Talking the Walk (19)

The Continuity Clause

(This passage and the two that follow it are taken from “On and Off the Learning Curve: Notes by a Bipolar Student,” a talk originally given at the University of Toronto on March 11, 2009. To preserve a closely woven argument, it has been necessary in places to repeat material from previous talks. I have shortened or reworked these sections where possible.)

Seven weeks ago, I, along with millions of others suffering a long-term malaise, was given a strong antidepressant. The treatment included watching chopper blades lift George Bush out of sight, and watching and hearing Barack Obama sworn in as the U.S. president. Many of you will remember this vividly, I’m sure, especially if you were a fellow sufferer. Like all treatments, though, this one had its unwanted side effects, one of which was exposure to potentially toxic levels of rhetoric. That same day, I heard a commentator gush: “It’s a brand new country!” Immediately, this was contradicted by a colleague’s more sour view: “It’s the same old place.” Which was true? I wondered. And I decided they both could be. It’s the same old, brand new place.

And within a few days, influenced no doubt by the ceremony to the south, I wrote the following, applied to a person instead of a country. I call it “The Continuity Clause: Amendment to the Constitution of the United States of Self”:

“I” shall still be considered “I” in spite of lapses or contradictions in the behaviour of myself or the partial or complete disappearance of myself for whatever duration and for whatever reason.

So help me...anyone.

What does this have to do with a book on mental illness called The Lily Pond: A Memoir of Madness, Memory, Myth and Metamorphosis? Everything, really. A core theme in the book–addressed both explicitly and implicitly–is the existential conundrum of how to maintain a self and a life, when that self and life are subject to regular and radical disruption. How does chaos become continuity? The answers to that very big question, which I can only begin to suggest, have, I think, a special relevance to education.

The Lily Pond has four sections, which are like concentric rings. I imagine them sometimes as the ripples set up by a frog jumping into a still pond. They might also be seen as a series of lenses, with each lens offering a wider view of the subject. The first view is a close-up of a patient in crisis, me; the second, of the patient’s family, companions and fellow sufferers; then, moving further outward, a view of living in the wider community as a writer and a participant in psychotherapy; and finally, to caring–trying to care–for my wife Heather as she survives her own mental health crisis. The last view, though it involves many close-ups of each of us and of our marriage, is the widest view because its focus is on trying to make use of illness, trying to turn its hard lessons to some positive and outward-facing account.

The book’s four rings, then, move gradually outward from isolation and passivity–lying motionless on a hospital bed–to a life shared with others, including shared illness. They chronicle the journey (as the back cover says) “from the darkness of unconscious suffering to the daylight of mindful recovery.” What I mean by mindful recovery is not a cure–nothing so final or triumphant-sounding. It is more like tugging recurrent problems into better light so they can be worked on, coped with, managed. This is a long, indeed endless process. Ongoing active awareness is what I mean.

I also think of these concentric rings in another way: as my own story of mental illness, inside the larger story of mental health, which in turn fits inside the much larger story of existence and its challenges, for some of which we use the shorthand “mental health.” The story in The Lily Pond spans four decades. There are mentions in it of my stop-and-start university career, but that’s not described in detail. I’d like to look at it a little more closely now.

I got my Honours B.A. on the 13-year plan. I started in 1973 and graduated in 1986. While I have nothing against gradualism, it’s not a schedule I would recommend to anyone. You see, I was never a part-time student, but rather a full-time student who kept being forced to drop out. Interruptions to my course of study included those eighteen months on a psychiatric ward, working (after my discharge) as a dishwasher for two years, stints of unemployment and short-term jobs, all of this in a series of rented rooms–a “tumbleweed life,” I called it once–before I decided, at age 30, to complete the last year of my degree which had stalled at the three-year mark.

Why did it take me so long? And what, since I call the interruptions “forced,” was forcing me?

There’s more than one answer to that question. But the main reason, I think, is one that eluded me for many years; in fact, it was not until fairly recently that I fully acknowledged it.

Mental illness. Plunges into listless or agitated depressions, followed by equally destabilizing flights into rushing manias. And–far more damaging than these swings themselves–my bewilderment about what was happening to me, which led me to ascribe my swings to other, misleading causes.

Here is what kept happening. I’d start a school year with energy and enthusiasm–attending lectures, doing the readings, getting good marks...learning–and then at some point–usually in the late fall or spring, though it was not strictly seasonal–I would simply bottom out. Lose interest in the classes and the readings, start falling asleep over books, have trouble following a line of argument or even a sentence...and I would think: Why am I here? I’m not interested in this stuff. Or: I’m not smart enough, I can’t do this. (Forgetting–for depression has its characteristic amnesia as well as other forms of inattention–that only weeks or days before I had been smart enough, interested enough.) My reading and attendance became spotty, my work and marks trailed off...I dropped out. Usually vowing never to return.

Looking back, I see that what I was mainly lacking, to pursue my education, was not intelligence or desire or diligence, but self-knowledge. I was not well enough acquainted with myself, and not forgiving or understanding enough of those parts with which I was acquainted, to succeed in school. I needed to educate myself about myself before I could educate myself about anything else. Or at least–since the processes should occur in tandem–I needed to be learning about myself while I was trying to learn about Geoffrey Chaucer and John Milton.

Like generations of bad students before me, I aspired to speak passably well about lives and minds and relations in worlds remote from my own, and to do so I turned exclusively to textbooks and experts, disdaining the materials nearest to hand: my life, mind, and relations in this world, now.

Talking the Walk (18)

My Medic-Alert Bracelet

Dear Mental Health Professional:

If you are reading this, I assume it is because I am not in my right mind and someone has directed you to this page. Unless you believe that my long history of mental illness renders my advice useless, I hope you will take a minute or two to read these instructions which I have set down while of sound mind. They are too long to put on a bracelet, but brief nonetheless. They could save us both a lot of time, and grief.

Sedation is likely a good idea. I am sure that before I landed in your emergency ward, my sleep had been dwindling to three, two, one, zero hours a night–possibly for a long time–so that my most pressing health problem is extreme exhaustion. It might even be the principal cause of many of the symptoms confronting you. Let me sleep as much as possible for two or three days. Make no attempt, or as little as possible, to hurry me back into a “normal” routine. I don’t need normalization as much as I need sleep.

When my brain and body have rested a little, ease off on all drugs to take a look at my baseline condition. I have come back spontaneously many times from where you see me; try to get a read on my ability to do so now. If my frame of mind is even halfway reasonable, give me some time–a few days perhaps–to see if I can restabilize on my own. Allow me to spend the time quietly, doing little or nothing, with as little contact with others as your facility will permit. Resist the urge to intervene. It is tough, I know, to feel that “standing by” is legitimate treatment, but it is sometimes the only legitimate treatment.

If you feel you need to begin a course of drugs, do so extremely cautiously. I am a slow metabolizer of drugs, so it is best to start me at a half, a quarter, an eighth of what you are used to thinking of as the normal therapeutic range. Trust me: if the drug you prescribe can benefit me, it will do so at a far lower level than its manufacturer recommends; and if it can harm me, it will do so rapidly even at low doses. I have thirty-five years of drug disasters to attest to this. Start small, and advance in minuscule increments. Continue mild sedation so that my sleep schedule is maintained.

As soon as I am even halfway stabilized, ask me what further course I would recommend. I realize this may be difficult in front of your colleagues; do it in private if it helps. I have been through this many times, and have a wealth of suggestions about what could help and what will definitely not. Seek my advice, and I will be more likely to seek yours. Each of us has information the other needs.

Do not panic. Try especially to avoid the type of panic that calls itself “aggressive treatment.” Remember that the patient in your interview room (or on your examining table if I have hurt myself physically) is the same person who wrote these notes. The note-writer will return faster if you follow the steps above, and the faster he returns, the better the chance that he will remain. He is the best colleague you can hope for.

Trust yourself. Try to trust me. And good luck, for both our sakes.

Talking the Walk (17)

The Truth (and Trouble) of and

Again and again I come back to it: the truth of and. It is such an important truth that sometimes I think I will be well precisely to the extent that I understand it. Meaning know and live it...down to my bones.

I once won a literary prize, and part of the judges’ citation stuck with me: “acceptance of puzzlement as a natural state of mind.” With a couple of adjustments it could stand as the truth of and: “acceptance of contradiction as a natural state of life.”

Substituting and for but, though, either...or, or any of the binary exclusions that occlude our daily language, works wonders. Try it. I am a hopeful, happy person and (not but) I am often sad and listless. I am energetic and ambitious, and (not though) quite lazy. I am loyal and disloyal (not either/or).

Why force a great, wandering river into canals?

But that little word and can be a terribly hard word to remember. I learn it and forget, practice and neglect. Over and over, I slide from inclusion and acknowledgement (not blanket acceptance: I can acknowledge a part of my nature and work actively to change it) to exclusion and denial. I try and convict myself in the Court of Either-Or, and hear Judge One-Way (me again) pronounce sentence: You must be one thing or the other; you cannot be both.

I learned all this again just last fall. Ironically, after my book launch in October, and at the talks I gave subsequently, some listeners said to me, “You seem well now,” as if all the troubles I was describing were safely behind me. “I do feel well,” I said, “...now.” But I could tell they didn’t believe me when I said I knew bad times would return, times they, and even I, could scarcely imagine. Sure enough, within a month, I was floundering, slipping into a netherworld of sleeplessness and incoherent thoughts and depression and even hallucinations. I could barely understand the book I myself had written or the talks I had given about it. But while I felt myself slipping, while I still had time, I did a useful, practical thing. Using what few verbal resources I had left, I wrote myself a letter, a sort of “message in a bottle” from my still-hanging-on self to the unwell self I felt gaining on him. I taped the letter to the wall beside my desk, and read it often in the next two months, feeling disbelief but also comfort at its assurances that I had gone to this black place before, and had returned from it. I wanted to read it as part of this talk, but it is a little too long. “Letter to Thursday” is still taped to my wall, waiting for when I need it again. It is a frank and simple statement from one self to another, saying in essence: I know you, even if you don’t remember me. We are in this together.
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Still, a real and practical difficulty posed by “the truth of and” is planning. Planning requires a committment based on some assurance about who you will be in the future, so it relates to that difficulty of maintaining a reliable storyline of self and life. I think all of you will know what I mean. When I was asked to come here today, I was just emerging from a bad depression. I had to perform a familiar calculation, a kind of guesswork, i.e. if I’m a little better now, will I be better enough by then? What if I’m not? Future planning is really tough with a mood disorder. How do I plan for an event 2 weeks, 2 months, 2 years from now–when I don’t know who, what version of myself, will be present then? In practice, this is not an easy problem to solve, but in theory at least I have developed a simple approach: Say yes to whatever seems reasonable now, but allow yourself the option of backing out if necessary when the day arrives. When and if that happens, telling the truth is preferable–overall, I’ve been greatly helped by being more open about my condition–but don’t be too hard on yourself if, in an imperfect world, where intolerance and misunderstanding and stigma are all alive and well, circumstances force you to lie, and instead of “I can't make it; I’m in bad shape mentally,” you say “I’ve got the flu,” or “I have to work,” or “My car broke down.” Metaphorically, they’re all true, after all: you are sick, you do have to work (on yourself), and your vehicle (you) needs maintenance in the shop.

I tell the truth when I can, and lie when I must. (Unless it is it the other way around...)

Talking the Walk (16)

Needles and Haystacks

About drugs I only have one thing to say. It is a very recent insight, but it offers a glimpse into a wealth of possibilities. It’s not about drugs per se, but about dosage. Over the years, I’ve tried a huge spectrum of drugs–from phenothiazine tranquilizers to antidepressants to various mood stabilizers–but all of them, even the ones that seemed to help, had side effects I couldn’t tolerate. So I’ve become very wary of drugs. My psychiatrist doesn’t push them–“I’m here to advise; the decisions are yours,” she says, which is one of the reasons I trust her–but she does sometimes suggest, especially when I get backed into a particularly bad corner, that there might be a drug that could help. Last fall, I got backed into such a corner and she suggested quetiapine (or Seroquel, its brand name). But when I tried it, at the lowest standard dose of 25 mg, it zonked me out so thoroughly and for so long–the familiar “zombie” effect–that I realized I could not possibly function in any normal way on it. An hour after taking it, I was drooling (literally) in front of the computer screen. I lurched down the hall and collapsed into bed, coming to hours later with a brain like wet burlap.

I cut the pills in half, then into quarters; though better, it still knocked me too far under. So I dropped the trial. But Dr. George happened to mention that she knew a couple of people who were helped by extremely small doses of this drug. And then Heather’s doctor said the same thing, that she’d heard of people who were aided by a mere “whiff,” as she put it, of quetiapine. So Dr. George wrote me a prescription for 1 mg–we would start from that baseline. The trouble came when I tried to fill the prescription at Shopper’s, only to be told by the pharmacist, very insistently, that the lowest dose sold was the 25 mg tablet and it was unobtainable in 1mg strength. “But that's the prescription my doctor wrote,” I said, pointing at the slip. “You might try a compounding pharmacy,” he muttered, then looked past me and said, “Next?” To make a long story short, in all of Toronto I found only two old-fashioned compounding pharmacies who could make up the prescription in the lower strength. I have been trying it for a few weeks now...it shows promise. But my point is (or rather, my two points are): 1) Cui bono? Who stands to gain if drugs are only sold in higher-strength amounts? You don’t have to be a conspiracy theorist to see that drug companies would not want it widely advertised that minute portions of their brands might help some people. Would any drug seller want it known that some buyers got by on a “whiff” of his product? Would he want to pay for the tests to discover such a possibility? 2) Which of my many failed drug trials over the years might have stood a chance of success at a dosage of one half, one quarter...one sixteenth...of the normal range? A “tincture of this, a tincture of that,” as the old saying went.

A bit of this...a bit of that. Even tiny pieces can have an important place in the mosaic.
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Dr. George tells me that one thing that has changed for the better about psychiatry–at least with good psychiatrists–is the understanding of how variable the optimal drug dosage is for different people, and how some patients may be helped by very small doses. Naturally this is not something the drug companies are eager to admit, and you often have to dig out the information yourself and insist on it. Also, more is now known about the very different rates at which people metabolize drugs. It is clear now that I am what is known as a slow metabolizer. Despite my large size, I absorb the psychiatric drugs very, very slowly, so that a little goes a long way with me. For instance, Heather is only two thirds of my weight, yet she easily tolerates, and needs, more than twice the dose of one drug that we are both on. This helps to explain some of the drug disasters I experienced on and off wards, when the “normal therapeutic range” was administered to me and it knocked me flat or sent me reeling. And it is why I combine very small doses of things–pieces of “the shifting mosaic”–to try to find the right overall treatment program.
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Now it is a year and half later, and that 1 mg of quetiapine has inched in tiny stages up to 5 mg, which seems to be the dose that helps without hampering me. Still one-fifth of the recommended starting dose. For the moment, that piece of the mosaic is in place. But another that showed promise has fallen out. Last July I started on 5 mg of celexa–one quarter of the standard therapeutic dose–to address the intractable depressions which have become ever more frequent and severe. We proceeded cautiously because of the danger that any antidepressant will kick a bipolar patient up into mania. The 5 mg gave me a helpful nudge, but soon I needed more. Upwards...slowly. 7.5 mg, 10, 12.5, 15, 17.5...all this over a three-month period...and finally to 20 mg. Good. For a few stable, productive weeks. Along the way there were side effects, but these were manageable and lessened with time. But then the serious side effect of akathisia developed, and worsened rapidly. Akathisia tormented me so relentlessly on the psychiatric ward that the very word is horrid to me. Its agony is indescribable except by metaphors: imagine a brush fire along your nerves and muscles, which can’t be relieved by scratching, clenching, kneading, pulling, tearing, squeezing, or pummelling (all of which you’ll try; along, perhaps, with throwing yourself at walls or floors; I was one of many on the ward stitched and bandaged for that); only vigorous activity lessens the inner burning, for a few seconds; then it catches again. Sufferers go vacuum-eyed fighting it day and night.

Tapering off celexa...quickly. Still feeling the burning-tingling-needling-itching. Fear that celexa is not the cause, or it has started something which now cannot be stopped. I have a new prescription for escitalopram. A cousin of celexa (citalopram), but one with slightly less potential for akathisia. It frightens me...but so do the depressions.

If I can get clear of the akathisia, I will probably give it a try.

Like looking for a needle in a haystack. Yes, but what else can you do if you need the needle?

Talking the Walk (15)

Here

Last October, in Hamilton, I was walking up the street with Holly, a woman who was helping me organize the book launch for The Lily Pond. I remember it was a cool but sunny day.

“Can I ask you something?” Holly said out of the blue.

“Sure,” I said.

“Is your book hopeful?” she asked. “Because I found hope in it.”

She sounded a bit perplexed, even a bit apologetic, as if she might have found something in the book the author hadn’t intended to put there.

“Yes!” I said. “Of course!” All books are fundamentally hopeful, whatever their subject matter; without hope, no one would try to wrestle raw, chaotic experience into the coherent patterns of art. But also: I’m here. No one would grapple for nearly 40 years with an illness pulling him down, pulling him apart, unless he had equally strong allies (internal and external) pulling him up, pulling him together. Those allies include love, joy in life, and a strong and resilient spirit. They are not unique to me. Any survivor has them. And they are rightly to be cherished, as wellsprings of pride and constant renewal.

To underline the reality of hope, and to remind myself of it, I’d like to read a passage from the book. A paradox of autobiographical writing is that, as it becomes more vivid and convincing, it tends to obscure–make dubious, even–the real life it purports to record. To suggest totality it must extract, and to convey immediacy must freeze the past, sculpting in ice what was once flowing water. Picture supplants pictor. This is especially true of descriptions of low points: if they live at all, they make ghostly the survivor who has won, at the least, the leisure and the will to recollect.

In May of 1979, the water level of French River reached its highest point in living memory. On a vertical rock just east of Dry Pine Bay, someone chalked and dated a line marking the water’s furthest climb. Just as someone doubtless will note–on paper this time, for a rock would be submerged–the record low water mark attained in the summer of 2005. In 1979, I came north with my parents to open the cottage; I remember loading the boat as it floated beside the gas pumps at the marina, three or more feet above the usual docks even at high water. I remember little else about that springtime trip; probably there was little of me left to remember with. I had only recently been discharged from a psychiatric ward after a year-and-a-half siege. It was really a siege of seven years, beginning with my first serious depression and psychiatric treatment at age seventeen, which cut short my last year of high school and inaugurated a long, chaotic slide away from active and communal life, culminating in the self-mutilation that earned me a diagnosis of schizophrenia and embarked me on the hospitalized ordeal of neuroleptic drugs, electroshock treatments and hydra-headed symptoms that came close to killing me, and, in the sense of obliterating all vestiges of my former life, in a way did kill me. My amnesia of that springtime trip north with my parents seems fitting; I could not have accompanied them except as a dazed and depleted survivor, a convalescent with tremors and scars and a battered brain, a broken and wide-eyed child though nominally a man of twenty-four, gaping at the debris left by the flood.

That is where I was almost exactly thirty years ago. And today I’m standing here in this room. In some ways still the same, in some ways greatly altered.

But here.

Talking the Walk (14)

Crusoe and the Swinging Door

Another figure that recurs in my book is not a shadowy stalker but an amazed, and dazed, wanderer on a beach. Robinson Crusoe. At one point I talk about the frequent sense I have of “stepping out from [a mist] to stare, alert and surprised, at the present I find myself in. Crusoe mode, as Heather and I call this islanding in the present, has its positive aspect. Washed up on a new beach, you focus intently on the things about you: grains of sand, a shell, the leaves of a new tree, a footprint. You are alive to the life about you in a way you scarcely could have been during the routine and tedium of the voyage.” This sense of witnessing an ongoing miracle–and a newborn baby, if we knew how it thought, must also live in Crusoe mode–was one of the most striking results after I finally got out of the hospital. I hitchhiked across Canada with my friend that summer. It must have been a somewhat harrowing trip for him–I would only sleep an hour or two at night, and often saw strange things, such as the giant, 2-metre-long crow that swooped repeatedly at one ride’s window–but luckily, my friend was a good sport, and even more luckily, a sound sleeper. I remember one day we were in a diner, I think it was in Kamloops, having breakfast, and I was sitting there after my scrambled eggs, watching my spoon glitter in a pool of sunlight, and my friend said, sounding surprised, “You feel good now, don’t you?” Yes, I told him. And more than good: wealthy. He asked me about that and I tried to explain. I was warm and comfortable, I’d been fed, I was free to sit on a vinyl chair and look about, listening to my friend, gazing at a spoon, watching other people...what more than these riches did I need?

To a large extent I’ve never lost that perspective. It’s a permanent gift I received.(1) A legacy of madness. Or, perhaps, a grateful ebullience that was always there, but that madness, or just hitting bottom, heightened. I’m aware of it standing here now. Inside–out of the November elements–invited to talk to people...pretty confident I’ll get a good lunch somewhere. I don’t really need anything more. Except–I need to say something... or else you’ll begin shifting uncomfortably in your seats. And then we’ll all feel bad.

And there’s the rub. How to live in the moment, but move to the next moment. A practical problem for all of us: how to live now, but still be living tomorrow. Which I must have solved somehow, or I would be a skeleton grinning at a dusty spoon in a boarded-over diner in Kamloops.

How did I solve it? I wonder. How do I? I think perhaps, at my best, I solve it by becoming, by living as, a moving now, a moving readiness. A newborn on the move...as newborns always are (even when they're sleeping). A Crusoe with a plan...as Crusoe soon developed.

Continued life does involve forward-thinking. Future-thinking. But...I have trouble with future-thought. For a good and healthful reason–my tendency to marvel at the miracle of the present–but also for a more destructive one, which is a simple inability to believe I can have a future. That it won’t be swept away by another trip through the swinging door of madness.

My current psychiatrist, an excellent doctor, has given me much counsel on this problem, but a lot of it boils down to two of those simple words that call out for attention: “as if.” Live for today, but also “as if” tomorrow will come. Prepare “as if” you will be granted a future as well as a present. A tall order, but a sensible and necessary one.

Doors are another metaphor that run through my book. I think of the altered states of madness as a door that, for someone of good mental health, should properly be a little sticky and resistant. But if it bangs open once, it will open more easily again. It it swings open many times, as it has with me, it starts to resemble one of those screen doors with worn-out hinges that flap at the slightest breeze. You have to learn to live with a door with loose hinges, which means the possibility of something coming in...or something, maybe you, going out. You have to learn to live with a door that is ajar.

There are worse things. Permanently locked doors, for example. Being sealed out...or in.
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(1) A blessing and a curse, actually. “Live for the moment,” runs the advice we are always getting–and often, most of us, giving. But it is a counsel of ruin for so many of the important moments we find ourselves in. Moments during a job interview, a consultation about health or finances, a pledge of romance or friendship–when success, when fulfillment, depends precisely on the degree to which we can offer ourselves as a person capable of deferment, someone who can be reliably counted on to bank a portion of every moment’s potential for future spending. Someone prudent enough to have opened, long ago, an RRSP of vital energies and to be committed to making regular, incremental contributions.

Talking the Walk (13)

It’s true. It’s true.

Soon after my first admission to hospital, I entered a state of complete catatonia, either as a result of psychosis or the powerful tranquilizers I was put on, or most likely a combination of both. But before that, I have fragmented but clear memories of an exchange that kept recurring during my first intake interviews. It involved the doctors telling me, with regard to the wound I had given myself–what I called my “self-Caesarean”–and my beliefs about it, that it was a delusion, a hallucination, part of the psychosis. And I kept saying, with the monosyllabic stubbornness of a trapped person, “No...it’s true.” I think I kept repeating this until it was just a whisper, and then it became an internal voice: It’s true. It’s true. You see, I had been guided by a vision that a rebirth was coming. That the person I had been was dying, and had to die, so that a new person might be born. “You’re sick,” they kept saying. “No, it’s true,” I kept saying. We were speaking from different vantage points–they from sickness, symptoms, and treatment; and I from existence, metaphor and what I saw as salvation–so we couldn’t understand one another. What I might say to them now, if I could travel back in time, is, “I’m sick...and it’s true.” What I’d done was violent and horrible and terribly distorted–with more violence and distortion to come–but it was also true. Twistedly true. Or, if you prefer, truly twisted. And true in the most literal way. A straight-A high school student, a good and likeable boy whose future seemed promising–now lay bandaged and mute, drugged and shocked, on a psychiatric ward, with, after a while, very little hope held out, even by the doctors, for his recovery. Clearly, someone had died. And then, two years later, working as a part-time dishwasher and living in a rented room, tramping about the city all day and night scribbling poems on scraps of paper, restaurant napkins and placemats, even the margins of dollar bills...hand-stitching little books, making collages out of curb-found objects...and feeling exultant, jubilant that at last I’d found the life in art I was meant for. Just as clearly, someone had been born.

Un-making

It is terrible, of course, to be un-made as a person. And exhilarating. And terrible to be exhilarated by your own un-making. As I thought about this the other day, what flew into my mind, like a flaming arrow, was the famous war cry attributed to Crazy Horse: “It is a good day to die.” Which means, as I understand it, that it is also a good day to live. (Especially if you couple it with the first sentence Crazy Horse is supposed to have said: “It is a good day to fight. It is a good day to die.”) If it is a good day to die, it is a good day to live. And...if it is not a good day to die, then probably it has not been a very good day to live. This, by the way, is not related by any neat corollary to suicide, which stalks through my book like a shadowy hunter. I won’t generalize about suicide, which I think is talked about too glibly, when in fact it must be as various and complex as the people and moods that turn to it. I only want to say that I have known the impulse to exit life not as a good day to die, but rather as a day so bad to live that dying seemed the only way to end it. That is very different.