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Josh Roiland | Longreads | November, 2019 | 10 minutes (2,622 words)
I once lived in Delaware for two days. I had moved there under the pretext of graduate school, but soon fled back to Minnesota amidst the clanging static of a panic attack.
The morning of the move my car had a flat. Once the tire was patched, I headed east with an atlas and not much of a plan. After 15 hours, I stopped in a Walmart parking lot in Columbus, Ohio, and tried to sleep in my overstuffed car. At dawn, I pushed through the Ohio River Valley and emerged in Newark, Delaware, seven hours later.
It was my first time outside the Midwest.
I had booked my apartment online, and when I arrived, I saw that it sat next to a fire station. Inside, there was a woman painting my walls and singing songs from The Wizard of Oz. I unloaded my car as she packed up and left. My only furniture was an air mattress with a hand pump whose nozzle was too small for its opening.
Once my car was empty, and my apartment slightly less so, I stood surrounded by wet paint and cried. I scared myself by the force of everything pouring from me. I didn’t know where it was coming from, and I didn’t know how to stop it.
I tried to stay busy, distract myself from everything that was to come — whatever that may be. I went to Kmart. Because I was traveling, I thought I needed traveler’s checks. I paid for my home supplies with 15 10-dollar notes. The cashier had to call an 800-number to verify each one. The line grew while his patience shrank. My chest tightened. I fled back to my apartment where I plugged a random coaxial cable into my 13” television. I watched the Food Network until I passed out. In the morning, I awoke on the floor with the air mattress folded up around me.
There are, today, mornings when I wake up and my body vibrates like a piano string struck by a hammer. The musical term for the section of string that experiences these tremors is the “speaking length.” Preconscious, my feet knock together like boxers’ gloves. I lay there shimmering as pulses push me up off the bed, where I hover and tremble. Stretched tight across the bridge, I glint and wink like a snap of sunlight.
Or at least that’s what it feels like to wake up in the thrall of anxiety. I crackle and can’t communicate what’s going on, where these vibrations are coming from.
Day two in Delaware began with the rounded whine of fire trucks. I showered behind my new vinyl shower curtain then left for the grocery store where the briny stench of fresh seafood shocked my Midwestern sensitivity. I found a bank and set up an account. I went to the post office and bought stamps.
But the truth is that I was already plotting my escape.
That afternoon I went to campus and stood in front of my English department mailbox. Having seen what I would leave, I left. I went back to my apartment, which had transmogrified from alien to comforting. Everything was shape-shifting.
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The evening stretched and sprinted. I circled through my apartment, too afraid to leave but desperate not to stay. With everything unfamiliar and nothing certain, I didn’t know what to do. What were my options? Once again, I stood with my arms wrapped around myself, digging my fingernails into my triceps.
I called my dad. My sobs scared him, and he wasn’t sure how to respond.
“Well,” he finally said. “You can always come home.”
My car was packed before I hung up the phone.
Then, just before I left Delaware forever, my phone rang. A returning grad student called to welcome me and invite me out for a beer. I stood there in my again-empty living room, holding the phone, not knowing what to say.
The stories we tell are never wholly our own. Words, and the stories they create, have their own history, and we all work within their limits. Writers and speakers, all of us, constantly reorder and encode new meaning in what has already been said. Our words, as the Russian literary theorist Mikhail Bakhtin put it, are always “half someone else’s.” This phenomenon came to be known as “metadiscourse.”
One reason we tell stories is so others can understand what we are seeing, thinking, and feeling. But often we misunderstand a basic premise, believing that the communicative norm is transparency when, in fact, it’s opacity. What is meant never fully transmits into what is understood. Linguists call this false belief the myth of perfect understanding.
As much as we may desire to control both the narrative and its reception, meaning is always contingent and never inherent. There is no such thing, Bahktin says, as “neutral and impersonal language.” We merely offer, in the words of Bahktin scholars, “endless redescriptions of the world.”
I first saw a therapist early in my second bout with a Ph.D. There’d been break-ups, and I once again felt dislodged from everything I thought I knew. But the counselor and I had a great rapport to the point where he questioned why I was even there. He thought my hyperventilating about certain regrets and uncertainties was overmuch. Though I shared and shared, I could not get him to understand exactly what was going on inside of me.
Nearly every session, in an effort to make me feel better, he’d joke: “So what’s wrong with you again?”
Nonetheless, I went on to see a psychiatrist, and then another, in an effort to better explain myself. Or have myself explained to me. OCD? Bipolar? Plain old depression? Who could tell? Regardless, medications were prescribed and ingested. Klonopin for acute anxiety. Zoloft for depression. Then Effexor when the Zoloft didn’t work.
There was little oversight with these scripts, and I experienced all the ignominious side effects without much psychic relief. When I told the doctor that the Klonopin didn’t seem to quell any sudden panic, she said it was because of my high metabolism and urged me to up the dosage until I felt OK.
Then one night, I was carried out of a bar.
A few years ago, I gave a public talk about my mental health. Its title, “Almost Aloud,” was a line clipped from the short story “Good Old Neon,” by David Foster Wallace. For years I had researched and written about the history of Wallace’s nonfiction, and the talk’s nominal hook was describing what it was like to work in his archive.
My first-ever publication argued that Wallace’s journalism lacked what Nietzsche called “oblivion” — the psychic ability to filter good self-consciousness from bad. The piece somehow ended up wedged between some famous authors in an anthology. Essentially, though, I just mapped my own experience onto Wallace’s work, and it happened they overlapped.
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And so it was that six months into a tenure-track job, I nervously told an audience of colleagues, neighbors, and friends how working on Wallace activated my own anxiety. Or was it that my already-activated anxiety was an a priori factor in my interest in Wallace’s work? How to tell?
I began the talk:
For me the sound of anxiety is silence. It’s an empty room where I sit, alone, and all I can hear are my thoughts, which quietly insist themselves upon me, both unbidden and unwanted. And after a time, a time when I get up and walk through other empty rooms, only to return, and get up and return, those thoughts begin to take the same shape as that recursive path through my apartment. Looping endlessly, relentlessly.
For six minutes I guided the audience through these seemingly overlapping maps. When I mentioned Wallace’s suicide — an act he himself described in Infinite Jest as “eliminating your map” — there was an audible gasp, then dead silence for several minutes.
I ended the talk darkly. I wanted to convey a desperation, even a resignation at the whole intellectual endeavor. At the absurdity of speaking and writing and teaching. Where did all that thinking, all those words get you anyhow? I closed with the last sentence from “Good Old Neon” — the only way, it seemed to me, to control a feral mind: “Not another word.”
Looking back, I misread that story completely.
I haven’t slept through the night in decades. Melatonin, meditation, booze, Benadryl — they’ve all pulled me under, but invariably my mind burns through the restraints and I surface. When I’m marooned in the middle of the night, legs scissoring and feet belting back and forth, I turn to all manner of sleep apps and ambient music. The song I come back to over and over again is “DLP 3,” by the avant-garde musician William Basinski. It is one of nine songs on his five-hour, four-record album The Disintegration Loops.
Writing in Pitchfork, Mark Richardson tells the album’s origin story:
In the 1980s, [Basinski] constructed a series of tape loops consisting of processed snatches of music captured from an easy listening station. When going through his archives in 2001, he decided to digitize the decades-old loops to preserve them. He started a loop on his digital recorder and left it running, and when he returned a short while later, he noticed that the tape was gradually crumbling as it played. The fine coating of magnetized metal was slivering off, and the music was decaying slightly with each pass through the spindle.
The Disintegration Loops are literally disintegrating loops. They erode as you listen to them. The change from one revolution to the next is imperceptible, but the tape is falling apart. Each pass, a redescription of the past.
“DLP 3” is 42 minutes long. The loop, a three-note horn fugue that pushes forward over a ghost march before sucking back in on itself, is only eight seconds long. It repeats 310 times. My fibrillating mind trains on its respiratory rhythm.
Turning and turning, the song softly transforms from hypnotic to unsettling. The gradations are subtle, but the crackles widen and a buzzy silence fills the perforations. If I don’t fall asleep during its first half, I’m worse off than when I laid down. My mind catches on the crepitates and recollects all that I tried to cast off, like a needle dredging dust with each revolution of a record.
The longer I listen, the harder it is to hear.
A decade after my first foray into therapy, I tried it again. Academia had drawn me back to the East Coast and all of its familiar dislocations. Soon, a much more substantial break-up left me unmoored. My therapist gave me language to understand these upheavals, but when those words miscarried, she suggested medication.
I met with a psych nurse and explained how meds hadn’t worked for me in the past. She suggested a genetic test. While I awaited the results of my cheek swabs, I started Lexapro. It did nothing. Six weeks later my GeneSight results came in. It sorted drugs into three categories: 1. Use As Directed; 2. Moderate Gene-Drug Interaction; and 3. Significant Gene-Drug Interaction. Many of my previously prescribed psychotropic medications were listed under the third category — meaning they were essentially incompatible. Below the drug columns were numbered notes headlined, “Clinical Considerations.” One referenced a high metabolic rate; another read: “Serum level may be too low, higher doses may be required.”
I was encouraged by these explanations.
My university health insurance, however, wouldn’t cover the test. The American Psychiatric Association says the science behind using biomarkers as a diagnostic tool is inconclusive. GeneSight’s website itself acknowledges these interpretive limits: “Psychiatric pharmacogenomics does not have an individual genetic marker or causative gene like is often typical in molecular diagnostic testing. … Instead of diagnosing the bimodal presence or absence of a disease state, the GeneSight test predicts patient response to medication.”
A year after starting Cymbalta, I finally felt I had a floor when I fell. But it did not eliminate the worry and doubt. I tried explaining to a friend the difference between my outward appearance and inward feeling; the incongruity between medication and the persistence of depressive symptoms.
“I guess that’s what makes it difficult to understand,” she said. “Because you have so many relationships and people to lean on and care about, and who care for you. But it’s so deeply seeded inside of you. I’m very sad about that, Josh.”
My life has nearly doubled since Delaware. The tenure track job’s gone. As are those colleagues and friends. Health insurance, medication, my retirement—none of it’s left. All stories too difficult to tell, yet harder still not to explain.
I now live in a camper, parked in the same driveway I departed two decades ago. The future feels weightier today than then, carrying everything that once was and the understanding of what can never again be. The strings still vibrate, louder sometimes than others, but I’ve learned, if not wholly accepted, that this is life. Or my life anyway.
A few weeks after I came home again, my dad nearly died in front of me. He’d recently been diagnosed with congestive heart failure, and one day after lunch I followed him as he walked to his bedroom to take a nap. Climbing into bed he looked at me and said, “Here it comes.” His heart slowed to a near-stop, and he began gasping for breath.
Since then, my dad, sister, and I have spent countless hours in hospital rooms genuflecting to doctors as they dispense diagnoses, which stirs complicated feelings for an unemployed Ph.D. whose own work never resonated with his father.
I’ve filled my reporter’s notebook with words I never thought I’d know: Ejection fraction. Asystole. Metoprolol. Amiodarone. Cardioversion. As I sit there asking questions and taking notes — grasping for agency — I worry that someone is going to ask me what I do for a living.
No one, of course, does, preferring instead to lightly fill in the blanks themselves. During our third visit to the heart clinic, a two-hour drive away, my dad’s cardiologist again observed my constant scribbling and said, “Josh is writing a novel over here with all his notes.” Everyone laughed. Then he doubled down: “Josh is like a historian!”
As misbegotten as faith ever is, hospitals can engender hope with their clear-eyed promise of science to diagnose, explain, and treat. They can offer a map. In my dad’s case, recovery has meant a CRT-D implant, a suite of medication, and cardiac rehabilitation.
Three days a week I drive him, in his pickup, to a rehab clinic where he pedals on an elliptical bike for 40 minutes, while I sit in the back of the room and record his weight and blood pressures. The nurses and other patients regard me benignly. They think I’m a college student, home for the summer.
It takes us a half hour to get to the clinic, and we don’t really say much on the way there or back. Sometimes, on the way home, we stop for ice cream.
My dad is months removed from the fainting spells and physical restrictions that catalyzed my chauffeuring in the first place. He’s returned to his routine drives by himself every afternoon and evening to look at crops, talk to friends, and go fishing. But every Monday, Wednesday, and Friday at 8:50 a.m. we head out to the truck, and he climbs into the passenger seat.
Sometimes I want to ask him why he still has me drive him to these sessions. But then, what really could he say?
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Editor: Krista Stevens
Fact checker: Steven Cohen
Copy editor: Jacob Gross