It’s another slow night on Ward 6. Joanna says the CIA is transmitting instructions to her over CBS and won’t let anyone change the channel. Bill the Lawyer, as he insists we call him, came unzipped from his elbow to his wrist and was rushed to City Hospital to be restitched. He vowed to sue his surgeon for shoddy workmanship. Jack wouldn’t take his Dilantin because the stripes weren’t lined up on the capsule. He said I was trying to poison him, and what kind of nurse wears army boots, anyway? Heather tried to hang herself again from the aluminum rod in her closet. If she keeps gagging up her meals, she may soon be light enough to do it.

Me, I’m feeling a little better, thanks for asking. No panic to speak of, just a little uneasiness today in the cosmetics aisle of the drugstore and perhaps some dizziness seeing my reflection in the Tiffany’s window downtown—nothing unusual for a failed anorexic. I immediately closed my eyes, let my jaw fall slack and breathed deeply five times. The feeling passed just as the Calming Breath Exercise brochure promised. Later, on my back porch, I smoked a honey blunt Howie left for me. I don’t think I even need to smoke anymore—I could just light the cigarette and let it burn next to me in an ashtray. The aroma sends my mind into other foggy worlds where no one expects you to see clearly, because how could you?

Coming to work tonight has lifted my spirits, as usual. If you can’t feel good about yourself working in a mental hospital, then you’ve lost all comparative powers. And isn’t that what happiness is all about—feeling better off than the next person?

Howie says I shouldn’t aim so high, that happiness may be a bit out of my range at this particular time in my particular life. He suggested I strive for hopefulness, which he said is the state most people live in anyway.

He’s probably right. I told him that and he said, “You know I am.” It scares me that he can see so easily into my soul. When I told him that I’d put in for the overnight shift for the extra pay, he looked at me with that squinty gaze of his, kind of like Superman trying to see through walls. He nodded almost imperceptibly. He didn’t say, “So there’s no use my moving in with you if you’re not going to be home at night” because we both knew that’s what I meant. Howie rarely wastes words, just as he rarely wastes movement. At that moment he got up from the sagging sofa in my living room, smiled a little bit in my direction and left.

* * *

The first time I saw M. it seemed to me a pleasant place to be crazy. Acres of lawns gently rising and falling like a friendly green ocean. Giant shade trees with their roots heaving from the ground, perfect for cooling yourself in the stinging heat of August. Graceful buildings with lazy porches and massive central chimneys. A century ago the brick and ivy hid people with syphilis and dementia. They needed rest and peace and stayed for months, sometimes years. I could have lived there, then. Today the wards are filled with schizophrenic teens and jumpy heroin addicts and the genetically violent. Everyone is healed in seven days, max. We call it the “HMO cure.”

You drive in on a curvy road under an arch of sycamore limbs. Once inside the buildings, there are no more curves, nothing rounded or soft at the edges. It’s all straight and narrow and gray. The fireplaces have been cemented closed, the doors reinforced, the windows fitted with more bars. Everything is kept out as much as in.

Sometimes you can go a week at M. seeing nothing but the everyday paranoids and phobics. The doomsayers are still dribbling in but have switched their obsession from the new millennium to some more convenient, dateless Rapture. They’re mostly harmless, if you can stand their proselytizing.

Then you get somebody like Mr. Sam Ghadafi, a 300-pound manic, the classic shitty admission.

Just a few minutes after Domenic dropped off our nightly four-cheese pizza, we got the call to prepare for a man built like a gorilla. He came through the door with two policemen holding his arms, and two more trailing. His eyes were smoky. His head was thrown back. His hair fell long and tangled over his shoulders. Mr. Ghadafi went surprisingly quietly into the isolation room while we processed the paperwork. He acted the model patient. But after the police left he cried out as if his feet had been set on fire. The four of us on duty rushed to the observation window. He lowered his head and rammed the door. It was guaranteed to withstand any mortal strength, but I doubted it had been tested against someone of Mr. Ghadafi’s bulk and intensity. Lester ran to the nearest patient room, pushed old man Robinson out of his bed and dragged away the mattress. We flung it up to the door and leaned our collective 700 pounds against it. Every few seconds Mr. Ghadafi hurled himself into the steel frame and rattled our bodies. The door held.

* * *

On a night like this I miss Howie. I don’t think it’s healthy being a solitary smoker, just as I don’t want to drink alone. There’s a certain desperation to getting high that feels better to share. He rolls the nicest blunts for me, no spliffs or cones, just thin and firm, the way I like them. He doesn’t smoke himself, of course, but just his being here would be enough.

We haven’t talked since I changed shifts. He sent me an email saying that he realized I needed some space for a while. He said he didn’t mind waiting. He lets himself in with his key when he needs some supply. He always comes by when I’m not here.

Howie’s the only one who ever understood why I surround myself with certifiables. I like the fact that they’re exactly as they act. No pretense or affectation, which you get everywhere else in the world. I’m talking primarily about the manics and psychotics, of course. They have Ward 6 to themselves, and I often sign up to work there. You haven’t truly glimpsed the human mind at work until you’ve watched a manic. It’s as if they’re tuned into a very weird radio station only they can hear. Their delusions are so grand I can see why they believe them. I’d believe them, if I were them.

It’s a locked unit, of course, no sharps or flames allowed. The design is strictly Monet—all vagueness and hazy light. Victor the orderly suggested to Dr. James “Harvard Med” Riley that the psychotics might relate to a Dali on the wall or perhaps some of Picasso’s Cubist period. When the young doctor asked if he were an expert in therapeutic artwork, Victor got angry and grabbed him by the lapels of his lab coat and shook him. Shortly thereafter Victor got reassigned to the junkies.

I’d have quit on the spot. You don’t meet a high class of people anywhere at M., but the druggie ward gets the absolute dregs. Guys piss on the floor instead of waiting for us to unlock the bathroom door. The women all seem to have multiple personalities and won’t speak until you figure out who they are today. I can’t stomach any of them.

I freely admit that compassion is not an emotion I come by naturally. Empathy is even more of a stretch for me. It’s one thing to feel sorry for the misery someone else is going through and quite another to project yourself into the nightmare of their lives. I’m willing to give compassion a try now and then, but I draw the line at empathy.

So why did I become a nurse? There’s a very logical reason. When I left the bookstore eight years ago for nursing school, I figured there would always be a job for a woman willing to wipe up the bodily fluids of others. I knew I could do that. After all, I did it free for years for my father after my mother left. At the time I was a single 32 year old “without prospects,” as Dad used to say, and I decided I needed a profession to fall back on. It seemed to me that the sick would always be with us, whereas books might not be.

Now I’m a 40-year-old without prospects, except for a man I love too much to let him love me.

* * *

It’s quiet at midnight. Mr. Ghadafi suggested a joint might calm him down, and I almost offered to go to my car to get one. But Dr. Riley brought out the Thorazine, and now Mr. Ghadafi is sitting in the corner of his room dozing like some giant stuffed bear you see in the department stores at Christmas. He has a big smile on his face.

My paperwork is done and the meds administered. So there’s time to listen to Classical Late Night on the radio. Ray del Vecchio is playing Mozart again, a piano concerto I’ve heard dozens of times. Or maybe I’ve never heard it—I can never be sure with Mozart.

Music is good for me, my shrink says. It clears my mind for “important” thinking. Tonight I wonder, Why did I maneuver Howie out of my life? He didn’t ask much of me compared to most men. He didn’t need me to be there for him, or acknowledge him, or cultivate his self-esteem—none of those cliché emotional dependencies. He never hugged me suddenly in the street or held my hands too tightly in the movies. He always settled for a few quick kisses goodnight.

Maybe it was the way he had been looking at me so often lately, with disappointed eyes. Disappointment from anyone else I can stand, no problem. Who are they to have expectations for me? But Howie . . .

* * *

I started on 10 mg of Prozac at the beginning of my summer vacation. At the end of a week I couldn’t convince myself to get out of bed, so my doctor doubled the dosage. She insisted I commit to weekly analysis—no more of this crisis therapy. I resisted at first because I’m certainly not rationally challenged. I work with them—I’m not them. I scrupulously follow the three cardinal rules of mental health: I keep my clothes on, probably way too much for my own good. I don’t scream in public. And I pay my bills on time. I learned that one like all my lessons, by perverse example from my father. He used to bundle up his bills in rubber bands and mark them by the month they came in, as if ordering them in some way was a step toward actually paying them.

He said I would never amount to anything. He said I wasn’t even pretty enough to marry well and bail him out. I always believed what he whispered in my ear. As a young girl I watched the shadow of him climb the stairway, fill the doorway, slip over me on the ceiling. “You won’t feel anything,” he said. On that he was right.

My shrink is very perceptive. At first she said I was suffering endogenous depression and free-floating anxiety. But after a month, she knew I was hiding something, though she still doesn’t know whether I’m hiding it just from her or from myself, too. She says, “The truth will set you free.” Sure it will, and laughing will cure you of cancer. Doctors see that all the time, don’t they?

Besides, I don’t want to be free, I want to be gone. I told her that: I feel like disappearing. She said, What do you think that would feel like? I said, I feel that it would feel like I had no feelings anymore. She nodded as if that made sense and wrote something on her large yellow pad. The narrow lines on the sheet always intimidate me. I can’t imagine saying enough to fill them up. Are her other patients that much more interesting? Sometimes at the end of the hour I sneak a look to see how much she’s written. There’s never more than half a page.

Howie didn’t push me. Our relationship progressed like a long Sunday opera, no notes skipped. He waited ten months before suggesting he move in. I said yes at first. But how can you live with someone and not accept his hand falling on your thigh now and then or let him curl around you as you watch a movie on TV? How can you go to bed with one man and see another coming at you in your dreams? Howie said I’d do just fine if I stopped thinking about the past so much. He said that’s why shrinks don’t work—they make you think more about yourself when what you really need is to think less. He insists I’m as sane as the next person.

Pity the next person.

* * *

I have no pity left. I wonder what else of me I’ve lost along the way—humor certainly, patience, desire perhaps, but not memory. Why is memory the last to go?

Fortunately, August is a slow time for craziness, so there are a few empty beds now. People prefer to be outside in warm weather, and there aren’t any inspirational holidays this month. Just before Easter you get the messiahs with persecution complexes, and Christmas brings out the Santa Clauses and Jesus freaks. In summer you get a few agoraphobics and the odd delusional following dental surgery, not a very interesting bunch. Some bring laptops with them to keep in touch with work. They pretend they’re on vacation.

“Johnny” was readmitted last night. He’s the son of an actress who appeared in a popular Western in the 1960s. You’d recognize her face if you saw her, but her name isn’t well known. She’s a character actress, and she was particularly good at playing kind-hearted whores. Her son’s an obsessive who can’t stop touching things and then washing his hands. The schizophrenics and psychotics don’t know they’re sick. But an obsessive like Johnny has some normal part of himself sitting off in a chair watching the crazy part get up and touch the clock or phone or television and then go to the bathroom to wash his hands until someone makes him stop.

It’s no comfort to me to know that a person can observe his own craziness.

* * *

My shrink tells me my job is rubbing off on me. “Craziness begets craziness,” she said. She recommended a change of scenery, an exercise at taking control of a different environment. So on my day off last week I drove myself to the outer Cape, one of those towns without a public beach. I parked at the end of a private driveway and walked onto the sand carrying my shoes. I was bold. I pretended I belonged there. At the edge of a dune, a woman with painted red toenails lay back in a low beach chair, angled toward the sun. She wore a red bikini. A large Thermos sat next to her chair. She was reading a thick book propped on her chest. Everybody walking by looked at her. I imagined being a woman like that, reclining by a dune in a red bikini with men passing by. What would I read?

The beach curled in and out of coves for miles, and I decided to walk as far as I could. But after ten minutes or so I came to a line drawn in the sand, perhaps by a child dragging some toy behind her to the water. It was a thick groove, and my mistake was to stop and think about it. If I had just stepped over and kept going, who knows how far I could have gone?

When I told my shrink this story, she said, Did you consider rubbing out the line with your foot?

* * *

The morning I tried to get rid of myself, I called Howie and got his answering machine. The message was a new one. It said, “Go ahead, talk.” The beep came faster than I expected. As I tried to remember why I was calling, the machine hung up on me, sensing that no one was there, I guess. I was impressed that a machine could be so prescient.

I could have called him again, but what would I have said, that I look in the mirror sometimes and wish to see someone else? That some days I can’t even bear the weight of my own skin? That I look out of my apartment window and feel like dissolving into the yellow city air?

He would have sought reasons, first causes. I can’t bear to tell him what his touch reminds me of. Instead I told him the triggers—an impending elevator ride, a crowded party, turning a corner and seeing strangers walking toward me. He knows it’s none of these things, really, at least nothing inherent in them except the possibility of possibilities—the brush of a sleeve, a look over the shoulder.

How could I tell him that I stopped in the middle of the square today and closed my eyes and screamed?

Howie said he had felt my pain. He didn’t mean it in that unctuous way of “I feel your pain.” He said he sensed something wrong with me as he was driving across town to get a haircut. He felt a pull on him, a psychic hand on his arm. He did a U-turn and came to my apartment. When I didn’t answer his ring he climbed the fire escape to my bedroom window. He pushed in the screen and found me in my bathtub, half awake, the water pink. He felt much stronger than I had imagined as he carried me to bed. He bandaged me up as well as he could and called for an ambulance. While we waited he held my head against his chest and rocked me in his sweet-smelling arms. I wondered if smell was the last sense to go for everyone, or just me.

* * *

It’s another slow night on Ward 6. Lilly has started speaking in tongues again, which is okay with me because she didn’t make sense in English anyway. Rob the Musician threw his shoulder out playing air saxophone and insisted on going to the infirmary. Sal faked choking on his milk and spit it on the floor. He said I was trying to kill him. Irene ran herself into the cinder block wall a few times, and if she puts on any more weight she might just bust through some day.

Me, no dark thoughts to report, just a little disorientation when I combed my hair this morning and didn’t recognize the woman in the mirror. I steadied myself on the sink and closed my eyes. The nausea disappeared in a few minutes. Later, I curled up in the easy chair to watch the Lifetime channel with Lilly, who fell asleep on my shoulder. I didn’t feel happy exactly, but at least I wasn’t alone. Sometimes being crazy just needs company.