“What is the longest stretch of time you have been sober?”
“I do not know,” is the answer I tell the doctor.
Dr. Franciosi jots down some notes in his pad. We are discussing which came first: my depression or my issues with alcohol abuse. Am I depressed, and as a result do I turn to alcohol? Or is it the opposite, does my drinking lead to depression?
He does not always face me when he speaks, although I have asked him a few times to do this. I need him to look at me so I can read his lips. I was born deaf, and if a person does not face me, I cannot understand what is being said. Lipreading is a skill I learned as a child, and I have been told I am remarkably good at it.
“Which do you think I should be treated for first?” I ask the doctor. “The drinking or the depression?”
“Both,” he says, spinning his chair away from his desk to face me. He’s coming to realize my need to read his lips. “I’m so sorry,” he says. “I keep forgetting.”
“People do,” is all I say.
“So you know,” the doctor continues, “you are here to get stabilized and to be detoxed from your excessive alcohol abuse. Withdrawal can be a very dangerous thing.”
I am in rehab in Florida at the opposite end of the east coast from my home. I am to be here for forty-five to sixty days. I am on day two.
“You are fifty-three years old?” the doctor asks. “Am I correct?”
I nod and he continues. “You say you started drinking heavily at the end of December?”
I nod again. He dramatically counts the months using his fingers and writes it down in his notebook. “You were hospitalized in February?”
“For ten days,” I tell him.
“I see,” he says, and he jots down more notes. “I have something I’d like you to fill out. Take as long as you need.”
He passes me a questionnaire and he waits patiently as I check off a series of boxes in response to various questions. I give him back the sheet of paper, and he does his assessments. Then he places the pad on his desk and says, “My understanding is you are not just depressed. You are severely depressed.”
He hands me a worksheet on which the nine symptoms of depression are listed. He explains that I have eight symptoms out of nine. The ninth is having suicidal ideations.
The symptoms I did have include: 1) Feeling sad, empty, and hopeless. 2) A lack of interest or pleasure in activities that I once enjoyed. 3) Weight loss or weight gain. 4) Difficulty sleeping or sleeping too much. 5) Restlessness. 6) Excessive fatigue or a loss of energy. 7) Feeling worthless or guilty. 8) A lack of concentration or difficulty with decision making.
“I am not suicidal,” I say, in agreement and a bit forcefully.
“Yes,” the doctor affirms. “The good news is you are not a harm to yourself.”
“Well,” I agree with uncertainty, “I do have eight out of nine symptoms though. That can’t be good.”
“It’s not uncommon, and it is treatable. Do not worry. You are in the right place, and we will work on these issues during your stay. I recommend you stay here as long as your insurance will allow you.”
I begin to feel trapped. I shift and squirm on the oversized sofa that is decorated with bright and colorful Native American pillows. I have a pillow on my lap, and my hands are clenched on top of it.
I’ve battled depression throughout my life. I was moody as a child. For most of my life, I was able to function but apparently, I cannot anymore. My life has slowly unraveled over the course of a long period of time and has become unmanageable. To cope, I drank excessively.
Several months ago, I experienced a myriad of conflicting emotions in response to trauma that I had come up against in my younger years. Flashbacks plagued my nightmares and haunted me throughout nearly every moment of my day. I found solace in alcohol which not only briefly alleviated my trauma but amplified it as well. Abusing alcohol became my primary focus and I prioritized it over my health, my family and friends, and the quality of my life.
After many years of seeking treatment in various facilities close to my home, I reached the point where I decided that to get better, I needed to remove myself from my current environment. As it is said in recovery, one must avoid ‘people, places, and things,’ all of which might contribute to having a relapse. These triggers are always a threat and are to be avoided especially during the early stages of recovery.
I think of home, over a thousand miles away, and I miss my partner of thirty-one years, my two dogs and three cats. I long for my life as it once was, but I can no longer be there and be safe and healthy as well. I feel hopeless.
As if he could read my mind about my yearning to be back home in New Jersey, the doctor says, “You’ve come a long way to be down here. You clearly know you need help.”
“But…” My voice trails off and feeling trapped within the clutches of withdrawal, I want to scream: “This is all bullshit!”
“You can leave anytime you want. You must want to do the work. I would not recommend you leave. But we’re not forcing you to stay. You came here voluntarily.”
He sips his coffee from a mug that has written above an image of a light bulb, How Many Psychologists Does It Take to Change a Light Bulb? And beneath the image, it says, One, but the light bulb must want to change.
I chuckle; he stares at me; his blank face reveals nothing. I restrain myself as he looks down and reviews the paperwork some more.
Alcoholism runs rampant in my family and throughout many branches of my family tree. During my childhood, family members and friends have made suicide attempts.
I myself have self-destructive tendencies but the idea of overdosing on pills and ending up in a coma frightens me. The notion of cutting myself with a knife freaks me out. Cutting my flesh and drawing blood repulses me, although I experimented with using a razor while in a downward spiral, after doing a massive amount of cocaine and being awake for several days and nights straight. As I wept, I only went down deep enough to draw a little blood. I have a few scars on my wrists to remind me of those moments of despair. I know I could get a gun and put a bullet into my head, but what if I survive and end up being brain dead? Suicide is futile to me. I am fearful.
I have fantasies of going the way Edna Pontellier did in Kate Chopin’s novella The Awakening. How she swam far out into the ocean. But at the same time, this terrifies me, being in deep waters, pulled downward, and perhaps having a change of mind at the last minute. My decision having become irreversible, the shoreline now out of sight, and my long wait as I struggle until the sea finally claims me.
If I were to die, I want my death to be quick and final. See, I have no options. Yes, I am too afraid. So no, I am not suicidal. I am a coward. The doctor smiles sympathetically, seeing the stricken expression on my face. He does not ask me what I am thinking about. He pats me on the knee and reassures me that everything will be okay.
There is a lull in our conversation. The doctor spins his chair to his desk, and he takes more notes. He’s evaluating me.
“Should I be saying anything else?” I ask.
He looks at me. “That’s up to you. Is there anything else you want to say?”
I begin to tell him more, but I stop myself. I do not tell him about the impulsive thoughts that I sometimes have or the way I talk to myself with disparagement which I have done since I was a child. I do not tell him about my impetuousness, fortunately much rarer these days than when I was younger. I do not stand too close on the bank of a raging river such as the one that leads toward and over Niagara Falls, for I am fearful I might act upon my spontaneous, fleeting, urge to jump. That lure. The pull.
I have always had these reckless thoughts. The same goes for my avoidance of the edges of tall buildings or bridges and my staying away from the tracks of a subway as the train approaches. I still sometimes, though rarely these days, feel that urge to lunge. I have these fleeting thoughts: “What if I do it?” and “I can do it. Why not?” Or “What’s going to stop me?”
I do not mention any of this. I don’t want to alarm the doctor and especially my family, should there be a family session scheduled in the future. I consider the fact that I am an eight out of nine on this scale of depression. I’d rather be eight out of nine as opposed to being nine out of nine. It’ll have to do.
The doctor shifts in his seat and says, “Have you ever heard of the term: the black dog?”
I shake my head.
“It is famously attributed to Winston Churchill in reference to his depression, but it goes all the way back to the philosopher Horace. Depression has lasted for centuries. Many of the greats have had it all the way to those of today. Depression is no longer a stigma and is now treatable and manageable.”
I nod compliantly, not sure what to say at this point.
“You’d be surprised how widespread depression is,” the doctor goes on. “Most people experience various levels of depression at some point in their lives.”
Glancing at my file, he tells me that he sees I am a writer. “What do you write?” he asks.
“Short stories. Essays. And I’m working on a novel. A little of everything.” I don’t tell him I haven’t written in months. My enthusiasm for reading and writing has vanished.
The doctor asks me if I have read any of William Styron’s work.
“Of course,” I say, knowing where he’s going. “Darkness Visible.”
He nods. “And have you read Andrew Solomon’s The Noonday Demon?”
I tell the doctor that I have Solomon’s book, but I haven’t read it yet; long books intimidate me.
Wanting answers, I change the subject. “Tell me what I need to do now while I am here,” I say. “I’m a quick learner, and I want to get better.”
“One thing at a time,” the doctor advises. “Baby steps.”
I acquiesce with a nod, and he hands me some pamphlets. “Here’s some reading for you to do over the next couple of days.” They are colorful packets with beautiful people on the covers, all radiant, smiling, jumping and dancing, and proud of their successful recoveries.
I decide that I’ll review them during the quieter moments throughout the day. Since I’m not a smoker, I usually find myself alone in the lounge while everyone goes outside to smoke during breaks in between meetings. I enjoy those moments being by myself and not having people milling around or talking to me.
“Another thing,” the doctor adds, and he lifts a laminated card. On it is a dark blur of black scribbles and scrawls. It reminds me of an Edward Gorey drawing or a Jackson Pollock painting. He asks in a calm voice, “What do you see?”
I struggle not to roll my eyes as I stumble through my thoughts, trying to anticipate how I am supposed to respond to this image. The doctor says in a firm voice, “There is no correct answer. Just tell me what you see.”
“Chaos,” is all I can muster. “I see chaos.” I see my emotions and my depression, and my addictions all tied into one.
“Very well,” he says as he jots more notes on his pad, which I know will go into my file. I wait for a response, and he sips his coffee. He glances at his watch. “I’m afraid our time is up,” he says.
That’s it? I want to say. Instead, I stand up and thank him for his time.
“I’ll see you in a few days,” he says, flipping through the calendar that he uses to keep track of his appointments. “I’ll have the nurse find you and bring you here.”
After I leave the doctor’s office, I pause in the hallway that leads to the rooms where the morning groups are held. I lean against the wall and think about the word chaos. I do not want my assessment to be made based on a quick response to a mere image on a flash card. Then it comes to me. Is this what my life has become—Chaos?
I follow the long corridor to the end and quietly enter the room where the first group of the day has assembled. Everyone is talking at once; the counselor is trying to maintain order. I do not make eye contact. Suddenly everyone falls silent, and the meeting begins. We go around the room and name something that we are grateful for. Then we share our stories, and the chaos of everyone else’s lives becomes entwined with that of my own.