They woke me up in the middle of the night to transfer me to Research Psychiatric. It was quiet in the ward: Everyone was asleep. Back then, in the winter of 2010, I had extraordinarily vivid dreams, and I loved to dream, because I often dreamt of my children and other good things that were no longer part of my waking everyday life.

“Can’t we go in the morning?”

They took the handcuffs off my wrist but stood very close to me as I got out of bed.

“We don’t decide when you get transferred. Your ambulance is here. You’re going to the psychiatric ward.”

“Why an ambulance?” I asked the ambulance fellows, downstairs at the doors. “Can’t we just take a car?”

The truth was it was walking distance. Maybe two blocks. It’s all on the same hospital campus.

“It’s a liability thing. You’ll get a bill for it. You’re not going to try to run on us, right?” the EMT said. I was shivering in my hospital robe and slippers. It was very cold outside, where the ambulance was waiting. They wrapped a strange, padded vinyl silver blanket around me. I was hot immediately. The field beyond the parking lot was covered in snow. The stars were bright. I thought, that’s what I’d like to be. As far away and indifferent as something in the night sky.

“Run where?”

“You can sit up here with us,” the other EMT said. “It’s not strictly according to regulations, but what the hell.”

It was a bench seat and I sat in the middle, between the driver and his partner.

“It’s like ‘Bringing Out the Dead,’” I said. “Did you guys ever see that movie?”

“Uh-uh,” the driver said. The other one said, “I think I saw it.”

“If you saw it you’d remember,” I said. “It’s about an ambulance driver.”

“Nicolas Cage. And he sees ghosts, right?” the driver said. He had a beard and looked about 20 years old.

“That’s it. You did see it.” I paused for a second. We were pulling up to the psychiatric building.

“You guys ever see any ghosts?” I asked.

I believe that suicidal people can see ghosts in a way that sturdier folks cannot. The Canadian physician and addiction expert Gabor Maté describes addicts like me as living “in the realm of hungry ghosts,” people who have become ghosts while still alive. I think you can almost see when a deeply addicted person, who is killing himself with his drug of choice, is making the transition into the ghost lands.

“Not Scorsese’s best,” the driver said, ignoring or avoiding my question. “I always thought ‘Goodfellas’ was his real masterpiece.”

“Or ‘Raging Bull,’” I said. “That’s one of the saddest movies ever made.”

“I’ve seen a couple of ghosts,” the guy on my right said. “People see them. It’s a real thing. My aunt once had a ghost ask if it could kiss her. A female ghost.”

“No one wants to hear that B.S.,” the driver said briskly, interrupting his buddy. “We’re here. At the psychiatric hospital,” he said, giving the ghost guy a pointed look.

At Research Psychiatric Center, in a tiny claustrophobic office just off the main waiting room—it was, I’d guess, 4 or 5 in the morning—a thirtysomething slender, pale intake nurse asked me: “Are you feeling suicidal right now? Are you having suicidal thoughts?”

I don’t know why, but I was honest with her. Maybe I was still high from the Benadryl they’d given me at the hospital to keep me calm, or maybe I was at the end of my rope.

“Well. Glad you ask. If you leave me alone in here, I will slash my wrists with your scissors. I will hang myself with the blinds. I will electrocute myself with a fucking fork. Yes. What do you think?”

“If you’re feeling violent ... are you threatening me? Are you thinking of attacking me?” She picked up the phone. I noticed she had chubby hands and fingers that tapered down like pyramids. She had a no-nonsense expression and an all-American appearance, with clean, nicely brushed brown hair. She looked like she could have been one of my eldest daughter’s friends, and I regretted what I had said. She was just doing her job.

“No, I’m not feeling violent. I apologize. I’m not having suicidal thoughts.”

I had forgotten to lie about what I was thinking, which is the cardinal rule of intensive psychiatric care: It’s like the “deny, deny, deny” rule for adulterers. With psychiatrists, “lie, lie, lie” is the only way to survive, the only hope of ever getting out of there.

“I just want to sleep. I’m freezing. Are you cold? It’s freezing in here.”

I had the too-hot silver blanket from the EMTs. But it was cold in her office, and I was in the mood to complain. I was still in the hospital robe. I’d lost the slippers, and I was barefoot.

“I’m sorry about the temperature, sir, but I would appreciate it if you would try to use civil language with me. What have they done with your clothes?”

“I need some socks. I don’t have any clothes. They found me in a bathtub.”

“Oh I see.” This did not dismay or even surprise her. In fact, it seemed to reassure her, like now we were making some progress. She typed it into her computer. “Well, there’s a bed opening in the morning in the annex. I think you’ll have to wait for a few hours here. We’ll finish your paperwork, and you’re welcome to take a nap in the waiting room if you like. I’ll find you a real blanket. You should have someone bring you down some clothes.”

“Can I make a phone call? I’m sure I can have someone come right away. That would be really helpful, actually.”

The white office phone sat there on her desk. Her cellphone was beside it.

“No. No, I’m afraid not.”

Unlike when you’re arrested, when they whisk you off to the madhouse, there is no guaranteed right to a phone call.

She went to get me another blanket and I heard her lock the door behind me. She took her cellphone with her and when I tried to dial an outside line on her desk phone I couldn’t get through. It requested a security code. I sat back down in my chair when I heard her at the door. She gave me an irritated, suspicious look when she came into the office.

“There’s a camera right there,” she said, and pointed to the corner above her desk.

She handed me a red cotton blanket and some blue cotton slippers that looked like they had been left behind by another patient. They were too fuzzy to be institutional slippers.

“You’re going to have to wait in here with me,” she said.

I was regretting not making a run for it while they were putting me in the ambulance. Those guys were bigger than I am and no doubt faster, but I could have found a place to hide. Dejected, I put the red blanket around my chest like a towel under the silver blanket so that I’d be more comfortable. And then, on impulse, I stood up abruptly and tried the office door. It was locked. I startled her. She started to rise from her desk.

“Do you need to go to the restroom?”

“Yes,” I said. “Please.”

This was my chance. There were a few chairs in the little waiting room and a security guard was talking to a nurse or orderly who sat behind a desk behind a counter with a sliding glass front, like in a doctor’s office. The door out had a big metal push bar. It was a frozen Kansas City winter night out, but if I were free, there would be opportunities. Something would present itself.

This is how I thought at that time. Everything was one second to the next. I truly couldn’t conceive of tomorrow. Things were just happening, and they were either good or bad, and I wanted to get away from the bad things and find the good things; or, if there were no good things to find, kill myself to get away altogether. It was basically the opposite of what William Blake and Søren Kierkegaard might have been talking about when they wrote about the bliss of immediacy in mystical experience. I had an immediacy of despair, I suppose. Or I just couldn’t bear to think more than a few minutes ahead, because I knew what was coming.

I twisted away from her and ran for the door.

She said, “Sir,” and the security guard turned. But I was too quick for them. He didn’t have time to get up.

I’d made it! Bang! Hit the metal bar! Dropped my silver blanket.

The door was locked. I pushed against it again with my whole body. For a moment, imagining liberty, I rested my forehead on the cold glass. Then I turned around, shrugged, and tried to act like it was their fault.

“Why did you do that?”

“I’m sorry,” I said. I knew I had betrayed her trust. Plus, I was stealing her slippers.

“Do you still need to use the restroom?”

They didn’t say anything else about it. I expected some kind of formal reprimand, perhaps a punishment or restraints. But it was like it never happened. It must happen more often than you think.

“Yes, I need to use the bathroom,” I said. There was a door with a men/women/wheelchair sign on it. I went in and saw there was no lock, nor was there an air duct you might climb into like in a movie. The architects clearly knew what they were doing.

I sat on the toilet and cried. Then I stopped and looked in the mirror. It was a normal mirror, not a stainless steel one like you find in many institutional settings, and it was the one thing you might use to kill yourself with. I could smash the mirror and slash myself with a shard of glass. If I had been a different person, I could perhaps have used a shard of glass to menace someone into an escape. But all of my fight was exhausted by my useless dash for the door. I was defeated. I doubted I could break the mirror if I tried.

In the mirror, in my great self-pity, I looked like I was about 12 years old. My eyes were large and red, my face was pink from the cold and my hair, freshly washed from my stitches, was tousled and boyish. I wiped the tears off my face and for a moment relaxed the armor of irony about my ridiculous situation. I let myself feel very, very sorry for myself. I wanted my mom.

For years, growing up, I was consumed with the thought of suicide. My awareness of my inadequacy seemed to require a resolution. This sounds shamelessly self-gratifying, but there’s really no other way to put it. Among my earliest memories is the desire to run in front of an oncoming bus. I was already thinking about suicide in a daily way when I was 3 or 4 years old, and this didn’t stop until I was in my early thirties. Every day, for as long as I could remember, I fantasized about suicide. When I was young, I imagined that I might even get to watch the funeral and the aftermath. As I grew older, I accepted that it was not because I wanted to see what would happen, but because I was sure I wouldn’t have to live any longer. Essentially, I started with the “Fame” version of suicide and transitioned to the “Consolation” version.

My parents divorced when I was 4, and my mother married a man who had seven children. That made 10 of us kids in the house, including me and my two brothers. One of my early memories of that new, dangerous family is attending my stepbrother Paul’s funeral after he leaped from an office building in downtown Calgary. It may be for this reason—the usual dysfunctional family reason—that both of my brothers have talked to me about suicide, and that my older brother seems to have it on a default setting, like I do (though, happily, he has never made an attempt, so far as I know). When we were in the jewelry business together, my older brother and I, we would sit and joke about killing ourselves, or in darker moods coming down off cocaine, we would commiserate about how much we needed to kill ourselves, and make each other promise not to do it.

As I tell my philosophy students when they come to me with their worries about suicide, I think it can be helpful to remember that suicide often seems to run in families. Maybe if you believe you have a genetic predisposition, it’s easier to resist the view that the desire to kill yourself is well-motivated. One example I sometimes mention is the Wittgensteins. Three of Ludwig Wittgenstein’s four brothers killed themselves, and Wittgenstein himself often reported the desire. The Wittgensteins were brilliant, hugely wealthy, important members of Viennese society: people who, superficially speaking, ought to have had every reason to live. Of course that’s not the way suicide or even just the very ordinary experience of the difficulty of life works. We don’t know exactly why we are miserable, no matter what our circumstances may be, and that is a significant part of the problem. I ought to be happy! I have every reason to be happy! And yet I am filled with self-loathing, with unhappiness, with self-pity. Meanwhile, other people around the world are dealing with the unexpected deaths of their children and are still waking up in the morning to make a meager breakfast for their hungry families. More proof that I don’t deserve to live.

When I talk to my mother about suicide, she changes the subject. Emotions frighten her, and she believes that talking about things makes them more dangerous. When I was 13 or 14, I told my father I was thinking about suicide very often. He explained that people who kill themselves go to “the astral hells.” My father was a New Age guru and believed in reincarnation and many different planes of existence. “Don’t do it, son,” he told me calmly. “You don’t die. You just wake up some place much worse. But call me if you’re feeling that way. Are you feeling that way now?” I knew to lie to him, naturally: He was my dad. Thinking about it now, I realize he was right about suicide for me. Every time I’ve tried it, I’ve woken up someplace worse.

Once the hospital admission formalities were complete, they took me through some hallways and a couple of security doors and showed me to my room. It had two beds, a nightstand by each, two small dressers, a toilet and a shower. It wasn’t too much unlike a cheap motel room, only cleaner, unadorned and without the well-worn hominess that most motel rooms get. I took the bed by the door instead of the one close to the bathroom, which seemed less prestigious.

The floor was gray vinyl tile, but there were two big squares of yellow and one of red in the middle of all the gray, and I wondered about the tile layer who had installed the floor. Did he miss his home where maybe there was a tree with yellow and red fruit or flowers, or did he simply want to add a little color to the rooms of the people he knew would be sleeping here, people he knew would be scared and sad?

A nurse came in, checked my blood pressure and heartbeat, and then took a blood sample. This is something they do all night long, for reasons that seem diabolical. Every two hours. Wake you up, stick a thick needle into your arm, take your blood.

“It’s almost time for your meds and breakfast. You want to go on and wait with the rest of them.”

There were more people in the main entrance area—men and women, younger than me and older than me. There was also a round receptionist area, which separated our side from where they kept the dangerously crazy people. That was where they sent you if you really misbehaved. They had honest-to-God padded rooms, I was told, like in the movies, and many different kinds of restraints. Personal Safety Rooms, they called them. Aldous Huxley couldn’t have come up with a name so sinister. I had never been in a Personal Safety Room and I knew that, if they put me in one, I would go crazy.

People were crowding around one of two portable medication stands—they look like the kind of tall rolling tool chests you see at Home Depot—and I sat and waited on the floor for the walk to breakfast next to a woman who was being released. “You going to line up for your medications? That’s the best part of the day,” she said and smiled at me, a gentle, resigned smile that was like shrugging her shoulders. “I don’t think they have my prescriptions yet,” I said. She had red hair and a drawn face. She was too skinny. She didn’t ask me why I was entering, and I didn’t ask her why she was leaving. She told me she was a high school math and science teacher. She said her husband hadn’t divorced her yet, but he had moved out and wouldn’t let her see the kids.

“Mine hasn’t divorced me yet either,” I said, “but we’ve been separated a while. Sometimes she lets me see the kids and sometimes she doesn’t.”

“That’s how they do you,” she said.

“I guess technically she’s my wife, not my ex-wife. But she’ll be my ex-wife soon enough, I’m sorry to say. Sorry, I’m talking too much. I’m nervous.”

A nice thing about the psychiatric hospital is that you’re allowed to say how you’re feeling—so long as you’re not talking to your psychiatrist, who will use it against you. But I knew if we talked about our children for long we’d both start crying, so I was grateful when she changed the subject.

“Do you want to go outside and smoke? They give out the drugs and then they let everyone out to smoke. Then it’s breakfast. You’ll get a smoke break every two hours. You can have the rest of my pack.”

“I don’t smoke,” I said. “But I’ll go outside with you. The outside is the only good thing about this place.”

“What are you doing here, anyway? It’s none of my business. Hey, Debbie,” she told one of the nurses, “we’re going to smoke. If my paperwork comes up, that’s where I am. I’ll be right back. Don’t forget I’m out there! You’re going to be too cold without a coat,” she said to me. “Here, why don’t you just put on my coat, since I’ve got two sweaters on and my boots.”

We stood and she put her big jade-green parka over my shoulders. She was wearing well-worn, expensive-looking brown leather riding boots.

“Martin? Clancy Martin?” The nurse at the med station was looking around and calling my name.

“Those are your meds,” the teacher said. She smiled at me kindly. “You sure don’t want to miss those.”

“That’s me,” I said. “I’m Clancy Martin.”

“I don’t want to have to look for you next time,” the nurse said. He was a soft-featured man who looked a bit like Barney, the sympathetic psychiatric nurse from the Hannibal Lecter movies.

“I’m sorry.”

“I’m just teasing you,” he said. “I know it’s your first day. What’s up with the coat?”

“It’s hers,” I said. We both looked at the science teacher, who had sat back down on the floor. Barney gave her a smile and a little wave, and she smiled and waved back.

“Rosalind? She’s a buddy of mine,” he said. “OK, let’s see what we’ve got here.”

There was my regular antidepressant, an “antidepressant booster” and three new medications I hadn’t taken before. They were also putting me back on lithium, which was not a good drug for me. Six drugs.

I asked Barney what the new medications were for.

“I don’t need all this medication. I do need my Valium, though.”

“They don’t have you down for Valium,” Barney said. “I’ve got Ativan here. It’s less addictive.”

It had taken me months to get off Ativan, which I had done the year before, using Valium to taper down.

For me it has gone:

1985 - 2009
Booze, and occasionally a little cocaine, speed or weed

2009 - 2010
Baclofen, Ativan, lithium, Wellbutrin, Zoloft, and two or three others with chemical names

2010 - 2011
Baclofen, Ativan, Zoloft

2011 - 2015
Valium and Zoloft

2015 - December 31, 2016
Valium

2017 - Present
Drug-free. (I sometimes still take Valium from an old prescription on plane flights and long taxi drives for nausea. I stored up about 3,000 mgs when I was tapering off for the purpose of using them to kill myself, if necessary.)

“I’ll take the Ativan. At least until I can get Valium,” I said. I was starting to get those little waves of electricity that run through your arms and legs and make your mouth dry when you need your benzo. “What are the others for? I don’t want to get started on a bunch of new drugs. It’s too much work to get off them.”

“You’d better ask your psychiatrist. Let’s see who they got you down for. Dr. Ellis. He’s all right. You’ll like Dr. Ellis.”

“That’s my doctor,” Rosalind told me from the floor. “That’s good luck. He doesn’t like to keep people in here for more than a few days. He diagnoses everyone as bipolar and mood disorder. He’ll put you on lithium.”

“Yeah, they just put me on it. I don’t like it. I’ve taken it before.”

“It’s harmless, though. I’ve been taking it for three years now and I don’t notice any difference at all. It sounds scary but it doesn’t have any kick. The ones you should watch out for are the ones that give you a high.”

“Yeah,” I said. For the past year or so I’d been trying to avoid the stronger benzos. But during AA meetings, when I was first getting sober, I ate Ativan like they were Altoids. I came to love the flavor. They are a little sweet.

“Klonopin, that’s the worst drug I’ve ever been on,” she said. “I’d rather be back addicted to Oxycontin than have to come down off Klonopin again.”

“One psychiatrist told me to cut back to three glasses of wine a day and two Klonopin,” I said. He was an interesting fellow from Egypt who had his medical practice near my university. “I tried to kill myself after about a month on that regimen.”

“I like the sound of that,” she said, and laughed. “Come on, let’s smoke a cigarette. I’m about to get out of here. The principal of my school is coming to get me. He’s a good guy. I guess I’ll stay tonight at his place.”

I raised an eyebrow.

“Come on, it’s nothing like that. He’s married. Not that I’m saying I wouldn’t. I would. He’s very attractive. But married is off-limits. That’s what started all this for me. Married men. They’re more like heroin than heroin. That’s my thing: downers. Watch, I’ll be back on dope three months from now. Then in six months I’ll be back here.”

“Come on, now, Rosie. That’s no way to talk,” Barney the nurse said.

“Yup, downers. That’s why I like married guys rather than single ones, I guess.” Rosalind gave me the same shrug and smile.

“I’m married,” Barney said, and that made me laugh. It was the first time I remembered laughing because something was honestly funny in a long time. It was my normal laugh.

I repeated it when we went outside into the yard so that Rosalind could smoke: “I’m married.” Rosalind started laughing too. There were a couple of trees in the yard and a wooden fence, probably 12 feet tall, and a wooden door on the far side of the fence. If you climbed one of the trees you could probably walk out on a limb and jump over the fence. But you’d have a 15-foot drop or so. My ankles broke easily. I had broken both of my wrists and both of my ankles at least once when I was a kid, climbing trees and jumping off our garage into the sand, plus my elbow at a roller rink. I broke my foot as an adult stepping off a four-foot ledge.

Anyway it didn’t seem like a practical escape plan, climbing the tree and leaping out into whatever was on the other side of that wall. Probably a parking lot for cops.

“I’m getting my feet all wet,” I said. My slippers were muddy. I liked watching Rosalind smoke. She hid her cigarette under her hand like it was a secret. I kicked at the snow. It was mostly melted in the wet paving-stone-and-grass courtyard but there was a crust running against the brick wall of the building. Rosalind looked over her shoulder, threw the cigarette into the grass and lit a second one. A kid in a black wool hat bent over and picked up her half-finished cigarette.

“I just got out of jail,” I said. It seemed relevant. In fact it had been a couple of weeks, but it felt fresh.

“They brought you over from county?” Rosalind asked.

“No. I just woke up in the hospital and then they brought me over here.”

“You’re lucky. Usually they’d put you in the tower. It’s awful up there—like you’re stuck in somebody’s bad dream. I was up there once for a week before they even knew who my psychiatrist was. They give you your meds and forget about you. If you have lousy insurance that’s where you go. All the homeless wind up there. They don’t even separate the violent offenders from the regular ones like us.”

I had been up in the tower. It was indeed an awful place. My father had died in a tower like the one we were talking about, in a mental hospital for indigents in Palm Beach, Florida.

“Yeah, I’ve spent some time in the tower,” I said.

Rosalind looked at me with surprise.

The sun was out and it was warming up a little.

The whistle blew, and we went back inside. Rosalind’s paperwork was ready, and she gave me a hug before she left. She wrote down her email address for me. She fished around in a big yellow canvas duffel bag and pulled out a coffee-stained hardback copy of Richard Yates’ Liars in Love.

“Did you ever read this?” I shook my head no. I had read it, but I believed she would be happier if she thought she was introducing me to the book. I had almost pretended to be a smoker and taken her cigarettes. “He spent a lot of time in mental asylums. He was an alcoholic. He was crazy, too, really crazy. So we all have that in common. I didn’t know about him, but the last time I was in here someone showed it to me, and it’s great. It was still here when I got back, and I was going to steal it because basically it’s the only good book we have, the rest is romance novels and Stephen King and the Bible, though we have The Shining, which is good, of course, but since you came now I think I should leave it. It’s yours if you want it. Nobody here reads. They all just argue about what channel to put the TV on.”

“Thank you,” I said. “I was hoping I would have a book to read.”

I didn’t know if there was anyone who would bring me books. During one stint at Research, I had Rebecca, my wife at the time, bring me The Collected Shakespeare, for the volume and the variety, and that was a mistake. I must’ve thought it would make me look cool and smart, but I felt silly reading it in the common room. It was good for going to sleep at night.

“I’ve read it about 30 times now and honestly I think it’s probably not helping me with my recovery. Dr. Ellis says we should stay away from books that are written by other addicts or about other addicts. He says even literature about recovery can trigger a relapse. But I mean ‘Heroin’ is my favorite song. Am I really never going to listen to Lou Reed again?”

“Don’t ever read Alvarez’s The Savage God,” I said. “I read it and Styron’s Darkness Visible in a hotel room downtown a few years ago, and I tried to kill myself about a month later. Back in 2008. Well, 2008 or 2009. It was New Year’s Eve.”

That was the first time I’d tried hard to kill myself in Kansas City. I was working on a book and my editor, who didn’t know me very well yet, recommended I take Alvarez as a model. I was still a drunk at this time and one morning with a blistering hangover I skipped classes, checked myself into a nice hotel downtown and spent the day in bed reading Alvarez and Styron and drinking myself back onto my feet to come home to Rebecca and our children at 5:30 that afternoon. But the Alvarez—which is a study of suicidal poets—and the Styron—which is a study in the depression he suffered when he quit drinking—stayed in my head. A few weeks later, on New Year’s Eve, I was drunk on champagne I’d snuck out of the refrigerator and although Styron and Alvarez were not romanticizing suicide, they did make it seem inevitable. I hanged myself in a closet with a sheet. My wife found me when I started kicking at the door.

“Well, hell. I wish I was going to get to know you.”

“Me too,” I said. “I’ve never had a real friend in one of these places.” Which was true.

“Email me if you want when you get out. We dingwingers always say we’re going to email each other and then we never do. We’re not supposed to do that either, really. I dated a guy I met in here. Yup, you guessed it. He was married.”

“OK, Mrs. Maxwell, time to go,” the nurse who had Rosalind’s paperwork said.

“OK, time to go,” Rosalind said, and she hugged me. She was weeping. I felt like I had made a real friend and I didn’t want to let go of her. She was a mom who couldn’t see her kids. We could get an apartment together, just friends, when I got out. We could help each other raise our children.

Then she was gone. Later when I looked for the slip of paper with her email address on it I discovered I had lost it. But of course I could find her if I wanted to. How many Rosalind Maxwells were high school teachers in Kansas City? ^[1] Not her real name. I cannot recall her real name, and never looked her up when I still could.

The first time I was checked into a psychiatric hospital was after a suicide attempt back when I was 16 and living in Calgary, where I grew up. A psychiatrist had prescribed Librium for anxiety associated with a girlfriend who had broken my heart by dumping me for a basketball player at a different high school. Nevertheless, or rather for that reason, I was living with the girl and her family at the time—I had lied and told them my parents had thrown me out, so that I could stay with them and I could keep an eye on her, and they had kindly taken me in—and I swallowed the bottle of Librium with about half a twenty-sixer of rye in a snow-covered playground not far from their home. I took off my clothes and laid down in the snow. I remember the snow turning from white to blue to green to pink. I remember going from being so cold that I couldn’t bear it and then being very thoroughly wrapped, almost overwhelmed, in a blanket of warmth and contentment. I passed out, and should have frozen, but someone found me, saved me, and I woke up in the hospital and then spent a few days in the psychiatric wing.

I learned about other people who always fantasized about suicide—we already said “suicidal ideation” back then—and I learned the crucial fact that they won’t release you until you learn to say that you are no longer feeling like “hurting yourself.” I never wanted to hurt myself. I don’t like pain: If I could have killed myself painlessly, I would have been dead back in elementary school. I’ve always suspected that if we all had a switch on our hip we could casually flip, to turn off life like you turn off the light, none of us would make it to legal drinking age.

Not long after, the girlfriend’s parents threw me out, and I moved home again. That was back in 1983.

In 1991, in Austin, Texas, in my first year of grad school, I tried to kill myself again—slashing my wrists—and again I wound up in the hospital and later a mental ward. It was then that I started getting arrested for drunkenness. In the ’90s I was in the jewelry business, married to my first wife, and I thought about killing myself often, mostly early in the mornings when I was just opening the store. I would stand in front of the mirror with the gun in my mouth—it was an oily-tasting Glock with a squarish barrel—all very theatrical, safety off, and try to pull the trigger. I couldn’t do it. In 1996 I left my first wife and not long after that I tried suicide again—with a rope—and wound up in a psychiatric hospital in North Carolina. My alcoholism was accelerating, and with it, my depression. I married once more, moved to Kansas City, was arrested several times—always for drunkenness—and then in 2008 I tried to kill myself yet again, the Styron-Alvarez attempt, which led to repeated visits to psychiatric hospitals and eventually, after an affair with someone I worked with, my divorce in 2012.

This long litany of failure doesn’t explain much, though, except that I was a drunk and a bad husband. I guess in all of these things I can see now that I had developed a habit of running away: running away from myself with drinking, running away from one lover to the next, running away from life with an attempted suicide when I couldn’t bear the sight of myself. So I should confess it here: I am a coward.

A friend of mine asked me recently: How is it that you continue to live a normal, productive life as a philosophy professor, father and writer with this brain chemistry? And one answer is: What other option do I have? Either I’d be dead or I’d be locked up. I’m alive, and I have a terrible fear of being locked up. So, like the rest of us, in our many different ways, I’m making the best of a bad situation. My present wife, Amie, who has been a Buddhist all of her life, once remarked to me that she found enormous consolation in the Buddha’s observation that life is suffering because, as she said, “I realized that it wasn’t something wrong I was doing. Everybody feels this way.” Of course, like all suffering, the suffering of needing to escape is worse some days and better others, and I suppose if it ever got so bad that, as David Foster Wallace says, it was like the choice between being burned alive and jumping out of a burning building, maybe I’d do myself in properly rather than making another failed attempt. Today, for example, I’m a bit discouraged but otherwise happy to be here with the rest of us.

Another answer to the “How are you seemingly keeping your shit together?” is: practice. Still another is: well, wait. In the past, I’ve held it together for a while, and then things fall apart.

There were three phones on the wall near the smaller rec room that we could use almost whenever we wanted—between 10 a.m. and 8 p.m.—and unlike at jail, a phone was always available.

The phone was important to me. It kept me from growing too claustrophobic. We could call out when we wanted to, but it was a complex system because you had to ask the nurses to turn on the phone and then usually it disconnected as soon as the other person answered and then they would have to call you back. Some patients who answered the phone actually tried to find you, but others just said, “I don’t see him” or “He’s not here” or “Clancy who?” and then hung up. It was hard not to get angry at these people—many of us were desperate for any kind word from the real world—but I never saw the point of losing my temper with another crazy person.

I knew very well that I had only one person I could call: my older brother Darren, who would tell our mom what had happened, who would in turn tell everyone else. I knew I shouldn’t call either of the mothers of my children because I felt certain they would conclude this was further proof that I shouldn’t be around my daughters. Previously I’d called the dean of my college or whoever I happened to be dating at the time. Curiously, although people always take your calls from jail, they do not like to take your calls from the psychiatric hospital. Or maybe it’s just that I have more access to a phone in the psychiatric hospital and so call more often. In both places, the problem is killing time without losing your mind, without panicking.

I called Darren at his jewelry store and asked him if he could come down from Calgary to get me out.

“I don’t know, Clance. It sounds like things are kind of dangerous for you right now. There’s an edge in your voice. Have you been having violent thoughts?”

“Come on, Darren, you know me better than that. I’m not dangerous to myself or to anyone else. I didn’t even exactly try to kill myself. I got drunk, and I got maudlin, and I called an ex-girlfriend, and then it was like she wanted me to kill myself, so I started making threats, and then I was drunk so I thought I had to act out the threats. It was stupid, yeah, but it wasn’t an actual suicide attempt.”

This was a lie, but it wasn’t entirely a lie. I don’t think I would have taken 40 Valium if I hadn’t been drunk, and if I hadn’t taken 40 Valium, I wouldn’t have tried to cut my wrists in the bathtub. So … it certainly wasn’t planned.

“You were in the hospital. They pumped your stomach. Come on, Clance.”

“I chose to kill myself at some point, sure, but it wasn’t deliberate in the rich sense of the word. It was like, spur of the moment. I need to get sober again but trust me, I have no desire to drink.”

I heard the sigh on the other end of the phone. “I know that’s not true, Clance.”

“Please. I just need to get out of this psych ward before they make me crazy. I need to get off of all these medications. I feel like my brain is nothing but chemicals. You don’t know what it’s like to have this chemical-y buzzing in your head all day. It’s horrible.”

There was a long silence on the other end.

“Clance, they have you on a 72-hour suicide hold—”

“Stop right there. Please don’t say ‘suicide’ to me right now. I am so sick of the word suicide. I am not going to kill myself.”

He spoke right over me. “—and then they have to release you. As long as you don’t do anything else. As I understand it, you just keep your cool for three days and you’ll be out.”

“They can renew those holds indefinitely, Darren. There are people who’ve been in here for six months. Just do me a favor and have your lawyer call. Please. Get your lawyer to call my psychiatrist. He controls the whole thing for me. His name is Dr. Ellis.”

More silence.

“Hello? Darren? Are you there?”

“You know you really need to try to put things back together with Rebecca, Clance.”

“Oh, please.”

“But listen, bud, I’ve got a customer. I’ve gotta—”

“What I need, Darren—”

He had hung up.

I finally got sober and stayed that way in 2012, and since then things have been much easier, though yes, there have been relapses and suicide attempts. These attempts have increasingly been conducted as secret experiments, because I can’t bear the thought of explaining to anyone, ever again, why I am giving up. But the time I’m telling you about now was 2010, a year when I tried to burn everything to the ground, and very nearly did.

I don’t know why the people who continued to love me through this time didn’t give up and cut me out of their lives. They must have been tempted to do so. My first wife, my second wife, my daughters (especially my oldest, who had to live through so much of this), my brothers, my colleagues at my university: They all continued to believe in me and support me. I was a petulant, deceitful, unreliable, manipulative, outrageously selfish and self-absorbed person. How do you repay that kind of a debt? How do you start to apologize for all of this? I guess you try to become a more honest and trustworthy person, you try to keep your promises, pay your bills, help them with their homework, call them on the phone. Don’t lie to them, if you can help it. You try to stay out of the hospital. If you’re a drunk, like me, you quit drinking. You tell them you’ll try to do better, and then you try to do better. You pray every night for some unknown power to make you a little less selfish.

One thing you don’t do is kill yourself. But I can see this clearly and then a moment comes when I am a child again and I see a subway coming and I have the familiar struggle of not leaping in front of it, just to be free, or sitting in the bathroom with a bottle full of more than 100 Valium that I have saved for a long time, sure that it is enough, and reminding myself of my promises. It’s no coincidence of course that I don’t choose the irrevocable methods. But then again, I have owned a gun, and many times stood on the edge of a building trying to jump.

A psychiatrist once told me: “Don’t not kill yourself because your children need you. They do need you, but they’ll be fine without you. Everyone’s parents die sooner or later. Here’s the real reason you shouldn’t kill yourself. Think of the example you’re setting for them.” A friend of mine thinks this view is bonkers, but to me it’s the only really persuasive reason I’ve ever heard for not killing myself.

Many people were in for three or even four days before they got to see their psychiatrist. The doctors looked at their charts and prescribed medications based on the case history but didn’t actually meet with their patients until they’d decided they were good and ready. Nobody could explain any of this to you except other patients. In this way it was exactly like jail. The only reliable information came from the inmates. They were also the only people who looked away from you when they lied. The nurses were like jail guards. They stared you straight in the eyes and said whatever they wanted. It was like they were talking to cartoons instead of humans so the normal rules of communication didn’t apply.

“What are you doing here, Clancy?” Dr. Ellis asked me. (That is not his real name.)

He was short and round and very Kansan. He wore an earring in one ear and cheap gray suits and shiny shoes. His cropped black hair was going gray, though I guessed he was in his late thirties or early forties. I was in no mood to tolerate his platitudes. To me he was just another lying psychiatrist I had to escape. But his hands were fine-boned and handsome, and I liked the way he rested them on his desk while we spoke.

“I don’t want to be on all of these medications. I don’t know why you have me on so many drugs. I take six pills twice a day. I don’t need to be on lithium.”

“Let’s talk about why you’re here. You tried to kill yourself, Clancy. You were in your bathtub and you overdosed on Valium and alcohol and slashed your wrists. How do you feel about waking up and learning that you could be dead?”

“Do you have any clue what you are talking about? You know they have a DSM-5 now, right?”

“Clancy you have no reason to be angry with me. I’m trying to help you.” He picked up a folder on his desk and turned through the pages. He tried to look focused. “It says here you’ve been doing fine. I’d like to recommend your release this weekend. But not until I’m certain that you’re stable. Maybe you’d like to talk about your drinking. Have you had any withdrawal symptoms since you’ve been here? I notice you’re not shaking. Your skin looks bright. Your eyes are clear.”

“No, I did not have any withdrawal symptoms when they checked me in and I don’t have any withdrawal symptoms now. I’m not in denial about my drinking. I know I’m an alcoholic. I am open to attending AA meetings, though in the past they haven’t helped me much. I’ve been going to the 12-step meetings here.”

We went back and forth like that until he wore me down and I sat there and said quietly: “Yes. Yes. Yes.” He knew what he was doing much better than I did, he understood who was in charge, and so of course I submitted, which was what everyone has to do. We were going to have weekly office visits after he released me. Then we’d switch to phone consultations if all went well. We’d moderate the drugs as necessary. If I continued to do as well as I had been doing, he’d release me on Sunday or Monday. He recommended I join the AA group that I had in fact previously attended.

“They’re very smart people, Clancy. I’ve never met a stupid alcoholic. Many UMKC professors attend those meetings. I think you’d feel very welcome there.”

Thinking of Dr. Ellis, I paced the hallways and stayed in the common areas to read so that the nurses couldn’t accuse me of being reclusive, which would get you extra time. I went to the group sessions for the same reason, though you could skip group as much as you liked. We knew this was a chessboard, a movie set, a scary game we all agreed to play, and really therapy wasn’t the goal. Recovery wasn’t the goal. The goal was just to get you to talk and act like everyone else who wasn’t presently in a psychiatric hospital, to make you pretend to be some made-up idea of ordinary. I wanted to approach the nurses at the station and say: “Let’s take five minutes and just be normal.” But I knew better than that.

I once mustered my courage, or was simply foolhardy, and addressed this point with Dr. Ellis.

“Do you have like a form? A list? I’m just asking. How do you decide whether or not I’m in a better frame of mind?”

“No, Clancy, I don’t have a checklist. I do try to assess whether or not you have accepted the fact that you are struggling. Whether or not you can see that you have some work to do on yourself.”

“But don’t you ever worry that we’re just telling you what you want to hear?”

“I’ve been doing this a long time, Clancy. I think I can tell when someone is faking it. Do you feel like you have to fake something in order to show me that you’re ready to leave?”

I was a jewelry salesman for years, and I specialized like any other salesperson in the art of seeming to be what someone needed me to be, of telling people what I knew they wanted to hear. But any child would know better than to answer a question like Dr. Ellis’ honestly. It was like he was feeding me the right answers.

“Of course not. I just mean that we all have fears we are afraid to express, we all have self-destructive ideas now and then, and it’s hard to know, in here, what you can be honest about.”

“You can be honest about everything. That’s the therapeutic process. Are you having self-destructive thoughts?”

The same question the intake nurse asked me.

“No, no, thank goodness,” I lied. “But I do worry they may return, you know, once I’m dealing with my ordinary stresses.” More bullshit. “But I guess that’s why we continue therapy after I’m released.” I was appalled, listening to myself. Like I could just sit there for hours, repeating clichés from movies about recovery, and his confidence in me would grow and grow.

“Exactly.”

Before landing inside Research Psychiatric this particular time, I’d once, as part of a DUI deferral, spent a long weekend in a minimum security prison that everyone was free to leave if he chose. Of course as soon as the guards discovered that you’d left, they issued a warrant for your arrest. But the fact that you saw the exits and understood you could walk out at anytime made it so much easier to be there, and in a more humane penal system, these prisons would be commonplace. There, the choice to remain was an exercise of the will, and it felt good.

I didn’t know it, but my desperation to escape from Research, like the panicked claustrophobia I suffered in every psychiatric facility or jail, was an expression of health and strength. As long as I still believed that I could live in the outside world, if only they would let me go, I still had some hope for myself. I still believed in Clancy.

But as I began to worry that I was fading from the minds of the people who had cared for me, that hope was dissipating. My regular psychiatrist from outside told me to “trust the people there. They know what they’re doing.” I called an old girlfriend and yelled at her for leaving me for the lead singer of a band, seven years earlier. She stopped picking up after that. I called my brother again and he said, “Clance, I can’t help you this time.” I screamed “Fuck off!” into the phone and hung up on him, refusing to call back until he called me first, which he sensibly never did. I didn’t understand why no one would believe that I would be OK if they’d just give me another chance, if they’d only help me get out.

One night, I was lying in bed because I had asked Dr. Ellis for something stronger. He had agreed immediately. But the new pills made it impossible to walk without falling down.

I guess I stayed there for a while, because people started to visit me. Veronica, a frightening woman whom the other patients avoided, with hair turned bright yellow from electric shocks (or so everyone said), came and sat at the end of my bed.

“So you’re going to stay with us, I guess,” she said. “I like it here just fine. I think it’s safe here. I’m glad you’re staying.”

“It doesn’t matter to me. I hate to be anywhere,” I said. “I don’t know why anyone is alive.”

“I do,” she said, and her eyes grew large and truthful. “Fear.”

Another time, after breakfast—I had lost my appetite but still went to most meals, because I knew they kept a chart on that sort of thing—I was lying in bed and thinking about my three daughters, and how I had let them down. I thought about watching “The Secret of NIMH” together and making them spaghetti carbonara, their favorite meal from dad. I thought about walking through snowy nights with my youngest in her Boba Wrap when she was a baby. It was the only way she could get to sleep back then. I doubted I could ever be a good father again, the father they deserved.

There was a knock on my door. “Come in,” I said, not knowing what to expect. It wasn’t a nurse. The nurses knocked before they entered, sometimes, but it was always just a tap and then the door opened. No one knocked for politeness.

The crier came into my room. We only called him the crier when he wasn’t around, obviously. He was a slender, tall, lean-faced man with a light beard, in his early thirties, handsome, a bit intimidating. He looked like the soulful guy all the girls liked when you were in college, even though they agreed that he wasn’t traditionally handsome. He cried constantly, unceasingly. He came into my room and loomed over me at the end of my bed.

We all knew this guy from group therapy and from meals, but we gave him his space. He never spoke to any of us. He walked through the hallways or sat in the TV room with his long, mournful expression and silently wept.

Suddenly I got really angry. What right did he have to come into my room and gawk at me with his gloomy face? Weren’t things bad enough?

“You really have just given up, haven’t you?” I asked him. I couldn’t look him in the eye. I stared at my feet in their oversized, gray cotton hospital socks. Then I felt him looking at me so I glanced up. He looked quickly away. I grew even angrier.

“It’s like you’ve found an easier way than suicide,” I told him. “It’s really chickenshit. You’ve just decided you’re going to live here. I could do it too. I could just say, ‘Fuck it, I quit.’ It’s better than killing yourself. No one’s angry at you. They keep feeding you your drugs and feeling sorry for you. And you just keep on crying like that. But no one feels sorry for us.”

He was still weeping, but he looked me straight in the eye. I don’t think I’d noticed before that he had green eyes. His grief seemed much more real than my self-pity, and that made me sick to my stomach. I got up to leave my room, but it really was hard to stand up, because my morning medication had kicked in. I sat back down on the edge of the bed. He sat on the bed across from mine, and we both looked at the wall, not at each other. Then, after two whole minutes of silence, he got up and left.

I never learned why he came into my room. Maybe he’d planned to speak to me. Maybe he just needed someone to be kind to him for once. Maybe he also felt abandoned by the people he loved. And then I’d told him the truth, and that was just the opposite of what he’d needed to hear.

I was afraid to speak to him because I knew that, in this moment, I had more in common with him than with anyone on the outside. I knew we’d actually be able to help each other. I knew that I was exactly where I belonged.

I went to the bathroom and vomited. Then I lay on the bathroom floor and cried for a long time. It was then that I gave up hope. I decided to become a resident.