Cracked: Putting Broken Lives Together Again - Drew Pinsky, Todd Gold (2004)

Chapter 12

ON HER WAY to have lunch, Amber suffers the first in a series of flashbacks. The second episode occurs later that afternoon. Two weeks of treatment are taking a toll. Amber’s weight has dropped slightly, and she looks even more fragile than when she came in. The flashbacks are the worst thus far. These explicit visual memories of her abuse intrude upon her consciousness frequently, and without warning. They are probably what motivated her to use in the first place, long before she became addicted.

After dealing with the latest attack, Alexi stomps into the nursing station, where I am filling out paperwork. “She’s possessed,” she declares.

No, she is traumatized. “Those are the actual symptoms replaying themselves,” I say. “Can you imagine? They’re causing panic and anxiety at a time when her brain is already twitching from the effects of withdrawal.”

Getting through addiction is a roller coaster through hell, and this girl has the front seat on the lead car. It will be weeks before the burning and trembling sensations she complains about start to dissipate. It’ll be even longer, many months, before she sleeps soundly.

But that’s only one of the afternoon’s amusements. A few minutes earlier we took in a new admission. Before I check him out, I ask Alexi for her opinion of him. She opens a can of soda, then glances across the ceiling, as if she’s following the flight of an invisible airplane as it arcs across the sky and then crashes into the distance. “He gave off bad vibes,” she says.

I feel them, too, as soon as I meet him. Matty’s a big, strapping, muscular guy in a Metallica T-shirt, jeans, and work boots. He is twenty-eight, and his résumé includes a two-year history of GHB, a synthetic liquid downer with properties similar to Valium, that’s become popular with clubgoers and athletes. I have seen a lot of GHB and speed use in major league ballplayers. Just a Dixie-cup-sized dose can result in the same type of intoxication as a six-pack of beer.

Matty fills the room, even though he’s just sitting on a chair. He sits as if posing for a photographer. I sense he is enamored of his own muscular physique. He likes himself. I understand what Alexi meant by “bad vibes.” I can envision him cruising the unit as if it were a pickup joint. It won’t be long before this guy is acting out in a big way.

“Ever used anabolic steroids?” I ask.

“I’ve dabbled,” he says.

“By any chance, are you a pro ballplayer?”

He laughs. “No, I work in aerospace.”

Matty has come for treatment after going through some pretty significant upheavals in his life. A week earlier he had spent an entire day hammering boards over his windows, convinced that his boss, his mother, and his girlfriend had him under surveillance. Then, just the other night, he lost control at a bar and got into a fight. The cops taking him away found a trace amount of speed in his pocket.

“How much GHB have you been doing?” I ask.

“Three capfuls a day, give or take,” he says.

Acting as if my questions are a distraction, he starts checking out his right bicep. He flexes and moves his arm in different positions. He seems mesmerized. I sense his resistance, his cockiness, his disregard for anything other than his own gratification. His type is oblivious to the pain he causes in other people.

“Marijuana?”

“A little in high school,” he says. “It made me paranoid.” This from a guy who was boarding up his windows just a few days earlier because he thought surveillance planes were spying on him.

“Cocaine?” I ask, scrolling through a routine drug history.

“I had a run-in about four years ago for a summer.”

“Speed?”

“Occasionally.”

“How often?”

“I don’t know. Maybe two or three times a week. But I started smoking it lately, so maybe I’ve been doing a little more.”

He’s not bashful about answering questions, that’s for sure. He sits openly, true to character, his body language telling me to ask him anything. He started doing speed two years earlier. In the beginning it was a tool that helped him maintain his social life and work. Then the addiction kicked in. (I see a lot of students doing the same thing to help them through crazy study hours. They don’t understand that methamphetamine, like X, is one of those drugs that damages the brain. It causes mood problems and impairs memory. So much for academic performance.)

“You need to be willing to consider that these thoughts and problems you have had have been caused by the drugs you’ve been using. It’s typical of speed. Sometimes using only two or three times a week causes a slow, intense delusional preoccupation, and it’s almost always with family, co-workers, friends, and neighbors. You think they’re all talking about you.”

“I know it sounds crazy, but you need to hear this story,” he says. “We live by the airport. My girlfriend knows this guy who works in air traffic control, and one day he shows up at our house. He used to work for the FBI—”

Matty ended up thinking the entire L.A. bureau had him under watch. This is a pretty typical delusion among speed addicts. They all start with some innocent observation, around which they construct elaborate fantasies. The creativity and the detail are always astounding. It’s like John Nash, the character Russell Crowe played in the film A Beautiful Mind. The stories are easy to believe—to a point. I don’t think the U.S. government is too concerned about Matty, but he thought otherwise.

“I bet these experiences are taking a toll on your relationship with your mom and your girlfriend,” I say.

“Well, that’s why I’m here. I had to promise them I’d get help.”

“Good, that’s a good move,” I say. “I bet you’ve been really uncomfortable. You’re going to start to feel better with some more time off the drugs.”

“So I hang out here a while,” he says, nodding. “Cool. Just like my lawyer said.”

“There’s a lot of other personal work we’ll want you to do.”

“Whatever,” he says with a shrug. “This place doesn’t seem too bad. And some of the patients are kind of hot.” When I don’t react, he adds, “Just kidding.”

Except I know he’s serious. Over the next couple days, he bothers a number of women in the unit, both patients and staff, with strongly sexual, highly inappropriate remarks. Alexi issues a stern warning: Either tone it down or leave. Of course, that can only have so much effect; after all, he is out of control.

As dislikable as the situation is, we can’t forget that Matty is sick. His harassment is a symptom of the disease that has brought him here. Sexuality is another drug for many addicts, another means of activating the brain’s arousal apparatus to escape or manage unpleasant feelings. Sex makes Matty feel good. It’s like a pill. Women for him are merely sources of gratification; there isn’t much difference to him between compulsive drug use and compulsive sex.

Still, his behavior disturbs people. After another complaint from a nurse, one of many, I have to talk to him. As I head toward his room, I think how convenient and efficient it would be to simply kick him out. Good-bye; no more complaints. I can’t, though. He hasn’t violated any rules. He has just been obnoxious. So when I find Matty reading an old Sports Illustrated and greeting me as if I were a friend picking him up on the way to happy hour at the corner bar, it occurs to me to try to connect with him, in the hope of getting him to start following directions.

“Have you had any long relationships?” I ask.

“Yeah, after I left college,” he says. “There was this great girl who lived across the hall from me. She was the greatest. I really loved her. We hung out together. She was always around if I needed her. We’d have sex pretty often, and there were no strings attached. What do they call that now?”

“Friends with benefits,” I say.

“Yeah. Perfect description.” He laughs.

“Have you ever had a sexually transmitted disease?”

He brushes some of his black hair to the side. “About a year or so after college, I had warts. The doctor gave me something. My friend, she got upset when she got them, too. But no big deal, you know? We were friends. She understood.”

“There were other women, too, right?”

“I had other friends, sure. I slept with some of them.”

“How long were you with this girl?”

“Around a year, I guess. Eventually she started taking things seriously. Even though I was always honest with her, she seemed to want a relationship.”

“After being together a year, what did you think you had?”

“A friendship. An understanding. I was always up front about that. But then she developed feelings for me, and that wasn’t what we’d agreed on. Then I had another girlfriend who did that, too. She was this hot dancer. One day she just flipped out. We had to break that off.”

I can imagine that nightmare. The stripper. Drugs. Arguments about commitment.

“Dr. Pinsky—just so you know, my girlfriend now is the greatest.”

“How so?”

“She doesn’t pressure me or anything. She lets me do what I want.”

“Did she want you to come in for treatment?”

“Oh, yeah. She was real supportive. She and my mom have been talking.”

“Does she talk to your father, too?”

“My dad? Who knows where that asshole is?”

“Will we see your girlfriend in family groups here?”

“Family groups? I don’t know. But she’ll bring me stuff all the time. Anytime I want something.”

Perfect. He has a servant, a puppy dog at his disposal. I don’t know this woman, but I’ll bet she learned that caretaker role early, perhaps growing up with an alcoholic father. Other than the relationship she’s forged with his mother, she’s not much different from the stripper who came before her. She’s just dancing better.

I’ve heard this story before, so I know the dynamics of his personal life. His girlfriend tolerates him in order to maintain the status quo. She doesn’t want to lose him. She has her own issues. But there’s no real relationship, no discussion of feelings, needs, or love. Matty would find that too much of a hassle.

I wonder if he has any idea.

“How does she deal with all of your bullshit?”

“You know what? She was great until I got picked up after the fight.”

Later, I realize I’m worked up about Matty. It’s a delayed reaction. Talking to him put me into a blue funk. He’s in such deep denial that I can’t conceive of him getting anything positive from treatment. I hate to say that, but it’s true. It makes me feel I’m wasting as much time as the patient. My depression is compounded when I see Matty on the patio, talking and smoking with Amber. Then he moves on to another table and more women. It’s just a matter of time until he attempts to prey upon one of them.

Finley, as is his way, catches me at my worst and scoops me up like a flapping fish. I unload. I’m terribly conflicted. Yes, I am supposed to be treating Matty, but I have a serious aversion toward the guy. He uses women to gratify himself, and he does it without any regard for the consequences. He doesn’t appear to have any conscience about his behavior. Okay, out of pure frustration, I try to look at things another way. Maybe I’m jealous, I think. Maybe I wish a part of me could act on every primitive urge I felt.

“Drew, you couldn’t be less of a caveman,” Finley laughs. “You don’t like this guy. End of story.”

“Yeah, you’re right,” I say. “As I think about it, I thought, I might be reacting most strongly to what Matty represents. He’s a little older, but he epitomizes the whole hooking-up culture that’s screwing kids up all over. I was just talking about that with those students at Princeton.”

“What’s wrong with our culture?” Finley asks. “Where have we gone?”

“This is what depresses me,” I say. “Because I think we created it. I don’t know if we aren’t guilty. We opened the door in the 1970s. We celebrated sex, drugs, and rock and roll. We fantasized about what the freedom rock gods and movies stars had. That was me back in 1978. The Amherst student newspaper described the typical male student as athletic, intelligent, a beer in one hand, the other hand searching for a breast to grab onto. Get high, get laid. That was the rallying cry every weekend.”

“It was innocent.”

“It was misinformed. It’s not healthy. And instead of learning from our mistakes, we made the music faster and louder, and the drugs stronger and cheaper.”

“Go home, Drew,” Finley says. “Put on an easy-listening station. Stop at all the red lights. Keep the world righteous.”

“Go ahead, make fun. I don’t care,” I say.

It’s nice to know I can leave the craziness and go home where the TV is on, the kids are doing homework, my wife has got things under control, and everything is disorderly, hectic, and enjoyably normal. It is a short drive home from the unit. When I walk in, Susan is preparing dinner; the kids are doing their homework, and arguing about what they’re going to watch on television later.

I know this Normal Rockwell sort of family scene is fragile and precious. In 1995, we were vacationing as a family in Las Vegas when it was nearly torn apart. The children were horsing around in the hotel room when Douglas jumped off the bed and struck his head squarely on the floor. He lay motionless on the ground while the rest of us freaked out, me included. He began coming around by the time the paramedics arrived and rushed him to the hospital. There doctors found a cyst in his cerebellum, which had moved in the fall and momentarily knocked out his brain stem function.

With Douglas in the hospital and seriously ill, we consulted with specialists and plotted a course of treatment. A few days later we transported Douglas to Los Angeles, where surgeons at Children’s Hospital put a window in the cyst, allowing the cerebrospinal fluid to flow freely from the cyst. Douglas has been fine ever since.

My recovery has taken much longer. The emergency opened that old Pandora’s box of fears about the dangers I’m convinced are always out there waiting to happen to me. The repercussions drove everyone crazy. I was like my mother had been with me. My mother wouldn’t let me have sleepovers. She practically broke into tears as I pedaled my bike around the block. Now I started acting the same way; I didn’t want the kids riding their bikes anywhere, lest something happen to them. I never got as bad as my mother, but Susan still forced me to spend a little time in therapy.

And now? Nobody’s perfect, including me. I still go from all’s well to the end is near faster than anyone west of Woody Allen. Doesn’t matter that I spend half my day instructing patients to have faith that things will work out, I still expect to walk around the corner and be confronted by the worst. Consider tonight. Dinner is great, the conversation boisterous, and when the kids go to bed I marvel at how they can lay their heads down and fall asleep instantaneously. I run through a quick catalog of my fears. Will one of us get into a car accident? What about the flu? Then I turn my attention to the unit. Matty’s driving me crazy, but I would like to help him. What about Amber? She’s really going through a tough time. And Linsey? Did I do a good job? Am I doing all I can for these people? What about tomorrow? Admittedly, this is a none-too-healthy burden to shoulder on a daily basis. I’m just lucky that my fears of crisis are usually proved wrong.