Lexapro 20mg PO qd

If I had Internet, I could tell you.

Some guy—Robert Whitaker, I think, and how did we live without Google?—wrote a book about the drug industry and the explosion of mental diseases. His thesis went something like this—for most diseases, the incidence rate drops as new drugs are developed, patients are treated, and presumably cured. But ever since Prozac, we’ve had a spate of new antidepressants, and the rate of depression has…

…skyrocketed.

So what’s going on?

I know all about this because Eric is writing a blog for Psychology Today. He sent me a link for the book, as well as a quote from a psychiatrist at the University of Michigan, who says that exercise is at least as good as antidepressants in the treatment of major depression.

Oh yeah?

I did my three-mile walk today at 8 AM—I’m rigorous about doing it. I listened to the first two string quartets of Brahms—my walk time is also music time. I came home, tried to get down to work, and couldn’t.

I hadn’t taken my Lexapro.

Little things began to annoy me. The damn Internet connection is down again. I tried to write a post. My mood is apparent in the first line—“It’s 2500 bucks of sheer fucking frustration.” (I was writing about my Zen MacBook Pro….) I wasted time rereading some old posts. I began to wonder whether it was worth it all.

Cousin Brian popped into my mind. His words: I said to myself over and over as I read, "he's so brave." You hold nothing back: Franny's character, her love, her pepper, John's stoicism, the terrible tensions between you and Eric, your own utter devotion to Fran, your struggles with depression before, during, and after...it's remarkable.

Yeah? Well, this morning I wasn’t feeling so brave. I was feeling pissed. And sorry for myself. Why has my life been such a fucking struggle? Why have I had to fight all my goddam life? The titanic struggle with the cello, the battle with depression, coming out, moving to a land where I’ll always be a stranger / visitor. What the fuck have I NOT had to do?

Shit!

Right. So then I got mad at Eric. Fuck you, you mental health experts, I raged! Have you ever been so far gone that you felt your thoughts turn to voices? Have you ever been, as I once was, in a bus sitting in front of a deranged street person. The guy was furiously snarling obscenities at me—“you mother-fucking asshole. You fucking think you’re so great… Pussy! Cock-sucker!”

And I didn’t move away.

Why?

Because I wasn’t entirely sure that it was the guy behind me.

It might have been me, pouring out that venom.

So it’s easy for you guys, the experts, to talk clinically and analytically about antidepressants and the rates of major depression. Sit in a dark room at 3 AM and struggle, as I once did, through a ravishingly beautiful amen of Monteverdi.

And have that be the one thin thread that ties you still to life.

At some point in the morning, it became clear.

ONE day without my Lexapro is enough to start me off on the slide to despair, darkness, death.

Well, I am rigorous, too, about going to the shrink. And I had gone last week, and gotten the prescription.

So I went to CVS.

I took the Lexapro one hour ago.

I can now write. I am no longer angry at Eric. I know what I will do today. I have a to-do list, and will work my way through most of it. What I don’t do today, I will do tomorrow.

Yes, tomorrow I will walk and listen to music and contemplate the sea. That will make me feel better.

I will also reach for the one thing that apparently means life or death. 

Lexapro, 20 mg. PO QD. 

2000 Bucks to Get Screwed?

Must be common for some guys, but it was new to me: paying two thousand bucks to get screwed….

Actually, let’s put the record straight—I’ve never paid anyone anything to get screwed.

OK—drop the cheap humor. The work of today is recovering from the surgery of yesterday. I now have two screws—titanium, they are, and the surgeon said, “bones just love the stuff…”—in my left mandible.

Compare and contrast—started every exam question I ever took as a child. “Compare and contrast ancient Greek attitudes towards democracy with our own.” Why? What was the point?

But it stuck. And there I was, absorbing the fact that my bones love titanium (yeah, but what about the airport metal detectors?) when the surgeon began a somewhat lengthy and more-technical-than-I-wanted description of the procedure.

I noted one of the many plaques on the wall—the surgeon, I am happy to say, is a fellow of the American Academy of Osseointegration. (Just added that to the computer’s vocabulary!)

And it was new for me, too. ‘What would that be like,’ I woundered. (Wanted to write ‘wondered’ but going back to retype, I turned up again with ‘woundered’. Seems appropriate, somehow….) It’s wounderful—sorry, did it again—to think of all these oddball academies. Remember the German ornithologists with their passionate debate about the ‘near passerine’ status of the Motmot? Interesting to know how that would compare—and contrast—with the American Academy of Osseointegration.

Also interesting to compare and contrast—look, can we just call it ‘cc’ from now on? I’m still groggy from the anesthesia—the historical role of the surgeon / barber with our current tooth guys. “Do you like your smile?” the questionnaire asked.

No—why should I?

Two hundred years ago, the question would have been ridiculous. And maybe still is.

It was also interesting to cc Franny’s story with my own. As usual, we’re going parallel, here. She lost her mind, I lost mine. She battled for death, I battled for life. Six months before her death, she had a root canal. And there I was, yesterday, holding the same drug—Vicodin—that I had held so many times in Wisconsin. The pain wasn’t bad, but hell, I’m a druggy. Why wait? I chugged it down, and felt like a zombie. 

Right——no drugs for the non-suicidal brother, either….

Mostly, though, I am comparing and contrasting my own life, as it has changed in the last years. And speaking of zombies, is it too much a cliché to point out the effect of corporations and corporate life on the human psyche?

Right—I was never too into it. They used to give us stress balls——the little rubber spheres emblazoned with the corporate logo–Wal-Mart!—and its happy yellow face. This struck me as odd—the very thing causing you the stress is giving you a stress ball AND putting their name on it. The idea was to do to the company through the stress ball what you couldn’t in any other actual way.

Wanna smack that secretary? Have a stress ball, honey.

Well, everyone ignored them, of course. But Marc? No, he just couldn’t take it seriously. And when they presented everyone with a new and improvered  (woundering about that word?) version—a stress ball with a little elastic band—I was delighted. 

So there I was, doing my TBWA (should have been “coaching by walking around"—CBWA—but mine was “teaching by walking around”), and fiddling with my stress ball. “What are you doing with that thing,” the electronics buyer would say. He’s gotta sell sixty million dollars of gadgets a year. And was he roaming the aisles with a stress ball?

Hell no. He was glued to his computer screen, trying to figure out what happened to the thirty iPads that disappeared from the Guayama store.

“I’m relieving my stress,” I’d say.  

“Hunh?”

“I have a good deal of stress….”

This was not often taken seriously.

OK—it was NEVER taken seriously.

Marc—with stress? He sits in his office—far far away from anyone, especially his boss, and throws pencils at the students! What’s he got to be stressed about?

Good point, actually. There was only one of me—unlike the buyers, of whom there were many. My boss was a sweetheart. The students—most of them—loved me. What did I have to be stressed about?

I considered this this morning, as I walked past the bust stop where I used to sit…

At 5:30 in the morning.

Oh, and coming home at 6 PM, and racing for the toilet in the hotel next to the bus station. It could take 40 minutes for the yellow bus from Caguas to arrive. Then, it would take another hour to get home.

And of course I’d been drinking coffee all day….

Having talked all day, I would ache for silence. Raf could throw me into fits of irritation by asking perfectly bland questions.

“When do you want dinner?”

Answer in my mind—I WANT FUCKING DINNER WHEN IT GETS ON THE FUCKING TABLE, ASSHOLE!

Answer through my lips—“half an hour.”

Or, “Do you want Hollandaise sauce on the asparagus?”

NO YOU ARE NOT FUCKING MAKING HOLLANDAISE SAUCE BECAUSE YOU ALWAYS SPILL THE FUCKING FLOUR ON THE STOVE AND I AM TOO TIRED TO CLEAN THAT UP AND WASH THE FUCKING SAUCE BOAT.

“Great!”

So justified or not, it seems I did have stress—unrelieved by balls. Somehow it crept into us, despite all the motivational talks we got in the monthly meetings. Because yes, the company paid SERIOUS money to motivate us.

“Mejor, mejor, mejor” sang the ancient lady who had battled cancer and won and gone on to a wonderful (no wounderful for her!) new career of telling everyone how she had done it and how we could too! And how did she do it? Here she prompted the associates (read workers) to sing the answer—‘mejor, mejor, mejor!” We sang. Better, better, better! 

You can imagine the fun I had with THAT!

There was the guy you whirled around for no reason, put his finger on a button, and started to sing! (Odd, are all motivational speaker closet singers?) Oh yeah, and he ended up giving me a dollar bill. 

Why? 

There were thirty of us in the room, and he had finished telling the story about someone who had given HIM a dollar bill and told him he could do whatever he wanted in his life and now he was here in this room living his dream and it was time to pay it forward and so even though there were times when he really could have used that dollar bill he NEVER NEVER spent that dollar because the message was so important and life changing that…

“So why did you give it to me?” Of course I had to ask….

“There’s just something about you. You have the makings of a leader….”

The guy with the stress ball?

Well, the dollar got put under the laughing Buddha that sat on my desk and that in fact now sits on my desk. The Buddha and the dollar bill got packed away, as I got packed away, and delivered. As I have been delivered. For every day and in every way, I am getting…

mejor, mejor, mejor! 

Different Realities

The nice thing about having a shrink is that not only can you talk about yourself, you’re actually supposed to.

Which may be why I was freely kvetching, yesterday, as I sat (not lay) on the couch.

“I want my life now to go back to normal,” I said, or something of the sort.

Silence—all these guys know how to use silence. And a very effective technique it is, too. You find yourself blurting ANYTHING just to relieve the silence.

So I went on.

“First I went to Wisconsin for ten days in early May and that was nice…though not without challenges. Then I went to London for ten days and that was nice though cold. Then we came back and Taí was here and that was wonderful but…”

More silence. A Harvard degree he has, but he can’t talk?

“Things are subtly different when she’s here. Usually for the better. The house gets cleaner. Glasses left in the sink turn up washed in the drainer. I can crash early to bed and that’s perfectly fine—Raf will have someone to talk to. It’s better, but it’s not normal.”

I was pondering all this after my walk this morning, as I was reading the local rag—El Nuevo Día. Lead story—our local legislature is considering a ban on the cuidadores callejeros. Caretakers of the street, loosely….

…not that that helps.

OK—let me explain. For years, guys have worked the public streets, offering help in parallel parking and assurances that nothing will happen to their car. A minor protection scheme, and a good idea, really. You don’t want your car stolen, do you? Naturally, grateful citizens think to give a little something—a pesito or two—from time to time. And of course it’s logical that over the years these guys have staked out their territory—and fight fiercely anyone moving in on them. As well, with such a service, naturally a warm relationship develops between the street guys and the drivers (and / or parkers).

Churlish people allege that this has converted public parking into private parking for regulars. Oh, and also that anyone NOT offering that little pesito is gonna find his car badly scratched on return. Well, they were warned, right?

After all, their car wasn’t stolen….

This now makes perfect sense to me, though there was a time it didn’t. I had questions—silly questions—like “why can the governor call me up and invite me to the Three King’s Day party, but he can’t call to say the tsunami is coming?”

I learned, and explained it later to a friend.

“Webster,” I said, “there are when where what and how questions. But there are NO why questions….”

See?

But this didn’t come easily, this let’s-call-it relaxed way of thinking. Especially since by all appearances, the laws are greatly respected in Puerto Rico. No Estacione, Ley 40. No Fumar, Ley 160. I used to find it curious—were all the Puerto Ricans running around with law books, checking out and citing all these laws? Why didn’t I see people with them?

And why is the car right in front of the No Parking sign, or the guy smoking in front of the No Smoking sign?

I checked my words, not wanting to be the ugly American. But I did mention it to a friend, a Puerto Rican with the flag of the island tattooed on his neck….

“Puerto Ricans are the most LAWLESS people on earth,” he roared. “They will do anything—ANYTHING—for mamita. They will move heaven and earth for their friends. But they are completely clueless when acting toward a stranger!”

Note the pronoun “they” from the Puerto Rican tattooed gentleman….

“Now, AMERICANS—that’s different. Not one—ONE—American would park their car in a handicapped parking spot. But Puerto Ricans! Hah, they’ll run the lady down in her wheel chair, just to get her spot!”

He raged on. I feared his words might be incendiary.

“Absolutely,” a woman shouted from across the street—why risk life and limb when you can just raise your voice? “Beasts, absolute beasts—all of them!”

This no longer strikes me as strange.

Nor does it seem strange that the public streets have become private parking. After all, as one of the caretakers said, the government doesn’t give him food or a job. So he’s gotta do something, right?

Nor does it seem odd that one day the ACLU is terming our local police force as abusive and running amok (well, so did the US Department of Justice four years back) and the next day we’re worrying about the caretakers of the streets.

Nor is it terribly curious that anyone would be interested in what laws are being passed since…

…nobody enforces the laws anyway….

See?

Beethoven Quartet no. 15, 3d movement

It’s a curious thing how no one—at least I think—can write sensibly about the effect of hearing music psychologically and emotionally.

Think of it—we sit in a crowded concert hall, as the crashing last chords of Beethoven’s Fifth blast off into infinity (until the next time around). How to describe that elation?

Or we sit—as I once did—in a dark room in a large empty apartment and hear the slow “Amen” of one of the Monteverdi Vespers for theBlessed Virgin of 1610. I was suspended between faith and despair, and knew that somehow a question of life and going on was occurring. The tears flowed down my cheeks, I fought to stop the sound and the pain, and could not.

But who can write about it?

OK, I’m not all that well read. I should probably do some research. Tolstoy, I know, wrote a long short story based one theKreutzer Sonata—right, know the sonata, don’t know the short story. And others have tried, some of which I have read. And it always comes across flat, or forced, or sometimes just artificial.

Or worse, inflated.

And the better the music, the worse the writing tends to be….

So I should back away from making a larger fool of myself than I normally do. Because the piece that has haunted me, this last 6 weeks, has been one of the greatest of them all: Beethoven’s quartet number 15, third movement.

In German, it’s known as Heiliger Dankgesang, the words Beethoven inscribed on the manuscript. A holy hymn of thanksgiving, that would be, and Beethoven had every reason to be giving thanks—he had been severely ill, and feared that he was dying.

He recovered, and wrote perhaps the most haunting composition of his life.

It starts agonizingly slow—moving as if under water. Or perhaps floating—there’s an ethereal quality of suspension and immersion in some other dimension. And it’s modal—which means that it uses the one of the scales of Gregorian chant. And then, it breaks into a joyful, almost manic second section. Here it’s classical, ordered, as ornamented as a Versailles drawing room. “Strength regained,” writes Beethoven at this point in the manuscript, and indeed, there is all of the joy that attends recovery from a near fatal illness.

And then the slow section returns, though slightly altered.

The light breaks through again, as the second joyful section is repeated. 

And then comes the final—fifth—section, again slow as the first and third had been, again very similar thematically and harmonically. But now Beethoven introduces the theme that has been hiding in the prior two slow sections. And it’s here that words fail.

Not just for me. Apparently T. S. Eliot was obsessed as well. Some think that the Heiliger Dankgesang may have been the inspiration for the Four Quartets. At any rate, he wrote to Stephen Spender, “I find it quite inexhaustible to study. There is a sort of heavenly or at least more than human gaiety about some of his later things which one imagines might come to oneself as the fruit of reconciliation and relief after immense suffering; I should like to get something of that into verse before I die.” (Thanks, Wikipedia! http://en.wikipedia.org/wiki/String_Quartet_No._15_(Beethoven)

Well, not having read the Four Quartets, I’ve no idea whether Eliot did. I can only tell you my own experience, as real as Winterreise was for me. A party had been announced on the third of May—the second anniversary of Franny’s death. Being a guest myself, I was spared the problem of who should be invited or not. It was a Morning Glory affair—put together by the people who had cared so lovingly for Franny for the two years or so when we could not.

So—back to the Acres, to the house that had seen her last days, as well as so many others. Eric kindly put off planting a garden and joined me there—the two of us, greatly more united than before, would face this together.

It takes some fortification, of course, to go into any house in which a parent has died—somehow, the Acres presented even more of a challenge. This was also the house where so many parties had been given, so many friends joyfully received and talked to, so many stories had been told. And Franny had been something of a party animal herself—unlike Jack, who liked smaller affair.

So Eric hit on the possibly questionable idea of buying the largest vat of bourbon ever to hit the market—it would easily have filled a Victorian hipbath….

Well, we were equal to that task….

And it may have been a good thing. For as always, Franny hit us, first thing on entering the house.

Silence—as prevailing and lingering as the wood smoke from the Norwegian smoke had been.

Well, silence is something we don’t do well—either in Puerto Rico or in the Newhouse family. We cast around for rescue.

Fortunately, the Zanas—as ever—proposed coming out a few days before the party and bringing us food and diversion. This was quickly agreed to.

And they brought the stories—of Jack sitting down to eat his Chinese food, closing his eyes, savoring, and saying, “hmmmmm….” The talk turned a bit metaphysical.

“You know,” said Bess, “it’s a curious thing—I always associate my mother with deer. And once, when my sister and I had been talking about her, after she died, I went to the window and told my sister ‘wouldn’t it be wild if I opened the curtain and there was a deer?’”

Don’t have to tell you, do I?

There wasn’t one deer…

Just fourteen or so. All grazing gently, moving without care or concern.

You can imagine Bess and her sister….

“Might not have worked in New York City,” I was about to say, when…

…we were jolted out of our seats by the smoke alarm. I tell you the explicable because it leads so well to the inexplicable. No one was smoking—of course!—no one was cooking. There was no fire of any kind, and no smoke in the house.

And those babies are LOUD! So I grabbed the thing from atop the beam supporting the roof—Norwegian American height does come in handy, despite banging my head on every Frank Lloyd Wright entrance I’ve visited (he made all his entrances just an inch of two above his own head, the arrogant bastard)—and took it outside, where a strong breeze was blowing.

Clearly, someone had her finger (note possessive adjective) on the “test” button. The alarm wouldn’t stop.

Not at all sure that it would work, I removed the battery. And you-know-who took her finger off the button….

A silence even greater than the night of our arrival fell.

So she was there, all right. Well, why not? It is her house.

Though about to be sold.

But it may be that she was ready, at last, to go on. When the night of the party arrived, the weather finally turned warm—it had been a week of cold, sullen, spiteful rain. But at last it was warm—warm enough for the shorts I had blithely packed.  Relief!

At 1:40 in the afternoon—two years to the minute from her death, Eric and I listened by ourselves to the Beethoven.

This is called emotional preparation.

Within seconds, each one of us was weeping silently, shaking or rocking in our individual chairs. At the end—after 17 minutes of the most wrenching music Beethoven could produce—we stood and hugged.

Yes, a bear hug.

One of Eric’s specials—now gratefully received.

And then the hosts arrived, all 16 of them. Their party was to start.  We two guests welcomed them at the door, and let them go to it.

Of course they brought the food—and what food it was! They brought poetry as well, and what poetry it was! And the evening grew dim—the classic Wisconsin sunset that I had known, two years ago, had been revived.

It seems that no Newhouse can NOT have the last word, the last story.

I moved to the speakers I had bought. And played the Heiliger Dankgesang. If she had spent eleven days fasting to her death, some of her dearest friends could spend 17 minutes reliving it.

And we did. The light fell—softly, gently—and at last the violist announced her noble theme. The others joined. It became unbearable, as Beethoven took the theme, expanded it, came to a climax, retreated, rethought, reworked, reconciled, and then….

…rejoiced.

“That was amazing,” said Eric, after the last guest had left.  “Wonder what an outsider would have thought of this event….”

And then, the porch light went out.