Recently a close friend of mine asked me to write up his week long “experience” at Mount Sinai’s Clark 8 — a cryptic name, right? not at all descriptive — but what most of us would call a psych ward, or perhaps the loony bin. After a couple of talks, I tried to do so as best and faithfully as I could, but, it really didn’t satisfy either one of us. What he most wanted to convey was his feelings about the whole experience, not something that read like a neophyte reporter’s “sociological” account, which, I must admit, is how it first came out.
So we made a somewhat weird and counter-intuitive decision: I would write it up in the first person, still (largely) in his own words but as he painstakingly recounted it to me without himself having to put pen to paper. So there is no “he” here — it’s all “me” and “I.” My friend has read this new version and is completely happy with it, although I’m not sure that I am, having heard the whole harrowing (and really pretty funny?) story straight from the horse’s mouth. Consider this, then, a kind of slightly edited — but not embellished — Studs Terkel-type interview, minus the interviewer. OK? (Ed.: Admittedly I added a few editorial asides, in bold italics, which he’s approved, too. It helps, I think, if you know that my friend considers himself a “public intellectual without a public,” as he often says.)
Clark 8, or Welcome to the Hotel California
How I ended up at Clark 8 — what I did to end up there — I don’t think important enough or even relevant to specify. After all, there’re lots of different ways to land in the loony bin, as I’ve now learned. I will only say that I never meant to hurt anyone but myself: Not much of an excuse, I see that now in retrospect, but then you always hurt the ones you love, the ones you shouldn’t hurt at all (courtesy Fats Domino). This is not meant in any way to escape responsibility for my actions.
I know what I did to get there, but couldn’t tell you a thing about getting there. I just woke up the next morning in a hospital bed, drugged up and mostly drugged out. “How do you feel, Mr. Jones?” (Ed.: An unashamedly pedestrian pseudonym.) “Damned if I know, except not so good.” (At least that’s what I intended to say but even I could tell it didn’t come out quite right.) It never occurred to me to ask where I was, and if I had and they had told me “Clark 8” it wouldn’t have meant anything to me, anyway. But I knew this was no ordinary hospital. I’ve been in hospitals several times for different operations and ailments and this was clearly not an ordinary hospital.
I was mostly comatose the whole of that day and, by the evening, when I had regained some clarity, at least enough to talk a bit, my roommate — since he once called himself an Average Joe, let’s call him that — told me i was in the Psych Ward: “Welcome to the Psych Ward!” I asked him what day it was — “Saturday,” he said, “you picked a bad day to get here.” “How come? What’s wrong with Saturday?” “‘Cause, my friend, there are no doctors here on the weekend, you can’t get out without seeing one and you won’t be able to see one until Monday, if you’re lucky then, and no way you’d be be getting out of here on Monday, anyway, ’cause they have to diagnose and then observe you, see how you respond to the treatment. You’ll be on God knows what kind of meds all weekend so you might as well roll over and go back to sleep. The RNs will wake you up every once in a while, take your blood pressure and give you more pills. So just relax and we can talk more tomorrow.”
Average Joe was right, of course, and so there’s no point trying to tell this story day-by-day, since all days in Clark 8, except the aforementioned weekend, when you can’t see a doctor, are exactly the same. The only inevitable and somewhat predictable events are breakfast, lunch, dinner, Visiting hours, and Movie Night (which is every night), and everything else here is either erratic or completely unpredictable (even to the authorities, the docs, RNs, assistants!) So you have this weird combination of a little certainty with massive unpredictability. My first day in Clark 8 was about as uneventful as could be: Pills and blood pressure, just as Joe said. Sunday was only a bit different — I still mostly drifted in and out of sleep but in lucid moments I learned a lot from Joe, particularly that since I had not voluntarily admitted myself — that is to say, that I had been involuntarily committed — I had no say whatsoever about getting out. (To be fair, I had been in no condition to voluntarily admit myself.) “Nobody gets out of here until the doctors and Social Workers say so. Maybe you’ll see them tomorrow [Monday] maybe not, all depends on their workload, I guess. I’ve been here a few days now and I haven’t seen anybody. I have no freaking idea why I’m here. I hope you do.”
By the end of the week, Joe and I were calling the place Hotel California (Ed.: courtesy of the Eagles): “We are all just prisoners here of our own device…. You can check out any time you like, but you can never leave.”
So, yeah, I mostly slept, and so did Joe, for that matter, because he was getting sedatives, too. In fact, I assumed he slept more than I did, since most every time I woke up, he was asleep, an easy to make but elementary-stupid deduction. Turned out, as his meds got changed, he had a really difficult time sleeping. One morning I got up to pee and wash off as best as I could: We resorted to a larger version of baby wipes, because we had no shower curtain and, effectively, no shower, just three tiny nozzles spitting out jets of ice cold water. Anyway, that morning I noticed that three of four things opposite our “shower” that were completely inexplicable to us, (some relic of past Psych Ward torture, perhaps) and toilet, little round chrome pieces on the wall that reminded me only of the perfectly round, smallish breasts with aureole and nipple that you sometimes see in Cincquecento Italian paintings. I left them there on the floor and Joe told me later that day that he had awoken sometime in the middle of the night — BTW, there are only a couple of wall clocks at Clark 8 and you’re not allowed a watch of any kind, so you never know on your own what time it is — and had unscrewed them from the wall but would screw them back on later if he could. Pretty fucking crazy, I thought then, but as the days went on I realized, no, not crazy at all: What the fuck else do you have to do in Clark 8 in the miserable middle of the night when you can’t sleep? Why not see if you can disassemble these weird little things that are just stuck there in the wall?
Clark 8 is laid out like a plus sign and it’s not particularly large, so walking for exercise or just to kill time is both weird and ineffective: How many times can you walk down a hallway, turn around, go back, turn right or left, turn around, go back, repeat, repeat, repeat? There are windows at the end of each hallway but they’re either frosted so you can’t see out or, if they’re clear, just look directly into some other side of the hospital where there’s nothing to see but more frosted windows (or clear windows and, believe me, nothing to see in them, either). At one end of the plus sign is the Day Room, which (of course!) is locked most of the day, except when there are classes underway — more on classes later — or later in the evening for Movie Night (which, again, is every night, although there are only three movies, a Harry Potter, a Star Wars, and some straight-to-cable [and perversely ultra-violent!] crap starring a bunch of B actors). There’s also an Activity Room in which there are no activities of any kind except a television tuned to channel seven (Ed.: the ABC station in New York City). If you ask a nurse or admin to change the channel for something, anything else, the invariable and unanswerable reply is: Well, you’d need to have a remote to do that, wouldn’t you? It’s actually just a spillover room from the Dining Room that’s also kept locked except during and immediately after meals, LIVE with Kelly in the morning and ABC News after dinner. (I never wandered in there after lunch, so I don’t know what plays then.) There’s a Nurses’ Station or Administration Office where you can go to try to shot the shit with anyone on duty who’ll put up with you for a few minutes, or perhaps to ask when you’re getting your next meds, the answer to which is, usually, Soon, don’t worry, we’ll find you.
Sooner or Later…
For all the reasons mentioned above, time moves verrrrrrry slooowwwwwwly in the loony bin. One morning after I had finished breakfast — it was probably just a couple minutes after 9 then — I sat on my bed and tried to read the Times — I was a lucky one whose wife brought me the paper every day, although by the time I got it and could read it, it was already yesterday’s news. (BTW, the only newspaper available to Psych Ward patients was the Metro, a free and worth-every-penny of it rag you pick up in the subway.) And another BTW, you aren’t allowed any electronic devices, so no phone, no laptop, no Kindle. You’re allowed small paperbacks if your visitors are willing to bring you some, but no hardback books, presumably so you don’t attack a fellow patient with one or try to commit suicide by banging one against your head. I was thinking of asking my wife to bring me a nice fat paperback of Gibbon’s Decline and Fall of the Roman Empire just to see if they’d let me keep it.
Reading anything is difficult here, however: You might be awake but you’re still affected by all the meds — I mean everyone is on some kind of sedative or antidepressant or other kind of drug that, let’s say, slows you down, so it’s a slog to get through even a couple of articles or pages. Plus, one of the screamers is always nearby outside your door — not that a screamer has to be nearby, anyway, in Clark 8 — and the screaming obviously starts to drive you crazy. (I’ll talk more about the screamers later.) And the nurses made clear, by always opening closed doors, that they should never be completely closed: The doors have mirrors on them where you’d expect glass, so that the nurses, etc. can check in on you with the door half open, where it’s supposed to be.
Anyway, that was exactly my situation one morning; I was plodding word-by-word through an article, the screamer was driving me nuts, I couldn’t concentrate, so I got up and walked around, and around, and around… The screamer finally shut himself off for the moment, and I came back to my room, read a few more articles, dozed off for a while, woke up, forced myself through a couple more articles of the Times, and thought, Good, must be real close to lunch by now, which could be anytime after noon; and not that I wanted the food, I just wanted the time to go by. So I walked down to the Nurses’ Station, where there was a wall clock: It was 9:45. I had just killed 45 minutes in what felt like three hours. This never really changed much, even after I got to know quite a few of my fellow inmates, uh, patients, and could manage conversation. (The majority of patients were incapable of communication, either because they refused to, were too drugged out to even try, or wanted to talk but couldn’t manage coherence.)
The Five Rules
I know you’re not supposed to bury the lede (Ed.: for those not conversant with journalistic lingo, burying the lede can be defined as beginning a story with details of secondary importance to the reader while postponing the more essential points or facts), and I apologize for all these digressions, but I promised some detail on screaming, and this seems an appropriate time. Screaming goes on all the time in the Psych Ward; it can happen at any time, day or night, but it happens multiple times every day. But it doesn’t happen like you see it in the movies or on TV shows, where somebody goes nuts for a few seconds and screams, say, Where am I? Where am I? Where am I? OK, that dramatic moment has been established, and now the storytelling goes on. That’s not the way it works in a Psych Ward. In a Psych Ward the Where am I? is more like WHERE AM I? And it goes on and on and on: It’s not WHERE AM I? three times; it’s WHERE AM I? three hundred times.We had one guy screaming this very question the better part of one morning and afternoon, literally hundreds of times. Only later that evening did he switch to WHERE IS MY FAMILY? — also at least a couple hundred times at full volume. The next day he switched again, this time to WHERE IS MY DAUGHTER? And that continued much of the day and night. (This guy had tremendous stamina; he continued screaming all of the third day as well.)
It’s still amazing to me that someone could go on for so long, and so loudly, screaming the same thing over and over and over again. Indeed, it struck me as a kind of weird talent that psychos can develop. You know the little game of asking someone to repeat the same words over and over again: Every “normal” person will start screwing up, say, eleven o’clock, after at most a couple dozen times; it doesn’t take long for eleven to become, say, eleben. Not the screamers, though; they can manage perfect repetition of their question, demand, or statement at full volume for a good 10 or 15 minutes at a time. Then stop for a couple minutes and pick it up for another 15 minutes. Then stop again for a bit and pick it up for another 15 minutes. It’s enough to drive you crazy in the Psych Ward…
There are also intermittent screamers. We had a couple of these, including one woman, let’s call her Franny, grossly overweight and on a diabetic diet, who would start screaming I’M HUNGRY for minute after minute immediately after finishing her every breakfast, lunch, and dinner. That kind of gets on your nerves, sure, but nowhere near as much as her other usual scream, STOP SCREAMING AT ME!, which she might direct at anyone at any time who happened to annoy her for whatever reason. Imagine this particular screaming on a loop, as the American Military is said to use the sounds of a baby crying on an endless “noise stress” loop tape as an instrument of torture. Then try listening to someone screaming STOP SCREAMING AT ME! a few dozen times in a row a few times a day with, again, perfect articulation, and see how you feel.
One of the odder examples of intermittent screaming came from a middle-aged white male patient, who always introduced himself politely as Samuel, but whom all the nurses, assistant nurses, etc., and fellow patients called Bob. He seemed to have a particular habit of picking out certain people — the one with whom he interacted, or tried to, most assiduously while I was there was a young Chinese student at Columbia named Lin who liked to play the piano as a means of calming her nerves (and did it very well; it was a pleasure, completely unexpected, to listen to her) — yes, we had a piano in the Day Room. One evening there, while Lin was playing away, another patient sat down next to her, and Samuel (Bob) immediately jumped to her side as her protector, screaming, GET AWAY, LEAVE HER ALONE — holy shit, a two-clause scream, a novelty here — which caused enough consternation that our supervising nurse — you can’t be in the Day Room without a supervising nurse — felt compelled to call in some muscle, a couple of Black guys, upon which Samuel (Bob) began screaming at them: NIGGER, NIGGER, NIGGER, NIGGER, NIGGER, on and on, over and over. But when I was expecting a race riot, nobody blinked an eyelash, not the patients, not the muscle guys, nor the (Black) nurse. Apparently the Psych Ward is one place where racial epithets don’t matter, don’t even really register — a truly racially-blind utopia (or dystopia!) I began to fantasize: What if I started screaming CUNT, CUNT, CUNT…? Of course, I’d eventually get hauled away, like SamBob, but would I witness before that all the women, color-blind and in harmony, join together to beat the shit out of me… or would there be the same deaf and dumb acquiescence?
Of course, I also wondered why in the hell they couldn’t efficiently, swiftly, and similarly, take care of the WHERE AM I? WHERE IS MY FAMILY? WHERE IS MY DAUGHTER? guy in the hallway…
OK, on to the buried lede: There is in fact an answer to Depends on what? What’s sooner and what’s later? It’s the Five Rules. I learned these early on, actually, although not formulated as rules so much as an extended off-the-cuff comment from a young lady whom I had congratulated when she told me she was “leaving” early in the afternoon — a successful escapee!. When I asked what were her secrets of success — I was really being facetious because I didn’t know at that time that there were any such things — she very casually said: “Well, eat your food, take your meds, take at least two classes a day, don’t fight with the other patients, and don’t fuck with the doctors.”
I didn’t really take all this in at the time, certainly not as true Rules. After all, this was a very impromptu conversation with a girl I hardly knew, and had talked to only because previously we had shared “Hi” and “Hello” in the hallway once before — a small but rare evidence of mutual sanity and non-hostility. (Customary reaction to “Hi” in the hallway was complete non-recognition, complete incomprehension, or mumble-mumble-mumble. Most folks in the Psych Ward are incapable of or unwilling to socialize, so I thank the Higher Powers that I had Average Joe as a roommate.) But over time I did codify these off-the-cuff remarks into Five Rules, and here they are:
Rule #1: Eat Your Food. Imagine you’re married to a nutrition and diet expert; s/he prepares you perfectly balanced, nutritious meals: a protein, a vegetable, a starch, appropriate condiments, and everything in just the right amount. This is what you get for breakfast, lunch, and dinner in the Psych Ward. Now imagine airline food. Now imagine food that’s twice as bad as airline food — food so bad that you would not only trade for airline food but beg for it. That’s also what you get in the Psych Ward: Food that has been brilliantly conceptually designed but, by the time you get it, tastes like shit. Yes, it’s cold, and everything you’re eating is meant to be eaten hot or at least warm. But that can’t be the whole explanation: There seems to be a series of disconnects between the nutritionist’s brilliant design and the “food” as it is actually served on a tray and has to be eaten.
First couple days, I simply couldn’t eat this shit. Of course, I was drugged out of my mind, but even in that state I instinctively knew that this should not (could not?) be swallowed. Undoubtedly I earned a few demerits, but eventually I caved: (Oh, and more later about “caving in.) I got hungry, I had to eat something, and this was what there was to eat, so I ate it. Of course, it’s not easy to cut up a turkey cutlet, tasty or not, with a plastic fork and spoon, but then you aren’t allowed a plastic knife. On the theory of… what exactly? Why a plastic knife is potentially more dangerous than a plastic fork is beyond me, except if what you’re trying to accomplish is reduce both the efficiency and dignity of your patients.
A couple other things bothered me: The nurses checked what and, especially, how much, you ate. Not much, not good: Demerit. Cleaned the (plastic) plate?: Gold Star. I became a Gold, or at least a Silver, Star Eater (and at least a Gold Star spoon-meat-cutter): I always brought back a “light tray.” I didn’t enjoy this, but it was Rule #1: Eat your food.
Whatever was on the tray, however, that wasn’t eaten (with the exception of milk and juice and (sometimes) fruit (apple or banana) was trashed. (Joe loved fruit, so I usually saved mine for him.) Evidently hospitals are exempted from NYC recycling laws, so meat, vegetables, potatoes, rice, whatever, was simply dumped with everything else: plastic implements, plastic plate and covers. And so much dumped there was uselessly wasted, especially unopened sugar and salt and pepper and maple syrup and grape or strawberry jelly packets. I saved my maple syrup packets for Frannie, who liked to drink them —I’M HUNGRY! I’M HUNGRY! I’M HUNGRY! — although I did have ethical qualms about giving them to a diabetic: But, hey, then she didn’t scream at me, she left me alone. Once I did use a whole packet to manage to get down a portion of (I’m sure, nutritious) oatmeal, which I hate but, hell, I got it down.
Rule #2: Take Your Meds: You do have a certain degree of freedom of choice when it comes to food — you can “order” the next day’s soup, say, instead of meat, and of course you can choose to eat as much of it as you like (but not too little) — but there is no choice when it comes to your meds. You don’t question, you just tilt the meds cup with its pills into your mouth, take the offered water, and swallow. One evening when I was to be given an unprecedented baker’s dozen of pills, I foolishly revolted and said I wanted to know which each and every pill was. OK, nurse said: “This pink one is EGDSFOFDJGFHKL…; the big blue one is your ZKDHCOFJKFGT…; the white one is ASPDOHDFNTHYI…; the little green one is…” OK, I said, I get it, took the med cup and swallowed them all down. This is a fight you can’t win, can’t even discuss, and can only hope that you are getting appropriate meds in appropriate dosages at appropriate times.
Rule #3: Take at least Two Classes Every Day: Classes are given by very well-meaning outsiders but, boy, are they meaningless (except insofar as they fill up little parts of your day.) I took one class is which we practiced throwing one ball to a fellow patient, working up to six balls going simultaneously around a circle to each designated receiver. In another class I learned how to turn a scarf-like material into a… scarf, and later into a free-form expression of emotion; that was undoubtedly a boost to my mental health.
In another class, the one on Psychotherapy I mentioned earlier, we were asked to introduce ourselves to the leader and one another: Oddly, each patient introduced him/herself not by name but by diagnosis: I’m Bipolar; I’m a Depressive — Bipolar was most popular for whatever reason — because in the Psych Ward you are not, apparently, you, but your diagnosis. I was next to last to self-introduce and simply followed the others, assuming that this was what was expected: “I’m a Depressive” (I had to guess, since no one had told me what I was.) Average Joe was last and broke the routine with the simple declaration, “Sometimes I think I’m the reincarnation of Christ.” OK, that’s strange, I thought, really, really strange, since I’d had not the slightest hint of anything like religious mania out of Joe. Later I realized this was a sly act of rebellion — and also a reaction to the fact that Joe truly had no idea how or why he had landed in the Psych Ward — oh, and in its humor, a strong sign of mental health! — but humor, sarcastic, ironic, whatever, isn’t appreciated here any more than is questioning your meds or not eating your food. I’m sure Joe got a demerit for that.
Rule #4: Don’t Fight with Other Patients: This would seem to be pretty obvious, but not so to a lot of the patients. There were plenty who could and did unexpectedly fly off the handle at the slightest thing: a look, a word, a movement, sometimes real, sometimes imaginary. This was a easiest rule to obey, at least for me. I wasn’t looking for any kind of confrontation. (Although I sometimes did long to strangle the screamers.) Point is: Fighting could and did break out unpredictably, anywhere, anytime, for any “reason.”
During my stay in Clark 8 the single predictable source of “fighting” — we’re always talking mutual shouting back and forth here, except for a rare instance when a couple blows were thrown — was Roberto’s hogging of one of the two computers in the Day Room as his personal Karaoke machine. “Thirty Minutes Per Person” was the rule that Roberto broke any and every time the Day Room was open. You’d think the computer was not only his personal machine but also one that could play nothing but ’80s and ’90s YouTube videos. Aside from his hogging, what disturbed most of us (all of the ambulatory non-comatose) was Roberto’s “habit” of partially undressing himself while dancing and prancing around to his (loudly-played) videos. The shirt would come off to be put back on after the supervising nurse’s command, one time after another: pajama legs — oh, did I tell you that most of us were in flimsy hospital pjs most of the time? — rolled up to show off, I guess his calves and lower thighs — this, too, over and over. Despite the nurses’ stern disapproval, and eventually a petition written and circulated by Lin to shut him down, Roberto’s manic behavior never altered. Maybe he’s happy to be in the Psych Ward, for where else could he indulge himself to his favorite music stripping for a captive audience?
Rule #5: Don’t Fuck with Authority (the Doctors especially but also the Nurses and Social Workers): This, too, pretty much went without saying, or at least became obvious quickly. No matter how perfectly you were following the first four rules, you weren’t going anywhere unless and until the doctor said so (with, presumptively, input from the RNs and Social Workers). But following this rule wasn’t easy, if only because you never knew when or where a doctor might turn up to speak with you. But when one did, whatever else was happening with you then or just prior now became irrelevant: He speaks, you smile, listen attentively, and when he asks if you’re feeling anxiety — which is, of course, your constant state in Clark 8 — you know to say, No, I’m doing fine, Doc, gee, thanks for asking, I’m taking my meds, eating a bunch, I’m great, doing great. (‘Course he probably doesn’t believe you, psycho.)
The Social Worker is a big deal, too, and she, too, comes and goes as she pleases (at least from your perspective; undoubtedly she’s being pulled and pushed from circumstances beyond your ken). I had one visit from my Social Worker, lasting less than a minute: She could not manage to get out even one complete question or statement to me because our WHERE AM I? screamer was blasting on at full volume and she had already had enough: “I can’t take this” was all she said as she hastily left. Yeah, I thought, I KNOW how you feel…
Anyway, just don’t mess with the Man. It screws you in the long run and provides little comfort in the interim. You can ask the most perfectly logical question, you can make the most perfectly logical suggestion, but it’s to no avail: The doc parrots back PROCEDURE and PROTOCOL (whatever it happens to be in respect to your question or suggestion), and there are no heights, or depths, to his dissembling in “answering” you and re-establishing PROCEDURE and PROTOCOL. If you fight with another patient, you are just the bigger idiot for fighting with the village idiot, but if you “question” your doctor, you are Winston disobeying Big Brother’s law and order and you are destined to take the big pipe.
So, you cave; you cave to eating the inedible food, cave to taking the always mysterious medley of meds, cave to showing up for and “participating” in kindergarten “classes,” cave to virtually isolating yourself lest you inexplicably end up “fighting” with a fellow patient, and above all you cave to Authority. This may be the most insidious aspect of spending even the most minimal amount of time in the Psych Ward: You can’t get out if you don’t give up.
But it’s actually worse than that: After giving up, giving in, guess what? The food becomes okay, you get it down, you’re not hungry any more. The meds, well, they slow you down, but in doing so you really lose the energy to question them, you just get used to them and you are, indeed, fine with them. The classes? They kill time for you, which is precious because, as I said before, you have nothing to do and all the time in the world to do it, and you even end up having a little “fun” (however imbecilic it may seem).
The Five Rules do work; ceteris paribus, following them will get you out of the Psych Ward: But you begin for the first time to really understand the Stockholm Syndrome, because, guess what, you’re feeling it. You begin to identify with your captors. (And “captors” is not hyperbole: You’re legally in their custody and care, and while your Rights of Patients say you can fight for your release, just try it and see how far you get.)
Hell, stay in Clark 8 long enough and you may not really want to leave: Per, once again, Hotel California, “We are all just prisoners here of our own device…. You can check out any time you like, but you can never leave.”