when he lost his mind

We were on something like the 15th round of rummy, and my father was winning decisively. He cracked a wide, toothy grin as he laid his cards on the table. “That’s 321 for BaBa, and 227 for String Bean,” he said, tallying the ledger we were keeping on a piece of scrap paper.

The 6th Floor

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Jeneen Interlandi on dealing with her father’s mental illness.


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Elinor Carucci/Redux, for The New York Times

The author with her mother, Patricia, and her father, Joseph.

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Before he finished writing the numbers, he began a rapid succession of anecdotes about his first car. And his second. And his third. He reached for a magazine to show me the vintage Mustang he said he was planning to buy my mother for their 45th wedding anniversary, which, he reminded me, was just six months away. Then he began speaking Sicilian, instructing me to repeat after him: “Napeladan mangia pane!” (“People from Naples eat bread.”) “Calabrese testa dura!” (“People from Calabria have thick heads.”) My father has the most amazing blue eyes, and right then they were wide and eager, like an overexcited child’s. He was rambling, and the inflections of his voice betrayed sheer manic joy. It was a mood completely incongruous with our setting.
We were playing our card game at the Psychiatric Emergency Screening Services, or PESS, a small locked-down unit in the community hospital near my parents’ apartment in Somerville, N.J. Harsh fluorescent lighting fell on cracked and faded yellow walls. A disheveled, rail-thin woman paced and wept in the room across the way. Down the hall, a police officer guarded locked double doors.
It was early December 2010. That August, my father, who was 69, became abruptly and deeply paranoid. Convinced that nameless people were trying to kill him, he slept no more than an hour or two a night and started drinking after five years of sobriety. When his suspicions grew to include his immediate family, he became violent and threatened suicide. At one point, he tried to jump out of the car as my mother was driving down the highway on the way to the doctor’s office. On another day, he poured motor oil over her windshield as she was pulling out of the garage. More than once, he hit her. More than once, he threatened to burn the house down.
In rare moments of lucidity, he would cry and apologize, confessing that he was terrified. He didn’t know what was happening to him. But we did. He was given a diagnosis of bipolar syndrome in 2005, during a similarly disturbing period. He rode out much of that episode in a state psychiatric hospital, and having him admitted again seemed the best way to keep him and my mother safe. His lucid moments would pass quickly. Once his switch flipped back to manic, he would refuse to even discuss the possibility that something was wrong, let alone consent to seeing a psychiatrist.
The police had been to the house a couple of times, but there was not much they could do. In order for them to take him to PESS, or for the psychiatric screeners at PESS to commit him involuntarily, he had to be an imminent danger to himself or others. Domestic violence and verbal threats met that standard, in theory. But in practice, it seemed to mean that he had to be standing on the ledge of a building, or holding a knife to someone’s throat at the very moment the police arrived.
And so for weeks, we had been locked in a game of chicken: waiting for my father to do something clearly dangerous; praying like hell that it would not be his suicide or accidental death or the death of someone else. In the meantime, my mother had all but stopped sleeping and had started hiding the car keys and the checkbook. She would tiptoe around their one-bedroom apartment at night, waiting for him to doze off, then call my sister or me to unload her despair in a flurry of whispers.
Finally one December afternoon, he fell down in a neighborhood convenience store. The medics saw that he was disoriented. He thought the store owner was his son. He did not recognize my mother, who had rushed to the store when the owner called her at home. He said that he hurt all over and that people were trying to kill him. In the emergency room, he grew belligerent, shoving a doctor and nearly punching an orderly. That’s when he was injected with Haldol and sent to PESS.
As dismal as the place was, I felt relieved to be there. Finally he would be forced to talk to a psychiatrist, who I was sure would see right away that he was manic and dangerous and needed help.
While we waited for the doctor to evaluate him, my father did what mental health professionals refer to as double-bookkeeping. He remembered most of what transpired earlier in the day but still believed he was in the hospital to have his pacemaker checked. Even as we laughed together, I knew what would come: the psychiatrist would ask him about his behavior, and my father would deny all the paranoia, delusions and violence. He would curse and yell and try to walk out of the room. When the police officer stopped him, he would become enraged. And when I confirmed for the doctor that he had indeed done these things, and that we, his family, were asking that he be hospitalized, he would stop calling me String Bean. He would stop

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