Sunday, January 23, 2011

next to normal: Not Quite Normal Enough

I recently had the opportunity to attend next to normal, dubbed the “feel everything” Broadway musical by the New York Times. The play hit home for me, as the plot is centered around a character who has bipolar disorder, a woman who lives in an upper middle class home with her husband, Dan, and teenage daughter, Natalie.

The play won both a Tony and the Pulitzer.

Most commendable about the play is its willingness to tackle such a delicate subject as mental illness and bring a discussion of its many dimensions to the country. Less commendable is its actual message.

Contrary to the New York Times, I can’t say I felt “everything,” but the play certain conjured a range of reactions for me. My predominant emotion was pain, as I watched this character, Diana, go through struggles that were all too familiar to me, including bizarre behavior, alienation from family members, and battles with medication.

In one of the first scenes, Diana helps the family by making sandwiches-- on the floor. I thought this was realistic; it reminded me of a time when I sautéed the foam from a pillow cushion with eggs and proceeded to serve it to my neighbor, who looked askance at the concoction.

I also related to Diana when she would stay up late at night, classic manic behavior, full of projects and plans. I was reminded of the days that I spent awake “creating,” in truth, destroying property, even one time, my piano.

The play also depicts fractured family dynamics. Husband Dan is perpetually trying to help, to connect, to do the right thing, be the right man. His efforts are continually frustrated by his alienating wife. The daughter, Natalie, is estranged from the family, isolated by the lack of love from her mother.

These kinds of relationships are all too typical when an individual has a mental illness. I hearken back to the days when my illness was in full force, and I had tough-and-go relationships with my mother and brother. Thankfully, I have had the opportunity to stabilize and strengthen these ties in my recovery.

Another piece that resonated with me was Diana’s song, “I Miss the Mountains,” where she sings about the struggle of taking medication that numbs her senses.

In the third verse, Diana sings:

But I miss the mountains
I miss the dizzy heights
All the manic magic days
And the dark depressing nights
I miss the mountains
I miss the highs and lows
All the climbing, all the falling
All the while the wild wind blows
Stinging you with snow
And soaking you with rain
I miss the mountains
I miss the pain

Here, I think the song captures a true predicament of the bipolar person adjusting to medication. I know from experience that medications sometimes feel like one is covered in latex. Diana’s struggles here are understandable and certainly realistic, but she abandons the belief that medications can bring relief—also sadly realistic--and shortly thereafter, slits her wrists and is admitted to the hospital for ECT (electro-convulsive therapy.)

It is here that the play takes a turn towards One Flew Over the Cuckoo’s Nest in terms of its power in generating fear and stigma regarding treatment. Here, ECT is depicted with a mannequin on a gurney with a doctor overhead holding baton-shaped “shockers,” accompanied by flashing lights mimicking electrical pulses. The stage becomes a cacophony of “music” and color. The effect is gruesome and traumatic. From this experience, Diana loses her memory en masse. She can’t even recognize her husband or her daughter.

Then the song “Aftershocks” is sung by her dead son, Gabriel, who is an ongoing vision and trigger in Diana’s psychosis.

ECT, electric chair, we shock who we can't save
They've cleared you of my memory and many more as well
You may have wanted some of them but who can ever tell
Your brainwaves are more regular, the chemistry more pure
The headaches and the nausea will pass and you'll endure
You son is gone forever though, of that the doctor's sure
The memories will wane, the aftershocks remain
You wonder which is worse, the symptom or the cure

I found the sensational depiction of ECT to be stigmatizing, and this greatly saddened me. My experience of ECT was benign. The procedure is safe and painless. The patient is put under anesthesia, feels nothing, and wakes up to orange juice and a doughnut. For me, the memory loss was negligible. I know for others, ECT does have significant memory loss, but I have never heard of a case where the patient can’t recognize loved ones or forgets huge swaths of long term memory. For most, it is quite clear which is worse: the symptoms of depression or mania.

Of course, there is artistic license. The play’s second act hinged on a plot line dependent on Diana remembering virtually nothing of her life with her husband and daughter, which led to the resolution of the play, where Diana leaves her immediate family, sick and untreated, to go live with her parents.

Perhaps I am conditioned to the Hollywood ending instead of a Broadway one (after all, I am from Los Angeles,) but in my fantasy, I would have liked to see the main character find a positive solution, using medication productively and mending the relationships with her family, where she could resume “normal” life. Instead, in next to normal, Diana walks out on Dan and Natalie, and the ending is painful and less than hopeful.

Alice Ripley, the star who plays Diana, in the Q&A after the show, thought that Diana was empowered and experienced “liberation.” My interpretation is that Diana simply stayed in her symptoms, demonstrated deterioration with her illness, and made a rash decision which negatively affected her loved ones.

I think that the accolades for next to normal are valid for its dramatic and musical quality; however, its message is disturbing to someone who promotes the idea that recovery from mental illness is possible, that people with mental illness can live “normal” lives. Rather, deterioration from mental illness and ineffective treatment became the focus of the musical.

I think my positive resolution is not a very sexy resolution, but it is one that does happen in the real world. It would have been nice to have a role model on Broadway instead of a bipolar woman trapped by her illness who thinks that one can be freed by packing a suitcase and walking out the door.

Maybe the final scene of my version of the play would have Diana, Dan, and Natalie sitting on the couch watching TV, laughing at a dumb commercial.

Maybe Diana takes lithium, lamictal, abilify, clorazapam, wellbutrin, metformin, and synthroid. She feels a little tired, but fine.

The name of my version of the musical would be really close to normal.

The last number, sung by Diana, would go like this:

Really Close To Normal

This mellow life doesn’t fit me.
Life should flow like lava, hot and free.
I still miss the mountains
Its torrents of rain.
Something vital
Something I can’t tame.
But I’ve learned to love the pasture.
I know that I can last here.
The pasture’s a place I can grow
Even when I miss the world I know.
I miss the world I know.
But I can spend my life here
With the people that I love.
I may never have another exploit.
But I was spoiled anyway.
I was spoiled anyway.
I’ve learned to love the pasture.
I can last here.
I can last here.

Thursday, January 20, 2011

Grunion to the Death

Every year like clockwork my family would go on some foray into the great unknown for two weeks and come back sunburned. On this particular occasion, I was fourteen years old, prepubescent, and ugly. In fact, I was so ugly and prepubescent that Cousin Kim, who never quite fit her boobs all the way into her swimsuit, called me Worm.

For this year’s vacation experience, we would be staying at the home of Lou and Ann Dachs, a cultured couple who owned a modern home up in the hills of Malibu, California, a matter of an hour from our suburban house in Northridge in the San Fernando Valley. Lou and Ann were going out of town that summer, the summer of ’86. I don’t remember where they were going, only that my dad offered his able services as the Dachs’ house-sitter.

Now, Lou and my dad had worked together for years, and so it should have occurred to Lou that my father should not have been the steward of choice for his ritzy Malibu home. Dad’s first move was to transform the house-sitting experience into a family get together. Instead of merely taking care of the generous lawn and two over-sized cats, Tiggy and Migsy, we were taking over, and what we were taking over was a museum.

The house was split into four levels. On the entry level, through wall had a hypnotic view of the ocean, and in front of the wall stood a pedestal with a two-foot tall bronze sculpture of an object that looked like a bird. The furniture was of smooth dark leather, and there was a fish tank, a fireplace, and art and vases with ornate, dead arrangements. I’d never been in a house before that had things that you weren’t supposed to touch.

My mother’s side of the family from the Pacific Northwest was the main component of the family get-together and would be staying on the ground floor. The attendees included her parents, Granny and Crapa, hailing from Yakima, Washington, and her younger sister Auntie Carol, and Auntie Carol’s two daughters, Cousin Kim and Cousin Kari, all from Anchorage, Alaska, who were around the same age as me and Mike, my older brother.

In all McNeill family vacations, it was of utmost importance to have an itinerary of some sort. For our house-sitting stint in Malibu, my father came armed with a tiny, square clipping from the Los Angeles Times. He longed to post it on the refrigerator, but the Dach’s refrigerator had no magnets and was a clipping-free zone. As an alternative, Dad put the clipping under the mod salt shaker on the kitchen table and made reference to it constantly. It was the calendar for the phases of the upcoming tides, the schedule of the grunion run.

What I knew about grunion was that they were small fish that flapped up on the beach to fertilize eggs in the middle of the night. During the grunion run, the idea was to scour the beach for the fish, disrupting their mating ritual, and catch them. This activity seemed gross at best, but was soon to become the centerpiece of the vacation experience.

Now, Dad often spoke of the grunion run with nostalgic delight, tales of which were met with serious skepticism and horror by the members of the house-sitting party. Not even my grandparents who were usually moved by the acquisition of food found in nature, were not inspired.

When the time came, all the relatives packed into a couple cars in the middle of the night and headed to the beach.

When we assembled on the beach, my Dad was immediately on his hands and knees in the surf peering up and down for signs of grunion. The family stood around nonplussed. My grandfather, Crapa, named for his monopolization of bathrooms, had labeled this excursion a “snipe hunt” and “a fool’s errand.” Dad, however, had no problem being labeled a fool and instructed the children enthusiastically, “You’ve gotta look for the silver on the water. Go on! Get down to their level! Get down to their level! That’s the only way you’re gonna know when they get here!” Even in the dark, Dad wore his USC baseball cap, and in his semi-recumbent posture, looked absolutely ridiculous.

Cousin Kim, impervious to embarrassment herself, got down on her hands and knees. The pair seemed ludicrous, and though the family knew that the Los Angeles Times concurred with Dad that something marvelous would actually happen, the pallor of disbelief hovering over the crowd was too strong. I stood there with an empty pail, which I was instructed to hold, and waited impatiently to get out of the cold night air and get the hell out of there.

Kim sprung up from her position and dashed farther down the beach. Out of sight, she started screaming, “I got one! I got one! I got one!” When she returned, Crapa held a flashlight out for her to display her spoils which she held proudly clutched in both hands. There it was! A grunion!

Everyone got in on the action. I went berserk. The beach glinted with the silver of the tiny fish as they spawned—or tried to. I raced my back and forth on the beach, capturing fish after fish after fish. I felt exultant. Feeling the joy of being a predator, and in that moment, I was as close to hunting as I ever would get, and I liked it. The buckets kept filling and filling until we had a haul of about 300 fish.

We went home and put the catch into a series of coolers, on ice. What did we plan to do with them?

Well, eat them, of course.

The next day, the job of processing the grunion fell to the children. The kids were set up on the manicured lawn, each with their own station. I was opposite Kari as a de-header. The next child in line would have to disembowel the tiny fish, and finally, the children on the end, Kim and Mike, were the de-scalers. After their work was complete, the mountain of scales reached to their thighs.

After the kids were done with the processing of the fish, it fell to Granny and Auntie Carol to prepare them for breakfast. The little silver fish were breaded and fried in the Dachs’ swanky frying pan, and the heaping platter was served up at the sleek, mahogany table with the eager family gathered round.

Crapa was the brave one. He plucked a grunion right off the top and started eating. The crunching of the grunion’s bones could be heard by all assembled. The platter was passed, and all the children were expected to take a serving of the previous evening’s bounty, bones notwithstanding.

I made a valiant effort and bit into my grunion with as much gusto as I could muster. Chewing warily on the tiny fish, crunching down on the miniature bones, I became nauseated and excused myself. I ran up to Level 3, to the master bedroom’s bathroom and puked.

I returned to the table and refused to eat what was on my plate, at which point Granny uttered one of her standard epithets, “You crappy little kids!” In the Depression-era mind, it was a sin to waste food, and her little suburbanite grandchildren she considered spoiled beyond repair, although she loved us just the same.

This hoarding of food went so far that all the remaining grunion were packed up in freezer bags and prepared for distribution to all the family units. A third would go to Yakima, a third to Anchorage, and a third home to Los Angeles. So strong was the power of this principle of thrift that my mother nor my father offered a peep of protest.

The grunion ended up in the freezer in the garage for years. My father finally had the courage to throw them away when more space was needed for storage for a party. My grandparents never threw their portion away; after Granny passed, Mom and I found the grunion at the bottom of their industrial-sized freezer.

I guess even the bone-crunching was too much for them.

The Demon Box

A couple of weeks ago, I got an email from an unknown man in Canada. This fellow had bumped into a copy of a newsletter I had written for NAMI (the National Alliance on Mental Illness) in 2009 called “Suicide is an Illness.” (How he obtained a copy, I will never know.) In the article, I honored an old friend of mine from my undergraduate years at UCSD, a man named T.C., who was named outright in the original article. It turned out that the Canadian fellow, D., was roommates with T.C. in graduate school. D. spoke of T.C. in glowing and loving terms and brought back a host of dormant emotions.

To me, T.C. was all that and then some. I met him in my Latin class in 1990; he was the class superstar. His genius was apparent to everyone as the Latin phrases would slip effortlessly off of his tongue, and his translations were as fluent as English.

His other area of appeal besides his Latin acumen: he was an asshole. His ego could fill the Coliseum itself. He had something to say about everything, pop culture, classical philosophy, music, sexuality, politics, social dynamics, etc. No topic was too obscure for him to weigh in and slaughter any opposition.

He was also striking. Tall, broad shouldered, with a Roman nose and piercing blue eyes.

Then there was his sinister laugh. It often reverberated down the hallway in front of Latin class, authoritative and mocking.

I resented him at the outset, and then my distaste turned to fascination, and my fascination to infatuation, and my infatuation to love.

T.C. and I became fast friends. I’m sure it had something to do with my hero-worshipping ways, but it I’m sure I held some sort of attraction for him. At that time I needed saving, and I don’t think he minded being a savior. He also liked to have someone listen to him talk, read his poetry, and hang on his every word. We spent a lot of time together on the Revelle College campus, hanging out at a stone sculpture called Stonehenge talking until the early morning hours.

T.C. excelled academically. He would take 20-24 units a quarter and get straight A’s. He was in the hypomanic phase of his bipolar illness much of the time and was incredibly high functioning in the academic arena.

I would often ask T.C. about the bipolar condition. He once referred to a metaphor by Ken Kesey who said that the human psyche could be called a Demon Box. It was designed to filter information in such a way that it kept certain things in and certain things out. In a person with bipolar disorder, this filtration system, this Demon Box, was broken, and the individual sufferer could not separate positive and negative information in a functional way. Bipolar people suffered from an influx of demons. T.C. elaborated that once these demons came into play, that they would interact with one another, making the condition even worse. The challenge, he said, was to kill off the demons before they killed you. This metaphor struck a chord; I always appreciated T.C.’s imaginative way of conceptualizing the world.

Eventually, T.C. got a full scholarship to Stanford for a PhD program in classical philosophy.

Our lives diverged, although I would see T.C. when he came home to LA, where we were from. Incidentally, we grew up 2 miles from one another, so his parent’s house was a stone’s throw from my mother’s.

T.C. did well at Stanford at first, and then over a period of years, I noticed that his mind was beginning to fray. Our phone conversations were increasingly alarming. The philosophizing had turned to ranting, and his narcissism ran high. He was becoming paranoid and delusional. The demons were coming to roost, and he was powerless to manage them.

After a dramatic drop out from Stanford, he was moved to his parent’s house and made two unsuccessful suicide attempts until he succeeded on the third.

Before T.C. died, he left a box of his poetry on my mother’s doorstep with a note that he wanted me to publish his work after his death. The following piece that I share is one of his tame, introspective pieces that I feel demonstrates his alienation. He was perhaps 20 years old when he wrote it.

Sophocles

I’m tracing strange tongues
Down the page
Trains bound for the center of
Nowhere hoot in the
August air
It’s a hot, dry day
Here on the edge of the land
The theatres are crowded
With eyes seeking
A cheap vacation from the
Sun

The devil is a psychiatrist
And the city noise is
His voice
He wants to know how I feel

How do I feel?
His question coils in the void above my head

I feel like the lower
Half of an iceberg
Staring down into
Depths

I feel like a doll in a box
Hanging of the rack at the
After hours toy store

I feel like an umbrella
Discarded at the beach
Flapping in the wind at
The vacant endpoints of
A day gone by

I feel like a wheat field rolling
Before a scarecrow hung
With beads and knucklebones
That rattle when the wind
Rises

I feel like a locked
Steel file cabinet
Locked up in an
Empty office.

I feel like a fan
Rattling in a window
Above two naked
Sleepers

I have become silence
I tell the Devil
That is how I feel
I turn back to Sophocles
But he’s not there.

# # #

So, here I have discharged a tiny portion of my duty, to share T.C.’s work, as he wanted. Until now, I have kept his work in a shoebox for over ten years.

I'm still hoping to have a meaningful connection with the gentleman in Canada; his contact certainly brought up a lot of memories for me. I’m relieved that I’ve been able to air out some of my feelings, so for that I am thankful, though the process has been a painful one.

I’ve decided that if I ever have a big chunk of money when I die, I’ll have a bench at Revelle College campus, near Stonehenge, dedicated to T.C. so that generations of students can debate, and hold forth, and recite poetry, and carry on as we did.

As the treatment and awareness of mental illness improves, maybe the T.C.’s of the future can be saved from these deadly illnesses.