Now Reading
The Patient Records

The Patient Records

Anonymous

1.
It begins in the middle like this: the sun sets quietly in a Brooklyn sky. From the top of a hill we can see the Statue of Liberty signaling an idealism long squashed out from our hearts. Even so, trust does not leave the body completely, and I, floating between intent and the unwritten book, am about to hold my hand out to a young man for a prescription drug no doctor will prescribe for me, even though I need it. Instead, they prescribe me medicines I don’t want and that don’t work.

2.
It’s 2017 and I make my way to a section of the borough I have not been to before—somewhere bordering Williamsburg and Bushwick. A nervous kid about eighteen years old meets me in a regular New York deli across from some housing projects. Our agreement is thirty 20 mg pills of Adderall in exchange for $180. I am nervous too. I need the money first, he says, holding a prescription bottle tight in his hand. You don’t get the money first, I say, I need to see the pills to make sure they are real. He fidgets. It feels like a setup, so I leave empty-handed. I return to the comfort of my car and experience a familiar sensation, like I can feel the blood in my veins, adrenaline racing, the life of living. Anything can happen. The kid appears at my car window. Get in the car, I tell him, so I can make sure you’re not trying to rip me off . He says he can’t get into a stranger’s car. He is my height, regular male build for his age, but he probably thinks that I am the police and I am thinking that he is the police. This isn’t going to work, I say, and speed off.

3.
That feeling that anything can happen at any time is a condition inscribed into my body by the many things that happened to me as kid. Nothing was within my control then and because of this fact I began to understand the randomness of things occurring. A squirrel, for example, can fall from a thin branch the instant you walk under it right onto your face. There’s simply no way to plan for things or avoid other things. This is a revolting way of experiencing the world, but I’m also attracted to it. It’s a survival strategy. So when the drug dealer sends me a text that says, That wasn’t me. I sent my brother, and my brother can’t do anything right, I rush back in to meet a new guy and a revised scam. The presence of the drug dealer and my acting beyond the boundaries of reason surely signal, to the reader, an addiction; I understand this. I don’t know how to make a compelling case for some other relationship to the drugs I’m trying and failing to obtain.

4.
A certain difficulty lies in the difference between what we want and what we need. Conventional wisdom would have it that in order to differentiate between desire and requirement one must first be able access the past using memory. You have to figure out when memory is about a real happening, a pure feeling, or comes from made-up thoughts. For Freud, memory determines much of who we are (the beingness of being). When one has access to recalled memory, it presents, first, I think, in images and then the brain kicks in to do its interpretation work. We like to think about our memories. We like to ask questions about what occurred, about what we don’t remember or what was outside of the frame entirely. Want can only come from the mind, if you buy into this theory, and what we know about ourselves and believe ourselves to remember, while need is more precise, I think, but also more suspect. The body can have its own needs including, but not limited to, the nutrients that one must have for survival. But, when another person says, I need you, we think they are really referring to desire.

5.
I have a memory, akin to one you have, maybe, from a photograph in my mother’s photo album. I’m about three years old, dressed for church—it might be Easter—in a light blue dress and cape, and holding an open yellow umbrella above my head. It appears to me that I look forlorn and I remember keenly a forlorn feeling, trapped in the outfit and white tights and black patent-leather Mary Janes. My mother loved Mary Janes in her own youth and nostalgically purchased them for me, attempting, it seems, to hold on to time. She loves old-fashioned candy like Squirrel Nut Zippers and records on vinyl and Charlie Pride, born one year after her, and the Grand Ole Opry on the radio. I do not remember wearing the dress, but I do remember the house I’m standing in front of in the photo. It was in a part of town that my parents wanted to get away from, and did eventually, touching down in a part of town more integrated, which meant better.

6.
I no longer remember being inside of the child body dressed in soft blue, but I can still feel its precarious existence, and its knowing, even so, a possible power that might be accessed. One day, when I was older, four or five, I was playing outside on the old metal railing in front of the house’s side door. When I fell from the railing, I did so in a way where I landed on my child vagina, my legs splayed on either side of the bar. I had done this to myself but now it would have to be investigated, which meant exposure of a part of my body I hadn’t yet thought about in any significant way. In moments like these, one becomes the body’s flesh, skeletal scaffold, and blood. I imagine this child-body laid out on a silver examining table, under a stark gaze, yet somehow invisible. My mother wanted to check to see if I was bleeding given that the fall had caused me to wail hysterically, inconsolably. I don’t remember if I was taken to the doctor or what happened after. I remember nothing else except a shadow feeling of being in the kind of pain that happens to bones.

7.
Time is not linear; instead it’s like a strong breath tunneling up through experience and spreading out, inhabiting a body. A body can be infinite as much as it’s a mechanism for processing food. When my mother tells me a story, it’s as if time has stood still for her. No partition between the past and the future. No influence of one upon the other. She glances around her present surroundings, a vacant look in her eyes, and tells me about the time her uncle pulled a gun on some white men asking for directions. They weren’t asking for directions, she says with a tilt of the head. It was night. A gas station somewhere way out in swamplands. I can picture those white men and the goofy frivolity of their violence and my mother’s uncle and whoever else was in the car like apparitions in the room. One person’s good-old-boy fun is another person’s dismemberment, is their dogged haunting. I, too, am trying to concentrate on something outside of time.

8.
I tell you all of this—the fall from the railing, the nonmemory of wearing the blue dress, the man with his hand shaking, likely, around a rifle pointed at some white guys’ heads—as a way of blurring the distinction between desire and need and highlighting the possibility for nonlinear time. Also, I want you to know me better. Those memories and not-memories are also ways for me to three-dimensionalize the depths of my person as a character in this narrative. But here’s some advice: don’t try to talk to a medical professional about nonlinear time. The professions are there to tell you what you need and to disparage what you know to be true. I am very uncertain about the function of memories of the past and how they work if time is not a thing that we are simply marching through, or that’s marching through us. It can be challenging to develop your own idea of things when regulated by professionals’ bright laboratories. Those professionals with their badges of knowledge will look directly at the burning sore on your asshole and tell you that it cannot be from the medication they prescribed you. It’s a fungus, they tell you, cause unknown, produced by the body of its own accord. The badge-wearers tell you to take another medicine to cure the fungus, but they don’t tell you that the other medicine can make you sterile. Or, you enter the emergency medical center with a sore throat, and the doctors—two of them—say it’s probably gonorrhea and that you should probably get antibiotic injections right now before the test results come back. Your mouth falls open. You are 99 percent sure that you do not have gonorrhea of the throat but for a minute you actually consider the injections.

9.
All the ways your body is a site for investigation, someone else’s false documentary. Many years ago, when I was a graduate student, I accepted my psychiatrist’s invitation to participate in an ADHD study. The psychiatrist and I had the relationship that most patients have with their mental health doctors. I was under his care. In his care I could help him understand things about medicines for the mind. Or, at the very least, the way these medicines worked or did not work on me. It seemed like he was trying to find the perfect balance of medications to help me. He did this by changing my medicines and dosages periodically in a similar way that I might, not being a doctor. When I entered the ADHD study, I was hungover most of the time. No one asked me if I was hungover, and I wonder now if this influenced the result of the study. The psychologist who administered the tests—twenty hours of them—was very kind but had distractingly small hands and feet, like a child’s. Rather conclusively, the psychologist with the tiny extremities determined that I did not have ADHD. She became my therapist after that, and I would sit in her office once once a week, telling her some things but not others, mostly looking at the child-sized rain boots on the corner mat. I didn’t tell her about the vaginal wound. I thought she might read too much into it. Or the wrong things. She liked to view most things through the lens of conflict. She would say, If there’s not a conflict there’s not a problem. My primary problems were a deep sadness, anxiety, and also that I was having a lot of anonymous sexual encounters. I call them “encounters” because they weren’t sex exactly. And the people didn’t feel like people. It was mostly jerking off and inappropriate touching, sometimes with force: all sex games with pre-articulated rules. We met in secret, barely trafficked places. The encounters struck me as dangerous and the danger rose in my blood, propelling me toward the faceless, nameless bodies. The conflict was that I was doing something potentially harmful but I was unsure whether I wanted to be harmed.

10.
The anonymous sexual encounters were situated somewhere between need and want. They were also a way toward a reckoning, peeling back the skin to see what’s underneath, what you’re really made of. No one told me to do it. The actions just occurred to my body. I began to avoid all the other activities in my life, which became tatters around the edges, whispering my name. The encounters are how I know what I know about time, how it can shrink down inside itself and become like a black hole in outer space even as a day, for instance, turns from light to dark. I learned another thing, more practical, about how the creatures you meet in the dark are not all monsters. Or maybe the converse was my true education—that monsters often inhabit the light, look just like rest of us, have regular jobs. Their monstrous acts appear small and relatively harmless.

11.

Once a month I went to the psychiatrist, the one with the prescriptions. He didn’t ask me about conflict or how I spent my days. He asked me how I was feeling. I couldn’t focus on anything. The depressed state was alleviated but persisted. I thought I wanted to live. The stars of this imaginary documentary, the one about my body but not me, are two doctors whose offices are located in different buildings. They peer into the same test-tube body yet never speak to each other, secure in their individual conclusions. If I had known that a body can become a kind of object as it seeks relief, I would have told them both what they needed to know so that they could write a joint paper. It would recommend listening outside of what they think they know about the mind and memory and the uncertain balance of anyone’s psyche. I knew, for example, that the conclusion from the ADHD tests was incorrect. I didn’t know how to tell them that the fire that occupied me when my body was in potential danger was evidence to this fact. In other words, when my heart raced, when adrenaline pulsed through my veins, focus and calm kicked in, a feeling of equilibrium. I do not mean this to be evidence, but discovery. An internal landscape, partially mapped.

12.

My mother provides evidence in the false documentary. Standing outside of time, she is young and thin again, on a beach boardwalk with her sister, wearing a one-piece bathing suit and sunhat, smiling. What she does not know in this moment is that she will marry a man who will move her thousands of miles away from her family and that this man will not love her, nor she him. She tells the doctors, I have a girl child in your future. The girl child is an intellectual. She reads and reads. My mother does not know about the fire like a hot poker pressing inside my belly. The knowledge evades her in any configuration of time. I am beyond her world partitioned by the contours of a small body in view and the believed wholesomeness of a girl’s existence: this, whatever I am.

13.

I know better now than to ask any doctor for what I need, lest it be confused with want. There is nothing left for memory in service of medicine. If you give them your memories, they’ll likely see the prefigured drawings carved into their textbooks. What is held in the secret, mysterious spaces of our bodies? Throughout my entire childhood, I got nosebleeds of the epic sort. They came on suddenly, blood pouring out of my nose like a warning, until a washcloth filled with ice placed on the bridge of my nose slowed the bleeding and big clots formed that I’d snort out. There are some researchers who write about what the body holds, and what that holding does to the body and the mind. They tell us that the body holds trauma and doesn’t even know it because that holding produces an extreme disconnect from the body. And, even so, the body has to deal with that stress situation of trauma, and we can’t know what that will be like inside each person. Still, not everything is known.

14.

The ways toward transformation are mysterious. That a partial healing of the psyche occurred in whatever tangential way it happened, outside of medical prescriptions and the doctors’ claims about care, surprised me. It was intuition that drove me to allow strangers the sexual use of my body, even though I sometimes called that intuition “compulsion.” And it was this compulsion that enabled a purging. Something had been stuck inside my body, and I needed to work it out. The need for danger may have been a desire for death. The overindulgence in the courting of death moved through me because it had nowhere else to go. Free from it, I could focus on my actual sexual desires, not the driving obligations that felt like service instruments, but the ones that lived deep inside my being. The instruments allowed me to eject a good deal of vaginal hurt. Vaginal hurt, in this case, is a vast landscape of pain that includes what has been inflicted on the gendered body (female) and the vulnerable availability of the child body. I was still in therapy at the time and visiting the psychiatrist for pills. Once I could feel myself on the other side of my obscene and secret process, I fired them both and stopped taking all the medicines.

15.

Years go by. All around me, change. I watch the boy next door grow into a young man. I accomplish some things. Post-medication, I have to relearn how to feel the range of what’s to be felt. Anxiety and depression occasionally still send me into days of waste. The first time I take an ADHD drug it’s recreationally. A friend gives me Adderall to take in any way I want. I don’t yet know their power, and I take one at a conference in Boston during a blizzard. Imagine the knee-deep snow and more falling heavy like stones, blinding wind, the conference-goers stumbling around and falling in the middle of streets, everyone underdressed in a weird state of disbelief. But for me, it’s the first time in years when I haven’t had to binge on alcohol in order to negotiate an intense social situation. Suddenly, the excitement of it all does not overwhelm. I feel okay. Like, I feel fine in an even way. I’m in place, which is to say, the snow is beautiful.

16. 

I found my way onto the dark web after Dr. R, a psychiatrist who only does video conferencing, convinced me that I should try Cymbalta. This was after I had clearly communicated to her that I did not want to take long-term antidepressants because it had taken me years to wean myself off them when I fired my doctors back in graduate school. I told her this before the video meeting and again at the meeting itself, which was before she charged my credit card $400, if you’re still interested in conventional notions of time. Stupidly, I had also told her that my preferred medicine was for ADHD, that I found it calming. I had expressed my needs. I had drawn a line in the sand. This is what we’ve been told to do as women, to be empowered agents of our own destinies, yes? 

17.

Ignoring this request, she did a good talking up of Cymbalta’s possibilities. She seemed like she’d long been practicing the contortion of the face to appear empathetic. Same goes for her intonation. I was having a hard time seeing things as they were, and her performance created a tiny bubble of hope in the center of my throat. The hope bubble popped almost immediately because one introductory dose of Cymbalta turned me into a zombie.  My arms and legs buzzed, but at the same time I couldn’t feel them. A pall was pulled down over the space between me and everything outside my body. I could scream, There’s someone alive in here!, but no one would hear me. Dr. R, via a texting mechanism associated with the video-conferencing mechanism, said that I could be “a little tired” for up to two weeks but then I’d feel better. This was a lie. People on message boards talked about debilitating fatigue lasting months. They were stuck in the space between living and dying, with only those like them—or those afraid of becoming them—to listen to their claims of discomfort. I had a book to finish. Dr. R knew this, but she didn’t seemed to understand that there’s a symbiotic relationship between the creative mind at work and the transformation of psychic pain. The rest of the pills are tucked in the recesses of my medicine cabinet, if you want them. I told Dr. R that I had to find a psychiatrist with more imagination—one who did not insist, for instance, that there was no evidence that microdosing LSD or hallucinogenic mushrooms can have an effect on existential ailments that dig out the psyche. There is something beyond Freud and Lacan and Jung, my mother, the ego, the pathology of desire, and anchor events. I wanted to believe Dr. R, but she wanted to schedule another $400 meeting. 

18.

One Virtual Private Network (VPN), one Bitcoin account, and one TOR search engine later, and I’m on the dark web where, admittedly, some of the most horrible beings on God’s green earth lurk and organize and build connections toward some unimaginable catastrophe. But the mechanism itself is not monstrous, however much it allows for the worst of humanity to indulge in brutality. The dark expansive wildernesses of Mississippi are not responsible for the bloodshed, lynchings, and cutting of genitalia. It’s a mutated kind of person who makes the sacred land a wet burial ground for murdered lambs. And what to do when you must enter the wild forests at night anyway? They provide your cloak, too, as scary and risky as it all is. 

19.

In your future, a small package will arrive stuffed into the mailbox. No return address. The package contains four small capsules hidden in the lining of a disposable garment. They are individually packaged by the manufacturer. No matter the signs that seem to point toward the drug’s legitimacy, you have a panic attack immediately after your test run when you open one of the capsules and pour some of the contents into your mouth. You begin sweating and you feel like you’re going to pass out. It’s poison, a voice from nowhere says. Oh my God, I’m dying, another voice in your head screams. The voices quiet when death doesn’t come stabbing. About forty-five minutes later, you’re sitting on your patio writing this very essay and feeling quite at ease.

20.

A friend once told me that her mother is the quintessentially Indian mother, meaning that her mother’s goal is to anticipate and fulfill her children’s needs before they even know they have them. That seems impossible, I told my friend. What if she anticipates incorrectly? To me it sounded like a fictional creation of the child’s reality, a planting of foreign seeds into a consciousness, a means toward control. I told my friend this, too, insensitive to any cultural notions beyond my experience. I went even further: It seems very colonialist, I said. I think of the girl in the photo at Easter. All the props that construct that image. A camera’s lens often shirks its responsibility of transparency. In this case, however, the image profoundly reveals the erasure of the girl. Someone had asked that I place one hand on my hip, because there the hand is on the hip; the other hand holds the yellow umbrella, though it is not raining. But I have never willingly placed my hand on my hip for a photo.

21.

Rebellion happens in my eyes, which refuse to look up at the camera; my head is cast slightly downward, as if to say simply, No. If I am creating my own story, and I guess I am, the sunken forests, darknets, and shaded eyes are not where I gather my strength for resistance. It is here, in the light, with all of you, on the airy side of the blinded window alongside the micromonsters and everything else.

22.

In the documentary I make of myself, I am lying on a beach where time is slowed and stretched out, making the body soft like blue light. My mother tells me for the hundredth time that she told her primary care physician for the hundredth time that the injections they gave her have made her crippled. She’s stuck inside this conversation that begins, I know what caused my pain, and ends with the doctor saying, There is no reason for your pain. I am reminded of Joan Didion’s reporting in The White Album about Huey Newton being shot in the stomach, and the trial of Newton that follows. In the transcript of the trial, a nurse tells of his refusal to prove his insurance coverage and sign documents as he is bleeding from the gunshot wound. The nurse claims that even though he has been shot in that sensitive organ, he’s not in any “acute distress.” The presence of the human body and its language do not provide good evidence, apparently, about the experience of the person, depending on who that person is.

23.

My mother and I time-travel, in my documentary, to a far-flung coast on the Mediterranean Sea to talk to each other. In this way, we escape time and its trappings. We escape the world that claims to know us better than we know ourselves. I tell her that once I tried to buy ADHD drugs from a fake drug dealer in Bed Stuy who cheated me and gave me allergy meds instead.Nobody was listening to me,I tell her,so I had to listen to the sound of my own heart. What do I want from her, my mother, outside of time and the labor of her sagging living room where, in the other world, she always is? We doze a little in our chaise lounges, the ocean rhythms like the beat of existence. When we wake, she says,There are so many ways that they don’t see us, just as I’ve never seen you.

Previously published at The Point Magazine.

Scroll To Top