A razor-sharp debut about a woman who goes so far off the deep end, she might never make it back up
Sam James has spent years carefully crafting her reputation as the best psychologist at Typhlos, Manhattan's most challenging psychiatric institution. She believes if she can't save herself, she'll save someone else. It's this savior complex that serves her well in helping patients battle their inner demons, though it leads Sam down some dark paths and opens her eyes to her own mental turmoil.
When Richard, a mysterious patient no other therapist wants to treat, is admitted to Typhlos, Sam is determined to unlock his secrets and his psyche. But she can't figure out why Richard appears to be so normal in a hospital filled with madness. As Sam gets pulled into Richard's twisted past, she can't help but analyze her own life, and what she discovers terrifies her. And so the mind games begin. But who is the savior and who is the saved?
In this unexpected and addictive psychological debut, A.F. Brady takes readers into the psyche of a deeply disturbed woman desperately trying to keep her head above water, showing that sometimes what's most terrifying is what exists in your mind.
|Park Row Books
|5.90(w) x 8.90(h) x 1.30(d)
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October 18th, 9:40am
I'm kneeling on the floor in my office, tying the top of the garbage bag into a knot, and squeezing out the excess air as I do it. The maintenance guys always leave extra bags at the bottom of the garbage can, so I can replace this one with a fresh one, and just dump the tied-off bag into the bin. I find this is the most discrete way of hiding the rank stench of alcohol when I throw up in my garbage can. I want to believe that my tolerance is high enough that I never throw up, but the truth is, more often than not, I find myself on my knees in my office the morning after.
My name is Sam. I'm a psychologist, and I work in a mental institution. It's not like the ones you see in Rain Man or Girl, Interrupted. It's in Manhattan. It doesn't have sprawling grassy lawns, and manicured hedges. It doesn't have wide hallways and eleven-foot doors like One Flew Over the Cuckoo's Nest. It smells like a combination of antiseptic and bubble gum because they added bubble gum scent to the antiseptic. The lights are fluorescent and the toilets are always broken. The elevator is the size of an airplane hangar and it's always full. I've been working here for six years and I've never been in this elevator alone. Someone pushes the alarm button every day.
The ceiling tiles on the unit have leak stains in the corners. All the doors are painted grey and have oval windows with chicken wire in the glass. Except the office doors. There are no windows on the office doors, and they're painted pale yellow. They all have paper signs on them saying things like "Lunch" and "In Session" and "Do Not Disturb". We have to make new ones pretty regularly because patients write stuff on the signs.
It always feels like once you walk through the front doors, the world gets smaller. It's impossible to hear outside sounds and even though I'm in the loudest city, I can't hear it in here. There's only one group room that faces the sun and that's where the plants are, but it's always dusty and no one likes to go in there.
We have a lot of different kinds of patients here, 106 of them. The youngest is sixteen and the oldest is ninety-three. The oldest used to be ninety-five, but he died a few months ago. There is one wing where the men live and another wing where the women live, and pretty much everybody lives in a room with a roommate. If a patient is violent or something, they can get a single room. Once patients find this out, they almost always become violent. What they don't realize it that a single room is just a double room with an accordion divider running through the middle, and when the room splits, someone loses a window. The institution is called The Typhlos Psychiatric Center and I've never asked why.
It feels fraudulent and silly and sometimes even comical, but I'm not any different from anyone else here. The clinicians are supposed to instill hope. We're supposed to take our talents and patience and hard-earned degrees and apply our education to the betterment of others. We pride ourselves on having it all together. We fancy ourselves the shepherds. We are told that this is noble and upstanding work, and a benefit to society. But it's all a pile of shit. We're no different from them. There's no line in the sand. In the end, we don't have canyons that divide us. We barely have a fissure. I have a key and an office and they don't. I came here to save them; they can't save me. But sometimes, the lines get blurred. People say: "if you can't do, teach." Well, if you can't save yourself, save someone else.
October 19th, 11:12am
There is a new patient starting this week. No one wants to work with him. His file is nearly empty, and the rumors churning among the staff have been filling in the blanks with horror stories and nonsense. (He murdered his last counselor; he refuses to do paperwork; he'll be a nightmare patient.) Even I don't want to work with him, and I am the one who takes all the patients no one wants. No one really knows what he is all about; what's true, what's a rumor. He has one of those charts where nothing is clear. He obviously hadn't answered the questions during the psychosocial evaluations. Most of what was written was garnered from his physical appearance and intake materials. He was definitely in prison; those records are clear. For twenty some years, although somehow the charges aren't written in his file. Then, halfway houses for years after prison. And now he's mandated to treatment as a condition of his probation.
We take so much of our power for granted; it only really exists because our patients aren't aware of their ability to fight against it. And then this guy comes in and starts unsettling everything. I guess I respect him, in a way. I had been napping in my office hoping that something would change, and I guess this guy may be the one to change it.
October 19th, 1:15pm
"Okay guys, what does hereditary mean?" I'm running a group counseling session. This is a psycho-education group, so I am supposed to be helping my patients understand their diagnoses. So often psychiatrists will tell a patient that he has something, and then never explain in plain English what that means.
"It means it runs in your family, right?" This is Tashawndra. She had eleven children. Every single one of them has been removed from her custody by social services. She isn't sure of the whereabouts of most of them, and she believes that two of them are dead, but isn't positive. This is her reality.
"That's exactly right, it means there is a genetic component. So which mental illnesses have a genetic component?" I'm up on top of the desk, where I usually sit.
"Cancer. My mom had breast cancer and I had to go get checked for it because she had it, but I didn't have it." Lucy.
"That's right. Cancer has a big genetic component to it, so it's important to get checked out if someone in your family has it. But what about mental illnesses? What about the kinds of things we treat here?" "All of 'em, right? I know that if your parents or your brother is addicted to drugs that you will probably get addicted to drugs, too. And people here are getting treated for that. You treat drug addicts here. And sometimes, if your family is depressed, you could get depressed, too." Tashawndra.
"Yeah, that's a big one." I say, wagging my finger in her direction, "depression has a genetic component. So does schizophrenia, bipolar disorder, and many of the other problems we treat here."
"So you're fucked, huh? If your mom is schizophrenic, then you can't stop it from happening to you, huh? It's like you're born fucked over. You're born to be crazy, right? Ha, like "Born to be Bad", that song? Born to be crazy." Tyler. Tyler has schizophrenia. He's twenty-two years old and very advanced for his age. He seems to have some greater understanding of the world that the rest of us missed somehow. He has peace with things that the rest of us struggle with. Tyler has forgiven.
"Well, no, not always. And watch your language. When you have a genetic predisposition, which means when someone in your family has a disorder, then sometimes you will get it, and sometimes you won't. It depends on what else happens in your life. It depends on whether or not you are exposed to things that will help you stay well, or things that will make you get sick." I'm bouncing my heels off the front of the desk.
"What kind of stuff makes you sick? Like drugs and stuff?" Tyler. "Because I know my brother did drugs in school with his friend, and then he was crazy after that. He got locked up but he was crazy, man. He never acted like that before he did those drugs."
"Drugs, sure. That's a significant one, actually." I'm nodding, and explaining, bright-eyed. "Also, poverty, abuse, growing up without both parents, not being able to get enough food, or go to school. They are kind of like strikes against you. So, if you have the gene in you to get depression or schizophrenia, and then you have these strikes in your life, too, you could end up with the diagnosis."
"Like three strikes you're out, right?" Tyler. Tyler and I talk baseball in the hallways. I'm afraid of running into him one day at Yankee Stadium.
October 20th, 7:44pm
When it's almost time to go home, I start to look at all the things I have been avoiding all day. I don't have a drink or a cigarette with me to help me look at these things, but I start to peer into the abyss anyway.
I know when I get home and I am alone, and my phone isn't ringing, I will be looking at this, so I may as well get it started now. Maybe it will ease the burden. Maybe I won't cry so hard when I'm at home. Inevitably the only thing that happens is I am going to be forced to wear sunglasses on the train home because my face will be swollen with misery and my eyes will be brimming with tears that somehow, every single day, manage to cling to my eyelids until the very second my apartment door swings open.
It didn't always feel like this. Sometimes things made sense. Back when I felt like I understood what was going on, and I wasn't just going through the motions. There was a time that didn't feel like this.
The subway is down. There is a fire on the tracks on the A/C line, and I have to get off the train a hundred blocks from my apartment. For whatever reason, I am walking now. I tend to think when I walk, which is probably not a good thing because I don't have any cash and I can't stop somewhere for a drink to help me stop thinking.
It's cold out. The kind of cold that makes your knees hurt and your lips get solid so it's hard to talk. My eyes are watering, but I'm not crying. I'm smoking back to back cigarettes, and I don't have gloves, so I have to keep switching hands.
Even though it's freezing, there are families out in the street. I've seen them since I got off the train. There is a mother pushing a stroller on the other side of the street, and we have been pacing each other for blocks. She looks like me. Well, she looks like my mom, and I guess I look like my mom, too. We're blonde, and I'm guessing the woman has blue eyes like we do, even though I can't see that far. She's small, like my mother is. I'm much taller than they both are; I always thought my dad must have been a pretty big guy. Now I'm stuck thinking about my own family as I walk south in this bitter city.
It was just me and my mom growing up. My dad is somewhere, but I don't know where. I've never met him but it doesn't really make a difference because mom was almost too much to manage on her own. Sometimes she sang his praises: "Your father is a wonderful man" and sometimes she shit all over him: "He's just some mick fuck who doesn't deserve me". I wonder if that baby in the stroller knows her dad.
My name is Samantha because my mom's name was Samantha. I think that's why I go by Sam. Our last name is James. So I have two first names. I always told people never to trust someone with two first names.
I can see my apartment now. It's the only one on the floor with no lights on. It's in an old, limestone walk-up building in the middle of the block. I've been living in New York City for a few years. I bounced around different studios and tiny one bedrooms in Brooklyn and Manhattan after I came here for graduate school. My current apartment has three closets, which is practically unheard of, and a bathtub. I have a desk and a coffee table and it could pass for a grown up apartment if I could just buy food to put in the fridge. My couch is brown and I have different pillow covers for different seasons. Now it's the dark blue ones. I have a carpet that's mostly sun bleached because my windows face north, so the summer sun is in here for the whole day, and I used to like the colors but now I think it looks like a little girl's carpet. My kitchen is very clean and has a window above the sink, so I can look out while I'm washing wine glasses and see what everyone else is doing. The radiator makes noise, which is comforting because if it didn't, there would be no sound in here. I never turn on the TV because it makes me feel small.
The front door to my building has a tricky lock, and it always seems to get stuck right when the wind picks up and starts to make my ears hurt. The dark green tile floors in the lobby always look dusty and I'm afraid I'll slip on them and crack my skull. The stairs are wide and rounded, from a New York era long forgotten, and as I wind up the stairs to my apartment, I peel off my outside layers.
I'm opening a bottle of wine that I bought at the liquor store across the street last night. I always make sure to be delicate and grown-up about my drinking. I drink every night, but that's okay because it's expensive wine that I drink out of expensive wine glasses that I always remember to wash before I go to bed. I also always clean my ashtrays, because even I think it's gross to have stale butts around the house. I quit a few times, but then I gave up quitting because something else is going to get me first anyway. Desperation makes you hold on to funny things.
October 21st, 8:55am
I'm sipping the acrid, burnt coffee from the lounge, waiting for my boss, Rachel, to start the clinical staff meeting. My nails are grimy and dirty, and the nail polish is mostly peeled off. I look up to catch my colleague Gary staring at me. He immediately looks away when our eyes meet, but then he quickly turns his head back to me.
"Yes?" I ask him, eyes wide.
He brushes the side of his temple with the back of his left hand and juts his chin in my direction.
He does it again.
I put down my red pen and coffee cup and wipe the sides of my face. I pull back my left hand to see a streak of unblended cakey makeup across my pinky. Crispy little bits of scab are dotting the makeup.
Rachel begins the meeting.
"Good morning, team. Nice to see everyone bright eyed and bushy tailed this morning."
Muffled laugher and sarcastic snorts.
"I know it's been getting a little overwhelming with all the new patients starting, but as you know, there are seasons and cycles that are at play with mental health, and with winter almost here, even though it's only October" -she shakes her fists at the windows -- "with the shorter and colder days come more depression, seasonal affective disorder, hopelessness, and the like. I'm not telling you anything you don't already know.
That being said, as you're already aware, we have another new patient, and he is starting today."
The staff starts to look around nervously; people start adjusting their shirts, looking down at notepads, trying to disappear into the noise.
"I've heard a lot of chatter in the hallways. I understand that it's natural to speculate, but it's very difficult to maintain unconditional positive regard, an unbiased attitude, and an open mind when rumors are being spread in this manner. You all know what I'm talking about." She glares at us like we should know better.
"Well, can you give us a little more insight into the story with this guy?" Gary.
"I'm not really privy to any more information than you are, so I am in the same boat as you. But, I am urging you to put your preconceived notions away, set down these ideas you have about him, and focus on the little information that we do have. He is coming here for treatment, for help, and your job is to provide that treatment without making the man into a monster."
"Look, I'm all for positive regard, and unbiased treatment, but isn't it important to ensure the safety of the staff?" Gary again. "I mean, I heard his file is incomplete because he attacked his last counselor. I heard he refuses to answer intake questions, and won't discuss his history, and if you pry, he goes ballistic. I mean, he's forensic, and I'm not sure I'm comfortable treating a patient who is known for attacking his counselor."
"Well, we are not in the business of turning away problematic patients." Rachel lowers her head, and shuffles out the file. "And there's nothing in here that indicates he has been violent with staff in the past."
"That's because there's nothing in there at all! The file is nearly empty. It says he is a big dude, and wears a hat and doesn't talk. It says he's been in jail half his life. But, somehow, is doesn't say on what charge? Hmm? That's insane! You can't have a forensic patient with no history, and no psychosocial, and no diagnosis, and nothing in his file, just waltz in here, and we're supposed to figure this all out from nothing!" Gary is exasperated. Gary used to be a social worker in the finance world. He worked for a firm that did corporate lay-offs, and Gary's services were offered to those individuals who lost their jobs. He always ended up feeling like the messenger and he couldn't hack it anymore, so he ventured into something he thought would be cushier, less dramatic, more sustainable on a daily basis. He went from the frying pan into the fire, and he is still looking around, bewildered, wondering how he got here.
Excerpted from "The Blind"
Copyright © 2017 A.F. Brady.
Excerpted by permission of Harlequin Enterprises Limited.
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