John Castro is an undergraduate student in English, and the 2011-2012 recipient of Appalachian State University’s Truman Capote Literary Trust Scholarship in Creative Writing. Prior to coming to Appalachian State University, John worked as an EMT, and served (briefly) as a Midshipman at the United States Naval Academy.
Suicide: A Recovery Guide
Step into your new building. Thank the paramedic who sat with you on the way to the hospital, pretended not to know the reason for your transfer. Treasure the inanity of small talk, her gift of words without pity or mistrust. Walk with her to the front desk, through the double row of flags that salute from the shadows of a darkened lobby, sentries used to greet presidents in the splendor of day. Nod a greeting to the Marine on duty as the medic hands him your file. Wave goodbye and hear the ambulance rumble, the hiss of air brakes releasing as the EMTs leave your world behind. Go ahead and push the button for the elevator—the ward is upstairs, in a side wing, tucked away where visitors can’t stumble across it. Follow the emergency lighting. The officer on watch will direct you, but you’ll have to lead him in. Walk until you see a heavy door with a rectangle cut from the side, a keypad in the gap.
Wait to get buzzed in.
Whichever orderly is signed up to work the back twelve will be sitting through a divider across the room. He’ll have forms for you to sign, but it won’t happen right away. You’re on his time. He needs to yawn, stretch, bring his feet down from the desk to the floor, shuffle some papers. He’s somewhere in his late twenties, high school facial hair, an undisciplined gut. You won’t see him again until checkout, if then.
He’ll pull out an inventory form. Hand him the bag you brought from the hospital. It’ll hold mostly clothes, a dead cell phone, and socks, non-skid paint marks on the bottom. Sign the forms.
“Sorry,” he’ll say. “I need to collect all your clothes.”
Nod. Don’t say anything. Wait for him to come around to your side of the room. Start with the jacket. Eyes focused against the wall. Pull the zipper until it snags. Flip it over your head, let it take the undershirt with it, strip the pants to the ground and step out of them as if a puddle, down to the briefs. They’re not white. Don’t be shy. He’s seen patients worse off than you, and God knows it’s difficult to piss under observation.
He’ll need to inventory your clothes, search you with an apology stuck between pursed lips. You know how to stand for the examination. Let him tell you anyway. Spread your legs. Arms out in front of you. Palms up. Switch. Turn around. Run your fingers through your hair. Nothing? Good. Let him hand you a new hospital gown, even though you’ve got three in your bag already. Wear the pattern to match the other patients here. Hospital gown camouflage.
Follow him to your room. Be patient when he stops at the supply closet—you don’t want the sheets with the stains on them. Let him pick out something nicer. Take your towels, sheets, and pillow case to your bed. Don’t spend long making it—it’ll have to be redone in the morning, and without a watch, clock, or phone you don’t know how far off that’ll be. Leave the comforter at the foot of the bed, let it warm your feet. Better not to pull it up, not to inhale the scent of the sheets. Better not to have any reminders of the ward.
But the pillow you won’t be able to avoid. Try to find sleep with your face up—the pillow is rubber for a reason. The night man told you that everything’s been cleaned since the last patient. Don’t test it. Orderlies don’t like being in this place. It gives them the creeps as much as it does you. They won’t linger over the cleanliness of a single pillow.
Lie flat, don’t turn; the rubber’s loud, obscene. Off-gasses, slightly. No point to getting comfortable—you won’t sleep the first night. So don’t wake the unknown roommate a few yards from your bed.
Focus on the sound of snoring. Close your eyes. Let the sound reform, evolve. Let it become the sound of waves, crashing against the jagged rocks of a hidden cave. Imagine yourself with a fire within: warm, naked, content. Tell yourself that you are safe, that no one will be able to find you here. Tell yourself that you are alone in the world. That you are anonymous. That not even God could find you, should he choose. Better yet, tell yourself that God does not care.
Dawn, bright. The sun will burn the cave from your eyes, boil the oceans that guarded you. See your roommate lift his torso from the bed and stretch his arms. Watch your roommate. Study him, so that you know what you have to do. His morning routine is deliberate, slow, but it holds information. Teaches you the rules of the place. The rules of the ward. After a pause, begin to copy him.
Rise from bed while he’s in the bathroom. Make your bed neatly. See the closets built into the side wall, the narrow cubbies you missed last night. Fold your spare towels lengthwise, then into thirds. Stack them, bath towels on the lower shelf, washcloths above. After your roommate’s done with the shower, it’ll be your turn in the bathroom. Take your bag of hospital toiletries, arrange them so your half of the sink space won’t look so empty: toothbrush, toothpaste, bar soap. No floss. Nothing to put in the paper bag liner of the bathroom trash can. Nothing you could use to hurt yourself again.
Look up at what you thought was a mirror. Realize instead that it’s a solid sheet of stainless steel, bolted into the wall. Unbreakable. See how the metal curves against the bolts, warps the reflections, distorts the beaten face of a young man, where already a smattering of facial hair lies outside of regulations.
Don’t look too long. Step away and take your shower. Water will be lukewarm, no incentive to dawdle. If they gave you a soft towel, you might be able to find some level of comfort in its folds. Dress in the hospital gown you received last night. Fasten the drawstrings the same way you’d tie a shoelace. Leave the room through a wooden door that locks only from the outside.
Walk into the hallway. It’s okay to be slow. You’ll hear a mix of voices from another room. Listen to them for a bit. Follow them back to the source. Down the hall. It’ll be the rec room. This is where you’ll spend most of your time on the ward. A big, white room, with an entrance on each end, bookcases in the corner, cameras no one bothered to hide, and a television in front, half-muted, one that never sleeps. The furniture is hard, sterile, covered with the same slightly bumpy texture as a toddler’s plastic playground. On it’s a mix of adults, scared, angry, and scarred, a representative for every type, save one—you’ll notice there are never any officers that come through here.
Aside from the men in the uniforms will be you, too new to be allowed the right of your Navy garb, and the civilians. The civilians are always a mixed bag, the depressed wife or junky son of a military officer. You’re on a different level than they are—stick to the military men if you want someone to relate to. They know the stress that brought you here. The stress that brought you to the Tylenol bottles in your med kit, had you line up all one hundred and fifty pills in neat little rows of ten. The burden of the elite that brought you to swallow the first handful.
Talk to people, but keep your head down. A nurse will come eventually, a Petty Officer with tired eyes. She’ll call your name, tell you the doctors are ready to see you in the interview room. Remember, walk in front of her, just like with the guard. She’ll tell you where to go. Thank her. Open the door. It might be a minute before they acknowledge you. Don’t sweat it. Wait, and take a couple deep breaths. Let your heart slow down. Take a seat when one of the doctors points to the chair.
Doctors. Three of them. One to ask questions, one who’s still an intern, learning, one to tell if you’re lying. The first two could be anyone you’ve ever seen before. But you’ll know the look of the last one. His face will be lean, angular. He’ll look younger than he is. He’s a cyclist, or a runner. He stays fit in a sport where he can pass people, draft off their backs, drop them when they tire. He’ll watch you with blue eyes trained to catch any tell, read the slight quaver that comes into your voice. He’s the real threat—the questioner’s just reading from a script.
The first questions will be basic, meant to put you at ease. Simple little background nothings like what high school you went to, the neighborhood where you grew up, what kind of music you listen to. But they’ll keep building. Eventually, they’ll work up, try to provoke.
The interviewer’s job isn’t to find answers—those have been on file since speaking to the hospital psychiatrist a week or so ago. No, he’s here to elicit an emotional response, create stress so that the third doctor can read your physical cues. They’ll find a hole in some part of your story, a gap in the narrative that explains why you’re here. It’s their job.
Don’t retreat—your response is what matters. Admit your mistake. You’ve been caught up in the details of the last few days. Hard to remember everything that’s happened. The events that brought you here—they were traumatic. They’ll accept that.
“That’s understandable,” the student, a young woman, will say.
She’ll reach her hand out as if to place it on top of yours. She’ll pull it back as she remembers the rules: patients don’t touch, are not to be touched.
She’ll think you seem harmless. She didn’t see how you focused as you counted your painkillers, measured out four times the lethal dose. She wasn’t there to see the methodical manner in which you poisoned your liver, the dispassion in your eyes as you watched the head nurse explain that you were going to die. Because she wasn’t there, she’ll feel sorry for you.
She’ll say “Thanks, I think that’s everything we need for now. We’ll be looking over your file and should see you again in a few days.” As if she were the one to pass judgment on your case. No. The third doctor will make the final assessment. And he’ll never say a word to you.
Thank the doctors for their time. They’ll let you return to the rec room. If nothing changes, you did fine. No one gets released in the first couple days. You’re working towards the future, a week from now, more if need be. It doesn’t do to be hasty.
When you return, it’ll be time for breakfast. Yellow lumps of reconstituted eggs, toast that’s been sitting out too long.
The skinny black man with the cups in front of him—he’s an exception. He’s a Marine, one who voluntarily redeployed at the beginning of the war, but the PTSD bug bit him hard. He can’t sleep, can’t eat. Every day he puts his uniform on it drapes a little bit more. The nutritionist gives him three protein shakes in the morning, trying to get him to gain weight. He’ll give one to you. He can’t get more than a few bites of food down, and will finish one of the shakes at most. Take pleasure in the coolness of artificial strawberries and enjoy the associations it brings. Late night milkshakes with school age friends. Burgers and fries at 2 am, and bullshit around the table. Back during a time you told yourself you’d never end up in a place like this.
Slurp the bottom of the shake. Come back to the present. Fill out the menu form for the next day’s food. It doesn’t matter what you put, the vital thing is that you choose. Exercise control. You don’t get many opportunities. Use them. That goes for the other patients too. Keep control in your interactions. Don’t tell them why you’re in here. Pull the gown sleeves down to your wrists, cover up the track marks from the week’s worth of needles, the constant drip of the intravenous lines it took to keep you alive in the hospital. Leave them guessing. Keep your arms down as you hand off your empty tray to the orderly. Give her a small smile as you take it, just enough to be friendly. Not too much, or you’ll come off as eager. No one’s eager to be here.
Meal done, move back to the rec room. Look at the schedule—group therapy classes change by the day. Sit through the substance abuse seminars. Pretend to care, even if addiction’s not your demon. Participate. The mediator will be old, overweight, with penciled in eyebrows that are slightly off in shade. She’ll wear professional attire until it comes to her feet. White socks and support shoes. It fits in with the room. Stay on the mediator’s good side. Offer up faults you don’t have. They’ll be impressed with your willingness to share. Redeeming your invented faults is almost cathartic—it takes you away from the real reasons you’re here. Just make sure you remember the vices you’ve invented in case you see her again. Real healing will happen alone, not here. Nobody gets better in the ward.
Midday break. Take a nap. Classes are more strain than you’d expect. After what you’ve been through, even simple interactions can be draining. So take time to recover. Go back to your room to sleep—with the shades drawn it’s cool, quiet. Take the privacy you are given, and don’t abuse it—it’s how you build trust with the orderlies, the doctors. No one on staff will tell you the expectations. Learn rules from other patients. They’re simple things, and not much more than a mental laugh to fulfill. Still, meet them. Go to your room to nap, so that you’re not like him, the civilian patient snoring away on the couch in the rec room. He’ll continue to nap there after you’re released from the ward.
Get up when the bell rings for afternoon session. Afternoon sessions are lighter. Therapy dogs, or music, or art. Regressive therapy. Elementary school specials, subject to the psychological analyses of doctors who know your file intimately. Avoid over thinking. Play with the dogs. Draw a picture of what the word “perfect” means to you. Build a sculpture out of wooden blocks. Each of these is progress, a gold star by your name. Another assignment closer to passing a course you can’t afford to fail. Another assignment closer to home, where at least you have a chance.
Break for evening meal. Sit around. Go to sleep. Repeat this process day in, day out. Breakfast. Therapy. Reading time. Lunch. Therapy. Dinner. Journal time (your counselor thought it’d be a good idea). Bed.
The only rule: stay out of the lines that come before breakfast, after dinner. Let the beaten old men and women of the ward line up, take their pills. You don’t need them—you’re not crazy, you just think too much. Believe this if you want to make it out. Some get uppers, some get downers. A few get both. None look any happier than you. One more factor in the ward’s monotony, a millstone to grind away your soul, if you let it.
Now, maybe you have people who care. Maybe you have a father, a girlfriend who’ll come to visit, take over from your mom now that you’re out of the hospital. Wait for the call over the PA, always later in the day than you were told to expect. Sit down in the little green room the orderly brings you to. Set your hands in front of you on the tiny, round table. Wait for them to come in. Don’t stand. Look at them like there’s nothing wrong. Talk to the lines on your father’s face, tell them that you’re fine. That’s enough, you’ve never been close. Make eyes with your girl. Reach under the table and find her hands—half-curled, warm. They’re still yours. She’s got a small, drawstring rucksack at her side, the kind you get free with a pair of shoes. She’ll pull out a floral-patterned hand wallet, small enough to attach her keys to. The rest is for you—a softer toothbrush, gum, deodorant, a few scattered comic books from friends. Hidden behind her shirt, between breasts ripe with the warmth and softness of youth, she wears your locket—a small heart in white gold, a simple border around the outside. Pictures of you together inside, from the time before.
She’ll be overwhelmed, but afraid to show it. Comfort her. Tell her that seeing her again makes things better. Make her think she can reach through the numbness. She needs this from you.
Don’t drop those hands until the head nurse comes by, tells you you’re not allowed to touch her and talks about cameras in the ceiling while you know he’s full of shit.
Do as he says. Apologize and say you didn’t know that was a rule. Let him approve the little things they brought you, then say goodbye. Let them leave before you have to watch your father wipe away your girlfriend’s tears that you’re not allowed to touch.
See your routine disturbed unexpectedly that evening, after your visitors have left. Watch in bemusement as a local priest sees fit to throw holy water on your face, prays that you find your way back to God. Throw away the Bible he brings that offers brought you no comfort before, offers you none now. Go to sleep that night, and on waking tell yourself it was only a dream.
Wake up one morning, three, maybe four days into your stay. Eat your breakfast, ask about privileges. If you’ve been good in therapy classes, they’ll approve. With the doctor’s approval, win your razor back. Luxuriate in the act of shaving. Keep toilet paper handy—the skin’s become soft over the last few weeks. They’ll give you a single blade disposable, a woman your size to watch you. Use the blade slow; you’ll still cut yourself. It’s expected. The person you’re with won’t look away.
Put on the change of clothes you brought with you from the hospital. They’re not clean, but it’s what you have. The man who returned them to you explains that the drawstring’s been cut out of the jogging pants. Accept this matter-of-factly. It’s already been done, and it’s still better than a hospital gown.
Blue jogging pants, white t-shirt, white tennis shoes. All with Navy adornment. It may not be much, but after weeks in the gown it feels like wearing a tuxedo.
Feel great. Give in to a proud smile when you walk into the rec room that morning. Let everyone know how much this tiny speck of normality means to you. Feel like you’re the shit. Sit down on a cushioned chair. Read the book that your relatives brought you. Watch the words of poetry scroll meaninglessly by. Put it down. Walk over to the bookshelf; pick out a book with a dragon on the cover instead. Don’t read nonfiction—escape. Continue the routine. Mark off each day so you don’t forget how long it’s been.
Wake up. Nod your way through morning therapy. Hear from the nurse’s station that your file is up for review. Wonder if this is good or bad. Go to lunch. Afternoon therapy, distracted. The phone rings mid-session, orderly beckons you to come forward.
“Go meet with the doctors.”
You take the side door out, walk over to the room where you met the doctors before. Look around, puzzled, realize no one’s there. Find a nurse. Ask her. Hear her laugh at your question, let her lead you to the conference room.
Wait outside until they call your name. Maybe they called you early, maybe they wanted you to sweat out these five minutes. Open the door and feel fear again. Come in at the narrow end of a long table, feel the weight of a dozen pairs of eyes. Take your seat, shut up. Let them talk. Don’t worry about their names, ranks. Call them all “sir” or “ma’am”.
Within a few minutes you’ll know how the meeting will end. Watch the whole thing fly by in a blur. See a charcoal drawing you did for art therapy held up by a psychologist, see crude lines and stick figures turn into something more, become the key to your freedom. Feel terror at the knowledge that it was such a little thing that bought you your freedom. Thank the doctors, turn around, and exit the room.
Return to the ward. Focus on making the final moments last as long as you can—freedom is unsteady, brings choice and the potential for failure once more. You’ll have to pick a new school to go to, figure out what to do when you make it back home again. All this will come before you expect it. Next steps will come in time—think only of the restoration of your dignity.
Move on. Leave behind the hopes and plans you had before you came here, the lover you can’t forgive for seeing you at your lowest. Step away from the religion that gave you your last rites, the family that tried to coddle you from your own fall, couldn’t accept that you didn’t want them there.
Realize that you cannot separate yourself from your past, that a scar remains. Let it become physical. Let a tattoo artist burn the mark of it between your shoulder blades, etch the flesh to reveal your shame. Let the word read however you need it to, so long as it can become the mark of your asylum, a place where you can find sanctuary from the external world, an ideal to be carried as penance, branded upon your back.
And lead a happy, normal life.