exactly right—it means there is a genetic component. So which mental illnesses have a genetic component?” I’m up on top of the desk, where I usually sit.
“Cancer. My mom had breast cancer and I had to go get checked for it because she had it, but I didn’t have it.” Lucy.
“That’s right. Cancer has a big genetic component to it, so it’s important to get checked out if someone in your family has it. But what about mental illnesses? What about the kinds of things we treat here?”
“All of ’em, right? I know that if your parents or your brother is addicted to drugs that you will probably get addicted to drugs, too. And people here are getting treated for that. You treat drug addicts here. And sometimes, if your family is depressed, you could get depressed, too.” Tashawndra.
“Yeah, that’s a big one,” I say, wagging my finger in her direction. “Depression has a genetic component. So does schizophrenia, bipolar disorder and many of the other problems we treat here.”
“So you’re fucked, huh? If your mom is schizophrenic, then you can’t stop it from happening to you, huh? It’s like you’re born fucked over. You’re born to be crazy, right? Ha, like ‘Born to Be Bad,’ that song? Born to be crazy.” Tyler. Tyler has schizophrenia. At twenty-two years old, he’s very advanced for his age. He seems to have a greater understanding of the world that the rest of us missed somehow. He’s at peace with things that the rest of us struggle with. Tyler has forgiven.
“Well, no, not always. And watch your language. When you have a genetic predisposition, which means when someone in your family has a disorder, then sometimes you will get it and sometimes you won’t. It depends on what else happens in your life. It depends on whether or not you are exposed to things that will help you stay well, or things that will make you get sick.” I’m bouncing my heels off the front of the desk.
“What kind of stuff makes you sick? Like drugs and stuff?” Tyler. “Because I know my brother did drugs in school with his friend, and then he was crazy after that. He got locked up but he was crazy, man. He never acted like that before he did those drugs.”
“Drugs, sure. That’s a significant one, actually.” I’m nodding and explaining, bright-eyed. “Also, poverty, abuse, growing up without both parents, not being able to get enough food or go to school. They are kind of like strikes against you. So, if you have the gene in you to get depression or schizophrenia, and then you have these strikes in your life, too, you could end up with the diagnosis.”
“Like three strikes, you’re out, right?” Tyler. He and I talk baseball in the hallways. I’m afraid of running into him one day at Yankee Stadium.
When it’s almost time to go home, I start to look at all the things I’ve been avoiding all day. I don’t have a drink or a cigarette with me to help me look at these things, but I start to peer into the abyss anyway.
I know when I get home and I am alone, and my phone isn’t ringing, I’ll be looking at this, so I may as well get it started now. Maybe it will ease the burden. Maybe I won’t cry so hard when I’m at home. Inevitably, the only thing that happens is I am going to be forced to wear sunglasses on the train home because my face will be swollen with misery and my eyes will be brimming with tears that somehow, every single day, manage to cling to my eyelids until the very second my apartment door swings open.
It didn’t always feel like this. Sometimes things made sense. Back when I felt like I understood what was going on, and I wasn’t just going through the motions.
The subway is down. There is a fire on the tracks on the A/C Line, and I have to get off the train a hundred blocks from my apartment. For whatever reason, I am walking now. I tend to think when I walk, which is probably not a good thing, because I don’t have any cash and I can’t stop somewhere for a drink to help me stop thinking.
It’s cold out. The kind of cold that makes your knees hurt and your lips get solid, so it’s hard to talk. My eyes are watering, but I’m not crying. I’m smoking back-to-back cigarettes, and I don’t have gloves, so I have to keep switching hands.
Even though it’s freezing, there are families out in the street. I’ve seen them since I got off the train. There is a mother pushing a stroller on the other side of the street, and we have been pacing each other for blocks. She looks like me. Well, she looks like my mom, and I guess I look like my mom, too. We’re blonde, and I’m guessing the woman has blue eyes like we do, even though I can’t see that far. She’s small, like my mother is. I’m much taller than they both are; I always thought my dad must have been a pretty big guy. Now I’m stuck thinking about my own family as I walk south in this bitter city.
It was just me and my mom growing up. My dad is somewhere, but I don’t know where. I’ve never met him, but it doesn’t really make a difference because Mom was almost too much to manage on her own. Sometimes she sang his praises—Your father is a wonderful man. And sometimes she shit all over him—He’s just some mick fuck who doesn’t deserve me. I wonder if that baby in the stroller knows her dad.
My name is Samantha because my mom’s name was Samantha. I think that’s why I go by Sam. Our last name is James. So I have two first names. I always told people never to trust someone with two first names.
I can see my apartment now. It’s the only one on the floor with no lights on. It’s in an old limestone walk-up building in the middle of the block. I’ve been living in New York City for a few years. I bounced around different studios and tiny one-bedrooms in Brooklyn and Manhattan after I came here for graduate school. My current apartment has three closets, which is practically unheard-of, and a bathtub. I have a desk and a coffee table and it could pass for a grown-up apartment if I could just buy food to put in the fridge. My couch is brown and I have different pillow covers for different seasons. Now it’s the dark blue ones. I have a carpet that’s mostly sun bleached because my windows face south, so the summer sun is in here for the whole day, and I used to like the colors but now I think it looks like a little girl’s carpet. My kitchen is very clean and has a window above the sink, so I can look out while I’m washing wineglasses and see what everyone else is doing. The radiator makes noise, which is comforting because if it didn’t, there would be no sound in here. I never turn on the TV because it makes me feel small.
The front door to my building has a tricky lock, and it always seems to get stuck right when the wind picks up and starts to make my ears hurt. The dark green tile floors in the lobby always look dusty and I’m afraid I’ll slip on them and crack my skull. The stairs are wide and rounded, from a New York era long forgotten, and as I wind up them to my apartment, I peel off my outside layers.
I’m opening a bottle of wine that I bought at the liquor store across the street last night. I always make sure to be delicate and grown-up about my drinking. I drink every night, but that’s okay because it’s expensive wine that I drink out of expensive wineglasses that I always remember to wash before I go to bed. I also always clean my ashtrays, because even I think it’s gross to have stale butts around the house. I quit smoking a few times, but then I gave up quitting because something else is going to get me first anyway. Desperation makes you hold on to funny things.
I’m sipping the acrid, burned coffee from the lounge, waiting for my boss, Rachel, to start the clinical-staff meeting. My nails are grimy and dirty,
