SMITH is pleased to present an excerpt from Jason Thompson’s memoir in progress, Stella, about the writer’s experience growing up as the child of an angry, abusive, mentally ill mother. “A decade after leaving home I became suicidal,” says Thompson. “This excerpt describes my time in a psychiatric hospital after I tried to kill myself, and the start of my journey back to life.”

Thompson’s last story for SMITH was the four-part diary of his time as a first-year teacher, Reading Siddhartha in Oakland. He blogs about mental health on his site Neurotransmission.

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I didn’t have the guts to jump off the Golden Gate Bridge, and I didn’t own a gun, so I decided to slit my wrists in the bath. I had also considered trying to hang myself with a belt, even searching around my apartment for a suitable place to tie the noose, but none presented itself. Asphyxiating myself in the stove also seemed a possibility, but I wasn’t sufficiently confident of my ability to seal the kitchen from potential gas leaks. I also thought about killing myself with fumes from the car exhaust, but fixing up a hose to the exhaust pipe seemed much too complicated, and I worried that choking on exhaust fumes might make me feel sick. Yes, it had to be the knife in the bath: almost certainly lethal, and if I dosed myself with booze and tranquillizers first, hopefully close to painless.

I took out all the liquor bottles from the pantry and put them on the kitchen table. We had three bottles of tequila that were almost empty; a couple of mixers; and a bottle of Aquavit. My wife used the Aquavit to make salmon lox. I drained one of the tequila bottles. The alcohol went to my head almost immediately—I hadn’t drunk anything in months. I felt numbed and slightly exhilarated. I took a swig of Aquavit, then went to the bathroom, where I opened the medicine cabinet and took out a bottle of Klonopin, the anti-anxiety medication my psychiatrist had prescribed me for the past year. Emptying the contents of the bottle into the palm of my hand, I reckoned there were about twenty pills. Good enough. I put the plug in the tub and turned on the taps, then returned to the kitchen to pick up the Aquavit. The thought occurred to me: this is what it’s like for someone to kill himself. I had the sensation of watching myself go back to the bathroom and check the temperature of the water as if this action were being performed by someone other than myself. One fragment of the universe is being extinguished, I thought, like a god observing a flux in his Creation. This sense of distance shrank away as I began to take off my clothes and noticed that my legs were shaking. Taking another swig of Aquavit, I climbed into the bath.

I cannot love and am not worth loving, I reminded myself. I deserve to die. This is the right thing to do. Killing myself seemed the only authentic action, like the last act of a tragedy. But what next? Was there anything? Was I going to Hell? No, I told myself, there is no Heaven and no Hell. There is nothing afterwards. I opened the sharpest blade of the Leatherman multi-tool my wife and I had taken on a camping trip during our honeymoon in Hawaii. I looked at my fist-full of pills. To Oblivion, I thought, swallowing them.

I woke to find a doctor sewing stitches in my right thigh. My leg was covered in bloody scratches, extending from my knee to my hip. There were lighter scratches across my chest. My wife and her brother sat at the foot of the bed. My wife was reading The Noonday Demon, Andrew Solomon’s book about depression. “How do you feel?” she said. “Glad to be alive,” I replied instinctively, as if performing a script. Still buzzed from the tranquillizers, I felt oddly elated. My wife went to the bathroom. “How is this for you?” I asked my brother-in-law. “I just feel bad for Viv,” he said. I felt a twinge of shame. I opened the Solomon book, which my wife had left on the bedside table, to the index and found the entry for “suicide.” As I began to read the book, feeling like a tourist perusing a guidebook while on holiday, my wife came back to the bed and took the book away from me. “Go to sleep,” she said.

I woke wearing a blue hospital robe under starched white sheets when a nurse poked her head around the bedroom door and said, “do you guys want to eat, or what?” I was back in Langley Porter Psychiatric Institute, the mental hospital run by the University of California, San Francisco, for the second time in less than a week. As I got dressed, I noticed that my belt and shoelaces had been confiscated. I had been involuntarily admitted to the hospital on a seventy-two hour hold after trying to kill myself. A piece of hospital documentation on my bedside table recorded my suicide attempt.

I picked up my breakfast tray and scanned the room. I noticed some familiar faces. “How’s it going, Bob,” I said, sitting myself down opposite the long-bearded, severely depressed former computer engineer I had befriended during my first stay in the hospital. “Okay,” he said flatly. “My head hurts from the ECT.” ECT: electro-convulsive therapy. Bob had undergone fourteen treatments, giving him migraines and frying his memory to the extent that he read Harry Potter and The Prisoner of Azkaban twice in rapid succession, because by the time he got to the end of the book he had no recollection of the beginning. Kathy, a bleached blonde nurse allegedly in her early fifties but who looked at least a decade younger, came to my table with a compassionate smile and gave me my morning doses of Effexor (an anti-depressant) and Klonopin.

“How could you do that to someone you love?” my wife wailed when she answered the phone. The question was awkward to answer, because the truth was I didn’t love anybody: not myself, not my wife and family, nobody. But having grown accustomed to evading difficult emotional truths, rather than confessing my loveless state and risking abandonment, I said I was sorry. “Sorry doesn’t quite cut it in this situation,” said my wife. “I know,” I said. Then I asked her to tell me what happened during the black-out between swallowing the pills and waking up in hospital.

My wife had come home to find me sitting on the couch, reading People magazine. There were no traces of the liquor bottles, the pills, or the knife. The bathtub was drained. We had a brief conversation during which it quickly became clear that I was drunk. I claimed to have sunk a couple of beers with a friend that afternoon after visiting Glide Memorial United Methodist Church, of which I was a member and Gospel singer. She initially found my inebriation funny, because I hadn’t drunk any alcohol in such a long time, and wondered if it was perhaps a sign that I was reconnecting socially, until I tried to stand, and she realized quite how smashed I really was. An old friend of my wife called on the phone. My wife put me on the phone with the friend. “Hello, Ronni,” I said, slurring my words. Then I went to the bathroom and threw up. “Things will get better,” I said. “We can have children.” Concerned, my wife called the front desk at Langley Porter, from where I had been discharged the previous day after a seventy-two hour voluntary hold, to report the situation. Given that I was due to start the hospital’s outpatient program the next day, the nurse who answered Langley Porter’s phone was not unduly worried about my reported state, suggesting that my wife give me a shower and put me to bed. Since I was too heavy for my wife to prop up in the shower on her own, she called her brother for help. When she took off my trousers she found the cuts on my legs and began to panic. Calling Langley Porter again, the hospital suggested she bring me in.

Evidently, I had changed my mind about killing myself while lying in the bath and scoring my flesh with the Leatherman. Perhaps the sight of blood frightened me into realizing the genuine gravity of suicide. Perhaps, like the protagonist of It’s a Wonderful Life, a friendly angel intervened to protect me, allowing me to see the impact of my death on the world before returning me to it alive (this was my father’s interpretation.) More likely, I was scared of my wife’s reaction and tried to clear up all evidence of my self-murderous plan before she came home. Whatever the reason for my volte-face, I had come perilously close to doing myself serious damage. If I hadn’t thrown up so quickly, the pills could have damaged my liver. A little deeper and the cut in my thigh could have severed an artery.

My wife hung up, saying she wasn’t sure when she could visit me. She needed some time. I said I understood. A few minutes later I got a call from my brother in Vienna. He was as sympathetic as I could possibly have hoped under the circumstances, but unmistakably angry, too. “Why don’t you think about someone other than yourself?” he said. “What would have happened if you’d succeeded? You’d have damaged me and Dad and Mum irreparably.” I said I knew. “And what if it happens again?” I promised it wouldn’t. “But when you said you were feeling suicidal last month you said it was just a feeling and that you weren’t going to act on it.” That was then, I said. My feelings had since changed. “So how do I know your feelings aren’t going to change again?” They won’t, I assured him. He didn’t sound convinced. He asked me if I needed anything. Sheet music, I said. I found playing the piano therapeutic. He faxed me Oscar Peterson’s Hymn to Freedom.

Six of us, some still in blue hospital robes, the others dressed, sat opposite each other in a small room overlooking a steep eucalyptus-lined road at the back of the hospital. A light rain was falling. We introduced ourselves. Bob, my snoring roommate, was suffering a headache from his eighth electric shock treatment. He couldn’t remember the month prior to coming to the hospital, and still felt severely depressed. Sherry, an anesthetist in her mid-to-late fifties, was also recovering from an ECT treatment and equally dubious about its benefits. Diana, a talkative musician, was happy to be in hospital safely secluded from the clutches of her “workaholic, rageaholic, abusive” male colleagues, at whose hands she had suffered an unnamed trauma. Lisa, a mousey, fragile bookstore clerk in her late forties, was feeling “cynical” about the possibility of being helped during her hospital stay, having suffered episodes of anxiety and depression since she was a teenager. Lindsey, a Latina in her early twenties, missed her husband and baby, and was crying because she was ashamed that she had wanted to hurt her baby and kill herself.

My global negativity, a clinical hallmark of major depression, was one of the first things we discussed in group therapy on my first day in hospital. Was I guilty of “self-sabotage”, or “fortune-teller error,” always assuming that things would turn out for the worst? Yes, I was. If so, what would improvement look like? I would keep promises to myself and others. I would stay committed to the idea of improvement itself. I would take good care of myself. I wouldn’t space out. I would be financially responsible, stay connected with friends, invest emotionally in my work, explore more career options (social work, was my latest wheeze) and take action. This is what I wrote for the therapist. But the words felt hollow. I was paying lip service to the idea of improvement, like an atheist saying a prayer.

My suicide attempt predictably inspired an intense emotional reaction amongst my family and friends. Vivian felt a profound sense of betrayal. My brother was scared and hurt. By mutual family agreement, we decided not to tell my mother. From my perspective, this decision was less about protecting my mother than myself: I didn’t want to give her such inflammatory material with which to harangue me for the rest of her days. My father found it difficult to express his emotions directly but, judging by the fact it took him a week to visit me following my readmission to hospital, I sense he found the news initially overwhelming. Vivian wished that my father and brother could comfort her and take charge of the situation when they visited. My father and brother wished that Vivian could take it a bit easier on them, given the trauma they were enduring through nearly losing me. Everyone was hurting, and I was stuck in the middle of it all, feeling responsible for all the pain. Fortunately I found this sense of responsibility strangely liberating. By arbitrating the fraught emotional tensions between Vivian, my father and brother, I felt the glimmers of personal efficacy.

A nurse gave me my lunch-time medication and asked me if I was feeling suicidal. Yes, I said. “Do you plan to act on those feelings in the hospital?” she said. No, I said. “Then you can go outside.”

I accompanied two therapists and a dozen patients on the hospital’s rooftop basketball court, which overlooked a startling panorama framed by the Golden Gate Bridge and the Marin Headlands, cordoned off from potential jumpers by a fifteen-foot high wire fence. Eager for exercise, I ran sprint intervals up and down the length of the court, then joined two patients shooting hoops. I found myself thinking of my Oxford peers—an Emmy-award winning film director; a national newspaper columnist; a forensic psychiatrist—and wondered how my life had come to this, aged thirty-four, a novelist-manqué, playing ball with mental patients. The siren song of suicide resounded more loudly.

After forty-five minutes our exercise time was over and the therapists led us back to the unit. “Back to jail,” quipped Alfred, a manic Asian-American who talked incessantly, providing a deranged running commentary on life at Langley Porter consisting of his own thoughts, observations of the ward and events on television, that was by turns irritating and hilarious.

A lady from the Society for the Prevention of Cruelty to Animals brought in a Labrador puppy for us to play with for an hour.

We knocked and rattled various percussion instruments, accompanying the melodious xylophone played by the art therapist. For an instant I felt calm. “Chaos, violence, war, hell,” muttered Alfred, marching out of the dayroom, and all the patients laughed.

Lindsey danced with a middle-eastern autistic man in his early twenties who kept repeating the same short phrase that apparently meant, “I want to go home.”

Lia, Lisa and Bob invited me to play The Game of Life with them. I had uncannily good luck with the dice, rolling six after six, quickly progressing through college, marriage and my first job to home-ownership, wealth and children. My success in the game seemed like a grimly comic reminder of how completely I had failed in reality.

I played major scales on the piano for an hour.

Dr. S, an attractive psychiatrist in her late-thirties, and Dr. W, a junior colleague somewhere around my age or younger, summoned me to a private room. “Are you feeling suicidal?” asked Dr. S. “I feel like I deserve to die,” I said, and explained the full, knotty story of my ambivalence about parenthood, my hatred of my job, and my frustrations as a writer. “Depression is a finite phenomenon,” said Dr. S. “Yours has lasted longer than most, but you will get better.” She wanted to try some new medications. ECT was also a possibility.

“I don’t want that,” I said, terrified of frying my brain like Bob.

“We can’t force you to do anything,” said Dr. S. “It’s entirely your choice. But you should know that ECT really isn’t as bad as people imagine. It’s not like you see in the movies. You’re completely sedated, and basically we just give you a little seizure.”

A little seizure! Electrodes in my brain! I was ready to die, but shocking my brain seemed somehow worse.

Dr. S increased my dosage of Effexor (the anti-depressant Dr. John had prescribed for me) and added Seroquel, an anti-psychotic drug, to increase the effect of the anti-depressant.

I flopped down on the couch with Lia and Bob watching American Idol on television.

Nurses wheeled a gurney into the hallway. An obese African-American teenage girl lay on the gurney, shaking uncontrollably.

I woke, heavily sedated, and stumbled to the dining room, outside of which patients had formed a line. A pretty woman in her late twenties was slumped on the floor, trying to pull herself to standing with the wooden handrail that extended three feet from the ground along the ward’s interior wall. I helped her up. “Sorry, it’s the Seroquel,” she said. “I know the feeling,” I said. As more patients stumbled, bleary-eyed, toward the dining room entrance, the scene reminded me of the drug-casualties that wander the fields of the Glastonbury Festival or the empty desert of Burning Man in the early hours of the morning: the costumes and chemicals were different, but the mood of tripped-out exhaustion and removal from ordinary life was eerily similar. Supply some glow sticks and techno and it could almost have been a party. Perhaps a psychiatric theme camp at Burning Man was not out of the question; maybe, in fact, we actually were at Burning Man, and had taken so many hallucinogens we believed we were in hospital.

I helped the sedated woman to a chair and tucked into my oatmeal and decaffeinated coffee.

The fat black girl sat down opposite me. She was still shaking. I introduced myself. Her name was Naomi. The previous evening, she had swallowed one hundred-and-twenty lithium tablets and half a bottle of vodka, way more lithium than would have been needed to fatally damage her liver, but was rescued when she confessed the act to her mother only twenty minutes later and promptly had her stomach pumped.

Her pulse was close to one-hundred-and eighty. She took my hand and pressed it to her racing heart. The doctors could not give her any medication to help her shaking because her body was still too poisoned with the lithium.

“I’m so lonely, I wish I could die,” said Naomi, her voice tremulous, fingering my wedding ring. “Your wife is so lucky.”

“One day you’ll make a man feel very lucky, too,” I said.

“Really?”

Her eyes were wide open with a child’s searing innocence and credulity.

“Yes, I’m sure.”

“You’re a wonderful person,” she said, gazing at me as if I were Jesus. “But you’re going home today, right?”

“No, I just got here.”

“Oh. But I thought…”

“What?”

Her wide gaze shrunk to sadness. I felt painfully diminished in her eyes, as if I had broken a promise with a trusting infant niece.

“You think you know someone,” she said, “but then you don’t.”

Tags: jason thompson, mental health, stella