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Authors: Kay Redfield Jamison

Tags: #Mood Disorders, #Self-Help, #Psychology, #General

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BOOK: An Unquiet Mind: A Memoir of Moods and Madness
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T
here was a time when I honestly believed that there was only a certain amount of pain one had to go through in life. Because manic-depressive illness had brought such misery and uncertainty in its wake, I presumed life should therefore be kinder to me in other, more balancing ways. But then I also had believed that I could fly through starfields and slide along the rings of Saturn. Perhaps my judgment left something to be desired. Robert Lowell, often crazy but rarely stupid, knew better than to assume a straight shot at happiness: If we see a light at the end of the tunnel, he said, it’s the light of an oncoming train.

For a while—courtesy of lithium, time’s passing, and the love of a tall, handsome Englishman—I caught a glimpse of what I imagined to be the light at the end of the tunnel, and I could feel, however elusively, what seemed to be the return of a warm and secure existence. I learned how marvelously the mind can heal, given half a chance, and how patience and gentleness can put back together the pieces of a horribly shattered
world. What God had put asunder, an elemental salt, a first-rank psychiatrist, and a man’s kindness and love could put almost right again.

I met David my first year on the faculty at UCLA. It was early in 1975, six months after I had gone barkingly manic, and my brain had gradually knit itself into a rather brittle, but vaguely coherent, version of its former self. My mind was skating on thin ice, my emotions were completely frayed, and most of my true existence was lived within the narrow range of very long-cast inner shadows. But my overt actions were within the conservative range of my so-called normal colleagues, so—at least professionally speaking—all was ostensibly well.

On this particular day I had unlocked the door to the inpatient ward with my usual sense of annoyance—not because of the patients, but because there was a staff meeting scheduled, which meant that the nurses would be venting their collective spleen on the psychiatric residents, who would, in turn, be irritatingly secure in their knowledge that they had the final authority and higher degrees; the ward chief, who was hopelessly ineffectual, would allow the resentments, envies, and personal animosities to completely dominate the meetings. Patient care, on that particular ward, often took a backseat to staff neuroses, internecine wars, and self-indulgence. Having procrastinated as long as I could, I walked into the conference room, looked for a chair out of the line of fire, and sat down to see how the inevitable unpleasantries would unfold.

To my amazement, the ward psychiatrist came in accompanied by a very tall, good-looking man who looked at me and smiled wonderfully. He turned out to
be a visiting professor, a psychiatrist on leave from the Royal Army Medical Corps, and we liked one another immediately. That afternoon we had a cup of coffee together in the hospital cafeteria, and I found myself opening up to him in a way that I hadn’t done in a very long time. He was soft-spoken, quiet and thoughtful, and didn’t push too hard against the edges of my still very raw soul. We both loved music and poetry; had military backgrounds in common; and, because I had studied in Scotland and England, had common experiences of cities, hospitals, and countrysides as well. He was interested in learning about the differences between British and American psychiatric practices, so I asked him to consult on one of my most difficult patients, a schizophrenic girl who believed she was a witch. He quickly saw through to the medical and psychotherapeutic issues that had been so slow to come out of her guarded and frightened mind. He was unbelievably kind to her, while remaining very much a doctor, and she sensed—as I did later—that she could trust him implicitly. His manner was matter-of-fact, but warm, and I enjoyed watching him gently phrase and then rephrase questions so as to win her trust and reach beyond her paranoia.

David and I frequently had lunch together during his months at UCLA, often in the university’s botanical gardens. He repeatedly asked me to dinner, and I, as repeatedly, said I could not because I was still married and again living with my husband, after our initial separation. He returned to London, and, although we wrote to one another occasionally, I was preoccupied with teaching, running a clinic, getting tenure, problems in my marriage, and another bad attack of mania,
which, as day the night, was followed by a long, absolutely paralyzing depression.

My husband and I, although we had remained close friends and saw one another often, finally decided that our marriage was beyond the point of repair. I don’t think it ever really had a chance after I had impulsively left during my first manic episode. But we both tried. We talked a lot, and we discussed our mistakes and possibilities over many a meal and glass of wine. There was a great deal of goodwill and caring, but nothing could put our marriage back together after all that had happened in the wake of my illness. Somewhere in the midst of all of this, I wrote to David that I had again and finally separated from my husband. Life went on, a blur of clinic meetings, writing papers, seeing patients, and teaching residents, interns, and graduate students. I lived in terror that someone would find out how ill I had been, how fragile I still was, but—oddly and fortunately—sensitivity and keen observation are not always the long suits of academic psychiatrists.

Then one day, more than eighteen months after he had left UCLA, I returned to my office to find David sitting in my chair, playing with a pencil, and smiling broadly. He said, half laughing, “Surely you’ll have dinner with me now. I’ve waited a long time and come a long way.” I did, of course, and we had several marvelous days in Los Angeles before he returned to England. He asked me to come stay with him for a few weeks in London. Although I was still recovering from a long suicidal depression, and my thoughts were so halting and my feelings so gray I could scarcely bear it, I somehow knew that things would be made better by being with him. They were. Immeasurably. We had long,
late-spring evening walks in St. James’s Park, dinner at his club overlooking the Thames, and picnics in Hyde Park, which was just across the street from his flat. Gradually the exhaustion, wariness, and black faithlessness lifted. I began to enjoy music and paintings again, to laugh again, to write poetry again. Long nights and early mornings of incredible passion made me again believe in, or remember, how important a sense of life is to love, and love to life.

David worked at the hospital during the days so I reinvolved myself in the London I had once cared so much about. I went for long walks in the parks, visited and revisited the Tate, wandered aimlessly around the Victoria and Albert, as well as the Natural History and Science Museums. One day, on David’s suggestion, I took the boat from Westminster Pier to Greenwich and back; another day I took the train to Canterbury. I hadn’t been to Canterbury in years and had seen it only, but unforgettably, through rather manic eyes. I had long-lasting, mystical memories of the dark gorgeous stained glass, the chilled sounds, the simple, grim place of Becket’s murder, and the intense, transient light patterns on the cathedral floor. This time, however, I kneeled without ecstasy, prayed without belief, and felt as a stranger. It was, all the same, a quieter and gentler sense of Canterbury that I got.

In the midst of this godless kneeling, I suddenly remembered that I had forgotten to take my lithium the night before. I reached into my purse for my medication, opened the bottle, and immediately dropped all of the pills onto the cathedral floor. The floor was filthy, there were people all around, and I was too embarrassed to bend over and pick up the pills. It was a moment not
only of embarrassment, but of reckoning as well; it meant I would have to ask David to write a prescription for me, and that meant, of course, that I would have to tell him about my illness. I couldn’t help thinking, with more than a trace of bitterness, that God seldom opens one door that he doesn’t close another. However, I couldn’t afford not to obtain new medication: the last time I had stopped my lithium I had gotten manic almost immediately. I could not survive another year like the one I had just been through.

That night, before we went to bed, I told David about my manic-depressive illness. I dreaded what his reaction would be and was furious with myself for not having told him earlier. He was silent for a very long time, and I could see that he was sorting through all of the implications, medical and personal, of what I had just said. I had no doubt he loved me, but he knew as well as I did how uncertain the course of the illness could be. He was an army officer, his family was extremely conservative, he desperately wanted children, and manic-depressive illness was hereditary. It also was not talked about. It was unpredictable, and not uncommonly fatal. I wished I had never told him; I wished I was normal, wished I was anywhere but where I was. I felt like an idiot for hoping that anyone could accept what I had just said and resigned myself to a subtle round of polite farewells. We were not married, after all, nor had we been seriously involved for any extended time.

Finally, after eternity had ticked to a close, David turned to me, put his arms around me, and said softly, “I say.
Rotten
luck.” I was overcome with relief; I also was
struck by the absolute truth of what he just had said. It
was
rotten luck, and somebody finally understood. All the while, in the midst of my relief, the small, shredded island of humor that remained in my mind, recorded, on a totally different brain track, that David’s phrasing sounded like something straight out of a P. G. Wodehouse novel. I told him this and reminded him of the Wodehouse character who complained that while it was true that he wasn’t disgruntled, he wasn’t altogether gruntled either. We both laughed for a long time, somewhat nervously to be sure, but some of the awful ice was broken.

David could not have been kinder or more accepting; he asked me question after question about what I had been through, what had been most terrible, what had frightened me the most, and what he could do to help me when I was ill. Somehow, after that conversation, everything became easier for me: I felt, for the first time, that I was not alone in dealing with all of the pain and uncertainty, and it was clear to me that he genuinely wanted to understand my illness and to take care of me. He started that night. I explained to him that, due to the relatively rare side effects of lithium that affected both my vision and concentration, I essentially could not read more than a paragraph or two at a time. So he read to me: he read poetry, Wilkie Collins, and Thomas Hardy, with one arm around me in bed, smoothing my hair now and again, as though I were a child. Moment by moment, with infinite patience and tact, his gentleness—and his belief in me, in who I was, and in my basic health—pushed back the nightmare fears of unpredictable moods and violence.

It must have been clear to David that I despaired of ever returning to my normal self, because he set about, in his rather systematic way, to reassure me. The next evening, when he came home, he announced that he had arranged dinner invitations from two senior British army officers, both of whom had manic-depressive illness. The evenings that we spent with these two men and their wives were unforgettable. One of the men, a general, was elegant, charming, and very smart; his lucidity was beyond question. He was—other than an occasional restlessness in his eyes and a slightly melancholic, albeit savingly sardonic, tinge to his conversation—indistinguishable from the animated, self-assured, and entertaining types one encounters at London and Oxford dinner parties. The other officer was also wonderful—warm, witty, and, like the general, had a “frightfully, frightfully” upper-crust accent. He, too, had an occasional sad aspect to his eyes, but he was terrific company and has remained, over many years, a close friend.

At no time during either of the dinner parties was manic-depressive illness discussed; it was, in fact, the very normality of the evenings that was so reassuring and so important to me. Being introduced to such “normal” men, both from a world much like the one I had known as a child, was one of David’s many intuitive acts of kindness. “It is the history of our kindnesses that alone makes this world tolerable,” wrote Robert Louis Stevenson. “If it were not for that, for the effect of kind words, kind looks, kind letters … I should be inclined to think our life a practical jest in the worst possible spirit.” After knowing David, I never again saw life in its worst possible spirit.

I
left London with a terrible sense of apprehension, but David wrote and called often. In the late fall we spent time together in Washington, and, as I finally was feeling myself again, I enjoyed life in ways that I hadn’t for years. Those November days remain in my memory as a gentle yet intensely romantic swirl of long walks in the cold, visits to old houses and yet older churches, light snows covering the eighteenth-century gardens of Annapolis, and icy rivers threading their way out of and beyond the Chesapeake Bay. The evenings were filled with dry sherry and meandering dinner conversations about almost everything; the nights were filled with wonderful lovemaking and much-sought, long-absent, untroubled sleep.

David returned to London; I returned to Los Angeles; we wrote and spoke often, missed one another, and threw ourselves into our respective lives of work. I went back to England in May, and we had two weeks of long, warm pre-summer days in London, Dorset, and Devon. One Sunday morning, after church, we walked up into the hills to listen to the ringing of the church bells, and I noticed that David had stopped, was standing still, and breathing heavily. He joked about getting too much strenuous exercise at night, we both laughed, and left it at that.

David was posted to the British Army Hospital in Hong Kong, and he made plans for me to visit him there. He wrote in detail about the evening events he had arranged for us, the people he wanted me to meet, and the picnics we would take to the islands nearby. I
could not wait to be with him again. But then one night, not too long before I was to join him, I was at home writing a chapter for a textbook when there was a knock at my door. It was an odd hour, I was expecting no one, and for some even odder reason I suddenly remembered what my mother had said about how pilots’ wives dreaded the chaplain’s knock on the door. I opened the door, and it was a diplomatic courier with a letter from David’s commanding officer saying that David, who had been on general medical duty in Kathmandu, had died very suddenly of a massive heart attack. He was forty-four, and I was thirty-two.

BOOK: An Unquiet Mind: A Memoir of Moods and Madness
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