How hospice became big business. A new investigation in The New Yorker reveals an industry that at times puts profits before patients.
Award-winning writer Mark Brazaitis talks with Diane about his latest collection of short stories.
- Mark Brazaitis Director of the creative writing program at West Virginia University and author of "The Incurables."
Read An Excerpt
Excerpt from “The Incurables” by Mark Brazaitis. Copyright 2012 by Mark Brazaitis. Reprinted here by permission of University of Notre Dame Press. All rights reserved.
MS. DIANE REHMThanks for joining us. I'm Diane Rehm. Mark Brazaitis' latest collection of short stories evokes the century-old novel "Winesburg, Ohio" by Sherwood Anderson. Brazaitis' fictional town is named Sherman, Ohio. Residents struggle with life, mental illness and simply, the human condition. Just as the book's author did. Mark Brazaitis joins me in the studio to talk about "The Incurables" and how he eventually found hope after depression.
MS. DIANE REHMWe'll take your calls throughout the hour. Join us on 800-433-8850. Send us your email to email@example.com. Follow us on Facebook or Twitter. Good morning, Mark, it's good to have you here.
MR. MARK BRAZAITISGood morning, Diane, thank you very much for having me.
REHMIt's my pleasure. Mark, tell us about Sherman, Ohio, and the people there.
BRAZAITISWell, I picked a fictional town in Ohio. I grew up in Cleveland so I know Ohio well. I feel comfortable with Ohio. I've actually spent the last 13 years of my life in West Virginia and I still don't understand it, but I think I understand Ohio. So I chose an Ohio town and fictionalized it because I didn't want people to look for specific landmarks and wanted to populate it with people who were struggling with issues of mental illness that Americans all over the country, and indeed all over the world, are confronting.
REHMAnd to what extent were you drawing on your own personal experience?
BRAZAITISWell, it certainly evolved out of my personal experience. I wish it hadn't done that. I think having suffered from severe depression as I did was, without a doubt, the most excruciating experience of my life.
BRAZAITISBut being a writer when I saw the other side of it or got to the other side of that depression, I thought I've got to write about this. I've got to write about it because I want people to know about the experience. I want people to understand the experience, not my experience necessarily, but the experience that millions of people across this country, across this world, experience every day and so there was that compulsion.
BRAZAITISAnd it was also my own way of laughing or triumphing over what I'd gone through of saying, I'm going to have the last laugh in this encounter with depression.
REHMYou know, it's interesting that you say you wanted to have the last laugh because some of these stories are, well, they're all very serious and some, extraordinarily tragic. The first story, "The Bridge," tell us about that.
BRAZAITISWell, the origin of the story, we have a bridge in Morgantown, W.V. and I used to walk over it every day to go to work. And I imagined, well, what if there was a couple standing on that bridge and an observer saw them jump from the bridge? What would happen from that standpoint?
BRAZAITISAnd that's where the story grew and eventually, it wasn't just that couple, it was a number of people who began jumping from the bridge.
REHMThere was an epidemic.
BRAZAITISThere was an epidemic in that story, right. It evolves from two people to just about everyone, not only in the town, but in the country and people are coming from all over the world. It's this blooming suicide epidemic. And really though the focus of that story is the central character, the sheriff who is having to confront this issue, not only the public safety issue of a bridge gone mad or a world gone mad, but his own feelings of depression and his own sense that this bridge is calling to him somehow.
REHMThe sheriff is dealing with not only what he can do about this bridge. He tries to, in effect, through netting, through barriers, through all kinds of techniques to literally wall off the bridge. Is that bridge symbolic for depression itself?
BRAZAITISI think it is. It's interesting, the bridge as metaphor and bridges do connect us, right? But there's a certain danger, obviously, in this bridge and he is treating a certain part of the problem, but the problem exists beyond the bridge.
BRAZAITISWe can wall off the bridges, but as a society, can we really wall off depression? And you mentioned humor in these stories and reviewers have been kind enough to point out that many of the stories, in addition to being tragic, as you said, also have strong elements of humor and I wanted that to counteract the sadness.
BRAZAITISI didn't want to leave readers with a terrible taste of hopelessness. I think there is a triumph in being able to laugh at this situation. But the sheriff in this story connects with a sorority president who attempts to help him and their friendship forms. The hopeful message in the piece, that through connection, through friendship, perhaps we can overcome some of the inner demons that we're facing.
REHMYou went through your own depression, your own period of real hopelessness as your father, Tom Brazaitis, whom I knew well, who was a dear friend, was going through his own bout of cancer. In your mind, did you connect the two?
BRAZAITISI didn't then, but I certainly see a connection now. I think when my dad had cancer, kidney cancer, and it inevitably became -- it was evitable that he was going to die from it, I understood that intellectually. I accepted that intellectually. I did not accept it emotionally.
BRAZAITISI didn't realize I didn't accept it emotionally at the time. It took me a while after he died to realize I didn't accept it. I didn't accept it. I didn't go through a pre-grief period. I just accepted it platonically and then.
BRAZAITISI should say about my dad, we had -- he was a terrific man, a generous man, a wonderful writer, my favorite writer of all time.
REHMA columnist for The Cleveland Plain Dealer...
BRAZAITISThat's right, he wrote very lucid prose. I admired him greatly. But like all father/son relationships, it was complicated.
BRAZAITISAnd he was very ambitious for himself and for me and sometimes our ambitions competed with each other and sometimes they didn't. In fact, I have a story called "The Boy Behind the Tree" in the collection that's based on that relationship of trying to find a connection with one's father. So he's been an inspiration in many ways. But yes, that was one of the things that certainly I could point to.
BRAZAITISAnd I think William Styron in his memoirs says, I, William Styron, can point to the fact that my mother died when I was young as the core source of my depression. Abraham Lincoln had a similar issue in his life. His mother died young and he could perhaps, if you were to look in his past, he could point to that issue.
BRAZAITISI didn't necessarily have the same thing. My mother was still alive. I had a nice family so I wondered. I went on this mad search as I was becoming depressed, looking for that core thing I might pluck out or sooth or do something to, to change the depression.
BRAZAITISI was like Indiana Jones looking for the Ark of the Covenant. It was like Raiders of the Lost Mind or something with me. But yeah, and my grandmother had just died so there were a number of issues that were in play, I think, in my own depression. But some of it remains a deep mystery to me.
REHMSome therapists, of course, argue that depression is the flipside of anger. Do you see that in your own life?
BRAZAITISWell, I think there's some validity to that, at least as I interpret it personally. I think there's a lot to be angry or upset about in the world and I look out into the world a lot.
BRAZAITISI look at global warming or I look at mountain top removal. I look at the general attitude of our politics that seems so divisive, almost a gleeful divisiveness, showmanship divisiveness. Where is the embracing of the people as a common cause?
BRAZAITISWe have things in common. We need to move forward together, but there are these issues that are looming and seem troublesome and, again, perhaps a lot to get angry at.
REHMMark Brazaitis, he's director of the creative writing program at West Virginia University. He's an award-winning author of several books and a collection of poetry. His newest book of short stories is titled "The Incurables." Do join us 800-433-8850. Tell us about "The Boy Behind the Tree."
BRAZAITISWell, this is a story of a young man whose father, like my own father, loves golf and wants his boy to play with him. It would be their kind of unifying field, their way of coming together. The boy, however, is not a good golfer and doesn't like the game and has other interests that the father doesn't have or the father doesn’t connect with.
BRAZAITISAnd so there's a kind of struggle about whose game will prevail. Will the father be able to convince the son to play golf? Will the son be able to introduce the father to his own world or what will happen to this relationship? What common ground will they find?
BRAZAITISAnd then, there's a third character introduced who does like golf. He's the son's age and so this rival for the father's affection is introduced. And the story is about the strains on the father/son relationship because of this other boy who seems ideal in a sense. He loves golf. He's a good golfer and he has a rapport with the father that the son lacks.
REHMAnd what was it like to get inside the head of that young boy?
BRAZAITISI think, in some ways, it was familiar because, as I said, any father/son is going to have those kinds of struggles to find common ground and yet to find unique ground for oneself. And in another respect, of course, it's a little painful and a little difficult to contemplate a relationship in my life even through fiction that is so important and yet has elements of difficulty.
BRAZAITISBut that's what we do as fiction writers. We open ourselves to those very painful truths in our own lives and in the lives of our characters.
REHMMark Brazaitis, director of creative writing at West Virginia University. His new book of short stories is titled "The Incurables."
REHMAnd welcome back. Mark Brazaitis is with me. He is a writer, a poet, the author of a new collection of short stories titled "The Incurables." And at the beginning of the program we talked about his story, "The Bridge" where a new sheriff has to confront a suicide epidemic. Mark, would you read for us?
BRAZAITISSure. I'd be glad to. Thank you. And this is Sheriff Lewis as he watches this on TV. He's been up pretty much all night handling the suicide epidemic on this bridge in his town. And he's clicking on the morning news here. And Cece is the other character mentioned who's the president of the sorority who's working with him and trying to solve the problem of the suicide bridge.
BRAZAITISHe clicked on the TV on the kitchen table. On its 12" screen he recognized the scene immediately, the south end of the Main Street bridge. A woman with buttercup blonde hair was on live interviewing people about why citizens of Sherman were throwing themselves off the bridge. Because it was 6:30 in the morning her subjects were either old people who having gone to bed before 8:00 the previous evening were alert and coherent, or Ohio Eastern University students who had stayed up all night, perhaps in expectation of seeing another jumper, and were delirious.
BRAZAITISThere were a large number of people in the background like spectators at a high-wire act without a net, Sheriff Lewis thought. I think people in this town and in towns everywhere across the country have turned their backs on Jesus, said a white-haired woman. What they're left with is the devil or self destruction. Maybe self destruction is the better choice. I think it's like the Bermuda Triangle, said a young woman, half of whose black hair was died bubblegum pink. Her eyes darted around as if they were viewing a frenetic tennis match. The bridge is haunted and I bet when people cross it they hear voices saying, jump, jump, jump. I'm telling you there's an evil presence here.
BRAZAITISI'm willing to bet there are very strong gusts of wind that are lifting people off the bridge, said a young man who may have been sporting a goatee or may have forgotten to wipe his chin after eating chocolate pudding. If the mayor of Sherman was willing to put up some windbreaks I'm sure we would see a decrease in the number of so called suicides. The last person interviewed was Cece, who after spitting out a couple of sunflower seeds said she couldn't explain the suicides. My only concern is to stop them, she said. Today I'm meeting with the director of mental health at University Hospital and I'm hoping to have two volunteer counselors down here by noon. Last minute therapy might be exactly what people need to keep living.
BRAZAITISAs the anchorwoman asked a question of the blond correspondent the camera showed Sherman police officers escorting groups across the bridge. After they'd crossed some people chose to re-cross. The bridge, Sheriff Lewis could see, was becoming an amusement park ride. As the blond correspondent summed up the situation using words such as strange, disturbing, mysterious, weird and wacky Sheriff Lewis saw a blue van drive slowly past her and onto the bridge. The color and design of the license plate weren't ones he recognized.
REHMAnd that is Mark Brazaitis reading from his story "The Bridge," part of his new collection titled "The Incurables." What is it that you think becomes such a fascination when people are so low that they're willing to take their own lives?
BRAZAITISThe fascination that people have over this, I think some of it is -- I think it goes back to why we watch tragedy in a sense, that these are characters or people who have been pushed to the extreme of what human beings can face. And there's a natural curiosity, a fascination, an interest in what those people are encountering, and perhaps a certain relief in being the observer rather than the participant. Because really it would be so easy to be the participant if life had just been -- had gone a slightly different way.
REHMDid you ever consider suicide?
BRAZAITISOh, yes. Oh, yes. Oh, yes. Not only considered but made a feeble attempt at it. And that's when it was time to go into the hospital, which I did. I was taken to a -- my wife was extraordinary throughout this process, my family, my sister, my brother-in-law, my mother, everyone -- my father. Everyone has contributed to this. I'm fortunate that they were able to see the problem a lot more clearly than I was. I was so depressed I was psychotic. And I was taken to a mental health facility in New York and spent four months there. I now like to refer to that period as my research for "The Incurables."
BRAZAITISBut it was where I eventually began to get better to emerge out of this horrendous mental illness, this depression that I was facing.
REHMHow did you emerge?
BRAZAITISWell, I needed electroshock therapy, ECT eventually. I tried a lot of the -- several of the medicines, the antidepressants and they just weren't doing it for me. And I felt like I was -- the situation I guess is akin to -- on MAC computers there's that colorful rainbow pinwheel. When a program isn't functioning correctly it spins around and around and around. And that was what my depression was doing, my brain was doing. It was spinning around and around and really pulling me in deeper.
BRAZAITISAnd the ECT, after the first treatment -- and I reference this fictionally in my story afterwards -- after that first treatment I immediately began to feel better.
BRAZAITISBetter, yeah. It was -- I needed that reboot. I needed that reboot just like a computer needs the reboot when it has the colorful pinwheel. I needed a reboot from my brain. It had spun into the ditch, into a deep ditch, into a hole, into a canyon.
REHMAnd your family remained very supportive.
BRAZAITISThey remained very supportive. Clearly they were going through their own emotions relating to it but their support was incredible. My wife researched everything. She researched ECT, gave it an enormous amount of thought whether this was going to be the right thing for someone who needs his brain to make a living, and was tremendous in being able to move this forward and to find the cure that I needed.
REHMPrior to that intense depression where were you and what were you doing?
BRAZAITISWell, I was -- I was at West Virginia University teaching and it was really a slow spiral down I think into depression. At least -- and I did a little cheating. I talked to my wife last night to review for the show today. So we went over some of the history because some of it is still vague for me because I was so depressed. I had a hard -- I don't remember a lot of it, or not clearly. But I think it was a slow drip, drip into depression.
BRAZAITISAnd then finally I just couldn't really get out of the bed in the morning or found myself on my office floor for hours just unable to get up. And was still trying to teach and was doing it okay but there reached a point where it was just not working anymore.
REHMAnd did your employers come to you or did you voluntarily say, I can't do this anymore?
BRAZAITISI had to let them know that this is what was going on and I would need my classes covered. And fortunately I have excellent colleagues, generous colleagues at West Virginia University who stepped up and took my classes. I was teaching three classes at the time, which is not easy to do under ordinary circumstances. And when you're spiraling into depression it was not the right recipe for recovery. So generously they stepped in and took the classes. And I did have to take a medical leave and I wasn't paid for most of it.
BRAZAITISFortunately, you know, I was lucky I had the resources, my family had the resources. Not a lot of people have those same resources, which makes this such a difficult issue for a lot of people who are suffering from mental illness.
REHMThere are a number of people going through depression who feel as though they don't want to give up that depression, that going on to medication or undergoing electroshock therapy might take something away. Were you at all concerned about that, and did you feel there was any loss?
BRAZAITISI was terrified that if I went on medicine that I would lose what I had as an artist, as a writer. I eventually got over that and tried the medicine. I was equally as terrified that if I went through electroshock therapy ECT I would lose my creativity, the powers of my brain to do what I was meant to do or believed I was meant to do, which was to write. And I resisted that and it was -- it's funny -- and there are many humorous incidents that come out of being in a psychiatric ward.
BRAZAITISBut some of the -- two women there looked at me from the first day and said, you know, you need ECT. You're the guy who needs it. And I said, yeah I was resisting that but they knew right from the beginning and it took me a long time to get to that place. But after a while you think you've got to do something because you're not writing -- I'm not writing when I'm depressed. I'm not creating now. So, yeah, it was -- I was hugely resistant to that and I'm glad I got over that. On the other side, I've never written better. I feel so much better and my art is all the better for it.
REHMI have to say personally that I've been reading these stories every single night and am so drawn into them. I think you write beautifully.
BRAZAITISThank you, Diane. Thank you.
REHMMark, there's some of your characters who get very involved in, or at least consider extramarital relationships. Do you think that that, for your characters, is part of what one does to escape depression?
BRAZAITISI think it may be. I think the midlife crisis, we laugh about it sometimes, you know, the guy who gets a mistress and a Ferrari or whatever it might be. But I think there is a connection. My midlife crisis happened to take place for four months in a psychiatric ward. Other people drive Ferraris. But I think there is some need to be relieved, especially at certain points in human lifecycle. And maybe affairs are a kind of antidepressant. A destructive one. I'm not recommending them. I don't approve in my own life.
BRAZAITISBut I understand why people -- and that's why I have characters who make those decisions.
REHM...who run away from what is real into what becomes fantasy.
BRAZAITISAbsolutely. Yes, yes. And escaping the problems and pressures of their own lives through fantasy. And sometimes it's connected as it is in some stories here with the desire to be young again or to recapture one's youth. I have a story -- the third story in the collection "A Map of the Forbidden" for example is about a man whose father has died -- this is sounding familiar -- and meets up again with a woman from his past from high school who admired him when he was in high school. So here's an opportunity not only to have an affair with an attractive woman but in a sense to go back to a more innocent, joyful, hopeful time.
REHMAnd you're listening to "The Diane Rehm Show." I want to ask you about the story "Afterwards" because it's really stunning. And a man kills his entire family because he fears what's coming.
BRAZAITISYeah, and I think that connects to what I was saying earlier about what we're angry at in the world. And his particular vision has to do with, well, an apocalypse of global warming and oil running out and the economy running amuck. And he sees this horrible vision and he believes it because he's depressed and he's psychotic. And it's so powerful in his mind that he believes the only way to escape it is to -- is death, is to kill his family. He thinks he's doing it -- in his psychotic state he's thinking this out of mercy in a sense.
REHMSo they won't have to experience these horrible tragedies.
BRAZAITISExactly. And the kids have -- his two children have some medical issues and so he's -- in an apocalyptic world he's worried about the enormous pain they would suffer because of what's to come. And so he does this in his deranged mental ill capacity. And then it's about his friend, the really lone friend who stands beside him throughout this, who's having his own family issues. His wife and child -- his wife has left him because he's abusive and not very cognizant of how he's contributed to the downfall of his own marriage.
BRAZAITISBut through his relationship with his friend Ray he begins to see things in his own life, in his own marriage that aren't necessarily parallel but do suggest something powerful about the way he now wants to behave. The way he wants to give to his wife and family. And of course there are real ward examples of this kind of situation and I never, ever as an artist would've been able to write -- approach understanding these characters, particularly the man Ray who kills his family, if I hadn't gone through that kind of immense depression that I did. So it was a leap artistically to write about this situation and yet I could sympathize.
REHMYou could sympathize.
BRAZAITISWell, I knew what it meant to be afraid of the world that was coming or that was. I knew what it meant to -- I had -- I have some -- who doesn't have concerns about where the world is headed, what global warming is doing, etcetera? But I also knew what it meant to be psychotic. I was in my deepest depths psychotic. I couldn't trust anything. I felt like I was in a foreign country and I couldn't -- didn't understand the language. I didn't trust my wife, I didn't trust my father, I didn't trust my sister because I'd been reduced to this ball of anxiety and distrust.
BRAZAITISAnd so out of that on the other side again I'd recovered. I'd had the treatment. I had perspective. I was able to have a little glimpse into what people like my character Ray in "Afterwards" in "The Incurables" was facing.
REHMAnd what it said to me, which I've known for most of my life, is the value of relationship.
BRAZAITISAbsolutely. And many of the stories in "The Incurables" are about friendships or connections or relationships and how we need each other. And we need to forgive each other and understand each other and be there for each other in whatever capacity we can. I think some of these characters gain their strength through -- ultimately through single connections with friends or lovers or family members.
REHMWe're going to take a break now but I want you to know we have an email from Mike who says, "I have never heard anyone so articulate speak so graphically and honestly about their depression. Absolutely fascinating." Short break, right back.
REHMAnd if you've just joined us, Mark Brazaitis is with me. He's director of the creative writing program at West Virginia University. He has just come out with a new book, a collection of short stories. It's titled, "The Incurables." Here's an email from Thomas who says, "As someone who's been personally struggling with depression off and on over the last six years, how did you summon the courage to seek help? And what steps did you take to seek help for your depression?"
BRAZAITISWell, that's a great question. I think we hear so much misinformation about depression and mental illness that it's laziness or it's selfishness somehow. And so there's a real stigma attached to it, especially, I think, for men who need to tough it out on their own and be strong. And I fell prey to those kinds of stereotypes and misrepresentations and tried to be "strong." But ultimately I kept becoming worse. I couldn't get out of bed at all, I mean, when before I could get out of bed for a meal. Now, I couldn't get out of bed at all.
BRAZAITISAnd I think, for one thing, I was crying out for help to my family, who also was having trouble, initially, recognizing it as depression because they had seen me as a different kind of person or visualized me as a different kind of person. So it was a long process -- or maybe it seems long in retrospect, but it was a process by which I reached out to my family and said I need help and a process for them in seeing that I needed help.
BRAZAITISAnd then when you become so depressed that you are threatening to take your life or make feeble attempts at such, then it's clear -- and it has been for awhile and it should have been -- that it's time to take more constructive action and get serious medical help.
REHMDid they get the help for you or did you get it yourself?
BRAZAITISWell, my wife initially brought me to the hospital at WVU. And I spent a week in that hospital, but my family, in the meantime, researched the best care that they could find and believed that it was in New York at the New York State Psychiatric Institute and took me from Morgantown to New York. And my brother-in-law works at the Columbia Hospital connected with the New York State Psychiatric Institute so they were very vigilant about getting me help.
BRAZAITISBut I do think it was a combination of me expressing a need for help and my family recognizing that I needed it and getting it. In my position it was tough. I was so depleted as a person that it would have been hard for me to organize what my family organized in terms of my healthcare, but it's so crucial to make your situation known. There's no glory in toughening it out. That is the weak move. The strong move is saying I need help, could you please get me help.
REHMHere's an email from Bob who says, "ECT is electro convulsive therapy. My wife is going through this right now. I'm glad to hear it worked for your guest." What's involved with electro convulsive therapy?
BRAZAITISWell, usually it's about 8 to 12 treatments, twice a week. And it's being wheeled in on a gurney into a room and having a bunch of equipment attached to one's body and being put under anesthesia and essentially given a shock that's no more powerful than the standard light bulb, something like 75 watts. I'm not sure if I'm explaining that correctly, but it's a very light shock to the system. As I said earlier, it's a reboot to the brain. It's an attempt to reposition the brain out of the horrible realm of depression and into something more like what the person has been use to.
BRAZAITISAnd it's not easy and it's not fun. Although, one of my fellow patients in the New York State Psychiatric Institute was bipolar and had been through several course of electro shock or ECT over his life. And he was talking to a nurse one day and he said, you know, I really want to do it without the anesthesia this time, as if it were an amusement park ride. I guess he had been through it long enough he wanted to really experience it. I wouldn't recommend that, but that was interesting to hear from him.
BRAZAITISSo I think a lot of stigma associated with it, but boy, if you're so depressed and you need an out it's something to consider.
REHMIs there a difference between electro convulsive therapy and electro shock therapy?
BRAZAITISNo. I think they're interchangeable terms. In fact, ECT electro convulsive therapy is the more correct term. We know electro shock from "One Flew Over the Cuckoo's Nest," I was going to say.
REHM"One Flew Over The Cuckoo's Nest."
BRAZAITISAnd it's much advanced since those days. It's really a rather minor procedure.
REHMAnd Diane, from Fort Wayne, Ind. asks your thoughts about talk therapy.
BRAZAITISWell, I believe in it entirely and not just because my brother-in-law and sister are psychologists. I always believed that it's a good idea to talk. And I'd done that in college and in graduate school when I was going through some issues. I sought out the free counseling at the colleges where I attended school and had great experiences with the counselors that I had. And after I went through this depression that led to the writing of "The Incurables," I did and I do have a therapist I work with, not as frequently as I did in the beginning, immediately after my depressive episode, but every six weeks or so we regroup and talk and it's been a positive experience.
REHMAll right. And here's a caller in Morristown, Tenn. Good morning, Bonnie.
BONNIEYeah, I enjoy your program tremendously.
BONNIEAnd this is just right up my alley. I had one session back in the '60s with electro shock therapy and then 14 years ago I had a reoccurrence, I guess you'd call it. And my husband and I really didn't know what to do. And the hardest thing I ever did was to sign myself into a mental institution. I found the change was wonderful though. I had had the shock therapy at first and they said that you were anesthetized. I, to this day, do not believe I was.
BONNIEAnd I was 19 or 20 at the time. I'm 68 now. And the second time -- that was the reason I didn't want to go back. And I had to go that far. That time I wasn't as anesthetized and it's like the difference in daylight and dark. Shock therapy is not everybody. I even had a very good friend who asked me if I saw things when I was depressed. And I said I did not have schizophrenia, I was depressed. And that's been about 14 years ago. And I still carry a lot of baggage.
BRAZAITISWell, yeah, and these are never easy decisions, but depression needs an out. And so I think it's helpful to think about all kinds of possible treatments or solutions and if running an hour a day is enough to lift the depression then let's go with running and if it's an antidepressant then that seems worthwhile to try and if, in serious cases, as yours apparently was, Bonnie, and mine was, then ECT might be one of those options. So I think just opening ourselves to thinking about a range of options to get at this depression because depression is not a state we want to be in at all and not for very long, for sure.
REHMAre you ever fearful it will come back?
BRAZAITISWell, I was talking to my colleague, Katie Ryan, not too long ago about this. And we were talking about the story "Sonny's Blues," by James Baldwin, in which the Sonny, one of the protagonists had a heroin addiction and he's off heroin and his brother's talking to him. And Sonny says to him, you know, it could come back, his addiction, his connection with heroin. And I think that's true of depression, it could come back. I hope it doesn't, but I have from time to time felt the edges of it, just a little tickle of it, to know that it's still there and it's still something I have to be aware of, keep my eye on and not to think I've overcome entirely. That it's...
REHMWhat does that feel like when it's at the edges?
BRAZAITISIn my case, I begin to feel a sense of dread and a little bit of anxiety. And this pulling at my soul or psyche, this pulling down, this sense of helplessness, the sense of defeat. It isn't strong when I feel just it at the edges, but it just tickles those emotions enough to make me cognizant that it's out there.
REHMLet's go to Annapolis, Md. Good morning, Sophie.
SOPHIEHi. Good morning. Thank you so much for taking my call.
SOPHIEI really appreciate it.
SOPHIEAnd I'd just like to say, Mark, that I'm really touched by your honesty and your courage in speaking about depression and in mental health, as you are. And...
BRAZAITISThank you, Sophie.
SOPHIEAnd I don't know if this is a comment or a question or what, but what I'm really struck with is in this country it seems that mental health is still considered a bugaboo. And depression, when you were first talking I started to think about is depression or this whole topic, is it a messenger of something that's going on sort of in the bigger field of consciousness or humanity? That the way we look at it, it seems like there's something wrong or that it's bad. And I don't want to belittle at all what people go through when they have to go through these kind of things, but I just wonder if we were able to look at it in a way that it's actually telling us something about our world.
SOPHIEAnd almost that people who are maybe in that state are paying attention to something that the rest of us or not. That it's almost like how could you not be depressed with the way that things are going in our world? I mean...
BRAZAITISYeah, no absolutely, Sophie. I think that's right. And that, in part, is what my story, "The Bridge," is about, where the people in the world seem to be responding to this larger sense of hopelessness that somehow the world has created around us or we've created in the way we interact with each other. So I do think, as I said at the onset of the show, that there is a lot to be angry or depressed about. And when we don't have the resources, when we don't have the friendships, the family, the support around it, it's especially difficult.
BRAZAITISBut even when we do, it's still difficult. And so, yes, I agree, that there are some issues in our world, in our society that feed depression.
BRAZAITISThat depresses us, thank you. That's it.
REHMAnd that it is not in our personal, individual power...
REHM...to make right. And you're listening to "The Diane Rehm Show." Would you read for us from that last story, "Classmates?"
BRAZAITISSure. I'd be happy to. And this is a story about a man who has tried to kill himself and has failed. And he's visiting the wife of a classmate who has succeeded in killing himself. And he's just visited her in this scene and he's reflecting a little on that visit. And there's the mention of the phrase, five minutes, no more. The, you-character, the protagonist has attempted to kill himself by asphyxiation in garage and a doctor told him he had five minutes, no more and he would have been dead.
BRAZAITISSo here's from "Classmates," the last story in "The Incurables." "You call your wife, but she isn't in. You leave a message saying you'll be spending the night at a hotel and will be home some time after noon the following day. Three-hundred miles or so down the road, you pull into a Days Inn. Later, eating dinner at a Cracker Barrel, you think about your last exchange with your classmate's wife as you stood outside her front door in the vanishing light. I don't suppose you've cured your depression by trying to kill yourself, she said from within her house.
BRAZAITIS"You shook your head. What did make you better? There was something hopeful in her voice, as if she might yet discover a remedy for her husband's pain. You told her about your stay in a psychiatric hospital, the antidepressants you were prescribed, your twice-a-week talk therapy sessions and time, you said -- although she no longer seemed to be listening -- and luck. You vowed to call your classmate's wife Jennifer, Jen, tomorrow to thank her for seeing you, to see how she's doing.
BRAZAITIS"You returned your hotel room and watched television until midnight, but even then you aren't tired. You read articles in the four alumni magazines you have brought with you. It is nearly 2:00 in the morning when you turn off the light, but after 15 minutes you know you won’t be able to sleep so you check out of the hotel and drive home. You pull into your driveway at dawn. You don't have the garage opener so you leave your car in the drive. You have crossed over from tiredness into numbness, a dreamlike sensation, what you might experience in the first few seconds after receiving anesthesia.
BRAZAITIS"It is like existing between two worlds, neither of them quite accessible through your five senses. You walk around to the back of the house and stand outside the kitchen in front of a window whose yellow curtains have been drawn back. As you anticipated the kitchen light is on and your wife, her black hair in a ponytail, is at the table, the newspaper and a cup of coffee in front of her. Your eyes have trouble focusing and the scene seems as much memory or wish as reality. She reads for a few minutes before taking a sip. When she puts down her cup she looks out the window.
BRAZAITIS"You want to acknowledge her, but you find yourself froze in place. She continues to stare directly at you, her expression, if it holds any emotion, downcast. You remember the fume-filled garage and the blackness overwhelming your consciousness. Five minutes, no more. You step forward and press your lips against the window, kissing its coolness. Your wife smiles and kisses you back."
REHMMark Brazaitis, reading from the last of the short stories, called "Classmates," in his new collection, "The Incurables." Mark, having written this now, how do you feel about yourself?
BRAZAITISOh, I don't know that I feel any differently about myself than I do for having written this book or not written this book. I feel it was an important book to write for many reasons, some of which I'm still puzzling through and figuring out, but one of the reasons I did want to write it and I believe in--and I was a former peace corps volunteer. I believe in going out there in the world and I wanted to reach people through this book. And I hope I have.
REHMI think you have. Here's a last email from Randy. "I want to thank Mr. Brazaitis for his openness about his struggle with depression. It has inspired me to keep the faith that I will get better and not to stop treatment and seeking help."
REHMMark Brazaitis. The book is titled "The Incurables." Thanks for listening. I'm Diane Rehm.
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