on the desk. Then my paranoia turned
to Kaplan. "Which side are you on?" I asked. "Are you trying to hurt
me or help me?"

He handed me a glass of water. "I'm trying to help," he said.
"You're having a hard time now, but you should be feeling better soon.
I'll see you tomorrow for our appointment in the morning, and I'll call
you at home tonight to see how you're doing. OK?"

"OK," I said, then dutifully took my pills and went home.

Kaplan called that night as he'd promised; I was still having fears,
the beings had not entirely receded, so I was reassured to hear his
voice. By the next morning, I felt measurably better.

So—now he'd seen it. He didn't get scared or try to put me in the
hospital; he did exactly what White would have done, and he talked
me through it. I felt comforted in that continuity. They'd both said we
would be able to make that transition, but I'd feared it wouldn't
happen, and now I saw that it would.

On the other hand, Kaplan was already taking a firmer line on
medication than White. This became the theme of our next few
appointments. He wanted me on a higher dose of Navane; I resisted,
believing that the less medication I took, the less defective I was. I
stayed at thirty-six milligrams, just long enough to feel better, and
then I started sneaking my way back down again. I didn't miss a class,
and was able to get back to my writing in a couple of days.

So, right off the bat, Kaplan and I laid the groundwork for our
years-long battle—how much medication he thought I needed vs. how
little medication I thought I needed. Our relationship would become
similar to almost any other relationship between two strong-minded,
stubborn people who see each other often. Some days it worked well,
even happily. Other days, it was an unmitigated disaster.

chapter nineteen

I WAS BEGINNING
to feel somewhat comfortable with a few of my
new colleagues, and when I met with them one-on-one, or in a small
cluster of three or four, for coffee or a meal, I thought I managed
myself just fine. In fact, I soon became the person who gathered
people up to go out for lunch every day. I pushed myself to start doing
this because I was so scared that if I weren't the one doing the
gathering, I'd be left out entirely. (In fact, I continue rounding up
everybody to this day, and have become known in the law school as
"the Lunch Mother." I think I should get committee credit, but the
dean will have none of it.)

With more than a handful of people at a time, however, I was in
agony—the term "painfully shy" was apt. Speaking in or to a large
group of people struck terror in my heart. I was convinced I didn't
have anything interesting to say. Maybe USC had made a mistake in
hiring me; maybe other people were beginning to wonder about that
as well. I'd acquitted myself well enough in my interviews, but
sustaining that first impression over the months and years it would
take to get tenure—I worried that I wouldn't be able to handle it.

Perhaps sensing my struggles, one senior colleague, Michael
Shapiro, took a special interest in me and my work. Though he had a
gruff exterior, I quickly discovered that Michael had a great capacity
for empathy and old-fashioned friendship. A noted scholar in the
fields of bioethics and constitutional law, he wrote the first casebook
on bioethics,
Bioethics and the Law: Cases, Materials, and Problems
(with Roy G. Spece, Jr.). Michael began to read the drafts of my
papers, and he talked with me about ideas for writing. Once every few
weeks, he invited me to his home for dinner with his then-wife and
little boy (ultimately, there'd be two little boys joining us). To sit
around a table with a family—"would it even be possible that I might
have something like this in my own life someday? I hadn't realized
how starved I'd been for the human connection until Michael
extended his friendship, and what a timely gift it was. As a tenured
professor, he certainly could have spent his time in other ways, but he
chose to spend some of it with me. If someone like this finds value in
me, I thought, then perhaps there
is
value in me.

Edward McCaffery was another colleague who went out of his way
in those early days to be kind and inclusive. Ed was my "classmate" at
the law school—we started at the same time, our offices were next
door to each other, and we ultimately received our endowed
professorships in the same year. As the "new kids," Ed and I spent
hours trying to figure out our senior colleagues, strategizing about
how we'd get tenure, and sharing ideas about how to develop good
reputations in our respective specialties—his was the federal tax
system and its Byzantine code. He's widely published, and widely read
and respected by legal scholars across the country.

As that first semester went along and I seemed to be managing OK,
I began thinking about my second law journal article. One of my
colleagues mentioned seeing an article in the newspaper about a man
with multiple personality disorder (MPD) who was then on trial for
murdering his parents. I was immediately intrigued by the legal issues
raised by such a case: How could a court assess criminal responsibility
for someone with multiple personalities? If the person had ten
personalities, would all ten have to be guilty to put the person in jail?
Or would one guilty personality be enough to convict? If there were
ten personalities, and only one was cognizant of having committed a
crime, what rights to a defense and subsequent protection did the
others have?

The more I thought about the case and its practical complexities,
the more fascinated I grew with the philosophical questions as well:
What is a person? What's the difference between a person and a
personality? Can a person have more than one alternative personality?
I quickly discovered that while this situation may have been a staple in
daytime television soap operas over the years, very little scholarship
had actually been written about it. Even before I started any serious
research, I drew up a working outline in my mind. If I really work
hard, I thought, I could have a completed draft by the end of the next
summer. My article on competency would be ready to submit to law
journals by then, too.

Thinking about MPD, of course, led me to ask similar questions of
myself: Who was I, at my core? Was I primarily a schizophrenic? Did
that illness define me? Or was it an "accident" of being—and only
peripheral to me rather than the "essence" of me? It's been my
observation that mentally ill people struggle with these questions
perhaps even more than those with serious physical illnesses, because
mental illness involves your mind and your core self as well. A woman
with cancer isn't Cancer Woman; a man with heart disease isn't
Diseased Heart Guy; a teenager with a broken leg isn't The Broken Leg
Kid. But if, as our society seemed to suggest, good health was partly
mind over matter, what hope did someone with a broken mind have?

My class for the second semester was criminal law, and I was greeted
on the first day with what seemed to be a large, yawning auditorium
filled with seventy students, every single one of them looking straight
at me. Although it was a lecture class, I was so weak from anxiety that
I couldn't stand, and a few minutes in, I just had to sit down. I sat
down for the rest of the semester.

I knew going in that I wasn't as adept with criminal law as I was
with mental health law, and from the very beginning I fell behind
almost as fast as any clueless student. Most of the questions I was
asked in class, I had to research afterward on my own. Often, I found
myself so anxious and distracted that I missed most of what the
students were asking or answering. I didn't like the performance
aspects of lecturing to a large class; I knew I'd never be able to master
that. And I really didn't want all those people looking at me.

At the end of that semester, the course evaluations (unlike the
positive ones I'd gotten from the mental health seminar) showed that
I wasn't the only one who felt the whole experience had been
torturous. One student wrote, "Professor Saks is a very nice person,
but a very mediocre teacher." Another comment was even more
painful: "Didn't anyone ever interview this woman before hiring her?"
When I first read that, I wanted to put my head down on my desk. In
time, I could read it again and find some humor in it. He was right; I'd
been just terrible. He'd applied to a good law school, he (or someone)
had paid good money to be there, and for all that, he got me.

For the end-of-the-year humor issue of the
Law Review,
my
lecture class got a send-up all its own: "Elyn R. Saks, the sitting
Socratic method: lessons in dynamism."

I taught criminal law class four years, and although I became a
little better at it each time, I never got comfortable there, and
approached the evaluation period each time with the same dread. My
reviews got better, but I always disliked teaching first-year students.

As I liked to say, the neuroses of first-year students conflicted too
much with my own.

I was battling my usual demons outside the class as well. I still
wasn't talking much, except to the three or four people I was gradually
becoming close to. After one particularly difficult faculty workshop, a
colleague took me aside and said I really needed to take more part in
faculty discussions, both formal and informal. "I don't mean to be
insulting, Elyn," she said, "but you're practically comatose in there." If
I hadn't been so mortified, I might have laughed out loud at the
familiar terminology.

"Thanks," I said, and I meant it. "I appreciate your coming to me
with this." I could hardly tell her how hard it was to relax and enjoy a
meal or a meeting with colleagues while your demons bang on the
closet door and demand to be let out.

When that first year finally came to an end, I was hugely relieved,
and Ed and I went out for a nice dinner to celebrate. We each had a
drink (something unusual for me, as I don't like the effects and,
besides, drinking doesn't go well with psychotropic meds) and toasted
each other's success: We'd made it through year one.

With classes ended, I had nearly four months ahead of me to work
away at my game plan. And of course, I couldn't let well enough alone.
No longer responsible for students, I decided it was time to get serious
about stopping the Navane. Kaplan reluctantly agreed to cooperate,
and slowly I started reducing my dose. A month later, my psychosis
was in charge.

Except for my appointments with Kaplan, I kept to myself. "I'm
having headaches," I told him. "Head Aches, Aching Heads. Maybe
another bleed. Blood simple. Ha ha ha. Laughter occurs behind the
scenes. I'll take the scenic route."

Kaplan knew immediately what was bothering me. "You're worried
about your health," he said. "That's understandable, given your
history. So why not face that fear head-on and go see a doctor to
reassure yourself? I highly recommend an internist, Edwin Jacobson."

"The blood is all over. It's all over for me," I said. "OK, I'll go to see
Dr. Jacobson."

When I got to Jacobson's office, I explained that I'd had a bleed
and was having terrible headaches. He asked questions; I answered as
best I could. Some of what I said made sense; much of it didn't. "I'm
worried about my headaches. My brain may come out of my ears and
will drown lots of people. I can't let that happen."

Obviously he'd spoken with Kaplan, and the way in which he
responded could not have been more on point. "You don't need to
worry about drowning people with your brain, Elyn. That can't
happen." His voice was calm and reassuring. "It sounds like Dr.
Kaplan is right, that you need to go on more medicine. It's just like if
you had something like diabetes; you need to be on enough medicine
to keep your balance."

He hadn't argued with me; he didn't try to out-doc me. Rather, he
reassured me that there was nothing for me to worry about. That is
what I needed most—for my medical doctor to quell my anxiety—and
he did. And he'd used a metaphor that I could understand. As with
diabetes, my illness
was
treatable; as with diabetes, I simply needed
to treat it. I'd heard this metaphor before, but it stuck with me this
time.

In our next session, Kaplan made it clear that he wanted me to
increase my Navane. That session really disturbed me. It just didn't
feel good, on two counts: first, because Kaplan was telling me what to
do; second, because the increase made me feel like a failure. I resented
both things, but grudgingly agreed to go back up to thirty-six
milligrams.

Soon after that, I left for a few days of vacation in New York, where
I visited with my parents and spent some too-brief time with my little
niece and nephew. I didn't expect children of my own, so to have these
two as part of my life always gave me great joy.

And I made a special point of getting up to New Haven and seeing
Jefferson, who was now in a somewhat more stable position in a group
home.

"Hi, Elyn," he said, and there was the beautiful smile I
remembered. "I remember you, you're my friend. It's going good. Can
we get some ice cream? Where you been?"

"I moved to California," I told him. "It's on the other side of the
country so it's tough to come and see you more often. How have you
been?"

"Good," he said. "Got a job now. I put things in a box. It's good."

It sounded good; I hoped it was. "Let's go get that ice cream, OK?"
I said. "And I'll come and see you next time I come to Connecticut.
And you know, you can call me if you want. Your house has my
number."

"OK," he said. "Ice cream, and then you'll come see me soon."

I was pleased that he seemed to be doing better—I wanted him to
thrive. Given his vulnerability to the vagaries of the system, it was easy
to see myself in him. If he was safe and happy, it meant that maybe I
could be safe and happy someday, too.

And the news over time got even better: I recently learned that
Jefferson had been featured in a local paper for certain artistic
achievements, and that gave me a modicum of comfort that perhaps
our involvement had been a positive one in Jefferson's life after all.

When I returned to LA, there was still plenty of summer left. I went
back to my office, where I spent nearly every waking hour. As long as I
stayed on my meds, I was able to concentrate, and by summer's end,
I'd completed a first draft of my multiple personality disorder paper.
My article on competency, the first piece in my tenure portfolio, was
finished. It was ready for law journals to review for publication.

Bob Cover's memo had been my first test as a law student; the
competency article would be my first test as a law professor. I put
forty copies of the article and a cover letter in the mail, crossed my
fingers, and wished them luck.

Law journals accept articles by phone; rejections come in the mail.
Within a couple of weeks, my mailbox was full and my phone wasn't
ringing. Not having my first article published would end any realistic
chance for tenure and crush any hope of my becoming a real
professor. I felt as if I had been tested for some fatal disease; at any
moment, the doctor of doom would call with the bad news. I watched
the phone as though it were alive. And then one day, it actually rang.

The call was from a law journal whose standing was not very
strong, and acceptance into which would be little help to me in the
tenure process. By the following day, without having heard from
anyone else, I was convinced my project to be a law professor was
lurching toward failure. I'd end up on the streets, alone and disgraced.
In a matter of hours, my disappointment turned psychotic.
They're
trying to kill me with faint praise and my head is so hot on the inside
it hurts.