I think I’ve mentioned before I have a close relative with a diagnosed psychiatric illness. I’m not going to go into much more detail about that in this forum, but I would like to share something about what that experience is like. I’ve also mentioned that I write – independent of this blog – and one of my recent writings was published in our classes Collected Works, which is something that the med students put together each year.
It’s a collection of poems, short stories and photos that demonstrate the arts in medicine relationship that the school tries to foster, and I decided to write a short story for submission in this years collected works about my relative, and my experience with their illness. I wanted to share it in the Collected Works, and here as well because I think in the medical field we don’t consider how mental illness affects the people on the periphery: their relationships with family and loved ones. Or even, how mental illness affects that person’s life; symptom lists are necessary to make a diagnosis, but they don’t tell you anything about what that person is going through.
It’s one thing to learn about a paranoid delusion in a class: it’s another to sit with someone you love and watch it play out in real time.
So, what follows is a work of fiction based heavily in reality on my personal experiences of what living – and loving – someone with a serious mental illness is like. I hope it offers a tiny window into the parts of mental illness we don’t learn about as students.
A Saturday Afternoon Visit
The traffic is awful, though the traffic is always bad downtown in a city of this size. All these people living fast and driving slow, you think. Still, the AC in the car is working today, so at least you aren’t miserable in the heat. Summer is upon you, and you’re really more a spring person.
But honestly, you like riding in cars. After four years of buses the leg room afforded to you in your father’s old Honda is a real luxury. After your accident its stressful to drive, but you find it calming to be a passenger, to watch the world pass by your window.
You do a lot of your best thinking with your earbuds in and the smooth hum of a car around you.
It’s around mid afternoon when you arrive at your destination and pull up into an available stop. Unlike the rest of the city, there is always parking here.
Your destination surrounds you when you get out of the car. It is all the buildings that sprawl around you, a little world unto it’s own. It reminds you a bit of university, of shiny new buildings juxtaposed with older, more faded ones, big huge dormitories of people, all buzzing like bees in a hive. You’ve been here enough that you call it by its acronym now, pronounce it as a word. Now no one in your family ever needs to have it explained; they all know. You think of it that way, even. Perhaps its safer that way; innocent that way.
Your destination is, to simplify it massively, a mental institution.
You’re here to visit your brother.
The entrance to the building is swarmed with its customary occupants, who ask you for smokes or a light as you pass. You have neither. One of your father’s first edicts, drilled into you from childhood. “You smoke, you die.”
You’ve always been too straight lanced for rebellion. Your brother was not burdened by the same problem.
Still, it used to make you uncomfortable, all these people, with their scruffy beards and wild, unkept hair, because you can only imagine why they are here.
It doesn’t now. You’ve been here enough. Last time, you joked to your father that if you did bring a pack and a lighter you could probably walk out with an army of followers, and your father laughed. Sometimes you think that might have been a bit inappropriate, but well, what else can you do?
Might as well laugh as cry, your mother always says.
He’s on the third floor, your brother, in one of the locked wards. You have to buzz the nurse to get in, because the doors are never open. The people in this ward aren’t allowed outside without being checked out by a family member.
Your brother the library book, you quipped once. Even he laughed at that.
He’s waiting by the door when you finally get in. He gives you a hug, and he smells clean enough, if not a little musty. He doesn’t always, so thats nice. You’re never sure how often he washes his clothes here. Most of them are in storage anyways, after he was evicted the most recent time.
He went off his meds and keyed cars in the parking lot. You can’t remember if this time he also assaulted someone, or if that was last time. Regardless, you can’t blame the landlord for wanting him out. You never do.
You can’t leave yet, because he can’t find his glasses. He tells you someone stole them, and he disappears down the hallway, visibly aggravated, to go find them. Your father amuses himself by striking up a conversation with a nurse, but you didn’t inherit his gift of talking to strangers.
You watch, instead, to pass the time. Two men stare at a hockey game on a tv in silence. A woman about your age sits at a piano bench, but doesn’t play. A man in a blue gown slips out the crack in the door left when a messenger comes into the ward, and the nurses have to go chase him down.
You can’t blame him; you think you’d try to escape too.
Your brother returns with his glasses, which he found in the washroom. He asserts again that someone stole them and hid them there. You exchange a look behind his back with your father, but you both stay silent.
Nothing comes of arguing, you’ve both learned.
There’s a burger place you always go to when you visit your brother at this facility. It’s just a little bit down the road from it, so you walk. Your father joked once that you and he wouldn’t visit half as much if you hadn’t found this place, and although you are both loath to admit it, there is likely a grain of truth to it.
With your brother, one does not have the luxury of visiting just for the conversation.
The waitress is new, late twenties perhaps. She has a very pretty face, a thick New Zealand accent, and your brother is clearly flirting with her as he orders.
Your brother is a handsome man. You’ve always been aware that, when it comes to you and him, he got all the gold and good looks, and you got all the brass and brains. When you were younger, you wanted to trade.
You don’t anymore.
Still, the point stands. Your brother is still a handsome man, and the waitress is flirting back, because she’s never seen him methodically stack and unstack his shoes in the freezer and mutter nonsense in the middle of an episode. She doesn’t know what he looks like in an orange jump suit, lethargic and dead eyed, or what his voice sounds like through a jailhouse phone.
It’s so deceptive, this disease of his. So insidious in how it lays beneath the surface, hidden away, curled deep into every part of him.
He looks so normal.
Sometimes, like now, you want to tell these women he flirts with that he’s not a good bet. To warn them that he’s a nice man, a good man, but a clockwork one, and his workings are not quite right anymore.
The waitress turns to you. You order a burger with lettuce, barbecue sauce and bacon, as you always do. The restaurant doesn’t have a fryer, so you get onion rings instead of fries. You know your brother will steal a few if you do.
You don’t mention the other thing. You never do.
Then comes the conversation as you wait for your food, your least favourite part. You and your father speak mostly, and try to get your brother to interject, but its hard. He can’t leave the ward, so he has few things to contribute about his week, stir crazy as he is. Your father inquires about his meds and your brother says the voices are gone, but you both know better than to take him on his word. Your brother lies. If you had a nickel for every time he’s told you that he’s going to be good, stay clean and never, ever get in trouble again, you’d be rich.
You mention a movie your father and you have seen, a sci-fi you think he would have liked. He’s seen the trailer on Facebook, he says, and he’d love to see it. And then he tells you that Mark Zuckerberg is spying on his Facebook account, and you can tell he believes that completely.
Understandably, the conversation stumbles a bit after that.
Your fingers itch for your phone, for the distraction it provides, but you leave it in your pocket where it is. Instead you reach for your new handheld game console, your mother’s birthday present to you. You wanted it solely because they re-released a game from your childhood in HD, and you boot up the game and offer it to your brother.
Your brother was the one who introduced you to this game originally, probably a decade ago. He was practically gushing about it, such was his excitement as he showed you the fight mechanics and the graphics and tried to explain the story to you. Sitting with him, playing that game is one of your best memories with him.
Now, he hands it back to you after a moment or two. He can’t focus long enough to get any enjoyment out of it.
There are many things different about your brother now.
The burgers, at least, are delicious.
When the bill comes your father pays, and your brother gets the waitress’ phone number. You bite down on the inside of your mouth, nearly hard enough to taste blood, and only offer a smile as you leave. Your brother wants the things that most men his age want; companionship, a partner and a family. He thinks he is together enough to have them.
Once, you visited him in another hospital, and let him put his head in your lap and watch a movie on your phone. It had an actress in it that he was going to move to California for and see if she wanted to date him. He was entirely serious.
This is the true evil of his disease; how his own mind lies to him.
You hope, for both their sakes, he ends up losing the number.
Its a nice evening, so you go for a walk after you eat, to burn off some calories. You’re really doing it to kill time before your brother has to go back, but the platitude is more comfortable. Your father walks slower than you, because of a knee problem, so you end up walking with your brother. He tucks you into the curve of his arm, and starts on some anecdote about when you were younger. Its some story you haven’t heard before, some antics about you and he playing superhero with a toilet plunger as a weapon, and you end up laughing with him as you wait for your father to catch up.
He was always doing stuff like that, just to make you laugh. Most guys would have hated playing with their much younger sister, but not your crazy brother. That’s what he called himself, drawing out the syllables to make you laugh; your craaaazy brother.
You’ve walked back around the block, so that you can see the institution again, across the road.
Its not as funny anymore.
Your father catches up, and you cross the road, making your way back, and the time is up.
Goodbyes are always awkward. He hates this place, you know, and hates being left here. You hate this place too, but when he’s in here, life is less stressful for your family. At least when he’s in here you’re not worried that the next call you’ll get will be the police because he went off his meds again, and you lost contact with him for a week or two.
At least when he’s in here, you know he’s alive.
‘I miss you,’ you think to the brother who exhausted himself pulling you around in a laundry basket like it was a race car when you were a toddler and slept over on the couch so he could spend Christmas morning with you.
“I love you,” you say instead to the brother that stands before you in a mental ward, and mean it.
He is your brother, after all. What can you do, but love him?
You hug him, and then step back as your father hugs him, and then it is time to leave. And so you exit the door, and then, before it can close, you turn and look back at your brother.
You remember that he was vivid and sharp once, all full of life. Now you look at him, and he reminds you of a picture left exposed in the sun, or a watercolour painting. Still recognizable, still there, but faded, colours all pale and bleeding together.
He’s never going to be any better than this. You’ve been on this ride too long to believe differently.
Then the door swings shut, locked tight to prevent escape, and you can’t see him anymore.
You leave, go home, and continue living your life.
He can’t. He stays, stuck there, this faded spectre of his former self.
You’ll be back next week.