I take seven medications everyday. Four of them are psychiatric — the chemical scaffolding that keeps the architecture of my mind from listing too far in any one direction. The other three exist to manage the side effects of the first four, which is the particular pharmacological arrangement of a person whose body requires medication to function and then requires additional medication to tolerate the functioning. It is turtles all the way down, except the turtles are pills, and the stack has a copay.
This is not a complaint. This is an inventory.
The morning routine goes like this: I wake up, I go to the kitchen, I eat several hundred calories. I take the pills with water because coffee will come after and who wants to swig down a fistful of pills with hot coffee? At this point the routine has worn a groove in my day so deep that deviating from it would require more effort than following it. The pills go down. The water goes down. I make coffee. The day begins.
This has been the shape of my mornings for years now, and I have come to find it, against every reasonable expectation, comfortable.
I am a lead software engineer. I hold two degrees in computer science — a bachelor’s earned in Duluth during a period I now understand was marked by undiagnosed schizoaffective disorder, and a master’s earned later, both completed before anyone thought to suggest that the oscillation between semesters of unstoppable productivity and semesters of barely starting might be clinical. Two degrees, navigated without a diagnosis, without medication, without the language to describe what was happening — just the raw stubbornness of a person who did not yet know there was a name for the thing he was dragging through every lecture hall and lab.
I have lead teams. I have reviewed software repository pull requests. I have sat in meetings where we discussed sprint velocity and technical debt and whether to refactor the authentication module or leave it for next quarter. I architect systems. I debug systems. I explain to other engineers why the system I architected does not work the way I said it would, which is humbling in the ordinary way that software engineering is humbling — not because the stakes are high but because the code does not care about your intentions, only your logic, and logic is a currency that my brain has not always traded in reliably.
The mind that once could not be trusted to keep itself alive is now trusted to make decisions that other people’s work depends on. I do not know what to do with this fact except to note it, the way you note a weather pattern that defies the forecast. You do not argue with the sun when it arrives on a day the models said would be overcast. You just go outside.
The job is good. The job is, in fact, one of the more reliable anchors in a life that has required an unusual number of them. There is something grounding about code — it compiles or it does not, the tests pass or they fail, the system works or it throws an error that tells you, with admirable specificity, exactly where it does not work. The feedback loop is immediate and honest, which is a quality I have learned to appreciate in the parts of my life that are not my brain.
Melissa has been at my side for nearly twenty-four years.
I write that sentence and it sits there on the screen, simple and factual, betraying nothing of its weight. Twenty-four years. That is almost the duration of most mortgages. It is longer than I was alive when the schizoaffective disorder first started making itself known, though neither of us had a name for it then. Twenty-four years covers the manic episodes and the depressive episodes and the psychotic episodes and the episode where my pancreas attempted a mutiny and the forty-five-day coma that followed. It covers the psychiatric ward in New Ulm and the ICU in St. Paul and the rehabilitation facility and every fluorescent-lit waiting room in between. It covers the night I described a suicide plan to a social worker with the specificity of an engineer presenting project requirements, and it covers the morning I woke from the coma and could not speak because of the tracheostomy and could not move because of the open abdomen, and she was in the chair beside the bed, waiting.
It also covers the grocery runs. The mortgage payments. The property taxes. The oil changes. The particular negotiation of two people deciding what to have for dinner on a Tuesday when neither of them wants to cook. The twenty-four years are not all crisis. Most of them, in fact, are not. Most of them are the ordinary accrual of a shared life — the inside jokes, the unspoken agreements about which side of the bed belongs to whom, the knowledge that she takes her coffee a certain way and I take mine a different way and these are facts we learned about each other so long ago that they have become infrastructure.
She stayed. I do not say this with surprise anymore, though there was a time when it surprised me daily. I say it now with the particular gratitude of a person who understands, because the actuarial tables have made it very clear, that his continued presence in this life was not a foregone conclusion, and that her continued presence beside him was even less of one. She had reasons to leave. She had reasons most people would understand and no one would judge. She did not leave. She is in the other room right now, and the house is quiet, and this is a comfort that I do not have adequate language for, despite the fact that I have recently taken up the project of finding adequate language for difficult things.
About that. My counselor suggested I write.
She did not frame it as a creative endeavor. She framed it as structured work — a way to take the events that had piled up in my head and give them a shape they could hold outside of it. The coma dreams that sit in my memory with the weight of things that actually happened. The psychiatric ward and the diagnosis that reorganized my entire history. The recovery that left a body working differently than before and a mind working differently than before, neither of which had provided documentation for their updated configurations.
So I write. I write about basements full of junk and golden cities with hieroglyphic pools and empty train depots where the clocks show time that is not time. I write about paramedics with no faces and ambulance rides to small towns and the experience of being told, by a psychiatrist in a locked ward, that your brain has a name for what it does. I write about these things because they happened and because they are still happening, in the sense that the past is never fully past when your mind stores it with the fidelity of lived experience rather than the soft dissolve of ordinary memory.
I did not expect to be a person who writes. This was not in the forecast. The forecast, as I understood it for most of my life, did not extend much past thirty, and the things I planned for within that truncated horizon did not include one blog, let alone two. Because there is another one — a technical blog, moderately successful in the way that niche things are moderately successful, where I write about microcontrollers and programming languages and artificial intelligence and whatever else catches the engineer’s eye on a given week. I have a particular fascination with Jevons’ Paradox — the nineteenth-century observation that efficiency gains in resource use tend to increase total consumption rather than decrease it — and the way it keeps surfacing in technological progress, the same pattern repeating at every scale, from coal to cloud computing, the gains always eaten by the appetite the gains create. It is the kind of subject that a person with schizoaffective disorder probably should not find as comforting as I do, but there it is.
So there are two blogs now. One where I write about coma dreams and psychiatric wards, and one where I write about microcontrollers and the economic paradoxes of progress. I am not sure what it says about me that I find both equally necessary. My counselor would call it a healthy coping mechanism. I would call it something I do now because I find, to my honest surprise, that I have things to say and the stubbornness to say them.
Comfortable.
The clinical literature prefers “managed” and “stabilized” and “functional,” which are accurate but which carry the particular flatness of language designed to be precise rather than inhabited. “Managed” sounds like a mutual fund. “Stabilized” sounds like a building after an earthquake. “Functional” sounds like a coffee maker that brews but whose carafe has a crack and whose timer drifts by a few minutes each week. These words describe a life from the outside, the way you describe a machine — it works, it does not work, it requires maintenance.
Comfortable describes a life from the inside.
I have a mortgage. The mortgage is comfortable — not in the financial sense, because mortgages are never comfortable in the financial sense, but in the sense that having one means I have a house, and the house has rooms, and the rooms have furniture that has learned the shape of our bodies over the years. Melissa and I live in this house. We pay the property taxes. We replace the furnace filter on schedule. We do the things that homeowners do, the endless small maintenance of a structure that shelters you only so long as you continue to maintain it. I have noticed that this is a metaphor that applies to more than houses, but I will not press the point. It presses itself.
I have a job that challenges me and a wife who knows me and a medication regimen that works, or works enough, and a body that has been repaired and a mind that has been named and a daily routine that has worn its groove so deep that most mornings I can follow it without thinking, which is, for a mind like mine, a gift of almost unimaginable value. Most mornings I do not have to decide whether the world is real. It just is, and I move through it, and the coffee is hot, and the code compiles, and the day unfolds with the specific predictability of a life that has earned its routine through means that were anything but routine.
I could be bitter. The raw materials are abundant.
An eighteen-month manic episode that smoldered undetected while I told my mother I had never been happier. A brain that has tried to kill me and, when it failed, settled for tormenting me in ways that required a rotating cast of medications to moderate. A pancreas that nearly finished the job. A forty-five-day coma that left me dreaming of impossible cities and faceless paramedics while my body lay open in an ICU and a machine did my breathing. A recovery that involved relearning to walk, to eat, to distinguish reliably between what is real and what is not — a skill I had been practicing since my twenties but which the coma had knocked back to something worse than zero.
Seven pills every day. Four for the mind, three for the side effects. A pharmacological arrangement that would make a reasonable person bitter, because a reasonable person would look at that daily handful and see evidence of a body that has been broken and repaired and broken again, a life built on a foundation that keeps cracking and requiring new patches.
But I am not bitter. I keep waiting for the bitterness to arrive — bracing for it, the way you brace for a weather system the forecast insists is coming — and it does not. What arrives instead is something quieter and less dramatic, something that would not make for a compelling monologue or a good scene in a movie. What arrives is the morning. The pills. The water. The coffee. Melissa in the other room. The commute when I have to be in the office. The code. The standup meeting. The pull request. The afternoon. The evening. The couch. The quiet.
What arrives is a life, ordinary and improbable and mine. The mind said I would not reach thirty. The body said I would not survive forty. I am forty-five, and I have a mortgage and a career and a marriage that has outlasted most of the appliances in the house, and I am writing essays about my own brain on the internet because a counselor told me it might help, and it does, and here I am, comfortable in a life that none of the models predicted, doing the unglamorous daily work of continuing to be here.
The pills go down. The coffee is hot. The code compiles, mostly. The mortgage is due on the first, and I pay it, and the house continues to stand, and inside it a life continues to accumulate — ordinary, medicated, maintained, and, against all actuarial expectations, comfortable.
Quiet Mind, Loud Brain 
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