Every morning, Dr. Fish would poke his head into the room and wave, and I would wave back and smile. But I knew he was disgusted. Dr. Fish was a man who liked successes. He liked them so much that before I landed in the hospital, he told me that I was improving when I was not, and now that I was so conspicuously unimproved, he shunned me. My person had become the sign of his failure, a recalcitrant body, a taunt to his medical prowess. Our relationship had been false from the start. I now believe that this dishonesty was rooted in Dr. Fish’s method of interrogating his patients. He used a tape recorder. Had he actually recorded his patients’ speech, this approach might have been harmless, but as it was, the only voice on those tapes was Dr. Fish’s. When I arrived for my first appointment, he greeted me warmly, invited me to sit in a beautiful leather chair, asked me how I was feeling, and encouraged me to describe my symptoms. I told him that I had a painful head as usual, and was about to launch into the story of my headache when he grabbed a microphone from his desk and spoke loudly into it: “Iris Vegan. Case number 63912. Tuesday, September 2, 1980.” Then he nodded toward me and smiled, a signal to continue. I had prepared notes about my headache on index cards, and looked down at them to orient myself.
“It started last August,” I said. “I was walking home from the library on Broadway, and I remember that the street looked different to me, very clear and beautiful, and I felt incredibly happy. I even said to myself, ‘I’ve never been happier than I am now.’ ”
“Yes,” he said, and fingered his bald head.
I could see that Dr. Fish was restless, and although I wanted to explain that the feeling of completeness, of perfection, was essential to the story, I rushed on. “But as soon as I stepped inside my apartment, I felt a tug on my left arm, just as if someone had yanked it hard. I lost my balance and fell down. I was so dizzy and sick to my stomach that I didn’t get up for a long time. While I was sitting there on the floor, I saw lights, hundreds of bright sparks that filled up half the room, and after they disappeared, I saw a big, ragged hole in the wall. That hole scared me to death, and the strange thing was that I didn’t experience it as a problem with my vision. I really thought that a part of the wall was missing. I don’t know how long it lasted, but after the hole was gone, the pain started.”
Dr. Fish picked up the microphone. “The patient suffered a scintillating and a negative scotoma.”
This ferocious editing had a peculiar effect on me. As the interview continued, I mumbled, coughed, forgot words, and lost track of what I was saying. Before I was sent to Dr. Fish, who was known in New York as the “Headache Czar,” I had tried to tell my story to six less famous physicians, and each time, I had lost my tongue. I felt that if only I could articulate my illness in all its aspects, I might give a trained ear the clue that would make me well, but my words were always inadequate. And most of what I said was of no use to Dr. Fish either. He let it pass like so much irrelevance, interrupting me now and then for a curt synopsis. “The patient says that vomiting has on occasion relieved her pain.”
Every week, I went to Dr. Fish, and every week, I looked better to him, less pale, less drawn, less tired. He interrupted me more frequently and summarized my complaints in an increasingly optimistic light. I couldn’t see or feel these changes myself, but Dr. Fish was confident, and I half believed him. The truth is that I participated in the deception. I was studying for my oral exams then, and I was desperate for the treatments to work. If they didn’t, I would fail. Of the 647 works on my list, 233 novels, plays, stories, and poems were still only titles to me. I had to know them by May fifteenth. Every day, I sat in the library, staring at a great work of literature that I couldn’t read. My head was in the way, a stubborn, obfuscating cloud at best, an excruciating lump at worst. Measuring the degrees of my pain became an obsession. When my head lightened, I was jubilant. The pills are helping, I would think. But when it seemed to hurt more, I despaired. Mountains of books were piled on my desk, and as the days passed, the very sight of them threw me into a panic. Nevertheless, I pretended to be well. It was a point of pride. With Dr. Fish, I was always cheerful. I joked about my nerves. I smiled even when the headache raged and I had to hide my trembling hands by clasping them tightly together. Concealing illness from a physician is absurd, but I couldn’t bear to be seen for what I was—a person going to pieces.
Then in January I was suddenly worse. I couldn’t get out of bed. I threw up my pills and was leaden with exhaustion, but sleeping only seemed to aggravate the pain. After a week of unabated wretchedness, I dragged myself to Dr. Fish’s office for my appointment and blubbered shamelessly in his leather chair. He told me to check into Mount Olympus Hospital the following morning.
• • •
I seldom left the room. All its particulars became familiar to me: the tiny flaws and marks on the white wall adjacent to my bed, the long, narrow cut in the Formica surface of my night table, the frayed edge of my blue blanket. And I spent hours looking at Mrs. O’s bed curtain. One of its rings was broken; this disturbed the symmetry of the fabric’s folds, and when the curtain was drawn, there was a sag in the upper right corner. I can still see it perfectly. My senses were oddly acute during that time. I wasn’t always able to open my eyes to the room’s fluorescent glare, but when I could, I saw its contents with remarkable clarity. Every sound on the ward vibrated through me; my nerves were as resonant as a tuning fork. The smell of antiseptic, urine, and hospital food was often so pungent that I hid my nose in the pillow. But at the same time, my body was impossibly heavy; even lifting an arm required a huge effort. It was a curious state. I felt like a turtle hundreds of years old, its soft inner body encased in a stone shell. It was never clear to me if what I saw, heard, smelled, and felt was distorted or if I was merely hypersensitive. At any rate, things were not the same. I can’t say what was behind it—whether it was the drug, the headache, or my state of mind. Probably it was all of these, but while I was there, lying in that bed, the world changed. Mrs. O. had a lot to do with it. She was the secret—the paralysis and the frenzy—but I didn’t understand that until the very end.
Mrs. M. was a woman who took charge. She had instituted a hierarchy in the room according to illness. In her view, she suffered on a higher plane than either I or Mrs. O. did. She had a nervous disorder that made walking difficult, but her “mind” was unaffected, and she reminded us of this repeatedly. “Thank God, I haven’t lost my marbles. That’s the worst. As long as you’ve got your wits about you, you won’t shame yourself.” I ranked a distant second on Mrs. M.’s scale of maladies. She quickly surmised that my ailment, unlike hers, was psychosomatic, or as she bluntly put it, “There’s nothing really wrong with you, is there? It’s all in your head.” Nevertheless, my neurasthenia rated far above the affliction of poor Mrs. O. Mrs. M. referred to her neighbor on the left simply as “the looney.” Mrs. M. was supposed to practice walking but disliked it and walked only when the nurses insisted, and then she screamed at the disobedient limbs, “Move, damn you! Move, you idiots!” She much preferred sitting up in bed and talking. She went at it full tilt, babbling without pause, the bleached curls of her permanent trembling as she shook her head for emphasis. Her chief subject was money. “How do you expect me to get any service around here without something to grease the wheels, for Christ’s sake? Green. I need green.” Mrs. M. did get attention. I’m quite sure she bribed the nurses. They fussed over her far more than they did over Mrs. O. or me, and once, early in the morning, I witnessed a transaction. Mrs. M. dug under the corner of her mattress and pressed something into the fat nurse’s hand. I suspect she paid them not to make her walk, because she did very little walking while I was there. She talked. She talked all day—to the doctors, to the nurses, to me, to her daughter on the phone, to no one, to anyone, about money, about Mrs. O., and every word clanked and rang in my sore head. “Look at the looney, will you? She eats like a dog. Yesterday lunch she ate Jell-0 with her hands. She had gravy in her nose. Why did they put me i
n here? They should keep people like that separate, out of the way. I can’t stand to look at it anymore. It’ll cost me. It always costs me. I’ve got to get a different room—a private room maybe, with curtains, real curtains, not these cheap shades.” When she wanted to count her money (this occurred at least once a day), Mrs. M. would remain seated on the bed but would pull the sheet over her entire body to hide the procedure, and I would hear her muttering the numbers to herself—“Twenty, forty, sixty, seventy, seventy-five, seventy-eight, seventy-eight dollars and sixty-two cents.” When she spoke to her daughter, she always said that she had “no dough,” but Mrs. M. seemed to have bills and coins hidden everywhere—in her bed, on her person—and whenever she moved, she rustled and jangled.
Mrs. M. meant to dominate, to fill up the room with herself, but despite her incessant chatter and her bulk (she was a fleshy woman with jowls and a substantial bosom), it was the small and silent Mrs. O. who took up space. She was a delicate woman in her late seventies, the victim of some nervous catastrophe. That event or series of events had left her incoherent. What remained was a fragmented being, a person shattered into a thousand pieces, but those bits of Mrs. O. inhabited the room like a crowd of invisible demons.
When I first saw her, she was lying motionless in bed, a frail, corpselike figure, but when I walked past her, she sat up with surprising energy and pointed at me. I looked at Mrs. O., with her extended arm and finger, her face alert as if she were waiting for me to respond. It was only when I turned my head away that she let her arm drop. I have no idea why she did it. It was an act typical of her only in the sense that it was unpredictable. One never knew what Mrs. O. would do next, and it was this quality that made life in the room precarious.
Given that Mrs. O. was a conundrum to everyone, she was the object of rumor, gossip, and speculation. Like most people confined to an institution, she had been divested of a past life. She was born old and in her hospital gown. I asked about her. I wanted to know who she had been and where she had lived. No one knew. Yet the ward buzzed with stories of her mischief. The very first afternoon of my stay I overheard two nurses talking outside the door. I’m certain one told the other that Mrs. O. had bitten a doctor. There was some mention of “bathroom nastiness” as well. Mrs. M. swore that Mrs. O. was violent and, moreover, that she was hatching a plot. “She’s got something up her sleeve, mind you, and it isn’t pretty.” Later that same day, an orderly named Washington, one of the few people besides Mrs. M. with whom I ever had a real conversation, said that when Mrs. O. first arrived, she had spent one disastrous night roaming the corridors. He hadn’t worked that shift, but a friend of his had caught up with Mrs. O. in the maternity ward at four in the morning. She was standing outside the nursery with her nose pressed to the glass. “Just looking at the babies, all quiet and thoughtful like.” But later that day, various acts of sabotage were uncovered: the contents of a garbage can strewn in a stairwell, bed linens and towels ripped off the shelves in a hall closet and thrown to the floor, a missing food cart found in the shower stall of a bathroom. They were all blamed on Mrs. O. But how could she have wandered the halls without being seen? Washington couldn’t understand it. Mrs. M. adamantly maintained that Mrs. O. was capable of disguising herself in a staff uniform and sneaking about the halls unnoticed. “The looney’s crafty as hell,” she said. But Washington had a different opinion. “How could that itsy bitsy old lady lift one of those giant trash cans?”
The next morning, a neurologist came to visit Mrs. O. He was a young doctor, vigorous and handsome. I noticed that his face and arms were deeply tanned. He strode over to her, sat down on the edge of her bed, and drew the curtain around the two of them. He greeted her in a friendy way, something on the order of, “And how are we doing today?” There was no response. I heard stirring in the sheets, a few muffled grunts, and then nothing. Seconds later, the doctor flung back the curtain and hurried out the door. He looked stricken. When I leaned over to look at Mrs. O., she was smiling broadly, and it was then that she reminded me of someone I knew or had known. I tried to dredge up the lost face and name, but they resisted me. This uncanny sense of familiarity subsided very quickly though it left a residue, a doubt that stayed with me. What had spawned that moment of recognition? Was it really something in her expression or was it something inside me? In any case, I began to watch Mrs. O. more closely.
The residents made daily rounds to give us the test. It was an unnecessary ritual, but I supposed they needed the practice. It consisted of a series of questions followed by some mild pinpricking. Frankly, Mrs. M. and I both enjoyed it. The test punctuated our day, and it was pleasant to be quizzed by those rosy young men in their white coats. Mrs. M. even primped for the occasion. She would pinch her cheeks and pat her curls when she saw a likely candidate coming through the door, and was visibly disappointed when the resident turned out to be female. Mrs. O., on the other hand, was usually cantankerous. There were a couple of days when she lay passively in her bed, smiling meekly and nodding as the questions were posed to her one by one, but more often she rebelled, and when an examiner approached her, she would bat and kick at him furiously, letting out one high-pitched shriek after another. More awful, however, were the days when Mrs. O. was eager to take the test. It always began with the question “What is your name?” Mrs. O.’s face would contort into a look of profound bewilderment. She would squint and clench her jaw as she searched, desperate to extract the correct words from her unyielding brain, and then her small face would grow red from effort. It seemed that she thought she could press out the name if only she pushed hard enough. With each subsequent question, her straining increased. “Where are you now? What season is it? What is today’s date? What is this object?” the doctor would say, waving a pencil in her face. By the time he was pricking her thigh with a needle and asking, “Can you feel this?” Mrs. O. was exhausted and miserable. And despite the fact that she couldn’t reply to a single preliminary question, she felt the pinpricks. One day she looked up at the resident and said in a tired, plaintive voice, “Why on earth are you doing that to me?”
The fact was that Mrs. O. wasn’t one person, she was many people, and no one knew who might turn up from one moment to another. This plurality gave the room an air of expectation, and I found myself charting the course of Mrs. O.’s lunacy as if it were my calling. Every morning, Mrs. O.’s husband arrived for his daily visit. The climate of this morning encounter was often indicative of Mrs. O.’s persona for that day, and I always tried to be awake for it. He was tall and stooped, a man of clean, pressed suits and many ties. As Mrs. M. expressed it, he was “nicely pulled together.” The person Mrs. O. had once been could be seen in him and in the things he brought her: a pale blue quilted robe with silk ribbons at the neck and waist, a small, immaculate toilet bag with pink flowers, and a shiny brass travel clock. When he arrived, he would walk slowly to her bed, place his offering of the day on the windowsill, sit down beside her, and take her hand in his. He did this without fail and regardless of her reception of him. One day, he would find a stone in the bed, a body so pale and rigid it might have been dead; on another, a flapping, writhing screwball who laughed so hard she choked on her own saliva. Or he might find her ruminating, her old face solemn with concentration. He took it all very well, witnessing his wife’s metamorphoses with remarkable composure. I saw him excited only once. It happened in the early part of my stay. He had taken her hand, and I saw her turn toward him. Her face was completely transformed. The change was unmistakable. She knew him. He grabbed his wife’s wrists and stared into her face. “Eleanor! Eleanor!” he called out to her, but she had already lapsed into forgetfulness. He hunched over in his chair, and I saw his back quiver.
• • •
When Dr. Fish said, “I’m going to put you in the hospital,” I had felt immense relief. They’ll take care of me, I thought. I’ll get well at last. And when I’m out, I’ll read and read. But I didn’t rest in the hospital. Although my movements had been
slowed by the drug, my brain raced, and I was breathing poorly, in little cramped gusts. Fragments of the books I was supposed to know came and went in my miserable head. I had memorized the first scene of King Lear and tried to recall it, but it had vanished. It was all nothing then, nothing and more nothing. I worried about the books I didn’t know and the money I didn’t have, money to pay for what my university insurance wouldn’t cover: twenty percent of the bill. My headache would turn my parents into debtors, and there was nothing I could do. I was frozen in a hospital bed; it was impossible to know for how long. I had read once about an eighteenth-century English noblewoman who suffered from a headache for more than twenty years. I began to imagine that I would never get well, that I would die as a neurological footnote: “There is one reported case of a woman who was ill with migraine for fifty-two years. See Glower, ‘Vascular Migraine Syndrome,’JAMA 1498, p.43.” My parents called often. I lied, telling them I felt better. When friends called, I told them not to come. A few insisted, and they came with flowers and chocolates. During these visits, I always felt less pain, but after them, I was worse. I read the change as a further sign of my neurosis, and it depressed me. Stephen called. It was eight months since we had parted ways. A mutual friend had told him I was in the hospital. He said he was coming to see me, and I didn’t tell him not to come. “Tuesday,” he said. “I’ll be there Tuesday at two o’clock.”