Tristimania (9 page)

I had trusted him from the very first appointment I'd had with him, several years previously, not in a state of hypomania but of severe depression. During the three months prior to that very first meeting, I had spent weeks intolerably isolated, mainly sitting on the stairs, en route to the unreachable kitchen or the equally unreachable bed. I eventually made an appointment, walking into his office with some almost-but-not-quite-fictitious ailment, unable to say anything about depression. He dealt swiftly with this semi-fiction. Then he slowed right down, and I felt him searching my face. He asked what I did for a living.

– I'm a writer.

There was a pause.

– That must be very lonely.

Five words.

I wept and wept. The loneliness of my writing life, which fed the shrieking isolation I felt in depression, was named aloud. In five words, it was spelled and dispelled. Five words which began to link me back to the unlonely world. Five words which released me into being able to talk to a doctor about depression for the first time in my life, although I'd suffered from it since I was twelve.

In the intervening years, I'd seen him several times, and I felt he knew me in wellness as well as in illness. He had a yardstick to measure both the heights and depths of this current episode. Without that prior knowing, what does a patient face? What can a doctor do? A patient may need to explain who they've become, in depression, just when they are sinking to silence. They may want to portray who they truly are when they are well, just when that seems an unrecoverable state of grace. A doctor, meanwhile, attempting in ten minutes to diagnose someone they've never met, is working blindfold, sticking the tail on the donkey. Both of them often end up meeting in the no-man's-land of typical symptoms and the prescription
du jour.

In the years between my very first meeting with my doctor and this Grand Madness, I had also used the placebo effect; if a person is ill, and they make a doctor's appointment, studies show they often begin to feel better simply because of having the appointment. So from time to time in those intervening years, if I was feeling shaky and low, I would make an appointment with him, and let the placebo effect work, and then cancel the appointment three days before.

John Berger wrote one of the most stunning books about the life of a GP,
A Fortunate Man: The Story of a Country Doctor.
‘Clearly
the task of the doctor . . . is to recognize the man. If the man can begin to feel recognized . . . he may even have the chance of being happy.' In some cases, Berger writes of Dr Sassall, ‘he faces forces which no previous explanation will exactly fit, because they depend upon the history of a patient's particular personality. He tries to keep that personality company in its loneliness.' This is a perfect rendition of the reason why my doctor was so curative for me. He kept me company in my loneliness. He
saw
me. He also saw where I was in this illness. There is a healing power in truth, sheer healing in honest appraisal, with nothing hidden, and he was candid. ‘You're very fragile,' he said several times; other times he variously remarked: ‘You've been very bad'; ‘You've been in dangerous territory'; ‘I've been very worried about you.' Those observations made me feel unalone. He was alongside me, and truly acknowledged where I was. In Berger's words, a good doctor does more than treat patients: he is ‘the objective witness of their lives . . . the clerk of their records'. By witnessing and then naming aloud the situation I was in, my doctor made it at once real and recoverable.

I felt he was completely on my side and also wholly present; it felt as if he brought his whole self to the appointments, and this was equalizing. My mind had cracked open, been riven, wounded, horribly exposed. If I'd had to see a doctor who was masked, defended or guarded, who played a role or who wasn't truly present, it would have felt unfair, creating a power imbalance I would have hated. In madness, anything which increases one's sense of weakness and vulnerability is detrimental.

My doctor also openly acknowledged medicine's limits in dealing with the mind and yet made me feel he was not out of his depth. (Many of my friends were, and said so, and while I appreciated their honesty it left me feeling in greater danger. I was completely
out of my own depth, after all.) I needed to feel I was in safe hands, and I was.

He could be funny and serious; he combined sensitivity with solidity. He was tact incarnate when he needed to be but could also apply blunt common sense. He also knew how to use the gears: when to move quickly and when to go very slowly. He simply
could
not have had the time he made for me: the hours, the late-running and over-flowing appointments. But he gave me – in his leisurely thoughtfulness, his unhurried manner – the impression that no time was unexpandable, no appointment unstretchable, that time and hurry and pressure and workload and speed were all a mild irrelevance which could be left in the waiting room with the forgotten umbrellas and the fluffy dinosaur. And yet the speed he used when he needed to was remarkable: first getting me on antipsychotics and later getting me to hospital when I could no longer see.

As the lead climber is just ahead of you on the mountain, so I felt he was just ahead of me in this crisis. When I was flailing around trying to force myself into recovery, impatient and angry with myself for all I could not do, he gave me wiser counsel, permission to be ill, repeatedly saying that, if I'd broken my leg, I'd have no problem accepting that I couldn't use it properly. A broken mind takes far longer to heal. Just as importantly, when the time was right, he gave me the encouragement and, more precisely, the expectation to be well.

At one point during this whole episode, I talked to one of my nephews about my doctor. My nephew usually has the sweetest temperament, but he became exasperated with me for the first time in his life.

‘You're talking about him like he's a god or something. He's not
a god. He's not a saviour. He's
just
a
man.
He's
just
a
man.
He's
just
a man.'

Three times. The vehemence of his tone drew me up short. We are very close and he understands me well. If he was upset, I knew there was matter in it. It was only later, when I read Darian Leader's
Strictly Bipolar,
that I could contextualize those feelings. Leader writes of manic-depressive patients idealizing their doctors: ‘Pages of disappointment with mental health workers and medication will almost invariably be followed by a sentence such as: “Then I met the best doctor . . .” ' Leader surmises that ‘it is not simply the doctor or the drug that has helped her but the actual function of idealization itself.'

Quite so, I thought, reading this. There you go. It's just a feature of being bipolar. I felt, as I did so often reading Leader's book, a sense of comfort in comprehension of the tricks and treats played on me by this condition, and there is, in my view, no other book which gives such a succinct and accurate portrait. And, at the same time, when I came to reconsider the question whether or not my doctor was a saviour, I have to say yes, he was: he saved my life. Was he an angel for me? Absolutely. I saw his wings.

I could ‘see' the wings of people only very rarely, but every time was when I felt they had sent their minds in flights of understanding to try to find mine. They could hear what I was saying and in turn, when they spoke, their words had the power to reach me. All of them could fluently speak a winged language, though accented according to their natures and the character of my relationship with them.

All of them had minds which were fleet, kind, exact, close and precise. Like, I cannot help thinking, Wim Wenders's guardian angels in his film
Wings of Desire,
which describes a vision of a world
in which we are surrounded by angels. Children see them. Angels recognize each other. Libraries are full of them.

I could see their wings when I had the strongest sense of an exchange, a commerce of comprehension which left me infinitely less lonely. When, in other words, they were being good messengers – and this is Mercury's doing: the winged messenger bringing images of wings. Part of the intensity of my gratitude is because they were willing to cross over into my sky – to risk the different temperatures and air pressures. They also gave my psyche strength, because it seemed to me that the touch of their wings in my mind suggested that perhaps I could even follow their flight down from the savage mountain into a meadowsweet valley – that perhaps I could trust their wings when my own were broken bits of sky made of stars as brilliant as stars are useless, scattered and disconnected across a cosmos of chaos and night.

Why wings? Because we fly, we humans, all of us, in thought, imagination and empathy. Not for nothing is Psyche winged, not for flight after death but for flight before death. Perhaps the human mind's age-old sense of angels arises from an insight of what is now called madness: the word ‘angel' comes from the Greek
angelos,
meaning ‘messenger', and in highly sensitive states the mind is quick to note the messages, hyper-alert to the transactions at the border between the outer universe of the world and the inner universe of the mind.

The idea of the angel seems the very force that drives poetry, the spirit of Orpheus, something which Charles Lamb understood, describing Coleridge as ‘an Archangel a little damaged'. Angelism (as an idea within poetry), famous in Rilke's work, is a term said to have been coined by French philosopher Jacques Maritain, while the Portuguese scholar Eduardo Lourenço described poetic angelism
as the practice of poetry where the angel stands as a metaphor for poetry itself, and for the driving force of
Logos,
the Word.

Wings, flight and feathers have a long association with the poet-seer tradition, so Hebrew shamans would chirrup like birds when they worked. Ireland's chief poets traditionally wore official robes made of bird feathers; court jesters wore a feather as part of their costume; and shamans around the world wear, or carry, feathers.

Angels and messengers like the Trickster can cross the border between inner and outer, between self and other; the messenger can transform, shapeshift, metamorphose, play the enigmatic role, occupy the quixotic space – genie, Ariel, bird or angel – and the moments when I saw people's wings were all when their psyches were inter-intelligent with my own, and I felt as lucky to have them around me as I would guardian angels.

‘I WANT TO DIE,' I wrote in my notebook, in capitals of capital punishment.

It is a truth of mixed-state hypomania that you live at the poles: angels and demons, heaven and hell, levity and gravity dovetail with each other, while a sickening seesaw hurls you from one to the other. The major key becomes minor with just one chord-note altered. So it is that one moment I could be keeling over with laughter at something and then, in a delirium of pain, I could have happily driven off a cliff with a flick of the wrist, or jumped heedless as hopscotch under a fast train.

It was nearly midnight. In all senses.

It was 11 p.m. on December 21st, and I was in anguish. I wanted to read John Donne, who, incidentally, wrote the first defence of suicide to be published in English. As Donne wrote of this day, the
shortest in the year, ‘'Tis the year's midnight, and it is the day's.' And it was mine. It was my midnight, mind benighted by itself. My life had set. To longest night.

I had had an appointment that day with my doctor but, with Christmas intervening, I wouldn't be able to see him for a week. The lifeline felt too insubstantial when it had to rope together days which were just too far apart. Its strength was whittled by time to a frayed thread. In that day's appointment, I despaired of my stupidity, because my doctor was saying the same thing – the same
right
thing, be it said: that I would get better and needed to take the medication. But this day I couldn't follow his leading. This day, despair flooded up in me. Suicidality engulfed me, and I began thinking seriously about doing a long-distance walk around the Welsh coast because in this flinty winter weather I could ‘fall' off a cliff without much effort and with no explanation required. No
apologia pro vita mea.
This idea had been at the back of my mind for some weeks, but on this solstice night suicide tolled, hollow, low, now.

I didn't take the medication that day. Despair and alcohol got there first, and though a couple of friends were trying to persuade me, I refused. And there it was, suicide, no longer like a tormentor outside me but inside me, coiling around my heart, manipulating my mind. I did nothing other than a kind of silent keening for an hour. And then at midnight I picked up the telephone and phoned a friend. Asleep. Another. Same. A third, and I was praying: please pick up the phone. I have a friend who is an author and journalist, a man of great kindness but also, crucially, one of those people with a willingness and ability to take charge in difficult situations and an alertness to urgency and danger. Most of all, at this moment, his words had power for me, his voice a strong authority. He could outshout the suicidal callings – and he did.

Modernity can be obsessed with people expressing their feelings, spelling out their troubles and traumas, and conventional wisdom maintains that, when people are suicidal, they need to talk to someone. But it seems to me that sometimes people who feel suicidal do not need to talk so much as to listen, because they need to hear a voice stronger than the siren voice of suicide. In the terrifying abyss of suicidality and severe depression, what a person may need is not a listening ear as much as a speaking voice, talking from a place of wellness, clarity, strength and confidence: life coming towards you. Someone whose voice can reach you when you are the pelican in the wilderness, ugly, inept, unwordable, silent except for those gut-croak cries for help.

– What about your nephews who you love so much? my friend asked. Your brothers? (One of my brothers, in America, who hadn't known about my suicidal feelings, rang me the following day and told me that on that same night he'd had his first ever suicide nightmare; something alien was ripping his guts out.)