That night, I dashed out of the hospital room and into the hallway, where a group of nurses caught up to me and returned me to the AMU room as I battled ferociously, kicking and screaming. It was my first, but not my last, attempt at escape.
CHAPTER 16
POSTICTAL FURY
Deborah Russo, an attending neurologist on the epilepsy floor, visited me on the second day to conduct yet another examination. She came during the morning shift, accompanied by doctors, nurses, and a few med students. They were “the team.” Knowing about my escape attempt the night before, Dr. Russo sized up the room and confirmed that all seizure precautions were being maintained before moving on to the basic neurological exam: “touch your nose, stick out your tongue,” etc. I interrupted her midreview.
“You need to let me out of here. I don’t belong here,” I confided, looking nervous. “They’re all saying bad things about me.”
“Who’s talking to you?”
“The people on the TV.”
Dr. Russo allowed me to ramble on for a few minutes before redirecting me. “Can you tell me a little about how you felt before you came to the hospital?”
“I felt like I disappeared.”
“Can you explain what that means?”
“It felt like I was tired. I was tired until today.”
Russo wrote down “too tangential and disorganized to give us a full history” and continued with her exam. “I’m going to ask you some basic questions, and you do your best to answer them, okay? What is your name?”
“Susannah,” I said, craning my neck toward the TV set.
“What year is it?”
“You don’t hear that? They’re talking about me. Look, look, they’re talking about me right now.”
“Susannah, would you try to answer my questions?” Dr. Russo said, motioning for a nurse to turn off the television set. “What year is it?”
“2009.”
“Who is the president?”
“Obama.”
“Where are you?”
“I need to get out of here. I need to leave. I need to go.”
“I understand. But where are you right now?”
“The hospital,” I answered, caustically. Dr. Russo moved on, shining a light into my pupils with a small flashlight, checking for constriction and eye movement. All normal.
“Susannah, please smile for me.”
“No more. I don’t want to do this anymore,” I said.
“It won’t take long.”
“I want out now!” I screamed, launching myself off the bed. The team waited out my outburst, but even once I was calm again, I continued to pace, tugging at my EEG leads and lunging toward the door. “Let me out of here!” I snarled at the team, trying to push my way out of the room. “Let me go home!”
Dr. Russo led me back to the bed several times, calling for the help of a nurse’s assistant. She green-lighted a dose of Haldol, an antipsychotic. Later, typing up her impressions at the nurses’ station, she wrote that the “patient appears to be manic and psychotic.” She had two possible diagnoses: “First presentation of bipolar, versus postictal psychosis.” “Ictal” means seizure, so postictal psychosis is psychotic behavior following a cluster of seizures. PIP, as it’s called, can persist for as little as twelve hours or as long as three months, but the mean is about ten days.14 In 1838 a French psychiatrist described the condition as “postictal fury.15” A quarter of psychotic people treated in epilepsy wards suffer from PIP.16
Later that morning, the third doctor, William Siegel, arrived alone. He introduced himself to me and then to my mother, who was already aware of his stellar reputation. A day earlier, she had mentioned his name to her general practitioner, who had said: “You got Siegel? How did you pull that off?” Siegel was charismatic and approachable. After the neurological exam, he extended his hand to my mother and said, “We will figure this out. Susannah will be fine.” My mother clung to these words like a life raft and nicknamed the doctor “Bugsy”—her own doctor gangster.
CHAPTER 17
MULTIPLE PERSONALITY DISORDER
The mind is like a circuit of Christmas tree lights. When the brain works well, all of the lights twinkle brilliantly, and it’s adaptable enough that, often, even if one bulb goes out, the rest will still shine on. But depending on where the damage is, sometimes that one blown bulb can make the whole strand go dark.
The day after we met Dr. “Bugsy,” Dr. Sabrina Khan from the Department of Psychiatry arrived and introduced herself to Stephen and me. She was the fourth doctor to join the team and had already heard about my two escape attempts: one in the early morning and one this afternoon with Dr. Russo. In her progress note, Dr. Khan described me as slightly disheveled and fidgety, wearing “revealing pajamas” (my tight leggings and a see- through white shirt) and playing with my dangling EEG leads. It was important for her to provide a visual picture to match the psychological one, because my rumpled, suggestive appearance could be a sign of mania: those on a high often forgo grooming and exhibit less impulse control, engaging in destructive acts like sexual promiscuity. Though I had no previous history of mental illness, I was within the age range for psychotic breaks, which tend to occur in the late teens or early twenties, but also frequently happen later in life for women.17
While she was writing, I announced, unprompted, “I have multiple personality disorder.”
Dr. Khan nodded patiently. I had picked one of the most controversial diagnoses in the field of psychiatry.18 Now called dissociative identity disorder (DID), it is a condition where a person exhibits several distinct and entirely separate identities, to the point that the patient is often unaware of the other “selves.” Some doctors believe it exists, and others do not (especially in light of news that its poster child, Sybil, was a fraud). Many patients conflate DID with other types of mental illnesses, like schizophrenia. In any case, I was clearly confused.
“Have you been diagnosed by any psychiatrist or psychologist in the past?” she asked gently.
“Yes. A psychiatrist said I had bipolar disorder.”
“And were you taking any medication for that?”
