Lilly Of Glaxo

I first became aware of Lilly's presence at the Dead End Club in June, the first week of the Twilight Festival, and the seventh week since I began taking the anti-depressant SNRI Cymbalta.

She was sitting far across the meeting room and I became transfixed, certain that I knew her from somewhere long ago. When I traced back for the memory, my mind returned with broken images, like I'd gone far afield recollecting a dream.

Her physical presence grabbed and scooped at my insides. It was like I'd been in love but forgotten all about it. She was dressed in an ankle length, light floral, pleated skirt and wore a plain black sleeveless blouse. She had the complexion of childhood poverty: too early smoking and drinking, too early rolling in the hay. Her slightly tan skin, while soft looking and appealing, seemed to have absorbed enough rural dust to give her the permanent aura of hard-times.

She was smallish, about 40 years old, with pretty locks of curly, light brown hair piling softly upon her freckled shoulders. She wore clear wire rim glasses, and her bluish-gray eyes were wide with wonder, but clouded with hurt and irritation , if met directly. She appeared to have swallowed heart-ache and I decided she was dry eyed from crying (but from long ago). She had a cute, small oval shaped mouth with kissable lips. She almost continuously rolled her head and massaged her neck, like someone just off work and on their way to a chiropractor (or a psychic healer with strong hands). She seemed at home in an A.A. meeting and, noting her ring-less finger, I hoped she might be a genuine kook, I might persuade to bed and blind, loving servitude.
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Last March , Dr. Cooper, the young squirt who's been so interested in me, his first genuine hypochondriac, set up an appointment for me to meet his former teacher, the pre-, or perhaps post-eminent psychiatrist/neurologist, Dr. LeFevre.

The first appointment was not until late in April, which was a long wait and a long time for me to rebel. I hadn't so much been sold on this idea as accepted it politely, out of a feeling of obligation to the friendly Cooper. He'd just saved my job after I'd taken seven days off, devil may care, assuring my boss that I'd have a doctor's excuse, when in truth all I had was a crazy conviction that I could persuade Coop to write me one, ex post facto.

Now as I sat in an examination room waiting, upright and uptight with my arms crossed, I brooded, and felt angry and mean. I was ready to put this old paragon of 19th and 20th century European buncombe (or 21st century Paxilism) on the defensive, in hopes of provoking him into a nervous tic, stuttering, and finally an unprofessional display of choleric imbalance.

Coop surprised me, stepping in first.

"I wanted to stop by and remind him about you and why we wanted to see him. Now he wants me to ask you some questions while he's with another patient. Is that all right with you if we talk a little while?"

Every year or two it's as if I must meet my adversary, the Professional Human Being. The true Internist, the Sherlock Holmes or Rube Goldberg, able to explain the mechanisms of all my sins and mistakes by a logic of reverse engineering. Someone talks me into this misadventure and I am either charmed or gulled into trying new pills ('take this and in six weeks you'll feel like a million dollars') .

I always refuse counseling, though I'd probably change my mind if I knew the counselor would be female and attractive and not foreign born (with English as her second language, I mean. There is no fooling or charming them).

This unexpected appearance of my youthful, good natured, non-smoking, Mormonish G.P. made me feel foolish about my hopes of ambush.

Still, I thought of his generation being bewildered by Dr. LaFevre's. All the unreasonableness, and stubborn orthodoxies, which are the mirror opposite of the first generation immigrants of early last century, raising their children determined to carry on traditions and to excel in the new world of opportunity. Coop's generation, I imagine, must deal with so many rationalizations of evil they actually do correct their parents by age seventeen. As the boomers only imagined they could.

"Now that doesn't seem right, Dad."

Dr. Coop politely pretended to me that he was still very curious to discover something about my Hashimotos disease (hypothyroiditis) even though I was finally "stabilized".

We could do this , he'd explained in March, by ruling out any psychiatric illness. It was just after I'd asked him to invoke FMLA for my condition, which is about as common but less serious than gingivitis.

"Hashimotos", I secretly suspected all these years, was something laughable, like Chronic Fatigue Syndrome.

He said that maybe this "mental lethargy" was depression, maybe my free floating anxiety was due to the haphazard placement of the building blocks of personality in early childhood, maybe I kept asking him for job excuses/vacations all the time because of an allergy, or a mysterious "fear of success". That last actually made me smile. Maybe I even laughed out loud.

"Of course it's true Hashimotos can mimic mental illness in many ways, so let's sort this out," he said.
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Days and weeks passed until one beautiful evening, with the sky a sort of blue and orange sherbet color, I suddenly felt that it would be perfectly normal for me to take a spot at the picnic table directly across from Lilly.

I attributed this to Cymbalta. I still suspect that is so.

As usual, before meetings, she was holding a paperback open with the thumb of one hand while she smoked a long, menthol "100s" cigarette with the other. I'd heard her tell someone that she enjoyed reading "paranormal romance" novels, a genre I had never heard of in ten years of book selling. Something new that had been waiting all this time to be conceived.

"I hello," I said.
She looked up, her eyes friendly and surprised.
"I. i. ---" I affected a difficulty in speech, turning my head sideways then bringing my shoulder up to my right ear before the next syllable.

I had never tried this before. Turn inside out, be the stammerer!

"Huh!- huh!- huh- Hi, John!! You still don't have that right. "

"What, I've done that before? Listen, I can't place you, sweetheart. It's amnesia. I should know you right off. I'm sorry. "

"Wow! You really were drunk all that time. It's Lilly, John. LILLY. Come to think of it, I don't think you ever remembered my name from night to night, " she laughed.

Memories gathered up finally and there she was from four years ago. I almost recoiled, but not from her. I shrunk from that dissolute time in my life.

But her name was not "Lilly", I felt sure. And this could not be the woman of four years ago whose wardrobe of modern T-Shirts advertised Lucky Charms, Trix, and Fruit Loops. Today she looked like a school-teacher from the 1940's. Back then she was like a sprig of 21st century modernity and optimism.

How can time. So fast. And me, how old am I?

So we began prompting each other's memories.

"I spent all that time trying to persuade you to get on the Internet, didn't I?" And we had fun! I remember! People would come talk to you and you'd convince them you had a twin. That you weren't you. You were a great actress I ever saw, I thought. "

"What! I have a twin, I tell you!"

"Really?!"

She rolled her eyes and said in a pretending, plaintive tone, "You wanted me to be your partner and help you find a girlfriend. You thought it would help if I clung to your arm as we walked from bar to bar.

"I was flattered, you thought I was a prize. You must have thought so, didn't you?"

"Of course," I said. "And we'd end up at the Great Wall Of Buzz-saws, you called it."

"And you always flipped off the lead guitarist or the singer. Well, not every time. "

"Once," I said. "It was impossible to talk in there! What's the point in going out if you can't talk?"

We were laughing pretty merrily now. Yes, I remember that! Yes!

How could I forget?

It'd been four years now, since the time of my nightly, tipsy rounds downtown, where I had a crib.

To "The Sanguine", "Woot!" and "The Airliner". Lilly was reliably found at The Airliner. Our first conversation, I realized she'd been taken in by a phony writing contest. She showed me her verses printed in a thick expensive book sold "half-price" to all the "winners". The type was very small. It was a pretty book. I remembered that, and of course not saying anything.

She was talkative. Adventures in community theater. Life in a small, one-cop town (how everyone cat and moused with him); her no account brother she loved and she wished would move to Colobocomo; a dream she had of starting an old fashioned "rooming house".

And then of course long talks about books and philosophy and did-you-ever-read Freud's book about religion?

It was like this with most of the strangers who initiated conversation with me. They seemed assured that I was a befuddled Sartre devotee, stuck on page 31 of Being And Nothingness. They let the glasses and the knitted brow fool them. Like I was concentrating on the human condition instead of calculating how much money I needed from the ATM for the night.

And how to win Miss Kitty's heart this late in the game. Spend my life at her bar doing odd jobs and getting kissed each time she passed by on her way to a table to entertain guests. (Actually there were two Miss Kitty's. One owned this place but was only here two nights a week. The other was at my usual, second stop of the night.)

"Wow I thought all this time you were embarrassed to talk to me," she told me now.

I remembered how she sat alone at the bar writing in a spiral notebook until someone spoke to her, and it was always briefly and had nothing to do with making plans or anything. She was well-known but not popular, apparently. A fixture, tolerated and sometimes warned about something.

I remembered she seemed out of place on campus, not due to her age but something else. Had she been divorced, did she have kids, I tried to remember now. Maybe the people who stopped to say hello were her ex-husband's friends. People who had abandoned her during a divorce. I never found out.
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Now she asked, "Do you know what happened? Did you read in the papers about these foster parents having a kid locked up in their attic nearly starved to death? That was my aunt! My mom's sister! You remember that my mom had cancer?"

I did remember. (Or was it like a trick of deja vu? And how many times in my life have I had someone confide sad news like that?)

"She died about a month later. My whole family is nuts now, I didn't know it before, maybe it wasn't true before, maybe it was only my aunt but now it's everybody. But no, we were always, all of us on drugs or at least pot and alcohol. I loved my aunt, and she was a lot younger than my mom. She loved me! But she made this little kid eat grass.

Since I was a little girl my Aunt Jo was ---I mean I'd flap my arms when I'd hear she was coming to visit and I'd run and jump into her arms even when I was too big for that. She's in prison! She duct-taped the girl to a toilet. She was missing two fingernails. She belongs in prison! But I can't get my mind around it, John."

I sat now wondering how close were we?

I never brought her home. Trying to remember. ...

"Neither of us ever seemed to be drunk..." she said, and then laughed. "We were smashed."

"Summer was ending, wasn't it?"

"Yes."
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He would represent to me the demigod of amoral "self-actualization" and permissiveness. He would stand in as a sort of credentialed modern Philosopher, answerable only to his peers. If he wanted to give me pills, I brooded that he may accidentally cure me of my humanity as anything else.

(the humanity of the alcoholic?!)

Why...! Who can stop such men, if they are corrupt, from misquoting you and then locking you up for 72 hours? Or, more likely, who can stop a stupid man from misunderstanding me, with the same result?

Incredible, really, for me to resist, though. I see that now.

I mustn't let myself forget that old men nowadays are not from my grandfather's or even my father's generation. They can't help affecting the looks and the mannerisms, but they are , I usually suspect, the brash, stubborn, conformist "freaks" and 'niks' of the 1950's and 1960's.

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Lilly and I met at the picnic table three or four times a week. We caught up, while discussing A.A. , Psychiatry, various characters of fiction, and characters who visited the A.A. club.

I told her, "Carl there, with the antennae? He gets a shot once a month, and then for a week or two he's lucid. He was an English/History major for years. You can tell. Then the shot wears off, and he either becomes an alien like today, or he cross-dresses. When the month is up and he needs another shot, he makes no sense. Everyone gets tired of him and he gets angry. We're relieved when he gets his shot. I don't know what medicine that is."

Why isn't addiction considered a personality disorder?

Lilly said our personalities simply are the characteristics we have, like the color of our eyes, the sound of our vocal chords, how we laugh and when we laugh. Who we like and who we don't. Was it just a desire to change, and then change back? To travel and then go home?

Lilly was on Lexapro.
I said, "Cymbalta".
"Hello, Cymbalta," she said.

"After my mother died ---not from cancer but from this Evil that came out of nowhere---my crazy aunt and uncle, god damn them---I decided I had to get sober. I can't even tell you why, but I'm glad I did.

"I wasn't in any trouble. Just with this upheaval, I could tell that if I kept drinking then everyday would be just like the last, and it would be like nothing happened, nothing was wrong. Do you know what I mean? I wanted to rocket above everything and see. What had happened to my family, how did we miss this about my Aunt Jo and my uncle?

"It was pretty easy after 21 days at Last Word. Well, I had an affair with my counselor." She laughed loudly, then leaned forward with her chin low and mischief in her eyes "with a woman! A woman, John! Ha, ha!!"

I gave my standard response. "Good judgment. Men are pigs."

"No! Stupid people with power are pigs. Aggressive, ignorant people are pigs. This woman was a pig, John." Lilly lit another menthol 100 and blew a thin, swift stream of smoke up in the air.

"She thought she was Oprah and Dion Warwick's love child. She'd tell me things about myself and look so proud I'd agree with her just to be nice, like I didn't want to see any disappointment on her face. She was handsome, a black lady with a German father. But then, in group sessions I saw how she seemed to really help people, all the women were totally convinced Nat could feel their pain and find the source. The more time went by, the more I thought I loved her, and I started to believe what she told me about myself. Then one day, I forget what she did but I was sort of angry at her, or tired or something. She just talked talked talked, like me now. And it really upset her, she couldn't stand the thought that I might not be enthralled with her so she focused on me all this erotic power."

"I've never been with a man who hit me or abused me. I've just never been stupid, I steer clear, and if one did ever hit me I'd probably kill him. Or no, have him killed. You know? Anyway I moved in with her and after three months she just turned into a monster because I could see through HER, not the other way around. For real, I could see through her and she was in a complete fantasy about herself. I should have known she'd be dangerous. Actually, for awhile I warned myself, don't reflect back to Nat. But eventually I couldn't help it, I couldn't stop myself laughing at her sometimes. Like, she'd be on the phone all the time , jabbering away and giving me a headache, and you couldn't see how the person on the other end was getting a word in edgewise but she'd suddenly make this pronouncement about them, just like the Psychic-Hotline!

"I'd hide my face in the pillow but finally one night she knew I was laughing at her and she said 'Hold the phone', and then ran over and jumped on me with her knees in my back and started hitting my face and my ears and like, using her knees to try and squash my kidneys."

"I went to stay with my dad. He was in bad shape, and expected me home after my treatment. I felt guilty for that. Three months. But then I relapsed for a week, taking Valium. I told my doctor and that's when I started Lexapro."

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Dr. Cooper took good notes.

LaFevre, a plump, bearded old gent who looked like he'd stepped out of a Thurber cartoon, was direct.

"In 3rd grade did you start to miss school a lot?"

(I'd told Coop that it was in 3rd grade people and kids started remarking and wondering at how thin I was. And I'd become self-conscious and even freaking despairing.)

I said yes , at that time I had a lot of stomach aches made me double over. I wasn't faking. Then I got asthma and that was my free pass for years.

"Did you worry about returning to school after your absences? Because you would have work to make up."

"I don't remember. I suppose I did, yes. Not enough to stop. My older brothers got all A's and B's and finally in 6th grad I got a "D" in English and my parents were mad. I'd missed 45 days one semester.

"But no, it was later in life, when I was a drunkard and afraid of losing my bookstore job."

"Now," he slapped his hands to his knee, sat up, lowered his chin and looked over his glasses. "That is mental illness," he said. "This is what we can help you with."

"It is? But my fear was reasonable."

"Yes, but things were spiraling out of control, you see?"

"Then it was drunken or cowardly foolishness, but not mental illness. No. "

"Ah. See, you were self-medicating with alcohol and out of control. Don't you admit that to me? Isn't that the first step in A.A., admitting you were out of control?"

"I was an alcohol addict and had poor judgement. Over time it naturally became worse."

My dad denied that I was alcoholic, all his life. My older brothers laughed and challenged him. He said, "No. John's a ...habitual drunkard." He grinned at their laughter. "He drank himself into this."

But that sounded right to me. What the hell is 'Alcoholism'? Alcoholism is like what? It's like nothing else. Was my dad just saying that I'd remain out of the gutter somehow?

We came to my real complaint, which is my life-long lack of ambition, energy, and depression.

Dr. LaFevre said: "Have you heard of the Nike Maxim? No? Do you watch TV? Nike. The maxim is "Just do it". Yes. Or, 'go for it' or something...."

This was like my own "hold the phone" moment.

"No. This is why I come to a psychiatrist or psychologist, this is what's wrong with me, all my life. This is the psychological problem! This is what I want figured out, fixed with your meds, whatever you can do, this is the malady! I'm like Bartleby The Scrivener, 'I would prefer not to!' What you call a psychological problem seems reasonable, not mentally ill, even the destructive cycle of addiction and having secrets, that all makes sense, can be reasoned through. I've had parents and gym coaches, I have friends who try to shake some sense into me but all my life I'm like this.

" 'Just do it', you say.

"But it's this, I'd take electric shock treatments for this. I can be so listless sometimes I won't eat when I'm hungry. You can tell me it's character, all right, but you can understand why I've spent my life hoping maybe this isn't about my character. I'll take your pills if they can help with that! Yes!

"I still risk losing that job almost once a month. Ten times in my life, I dropped out of school. I just stopped going, knowing full well that the safety and security of home would turn into a teetering, fearful nightmare...

"What's not reasonable is that I could be rich a hundred times over but I stopped. I had moments, see , when this balking went away, that's what gives me hope that this is psychological or physical.

"In 1985 it went away, this fear of living, ("Fear of success?" Cooper smiled) only I became manic because I was so happy to be alive. They put me down with Haldol and it's never happened again. But I know I can put it over on the world. I know I can float! I can wake up and see the world as it is, as something to plunder for the rest of my life and be sated like normal people.

"But when life went away I got afraid and I shut down."

"Hoo! 'Normal' he says." LaFevre chuckled.

"You're a scientist. Of course there is "normal". There is a normal 'range', isn't there? In human behavior? In the levels of neuro-transmiters?"

"Wait. Back up to 1985. Are you telling me you were hospitalized and treated for 'mania', as they called it then."

"Yes." I turned to Coop and asked, "Did I just throw a tantrum?" He shook his head no, and grinned, embarrassed I think.

"Where were you hospitalized? Here? But I thought you were from ..."

"Yes but it happened here. "

"Was it...Think of right before, were you in some unusually sadness?"

"Yes. There was this red-head, Lisa, and her parrot, Oliver."

Then I hoped he would say 'tell me more about this parrot'.
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Lilly said, "I always return to God. Only God can change my character, not psychiatry, not fluoxetine. But I'll be on Lexapro the rest of my life, I mean I want to be, it makes me stable, it helps me sleep and I have good dreams and I just feel better. "

I asked her twin sister's name. Jody, she said.

"Can I call you Jody?"

"No, of course not. It would be like you were making fun of her."
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"My only concern now, " Dr. LaFevre told Coop and me, "is that the Cymbalta will make him elated. Yes. Too happy. I don't want you to be too happy. You are bi-polar, "bi-polar depressive" but with the SNRI there's too great a chance of another manic episode. Now, there are three choices. We could try Lithium."

"No, no," I said. "That seems to make people crazy."

"What? But they're crazy as june bugs to begin with!"

"Eh. Dr. Cooper will tell you I have complaints about my logic too. What else?"

"There's Depakote..."

"No. At my treatment center, that's the drug everyone complained about. You mentioned a third. What is that?"

"Lamotrigine. It's the latest treatment, approved as a mood stabalizer a few years ago. It has the least side effects."

"Is this the one that gives you a rash?"

"Oh, ho! " he exclaimed to my G.P. "Your patient knows his business! Yes, there is a 1 in 10,000 chance of getting a rash."

I turned to Coop. "He means a rash that would land me in the burn center at the I.C.U."

"He's talking about T.E.N. Toxic Epidermal Necrolysis. You didn't know that, did you?" , he teased Dr. Cooper.

"I'll take that," I said.
___
"Why?" asked Jody. "Why on earth did you choose Lamictal?"
"I puzzle over that myself. It's like for the comic suspense but it's not funny."
"No,---spontaneous human combustion--- yeah well it depends..."
"Or , I guess because it seems radical," I said.

"How crazy are you, John?"

Her question and her tone lent too much seriousness and put a lump in my throat. Tears surprised me, coming up but not to a level to wash my eyes. Jody (or Lilly's) voice and question were like some inner voice I'd put out of business long ago.
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By the end of July, what was happening between Lilly and I might have been what happened the first time. We were summing everything up, three times, four times, continually, almost like we were repeating lines from a sketch.

It's sad to grow tired of someone. You feel shallow, no longer wanting to mine or be mined. It was as though we'd each come to represent a stereotype the other knew too well...even though there seemed to be no one before or after that would recall the stereotype or template.

One day she announced she was going back to school to be a substance abuse counselor, but then she landed a job at the local Border's Books. One evening she proudly presented me with our towns alternative paper and said "turn to page 11". There was her photo and long poem with her by-line (Jody Twirlinger) , titled "Just For Today: So You've Decided To Be Evil ".

The poem began,

"This isn't about anyone you know."

It was dragnet, an attack, a litany of accusations, "all too true for publication". It was about fallen angels and demonic posers, case after case beginning innocently about women who filled their houses with stray cats, then abruptly about charity workers who embezzled, psychologists counseling divorce, psychiatrists drugging children, priests molesting kids, doctors who murdered. Instead of gore it was dry, like an enourmous grass fire. Notably she'd struck out anything about foster parents.

"It was my favorite line, too. They tell you to always edit out your favorite line."

During the last Twilight Festival I spotted Lilly across the roped off avenue, through the miling crowds and the childrens' balloons. She was with friends and had their rapt attention, laughing and talking and stopping just a second to hear a response and then laughing again. She looked great, happy, more than happy, exalted. I feared for her but I envied her too. She seemed young again, in another one of her ironic, cartoony, brand-name t-shirts.

She was drinking from a sports fans' cup of beer, but just, shall I say, incidentally. Her friends were probably co-workers from the bookstore or the magazine. She saw me and raised her cup and spilled it out from that heigth and laughed. She'd get more.

I went along my way, smiling, but still mixed up, what success is.