Chapter Text
Ever so slowly, November morphs into December. Tyler was admitted when the trees carried their colors like a promise. Yellow and orange radiated the memory of summer, of warm nights spent on the patio, looking at the stars, feeling enveloped by the universe, wrapped up in a sense of belonging, to this world, to yourself. Making bonfires, memories, promises. To himself. To his family. I'll take care of myself this time. It won't be like last year. Promise. Pinky promise.
The darker, more subdued tones of fall, the red and brown a vague promise of what lied ahead, of letting yourself fall into a pile of fallen leaves over and over again, each and every one as crisp and fresh as a pile of warm laundry. Summer feeling more distant, like a memory, like something printed on a postcard, a piece of paper soon to be thrown away. Tyler could see it in his siblings' eyes, in his parents' gestures, his mother longing to give him a hug but knowing better, silently coiling away from the sickness that's oozing from his thoughts, his clothes, his hands. Dark, gooey stuff leaking from everywhere, it's a smell pervasive and piercing, a stench, disgusting and raw, making you hide from everyone, like an animal injured on the side of the road, unable to call for help. His soul a wild thing, ashamed of its ways, hiding in sickness, in silence. Doors being slammed. Frantic whispering. Tyler, you promised. You promised us.
Now the trees are skeletons tinged with snow, their knotty limbs dipped into glistening whiteness. On the acute psychiatric ward, Tyler sits on the smokers' balcony and lets snowflakes melt on his face. He half-expects them to taste just as sweet but the world always finds a way to disappoint. He can smell and taste something rotten. Grey slush on asphalt. A body, a bag of bones. His limbs tingle with the intention to just do it, do it, jump jump jump, but his mind is numb medication or what everyone else on the ward calls just drops. A potent benzodiazepine called lorazepam, to be administered as needed. That and the upped dose of his risperidone is enough to make anyone feel like they haven't slept in years but for Tyler, it's the bare minimum to exist. To have some sort of day that isn't defined by pacing around the ward, an agitation so vivid it feels like your insides are inflammed and you need to go go go just to placate the incessant need to move, to bolt, to scream. Now, the world has slowed down, a forced halt, skid marks still visible on his arms where his nails and a hidden safety pin found his body before the nurses did.
"Hello, Tyler. Do you mind if I join you?"
Almost instantly, a nurse appears by his side. Tyler doesn't remember if he's still on 1:1 observation or if the nurses just follow and observe him, counting his steps and breathing down his neck just like everyone else does. He doesn't respond. He can feel his neck stiffen and prickle with sudden pangs of paranoia. Fear clouds his mind like raindrops running down a window. His body knows before he does. Eyes, he can feel eyes everywhere, staring him down, assessing him, observing him, commenting on him. He can hear them clear as daylight, a thousand eyes with a thousand mouths yelling right into his ears.
Worthless
Ugly
Look at him, sitting there doing nothing, as usual
Schizo
You're nothing
Nothing
Nothing
Tyler shifts ever so slightly to cast a nervous glance to see which nurse it is, if he can risk to leave or if that will end up in his notes again as "challenging behavior." Josh. It's Josh, just Josh, he tries to tell himself, calm himself. Josh with the colorful hair, sitting next to him, a cup of coffee in his hand, chatting animatedly to another nurse, gesticulating, his hair a shock of radiant pink against the gloomy, overcast sky. This is ordinary, just ordinary, he's whispering to himself, an ordinary afternoon, on an ordinary psychiatric ward, except that nothing is ordinary when you're in the throes of psychosis, deep down in the trenches of what's left of your soul, in the muddy, barren, bleak wasteland that's your mind now. A far cry from the colors you used to remember, that sense of calm and security you used to feel as you inhabited this world, this body, and this brain without a doubt. Now it's all doubt, all fear, all shame. If sanity is ordinary, then psychosis is the worst kind of extraordinary there is. The kind no one dreams of when they say they want to be special, to stand out. It's utter disconnect, it's silence, it's isolation from the world as it is and from the world you used to know. From the person you used to be. It's
Nothing
Nothing
Nothing
Technically, Tyler can tell what the people around him are saying - he can see patients bumming cigarettes off one another, can see nurses giving out lighters like Christmas candy (and counting them). One part of Tyler knows they're exchanging the usual phrases, small talk, about the weather, the snow, the weather, traffic, Christmas, the cold, who's got a lighter, who doesn’t, who stopped smoking, who just started, who never wanted to and gave in eventually. Yet inside his mind the words are distorted, warped and twisted until they acquire a completely different meaning. It’s meaning only to be found in the patterns of tealeaves and in the shapes of clouds, in flocks of birds and in the dead air on the radio, in the static, incessant, all-encumbering, deafening roar of the world, a world that’s threatening to swallow you whole.
A thousand eyes
with a thousand mouths
yelling, yelling, yelling
A thousand eyes with a thousand mouths. A thousand voices, layer upon layer, until his thoughts are a blur, a glimmer, a screech and a scream.
They're not talking about smokes or Christmas. They're talking about him, about Tyler, about the police that's coming to take Tyler away, they're on it, too, and every move, every color, is part of a code now. A red lighter means they're going to come soon. A fellow patient rubbing their hands and laughing sycophantically means he's complicit, always has been, and now there's a plane passing overhead, the sky a blur of roaring enginges, except it's not, it's helicopters, which means they're coming for him, and he's got to hide, hide NOW. The urge to move makes his feet itch and prickle with fear until every cell is on edge. But his body is saturated with meds, soaked in sedation, and so he keeps still, picking at his cuticles. The skin is red and angry, always one step away from breaking open and bleeding. The nurses have yet to notice and it's the only form of self-harm, the only harbor of safety he gets away with, still.
It's real but it isn't it's not it's not is it is it is?
"What are you up to, Josh? I don't think I've seen you on the balcony. I didn't take you for a smoker."
Now someone else joins in, it's Laurence, the ward's psychologist, the one with light brown hair and beady brown eyes. Tyler long since stopped wondering what made her work on this particular ward. He's been long enough in the mental health system to know the profound stigma of working in acute psychiatry and patients with psychotic disorders, even among professionals. She's a regular on the balcony though, coffee in one hand, cigarette in the other. For someone who specializes in the health of the mind she doesn't seem to mind coating her lungs with smoke, nicotine and tar. She smiled when Tyler told her this, a true, genuine smile that made her eyes crinkle, and deflected immediately. "We're here to talk about you, Tyler. What makes you sit outside there, with the smokers?"
Tyler could have told her that he doesn’t smoke and has never tried to, in all of his hospital stays, his "pretty impressive career as a revolving door patient", one vile nurse sneered. The comfort he seeks by sitting outside with the others is a desperate, constant craving for some form of normality. A desperate attempt to cling to something other than a reality that's turned upside down. Outside, on the balcony, time passes differently, in measured, neat installments of five to ten minutes. One cigarette gets smoked, the other one is finished. Fingers fish for another cigarette. The rhythmis click click click of the lighers. The sound of patients and nurses exhaling smoke, blowing air suffused with nicotine, of bruised lungs struggling with the cold, dry winter air. Hacking coughs, bondies bending over. It's a rhythm, a routine rooted in time. The one thing that keeps him grounded. Inside, time doesn't make sense. Inside, it's all falling apart. Besides, he doesn't mind death, doesn't mind dying from second-hand smoke, but he doesn't tell Laurence that.
Tyler could have told her that sometimes, just when he begins to feel not better, no, but anything other than apathy and numbness, he pretends that this isn't the smokers's balconcy of the acute psychiatric ward (which, in all truth, isn't even a balcony but a bit of space fenced off properly and appropriately to keep patients from jumping). Instead, he pretends that this isn't the psychiatric ward at all, this is the front porch of his parents' house. He wants to pretend to be normal again, he just doesn't know how. He could have told her that he imagines his soul coated in layers of cement with holes everywhere, holes only to be fixed with tar and time. Make him whole again.
But Tyler doesn't have an answer, not one he trusts Laurence with. He could tell her about the thoughts, the voices, the paranoia in his chest, curled up like a sleeping snake, coiling and moving and breathing, pumping fear into his veines, but everytime he tries to speak the words come out jumbled, nonsense, and so he's clinging on to silence and staring at his feet, to chewing his lips and ripping off pieces of dead, bleeding skin of his fingers. Laurence hums in return. She knows he doesn't trust her, yet she never stops approaching Tyler when they sit in her office once a week for 45 minutes. On the balcony, Tyler turns away from her. He's got an appointment with her later on, 45 minutes of silcence, shared and sliced into tiny blocks of hospital time that weigh heavily on his mind.
Josh turns slightly, talking to another nurse who just appeared. They exchange words, looks, laughter. The language of the healthy. Tyler doesn't notice. His thoughts are cerulean, his mind far out at sea, getting crushed by wave upon wave upon wave. He’s drowning but he’s not, he’s breathing but he’s not, he’s trembling but he’s not. His body feels muted and heavy with that much lorazepam and risperidone in his bloodstream, his limbs floating along like driftwood, yet is mind is racing and hyper-vigilant. Psychosis means existing in two worlds, the outside and the inside, with one forever threatening the other. Psychosis means feeling tectonic plates shift inside your mind, making your world, yourself crumble, until all that's left is rubble.
Tyler rips flakes of dead skin off his cuticles, causing them to swell and bleed. Drops of blood land on the hem of his white t-shirt. Smears of bright red. The absence of pain is curious, but only for a moment. Tyler digs deeper into his flesh. He remembers trees and colors, but not feelings. He longs to be buried underneath piles of dead leafes and feel the weight of his soul crushing him.
All around him, patients appear and disappear. The smokers, which is practially everyone on the ward (except him). Tyler can tell who’s psychotic and who's manic, who's suicidal, who's been here many times before. Who’s struggling beyond breaking point. Smoking keeps you calm and occupied, it gives you something to do with those shaky hands, those trembling legs. No one is allowed to carry a lighter here. Nurses, the veteran smokes, those who go through an entire pack in a single shift, light cigarettes. Everyone sits huddled on cheap plastic garden chairs or stands in corners, making smalltalk, talking to themselves or not saying anything at all. Tyler is carrying his silence "like a shield", the attending psychiatrist remarked during rounds last week. Tyler looked at him, a pot-bellied man wearing his polished white coat like a trophy. A wife, a big house probably, healthy, happy children. The full package. The attending is book-smart on psychosis but has zero experience as to what it's like to actually live with it. What it's like to be put through the wringer, by your own hands, your own mind, and to come out the other side. To be fully emerged, limbs, flesh and soul, to be what other, healthy people deem "insane," "crazy" and downright "dangerous." To what it's like to sustain yourself when your mind threatens to throttle you. Asphyxiated by apathy. Poinsed by your thoughts. Tyler shrugged in response. No answer. He knows just as well that this is the kind of behavior the attending is looking for, a sign that he's right, right in his knowledge, authority, and his ability to further clouden Tyler's mind with unwanted medication. Let's just raise the dosage of his antipsychotic and see where it leads us. Risperidone, is it? And Lorazepam as PNR?
Tyler could have told him that his silence is indeed a shield, a shield for him to hold on to. No one ever tells you how loud psychosis is. Your mind is crowded with a thousand foreigners, a thousand thoughts you don't recognize as your own. It's utter chaos, distortion and destruction, it's your mind taking itself apart again and again, scrambling for any meaning, any sense. The attending has a lot to say about this and the nurses type up strange, foreign words in his file, words that make Tyler's parents cry and the ward's social worker exhale deeply. Retardation associated with psychosis. It's loud and scary and frightening and you've lost all ability to speak, to sleep, to care for yourself. Tyler doesn't remember needing this much help but he can't remember how it's been before, either. He closes his eyes when the nurses help and shower him, when hands in blue gloves manhandle his body as if he was a piece of furniture. They have to supervise him anyway, so what's the point of privacy? There's no dignity left in psychosis. Out of the snarky, the bored, and the hectic nurses assigned to help him with his personal hygiene, Josh is the only one who's different because with Josh, quiet is okay, slowness is okay, doing things on your on time is okay, neverminding the 6 minutes hospital protocol has assigned for your shower. Josh doesn't seem to mind Tyler's silence, he doesn't talk over it, yet doesn't ignore it, either. A washcloth in his hands, his hands move over Tyler's body without snide remarks or rude comments on the scars years and years self harm have left on Tyler's body. Tyler doesn't respond but relaxes, visibly. Psychosis means being on guard, always, and it's only when you give in and relax, in the absence of pressure, that the heaviness of it all makes itself felt in the bones and marrow of your soul.
To smoke a cigarette takes roughly 6 minutes. 4 if you’re busy, 10 if you’ve nothing to do. The average for a patient, Tyler has counted, is 8,5 minutes. 5 for the nurses. Tyler measures time in nurses and patients appearing and disappearing, in the rhythmic clatter of the balcony door banging open and clicking shut again. It’s the only door that isn’t locked. Tyler could almost pretend that he’s sitting on the porch of his parents’ house, listening to doors opening and shutting, to footsteps, to voices, to a world he’s a part of, if it wasn’t for the fence encasing the area, a wall built for those who can’t be trusted. The balcony feels less claustrophobic than his mind, though, and Tyler stays outside, letting snowflakes rain down on him like bullets, ignoring his shivering body, until the balcony door bangs open again and Josh comes out, a blanket in his hand.
„Come on now, Tyler. It’s freezing. You’re going to catch a cold.“
Josh coaxes him inside, wrapping the blanket around his body. There’s a tenderness inside Josh’s voice that makes something split inside Tyler, a tenderness, a kindness he can’t feel for himself, and he focuses on his hands, bright red with frost instead. The cold stings and bites. It makes him forget he has a body at all. It doesn't make him whole. It just makes him comfortable in its absence.
...
For days, Tyler has been watching the world change, from ice to water to nothing. His body folded into a knot on one of the reclining chairs in the TV room, right by the bit of window that protects the actual window. Nothing like protecting yourself against what's out there, Tyler gets that. The chairs aren't even too bad, at least not as bad as the "comfortable" blue squishy chairs they have you sit on during sessions with Laurence, so old and worn the stuffing keeps falling out, probed by generations of trembling fingers pulling, pushing and clawing. The chair isn't unlike your ordinary reclining chair but as with everything else on a psych ward, it's big, chunky and virtually unthrowable. Tyler folds his limbs into a knew knot and leans his forehead against the security glass. The knotty tree limbs are getting heavy with snow and the next second, they’re threadbare again, black stumps stretching into a sky, empty as ever. He can taste it on his tongue, the lure and lull of winter, the promise of nothingness, of being buried deep in the earth, your heartbeat making tectonic plates rumble in response. Everything’s quiet now, eerily so, but not silent. The voices are outside and inside, leaving traces inside Tyler’s mind like a deer in the snow.
...
On the day Tyler turns 25, clouds, high as cathedrals, hang in the sky. The snow has melted away, only the sludge on grey asphalt remains, a gnarly reminder that there's still a world out there, threatening to swallow you whole. Tyler imagines his insides smearing white-grey-black on the street outside. He doesn't tell anybody and buries himself in his yellow hoodie, with the hood up. Yellow feels good for the moment. The nurses can read his thoughts, he knows deep inside his bones, they can read and inject thoughts into his mind, strange sensations but not when he's wearing yellow. He doesn't remember what it feels like to be safe. He only remembers the notion of threat lurking around every corner and the constant need to stay protected. Yellow may never feel safe, because nothing ever does, but it keeps him protected, geared up. He even smiles back at Josh during morning meds, or what he thinks might be a smile but is in fact just a grimace. Josh doesn't know. He doesn't know.
On the day Tyler turns 25, Tyler dreams of hanging by his shoelaces, in darkness undetected at the first day of the new month, the last month of the last year. The irony isn't lost on him. His birthday always seemed odd to him, him beginning a new year of his life when the year is so clearly coming to an end. In a different life, he would have been born in January, beginning anew in a fresh year, a fresh life. A brand new start, crisp and clean as a white sheet untarnished by thoughts. In a different life, he wouldn't mourn his birthday. In a different life, his birthday would have foreshadowed Christmas in the best possible way, with cake and family time spent huddled on the couch in front of the fire place, watching cheesy Christmas movies. The memory of laugher, warmth and joy is distant and distorted, separated by layers and layers of fogged glass and the constant beeping of doors being locked. His mom brings self-made muffins in Tupperware containers. They're well-versed in hospital birthdays now, his family, he, the staff team. The muffins are a favorite with the nurses and the doctors, as always. Even the attending takes one. Tyler shakes his head at the offer. To eat a muffin would remind him of home and how much he misses it. His bedroom, his family. His siblings. His mom and dad. His entire body aches but he's not allowing himself to feel any of it.
Happy birthday to you, happy birthday to you, happy birthday, dear Tyler, happy birthday to you.
A cacophony more than a choir. Tyler looks up. He’s sitting in the kitchen, his mom, dad and Zack around him, each one with a muffin on a plate, singing a birthday song, their voices quavering. Tyler stares at them, wild-eyed and bewildered. He doesn’t remember how he got into the kitchen. He can’t tell whether is family is real, either. There are two trembling hands on the table in front of him, with an IV on his right hand. Having an IV inserted into one of the veins on the back of your hand hurts a lot more than having them in the crook of your elbow but Tyler can’t remember, neither the pinch nor the needle going in. He fumbles with the tape and the dressing that's holding the cannula in place. His mother takes his hand in hers. Warm, wrinkled skin that smells faintly of handcream and cookies. Tyler forces himself to hold in the sobs. In a year from now, he’ll look at the photos of this particular hospital birthday, the way his brother Zack snuck a photo of him without him realizing. In the photo, Tyler's looking over his shoulder, eyes droopy, a party hat balancing precariously on his head, staring into the distance, into something only he can see. There's not a trace of joy on his face, the thousand-yard stare giving way to something more sinister and claustrophobic, something only Tyler can feel. There's muffins on a white plastic plate in front of them and presents with the ribbons missing. It all looks like the cheap replica of a play, a performance with the main character missing. In a year from now, Tyler will celebrate his birthday at home, for the first time in what feels forever, but he doesn't know that yet. In a year from now, he'll have lived and survived another 12 months in this body, this mind, but he doesn't know that yet. When you're locked in psychosis, a year feels like an eternity, a concrete slab of days and weeks and months cemented into your mind. I cannot go through this again. I cannot go through this again.
In a year from now, Tyler will have gone through his, again, but he doesn't know that yet.
A year is nothing when each second feels like a stone being thrown down a well and you're waiting for the stone to hit rock bottom, to crunch, to finally come to an end.
But there's no sound. No smashing, no echoes, no fallen body. Just silence, eerie and still, until it's December 1st again.
Tyler's mom is fumbling with the stack of birthday cards handwritten by Tyler's siblings and family friends, friends of friends of friends, they all heard, Tyler is in hospital again. No, we don't know for long. Thanks, we're managing. Yes, thank you for keeping us in your prayers. Tyler can almost sense his mom's despair radiating through the thick, heavy paper. There's promises made on a bonfire night and then there's expectations of family life as you know it, almost an unwavering belief that the kid you brought up in this world will do well. Her eldest, raising to the occasion, always. A favorite with the neighbors, at school, at basketball. His life one accomplishment lined after the other, the basketball scholarship he won to go to college just the tip of the iceberg until his mind ran off the wails and smack into the brick walls of an underfunded and overstretched mental health system. Talk about staying humble when your biggest accomplishment for the week is taking a shower by yourself.
Tyler hides his hands, his shame. He pretends to look at the cards, not taking anything in. Scribbly hearts and perfunctory phrases. Get well soon. Hope you're feeling better! As if Tyler was lying in hospital with a broken leg. A broken bone isn't the same as a broken mind. It's not the same as finding your brain shattered into a million little pieces, certainly not, and it's in the psych ward's kitchen amidst meagre hospital birthday decorations and a set of matching plastic cups and plates that Tyler's mom starts to regret bringing cards and presents at all. Nothing could have prepared her for this, for watching her eldest out in the freezing December cold. Tyler is wearing his signature yellow hoodie and the army parka she had packed for him back when he was admitted. She wanted to do her son a favor, she knows how much Tyler loves that jacket and she longs to see him well. Besides, she wanted for Tyler to have something to hold on to during the hospital stay, something familiar, a smell and a touch, a memory and a promise, something that reminds him of home, of the family that's waiting for him. We all miss you, Tyler. Hope you're back home with us soon. Tyler hasn't looked at the cards once. He doesn’t seem to remember or recognize the clothes and he doesn't seem to realize that he's got a family after all, his mother thinks with a lump in her throat. Her son is no longer catatonic with silence like the last time they saw him, he's different now but still ill, visibly so. All wide-eyed and bewildered, Tyler's talking, no, he’s rambling with a feverish, manic energy and he's pacing the small balcony that's connected to the kitchen now, "like a tiger in a cage," Zack mumbles. No one responds. Something about ornithomancy and code cracking, the words all mixed up up, jumbled, as if some invisible string between Tyler's brain has been cut, and it makes Tyler's parents wince. A couple of nurses have entered the balcony, all talking to Tyler, their hands patting the air. Verbal strategies of de-escalation, Tyler's parents have been on enough psych wards to know the drill, and yet there's a collective shudder as Tyler covers his ears with his hands as one of the nurses, the nice one with the radiant hair, Tyler's mom can't remember his name, reaches out and touches his arm. Time and time again, Tyler’s psychologist and the attending psychiatrist explained to them the profound effect psychosis has on someone’s speech during one of their "family therapy sessions" but nothing prepared them for this, for seeing their son like this. Nothing prepared them for seeing Tyler in a state they had associated with drugs and alcohol, with homeless people yelling and talking to themselves out on the street. They can see Tyler through the kitchen window and yet he seems faw away, beyond the reach of touch, words and memories. Nothing prepared them for reality hitting you full in the face and laughing, laughing, laughing, as their eldest son begins to bang his head against the concrete floor and they jump with every thud, Tyler's pain their pain.
There’s a method to the madness, a maw to the madness. There's tremendous power in being able to destroy yourself like that, tremendous power and tremendous fear, and there’s a method to the madness, even if that means banging your head against concrete, again and again, as you wish to fall through the cracks and disappear completely, as you wish to become nothing over and over again. You don’t dare to do more but that’s enough, bright red on indifferent grey. There’s a method, there’s a maw. There’s a stomach inside your brain that’s eating you alive.
On the day he turns 25, his dad tears up and starts crying into his hands, the stack of unopened birthday presents sitting in the backseat like ghosts of a time long gone as their car tears through the evening darkness.
On the day he turns 25, Tyler wishes he could disappear into earth, to crack the frozen ground open like a ribcage. For his soul to fall asleep in the frozen soil, never to come out.