Part 13 (1/2)

As soon as I sat down, Magic Doc delivered some bad news. Or what would have been bad news to a normal patient, but which turned out to be of interest in my case.

”I have to apologize to you,” he said. ”It seems your insurance company is not going to cover any more of your stay here.”

”Really?” I said. It wasn't clear to me why this was, or why it was his fault. ”I don't understand.”

”Well, they gave two reasons. One is that you're not taking medication. The other is that you've been going on two-hour pa.s.ses every day.”

”They think I don't need to be here?”

”Right.”

”Because I'm getting fresh air and exercise?”

”Well, their reasoning is that if you're well enough to leave the hospital for two hours a day, then you're well enough to be at home. I don't agree at all, but that's the way a lot of insurance companies see it. I didn't realize that you had out-of-state insurance. If I had, I wouldn't have given you the pa.s.s and risked this cancellation. Around here, most local insurance providers won't stop coverage because somebody is going on a pa.s.s, so it's usually fine. But a lot of carriers in other states will. Obviously, yours is one.”

”It's amazing. I do something that will actually speed my recovery, and they penalize me for it,” I said, shaking my head. Then I added, ”You know, that reminds me, not that I haven't been immensely grateful for the pa.s.ses, for all kinds of reasons, because I have been, but I've been meaning to ask you this anyway. Why don't you have a gym right here in the hospital, or an outdoor track or something? That way people could work out and not have to leave for two hours to get it all in.”

”I agree,” he said. ”I've tried. I lobbied for a lap pool and all kinds of things, but the liability insurance costs are just too high to have exercise facilities here. It's just easier to give you a pa.s.s so that you can go across the street to the Y.”

”Ridiculous.”

”I know. I know.”

”And the meds are the same story?”

”It was probably both things, the pa.s.s and the lack of meds, but again, att.i.tudes on meds are different in this state. That's, in fact, why I came here. I'm not from here, and, as you can imagine, I wouldn't have chosen this town for lifestyle reasons, but it happens to be one of the few places in the country where the insurance companies don't make it impossible to practice real psychiatry.”

”You mean psychiatry without meds?”

”Yes, or at least the option not to use them.”

”What happened with that back in your home state?”

”I was practicing child psychiatry, but I didn't want to prescribe Ritalin to kids. First thing I did when I got a new patient was take them off the drugs. I wanted to see who the person was.”

”So you think the drugs really got in the way of therapy?” I asked.

”Oh yeah. And the kids end up taking much more than they should. What often happens is that the mothers give the kids the pill in the morning and it works great. But then when it wears off, the kids are worse than before, so they give them another pill in the afternoon, even though they're not supposed to.”

I thought of Bard, and asked, ”And do you think that this ends up predisposing them to taking street drugs like meth as they get older?”

”Sure. They're craving that high.”

I thought of myself going off the Prozac and feeling worse than I'd ever felt before taking it. I wondered if I was hooked in much the same way, needing the drug just to feel normal. I told Magic Doc that I thought a lot of psychiatrists were prescribing too much medication to a lot of people and either not understanding or not disclosing the dangers of dependency.

He agreed.

”A lot of psychiatrists these days are not really practicing anymore. They're not listening. They're just prescribing meds. I don't know why most MDs even go into psychiatry.”

”No s.h.i.+t. Most of them have got the emotional intelligence of sandstone. And I won't even get into the way too cozy relations.h.i.+p between doctors and pharmaceutical companies.”

”Yeah, I had that out with the drug reps at one point. They wanted to sell me on Lexapro when it first came out. Lexapro is just half a Celexa molecule. The patent was running out on Celexa, so they needed a new drug that essentially did the same thing. They realized that they could get the same effect with half the molecule, so they created a 'new drug' by cutting an old drug in half. I told them that I'd prescribe Lexapro if they admitted that they'd released it when they did and in the way that they did because the patent was running out on Celexa. But of course I got no answer.”

This jibed with critiques I had read in which it was a.s.serted that when drugs go off patent and the pharmaceutical companies market their patented replacements, only then does the public learn about the original drugs' downsides or unknowns. It is either that or, as happened with Zyprexa, lawyers and the media got hold of suppressed information and blew the whistle.

I brought up Zyprexa, and mentioned how heavily I'd seen it being advertized in places like Meriwether. I told him about the pens and the clipboards that the nurses carried around.

”Yeah, I've seen that, too,” he said. ”I used to walk around the offices throwing away all that stuff-calendars, pens, clipboards. I used to say that if they want to pay us to advertise for them, fine. Otherwise the stuff was going in the garbage.”

I was really impressed. What a find. This guy was a jewel, stuck out here in the boonies because it was one of the few places he could help people try to get better without drugs, and where he could give them access to a few healthy and genuinely recuperative options like fresh air and exercise. He was in the minority in his profession, it seemed. Maybe even fighting a losing battle in the system. I admired him even more for that and was grateful for having met him.

He saw to the greedy core of the pharmaceutical companies and refused to buy the line they were selling. Not that he never prescribed drugs. He obviously did. He was nondoctrinaire enough to realize that the meds on the market were, in some cases, probably better than nothing. But he was exercising his judgment, evaluating patients as people and not just opting for the prescription pad as a reflex.

As for the insurance problem, I told him that it was fine. I could cover whatever was left. I'd been in for a week already, so I figured I didn't have much longer to stay. We worked it out that he'd discharge me on day 10, and they'd bill me for whatever my insurance didn't cover.

As I left his office, laughing again and glowing with appreciation for his renegade style, I said, ”Welcome to the lunatic fringe.”

I spent my last two days at St. Luke's trying to avoid as much group therapy as I could, hiding on the addicts' side or in my bathroom until the session had already begun. I was bored and I had gotten the material I needed. I didn't see the point. The staff wasn't usually too strict about hunting you down or making you go to meetings if you really didn't feel like it, and, unlike at Meriwether, I didn't have any fear of jeopardizing my release if I didn't comply.

I tried to sneak my way into some of the addicts' meetings, just to get their stories, because I knew from people like Fenske that I was bound to hear some pretty entertaining stuff. But those meetings were very closed and carefully monitored, so I usually ended up going to one or another of the meetings I was supposed to be in, just because I felt it was part of my homework.

I went to occupational therapy and finished my tile trivet. I played Cranium and Worst-Case Scenario with Trevor and Delilah, Gerald and Molly, and the rest. I counted the minutes until three o'clock when I could pound it at the Y across the street and then pound a couple beers at the brewhouse thereafter.

I took long hot showers when I got back, and then washed my dirty workout clothes in the was.h.i.+ng machine and dryer in the hallway between the octagons. I went on every smoke break, just to overhear things and breathe the air a little more. I started taking the offered Ambien at night to sleep, because it was just nice to turn off at ten or eleven when pretty much everybody else was dead to the world too, having taken their own Ambien, and usually a whole boatload of other downers to stave off the jitters or the withdrawal or whatever else was wrong with them. Pretty much everybody was on Ambien. It was kind of a joke. We'd all be sitting around the TV at nine thirty, and somebody would ask you: ”Have you taken yours yet?”

A few hours after dinner, a line always started to form outside the medication window. Then people would recongregate in front of the TV and maybe have a bowl of raisin bran or a bag of microwave popcorn while they waited for the dose to kick in. Bit by bit, people would peel off, and you'd hear their doors closing softly behind them until there was n.o.body in the dayroom but me and some other holdout. That's when I usually made my way back to my night-light.

I loved that dependable sleep. No tossing. No going over the failures of your life as you lay there clenching your jaw. Your head hit the pillow, you closed your eyes, and you enjoyed those few aimless moments of knowing that you were coasting to the other side untouched. I knew the Ambien probably wasn't good for me, and I was as suspicious of it as I was of every other drug, but at times like that I just didn't care.

On my last night, Sister Pete came to see me in my room, as usual, where I was sitting with night-light. It was Palm Sunday, in fact, so she had made me an elaborately woven little token out of palm leaves. She gave it to me with a small card that had the Memorare printed on it. I remembered this prayer from childhood, the special prayer of the distressed calling to the Virgin for help. It had always moved me. Rereading it with Sister Pete, with her wide surprised eyes gazing into my still teary, still uncertain ones, I couldn't help but be moved by it again, and hope in some residually superst.i.tious way that it could help me.

Remember, O most gracious Virgin Mary, That never was it known That anyone who fled to your protection, Implored your help or sought your intercession,Was left unaided.

Inspired with this confidence, I fly to you, O Virgin of Virgins, my Mother; To you do I come, Before you I stand, sinful and sorrowful O Mother of the Word Incarnate, Despise not my pet.i.tions, But in your mercy hear and answer me.

Amen.

I was better than I had been ten days before, but I wasn't firm. I was still weakened and half down. I was susceptible to the power of prayer, as I always was in the bleakest times, not necessarily because I believed in its ability to make things happen but because I believed in its ability to comfort.

I thought it so perfect, so quintessentially Sister Pete, that at the bottom of the Memorare card there was a hotline number and a Web site address.