Every two weeks or so I am publishing an essay from an emerging writer. This week, we are publishing “Suicides” by Aishah Simone Smith. Aishah is a Brooklyn native and novice writer who has had a thirty-year career in law and advocacy. She writes from the intersection of race, trauma and mental illness.
I thought I was mentally ill. Turns out I'm just Black.
I woke up, 11 hours later, remembering little. I watched "Morning Joe," chatted with the cleaning lady, did a load of wash. My therapist called to ask the reason for my missed session the day before. I made plans for lunch with a friend. I fell, apparently, bruising my right knee.
And then the New York Police Department started banging on my door.
I later learned that it was that brief conversation with my therapist that resulted in me being first escorted out of my apartment building by armed police and subsequently, under interrogation in the gloomy basement Emergency Room of a private Brooklyn hospital. Once there, I cooked my own goose, so to speak. I laughed at the Russian nurse who insisted I refer to him as "Doctor." I showed off the hypertrophic scars on my wrists as if they were Tiffany tennis bracelets. I requested a B12 shot and an Uber home. I may even have shrugged.
It should have been obvious, but, evidently, scrupulous honesty bordering on glibness is little appreciated in a crowded inner-city hospital where an overworked staff is tasked with quickly assessing whether one is a danger to one's self or others. Transcribed in my record by that ridiculous ER nurse: "Patient shows limited insight." Meaning: "Patient fails to recognize the inappropriateness of taking 60 Ativan, 90 Lunesta, and then making a reservation at Balthazar." Instead of that shot of Bl2, I got an IV full of Thorazine. Next, I was in an ambulance, hurtling down the Brooklyn-Queens Expressway in the late afternoon light, on my way to a locked psychiatric ward at the foot of the Verrazano Bridge.
And so began my sojourn down the rabbit hole of rabbit holes, to a circle of Hell beyond Dante's imagination, to a place where I never dreamed of ending up, yet always knew I would end up, and where I never want to end up again, but just might.
***
When I was 13 years old, I put a plastic dry-cleaning bag over my head and waited to die. Two years later, after my first day of high school, I finished my homework, and then I swallowed a bottle of Extra Strength Tylenol. It is with those pre-teen years that I draw the line between Before and After: between hopefulness and helplessness; between giving a damn and giving up. Between counting time, not in months or years, but by the many, many attempts I have subsequently made to extinguish my own life.
I call myself a Suicide. Contemplating death is like hygge for my soul. Death, for me, is aspirational. Dying, I know, will solve all my problems, ease all my pain. Nothing moves me more than the idea of the absence of. And knowing that death is an option is the only thing that allows me to live.
My grandfather woke up one day, announced that he felt unwell, and then dropped dead of Takosubo cardiomyopathy, what doctors call a "broken heart." Grandpa had escaped Jim Crow Mississippi by the skin of his teeth, and the travails of his life lit up my child's mind with nightmares, images of persecution that I had never lived through myself. Grandpa insisted on telling me stories of the White children who spit on him from their school bus as he walked miles in the heat to his segregated school. Or the near-lynching he'd avoided when my 5-year-old mother dared to drink from a “Whites Only” water fountain. Or the "n-ger loving" Northerners who, refusing to acknowledge his credentials from the historically Black college from which he'd graduated at the top of his class, relegated him to a career sorting mail.
Grandpa had suffered from clogged arteries and mutinous blood pressure for as long as anyone could remember. He claimed his ill health was his internal pain externalized, and he blamed racism and The White Man. Inspired by the Ancient Greeks whose scholarship he so loved, my grandfather believed that Man had the right to choose the manner and means of his own death. And so, when he died, I knew it was by design. Self-annihilation, I learned, could be a noble pursuit. The last option of the optionless.
I grew up in the seventies and eighties, in a particularly American milieu: a Black middle-class life, shakily constructed on quicksand. My parents thoroughly schooled me in Black Respectability and Black Excellence, as they themselves had been schooled before me, meaning that I was taught to be so over-competent, so over-qualified, at simply everything I pursued, that I could never be turned back. But even as a child, I knew a lie when I heard one.
The truth: White people decided what Black people were or were not entitled to, and White people could, and often would, change their minds at any moment. It was not unusual at that time, whether in the hallways of my elite private school or in the elevators of my parents' respective workplaces, to be reminded by White people that we were "allowed" in those spaces solely as the beneficiaries of Liberal largesse. Promotions, good grades, invitations to kids' parties, were not benefits that my parents, my sister or I had earned or deserved, but rather were gifts for which we were to be grateful. We were permitted nothing for ourselves—neither accolades nor acceptance—despite being Respectable and Excellent. Everything could be taken away in a second.
Afraid, or unwilling, to profess unconditional love, express approval, instill self-esteem, my parents felt that their primary job was to take me down a peg or two before the world did it for them. I would have to “work twice as hard as White people,” my father railed at every family dinner, which translated into me anticipating having to grovel my whole life for even the smallest pittance. America, as my parents conceived it, was a hellscape of racist, duplicitous vultures and their collaborators. My friends were not really my friends. People who gave me compliments only felt sorry for me. No one I loved would ever love me back. The counsel that my parents perceived as protective left me feeling as if I would implode from anxiety, insecurity and self-loathing. I was taught that I was just a Poor Little Black Girl, and my life would be nasty, brutish and short.
Now go out and make us proud, kiddo.
My parents, I now know, were so affected by their own respective traumas—their abusive parents, the racist bullying they’d survived, the macro- and micro-aggressions that chased them no matter how much personal success they achieved—that to imagine inculcating their children with any sense of lightness or optimism probably seemed cruel to them. They wanted me strapped and ready. They wanted me to survive.
Unfortunately, I have never been the daughter my parents hoped for. My veins have always run thick with black blood—melancholic moods and an ornery nature—which was my genetic inheritance. My entire matrilineal line suffers from an intransigent strain of hopelessness and depression. They collect morbidities like trinkets from trips abroad. There has not been one natural death among us. Instead, our postmortems speak of strokes secondary to diabetes; Alzheimer’s and dementia; heart disease brought on by morbid obesity; so-called “deaths of despair.”
But despair is not something that my family has ever acknowledged. Indeed, what I now recognize as depression was not an emotion spoken about by anyone when I was growing up, especially not by Black people. My family refused to treat “feeling bad” as anything abnormal; they saw it as an intrinsic part of the Black experience. Indeed, “feeling bad” was better than “feeling good,” lest life decide you’d gotten too big for your britches. Happiness was suspect. Contentment, downright rebellious.
At the same time, my parents despised my moping, anhedonia and laconic withdrawals. To feel bad was one thing; to look as though I felt bad was another. My father told me to take walks outside. My mother advised me to wear lipstick and lose weight. There was no talk of doctors or therapy. I was diagnosed only with a “bad attitude” and told, repeatedly, to “get it together.”
I didn’t hear the term Bipolar Disorder until I had graduated law school. During a 15-minute consultation, a world-renowned Central Park Psychiatrist explained that my tendency to careen between hysterical productivity and inanimate despair was a symptom of a chemical imbalance for which I would require pharmaceuticals for the rest of my life. Neither “feeling bad” nor suicidal ideation, he assured me, was normal. And my desire to die, along with many other unpleasant aspects of my personality, could be successfully medicated away.
I may have shrugged. Despite my parents’ opinions on the matter, I had no problem believing that there was something wrong with me, that I had a disease or disorder. Bipolar sounded as good as any other. Soon I was medicated to go up and medicated to go down. Then I was medicated to alleviate the side effects of the medications that made me go up or go down. At one point, my daily total pill count reached 14, and I was unable to work. I gained over one hundred pounds; I drooled, I twitched, I snored even while awake. Rolling around in my childhood bed like an unhappy orca—unable to sleep, equally unable to get up—I never questioned my diagnosis or the medications meant to contain it.
Today I have been on psychotropic medications for almost 30 years. I have had round after endless round of ECT, CBT, DBT, EMDR, Ketamine infusions—and if you are not familiar with these abbreviations or therapies, consider yourself lucky. Each time the Diagnostic and Statistical Manual of Mental Disorders publishes an update, or, more accurately, whenever a new psychotropic drug hits the market, I get a different diagnosis. Despite all of this intervention, however, I have never stopped wanting, and trying, to commit suicide. I have tried over and over and over again. I have cut, I have overdosed, I have poisoned. I’m old school: give me a steak knife and a bottle of pills and that’s my Saturday night. Only to wake up, each time, like some deranged character from Rocky & Bullwinkle, crying “Curses, foiled again!”
As crazy as these acts of self-inflicted violence may seem, the Poor Little Black Girl is only doing what she was taught, what has been passed down to her from generations of Suicides before. Taking all that internal pain and externalizing it—flagrantly and outrageously. Hoping someone will listen.
***
As is common with me, things began badly. I was assigned a private room, not due to my gold-plated insurance (ahem,) but because I was “at risk for flight or self-harm,” and therefore condemned to one-on-one observation. I was handed a soiled pair of scrubs and thin socks with no-slip treads. My complaints about the vent pushing out hot air in the middle of summer and the dried blood on the thin, scratchy sheets went ignored. My cellphone was taken away and locked in a metal cage; I couldn’t send an email or a text to a friend or my family. My tablet and my journal were marked CONTRABAND and hidden away by the nursing staff. Dressed like an inmate, treated like an inmate—dumped in the psychiatric equivalent of solitary confinement in a supermax prison—I attempted to sleep, but couldn’t.
For those of you who have never been forcibly confined to an underfunded and neglected asylum for the insane, allow me to educate you. I was not surrounded by rolling green lawns, patrician doctors and blue-blooded patients. I was not ensconced in a pastel-painted bedroom, complete with chaise lounges and high thread-count sheets. This was Bedlam. The constant din and commotion were worthy of a South African soccer match. The walls were covered in what looked like boogers and shit. The toilets were clogged with vomit. There were room checks every fifteen minutes, twenty-four hours a day—a flashlight beamed rudely on my face, loud knocking on the door, “Hello!” screamed at me every time I dared close my eyes.
I was, therefore, already unimpressed by the time the psychiatrist who had been randomly assigned to my case managed to helicopter in from the Hamptons and stop by my room. He refused to look me in the eye. Dr. J asked my name and date of birth, never why I had tried to take my own life. He spent 10 minutes with me, noted the “seriousness” of my failed suicide attempt, and prescribed the highest possible dose of an atypical antipsychotic that had saved my life in the past while nearly ruining it. (Atypical antipsychotics do that, typically.)
Dr. J had no interest in whether or not I was working to resolve the stressors in my life, or whether I had gained the ability to re-enter society as a happy and productive member. Dr J cared only that I express INSIGHT, of which the first step—borrowed from the Alcoholics—was for me to admit that I was powerless over my disease or disorder, that my life had become unmanageable, and that only a power greater than myself, (namely: Psychiatry,) could restore me to sanity. He left. I didn’t see him again for another week.
After 48 hours, during which time I attempted neither to abscond nor to hang myself with my hospital-issued ankle socks, I was moved to a shared bedroom and I met my new roommate, Jax. Chatty and lovely, Jax attempted to reassure me that our mutual situation was not as dire as it seemed. The staff were friendly, she said, and there were turkey and cheese sandwiches every afternoon at 3 p.m.
I soon discovered that Jax was familiar, very familiar, with the particular asylum to which we were both confined. She was a “frequent flier,” in and out of the hospital a couple of times a year, for reasons that she claimed not to understand. Although, according to Jax, she had no mental illness diagnosis, no history of substance abuse or suicidal ideation, no disease or disorder to speak of, leaving Bedlam for her was more of an “au revoir!” than an adieu.
When I told Jax about my suicide attempt, she extended her sympathies. Jax herself claimed never to have felt so desperate or despondent that she’d considered taking her own life. “I feel so sorry for you,” said the lady whose idea of a good time was three hots, a turkey sandwich, and a cot. She went to art therapy while I stewed in my sweaty bed, and she brought colorful pictures back to the room as gifts.
I soon realized that Jax had the incredibly annoying and sleeplessness-inducing habit of prowling the hallways at night, muttering under her breath about “the wolves” whom, she reported, were waiting for her in her bed. Eventually more pieces of her history spooled out—tales of childhood sexual abuse, alcoholic parents and chronic homelessness. Although I was hardly confined to Bedlam to do reportage, I found myself sharing stories with and asking questions of other patients. The one patient I couldn’t communicate with, a Mandarin-speaking teenager who couldn’t manage his impulse to strip naked in front of the nurses’ station and publicly defecate, had a back so scarred from some unimaginable form of battery that his own backstory probably made Jax’s look like a fairytale.
I decided that Van Gogh had been correct in referring to the patients of the insane asylum to which he had once been committed as his “Companions in Misfortune.” Every patient I encountered at Bedlam had in common some background of misfortune, adversity, and trauma.
Nearly all of them, like Jax, were frequent fliers, cycling from Bedlam to a homeless shelter to the streets and then back to Bedlam. As much as I despised Bedlam, I had to grudgingly admit that it served a minimally benign purpose: it was a safe space for some, whereas the outside world most definitely was not.
Ultimately, however, where Bedlam, and Psychiatry, failed, was in helping any of my Companions achieve any form of permanent or lasting stability. Even I, with my supposedly sophisticated diagnoses, and new-to-market, mind-numbing medications, had been on some kind of horrific psychiatric hamster wheel for decades that I couldn’t get off of.
The problem, as I saw it, was that Dr. J and the other staff at the hospital were focused solely on balancing deviant brain chemistry, modifying allegedly aberrant behavior, without attempting to explore the motive and logic behind it. Is it irrational to fear going to sleep if you’ve been the victim of childhood sexual assault? Is it irrational to experience life-long, intransigent depression when you’ve been taught that feeling bad will protect you from having too high expectations of the world?
I learned to ignore Jax’s compulsive restlessness and the teenager’s unfortunate toileting habits. I felt compassion for the octogenarian who cursed me out every morning from across the hallway and the Yemeni store owner who stole my turkey and cheese sandwich every day at 3 p.m. I started to see my Companion’s actions as the unruly voicing of epigenetic trauma, destructive learned behaviors, badly misfired coping mechanisms. I started to see my own compulsive suicidality, not as a mental illness, but as a choice. A rebellious act of a Poor Little Black Girl who’d been taught to expect nothing good from the world. A girl who believes she can only live so long as death is an option.
***
In total, my hospital stay lasted thirteen days. Long past the 48 hours I had presumed was the legal limit for an involuntary hold. Long past the point where I could objectively be considered either a danger to myself or to others. Ultimately, I escaped Bedlam, despite Bedlam’s best efforts, only when my chart was stamped: “Patient’s insurance declines coverage.” I later received a bill in the mail for $150,000. An ignominious end to an ignominious beginning. But, hopefully, an “adieu!” and not an au revoir.
***
“Mental illness is for White people.” Ridiculous as that may sound, old canards are old canards for a reason. And it seems to me that this common Black adage expresses the idea that feelings of despair, anxiety, hopelessness, and helplessness are not the signs and symptoms of a disease or disorder, but are, rather, a normal part of Black life in America.
The experience of traumatic stress, clearly, is not limited to Black people. However, to Black people trauma is ubiquitous while being exceptional to other groups. Victims of the most overt racist acts conceivable, my parents and grandparents encouraged me, indeed directed me, that I would always be turned back. That I needed to remain hyper-vigilant, untrusting, suspicious. That I would need to take myself down a peg in order to survive. They modeled depression and suicidality to me as a form of protection, not as mental illness. And I watched and learned and did what I was told.
I am an expert in nothing other than feeling bad. But I adamantly reject the notion that I am mentally ill. Despair is not pathological; it is ubiquitous. Suicidality is the normal ache and pain of the Black American soul.
The most stabilizing and necessary things required for me to thrive are things that Bedlam and Psychiatry are ultimately incapable of providing: a sense of control over my circumstances; compassion and empathy for my forebears and for myself; love. Recovery – redemption – are available to me and to all of us through scrupulous honesty, transparency and the sharing of our personal narratives.
What I know: I can beat this. The only advice I can legitimately offer: hold on.
Your writing touched me deeply. In 1968, at age 19, my husband of two months was killed in Vietnam. My Italian, Catholic parents didn't know what to do with my outbursts of rage and grief. A week after the funeral, I slept with his best friend, and began a pattern of sleeping with men to feel something again, something close to intimacy. A few months later, as that failed, I took handfuls of Phenobarbital, and then ended up the locked psychiatric ward of a hospital in Utica NY. My mother stood over me and said, "You selfish thing." While in the ward, a young, handsome man who thought he was Jesus, made his way into my bed. The other patients were a mix of voluntary and involuntary. In my 30 day stay, I learned to get up every day and take a shower. So, I do that and don't stay in my pajamas past noon. The psychiatrist offered no help and I realized I had a choice - be a crazy person, full of drugs, and be cared for by a broken system, or do my best to appear sane. I have never taken Rx for anxiety or depression. My time in the 'ward' was 60 years ago. I've read and researched about the trauma of being a widow in various cultures. I rarely reveal that I think about suicide every morning. I live with my cat and that keeps me alive, worrying that no one will take care of her. I started writing again this year, publishing stories on Amazon Vella. It helps some. I've found ways to keep my physical body healthy and surprising, others find me inspirational. I continue to 'hold on.'
wow. i’m a black woman who can relate to a new diagnosis with every DSM that comes out -- and i just am so so grateful i read this. i feel like my existence has been affirmed. thank you for sharing 💛