And It All Began
by Josh Greenfield

The first morning in Dr. Rubin’s waiting room, my father and I sat side by side on the cream colored sofa. Off to the left was a polished, circular wooden table that supported an array of magazines, loosely aligned: three Smithsonian’s, an art catalogue and a year old copy of New York. In the center of the table, toward the back, was the figure of a Japanese Bodhisattva, her loosely fitting garment covering only one breast. With her right arm she reached out to the patients who had enough awareness to register her presence. Beside the statue was a miniature ceramic figure of an ancient Japanese man consulting a scroll and smiling at his own joke. My father wore a jacket and tie, a white shirt. I was attired in the same clothes I’d been wearing for at least two days. We waited for Dr. Rubin to entertain us, my father with the concentration of a man engaged in his life’s work, myself with the attention of a three day old dandelion seed pod about to be blown away by an evening breeze. I remained stationary and in the upright position only through the force of my father’s will.

In short order, Dr. Rubin appeared at the door, and he was smiling. Call it remarkable, or down right inappropriate, but he had a grin on his face. He welcomed my father and me into his office, the consulting room where he held his sessions.

“So, why did you bring him here?” Dr. Rubin looked at my father.

My father, not thrown by the direct address, began to recount a series of incidents that had occurred in the last year. He chose to emphasize the fact that I had called to change a dinner date some twenty or thirty times. Dr. Rubin felt he had heard enough. He escorted my father back to the waiting room and asked me what I thought about my his remarks.

“Well…. I….come on….” I said.

I wasn’t big on whole thoughts at the time. I tried to answer his questions. I was too intimidated to be impolite. At the end of the session, Dr. Rubin gave me his business card. I noted the home address in New Rochelle, and made some attempt at a humorous aside about living in the splendor of Westchester County. There was no ill will in my comment.

“That’s what will make you well,” Dr. Rubin said. “Humor cuts through the knot.”

We walked back into the waiting room where my father was seated quietly on the sofa. There were tears in his eyes. Rubin noted the tears.

“It’s a good sign,” he said.

Both of these simple statements reflected thirty years of practice in the psychiatry business. Rubin had made the walk before.

Dr. Rubin scheduled another appointment for two o’clock that afternoon. As my father and I walked down the gently sloping incline that led away from the Park Avenue building my father said,

“You’re lucky he could see you again on the same day.”

I slowed a step, in silent recognition of my father’s knowledge of the business of psychiatry.

That afternoon Dr. Rubin and I sat alone in his office.

“Jordan, you’ve had an emotional breakdown,” he explained. He smiled, again.

“We’re going to make you well.” There was not the least wisp of a doubt in his statement. I had made it into the office. I was sitting in the chair. Beyond that I had no perspective on what I was experiencing. I heard his words.

Dr. Rubin rose slowly from his office chair and walked the two steps to the wooden cabinet on the adjacent wall. He was a grey haired man who kept himself trim but he wasn’t as light on his feet as he’d once been. Rubin opened the top drawer and removed a small plastic bottle. It contained lithium carbonate. He handed me the bottle.

“I want you to take one of these three times a day. Take them with some milk or food,” he said. That was it.

Dr. Rubin’s simple straightforward statement did not invite a response. I held the plastic bottle in my right hand and looked at this strange human being before me. I didn’t trust him. I still wore the same stretched out t-shirt and blue jeans with a rip in the right thigh. My abundant supply of brown curly hair was still not combed. I was twenty-one and I was up a creek.

Two days later, I still had not taken the pills. Who goes around putting unknown, possibly addictive substances in their body? It was a Sunday afternoon and I was walking in the East 60’s. I took the business card out of my pocket and called Rubin’s New Rochelle phone number. I began to articulate questions, questions about the nature of the drug, its qualities, its side effects.

“Take your medicine!” Rubin interrupted me.

I got off the phone, walked across Lexington Avenue, and into a small neighborhood restaurant called Serendipity, known for its ample supply of Tiffany chandeliers. I sat down at a table for two and ordered the Welsh rarebit. I think it was the Welsh rarebit. Whatever it was, it had a lot of cheese. I set the lithium capsule on the place mat just on the far side of the pale, white plate and in front of the water glass. I looked at it. There was certainly an element of risk here. What did I really know about this character? Once you start in on these pills there may be no turning back. I tried to focus. Rubin’s tone of voice on the phone carried the day. I picked up one of the lithium pill, and washed it down with a gulp of cold ice water. I looked at the cheese on the plate. I didn’t eat anything.

The remarkable thing is that the capsule made me feel better. I think it was the capsule. Something eased in my mind. A little of the pressure was taken off. The balloon had been stretched to the breaking point. It might not have exploded, but it was still pretty uncomfortable. The lithium capsule eased the pain, just a bit. Some time later I learned that lithium carbonate is a clay found in the “waters” of some European resorts. For centuries manic-depressives have gone to these springs to “take the waters.” They didn’t know why, but they knew it helped. Then some brilliant doctor took the clay and put it in a capsule. I lucked out because they don’t have those springs in New York City.

The other thing that helped me out was realizing that lithium is found in some foods. Well, it’s in nature, so it could be in foods. How would I feel if a doctor told me to eat a lot of asparagus? I don’t mind asparagus, but the point is I wouldn’t really have a problem with it. It’s a food. How bad could it be? Anyway, it worked. That’s a bit strong when you consider the pain I was feeling at the time, but I did walk into our next session a little more open to what Dr. Rubin had to say.

You hear stories about the kid who couldn’t stop washing himself, but what isn’t always so clear is that the same mechanism, that’s a big word, mechanism, that makes him do that, can affect every aspect of the human thought process, everything, until the whole brain just about shuts down, comes to a screeching halt, like the 7:15 from Syosset crashing into an eighteen wheeler stalled out at an intersection. Wheels go flying, steel rails bend, seats are sticking out windows, flames, women screaming, men in suits looking like children lost at a state fair, mayhem and disorder ruling the day. It’s kind of like that. Only all this is taking place inside your head and it’s with you every waking moment. From the time you wake up in the morning, until you fall asleep at night, until it starts all over again the next day.

Sessions in those first few weeks went something like this. Dr. Rubin would invite me into his office

“So, how have you been?” he began. He was matter of fact, not overly concerned.

It was then my job to try and explain what I had been doing since the last session. The room itself had plenty of distractions. On the wall behind Dr. Rubin’s chair was a rug like decoration in swirling colors of muted orange and yellow. To the right was a floor to ceiling bookcase filled with medical volumes. The chair I sat in was a black leather affair, and it swiveled from left to right. When I couldn’t amuse myself with looking around the room I played air guitar. Or I played air guitar and looked around the room at the same time. I tried to avoid answering any direct questions.

In any case, there wasn’t a whole lot to report.

“I went to the museum,” I said.

That usually worked, unless I tried to explain that I had been at the museum on a Monday. The Metropolitan Museum of Art is closed on Monday.

“I was in the park.” That was another winner. The bottom line here is that there just wasn’t a whole lot going on.

“When ever I have a free hour, I go over to the museum. I always learn something new.”

Dr. Rubin was encouraging me to take advantage of this fine cultural institution. Unfortunately, my principle activity there was sitting in this court yard on the first floor and sorting through old post cards. I sat on a marble bench between two large nymph statues and a slowly trickling fountain and rearranged these important documents. When Rubin wasn’t asking about my activities, he generally let me have the floor.

“So how long is this going to take?” I asked.

This was not a relevant question. Time frames were off the table.

“We’re going to have hundreds of hours together,” he did contribute.

There he went again. That was clearly ridiculous. Wasn’t I an activist for the Nuclear Weapons Freeze Campaign? Didn’t I have things to do? I tried to do the math. Three sessions a week for roughly fifty weeks was a hundred and fifty hours a year. What is this guy kidding? Years? He thinks I’ll be coming in here for years? That’s rich, I thought to myself.

But from the very start, Rueben had a way of saying things that threw you.

“A professional tennis player demands complete silence so he can hit a bouncing yellow ball with a large round racket. A professional baseball player stands in the middle of thirty thousand screaming fans and tries to hit a small white ball coming at him at upwards of ninety miles an hour with a wooden bat. The point is that we’re creatures of habit. The way we’ve always done things is the way we expect them to be done. Changing habits is never easy,” Rubin was leaning forward in his chair the way he did when he really wanted to make a point. Rubin’s insights never hit me right away. I listened.

And then, just like that the session was over. Forty-five minutes as carefully registered on both clocks, one clearly visible from my swiveling, black leather chair. It was time for me to go. I started for the door. Session might be brutal, but the world outside the door of that building was all the darkness ever known to man. Anger to the severe-obsessive-compulsive is more than a transitory reaction to a particular stimuli, it is a state of mind induced by a radical chemical imbalance. In this condition anything and every thing has the power to exacerbate the anger, the sideways look of a passerby, the momentary hesitation of a car at an intersection, the friendly greeting of someone meaning only warm wishes. When you are that angry, everything makes you angry.

Hand in hand with the anger was the obsessive rumination. I walked out of Rubin’s office and immediately felt compelled to pick up the loose trash I passed on the side walk. As New York City neighborhoods go, the Upper East Side is relative clean and orderly but this is still a losing proposition. I walked past a piece of crumpled gum wrapper and resisted the urge to go back and pick it up, only to find that I was confronted by a license plate with two r’s, or was it three r’s? I walked five paces further overwhelmed by waves of anxiety. Was it two r’s or three r’s? My life, the life of my loved ones, the future of the planet itself might rest on knowing the correct answer to that question. I took three steps more and inevitably turned back to establish the definitive response. By giving way to the compulsion to return, I had strengthened its power to hold me the next time, but there is just so much a body can endure.

I did go into the park, Central Park, during those first few weeks. I used to join in pick-up softball games. I was commended for my positive attitude. I wasn’t depressive by nature. I was making the effort, but the drugs slowed me down. I guess you would have to say my hand eye coordination was a little off. I had a little trouble going to left. I always had trouble going to left. Actually, I usually grounded out to the second baseman. But the drugs made things worse. A slow line drive that I typically would have caught bounced off the center of my forehead and went for an infield single. This experience dampened my enthusiasm a bit, and I refrained from future participation. I don’t know if the drugs affected the coordination of my mouth and tongue, but I know that it often was difficult to articulate my thoughts. I would have the idea clear in my mind, but it just wouldn’t quite make it out my mouth. It could have just been the rage. I’m not sure.

Most of the time I was just thinking. I could get started on just about anything and run with it. I’d start in on some obscure point and develop it from every possible angle. On and on and on, until I was composing a three volume set on the arrangement of eating utensils. It’s exhausting. Actually, the obsessive rumination, that’s what its called, obsessive rumination, and the anger were really part of the same condition. If you can hold on to thoughts about the alternative arrangements of knife and the spoon on the placemat, you can also hold on to the resentment of the day. Cutting down on the time spent on obsessive rumination cuts down on the time spent with anger. That first year there was one long nightmare from which I did not know how to awaken; it engendered a profound confusion I utterly lacked the capacity to understand. I felt terrible pain I could not control.

It was a double dip. Two scoops. Vanilla and Butter Pecan. Manic-Depression is no joke. Before Lithium it was just about fatal. Some glorious tales of fortunes made and lost, and creative journeys undertaken, only to be followed by terrible depression and suicide. With Lithium the highs and lows can be controlled and normal life achieved. That was the first scoop. The second scoop is always the winner. The one you know you really shouldn’t have but you do anyway. That was the O.C.D. That was the one that took all the work, because once it gets a hold on your head it really doesn’t want to let go. Call it a monkey on your back, if you like, or being tied to the ground with ocean liner cables. That’s good too.

Before the breakdown, when I was still living in a western New York college town, I had a part-time job in a vegetarian restaurant. I was a waiter, though on some days I helped in the kitchen. It was communal in that way. I was staffing the dining room one Sunday morning, but there wasn’t a whole lot to do. The spinach had been washed, and the fruit juice bottles carefully arranged, all by people more functional than myself. The wooden interior was inviting, with the morning sun flooding in through the large picture window. In the kitchen the corn was quietly sautéing in garlic sauce and the brown rice was nicely puffed. All we needed were some customers.

A man and a woman entered to the sound of the tinkling bell above the door, not that we would have over looked them in the rush. They took a seat at a table for two against the wall. The woman wore a long maroon skirt, and the man had his hair pulled loosely back in a ponytale. Ready to serve, I approached the table and offered the couple menus. I looked at them. The woman smiled, the man nodded. They consulted the bill of fare in silence.

I stepped back behind the wait station and began to contemplate the water glasses. Five filled. Two empty glasses on the end…. Could fill them…. or ….not….If I fill them I’ll have to refill the pitcher…means walking into the kitchen….if I don’t fill them I’m going to run out of water glasses. Unless I fill them later…It might get busy…wouldn’t have time….I could fill the glasses but let the water level in the pitcher drop…How much would it drop? If I got a smaller pitcher, it wouldn’t drop as much. At least it wouldn’t look like it had dropped as much. No one is going to look at the pitcher. I could take the empty glasses off the end of the shelf…Then at least I wouldn’t have to think about them. I could put them under the counter…There…Now all the water glasses are filled. But three don’t have any ice….The empty glasses under the counter don’t have any ice either. They don’t even have any water. What will people think when they see empty glasses under the counter? Nobody puts empty glasses under the counter…better put them back on the shelf….there…

The couple had been ready for ten minutes. I walked over to take their order.

“I’ll have the soup and salad. With corn bread, right?” the woman asked.

I looked at her, but did not fully comprehend the question. I nodded. I made some effort to write down her request, but the writing was not coherent. These people had water. But the man had no ice, or very little. They needed ice.

“The choices?” she asked again, smiling a little more forcefully.

I tried to focus.

“There’s blue cheese. There’s also Russian and….. a French”

She ordered the French. I got something down on paper about the man’s order and retreated to the wait station. The ice glasses were still there. I counted them again, five filled, two empty. Of the five filled, three didn’t have any ice. “It’s getting warm outside. It’s going to get hot. No ice…the ice is in the kitchen. I could fill the pitcher and get the ice at the same time. What would Corey think? Doesn’t everyone fill the glasses with water and ice before the meal…during set up. There are two filled with ice. That’s enough for one more table of two. What if it’s a table for four? Two would get water with ice and two would get water without ice…Maybe they wouldn’t notice…. Better get the ice now…” This process proceeds indefinitely, or until interrupted. Some prisons have no walls.

The order slip with the pencil scratch marks on it was crumpled and placed in the front left pocket of my denim apron. The couple was quietly looking at one another across the table for two. The kitchen staff were leaning against the stove and perusing the Sunday paper. Nothing was happening. Forty-five minutes went by in this condition of suspended animation. The couple refrained from registering any form of complaint. They were very polite.

There are limits to what even vegetarian restaurants in college towns will put up with. I lost the job. All functioning effectively stopped. I wandered around lost in my own world. By the middle of June, I resembled a washed out rag left too long in the sun. I slept, I guess. I ate when I thought about it. I stumbled through parking lots unable to get to the far side without stopping to pick up the crushed soda cans and wind blown newspaper. Before the city cleared out for the summer there had been some contact with other students, but with my housemates gone, I let myself go. I spent nights in a top floor room strewn with cloths and three day old plates of dried spaghetti. I hadn’t paid any rent, but I’d lived in the house a long time and it was summer time. It was the same house where I’d wandered the halls singing Carly Simon’s I Haven’t Got Time for the Pain. I was trying to convince myself, but I was not successful. I’m not saying I was ignored. People had tried to intervene.

“Why don’t you go see some one?”

That question really pissed me off. I’d heard it from friends, from family members. I just snapped back. I had no great logical response. I just wanted nothing to do with it.

College towns do really clear out after graduation, at least this college town did. Just about everyone was gone. One friend was still around. We were standing around in the basement room that had been home for three. Craig, my roommate since freshman year, had pulled out right after graduation, and now Gary was preparing to move back to his parents’ house across town. He was quietly placing some shirts in a duffle bag. The room was largely underground, but it did have a line of windows, high along one wall that opened out on street level. One of the beds was on a platform even with these windows. Craig had slept on a mattress beneath and since my return I’d been camped out in a sleeping bag somewhere in the middle of the room. They’d taken me in along with my nine cardboard boxes of important papers.

I’d gone to Washington D.C. to take an internship with a leader of the anti-nuclear weapons campaign, known in some circles as The Freeze Campaign. He was a big kahuna, who organized rock concerts and protest marches, and gave out foundation money to smaller anti-nuclear weapons groups. In 1983 all of this was quite fashionable. Ronald Reagan had the leftist fringe of the college population convinced that he was planning Armageddon. The internship was an honor. Unfortunately things went flat when I passed the day seated on the floor with my back to the wall, unable to articulate urgency of my convictions.

Gary looked up from his packing,

“I didn’t say anything,” he said quietly. He wanted reinforcement for the tact he had shown.

I didn’t miss a beat.

“I’d only have turned on you.”

Gary finished his packing and later that afternoon, he moved out.

What was I suppose to acknowledge? That there was something wrong with my head? That I could no longer walk without stopping to pick up trash? That everything, I mean everything had come to a stop? I had no idea what was going on. I had no way of thinking about what was going on. Above all, I had no idea that there was anything that could be done to fix the problem. Someone tells you,

“You look tired.”

You say, “Yeah, I was out late last night.”

Maybe you go to sleep early the next night. Some one tells you, “It seems like something is wrong with your head.” You snap. I’m afraid that’s just the way it works.

Help did eventually come. It started with a phone call to my brother-in-law in New York. I think it was the ten minute pause in our conversation that gave me away. It could have been that. Something must have tipped him off because when I came home that night, my father and sister were sitting on the front porch. I walked up Oak Ave to see them swaying on the metal swing beside the front door, and some thing went off inside, a recognition that maybe there was really something going on here. I sat down on the swing and rested my head on my sister’s lap.

“You’re the only brother I’ve got,” she said. She’d been dragged six hours across New York State to salvage a fucked up brother, but she spoke with conviction.

We took a walk, my father, my sister and I up Oak Ave, through the western New York night and sat down on a grassy hillside.

“He’d have to be smart,” I said, as I considered turning myself over to a doctor.

“There are smart doctors,” my sister said. She wanted me in that car. She also knew how to talk straight. I wasn’t accustomed to addressing the subject of psychiatry in any manner.

The grass was damp and it was pretty late. They were anxious to get going, to drive me back to New York City. And I got in the car with them. It doesn’t sound like much, but it was a big deal closing that car door. I sat in the back seat, my sister sat up front with her ear phones on and my father drove. He drove the car but in a sense he was driving more than that. He was driving me toward some form of help. By getting in that car I had conceded that help was in order and I had turned things over to him. Had I chosen to walk away into the night things would have been different, but a lifetime of devotion had earned him that respect.

We arrived in New York at daybreak. My sister got out of the car, on West Ninty-Ninth Street to shower and go to work. With her out of the car something clicked, and I unloaded.

“You can’t do this! This is the one thing you can’t do!” I screamed at my father as we pulled out of Central Park at East Eighty-Fourth Street. I was referring to the whole idea of interfering in another human being’s life on such a fundamental level. I’d gotten in the car with my sister there, but with her gone, I couldn’t figure out why.

“I know,” my father replied. He kept his eyes on the road. He kept driving. There are times when even the most fundamental laws of individual respect must be abridged. It is the rare parent who is willing to do so.

Later that morning, he walked me over to Rubin’s office. And the whole thing got started.