Tracks in the Frosting
The heavy metal door, with a tiny chicken wire reinforced window, shut behind us with a resonating bang that bounced off the enameled construction brick walls. A chill tingled up my spine as I walked beside the nurse down the dimly lit corridor. She sucked in her gut to stuff the ring of keys into the pocket of her white uniform. Oh, God! Had I made a wrong decision? I shivered in the thin blue and white seersucker one-size-fits-all robe that drooped around my naked body. My paper slippers flapped against the gray tile squares like clown shoes. I peered into every open door for clues to my new environment.
"This is Miss Martin," the nurse said, leaning into the opening of the glass- enclosed nurse's station. "She signed herself in. Admitting will send the paper work up after while. The laundry should have her clothes marked by morning."
"Any meds?" Nurse Bradley said, without looking up from a stack of papers.
"No. Farrell's the doctor and he hasn't seen her yet."
For the moment, the feeling of relative anonymity was a reprieve. This wasn't part of the plan when I took the pills two weeks ago. Now, at age nineteen, I stood by, forced to add the disgrace of failed suicide to my defective life. I wanted to hide.
This first floor wing of Larue Carter Hospital, a state psychiatric facility, was designated F-1. It served as both evaluation and intensive care unit for female patients. I watched the women jammed in the area just beyond the nurse's station, feeling aloof as if to insulate myself from this new experience by viewing them from an imagined distance. I was different from them; brighter, better educated. I didn't want to believe this was really happening.
Two elderly women sat on a maroon vinyl couch with bent silver metal armrests. One rocked back and forth while the other shuffled her feet and giggled incessantly. In one corner, a middle-aged woman clawed at the sleeves of her blouse screeching, "They're burning me! They're burning me up! Help me get them off!" A tall, thin young woman walked around the room, shaking her finger at everyone she passed, shouting, "Your sins condemn you. Repent or die!"
A woman I guessed to be in her early thirties and two teenagers sat with an attendant, the psychiatric equivalent to a nurse's aid, at a square table playing a game of Aggravation. How appropriate. The game concept mirrored my sentiments precisely! Terror gripped my gut. I was now one of them or was I?
When I left home at eighteen four days after high school graduation in June of 1964 to attend Indiana University at Bloomington, I believed that I escaped from my parents. They were never overtly harmful or neglectful. Quite the opposite, they are delightful people; kind, generous, pillars of the church and our small farm town community. That's what made my unidentifiable sense of dread in their presence so baffling. For as long as I could remember, I'd felt a subtle sense that something was wrong. I assumed I was a misfit.
We were like actors in a family performance where mistakes were unacceptable and the curtain never came down. My parents communicated their disappointment through angry eyes, stiff bodies, and soft-spoken tones imbued with disapproval. All this spoke louder than words, their glares open to interpretation. Before I reached the age of was five, I would cringe, anticipating punishment far worse than Dad leading me off by the ear or Mother confining me to a kitchen chair, if overt discipline came at all. The greater, more painful chastisement came from internal attacks as I filled in the blanks.
Whenever I felt I did something wrong, which seemed frequently, I reacted with self-loathing. Believing I didn't deserve to live, I made my first suicide gesture when I was ten by hanging my head over the end of my bed for an hour or so. I only got dizzy. I hoped, in my ignorance, to re-create conditions for the stroke I'd had when I was five, the stroke that paralyzed my left arm and leg for several weeks, the situation where I overheard doctors say there was nothing they could do; I'd either live or die. When I was fifteen, I heard Coke and aspirin were dangerous together and I tried it, hoping for lethal results. Nothing happened.
Unable to live up to my parent's standards, I considered myself inadequate and pushed to achieve, especially academically. I was determined to compensate for my perceived deficiencies and justify my existence. Acting out a "good girl," accomplishment-oriented facade by day, I excelled in high school and ultimately graduated valedictorian with additional recognition for success in numerous extra-curricular activities. Such victories failed to improve my self-esteem. Longing for someone to care for me, I became the "bad girl" at night, in supposedly clandestine meetings with forbidden boys. Secrets were short-lived in our small town and the insidious effects of sexual promiscuity achieved suicide for my reputation. This was a great embarrassment to my folks' well-pruned pretense of "everything's okay" and contributed to my downward spiral.
I intended to become a physical therapist and start a new life. If I could become a skilled professional, I'd finally find my place and I would "fit in." After completing two years' work in little over a year at the Indiana University Bloomington campus, I moved to the medical center in Indianapolis in September of 1965 for the final two years of study. However, classes, especially human anatomy, were more difficult at the medical center. Always a slow reader, a month into the school year I fell behind, overwhelmed by all the required memorization work. I felt crushed by the pressure to succeed. Suicidal ideas sabotaged my studies and eventually dominated my thinking.
Finally, in October, I overdosed on muscle relaxants prescribed after a car accident. I had seen a girl kill herself like this in a movie on television. When nothing happened immediately, I assumed, like my previous experiences, there wasn't going to be an effect. I walked across campus to my scheduled anatomy class.
Looking for a seat in the crowded lecture auditorium, my feet began to stumble up the steps. I felt myself collapse on cold hard cement like a jellyfish. I heard muffled voices
... Something hard in the back of my throat ... suction tube... machines ... hospital ... Damn! I failed!
I recognized Mother's hushed voice. My eyelids felt too heavy to lift. Someone betrayed me ... called my parents. They drove a hundred and fifty miles to see me like this. I wanted them to go away ... no energy for anger ... wanted to return to sleep.
I pushed my eyes open. Mother stood beside me. Dad grasped the foot of the bed as if for support. Their solemn faces ushered in the same unexplained sense of dread that twisted in my gut like a snake when I lived with them, dread I thought I would never experience again.
"You just took on entirely too much," said Mother. She looked like a statue carved in stone. Her rigid pose reminded me of the tenseness I felt in her body the few times she'd hugged me. "We had to see our little girl."
I had nothing to say.
Mother left my cubical, with curtains drawn around it for walls, and Dad moved bedside. Thinking I was despondent over a soured dating relationship, he shared his devastation over a break up with a girl he'd cared for when he was a teenager.
The burden of Dad's confession confused me. Had we reversed roles?
True to a life-long pattern of pseudo-independence, I determined to deal with this mess myself. After several days in intensive care, a psychiatrist gave me the choice of either going home with my parents or signing myself into the psychiatric hospital on the medical center campus. The decision was easy. Either way I felt alone. A week later, I was strong enough for transfer to this strange place.
"You'll be in room six," said Nurse Bradley, moving toward me from the nurses' station.
She and I walked in silence through the hall to a four-bed room.
"This is your bed," she said touching the foot of a white metal frame bed, "and that's your locker for your clothes when they arrive. Laundry is done on Thursdays. The only time you are to be in this room is bedtime. Any questions?"
I shook my head no.
"We'll go back to the dayroom now. Dr. Farrell will be by this afternoon to give you a physical."
I stood back from the group of women I was supposed to join, wondering where to go. I didn't feel like talking with anyone. I was only passing through this place. I didn't really belong here. Maneuvering around the others, I chose a position by the windows secured by black wire mesh. I stood, resting my elbows and folded arms on the shoulder high cement block sill, then put my head down. Tears seeped from my eyes, slipping along a path down my face and spotting the sleeve of my institutional garb.
How many times had I passed this dull red brick building as a physical therapy student? It seemed set apart from the rest of the medical center campus as if to accentuate the difference between medical and mental patients. I imagined scary people here. Sometimes this image was fed by voices calling out to passers-by from one of the wire-enclosed porches, which never failed to remind me of Westville, a state facility near where I grew up.
Until now, my experience with psychiatric hospitals was second hand. My parents spoke of dangerous people in Westville. Occasionally my father sang there. I was four or five when he came home from one of his entertainment events, telling how a young male inmate had approached him with an outstretched hand. "Hello, doctor," the man said, vigorously shaking Dad's hand.
Dad laughed when he told it. Then, sobered and shuddering, he said, "That really gave me the willies."
Now that I was an inmate, being on the inside looking out didn't seem real. Was I actually as defective as I secretly believed all along? What would it take to get out of here?
"One out of ten of you will experience mental illness. Look around the room."
That's all I remembered from Mr. Broughten's high school psychology class eighteen months ago. Those words now felt like a curse as they floated in and out of my mind grappling for answers. Had he spotted me as a psychiatric causality?
Nothing from my first college psychology class seemed relevant either. I felt diminished in crossing over from the academic world to that of patient. I knew how to be a student but I had no idea how to have a breakdown.
That night and most nights thereafter, I stared up at the dim square ceiling light above me, wishing I would wake up and discover this had been a bad dream. Every few hours when an attendant lit up my face with a flashlight, it only reminded me that, for better or worse, nothing had changed. The bed's thin mattress rested on metal springs that squeaked when I moved. The flat sheets, roughened by repeated institutional launderings, came loose when I attempted to find a comfortable position, exposing the cold plastic mattress covering. At 6:00A.M., music blared from the day room, signaling time to get up from a sleep that was never restful.
Meals, delivered on plastic trays, were served on paper plates and eaten with plastic utensils. There were no doors on the bathroom stalls and no real mirrors, just shiny metal sheets stuck to the wall above the sinks. They formed waves in places, returning a distorted image to those of us already here because of such a view of ourselves.
Depending on the direction of the wind, the air carried either the stench from a meat packing plant or the sweet aroma of cereal from the surrounding industrial facilities. I hadn't noticed it much in my dorm room. Here it was a topic of conversation along with guessing what was for dinner, based on the smells from the kitchen in the afternoon.
"You're new aren't you," one of the women said. "Room six?"
She lowered her voice. "Keep one eye open when you sleep. Laurie gets out of bed at night and tries to kill people."
Laurie's bed was across from mine.
Several nights later, I was in bed when I felt nudged. I gasped, thinking the woman's prediction about Laurie had come true. I soon realized my intruder was the seventy-year-old disoriented woman in the bed kitty-corner from me. She was easily redirected back to her bed.
A few days later, though, Laurie attempted to strangle another patient. Several male attendants rushed to the unit to forcibly remove Laurie and restrain her while Nurse Bradley administered an injection. Lifting her by her arms and legs, the men hauled her to the padded isolation cell with only a tiny window in the door. She banged and screamed for the next three days. Her rage unnerved me.
After a battery of psychological tests, a psychiatry resident interviewed me in front of a room overflowing with medical and nursing students, other psychiatric residents, and a few full-fledged doctors. Recognizing two medical students from my anatomy class, I winced. My face flushed with embarrassment. I felt like a freak, a deranged specimen on display, undergoing mental dissection.
"Always a bridesmaid, never a bride then," the resident said, probing for the cause of my suicide attempt.
"I guess," I said. I didn't know what else to answer even though I lacked confidence he was really onto something. There was accuracy to what he said. I reacted with despondency over failed relationships with men, but his explanation didn't fit with the undefined fear and helplessness that gnawed inside me like an ulcer.
An attendant escorted me from the room while the professionals debated my case and conferred with Dr. Farrell. I wondered what good any of this would do.
At Larue Carter Hospital, your psychiatrist doubled as your medical doctor. From the moment Dr. Farrell touched me during the complete physical exam the day I arrived, the therapeutic relationship was tainted. Teenaged boys had molested me when I was seven, my piano teacher when I was fifteen. I never told my folks any of this. I didn't tell Dr. Farrell either. He was twenty-seven and single. I romanticized about him, an attitude that allowed my vulnerability to withdraw from my awareness. Whether I was that good at covering up or he was unskilled as a therapist, I'll never know. Maybe it was both. He never recognized the real agony inside me.
Even so, in the two sessions each week with Dr. Farrell, I spoke, unlike the mute sessions I endured when I was fifteen because the high school principal insisted I see a psychologist. I felt uneasy breaking the family code of silence that had ruled the first eighteen years of my life- "nothing that goes on in this house is to be discussed outside this house." Talking to Dr. Farrell gave me an imagined sense of distance from my parents, yet, equating emotional/mental breakdown with parental disapproval, I was quick to accept blame for my messed up life. This, of course, became one more way to berate myself and had nothing to do with actually taking responsibility for myself.
For a while, I was medicated. I hated what those little white tablets did to me, how my thinking seemed frozen and my mouth got so dry it felt like cotton inside. Instead of walking, I did the Thorazine shuffle. All I wanted to do was sleep and that was prohibited during the day. Medication felt like punishment and a suffocation of my will. After passing out from a drug reaction, I convinced Dr. Farrell to discontinue the medication. Lacking trust in him, making myself appear well enough for discharge seemed like the only way out. As far as I could tell, patients gained release by maintaining appropriate behavior and that included compliance with hospital rules. How easy it was to conform to these criteria. After all, not making waves, not revealing that I hurt, and behaving to please others was exactly how I functioned, living out a straightjacket mentality.
Eventually Dr. Farrell transferred me upstairs to F-2, a less restrictive ward. My parents visited once. They came to the hospital when I was on F-1, where visitors weren't allowed, and my social worker, a human sieve filtering the outside world, turned them away. My only other visitor, a college roommate on campus, came twice. I preferred not having visitors. Paradoxically, I now felt insulated from the outside world, while continuing to act out my dysfunction in hospital confinement by striving to be a model patient.
Part of my motivation for good behavior came from observing women who were receiving shock treatments. These women from the E-2 wing ate meals with those of us on F-2 in a small, off unit dining room. If I thought Thorazine transformed people into zombies, post shock treatment patients were worse. Blank, expressionless, they trudged from place to place like hollow shells. I got a cold chill every time they were shepherded into the dining area, a cold chill that hinted familiarity with their emptiness. Not yet ready to face myself, I turned instead to determination never to let that happen to me! Even the ones who returned to our unit, preparing for release, were different. It was as if their sparkle had been annihilated along with the destructive thoughts of self or others. They didn't seem to care as much how they looked or what happened to them. I wondered if anyone really left this place feeling better and more prepared to cope.
The institutional food was the most nurturing aspect of the hospital environment. One day we were passing through the cafeteria-style line in the small dining room when I heard Suzanne say, "Yuck! I'm not eating that," scrutinizing the sheet cake put out for our dessert. She called to the kitchen staff, "Got any ice cream back there?"
It wasn't hard to see the trail of indentations in the orange tinged frosting. One of the patients claimed she actually saw the roach that made the tracks. I grimaced. Others seemed to shrug it off as part of life in this place, if they noticed at all.
Outgoing mail was censored. If approved, it received the stamped message, "Mental illness can be cured," next to the postage mark. I didn't appreciate the advertising. I didn't write many letters.
Occasionally someone managed to escape for a few days before police found and returned her to the fold. Hospital gossip treated elopement like some sort of heroic event but most, including me, didn't attempt to leave even when we thought we'd found a key on the grounds. Going A.M.A. (Against Medical Advice) was always an option but, without knowing where I'd go or what I'd do, I chose to stay until my release.
When people from the outside presented entertainment in the auditorium, it was usually delivered with slow, exaggerated speech. Did they think "mentally disturbed" meant "dense"? On these occasions, infuriated by such patronizing, I broke my good conduct code and joined with others who felt a similar disgust. We took turns shrieking, wailing or creating contorted faces. This inevitably led to waves of giggles. It was the best therapy of the entire hospital experience!
I spent three months in Larue Carter Hospital before leaving for a half way house in Indianapolis, a job as a nurse's aid, and weekly outpatient sessions with Dr. Farrell. Later, I returned to the Bloomington campus and in 1970 I graduated with a B.A. in Zoology at twenty-four. I married in 1971 and had three children by the time I was thirty-three. However, my decision to sign myself into the hospital marked the beginning of a history of hospitalizations, suicide attempts, and fourteen therapists by the time I was thirty-eight.
If nothing else, this initial hospital experience sparked my interest in psychology and in 1979 I returned to school, completing fifteen hours towards a Masters in Counseling. During this time, I discovered the work of psychoanalyst D.W. Winnicott. His concepts of the mother/infant relationship as the critical dimension of healthy psychological development and nurturing vignettes of therapeutic treatment for severe psychopathology resonated with me, inspiring confidence that I could find help.
Ultimately, the stress of parenting my three special needs children (both boys clinically hyperactive and daughter developmentally delayed and psychotic), edged my illness closer to the surface, drawn out particularly by a conflictual relationship with my daughter. Seeing my unacknowledged vulnerabilities in her violent, erratic, and demanding/ controlling behaviors, I attempted to crush what I couldn't abide in myself, triggering rage, power struggles, and physical abuse.
At forty, I again arrived on the brink of complete desperation, overwhelmed by feelings of emptiness, alienation, and terror. The imperative to resolve my inner chaos was so strong that I knew I must find either real help or a successful means of suicide. This time I shopped for a therapist. Trusting my instincts, I interviewed six recommended therapists from a variety of disciplines before finding a therapeutic fit for a process that lasted twelve years. I ended successful therapy in 1999. I was fifty-three.
Looking back, those tracks in the frosting were like reading tea leaves. They foreshadowed a long and sticky journey, the beginning of a quest to find my authenticity and take responsibility for my life.
copyright2005 Carol Adamitis