My Body Is a Book of Rules. Elissa Washuta
in the normal range.
The patient’s hair kept getting shorter. Gold highlights the size of sunfish were added.
In May of 2007, the patient once again reported an episode of dysphoria with decreased social judgment. Lithium was increased to 900 mg.
The patient described a recent episode in which she had a lesbian encounter against a bathroom door and an encounter with a former partner on the lawn of a coffeehouse. The patient said, “Don’t write that down. Just put, like, ‘Manic shit going down.’” The patient could never make mental notes off-limits. When she once said hello to me outside the clinic, I pretended I didn’t know who she was.
In June of 2007, the patient had another episode of elevated mood, increased alcohol consumption, negative self-reflection, and a sense of hopelessness. The patient said it was getting hard to take out the recycling, and bags of beer bottles accumulated under the kitchen table. At this point we added 10 mg of Abilify. There was some insomnia and akathisia, for which we added 1 mg of Klonopin nightly.
The patient said that her internal organs felt as if they were being constantly unraveled and knitted into something too tight. The patient said that her brain was uncoiling and re-clenching, as her fist does during a blood draw. The patient said she was determined to stay on Abilify. This was her attitude when I last treated her, before her move from Maryland to New Jersey to Washington upon graduation and entrance to graduate school.
The clinical picture is compatible with a mixed, rapid-cycling bipolar disorder.
I missed her a lot when she left.
In conclusion, the patient’s mood has been frequently and episodically unstable. There have been episodes of depression, as well as mixed and hypomanic symptoms. There have been ten-degree nights in ten-inch skirts, nights spent going through the Ativan rations while trying to sleep under a window left open to let the murderers in, nights racking up every point on every inventory and dreaming up new ones—the Washuta Online Spending Inventory, Identification with Famous Rappers Inventory, and Facebook Posts about Self-Worth Inventory. There have been nights when she genuinely believed she could really do the rest of her life, and nights when she really thought that no drug company was ever going to make a pill that could even lessen her pain. It kills me to know that she thinks this during most of her daily activities.
Although the patient’s current course of Abilify has stabilized her mood, she does meet the criteria for bipolar disorder, mixed, rapid cycling, and will need to receive lifelong drug treatment. If anyone tells her otherwise and tells her to shrug it off and cheer up, I have promised her I will personally kick his or her teeth in. I wish Miss Washuta the best.
Sincerely,
The Psychiatrist1
Next psychiatrist’s postscript: The patient’s akathisia, described as a constant feeling of agitation and unrest, intensified immediately after her move to Seattle. There, because no one in his right fucking mind should prescribe Abilify, that and Klonopin were discontinued and Seroquel was added. After adding 5 mg Lexapro, the patient achieved stability.
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1 With edits from Elissa Washuta, 11/13/2007.
A Cascade Autobiography
PART 3
When I tell people I’m Native, they often ask, “How much?” It seems to be a reflex, the way, when I’m asked how I’m doing, I always fib that I’m “fine.” I don’t know why anyone cares to know my quantum, but I never want to be rude. I am three-thirty-seconds Indian: one-sixteenth Cascade and one-thirty-second Cowlitz. Since the Cascade tribe has been split into pieces, I am enrolled Cowlitz. When the Cascade leaders were hanged, all the other Cascade Indians were rounded up by Lieutenant Phil Sheridan, put on an island, and told that they would be shot if they tried to leave. You know Sheridan because you’ve heard, “The only good Indian is a dead Indian.” He was talking about me because he was talking about Indians like my great-great-great-grandpa Tumalth, whom he hanged on March 28, 1856.
Tumalth was survived by his wives and daughters. Mary Wil-wy-i-ty, or Indian Mary, is the daughter whose blood eventually became mine. If you’re asking me who the Indian was that made me Indian, I guess you’re asking about Mary, because she was the last fullblood in my family line. Her second husband Louis, Abbie’s dad, was Cowlitz. He was born to Lucy Skloutwout, a Lower Cowlitz woman whose descendants fill many chairs at council meetings. Mary was a very young girl when her dad died. Her sister Whylick Quiuck, or Virginia, was about nine at the time. When their dad was hanged, those little girls were enslaved, and the world was upended, never to be set right again.
For eight years, the teachers at my Catholic grade school stuffed my skull with anything that would fit, starting with phonics (kindergarten), then quickly pressing in the history of the Revolutionary War (first grade), the corporal works of mercy (second), long division (third), Lenape history (fourth), human reproduction (fifth), cell biology (sixth), and sentence diagramming (seventh). My dad’s Catholic school education had been structured but thorough, and my parents wanted to place me in a setting where my growing brain could absorb multitudes.
Our teachers challenged us to retain as much as possible. Our brains were empty vessels with stretchable walls. Every day, I was sent home with a backpack so heavy that I developed chronic back pain at age eleven, and my doctor suggested that I carry my textbooks in a rolling suitcase, a proposal I rejected. I didn’t need help becoming any more of a freakish nerd than I already was.
In seventh grade, my best friend and I filled a notebook with nasty comments about our classmates and teachers, and a mean girl discovered it. I apologized profusely to the teachers and vice-principal. My parents, teachers, and the vice-principal agreed that after seven years at the school, I still couldn’t fit in, so it was in my best interest to move on. I always say I got kicked out of Catholic school, because it sounds better than the truth: I had to throw in the towel because nobody liked me.
I failed while I excelled, learning the Ave Maria, Angelus, Apostle’s Creed, and Nicene Creed by brain but not heart, because at some point, I became devoted to memorizing sex tips from Cosmopolitan. My impure heart ached, not for the Lord, but for something even glossier than prayer cards. Cosmo was full of good tips I needed to know about if I was going to be good in bed and worthy of love. I knew that sex could happen at any time, with anyone, and I had to be ready to please any man who might have me. My glasses saw through the atmosphere. Children, we were told over and over, are little lambs, are vessels, are innocents not yet spoiled by the world. As a child, I was charged with the task of keeping my soul pristine as I grew. Around me, I saw fiery souls, angry souls, souls already dying. Mine began to oxidize as it touched the stale New Jersey air.
| THE COMMANDMENTS I PICKED UP ALONG THE WAY | QUESTIONS FROM COSMO THAT STARTED TO SEEM IMPORTANT WHEN I WAS TWELVE, EIGHT YEARS BEFORE I LOST MY VIRGINITY |
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1.I am the LORD your God. You shall not have strange gods before me.
2.Sister Agnes is always right and premarital sex is always a sin, because human bodies are made to advance God’s will through making families.
3.You will never snag a husband if you don’t know what to do with his dick. You learn this at twelve but still do not know anything else about dicks.
4.When it comes to your guy’s penis, remember three things: If it’s small, say it’s the perfect fit. If it’s average, say it’s huge. If it’s huge, he’ll already know, but he’ll still love hearing you say it anyway.
5.Say this: You are great, O Lord, and greatly to be praised. Great is your power and your wisdom is without measure.
6.Too many women can’t admit when they’re wrong, so letting him know when he’s right, no matter what the topic is, will score you major points |