lost ironies

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Tag: Psychiatry

Nurse Victory

the building coming down at the docks
was a thing in the war or some other romance
now hooded men stole its copper

but my body once slept inside
(it was derelict then too
but sheltered many)
that’s the point of this, the
angels in my pockets
winged pennies nickels & dimes
singing the Holy Holy Hosannas
& Torch Songs—

one is locked in tiny rooms
it turned out
for hearing such joy &
watched through tiny panes of glass

that’s how we met

hello Nurse Victory, I breathed
seeing her peek at me through the glass
me in my corner near the drain
(everything in a Psychiatric Quiet Room is near the drain)

from there I saw her once hopeful &
later at her Station so angry for marriage
never quite chill enough
for all the trend-setting psychotics &
never nearly as wise

pity?
I might have saved her
if not for the side-effects

& so the building comes down with the ball
Nurse Victory
where are you now?

 

 

 

 

 

 

Insulin induced hypoglycemia and suicidal ideation

How does one ask this question of a psychiatrist who’s so prepared to put a patient into the hospital: How do I manage suicidal ideation, that accompanies bouts of hypoglycemia, while mildly depressed?

The question is obviously one outside of the experience of most psychiatrists, since very few patients with bipolar disorder also have type 1 diabetes, for which injecting insulin is absolutely necessary, and can lead to occasional episodes of serious hypoglycemia. I’ve discovered that this is murky territory psychiatrists don’t want to visit.

In fact, in my experience, it’s a forbidden question because asking will almost certainly place me in danger of being incarcerated on a psych ward. I know because the last time I asked, the police were called and waiting for me when I arrived home from the appointment. All because I mentioned the suicide word, while asking what I thought was a perfectly reasonable question.

The point is that there are times when I have low levels of depression made worse by seriously low blood glucose levels. During these episodes, when my brain lacks the fuel required to function properly, any irrational thoughts I have safely stored away, may be let loose and run free.

FYI: The day the cops scooped me my glucose levels got lower and lower as the events unfolded, because the cops didn’t believe I was diabetic and wouldn’t let me eat. They justified this by pointing out that I wasn’t wearing my bracelet—my choice, my mistake. So, by the time I arrived at the hospital in the back of a police car, my sugars were so low that even the emergency ward nurse raised an eyebrow. When my glucose level was normalised, however, I was actually able to talk my way out of being admitted to the psych ward, a testament to my ability to think and communicate rationally when all is well.

The result is that now I don’t ask the question.

Am I capable of following through with an attempt at suicide, as a result of thoughts that come during a bout of hypoglycemia? So far I haven’t, obviously. All I need is a few seconds of clarity to know that I need some quick sugar. The problem is that the clarity doesn’t always arrive.

Is it smugness on the part of a psychiatrist, or a need to inspire confidence by presenting him or herself as all-knowing, that leads to an inability to calmly discuss this challenge? I’ve experienced both of these attitudes in doctors, much to my disappointment. So, what’s the strategy? Time will tell.

 

 

 

the photo booth

I wouldn’t recommended it, trying to thumb a ride on the road just out front of the locked gates of a mental hospital. It was cold and white, and there hadn’t been a car by in more than an hour. The two or three that had already passed by, had accelerated as they did. That it was Christmas morning didn’t help, I was sure.

The idea of me, an ex-patient, hitching a ride on a country road out front of the asylum from which I’d just been released, made me smile. But I had my shoes and a donated coat, and my pictures of her and I, and I knew that with these few things, I could wait until spring for a ride, if I had to.

By now she was just a dot on the rise in the road a mile away. We’d never been separated by such a distance before. Maybe I was finally on my own.

It was hard to believe, standing there, under the circumstances, that it had only been days before that Veronica told me that the walls of my room would bleed if I cut them with a razor. She said that the old hospital was dying anyway, and that the room I occupied was its last pulsing organ. Its acre of wooded land was its deathbed, and that I would be its final near-death experience.

So, on a night in late December, I took two hits of my smuggled-in acid and looked out of my second floor window, past the bars, believing that I saw gravity collapse stars into endless heroic outlines. Then I cut and waited to wash in the blood of the ancient hospital. But the walls didn’t bleed, so I had taped my razorblade back onto the underside of my night table drawer, and listened for the rest of the night to Perseus tap on the glass.

Veronica had been wrong. She was unreliable sometimes, too flamboyant, a thespian at heart. She took advantage of my boredom. I was her fond audience, and the dark spilling in through the window was her limelight. She was strong, too. Antipsychotics feared her. They stepped round her, respectfully, and obliterated everything else. And during morning rounds, she would cling to the florescent ceiling like a spider, and look down on me as the horn-rim, herring bone psychiatrist conducted his interrogation.

“Housekeeping says you’re destroying hospital property,” he’d said, the morning after the acid night. He said this tracing the cut lines on the walls with his fingertips. I was still tripping. It was the morning of Christmas Eve.

“So, evict me,” I said.

“Your next stop will be Isolation, Molly.” He paused for effect, still closely examining the wall. He was a thespian, too. “You don’t want to go there again.”

“Release me, then. Give me my shoes.”

“No.” He came and sat near my bed. “You’re still too vulnerable.”

“And the others schizos you cut loose, they aren’t? I’ll get along just fine on the outside, with a few pills.”

“And suicide…?”

“I hardly ever think of it anymore,” I said, “except at moments like these when I’m faced with your mania for it.”

“Are you having ideas? Are there voices encouraging you?”

“No. The voices are gone.” It was a lie, but fuck him. “You killed them all. It was a fucking slaughter. Now I’m stepping over bodies.”

He regarded me sternly for a moment, silent in saying the unsaid things of psychiatry.

Then I said, “It’s a trinket for you, isn’t it? Suicide, I mean. It’s a little paste jewel in your pocket. You finger it all day, worry over it, in with your coins and your keys. You even take it out occasionally, and gloat over it. Take an inventory, as you hold it, of all your patients devoured by the word.”

“Do you still believe in what happened in the photo booth?” he said. It was a quick unexpected thrust. Touché. He even allowed a trace of triumph to escape into the air, through his eyes. “You’ve only told us pieces of that story, but it seems very important to you. Central, even, to your being here.”

“You’ve made up your mind about it,” I said. “It doesn’t matter what I have to say.”

“You still associate the photos with Veronica, don’t you?”

“Leave her out of it.”

“Is she still lurking, a voice that I haven’t yet slaughtered?”

The photographs. Oh how the doctors had smirked when I tried to explain them. Veronica and I, the two us jammed into a midway photo booth and posing for the camera. Photographic evidence of her existence. Two friends at a summer fair. Her smiling, me looking tired and a little hopeless. Four small precious snaps in a strip. I’d kept them safe for so long, fiercely preserving them from the deep hole that inevitably swallows all of the meaningful property of the insane and destitute. But the psychiatrist said that I was imagining Veronica, that only I appeared in the pictures.

Now they were in a file, under lock and key.

“She’s real,” I said, ashamed of the confusion I hoped didn’t show. “You can’t drug-away what’s real.”

“You’ve certainly tried over the years,” he said.

“Yeah well, have a drink on me tonight, doc, and celebrate your reserve and resistance to all that’s mind expanding.”

“Tell me what the photo booth experience means to you right now,” he said. “What happened?”

“It would be impossible to describe to someone whose entire philosophy is based on doubt.”

“Then pretend I’m someone else.”

Veronica floated down now, from the ceiling like a leaf from a tree, and sat next to me.

“I don’t believe in the photos, anymore,” I said.

“You’re lying.”

I felt Veronica stroke my hair. “It’s okay,” she said. “Tell him again. He’s just a failed bully. Tell him ten thousand times, if you must. Destroy him with honesty.”

Outside, crows had noisily descended onto the hospital courtyard. I walked to the window to watch, glossy stones black on the snow. I’d take Veronica’s advice, if only to move another dull morning along.

“It was late August,” I said. The crows fought over something dead. “A Saturday. A crummy little town full of dented pickup trucks and dilapidated tractors. Everything a bit rundown and faded. I’d been hitching. It was where my last ride had dropped me.”

“How old were you?”

“Eighteen,” I said. “There was a fair in town, the kind that comes to a small town late in summer. It was rundown and faded too, but not as much as the town. Especially at night when it lit up.”

“And you were very sad,” said Veronica, putting her hand on my knee.

“Sad.” The word was too small. “I was very sad.”

“You’d raised a little money….”

“I’d begged on the street, and had gotten enough for admission into the fair, and a little besides. Seemed the whole town was there that night. I ate a hotdog, and watched the midway from a corner. Loud out of date music over the PA. Devout born-again farmers playing crown and anchor, and trying to toss dimes into milk jugs. There were rides, too. Nothing too big. Just what could be brought in on the carny trucks. It smelled good, in a greasy smoky sort of way, like childhood.”

“It was already getting dark,” Veronica said.

“It was dark when we went into the photo booth,” I said. “I still had a few coins in my pocket. Veronica asked me to sit on her lap, so we’d both fit, and then she said, ‘Smile’.”

“But you didn’t smile,” said the psychiatrist. He jotted notes.

“No, I didn’t smile. The camera must have been broken. The flash popped four times, without me pushing a button, before I could compose myself.”

“And those are the pictures we have?”

“Give them back.”

“No.”

“But they’re mine.”

“They only reinforce this delusion of yours,” said the psychiatrist. “I think you’re ready now to hear me say that.”

I wanted to be with the crows, to be unrecognisable in their strange order.

“Then the booth spit out the pics through a slot,” Veronica said, “and we stood in your corner on the midway looking at them, for a long time. You wept, a little.”

“Veronica and I looked at them for a long time, until the fair shut down for the night.”

“And the pictures were so beautiful, that you wanted to die,” said Veronica.

“I wanted to die long before we took the pictures.”

“What was that?” the psychiatrist said.

“All of the others,” I said. “The ones who’d followed me, everywhere since I was a kid. The voices and the faces that I couldn’t shake no matter how far I hitchhiked and doubled back. They wanted me dead. They harassed me until I bought the junk, enough to kill three people. I hid it in my backpack with the syringe and the spoon. Then they plagued me even more, to take it. Why aren’t you taking the goddamn heroin? End the pain, the pain. They wouldn’t let me sleep. I hadn’t slept for weeks, before we got to that shitty little town.

“Tell me more.” The psychiatrist was leaning forward, greedily. “Tell me how they wore you down, how they whispered and tormented, how they surrounded you and made it impossible to escape.”

“They didn’t,” I said. “Not like that.”

“Tell me, every detail.”

“Tell him that I wouldn’t let you take the heroin,” Veronica said. “That you’re too dear to me. That’s all there was to it. I fought the others off. I protected you. That’s what this fool refuses to understand.”

“Veronica saved me.”

“Nonsense!” The psychiatrist began to rapidly tap his pen on his knee.

“He’s fishing for something,” said Veronica.

“She told me to dump the junk down a storm drain, and I did. The others shrieked at me not to do it, but Veronica told me that death always comes on its own to the patient heart. She protected me because she loves me, and I love her.”

“That’s impossible,” the psychiatrist hissed. “No one can love a hallucination. Now don’t you see why it’s our goal to cure you of all your false perceptions? You can’t live a normal life loving something for which there is no actual stimulus.”

“Yes you can,” Veronica said.

“Yes I can.”

“I’m increasing your medication,” said the psychiatrist. “And introducing some others.” He wrote furious notes.

“I won’t take it.”

“Then you’ll be punished.”

“Punished?” said Veronica.

“Punished?” I said. “Did you just say I’d be punished?”

“No. Yes, but I meant placed in isolation, for your own protection.”

“Veronica can walk through walls, doctor. You’re throwing pills at a fortress, and they’re just bouncing off.”

“This is noncompliance.” He spit the word out like a curse. His most dreaded enemy.

On Christmas morning, as the other patients lined up for their medication and Christmas stockings of mean charity, I was escorted, with my backpack, out of the building, through the courtyard and left outside of the gates in the falling snow.

A sour nurse had given me back my strip of photographs, and had me sign my Release. Veronica and I stood together on the road for a moment, and looked at ourselves caught in that long ago August moment; her smiling, and me looking tired and a little hopeless.

Then she stroked my cheek. “Merry Christmas,” I heard her say, as she slipped away.

Rosetta

The psychiatrist peered through the lower half of his bifocals, as he turned the pages in the folder. A woman sat across from him, in restraints, adorned in cascading spiralling blue interlaced tattoos, visible from the top of her shaven head, covering her face, and extending down to where they disappeared beneath the neckline of her t-shirt.

The psychiatrist was reading her casefile as though it were a grocery store tabloid. His eyebrows raised when he discovered juicy slivers of glib clinical gossip, something the neurologist had added, or a nurse. Then frowning and making a too-too-too sound with his tongue, whenever he encountered less titillating synoptic gibberish.

“You haven’t slept for a very long time,” he said, a fingernail on his left hand having temporarily caught his attention. Then he turned the pages back to a place near the front, and said, “Ah, here we are: No sleep since admission, three days ago. Patient claims not to have slept since 2001.

“No sleep for three days…; we’ll have to work on that. But you say you haven’t slept since 2001? That’s very interesting.”

“Is it?”

“Do you want to say more about that?”

“No.”

The psychiatrist shifted impatiently in his chair.

“Are you hearing things?” he said. “Voices?”

“I hear your voice,” she said. The psychiatrist shifted in his chair again.

“Auditory hallucinations are a common effect of sleep disorders. And in your paperwork,” he turned more pages, “there are reports of observed symptoms of psychosis, perhaps even severe.”

It was the usual line of interrogation. Next, she thought to herself, he’ll ask me if I see things that aren’t there. He’ll without the apostrophe is hell. Then hell will ask me if I smell shit when there is no shit to smell.

“Can you see things that others don’t?” he said.

“Of course.”

“How do you know others can’t see what you see?”

“Because they’re blinded by their mediocrity.”

“Can you give me an example of what you see, that others can’t?”

“Why?”

It was true, she hadn’t slept in fourteen years, not since 2001, a result of a gravitational collapse, when her life reached a terrifying mass and density. Memories had become dreams and dreams memories, the molecules of each bonding into such close proximity that they were inseparable, perhaps irreversibly.

The cloudiness of childhood had returned, along with a ghost that had sat on her bed and stroked her cheek, saying it loved her. It had become a spider, crawling over her, then a leering thing looking down at her in her childhood bed, in the glow of nightstand lamplight. The doctors had attributed this to childhood sexual abuse. But maybe, she thought, it was just how a ghost loved a child, with grimly curious hands, a taut mouth and wide frenzied eyes. Suddenly, the only thing more frightening than sleep was the thought of awakening.

To fill the sleepless nights, she’d begun playing solitaire and drawing a mural on her walls and ceiling, in colourful pastels, as everything around her rejuvenated in the dark. During the day, she watched the cars on the highway from the window of her room in the boardinghouse, as everything decayed.

She had also begun to keep a journal on her computer, refusing to backspace as she typed. Backspacing was murder. It killed innocent letters, punctuation and numbers that existed only because she’d made typing errors.

At first she did this out of compassion, but then she realised that the protected letters were a code. In the beginning, the code was indecipherable, but then she became its Rosetta Stone. And only by decrypting the decree she had inscribed upon her body, from the top of her head to her toes, could she understand the code that described when and how to take action. She’d etched the decree into her flesh using razorblades and blue pigment. The ghost had tried to stop her, as though the code might reveal something horrible. It had.

“Sometimes it’s helpful to talk about the things you see and hear,” the psychiatrist said.

“You wouldn’t get it.”

As the sleepless years went by, she began to see the mural as an extension of the code, and used the Rosetta to interpret it. In the mural, the ghost had a body and a human face. And an accomplice. They walked confidently through their lives. They had family and security, and were loved and had respect.

“We’re also concerned about your cognitive impairment,” the psychiatrist said — “your decline. Your untreated psychosis is causing a loss of short term memory and other faculties, and it’s going to get worse without therapy. Soon, without medication, you won’t be able to recognise the passage of time, from one moment to the next.”

“Can you assure me that the moment that’s just passed is worth recognising?”

He paused a pause that filled the room, even the filthy corners and the spaces between the bars on the windows. Was he pondering her question, or just planning to retreat?

“Look,” he said. “This isn’t prison, but it is confinement. We want to help, but you can appreciate our need for security and structure. You’ve been found not guilty of a serious crime by reason of insanity. Refusing therapy is not an option here. I’ve asked them to be gentle with you, but that won’t last.”

“I can escape,” she said.

“No one ever has.”

“I can. Now that the work is done, I can finally sleep. That’s how I’ll escape. The dreams and memories have separated. I don’t fear sleep anymore, not since I found the ghosts, the faces in the mural. Fourteen years is a very long time to be awake, so I may never wake up again once I finally lay down.”

It was just the natural order of things. A year was how long it took for a tree to sprout and drop its leaves. It took twenty-five years for Saturn to orbit the Sun. And fourteen sleepless years was what it took to understand and find the ghosts.

She had first encountered them in a foster home a very long time ago, as the trees dropped their leaves and Saturn orbited. She was six years old, a foster child. It was the house of mister and missus ghost. She was a cast-off, and they had taken her in. But they had wanted something from her in return, something she didn’t have to give, something they intended to suck out of her.

They’d called her the girl, refusing to use her name. And they insisted that she call them father and mother, but she had refused, even after the beatings.

She knew these ghosts weren’t her parents, and her obstinacy had earned her a place in the cellar, in the cool dusky light of it, with things that creeped. She’d be left there for a week at a time. Then taken out and asked if she would concede, and call them father and mother. But she would not and, each time, she was returned to the hole beneath the house.

There she ate from shelves, hard to open jars of home-canned peaches and pears, and looked out of a small square window in the wall onto the winter lawn, covered in frost and then in snow.

Before the lady from the foster agency would come round, the girl was brought up, bathed and fed. Then missus ghost took her up to the room that was supposed to be hers, with the warm clean bed and the plush toys and picture books, and missus ghost would lock her in.

But before she did, missus ghost would say, “You tell that agency lady that you love us, dearly. And you tell her that you love your room, and all of the toys, and that we feed you good. You understand?” Then she twisted the little girl’s ear until it felt on fire, and shook her hard by her shoulders.

The girl only stared back in silence, though. And behind her blank stare, disorganised childish thoughts were forming into designs and an awareness of the importance of time. She knew no words for it, but sensed she had time for redress, and an endurance they lacked.

For a few days before the agency lady would arrive, the girl was allowed to sleep in her room to smooth over her gaunt fatigue. And that was when mister ghost came. Late in the night, turning on the lamp. When she awoke from her deep sleep, she saw him and his wide eyes, licking his lips, rubbing his hands together, perhaps to warm them, but they were always cold whenever they touched her.

“I’ve already prescribed a combination of medications,” the psychiatrist said. “I must insist that you take them. They’ll help you to sleep, and have other beneficial effects. But I’ll repeat that you must take them. The nurses and orderlies here follow strict policies of persuasion.”

Mister and missus ghost were surprisingly easy to identify by their mural faces, revealed by the Rosetta, and differentiated from the long strings of approach code in her journal. There were also her compressed memories of location and name.

She’d travelled by train, walked and hitchhiked to the house with the cellar. Then she hunkered down and watched them move through solid objects and conjure abundance. They were old ghosts now.

“I have come for you,” she whispered, on the outside of nighttime windows.

The psychiatrist released her onto the ward. The ghosts there were slouched, long fingered things. The hospital staff cast spells, fear and disunity, the patients shrinking. She took a corner in a threadbare easy chair, and wakefully dreamed of dreaming.

Her vengeance came on a night when the moon was a thin bit of scrap in the sky. She’d costumed herself in darkness, and was a mist that passed through recesses and knots in wood. And when she materialised, she stood above the ghosts in the house as they slept. It was strange that ghosts slept.

Her weapon was a knife that had found her years before, lying in an alley where she often walked before dawn. When it came into her hand, she immediately knew its history, knew why it had been thrown there, shimmering, calling out. There was murder in its blade. It was an experienced killer.

She yawned in her easy chair now, a thing she hadn’t done in fourteen years. The chair was so comfortable, and she was suddenly so drowsy. She closed her eyes, and glimpsed the possibility of dreams.

Soon, the staff would come with their medications, doctors and strong-armed goons. They’d smile and talk to her like she was a child, but would be ready for a struggle, unaware of her Rosetta Stone strength, of the hardness and wisdom, how the blue markings upon her skin would decipher their veiled anxieties, estrangements and hatreds. The staff might even try to strap her down, and inject her with potions. But she would be too powerful.

She’d sat on the edge of the bed, next to mister ghost, and stroked his cheek. He smiled and shifted, half-heartedly clearing his throat, but not waking. Then her hand went lower, as his always had, but she didn’t go nearly as far. It rested upon his chest, and he sighed deeply, his eyes moving rapidly under their lids. Then she ran the blunt edge of the knife along his throat.

When his eyes opened, he saw a woman in the feeble moonlight, behind a curtain of densely configured blue tattoos cascading down her face. He gawked with the once crazed eyes she remembered so well. The ones that had exposed his thirsts and obscene accelerated fascinations. She turned the knife round, so he felt the sharpened edge.

“Those are the eyes,” she said, with quiet satisfaction. “They’re what I’ve come for.”

“Please,” he said, so awake now, not recognising her. “Anything….” He swallowed hard, involuntarily, and it caused a trickle of blood.

“I never said please,” she said. “I never could. You never would have allowed it. You’d have hurt me more. I was powerless. It was rape, and I was so young.”

Missus ghost rolled over now, and her arm fell across her husband’s belly. She was almost snoring.

“You don’t know who I am, do you.”

“No,” he said. She was unrecogniseable behind the Rosetta Decree.

She said her name and he tensed further, but had no words. Then she removed the knife from his throat, and went for his once leering eyes.

His screams were soon accompanied by those of missus ghost, and were enough to fill the neighbourhood. Dogs barked, and a few nearby houselights came on, shining brightly. A man in his robe appeared on his porch across the street, with a cellphone in his hand. She remained sitting on the bed until the police cautiously surrounded her, then she dropped mister ghost’s eyes onto the floor.

Now she sat silently in the chair, surrounded by the team that had come to administer drugs.

“How come she won’t wake up?” said a doctor.

“Weak pulse,” a nurse said, “almost none at all. Get a BP cuff.”

“Forget the cuff. Get the crash cart, room 3.”

“I can’t find a pulse at all now.”

“Let’s get her up. Call for a gurney.”

She was finally dreaming, and her dream had the mass and density of one that had waited too long to be dreamt. And as her heart gently failed, she was a child once more, but free of interference in the tall grass of a blue sky field surrounded by the buzz of summer insects. There was a tall wooden house nearby, that was a true refuge and that she could call her own. A bright red car motored by on the quiet highway, and someone waved out of the window.

The blue markings were gone. They’d fallen to the floor in a clatter. She was no longer her own Rosetta Stone. There was no need.

Virtue

You will see it, if you care to look, the sign over the broken wrought iron gate to his mind and marrow, that reads, Madness will Set You Free. He didn’t put it there. It just appeared one day, and it’s never gone away. Sometimes he looks up at it, as the crows fly by, listening to the whispered song of his dear choir, the voices holding their glorious, prolonged note that he has heard forever, and he wonders if the sign is true.

“Mr Virtue…?”

The bright white 2×2 metre isolation room had a telephone booth florescent ceiling light, and a yellow tile floor with a drain in the centre. In contrast, he wore a blue hospital gown, smeared with his own blood, and nothing else. They’d probably already burned his clothes, stinking like creation, of shit and sweat, as if he were his own primal season. But they hadn’t yet attended to his cut lip, or the scabbed over blows to his head. Earlier, as they restrained him, as they held him down with a mattress, someone had shone a penlight into each of his eyes, and had said, calmly, everydayishly, no contusion.

No contusion? The cops had tried and failed.

“Mr Virtue?”

It was a tall, obese male nurse, with another standing behind him. Either one would be difficult to move; escape was impossible. The nurse was calling him by his alias, the one he had thought up when he arrived cuffed, in a cop hammerlock — Mr Virtue.

“We need to draw some blood and take your blood pressure, Mr Virtue,” the fat nurse said.

“No more sedation,” Virtue replied, sitting up. “No more goons holding me down.”

“Just try to trust us, and maybe there won’t be any need.”

Trust was a greasy sloping floor he’d skidded down before.

“Fuck you,” he said, spitting up a brown metallic tasting substance, which might have been blood or half-digested Pentecostal soup.

The BP cuff went round his bicep, and was unpleasantly inflated.

“You had no ID when you arrived,” the nurse said. “Where do you live?”

Virtue only shook his head.

“Do you take street drugs?”

“No, but I need a drink. I need a fucking cigarette.”

“Do you have allergies?”

“People,” he said, fists clenching and banging his thighs. “People give me spots, man. I swell up and itch. Sometimes I can’t breathe when they’re around. I go anaphylactic. Especially cops and nurses. Just give me a pill for people.”

“Is there anyone we can contact?”

“No,” he said. “Everyone’s here.” And he knew as the words dissolved into the florescent air, that he’d said the wrong thing.

He looked around the room, and all were present. The bus driver who told him to get off of the bus, even when he wasn’t on the bus; Natasha, who said she loved him, and who had laid her soul upon his cutting board, but who remained untouchable; Raymond, with whom he enjoyed shouting obscenities in public library; Chico, with his bleeding eyes peeking out from between the elastic bands wound tightly round his face, who Virtue had loud quarrels with, who brought his rubber band face so close to his own that Virtue swung his fists wildly at what no one else could see. And the choir, whose members were harder to observe, fading in and out. Infants who never aged and the foul smelling spirits with their backward faces. They never stopped singing their endless note — Ahhhhhhhh — in E-flat major — for forty-five years, never stopping once to take  a breath.

“They’re all here, baby,” he said to no one. “I don’t know how they all fit, but they’re here.”

Shut the fuck up — Chico said — You always tell them too much.

“Kiss my ass,” Virtue yelled, and swung his fists.

The nurses stepped back.

“Have you ever been on medication, Mr Virtue?”

It was a new voice. He stopped swinging and focussed on the door, listening very carefully.

It was a woman’s voice this time. She was a tall one, too. He knew before he even saw her. The tall ones’ voices were as lofty as ceiling beams. He had to look up to see their spoken words melt like lemon drops. She walked into the isolation room, the nurses exiting, but standing nearby.

“Are you in charge round here?” Virtue said.

“My name is Dr Elizabeth Chang,” she said. “I’m a psychiatrist.”

“You say that like it’s Christmas,” Virtue said, running his tongue over his cut lip, “like I’m gonna get presents.”

“What about it?” she said. “Have you ever been on medication? For the voices, the hallucinations, I mean.”

“Hallucinations?” he said, looking round him.

Shit! Fuck! Motherfucker! Shit! Shit! Fuck! — Raymond screamed.

Virtue covered his ears with his too tight fists.

“Mr Virtue…?” Chang said.

“Yeah,” he hollered, banging his ears, gasping, clenching his entire body. Then, quieter, rocking a bit, he said, “Sure, they gave me pills once. Little white and blue things. They crawled around in my mouth like bugs, like beetles with switchblade feet and napalm in their bellies. Like drones looking for a Pakistani wedding party. I spit ‘em out, and the goons put us all in a room just like this.”

“Us? Who is us?”

“Me and the gang,” he said, looking round him. “We played cribbage for three days.” He saw Natasha smile. Maybe she remembered. “They slid my food under the door. I never won a single game. Chico cheats.”

You’re a fucking whiner — Chico said.

“How long ago was that?”

“Several centuries.”

“Well medications have improved since then.” Dr Chang said. “Would you like to try something now? Something that would calm you, take the voices away?”

He frowned at the idea. Was it sloppy disdain in her voice?

Get off the bus — said the bus driver.

“I paid my fare,” Virtue said.

Get off my goddam bus!

“Mr Virtue…?” said Chang.

The choir sang louder.

“Who else have I got?” he said. “If they go away…?”

You’re a pussy — said Chico, bringing his bleeding eyes close, closing them hard so that the blood dripped off of his chin. Virtue could see the outline of a smile beneath the elastic bands around his mouth.

“The police want to take you to the Forensic Unit,” Chang said. “They’ll force you to take medication there, and you’ll be placed in with some very dangerous people. If you consent to treatment here, you’ll be certified, and I can keep you in relative comfort, get you cleaned up, let you stay on the P5 ward.”

“Psyche ward,” Virtue said, repulsed.

“Yes,” said Chang.

“It’s a petting zoo.”

“Will you let a doctor look at your cuts and bruises?”

“You want to kill them with pills,” Virtue said. “Would you take a pill to kill your friends, your family?”

Don’t let her put me in the morgue — cried Natasha.

“They’re obviously causing you distress, Mr Virtue,” Chang said.

“And your family doesn’t cause you distress,” Virtue said. “Occasionally?”

“Yes,” Chang smiled, “of course. But I can take time away from them, when I want to.”

“Ha! No you can’t,” Virtue pounded the floor. “You can’t take time away from them, at all. They’re always in your head, aren’t they? The anxieties they cause, and their smothering conditional love? Don’t lie to me. All of what they’ve said to you, done to you. The passive aggressive acquiescence. The religion. Their platitudes and bizarre poisonous illogic. False memories. The counterfeit Christmases. The viral dysfunction. Their dissatisfaction and mock appreciation. Their doubts, your doubts. Fear for their safety. Your fear of death, of abandonment, of watching them age and perish before your very eyes. The madness children will bring with them out of the womb. How the wealth of generations is redistributed. All of that’s pulsing through you, right now.”

“No, Mr Virtue,” Chang said. She’d hesitated — barely perceptive uncertainty. He’d hit a chord.

Go for it — Chico yelled.

“Oh, I can hear it like a siren,” Virtue said, smiling for the first time since his arrival. “Like someone scratching at the door to a cell she’s wanted to escape from since the moment she first felt the hands grab her round the throat and squeeze. You feel those hands squeezing right now, don’t you! You see their mute faces and their unblinking eyes. Don’t tell me you can take time away from that, and I won’t tell you that it’s easy for me.”

Virtue struggled now, to get to his feet. He’d aimed a communication beam right into the psychiatrist’s brain, and poured on the power. He would draw her in. He would introduce her to Chico. Chico would thank him. Chico was lonely.

A nurse stepped in to hold him down.

“Word salad,” Chang said to the nurse. “Olanzapine, 20 mg intramuscular injection. I’ll draw up the order.”

“Twenty milligrams?” said the nurse. “Are you sure?”

“I’ll be at the desk,” she said, “writing it up. Restraints if necessary. Prepare him, and I’ll arrange for transport to Forensics.” She walked away.

“Sorry, dude,” the nurse said to Virtue. “Things are about to get nasty for you.”

Your body’s a fire, Virtue — Chico said — Let ’em send you into hell.

Virtue looked up and saw the crows fly by. He saw the sign over the broken wrought iron gate, and said, “I’ll burn the whole fucking place down.”

the dust bunny dark

I have stopped believing
that Edvard Munch &
Friedrich Nietzsche
live behind my refrigerator
whispering Übermensch
in the dim Plasticine shades
of the dust bunny dark

Edvard planning to paint me
sneakily grim
at the Cuisinart with celery sticks
&
Friedrich leaving his Superman
in the crisper with the cranberries
and all of the degenerate onions

psychiatry has won
I have stopped believing
& am wicked alone once more

holy day

it is easy to lie about your religion
with hunger in your pockets
people will only look and wonder
how you will be saved from their good gods
will it be pills or e.c.t? or a
disconsolate edict
with new heels on its boots

it’s just that the doctors are crazier
and have their own lunch to consider
and who will cross the Tees
crosses on a hill, yes
there was more than just one
religion again
socks and salty soup
dished out by the stolidly saved

the neon purple SOS

The hotel’s ancient neon sign still shines through my window every night, even with the venetian blinds closed. During the day it’s like any other sign, but after dark it blinks out an SOS dispatch in purple Morse code. · · · – – – · · ·, · · · – – – · · · , · · · – – – · · · . All night, every night. But no one responds to the plea. If this old hotel were a ship at sea, it would sink with all aboard. Without a trace. Without ever being remembered.

I told Vladislav about this once, before everything happened, mostly to fill up some of our hour together. He increased my Thorazine. I always left the pills in their bottles at the Altar of Our Lady, in the cathedral down the street. She accepted them as an offering. They were never there the next day.

A new tenant moved into the hotel, just before the shit hit the fan. He sang a cappella at night. Cole Porter, Harold Arlen, Johnny Mercer. Until about 4am every morning. With all the right breaks in all the right places. He had amazing timing. Kind of like Sinatra, after he divorced Ava Gardner. I could hear him through the air vent over my bed. It was like having a Vegas floorshow piped in — with the old neon sign going SOS SOS SOS, ad infinitum. So, who the fuck had time to sleep?

At one of my last appointments with Vladislav, he suggested that perhaps the new tenant wasn’t real, and asked if I’d been taking my meds. He used to get a little thrill out of suggesting the things I enjoyed in life weren’t real. Like all of the beautiful red and orange leaves in autumn, that blanketed the floor of my room, and crunched under my feet when I got up in the night to go to the can.

I smiled and lied about the medication, of course. And purposely failed to mention that the Virgin Mary was taking the pills now, instead of me. And that her beatific smile seemed to imply that they were working better for her than they had for me.

He shifted belligerently in his chair, and took iniquitous notes. But we weren’t friends, or anything.

In fact, by then, Vlad had become a problem. He only wanted to see me biweekly, and said I could email him if I had an issue. Except he never returned my emails. Even when I emailed him that I was surrounded by the Greys, and they were eating out of my refrigerator. The little alien fuckers would scare the hell out of me. Standing round my bed, staring at me with their big orbicular eyes, eating my KFC leftovers, throwing the bones onto the floor. Would they do that on their own planet? I don’t think so.

Anyway, I’d been planning something special for ol’ Vladislav. Something based on an idea hatched out of one of those crushing, self-obliterating darknesses I enjoy so much. The ones that permeate my inner-metaphysical assemblages at the deepest possible level, and suck every molecular spec of me down the kitchen drain. Then spit me back up in a seweratic bloom, renewed and radiant like the still-glowing hands of a long dead thrift store alarm clock.

It always surprised me and boosted my mood, the creativity that bled out of my blackest despondencies. It was like getting my bonus Air Miles in the mail on a gloomy day.

My depression inspired idea was a mind control transmitter. It turned out all I needed was a PC, an internet connection and a proper set of headphones. Not earbuds, mind you. But a full-on headset, like the hippies used to use. Skullcandy’s okay, but Bose is better.

This was the trick:

  1. Plug the headset jack into audio-in, instead of audio-out.
  2. When this is done place the headset on your head, over your ears.
  3. Twist the headset ninety degrees to the right, so that the left earpiece is on your forehead.
  4. Now you had a direct line, through the left earpiece, from your prefrontal cortex into the CPU. And you could stream your thought controlling messages into Gmail.

It took up a lot of bandwidth. But when I pressed send, my thought control messages would go out over the driftnet they called the worldwide web, and they were delivered to the addressee. When the recipient opened the email, his or her brain would lock onto the message, and they would do whatever I demanded.

I used Google Drive’s 10GB attachment size limit to avoid Gmail’s meager 25MB limit. A thought control message could be pretty huge. There was a lot of code involved. Maybe that would have changed once it caught on. Mothers could have used it to sneakily coax their children to call, and governments to convince the people that critical thought was terrorism.

The first thought control message I sent was to the Mayor, and it took him less than a week to fix the sidewalk out front. It had been cracked and bumpy before, and old people had been tripping and falling all over the place. By lunchtime, most days, it looked like a geriatric killing field, all of the oldsters fallen and unable to get up. But after my mind control message made it to the Mayor, and the sidewalk was repaired, they just floated by with their walkers, like wheeled robots blissified in their new found movability.

My point is that this was a proven technology, baby. I didn’t hold any patents or copyright on it, though. It was like shareware. You could have tried it at home. I didn’t care.

After the Mayor, it was Vlad’s turn. I didn’t have any demands like fix my sidewalk for him. He probably couldn’t even use a screwdriver. I just wanted to fuck him up a bit, introduce the cardigan-wearing comb-over mother fucker to an existent reality, separate from the DSM 5 and Land’s End deck shoes.

And so, by now you’ve probably figured out that Vlad was a psychiatrist. He wanted me to call him Vladislav, instead of Dr Pulin, because he thought being on a first name basis gave him some perversely deserved form of street cred. But it just made him seem like Sally Field in The Flying Nun. And like I’ve said, he liked to tie most of my lived experiences to my presumed psychosis. He even refused to acknowledge the presence of the Greys, with their big buggy eyes and Domino’s Pizza, whenever they’d come along with me to an appointment.

His office was on the twelfth floor of an old downtown art deco number, with a stone balcony above the busy street. The balcony was festooned with flowering potted plants, vines and shrubs. And he had a small Ethiopian man named Bruck come in once a week to take care of them. Vladislav didn’t really like Bruck though, and Bruck thought Vlad was an asshole.

Sometimes Bruck offered insights into what he overheard from patients on the balcony. Insights that seemed far more informed than Vladislav’s. Vlad really resented this. I watched it happen in the waiting room a few times, as Vlad leaned forward, breathing heavily over the receptionist, pretending to read a file on the counter. Bruck would say something clinically astute, and Vlad would sneer and send him back out onto the balcony with his pruning shears.

“That little African bastard’s really pushing my buttons,” he’d whisper into the receptionist’s ear, with his garlicky lunchtime escargot breath. “Can we do anything to revoke his citizenship?”

The receptionist would shrug and wheel away on her desk chair.

In the summer, I’d sit out on the balcony for sessions with Vlad. This would have been almost enjoyable if he wasn’t such a dick, smoking his pipe, nodding needlessly, raising his eyebrows and squinting critically, displaying mock empathy at what might have been the right moment, but never was. It was like a well-rehearsed alienist pantomime, probably perfected in his intern years, surrounded by slobbering imbecilic psych ward inmates in a hospital just off of skid row. And it had the adrenaline stink of his own internalised horror. But I never said anything; sometimes the patient must accommodate the physician.

Sometimes he’d say shit like, “Let me help you take joy in choosing life.” Like he wasn’t the single most suicidal ideation inducing factor in my life.

I would have split and run if the visits weren’t court ordered. Hell, if the visits weren’t court ordered, I’d have been drinking beer and snorting amyl nitrite under a bridge somewhere.

But getting back to mind control via the doubtable Windows operating system.

I’d bought a pair of Bose SoundTrue on-ear headphones the day before it all went to hell. I believed they’d work better than the vintage Sears model I’d been using, with its adapter plug and fraying cord. Besides, I probably looked like a total loser with a pair of headphones from the eighties, turned ninety degrees on my head. The eighties wasn’t a bad decade, but they had different ideas about what was compact and streamlined back then. As soon as I tried on the Bose set in the store, gave them a quick turn so the left earpiece was on my forehead, and asked to see myself in a mirror, I knew that I was making the right choice.

That night I came home, sat in the blinking neon purple SOS light and listened to the Vegas floorshow guy singing through the air vent. And I composed my mind control message to Dr Vladislav Pulin, as I did.

I’d brought home a couple of six packs and started to guzzle. This was going to be great.

I really wanted to set the shithead up for some grief, and I’d spoken to Bruck earlier in the week to tell him what to watch for, that there would be a chance to peg Vlad with a harassment complaint that might really pay off.

“Do you believe you can control world events, Tommy?” Bruck asked me.

“No,” I said. Okay, I sort of lied.

“Well that’s fine, then.”

After I explained my plan to him, he put his hand on mine and told me that he understood that realities could differ greatly, but that that didn’t deny the importance of one’s personal perception. Then he said that I should proceed with my plan, as long as no one got hurt.

It was absolutely the right thing to say, in so many ways. And it came out of the mouth of an Ethiopian grader. Ain’t that something?

The as long as no one got hurt part really didn’t sink in, though. That might have been the beginning of how it all went so wrong. And in hindsight, I might have worded things differently. Too late now.

The message sort of went like this:

Hi Vlad, (regular email salutation protocols apply to thought control messaging) Why don’t you get back at the little bastard, Bruck, and push his button? Find it and push it, Vlad. Push the button that will ruin, even eliminate, your greatest enemy. Go ahead, Vlad, push the button that will change the world and put you in charge. You know you want to.

By then I’d gotten through the first six beer. I was a little bit tipsy, I’ll admit. I forgot all about the Google ezAutoCorrect extension that lived on my computer, in an alternative reality all its own. It ended up drastically changing the spelling of key words in my message. In the address field, Vladislav.Pulin@gmail.com became Vladmir.Putin@gmail.com. And in the text field, Bruck was changed to Barack.

I take no solace in knowing that I’m not the first drunken fool to press send, when he should have held off until the morning after.

And who the hell knew Vladimir Putin had a Gmail account?

The mind control email message arrived on Putin’s PC in the afternoon, and The Button was pushed shortly after.

So, now the neon purple SOS has a new kind of importance. Worldwide electrical grids are failing, along with mass communications. A massive electromagnetic pulse wiped every hard drive and flash drive on the planet clean in a nuclear second. The Vegas floorshow guy still sings, but his songs seem a little more melancholy, and he’s developed a persistent cough that messes up his timing. The good news is that the Greys haven’t returned. I guess it’s because KFC and Domino’s don’t deliver anymore.

the bust

you the suicide?
says the cop
black in wish and uniform

not yet
I say
bewildered

you better come with us
your psychiatrist called

oh, I say
my psychiatrist
¿the lonesome alcoholic? who
sits in the corner
nodding like a dog
on the dashboard of a vintage Chevrolet

the one with the pink noise
in the waiting room
blunt crayons
and colouring books

that must be her, says the cop

to him, I am torment
he didn’t join up
to scoop forlorn poetasters
with tricksy razor blades
and teary notes good-bye

he’s tragic, I can see
his head imbued with
procedure, heartache
and internet porn
his state granted gun and
the power of arrest

he’s heard of jazz and
thinks it’s the blues

he has parcels coming UPS

and yet
I am to go with him
in the backseat as though
he is the chauffeur
and I am the fiery fine King
of Tuesday Afternoon

hallucination inventory

the voices stand on the corner
of Brain Street and Soul
dressed like Sid and Nancy
laughing at the pills and voodoo

one whispers the
garden is an abattoir this
door has slammed for centuries
better the shame you know
you are the false sum

what else do you hear?
the psychiatrist asks
I hear you, I say
and he clicks his pen
the office is falling into him

his black hole gravity
is different than mine