Suzanne Scanlon

1. (Morning) The resident from South Africa smiles, makes jokes, talks about his acne—endearing to the breakout-prone aboard the S.S. Lyle. Ava hisses something about fresh blood. Maria looks up from the biography of Virginia Woolf she is reading. Ava's hand shakes so much she has to move her mouth to the cigarette and not the other way around.

2. (Time) She hasn't been outside for weeks but can see that the weather is changing, the air cooler. A doctor wears a jacket; a nurse, a sweater.

3. (Perspective) It is easier than she thought it would be, not going outside. Like everything else, you get used to it.

4. (Ambiance) The sound of a drill from somewhere below an open window in the activity room. The activity room large with a television, institutional furniture. Each Wednesday, the room becomes the setting of Community Meeting. The beep of the elevator, the soft and then hard sound of the doors opening and closing. The reserved smile and swift movement of an elder doctor passing a group of barely dressed female patients who sit like little children who've forgotten how to play. One or another looks to him with a big-eyed, closed mouth neediness that gives him a sense of purpose.

5. (Personality) Doctors who need to be right. An identity based on the ability to solve a problem; to know an answer; to describe the ineffable thing.

6. (Maria) "You okay, honey?" Ava doesn't move as she speaks to her friend, who nods in response. Maria spent the night in the Quiet Room. This news spread quickly around the S.S. and particularly within the C.O. Dorm, where Ava and Lizzie are pretty much settled in for the long run. Ava said that she saw Maria in a pretzel on the couch outside of the nurses' station; she heard Maxine say something about her secrets and how she needed to talk and the next thing she knew Maria was screaming ("bloody murder" she called it), her mouth shaped like an "O". It surprises everyone. Maria spends her time reading or writing in her notebook. She cries a lot--or looks like she is about to cry--almost all the time. Ava thinks it is weird. That is weird, Lizzie affirms, with a high-pitched rising and then falling intonation—the vestiges of her cheerleading persona--that makes up for Ava's complete lack of affect.

7. (Goth) Ava's basically the opposite of a cheerleader.

8. (Maxine) "I know you have secrets, and the longer you keep them in, the longer you'll be in here, like a turtle, curled up in the shell of your own misery."

9. (Quotidian) Monday is the beginning of the work week, even if you aren't working. This can be a problem. It can also be reassuring: Something is getting done, somewhere.

10. (Mary) A chair stationed at the dividing wall that juts out to separate the women's C.O. beds from the men's. There is not an actual wall or door that separates the two, but there are rarely men on the Ward.

11. (Chuck) One man is sleeping on C.O. tonight; no one really knows why.

12. (Trauma and Recovery) Something Lyle likes to say in Community Meetings: "You are only as sick as your secrets." There is a lot of pressure on the SuperSensitives to confess. Lots of the girls remember being abused or raped or otherwise violated; doctors encourage it.

13. (Lists) Lizzie keeps track of the cliches in one section of her notebook: Next to "You're only as sick as your secrets" she's got 16 check marks—second only to "It gets worse before it gets better" with 23 checks.

14. (Perspective) It depends upon whom is defining sick of course; Lizzie recalls an interview with a famous novelist who spoke of the necessity of secrets, that secrets fuel artistry. This is not something Lizzie can yet articulate, but somewhere soulful and deep she recognizes it's validity as truth. Possibility linked inexorably to hope.

15. (Night Shift) 'So then Maria starts screaming.' 'Mary I forgot to brush my teeth!' Lizzie leans out of the women's section of the C.O. dorm. 'Maria told me that she sometimes thinks that if her mother had lived, if she hadn't died, she wouldn't be here.' Lizzie is turned to Ava now. Mary is humming an unrecognizable tune as she knits. 'If Fiona hadn't died, I wouldn't be here.' Lizzie says. It is competitive in tone. Which is how it often goes. Fiona is Lizzie's older sister who died in a car accident when Lizzie was a teenager. 'She said Maxine said she was feeling sorry for herself. And then Pat gave her the No Whining button.' 'FUCK. I have the worst cramps.' Chuck coughs loudly from his side of the C.O. dorm. 'Trying to read back here.' He feigns annoyance but you can tell he sort of likes it; it'd be worse to be reading off alone somewhere. Ava sits up. 'Sorry Chuckie!' 'We're sorry Chuck. We can whisper.' Chuck groans but with a smile; he won't admit it but it's not always so bad, that he's the only guy here.

16. (Sexual Dependency Issues) If you didn't know better you might think that Ava and Lizzie were flirting with Chuck. They were flirting, but it wasn't a kind that signified any real romantic interest. It was merely how they related to each other--and to everyone. Lyle called it "sexual dependency issues" which nobody knew what that meant but didn't argue either. It sounded pretty accurate. Plus, every patient on the ward was under 30; the average age was 25. The place was sticky with it.

17. (Orgasm) Not long after she'd come aboard, Denise O'Byrne told Lizzie not long after she'd come aboard that Lyle recommended pleasuring oneself. This is how he phrased it, which creeped Lizzie out, noting that it was important. The nurses would arrange nightly checks around it—they wouldn't knock on the door if they could see through the small window that you were busy. That it would help.

18. (Insight) "It must make you feel good to be in a hospital" "What do you mean?" "Your mother. You have memories of her dying in a hospital. Of being cared for by doctors and nurses. Maybe this is your way of getting close to her, following her example." "..." "She was a nurse, right?" "Do you have to work hard to be mean or does it just come naturally?" "I read your chart." "Is it a cultural thing?" "Your mom was a nurse; your dad was a doctor. I can imagine hospitals offer something familiar at least, if not comforting." "Because in my culture people are nicer than that. They don't say things that might hurt the other person." "For the most part. It's one of those unspoken rules."

19. (Lizzie) Smiles a little. She can't help it. Maxine sits next to her on the lime green plastic couch, down the hall a bit from the activity room. Maxine is a foot taller than Lizzie at least, though you can't see that now. She has one leg tucked under her and occasionally tosses her hair back. She's leaning forward, slouched down, opening her big eyes to Lizzie as if to ask—to never stop asking, "And so? What's your problem?" But in a nice way, Lizzie has come to think. It is that New Yorker thing of being rude or mean before you can be nice; she can't get used to it.

20. (Makeup) Maxine doesn't wear any. She notices. Just lip gloss. She stares at her for a moment. There is so much white in her eyes. She looks back down at the plastic, her long hair falling into her face. She is counting how long she can hold eye contact before letting it go. Three seconds so far. She told Lyle the eye contact thing is about being seen and how hard that is; he suggests that it is actually about seeing and being seen; it is about the connection she makes when she looks someone in the eyes: the intimacy of it terrified her, he tells her, as if he knows her better than she knows herself. Which sometimes seems to be his point, Lizzie thinks.

21. (It Does Matter What You Call It)
      "I'm going to get a cigarette, Elizabeth, before meds. Want to join me?"
      "You're just going to sit here alone, then. Isolating?"
      "Suit yourself. Isolate away. Just don't forget your meds."
      "I wish you wouldn't use that word."
      "Isolating. I'm not sure it's a word. It sounds wrong in that context."
      Maxine rolls her eyes, "Okay. Intellectualize it, Lizzie. It doesn't really matter what you call it. It's still your problem, not mine."

Maxine is walking away now. Maxine is what Lizzie's grandma would call "big-boned". Lizzie watches her large hips shifting from side to side, her Birkenstocked feet shuffling—she never completely lifts one foot or the other—down to the Aide's station, across from the Dining Room. Maxine always wears the same thing, a variation on the theme of a man's Oxford shirt, Levi's, and Birkenstocks. Her Levi's sit low on her hips, a thick belt. She doesn't have a waist. Lizzie can't get enough of bodies. How weird they are. Like puppets.

22. (Margaret Polley) Within 24 hours of her arrival, the patients of the S.S. Lyle, lucid, observant and skilled listeners with the acuity but indiscrimination of Hypervigilants, know the following about Margaret Polley: that she grew up on the Upper East Side; that she was a heroin addict who took methadone; that she'd abandoned her dependent boyfriend, also a heroin addict (he was in an abandoned Bronx building somewhere, shooting up); that she spent much of her trust fund supporting this boyfriend; that, at the urging of her parents and wealthy matriarchal grandmother, she checked into Austen Riggs where, she noted, and in stark contrast to the rooms of the S.S. Lyle, there were fireplaces in every room; that she did not dye her thick long black hair; that she preferred The Washington Post; that she dropped out of Columbia University; that Columbia University was a very good place to become a heroin addict; that she didn't really think she needed to be on a psych ward but that she was willing to give it a try; that she had hit bottom; that she needed support (rarely did a patient say this out loud); that she was attracted to women but had boyfriends; that she liked Maxine Brauer; that she and Maxine had a certain simpatico, were kindred spirits in a way (via culture, ideology) everyone could recognize but no one would talk about.

23. (Tete-a-tete) Margaret sits next to Maxine, who is lighting a cigarette. Who lights Margaret's cigarette. They are talking now, smiling. They don't mean to make it exclusive—they have loud voices and are in the middle of the ward, where smoking is allowed—but each has a way of looking at the other—it is clear that no one can casually or easily enter this conversation. Margaret, like Maxine, has a way of talking that is also a way of being in the world, somewhat independent of listener engagement. She seems constitutionally unable to remain quiet for very long. This is obvious. She'd explode. What Lizzie notices is that Margaret has zero problem with eye contact. She looks into Maxine's eyes when she speaks, sometimes leaning forward, as if to make her point more forcefully, to connect more deeply. Maxine appears to love the attention--laughing often, rolling her eyes, nodding, turning away only (and not always) to exhale. The other thing that no one could have predicted was that within the year, Margaret would be abruptly discharged back to her Upper East Side home where her grandmother lived and, some weeks later, Maxine would be dismissed from the unit altogether, sent to inferior work in an outpatient testing center. A day shift. Kathy, the other night nurse, would also be dismissed; later everyone would learn she'd moved into an Inwood apartment with Denise O'Byrne. None of this was, in fact, as scandalous as it sounds. Patient-staff affairs are probably a lot more common than is generally acknowledged, and, generally speaking, innocuous.

24. (Maria) Maybe she isn't sure why she is screaming. Maybe it is something to do. This is a psych ward. She's been here for months. Nothing happens. Something no one will officially tell you about a long-term psych ward (you might guess): pretty much nothing happens. Lyle, with his belief in the Kernberg model, repeats the line that makes Lizzie cringe: It Gets Worse Before it gets Better which gives the impression of a kind of progress; but really, the days pass one after another with Nothing At All Happening. Zero sense of production. There's something radical about this. For many depressives, production has been a vital counterpoint to Depression. I'm not Depressed but at least I'm productive. Or rather: I'm Productive and therefore I'm not Depressed. I'm doing well is a way of saying I'm Productive.

25. (The Scream) Aboard the S.S. Lyle, Maria—graduate of the High School for the Performing Arts—screams. She screams with her mouth in an "O" shape. She screams "Oh!" and "No!" and holds the scream: a long excruciating "Noooooo." Chrissy and Ava come by, take turns rubbing her back. "What's going on with her?" Even as the scream consumes her, Maria can hear Chuck. Iris walks by. She winks. Maria screaming.

26. (Drama) She still sort of believes it. That production is the antidote to that vague, nauseating feeling she started noticing, usually in the morning, when she was about 16. There were ways to keep It at bay. The first she'd discovered by chance: it was around the emergence of It that she had her first role in a school play. Anyone who's acted in a school play might discover that it can feel glorious. That is, to the young actor, to one who is meant to have a life in the theater, the sense is the same: you are the center of the universe. You have an identity; you have an audience (which is all any actor needs, and then craves). This becomes the reason many young high school or college actors move to New York or LA: that first transcendent feeling.

27. (Negative Attention) Kathy is always nice when something like this is happening, Maria notices. Otherwise, Kathy is awful. She has a soft intense voice and her long red hair smells of lilacs and soap. Kathy holds the hair to her side as she leans into Maria. "What is going on? What are you doing with your hands?" Maria has her hands on her head. Maxine: "Here. Drink this." Thorazine. "It will help you calm down."

28. (Acting 102) Tuesdays at 10:00 a.m.: Acting Intermediate because in her audition she had shown some felicity; she was assigned, for the first time, the famous Private Moment exercise. She rehearsed. She was prepared.

29. (Her Body) An insoluble problem. A black skirt and a black sweater, black tights and gray boots. She unzipped the sweater. She stood in her bra and skirt. This was not unusual; students loved to dress and undress in Private Moments. She looked at her body in the mirror, considered her body, the shape of her body, her hips, and in particular now her fully formed and distinct waist. She sucked her stomach in, put her hands on her hips. It was the same here as at home, she noticed, and this was Acting: the waist too short, the gut too full, the swollen breasts. The breasts now a definitive C cup a size 34. She is disgusted, you can almost see it, considering her body in the mirror, this one, quite different from the one she seemed to have only what? A few years ago. Now something else entirely. A swollen, fleshy thing.

30. (The Nineties) The cult of Self was all the rage. Maria had no idea how her life was determined by the cultural moment.

31. (Oscar Wilde) I love acting. It is so much more real than life.

32. (Design) The hallway in front of the nurses' station is situated so that no windows are visible. From the south end of the hall a patient can see the bright overhead florescent lights of the visitor's area. There are less of these lights outside the nurses' station. The station itself is enclosed in glass. When the door is closed, it is impossible to hear what is discussed inside.

33. (Etiology) Maxine grabs her hands. "What's the matter?" Maxine yells at Maria. Ava thinks that Maxine looks almost scared. Kathy stays calm. "We are going to the quiet room." Maxine asks, insists: "What's the matter?" as if Maria might answer. As if there is an answer.

34. (Memory) Lizzie's big sister Noreen likes to tell stories about how Mom used to come back from the various foreign countries she got to visit with Dad and tell stories. Noreen told Lizzie that she liked hearing these stories, though Lizzie couldn't remember. Noreen would explain how their Mom would speak of some cultural oddity—excessive tea drinking, say, in Turkey–then add with heavy emphasis: "That's what you do." Bike-riding in Amsterdam. Russian frowns. Bowing in Japan. "Is that what you do?" Noreen remembers Mom asking everyone and no one in particular. It confirmed something of who she was, to separate people into categories this way. To believe there was a higher power guiding each set. Even if she couldn't define the power. Noreen said she always wanted to ask Mom who You was. Mom seemed real attached to You, she said. Noreen said that she'd speak always with a measure of condescension and orientalizing that she found mildly sickening but also greatly entertaining. Noreen said that Lizzie wasn't old enough to know Mom for real before she died—to know that she was flawed--and that that was Lizzie's own personal serious tragedy.

35. (Kathy) She stays calm—you can tell she is trained for this—and tells Maxine, "It doesn't matter what's the matter, we are going to the quiet room." Maria notices that she is taking her more seriously than she takes herself, and that she is kind. She has never been kind before.

36. (The Mirror) Some of the students notice that it is not a look of disgust they see on her face when she picks up a bottle of Coke. It still isn't disgust not really when she takes the bottle and slams it against the table, the Coke spilling onto the floor and then, within seconds, the girl grabbing a shard of thick but edged glass and digging it into her left arm, slicing her skin, which opens as if unzipped, digging the glass in, deeply, in a way no one expected. The blood gathers darkly, like fruit, rolls down her leg. Someone gasps. Someone else says No Way. A few of the girls scream in a way that is more like a squeal.

37. (Protocol) Maria lies down on the mattress in the quiet room. Maxine tells her to turn toward the door. They must see hands. Ava once put a screw through her wrist right there in the quiet room. Since then, hands must be visible.

38. (Chelsea Hartman) Recalls later that she'd never before seen something so purposefully violent and yet sort of peaceful at once. No one ran to help her, not immediately, because she was doing it to herself, however awful it looked, and after she'd done it she looked calm and lovely, really, the dark, thick blood running down the pale white of her arm, her body relaxing down into a chair; the look on her face far away, almost wistful.

39. (Dora Putter) Lizzie thinks the doctor on call looks a lot like Amelia Bedelia. Kathy returns with a pair of sweatpants for Maria. Maria has never received so much attention from the night nurses.

40. (Debriefing) On the phone that evening Chelsea will say that it was manipulative and Judd Rankling will say that it was incredible. That he had never seen anything so totally riveting. Chelsea will hang up on him, nearly. Eventually, the moment ceases to be private, becomes markedly public. Professor Mark Wagner could not tell anyone exactly how he felt about it, as his response was so emotionally complex that he hadn't even broken it down, intellectually or artistically; it all happened very fast: the class was dismissed, the nurse, fetched by a fleeing student, already in the room; the ambulance would arrive soon.

41. (Virginia Woolf) Something Maxine said in Literature group that week, about Woolf: "She was one of those few people who was entitled not to have to deal with the company of other human beings."

42. (Narrative) I didn't know what I was doing.

43. (Alternatives) Or maybe I knew exactly what she meant. Maybe I thought of Virginia Woolf, of convalescence, of rest cures. Maybe it seemed romantic. Maybe I was desperate. How could I know the difference. How do you know the difference between passion and panic? Is there a difference? Maybe I had gone mad. Lost my mind. If that meant something, it could be an answer. "I will get a bed for you there," she told me, "next week. Or would you rather go right now?" I don't know what I said.

44. (The Paradigm) What I did not know was that the Prozac would lead to Zoloft would lead to Ativan would lead to Mellaril would lead to Halcion. Would lead to hypnosis and shocks and lots of groups named with acronyms. I did not know that the week would turn into a month or that the month would turn into an interview with Lyle, who ran the famous Institute. It all just sort of happened. I did not know there would be consequences. No one spoke of stigma–and not just societal stigma, which is very real but less important than the worse stigma, the kind you internalize, the kind Woolf internalized, which wasn't romantic after all—the way you come to think of yourself as sick or mad or mentally ill. Loony or bonkers or someone with emotional problems. Which is how they put it these days. As if. Aren't all emotions problems? She wondered. No one spoke of how this might follow you; how it might alter the very shape and direction of your life. One you might regret pursuing. No one spoke of this because they were part of a system which does not readily consider alternatives.

45. (Freedom) How does a person know what the right thing is, ever? They said it would be the right thing.

46. (Redux) When you are in the paradigm, you can't see out of it, was something Les liked to say. Which is not a cliché, Lizzie notes.

47. (Choice) I didn't feel good. Plus he was kind and sweet when he said it, leaning in close, telling me over and over again that he could help me. And so yes, I said yes.




"Constant Observation" is one in a collection of linked fiction. Other pieces from this collection can be read [here] or [here] or [here]. Or [here].