There are some things I cannot formulate into thoughts, much less words, that keep me staring out into the middle space, searching. Since this silence, it has become more prevalent that a feeling has come over me that I can’t identify, that I cannot shape with description, that makes everything formless and blurred. I thought silence would bring me clarity, but I see nothing now but cloudy abstracts.

     “If you woke up tomorrow and everything was the way you wanted it to be, what would that look like?” Carol, my therapist, is fond of asking me this question at every session, though the answer seldom changes.

     I didn’t have to close my eyes to visualize it. “I would be sitting next to my camper, at a campground somewhere in…Virginia.” I’d have a table and chair set up next to a fire and I’d be sitting there with my laptop, and my little dog, looking out over a lake, writing. I could stay two days or two weeks. There would be no hurry to come or go. There would be no need to decide anything at all. When I wanted company, I’d visit with other campers. When I wanted solitude, it would be there, all over me, saturating me until my soul overflowed.

     “Can you see yourself doing this?”

     “I can see no reason why I shouldn’t.”

     “Okay,” she said. “I’ll play devil’s advocate. How would you finance living on your own and traveling around America?”

     “I’d work remotely, from my computer, doing case management for Aetna or some other insurance agency.” The financial aspect didn’t even factor into the equation.

     “And what about some of those things TD brought up about the safety issues?”

     “Yes,” I said quietly. “There are those.”

     There was always something, though. There were always challenges and obstacles to overcome. This was life and it wasn’t easy. And who’d want it if it were? If it were all handed to me tomorrow with a shiny, red bow, would I even want it? Haven’t I had to scrape and claw to get everything else? The fight didn’t matter to me. The challenge was part of the cost and had to be paid in full, up front.

     Still, I thought about taking the easy way out by posting an ad on Facebook that read: “WANTED: Driver/Travel Companion to drive camper across America. Must be mechanically inclined and keep up maintenance on travel trailer. All expenses paid–includes sex. Only fishing-hunting-outdoorsy butch lesbians need apply.” I couldn’t help but throw my head back and laugh and laugh every time I thought about it.

     This morning before TD and I left the house, I felt a small wave of depression trickling in so viscerally that I actually took a step back to keep it from getting my toes wet. I was standing in my room putting on my brace and caught a quick reflection of myself in the mirror. As usual, it took me a few seconds to make out a human shape. My hair was cut a few days ago, nearly scalped, and it’s hard to get used to. I ran a hand through it and stood up straight. I had on the same clothes as yesterday: green t-shirt, jeans, sneakers, brown sweater. I took a few steps closer to the mirror but the proximity seemed to only diminish my size. I’ve been having a hard time eating. I’ve been hungry but when I try to eat, I can only get in a few bites. I’ve lost some more weight. The sweater I was wearing was too big for me a hundred pounds ago. Today I was just shriveled inside it like a cadaver. My head resembled a naked lightbulb. I am a thin layer of skin over sharp bones, especially in my face, where I am beginning to notice angles and edges that have never been there before.

     Clothes don’t matter. When I had weight loss surgery I couldn’t wait to go shopping for clothes! Now I don’t give a shit. Depression doesn’t care what you look like. I remember doing an admission on a man whose wife was with him for the assessment and she said, “I’ve told him he needs to fight this depression, but he won’t” and he had looked at her and said, “Fight? I fucking put clothes on today, didn’t I?”

     I stared harder into the mirror but got nothing back but a catastrophic emptiness. It always amazed me that I could so easily see the good in others but found it so difficult to see it in myself. Even in my patients, especially in my patients…rapists, child molesters, sociopaths, drug dealers, murderers, I could dig out a professional empathy that was so keen, I was known for it among my colleagues. But ask me to name one good quality about myself. Well, that would be it. I can find the good in any person.

     One day at work a patient was brought to the unit in handcuffs and slammed into a chair by the nurses’ station. There were angry words exchanged between the officers and the staff. There were death rays fired at the girl sitting there, who surprisingly, was devoid of all facial expression. They forced her to stand and ripped off the cuffs and then shoved her into the chair again. She had been brought up from the emergency room for a 24-hour psych evaluation after telling the doctors she had been hearing voices and believed the world was going to end. That morning she had lowered her infant daughter into a pot of boiling water and cooked her on the stove. In treatment team the staff’s contempt could not be contained. “What kind of animal does this?”

     “She should burn in hell,” said the charge nurse.

     “She should have done to her what she did to that baby! An eye for an eye!” said the social worker.

     “I can’t even look at her,” another nurse replied.

     Because the room had grown quiet and they seemed to want me to add to the conversation I said, “Would ya listen to all the Christians?”

     They stared at me like Nazis who had just discovered a Jew in the congregation.

     I tried another approach. “Judge not, lest ye be judged?”

     There was no comment.

     I brightened. “I know! He who is without sin, let him cast the first stone!”


     Sometimes I had to wonder if my co-workers forgot where they were. I had to wonder if they forgot who they were. How could they stand working in a place where people urinated on walls, played with their own feces, stole priceless heirlooms from their own mothers to buy drugs and killed their babies if they could not look past all of that and see before them a human being suffering life’s cruelest atrocities? It was hard sometimes. It could be difficult to hone in on the medical importance, and ignore the personal implications, of drunks and junkies with urine-stained clothes, hair and beards crawling with lice, oozing track marks, scabies, infections and sores. I often had to fight the impulse to turn my head away in disgust or hold my nose…or force myself to speak kindly to a man whose wife was in ICU after he had beaten her half to death. In the end, with patience, without judgement, sometimes you have to be Jesus.

     I don’t know how long I stood in front of that fucking mirror. I walked out to the kitchen where TD was sitting and texted, “Do I look like a cancer patient?”

     “No!” she said.

     “A dialysis patient?”


     Because she wasn’t already mad enough, I texted, “A concentration camp victim?”

     “NO!” she yelled. “STOP!”

     On the way to the therapy appointment I set up my imaginary battle field. Over the years this battleground has gotten more and more complex. In the beginning it was just me on one side and this big black blob on the other, facing off, rushing the center, withdrawing. Now there are strategic plans, outlines, time frames, specific courses of action. I face off against an enormous mass of growling, frothing, snarling anger that can spit fire and shoot lasers from its eyes. I take stock of my weapons: medicine, therapy, doctors, friends, family, writing, exercise, relaxation, reading. I take stock of the enemy’s arsenal: mood instability, sloth, hypersomnia, poor hygiene, apathy, lack of appetite, negativity, delusional thoughts, low self-esteem, lack of energy, cut-throat sarcasm, suicidal thoughts. When the battle starts, I can duck and dodge without much effort. He throws me a ball of anxiety. I practice deep breathing exercises. He trips me up with a bout of insomnia. I write through it. But sooner or later, he’s going to start tossing grenades into my camp faster or bigger than I can stand up under. This past Sunday a bomb of depression and self-disgust exploded when I woke up and released the toxins under my skin before I could react. I decided I wouldn’t eat. I decided I would stay in bed all day and watch a marathon of Snapped. It took TD dragging me out of bed by my leg and walking me to the table and forcing me to eat before I was even able to visualize the field. And there I was, puny and exhausted, lying in a heap of failure, more than ready to be annihilated by whatever landed next.

     I have been the victor in this war many times. I have stood on my side of the battleground and loaded a bronze Howitzer with high trajectory canisters. I have fired 32-pounders across the lines in a

blaze of fire and destruction big enough to torch the sun. I have hit targets behind hidden terrains and wiped out structured fortifications with a single shot. I have fought with the religious convictions of Joan of Arc and guarded the perimeter of my fortress like Cleopatra defended Egypt.

     The thing is, you must win the last battle. You must be the last man standing. I’m not so sure if I’m going to make it. The older I get, the tougher the enemy grows. The weaker I grow, the heavier the canons are to lift. Sometimes when I see myself on that field, there is fire and chaos and anarchy engulfing everything around me and I am just lying there, letting it happen, not giving a shit.

     Still, if hope lies in the courage of those who dare to turn dreams into reality, then I am still fighting. I started off wanting a motorhome with all the bells and whistles and then quickly changed my mind to pulling a tiny pop-up behind an old VW bug. I have always imagined a little Pomeranian as my companion. When I think about the picture of what it would look like if everything was as I wanted it to be, only incidental details get moved about…the quest remains the same.

     “It has changed again,” I told Carol and smiled.

     “How is it different?”

     Having to learn how to maintain a camper? Having to know how to make sure everything is in working order? Being responsible for maintenance on the vehicle? Doing it alone? “I’m going to need a bigger dog.”

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