The Center Cannot Hold: My Journey Through Madness (41 page)

Battered but unbowed, Alicia and I (and our respective families) made
it through our cancer battles. We were tired and shaky and a little
ragged around the edges, but by God, we were going to throw a
wedding!

For weeks in advance, Will baked cakes and tested recipes, and
every few days there was another confection. Remember when you
were a kid and said something like "Someday, when I grow up, I'm
going to eat all the cake I want!"? Well, that's what we did, every night
after work. A French cake, with beaten egg whites and ground nuts. A
ginger-flavored one, with fresh raspberries. A creamy lemon one,
which Will then switched to orange. Yes, we both agreed—that's the
one! Happily, we then hired a caterer to prepare and serve the rest of
the food. If Will had tackled anything beyond the cake, both the
kitchen and our relationship would have been at risk.

He'd also been taking a computer animation course, and was
about halfway through the "advanced editing" section of the class
when he came up with an ingenious and very funny form of wedding
invitation. It was a video, which opened with the theme music from I
Love Lucy,
the familiar typeface that the show always used, and a
black-and-white scene in Lucy and Ricky Ricardo's living room—with
Will and me appearing as Ricky and Lucy, complete with scripted
dialogue. For the background, he'd done some "screen captures" from
Nick at Nite, then matched the video frame by frame, substituting
pictures of me and Will into the "portraits" of Lucy and Ricky on the
living room wall. When he dropped the driving directions into the
video, he used the theme music from the old
Route 66
TV series, and
to end the invitation, he closed with the theme to the Jackie Gleason
show. We sent out fifty copies all over the country. Not for me the
heavy ivory bond paper from Tiffany's; no, this wedding was being
announced with a contemporary cultural artifact!

We were married in June, on a beautiful sunny day. Janet and her
husband Al, and Michael and Ed, from the law school, were my
witnesses; Steve and Alicia were my people of honor. Afterward, Steve
gave a loving and hilarious toast.

In spite of the free-form nature of the event, there was just enough
tradition to fit my sense of what a proper wedding should be. My
family was there. My brother, who had been struggling with a terrible
phobia of flying for some time, managed to make the trip. It was the
most generous gift he could have given me.

That's not to say the day was without a bump or two: Earlier that
morning, after I'd had my hair done, Steve and I were out sitting in my
car, talking quietly, away from the din of preparations. A serious
question had been troubling me for hours, and finally I just had to ask
it. "Will aliens be attending the reception?"

"No," he said calmly, and he reached out to hold my hand. "There
won't be any aliens there, Elyn. Don't worry about that."

I needed to hear that reassurance from him, and having heard it, I
happily went on with the day. It was as beautiful as I ever could have
imagined, and it left me feeling quite fragile, as though a sudden noise
or movement would blow the dream wide open. It was true, then: I
was married, to the man I loved.

Will and I went on a honeymoon trip to France and England.
There, we met up with old friends from my Oxford days—Patrick,
Dinah, and Janet—and had great fun reminiscing. Janet was
romantically involved with a nice American man, and her lovely
daughter, Olivia, was now the age I had been when had I lived in
Janet's house. Though many miles away, I had continued to love and
value these people who'd stayed my constant friends, and I always
believed that they felt the same about me. And now we could add Will
to the mix. Will, my husband.

Within a few years, with two dozen articles and three books published,
I was deemed deserving by the law school to receive an "endowed
chair," one of the highest honors that a university bestows on a faculty
member. On a spring afternoon, with friends and family gathered, the
University of Southern California Law School named me the Orrin B.
Evans Professor of Law and Psychiatry and the Behavioral Sciences.
Ed McCaffery—my "classmate" and dear friend—was similarly
honored with his own chair. It wasn't hard to remember our first days
wandering the law school halls together, trying to figure out what we
were supposed to be doing in order to be successful, and half worried
that any minute we'd be "discovered" as poseurs. I was so happy that
Ed and I were honored in this way at the same time. In my acceptance
speech, I even dared to make a small joke, suggesting that perhaps a
couch would've been more appropriate for me than a chair. Afterward,
there was a lovely luncheon reception at the Town and Gown (often
referred to as the "living room" of the university), and that was
followed by another party that my family threw for me that night. It
was a beautiful day, and a night full of great fun and strong emotions.
It seemed that I had come at last to a time in my life when there were
more good days than bad ones.

chapter twenty-four

T
HE HUMAN BRAIN
comprises about 2 percent of a person's total
body weight, but it consumes upward of 20 percent of that body's
oxygen intake, and it controls 100 percent of that body's actions. So in
terms of how much territory the brain occupies vs. how much power it
wields—well, it is mightily powerful indeed. And as much as we've
learned about the brain over time (especially in the last two decades),
we're nowhere close to knowing everything. Each revelation opens the
door to a new set of questions; each mystery solved leads to another
mystery. For a research scientist whose primary focus is the brain, it
must sometimes feel like the laboratory is more akin to a hall of
mirrors; for me and my somewhat ad hoc exploration of the brain, it
feels on some days like I'm walking on the edge of the Grand Canyon,
constantly at risk of taking that one big wrong step. And always, just
before I fall, comes the same question: How did I get here?

As successful as I'd been on the Zyprexa regimen, I had my usual
concerns about side effects; after all, it was still a relatively new drug.
And then there was the annoying weight gain, which I was having a
hard time reversing. So once again I wondered about lowering the
dosage. Could I do it, and, if so, how far could I take it and still be
safe? When I discussed it with Kaplan, he agreed to go along with me
this time, on one absolute condition: If, in his judgment, I was in
trouble and he decided I needed to go back up on my dose, I'd do it,
immediately—no bargaining, no equivocation.

"You have to promise me," he said firmly.

"OK," I agreed. "That sounds fair."

As I dropped my levels over the next few weeks, I faintly sensed the
fog drifting in, the early signs of disorganization beginning. I gritted
my teeth and concentrated on work.
I can adjust to it
, I thought.
It'll
get better. Just wait.
I flew east for my tenth law school reunion
(accompanied by the familiar horrors on the plane flight), and for
most of the evening's program at Yale, I sat next to Steve and
struggled with the urge to jump out of my chair and scream at the
terrifying creatures hovering in the air around me.

When I returned home and reported in to Kaplan, he quickly
invoked our pact: I needed go back to a regular, healthy dose of
Zyprexa. We settled on my usual dose of forty milligrams, double the
maximum dose recommended by the manufacturer but one that had
worked well for me before.

Soon afterward, I went to San Francisco, where I was scheduled to
present two papers at a weeklong conference on dissociative
disorders. Evidently, the Zyprexa withdrawal had been rougher on my
system than I knew, leaving me vulnerable and even a little frail. I
began to feel "off' soon after I arrived at my hotel. Once again, I
gritted my teeth and narrowed my focus to work and my obligations at
the conference, hoping no one would suspect anything was wrong. But
the delusions and the disorganization accelerated; I was coming apart
at the seams. I called Kaplan.

"If you can, why don't you deliver your Saturday paper, as
scheduled," he said, "and come back here. Then you can fly back up
early Wednesday morning to deliver that one."

On some level, his suggestion made sense; I was never very good in
unfamiliar territory, but maybe I could regain control once back in LA,
in my own apartment or in the haven of my office. But as I mulled over
Kaplan's suggestion, I decided that having to leave the conference
would signal that I was a failure. Of the two scenarios—being sick vs.
being a failure—I could more easily accept the first one. So I decided
to stay.

At which point my sickness took a new, horrific turn. For some
reason, I decided that Kaplan and Steve were imposters. They looked
the same, they sounded the same, they were identical in every way to
the originals—but they'd been replaced, by someone or something.
Was it the work of alien beings? I had no way of knowing, but I was
terrified.

Much later, I learned that what I was experiencing was called
"Capgras syndrome." The scientific literature about Capgras likens the
sensation it produces to the cult film
Invasion of the Body Snatchers.
In my mind, the people I so depended on were simply gone, and the
two who remained were not who they said they were. Therefore, I
could not trust either of them.

It was a struggle, but I delivered my Wednesday paper and fled
back to Los Angeles, shaky and completely paranoid. In nearly ten
years of treatment, I had never missed an appointment with Kaplan.
Now I didn't go to my next two scheduled sessions, and didn't call him
to tell him why. So he called me. "Elyn, you're not at your
appointment. What's going on?"

I did not respond.
It's not him. Don't say a word, it's not him.

"Elyn, what's happening?"

Nothing.

"I think it's important for you to come to your sessions," he said. "I
expect you to be here tomorrow. Is there something I can do?"

"I know what's going on and who you are or are not," I said finally.

"That doesn't get us anywhere," he said. "Talk to me straight."

Nothing. No answer.
Because you are not you.

"Okay, then, I'll see you tomorrow." And he hung up.

I did not attend our next session.

Steve, sensing that something was very wrong, was calling
frequently. I didn't return any of his calls.

Will, of course, recognized that I was very agitated, but he didn't
know why. "What's going on?" he asked.

"The two who call themselves Kaplan and Steve are imposters," I
said. "The real ones are gone, and they've been replaced; the ones who
are leaving messages on the answering machine are fake."

To his everlasting credit, Will stayed calm. I'd warned him that this
might happen, and now it had. "Maybe I should call Steve," he said.

"I don't see the point, since Steve's not there anymore," I said.
"But go ahead, if it wall make you feel better." He thought it over for a
while, then called Steve in the middle of the night. Steve awoke early
to find the message on his machine and called back. As best he could,
Will explained what was going on.

Steve began to call and leave messages for me on the machine ten,
sometimes twelve times a day. I ignored them—because he wasn't
Steve. And I got angry—because he was treating me like a recalcitrant
child. In analysis, there's a term for this: infantilizing. How dare he, I
thought, looking at the answering machine as though it had been
manipulated by aliens as well. But of course, he was in an impossible
situation.

I was frightened and isolated. Even though I somehow knew that
Will was the real Will, I found no comfort in that. I couldn't sleep, I
couldn't work, and I couldn't make the connection between what was
real and what wasn't.

The next day, after my third missed appointment with him, Kaplan
called and insisted I go up on my Zyprexa. Although I knew in my soul
that he wasn't really Kaplan, I paid attention to him, because I was
just that desperate and miserable—and over the next several days, the
delusion slowly passed.

If I was still harboring any hope that I would someday be free of
the need to take antipsychotic medication, losing both Kaplan and
Steve to my psychosis convinced me utterly.

This was Will's first major experience of me as wildly delusional.
He didn't get too scared, he didn't go away, and he never treated me
with anything less than kindness and tender care. Afterward, he did
admit to being shaken to see me so disturbed and unhappy, and being
frustrated at not being able to comfort me or calm me down. "But I
still want you to tell me when you start to feel like that," he insisted.
"I'm not much use if you don't let me know what's going on."

Sometimes, even now, when I'm going into an episode, I don't tell
him—not to keep secrets, but so as not to burden him. Nevertheless,
he almost always knows. He can tell from my silence—or a certain
kind of silence. It's a gift to have someone know me so well.

Dr. Kaplan and I had done years of good work together—thirteen
years, to be precise. And I'd accomplished many successful life
changes during that time. But he'd often been hard on me, and over
time (Kaplan's many strengths and his humanity as an analyst
notwithstanding) it had come to feel too hard, even punishing. He'd
become more restrictive somehow—for example, he didn't want me
moving around the office; he didn't want me to cover my face with my
hands during our sessions, something I'd done with all my analysts to
help me feel safe and contained. He kept saying that if things didn't
change, he'd "terminate" me. "I'm going to terminate you." It was
brutal to hear that, brutal for him to keep saying it. Was he doing it to
elicit some kind of response from me? I didn't feel safe with him
anymore; he was unpredictable, mercurial, even angry. Some days, I'd
walk out of session feeling like I'd been beaten up.