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Schizophrenia Screening Test |
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For me, it usually starts with music.
Not the kind you know is only an echo of some recently heard song �playing� inside your head, something you understand is actually your thoughts repeating the song to yourself, though it may start out that way. No, this music, once it becomes audible, is quite distinct from that; for one thing, I hear the music coming from outside, not inside, my head, as if an invisible radio is playing from within the walls or floor or some place well-hidden. There might even be a DJ�s commentary in the background, mumbled, indistinct, but adding to the impression that I am listening to an actual radio.
Except that the music is never right; the words or tune are always sinisterly distorted, repetitive and ominous-sounding, so that even the most harmless or delightful of songs soon turns to misery-making.
But it doesn�t end there. Rarely if ever does it harmlessly fizzle, sputtering away into nothing. Instead, it invariably escalates. Occasional bursts of melody become constant and nerve-wracking as songs change and deform and come back to haunt me, or certain phrases may be repeated endlessly, over and over and over, to the point that I want to scream and have to turn on a real stereo as loud as possible just to drown them out.
Then the jumbled, vague DJ commentary turns nasty, as recognizably human voices start calling me the worst names they can think of � whatever would be the most hurtful, harmful and insulting. Usually some variation on �Fatso!� or �Satan�s spawn!� This is not necessarily done at full volume. Very often, I have the sense that what is spoken is done so secretly, the way, on the old gameshow Password, the correct words were whispered to the TV audience, supposedly so the participants couldn�t hear.
For me at any rate, this secret exchange of information always gave me the sense that I alone was being given the answers, which is in fact what I believe they wanted each viewer to feel. But this is often how the voices sound now: as if they are passing along secrets or letting me know something no one else is privy to, even if it is only to insult or deride me. The Password quality of these exchanges is so powerful that I know, or feel I know, that what they tell me must be the truth, a truth given only to me.
While I have heard loud voices and once heard Japanese being spoken in the walls, a Japanese curiously enough that I could completely understand, though I speak not a word of the language, much more often do the voices take on this secretive quality. They may go on and on, but will do so as if careful not to be overheard. Which only adds to my disquiet, as I sense what is in fact true: that no one hears what I hear.
But my understanding is that they don�t hear it not because it isn�t real, but because the speakers deliberately pitch their voices in such a fashion as to prevent anyone but me hearing them. So naturally people will deny the reality of what I hear. It�s meant for me alone; they aren�t supposed to hear it! But I do hear it, I hear something, and after the first few years, when the messages were relatively benign, all I�ve heard has been nasty, abusive or downright dangerous.
There is a part, early on, in the movie LULU ON THE BRIDGE with Mira Sorvino and Harvey Keitel, where Keitel�s character is walking alone at night past a wall where it seems he, or the audience, can hear people mumbling and chattering invisibly. This struck a chord in me, because it wasn�t the movie-loud screaming that many people associate with �hearing voices,� but rather what is more common for me: the experience of hearing conversations or commentary as if from a room away or from behind some barrier, the apparent distance from the source of the sounds making it seem all the more possible that what I hear is real rather than �imaginary.�
But what struck me as I watched it, was how similar this was to my experience of hearing real sounds from unreal sources. In my case it is not just memories or fantasy or imagination, or at least it doesn�t feel that way. It feels, it sounds, completely real and reasonable, which is part of the dangerousness of it, because if the sounds are real, if the content of what is said seems reasonable, then shouldn�t I reasonably trust them to tell me the truth and instruct me how to act? If the little dancing red man from the BioHazMat sign seems completely real and credible, both as a being and as an authority, why then should I not obey his dictates or listen when he tells me I must immolate myself and here�s how�
The problem lies in the brain, as I�ve been told innumerable times and as I believe to the best of my ability, but how can I distinguish real human voices or the actual radio from ones that don�t truly exist? It is a conundrum that escapes my solving it every time, because I have no touchstone, no yardstick to measure a human voice or radio DJ against that would reliably tell me which ones are hallucinatory and which are not. The big question becomes, how can you distinguish between the real and the not so real when your brain, which is supposed to do the discriminating, is the one simultaneously creating the confusion?
Here endeth my 13th blog entry.
Susie D was my one longtime friend in high school, an all girls� private day school in Connecticut. From 8th grade, when I started, through 11th, when she left for boarding school, she was the one person I could count on to be loyal and accepting, even in the dark days when my other classmates were beginning to laugh at me and dub me �the zombie,� because I stared blindly into space and wouldn�t respond to conversation, not even a direct question.
A tiny, birdlike thing, with pipe-stem limbs, an oval face, and thick wavy hair, Susie had large, dark, hyperopic eyes, magnified only the more by her thick lenses. She was by the far the smartest girl in my class, having skipped a grade in days when that was virtually unheard of, and was especially talented in music � composition, violin and piano � and languages, though frankly she was good at everything she undertook. Even when, for unknown reasons except general disaffection and unhappiness, she refused to do any schoolwork and her motivation slipped, her grades plummeted, she still easily got into Columbia (Barnard in those days), and missed Harvard only by a hair.
Then, just before she turned 21, she took an overdose of pills and alcohol in her dorm room, and died, the first suicide at Barnard in nearly a decade. I know this because though Susie and I were only exchanging letters at the time, with rare phone calls in between, my father saw the article in the New York Times and announced -- to one and all, but his intentions directed at me, sitting as far away from him as possible in the dining room -- �Guess who died!�
Naturally I had no idea. �Who?� I grudgingly responded.
�Susie D--� he said, with what seemed like a certain gloating satisfaction.
I felt my heart go cold and dead. Now what had I done? Why hadn�t I known she was in trouble? Why hadn�t I saved her? Hadn�t I walked by her house during school vacation only a few days earlier, or so it seemed, and not stopped to say hello, mostly because at 80 pounds I felt I was too fat to be acceptable? I�d even crossed the street and hid my head lest her father, working in the pachysandra outside, recognize and invite me in.
In the days and weeks that followed, Susie was with me everywhere. In my dreams, in my fantasies, even seemingly in strangers I passed on the street. The pressure of my guilt kept me up at night, and during the day I saw everything with the eyes of the newly grieving. I never let an hour go by when I didn�t think of her, desperately afraid that were I to slip and forget her, even for a moment, that ultimate betrayal would push her away forever. I often woke from sleep thinking I could call her to chat or even just to get her expert help in solving the notoriously difficult Sunday Times doublecrostic. I forgot she was dead. It seemed to me that if I kept her in my thoughts, she was still truly and actually alive, and I did all I could to keep her that way, refusing to accept the stone-hard fact of her death.
One particularly troubled night, I went to bed late and when I dreamed I dreamed of Susie, as I so often did. I describe this episode in my book, and so won�t ruin the suspense by relating it here, except to say that I woke feeling better than I had in months, certain I�d had a visitation and had been advised by Susie herself to let go of my feelings of guilt and understand she�d chosen to do what she did. Most important of all was her �message� that I was not to follow her to the grave, but was to �join the party,� continue living my life.
I never forgot her, though she died over thirty years ago. And every so often late at night I�ll find myself writing a poem, yet again about her or to her. But this is not unhealthy. Susie was my friend. Why shouldn�t I still remember her, her wittiness and intelligence and loyalty, with fondness and affection? In some sense it *has* kept her alive, if only in my memory, and for that I am both glad and grateful.
What follows in a three-part poem I wrote about Susie several years ago that was published in the Tunxis Poetry Review�s final edition, �Three Poets.�
THREE POEMS FOR HER PARENTS
1) Grieving and Staying
The dead do not need us
to grieve or tear our hair
or keen extravagantly.
Stepping free of flesh
a double exposure (one ghost
rising from bed, another napping
at mid-day), their spirits follow
the curves of their late bodies,
rehearsing again and again
what we�re always too late for.
Just so, my friend Susie,
scrubbed clean of life�s debris,
twenty years later returning
in my dream of the dead
returning and I can�t let go
my guilty retrospection,
the arrogant suspicion
I could have saved her.
Now, though I know no dream
will return her utterly, I cling
to this one: Susie and I at twenty-one
standing before two doors,
how she points me towards the one
where a celebration is taking place
then disappears through the other
marked No Exit, as if it has to be,
as if it�s fair, as if either
of us in this world
has ever had a choice.
2) At the Lake, Under the Moon
In memory, the moon�s always a new dime,
glinting off the dark chop, ticking the night away
ruthless and indifferent as a parking meter.
As always, the lake shimmers, ebony splashed
with silver and we�re sitting there at the end
of the dock, thirteen, dangling our bare feet
above the water�s corruscating skin. We barely
ruffle the surface but it�s enough
to shatter the still shaft of moonglow,
potsherds of mercury, dancing tesserae, a mosaic
of light illuminating the water.
Is it possible we don�t yet suspect
how things must turn out? We shed our clothes
to swim shy and bare-skinned, silvered bubbles
rising to the surface like stars
of the wayward constellations
by which we�ll navigate our separate lives.
What we know is this: the sleek water
rolling off our skin, the frangible sand, schools of
glowing nightfish nosing amid algae.
We can�t guess how fate will interpose
its coups and tragedies, how far in ten years
we will have traveled from that night.
I never got to say good-bye.
I scatter your white ashes,
moonlight over dark water.
3) In My Dreams You Are Not Silent
Time heals nothing
but the space left behind
is filled, little by little,
with the critical minutiae
that make a life: shirts
at the cleaners, supper
in its pots, a half-read book
overdue at the library,
lying open, face down,
on the table.
Here endeth my 11th blog entry.
This is me in the very lower left corner, sitting in my command central recliner, in front of my maps and Tibetan Buddhist prayer flags on the window.
This is my bedroom, papered with tinfoil and a metal blanket so I can have some privacy.
Another view of command central without me in it. This is the usual state of disarray, though occasionally it gets cleaned up!
Dolly the Lllama is made of junk I found in my 2 room apartment, mostly a large mailing tube, a TV table (for the legs!) and bubble wrap, all covered in paper mache. The painting is not yet finished, being an attempt to copy Huichol string paintings until my energy, manic as it was, gave out.
Eemie, the cat and my roomie
A triptych I'm making out of gold leaf for my twin sister, who just converted to Catholicism.
My friend, Joe, who will hate me for putting his picture up here...
And that's it for blog entry #10, which endeth right here.
NOTE: The following is part of a chapter from our book SOLO FOR TWO. I have only included a partial chapter half, not my sister�s half, though it will be an integral part. Italics have been deleted as I do not know how to put them in without using Windows, and I have a Mac.
__________________________________________________
I barely remember the day the world ended.
Even now it replays like a grade B movie.
Early morning shot, the sun is barely rising over tired-looking city streets. Cut to a small apartment bedroom on the top floor of a high-rise. Cigarettes overflow in half a dozen ashtrays; coffee cups, clothing and books are strewn about. A middle-aged woman, distraught, smoking frantically, is half-yelling half-whispering on the phone to someone she calls �Nina� but doesn't seem to know well. There�s a sudden hammering at the door. She puts the phone down, yells hoarsely, �Who�s there? Go away!" More pounding followed by sounds from the phone. She fumbles, brings the receiver back to her ear. �What are you talking about? Nina! You told me you wouldn�t�� She's still protesting when the door is forced open. Paramedics and police quickly take over...FADE
"Nina" � whoever she is at the other end of the hotline -- must have secretly called the police. �Get out of here!� I yell, trying to push them back, still on the phone.
�I hate you, Nina!� I scream, �I told you I didn�t want the goon squad. Why did you do this?�
The female officer takes the phone from me, murmurs something into the receiver. She hangs up. I back up against the wall, trying to get as far away from the intruders as I can.
�Now, what�s going on here, Miss Wagner?�
�It�s Pam, just Pam. And I wouldn�t jump. I mean, I mean I wasn�t sure what I�d do. Don�t you see? I don�t need to jump. It�ll all be over in just a couple of days.�
�What�ll be over?� one of them asks.
But I can�t explain. How can I condense into a sentence or two something that has been building up for more than a year? That the world is ending, that I can�t stop it, that it�s my fault because I didn�t try hard enough to warn people. Tears start coming down my cheeks. But instead I insist I�m safe. I won�t do anything to hurt myself. A good night�s sleep is all I need.
I�m not lying exactly, just not telling the whole truth. I don�t tell them that Dr Kitzman, the psychiatrist that saved my life, is retiring unexpectedly, after taking a six-week vacation starting in January, or that my best friend and I had a terrible fight right after Christmas that ended our 20-year relationship. I can't tell them I really believe the Y2K bug will bring an end to civilization, should a Biblical Armageddon fail to materialize. Nor if it did, how I would most certainly not be going to heaven. Nor can I tell them how the voices, silent for three whole months on a new medication, have returned with a vengeance, bringing hell to my nights and days. With scathing criticism and a running scornful commentary on everything I do, they sometimes order me to do things I realize I shouldn�t, but I might not always be able to. Or that I barricade the door each night for fear of beings from the higher dimensions coming to spirit me away, useless as any physical barrier would be against them. I don�t mention the NSA or the DIA or the Interpol surveillance I�ve detected in my walls or how intercepted conversations between these agencies have intruded into TV shows either.
Oh, I want to tell them all this, I really do. But I know too well what would happen, and I don�t want them to take me away. Still the tears keep coming. A paramedic reaches out to put a maternal arm around my shoulders, in comfort.
�Don�t touch me!� I shriek, shrinking from contact. �Go away! Leave me alone! Get out of my apartment. Now! Who the hell do you think you are?�
They look stunned. Meanwhile my hands are doing their writhing thing up near my face. But I can�t help it. It takes too much concentration to still them and keep my brain under control at the same time.
One of the policemen looks through my room. Pawing through my things, he picks up one of my pill bottles, then gestures to one of his buddies. They confer in low voices.
Together they collect all my medications and ask me if I have been taking them.
�Of course!� This is the truth. One cop shakes his head. I don�t like him; he hasn�t been on my side from the start. I realize he�s connected to the Five People who monitor my movements wherever I go, their true identities always disguised. He has something to do with the other dimensions, the Supermetal Cannister and most important of all, Grey Crinkled Paper. I�m not sure how deep it goes. But something tells me to keep as far from him as I can.
In the end, it�s no dice. All they can see is the mess, the pill bottles, the ashtrays, the way my hands keep moving, my tearfulness. And the inescapable fact that I live on the 12th floor. To them it suggests too much trouble, more than they can leave behind. They�re going to take me to the hospital, just to cover their asses, they insist, to make sure I�m all right. If the doctor okays it, I can come right back home. But I know they�re only sweetening an offer I can�t refuse.
I know this. I know this. But I start yelling anyway. I'm all right, I scream, I�m not going anywhere. I don�t need a doctor. I'm fine, goddam it!
That�s when they harden. I don�t look at people, but I should have, I would have sensed it coming. They huddle around a crackling walkie talkie. Then one of them tells me in words of one syllable that I have two choices: I can go with the EMTs the easy way or with the cops the hard way.
�Take your pick, Pamela, we don�t have all day.�
Shit...I mutter. I know they mean it. I�ve been through this business before. I give up, but it's hard to swallow when they start crowding me, watching my every move. Do they think I'm going to slit my throat with a sharpened sock?
�Can I at least put on my clothes without all of you watching?�
The female medic motions the men out of the bedroom. I struggle into a dirty black sweater, add dark sunglasses on top of my regular ones, then wrapping a hooded black muffler around my face � protection -- I shuffle out into the living room in my coat. Clinging to what shreds of dignity still fall to me, I keep my body rigid, making them lift me onto the stretcher like a plank of wood. Then they start tightening the straps around my hands. This time I do resist.
�Please, no! I�m not gonna do anything, I�ll be good, I promise.� Panic has turned my voice to a whisper. They sigh, looking at each other, eyes rolling. I know what they�re thinking: Oh no, not again. Amazingly, though, they concede, deciding to risk it rather than face another fight. But I feel useless and despised, a worn-out left shoe, something they want to dump as soon as possible.
Finally, the procession -- guards, handmaidens, heavy artillery � begins down the hall to the elevator. I don�t know who�s out there watching, but even with my eyes screwed shut I sense the old ladies peeking through their doors. I can feel the stares, I can hear the rumor mill start to grind.
You old hens, I mutter. Chickenshit begock-begocks! My hands fly up to my mouth to muffle the curses because I know my swearing always gets me in trouble. But it�s some protection and what else do I have to defend myself with?
You know how people say only sticks and stones can break your bones? Well that�s a damn lie. Even bullets are nothing compared to the ax-murderers in people's eyes. And ain�t it strange how it�s the same people murdering you who just moments before were murmuring, �Don�t be frightened. We�re going to help you --�?
A new problem. They want to take me to Hartford Hospital, the biggest and nearest. No way, Jose�. I refuse, pointblank. The ER nurses there have tried to kill me one too many times, not to mention the Five People who once secretly irradiated me in the nuclear physics lab when I was there. They�ll take me to the University of Connecticut�s John Dempsey Hospital in Farmington or I�m not going anywhere. That�s my right and they�d better do what I say, or else. A mostly empty threat, perhaps, but they know I�m right. And they agree, though it�s a much longer drive and it�s obvious they can�t wait to get rid of me.
The ride uses up all my resources. When we finally arrive, I�m sweating, trembling, at the end of my rope. The paramedics roll the gurney inside the ER, sign me over, then disgorge me into a small cubicle. The smell of the place hits me like a shockwave � rubbing alcohol, disinfectant and something so sweetly acidic it makes me retch. Before I can say anything, a nurse and an aide hurry in, wrestle my bag and coat away from me. Without a blink, they order me to take off my clothes. I hit the roof, yelling and cursing. I�m not fucking undressing! There�s nothing the fuck wrong with me!
You should be ashamed of yourself, one of them scolds. This is a family hospital. Oh sure, I scoff, those asshole rugrats out there spitting up on their parents hear worse every day on TV!
�That�s enough, Pamela,� she warns.
�Bullshit! I don�t give a fuck!�
If I don�t calm down, they�ll give me a needle, the other threatens.
�I am calm!� I scream, and I counter-threaten � even louder. I�m thinking, Stay calm? I�m fighting for my life here!
Then it�s a blur. As if on signal, people suddenly crowd into the small room. Men in surgical scrubs grab me while the nurses, still telling me no one is going to hurt me, hold me down and I�m yelling and struggling against all of them and somehow my clothes are taken away and somebody comes at me with a syringe full of something the aides smirkingly call �Vitamin H� � Haldol -- and it hurts like hell when they jam it in my rear end.
That�s where the struggle ends. They�ve won and they know it. The room clears like a bad fart, but I let the entire ER know I intend to sue, I have a right to refuse medication and it was given to me against my will, violating my constitutional rights and �-
Loud enough for everyone to hear, one of the aides mutters, �So fine, sue the whole damn hospital. Meanwhile, shut up and go to sleep.�
Then I�m left alone on the narrow hospital bed, side-rails up, in nothing but my underwear and two flimsy hospital gowns, one open to the back, one over it, open to the front. I can only seethe at this injustice. Rocking, muttering, sobbing, I rage and rage at the aide guarding the doorway. But she only ignores me, yawning with deliberation and exaggerated boredom, telling me in no uncertain terms: You�re nothing new. I�ve seen it all before.
They can�t drug me up without a fight, I keep yelling, continuing my harangue. I�ll see you all in court, just watch me!
But after a while I get woozy. I can't sit up straight any more. I have to hold onto the side rails. My words get mushier and mushier. My brain fogs up, my eyes cross. I�m getting confused; I can�t remember the beginning of my sentences by the time I get to the end of them. Against every inch of my will, my jaw sags, my eyelids droop and I slump back against the pillow. I think, Maybe I�ll close my eyes for just a moment. Though I promise myself I won�t give in to sleep, my mind keeps drifting away no matter how I try to bring myself back up to consciousness. No use. It may not be voluntary, only the drug that makes me compliant, �manages� me, as they put it, but either way, before I know it, I�m out like a light.
I wake in the psychiatric ward, on a bare mattress on the floor of an empty room. Alone.
A bit of personal history: when I was in fifth grade, in England, I was spending an afternoon alone in the flat with no one but my father around. For some reason I don�t recall, I remember him appearing at the playroom door, his normally ruddy face apoplectically florid with rage. I must have done something wrong, but what I cannot for the life of me remember. All I know is that he soon had me by one arm, and was swinging with his free hand to swat my behind, and I was swerving to avoid the blows, so that we lumbered around in circles like some misshapen two-headed elephant. I was screaming and crying, more in fear and rage than pain, since he couldn�t get enough leverage to really hurt me, when it hit me like sticking my finger in an electrical socket that he wanted to get a rise out of me, that that was his single purpose. He would only be satisfied when he heard me scream loud enough. At that moment, I realized I didn�t need to give him what he wanted, and I ceased at once both my protests and my seeking to avoid his paddling. I simply relaxed in his grasp, and the surprise of my lack of resistance made him almost supportive as he sought to keep me upright even as he continued to try to spank me. But now I gave no satisfying howls, made no squirming to get away.
And this was so dispiriting to him that to my intense amazement, almost at once he stopped hitting me. He let me go, leaving us breathless the two of us. But he wasn�t through with me, not yet. He still wanted to get to me, to hurt me. Only if he hurt me, could his own rage and impotence be relieved�That�s what I saw so clearly, so terribly clearly. So when he thundered across the room to our precious tin-sheathed cardboard dollhouse and began systematically dismantling it and throwing the pieces in the waste basket, I felt immediately that I had no choice but to join him. And not only that, but to laugh uproariously, even while we both trashed my single most favorite plaything, on which I had lavished both hours of my time and all my pocket money. Well, this did the trick. Seeing as he couldn�t obviously hurt me, in the sense that he couldn�t provoke me to tears or outrage, but only encouraged me to laugh merrily, he abruptly stopped what he was doing, glared at me with murderous rage in his red eyes, and then, clearly fearful of what he might just be capable of if he didn�t leave me right then and there, he pounded out of the room and left me to my triumph. I fully admit I cheered, and jeered. I felt more victorious than if I had beaten my brother to a pulp! I had won, and he could do NOTHING against me; he could not hurt me, no matter how hard he tried, not physically, not emotionally. He had tried and failed, and therefore I was the winner, and I gloated in my victory over the tyrant of 839A Finchley Road.
But what was the price I paid? And why did I automatically resort to such an emotionally self-destructive behavior, rather than submitting to the less damaging effects of a spanking? Was I programmed by my genes to respond this way? It certainly felt innate, not learned, not conditioned. No one had ever taught me to react this way to abuse before. I just happened upon it, and understood that it was the only way to successfully beat him at his own game.
I suspect that something innate in me leads me to see the world in black and white, in terms of absolute good and evil instead of shades of grey. I have never not been prone to such a division of labor, even when I myself am partitioned off into the all-bad category, as I usually am. Why do some people see the gradations in things, in events and people, and others, like me, see only the stark contrasts, and find it so difficult to accommodate to the idea of in-betweens and relativeness? Have I merely learned to be this way, or is it, as it feels, a natural native response that I must constantly keep in check?
I saw no other option that day but to destroy my dollhouse with my father. I could have sobbed or objected, or simply mutely watched as he went about his murderous business. But no, I felt obliged to join in, to destroy my own things myself, and to actually feel cheerful doing so, albeit somewhat hysterically so. And to this day I often choose to hurt myself if I perceive that someone else wants to hurt me. I�ll do it first, I reason, so I can control it and it won�t hurt so much. No one can hurt me as much as I hurt myself, I know that. NO ONE would dream of burning me with multiple cigarettes over large patches of skin. No one would slash my wrists or cut at my face just to get back at me. Yet, with or without the help of accompanying command hallucinations, I do so, and do so frequently. Or at least have done so many many times, each time without even considering other options, or simply waiting for the feeling to pass. It never occurs to me to think about what the scars will look like, not even on my face. I just lash out, and obey both the voices and my own self-poisoning hatred.
This continues, and feels right, even as, objectively speaking, as a phenomenon, it continues to puzzle me why I engage in such obviously unproductive and harmful (if non-painful) behavior.
Here endeth my 7th blog entry.
If George H. W. Bush represented Republican thought when he spoke of his quest for �a thousand points of light� then my political metaphor magnifies his. The Republicans are indeed like a thousand points of light, a thousand stars in the sky � each rich man on his big estate twinkles alone, giving off no heat or light, sharing nothing with the rest of the world. But in the Democratic universe, the sense is we stars must join as one and together not only will we give off a great deal of warmth and energy but all will benefit from these pooled resources, those who have much and those who have little.
Here endeth my 6th blog entry