Chapter 23 - Return to the Psych Ward

As early as May 2015, I noticed something was wrong with my memory. I couldn’t remember things I had written at work even a week earlier, and I was writing words that weren’t the ones I intended—again instead of agoway for was. 



The Shining (1980), a movie much on my mind at the psych ward

I was concerned that this was early stage Alzheimer’s and that it would make me lose my livelihood of writing. But ultimately Alzheimer’s is fatal, and I didn’t mind any disease that was fatal. 

In August, new symptoms emerged that suggested something was wrong. Insomnia, which I rarely had, began to bother me. One night I couldn’t sleep at all. During the day I felt feverish, with chills and nausea. Once I vomited in the men’s room sink. Another day, meeting me for lunch, Veronica noticed that my lips were blue. They were extremely chapped, in tatters with blue edges. My jaws were making chewing motions, as if I were chewing gum, but I had nothing in my mouth. 

At the same time as I developed strange physical symptoms, psychological ones appeared. A vise of anxiety and depression seemed to be crushing my mindGrief about losing Martha became more pronounced. Work became a major irritant. I could hardly stand to be in the office. 

Most distressing of all, my memory was rapidly getting worse. I would get to the end of a sentence and forget what I had written at the start, so I had to keep going back and rereading, but then I’d forget again. It turns out you need memory to write. My productivity and the quality of my work suffered as a result. I was also generally confused. I had trouble with any kind of calculation. By that time, I was taking a lot of pills every night—Dr. Sanders liked to prescribe more meds as a solution to almost any complaint—and counting out the pills was more and more difficult. I never knew exactly how many pills I was taking. 

My balance was shot too. In September, while running across Forty-Second Street in a heavy rain, I fell backward in a puddle and cracked my head on the asphalt. People surrounded me and lifted me up. I was amazed to see that much concern. 

I was obviously very sick, but my boss, Chuck, didn’t notice that. He just noticed that my work output was bad. He had never really liked my work, but he had also never discussed it with me, so I wasn’t aware of the issues he had with it. Some managers deal with problems as they develop, others never deal with them, and still others avoid dealing with them until exploding in anger about them in one big boomChuck was this last type. 

On September 15in one of the glass-walled offices of the partners, Chuck lashed at me like the whip that had tortured Aleksei for the terrible performance I had been exhibiting. It took you three days to revise one slide! he exclaimed. I couldn’t argue with him about that—my performance had been terrible lately. He went on to berate me for various other offenses over the preceding ten months, and I didn’t argue about those either. There was no point; it was clear where this was leading. Finally he said, “I’m going to have to let you go.” I said, “That’s too bad.” But secretly I didn’t feel too bad. It was a lousy job. And I was much too sick to be working anyway. 

I cleaned out my desk and went home. Melinda was terrified that we were about to slide back into penury. I was less concerned, because I was too confused to be concerned. Besides, I had just done this. All I needed to do was freelance and send out resumes, the way I had done before Magnificum. That very day, I alerted my freelance contacts that I was available again and updated my resume. Things would be all right. 

Things were not all right. When the freelance jobs started coming in, I wasn’t able to do them properly because of my confusion and amnesia. I got an assignment to write a needs assessment on gastric cancer, and introduced it with a meditation on how losing a child was the worst thing in the world. I lost my computer file folder with a copy-editing assignment and had to copy-edit the document again, and maybe a third time. I couldn’t perform the math needed to calculate an invoiceI sent out resumes but forgot to whom I sent them. 

This is a sample of my writing at the time: 


A scene of writer’s block clock has some on tomorrown’s now own wom: has now on the writer’s the new writers has gwriteir’s, so that new plots cannot cannot occur. If this isn’t fixed, the program will end.  


I visited a primary care doctor for my various symptoms. She thought I was chewing gum and handed me a trash basket to throw it out. I explained I had no gum; I was just making involuntary chewing motions. She said I had tardive dyskinesia, permanent neurological damage caused by my years of taking antipsychotics.  

The tardive dyskinesia was not only unsightly but, worse, painful. I kept biting my tongue and the sides of my mouth, especially when eating. This hurt and created a lot of little wounds in my mouth, so that I avoided eating. Melinda tried to force soft foods on me, like apple sauce and ice cream, but even those were unappetizing. Fortunately, my appetite disappeared around this time, so I didn’t really miss food. 

My main activity at the time was sleeping. I lay in bed or on the couch most of the day and night, sleeping around the clock. Naturally, this interfered with my freelance work, and my editors started calling to find out what was happening with my late assignments. When they reached me, my voice alarmed them. It had become rough and raw, thick, hardly recognizable. “Are you all right?” they asked. “You don’t sound like yourself.” I tried to sound professional, to reassure them that I had everything under control. But I had nothing under control. I was barely conscious. 

Under the circumstances—losing my mind, disabled, unemployed, the father of a dead child—I decided in the middle of an October night that suicide was the best course. But I couldn’t do that to Melinda. It would be too cruel. The dilemma kept me awake, forced me out of bed, followed me onto the Oriental rug in the living room where I lay in the dark and agonized. And the solution came to me. In the basement I kept an axe. What I had to do was go downstairs, get my axe, and kill Melinda. She would be safe then, at peace, unable to be harmed by losing me. Then I would kill myself. All problems solved. 

I lay on the rug picturing this, and terror filled me. I was serious. I was contemplating something out of The Shining as a reasonable option. I might do it—was on the verge of doing it. I was a danger to Melinda. 

 I went upstairs to put distance between us and figure out how to save her from me. Maybe I should call my friend Frank Wortner to stay overnight and protect her—although I might kill him too. I thought of calling 911 to get myself hospitalized, but since I left Magnificum I had lost my health insurance. Without insurance, the hospitalization would bankrupt us. With no good options, I went into the playroom, at the opposite end of the house from our bedroom, and barricaded the entrance with Melinda’s stationary bike. I stayed awake to keep vigil on myself, fearing that if I fell asleep I would kill her in my sleep. 

I never told Melinda how close she came to dying that night. I didn’t have to, because the feeling passed the next day, as I grew weaker and sleepier. From then on, I remember very little. I just lay on the couch and slept. Periodically, Melinda would wake me and ask, “Don’t you want to eat something?” 

“No,” I would say. 

“But if you don’t eat you’ll die.” 

“I want to die. Then I can see Martha again.” I didn’t tell her that I was already seeing Martha, behind a shadowy curtain on my right, already extending her hand to bring me in, and God just behind her. 

It was the perfect suicide, because it wasn’t deliberate. God wouldn’t punish me in hell for it as a choice, because it wasn’t a choice. I was sick and couldn’t eat, so I would starve and die, which was what I wanted. I had no fear of death; I welcomed it, acquiesced in it. The only part for my will was to consent to what I couldn’t avoid. 

It was the climax of my grief for Martha. Ever since she died three years before, what I had wanted more than anything was to see her again, to live with her again in death. Now, soon, I would. 

Melinda ruined it. On Tuesday, October 20, she called 911. She waited that long because we had no insurance and couldn’t afford it, but finally she was desperate. I have no memory of how she got me to go along with it—probably I was too weak to have any choice. My only memory of that night was waking up on a stretcher in an ambulance to the face of an old schoolmate of Martha’s, Swapnilnow a young man. He asked, “Do you remember me, Mr. Ochoa?” I remembered him. He had waited for the school bus with her. He was a paramedic now, taking care of me. 


The ambulance took me to Phelps, the site of my last hospitalization. Once again, I passed through the ER; once again I was admitted to One South, the psychiatric ward. The next day, standing in the bathroom, I took a fall and landed on my mouth. My right upper lip split open and poured blood. This is what they told me; I have no memory of the accident, though I still carry a small scar in that spot. They rushed me upstairs to the medical unit, where they took X-rays and a dentist checked for damage to my teeth. Indeed, I developed a dental infection that required antibiotics. I remained in the medical unit for three days. 

While I was in the medical unit, memories began to form again, but they are confused and distorted. My first memory was of kicking a female nurse in the chest, with a move I had learned from action movies. kicked her because I was trying to escape. I had an idea that the institution I was in wasn’t a real hospital, that it was run by a Black man named Perkins who had been to Harvard Medical School but had failed to complete his studies and was not a doctor.  I believed I had read this in the New Yorker. The nurses must have subdued me, because my next memory is of being in bed in restraints, my hands in some kind of cloth sleeves that tied me down. Like a fox in a trap, I tried to chew off the restraints—chewed into my hands, causing lacerations that lasted for days. 

don’t know if I was delirious or psychotic—afterward, different medical people labeled me differently. But I was definitely delusional. The nurses threaded a catheter into my penis, to try to draw off excess urine I was retaining, and the pain was so awful I believed they were torturing me on Perkins’s orders. I even hallucinated that I met with Perkins in a place like the old TWA terminal at JFK, and he warned me he would kill me if I kept talking about him. Even so, I told Melinda about him when she came to visit, urged her to read the New Yorker article about him. She never did, because it, like Perkins, was a figment of my imagination. The whole time I talked to Melinda, a young female nurse watched us, and I felt sure she was a spy of Perkins who would report to him everything I said. I didn’t even trust Melinda; I thought it possible she was an impostor or illusion sent there to trick me. 

When my physical condition stabilized, they returned me to the psychiatric ward, One South. My mental condition was still highly unstable, but that’s what One South was for. When I got there, I had no memory of having been there before—either three days earlier or two years earlier—but was convinced they had put me there in preparation for torturing and killing me. I wasn’t afraid of death, but I was afraid of tortureA nurse, a Guyanan named Jennifer, was assigned to watch me overnight to make sure I didn’t fall againso I couldn’t escape right away. But when she fell asleep I picked up a tray-table and smashed it against the window, trying to break out. Unfortunately, the glass was shatterproof. Jennifer yelled and other nurses rushed in, forcing me to stop. One of them knocked me out with a big dose of Ativan. 

After that, I tried to behave better, knowing they would only let me out if they thought I was sane. But I wasn’t sane. For one thing, I thought my roommate was Jesus. He thought so too. He was a snowy-haired man with an eagle-like face who wore a big gold cross and used a walker. He was hardly ever in the room because he preferred to sleep in the quiet room, which they normally reserved for very disturbed people. He informed me that his mother was the Virgin Mary and that she would leave $50,000 for me in my kitchen at home on Sunday. I asked Melinda to check, but the cash wasn’t there. 

I thought some of the other patients in One South were zombies. One woman in particular looked like the walking dead, with a cadaverously thin, pale face. Another walked stiffly and wore a scarf around her neck, I thought to hide how her spine got broken when she died in a riding accident. I myself looked like the walking dead. I caught a glimpse of myself in a pane of glass in a door, and I was hollow-eyed, scrawny, almost skeletal. I had been overweight before, but during weeks of not eating I had lost thirty pounds. 

Some of the other patients looked like ghosts or phantasms to me, spirits who lived eternally in One South like the spirits at the Overlook Hotel in The Shining. 

On Monday, October 26, almost a week after my arrival, my mind began to clear enough that I could write in a notebook. I was still confused, trying unsuccessfully to write out the invoice I owed to a client, but light was beginning to penetrate. That night I had an intensely vivid dream, so vivid I thought at the time it was real, or perhaps a play staged for me by the nurses. I was in my bed, when an explosion happened and I was transferred into an apartment where a man, one of the nurses, sat scrolling through his phone. In the phone were answers to all life’s mysteries, and, in a low-pitched, terrified voice, I asked him questions to get the answers. At the time, I was in pain from injuries from my fall, including a chest contusion, but I didn’t know that was the reason. So I asked, “Why do I ache all over?” Because it was time for me to stop lying in bed and start doing things, he saidI was one of the top writers of the age, he reported, and I had more things to do. Was there a God? Existence was Buddha-like, he said, except for the one time God became man. Why did Martha die? He had no information on that.  

This was what I came to call the pivotal dream, telling me that I had to start moving again, living again, writing againI had to keep caring about Martha and Melinda, recover my health, and know that God was watching over me with power and love. The next morning I opened the drapes to look out the window in daylight for the first time. It was a brilliant fall day outside. A nursing student was assigned to watch me to make sure I didn’t fall, and we got to talking. I told her the story of Martha. She listened sympathetically, respectfully. 

In the days that followed, it seemed like everything was meaningful. Every object in my room, every scuff mark on the wall was a communication from God. I tried to interpret it, but my mind went round in circles, unable to fix the meaning. Gradually, as I regained my sanity, my surroundings became less charged with meaning, more ordinary and quotidian. The walls meant nothing; the people were not zombies or ghosts but people. 

Melinda could only visit every couple of days because, since my last hospitalization, she had become more afraid of driving outside Dobbs Ferry, and had to find people to drive her. Her timidity about driving was connected to her growing disability from MS. I was glad to see her whenever I could. For years I had wondered whether Melinda or Martha was the best thing that had ever happened to me, and I realized in One South that it was Melinda, because Melinda was still here. Martha wasn’t. I told Melinda this, and she said I was the best thing that ever happened to her too. 

One day she got Father Jim to visit me, the Indian priest who had consoled us right after Martha’s death. Father Jim quickly became the most popular man at One South; the sight of his clerical collar made other inmates want to talk to him, perhaps to exorcize their various demons. Even my roommate Jesus asked for a word with him. But Father Jim focused his time on me. He sat with me in my room and I wept about Martha as I hadn’t in a long time, wailing, “I lost her! I lost her!” My grief seemed as fresh as if she had died only yesterday, not three years earlier. Nothing he said could comfort me, but he gave me the sacrament of the anointing of the sick, and the Eucharist. Those did afford some comfort. 

On Friday, October 30, my psychiatrist explained her theory of how I had gotten sick. According to her, I had somehow overdosed on lithium. The symptoms I had developed since August, of memory loss, confusion, delusion, somnolence, loss of appetite, unsteadiness, and urinary retention, were all the result of lithium toxicity. The symptoms were resolving now because she had stopped my lithium. I still had tardive dyskinesia, but that was better now too. Ironically, both my lithium toxicity and tardive dyskinesia had been caused not by my underlying mental illness but by the medications used to treat it. The tender care of my doctors had almost killed me and put me in the hospital. 

I didn’t tell this to the psychiatrist, but it also seemed to me that the lithium toxicity had been the occasion for my first suicide attempt. Unlike most suicide attempts, it had been passive rather than active, requiring me only to succumb to my symptoms rather than initiate action. But suicide is deliberateand my passivity had been at least partially deliberate because I knew I was dying and wanted it, did nothing to fight it. In some respect, it wasn’t deliberate, because my mind was too foggy to be entirely clear about what I was doing. But I was clear enough to feel disappointed afterward that it hadn’t worked. Melinda had saved my life by calling 911, but I was not grateful. I wished I had died peacefully. 

The psychiatrist expected I would be able to go home soon, on a new regimen of medications that didn’t include lithium. I wanted to go home because I disliked being caged. I wanted to be with my wife again, in my house, living my life, free. I didn’t know when I would be able to work again, but whenever it was, it wouldn’t be till I was home. 

While I was in One South Halloween came and went, and the Mets lost another World Series. As my mood improved, I regained my appetite and participated in more group therapy. At a karaoke session, the group leader played the Plain White T’s song “Hey There, Delilah,” which I hadn’t heard since Martha and I used to listen to it. It pierced me with longing for Martha, who, in my imagination was the beloved Delilah in the song, separated from me but with the plaintive hope that we would see each other again. 

One of my fellow inmates was a young man, in his early twenties, who looked muscled and innocent, like a bearded Superman. He was at One South because he had tried to kill himself in imitation of a girlfriend who had killed herself. I talked with him for a while, and emphasized one bit of advice over and over: “Stay alive.” I couldn’t give him a reason for this advice, couldn’t back it up, except to say I had lost a daughter to suicide and had nearly lost myself, and the only thing that experience had taught me was to stay alive. I hope he listened, but I’ll never know. I never saw him again, and I don’t remember his name. 

On Tuesday, November 3, I was discharged from One South for the second time. Melinda and my brother-in-law picked me up. Walking down a long hall and nearing the threshold of Phelps, I remembered an idea I had that Perkins, owner of the fake hospital, would never let me leave here alive. He planned to gun me down as I exited. At the sliding glass doors I looked around for assassins, saw none, walked into the drivewayBullets didn’t riddle me. As my brother-in-law drove me home, I regained that much more of my sanity. 


Copyright 2020 George Ochoa.

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