When you fill a glass with water, wait eleven seconds before holding your cup under the flow. This frees poison from the pipes. If you forget and time slips to twelve seconds or thirteen, wait until twenty-two seconds. If it happens again, thirty-three.
Set alarms for palindromes. Wake at 6:06, 6:56. Aim for the nearest hour or half hour: the right alarm is 6:26, never 6:36.
Cook by palindrome. Remember, germs—thus death—come from undercooking, so overshoot to the next palindrome. Things might burn. Better safe than sorry.
Symmetry is safe. Even numbers of candles, chairs, cats. Unless the space calls for groupings of three. Pillows, plants, picture frames. These must be in odd numbers. Crave symmetry for security, the reassurance of numbers an antidote to what is wrong with the world.
Aesthetics rule. Notice if angles don’t line up. If wood colors or grains don’t match. If a painting hangs uneven, a floor dips, the seam shows in the carpet. Leave dirty stores, crowded stores. Visually remove the clutter from a friend’s house when you Skype.
Feel most comfortable in your safe, symmetrical home. When you move across the country from Nebraska to Massachusetts, see tiles out of place, discolored planks in the wood floor. See spots in the paint, places where the painters dripped. See gaps in the windows, dirty screens. A closet door sticks and you can’t breathe. The ceiling fan lurches and so does your heart. Try to sleep at night and hear the on on on of the air conditioner. The moon shining from its new position makes your shadow the chalk outline of a dead body.
I was diagnosed with Obsessive-Compulsive Disorder without being informed.
One afternoon, several years into anxiety treatment, I was at my doctor’s office for a routine medication checkup.
“You’re here about anxiety and OCD,” the nurse said, yellow ducks on her scrubs staring blankly at me.
Too surprised to be incredulous, I murmured, “OCD?”
The nurse pointed—”It’s here on your chart”—and put a thermometer in my mouth.
I never asked who added the diagnosis—my current doctor, a prior physician, a specialist, a therapist?—or when it was added. Perhaps I was too surprised. Perhaps I’d never considered comorbidity, or the fact that mental disorders can occur alongside others. Mostly, I think I didn’t believe it, figured it another error or miscommunication. I’d never suspected I had OCD. No one had ever suggested I did. And I’d never consulted with a physician.
My youngest brother was diagnosed with OCD as a young child right around the time he learned to tie his shoes, a long process that sometimes lasted an hour as he painstakingly arranged his socks, placed a foot gingerly in one shoe, tested it out with a few steps, then put the next foot in its shoe. He tied the laces slowly, retying them as many as ten times, measuring the length of each tail, the width of the bows. After getting his shoes tied, he’d carefully cuff his socks, each fold the same width, and finally walk around, quickly finding fault and starting over. Though he has since moved on from this fastidious process, he approaches many tasks—washing his hands before dinner or after ice cream, cleaning his room—the same. He is often unable to complete homework because he writes and rewrites the words, trying to perfect the arc of the letter “C,” the straight back and contradictory curve of the letter “P.” Sometimes he is so concerned with penmanship or producing the correct answer he is unable to write at all. At the movies, he focuses on the dirty screen rather than the film, clenching the arm rests, moving his head from side to side, whispering, near tears, “I don’t know if I can watch this.”
When the nurse announced I’d been suffering from OCD unbeknownst to myself, I didn’t believe her. As with anxiety, I felt the way I always felt. I knew there was no good in protesting, however—arguing further cements madness in the eyes of sane. To prove how not obsessive I was, I tried not to obsess over the fact that I’d been diagnosed without my knowledge or participation. Why hadn’t anyone told me? Had I been treated for OCD without my consent? Was OCD the reason my doctor wanted me to remain on my current medication? Or had an OCD diagnosis been added but without proper treatment? I tried not to think about the power of suggestion. The harder I thought about not obsessing, the more obsessive I felt.
Now, years later, my OCD is becoming more extreme. Compulsion enters from the right. It pierces through my eye again and again, reminding me, scolding me, warning me. The rhythm jolts, makes me squint and wince. It’s like a record skipping inside. The vinyl scratch signaling the comedic “uh oh” in a movie, only gone terribly wrong. The repetition feels like ragged nails on the chalkboard of my mind, a sickening cue in my temple. It stabs. Lately, when it comes I wince, my eyes at first, then my head, like I’m bracing for an invisible blow.
The tics are increasing. When I try to explain what it feels like to be on repeat, 11, 22, 33, I blink, I grimace, I rock back and forth. Sometimes I get stuck on a word, on a word, and so I snap to try and clear it out of my throat, blink and cough, my speech punctuated, dramatized, but still I’m hinged on that word that word that word that won’t come free, get loose, come free and so I snap, dodge the pierce again, and again it reminds me to get off that word that word, that word I know clearly but can’t manage to get right.
I can’t look in the mirror lately, because I am not symmetrical. One ear is higher and my glasses sit cooked, or is it my eyes that don’t line up? One cheekbone is wider than the other. One eye bulges. I’m convinced my teeth move—one front tooth dangling a millimeter lower than the other, some suddenly too square, others too round—and I stare and stare, trying to convince myself of what is right, what is real. My lower gums have worn away from my furious brushing. I’ve learned it’s best not to look in the mirror. I don’t even know what I looked like on my wedding day.
If I pay attention to my body long enough I realize it’s decaying. I am less worried about being unattractive or aging than I am about my body changing without my permission, moving on without me. Nothing is fixed. The only thing permanent is that everything falls apart.
Even language. Tiles surround the fireplace in my living room, crisp white symmetrical squares. I like to watch firelight flicker across them. I like how they are warm in the winter, cool in the summer. Lately, though, I play a game with the tiles and the words on TV. The game is this: When I hear a word, I must put each letter into a tile until the word is spaced evenly around the fireplace. I can have empty tiles between letters if this helps the symmetry. It’s best to fill all the spaces, but if I can’t, then there are rules about how to fill them, how to arrange the words in a manner that doesn’t hurt. There are lots of ways to lose points. When I’m playing the rules come sharp, above my right eye, over and over until I know not to fail. Here is one rule: I can’t breathe until I finish. I can’t stop until it is right. One letter, one space. When I win—and I will win—I get the ability to move onto the next word that catches my fancy. Sometimes I see the tiles when I’m not in the house. I put words from billboards around my imaginary fireplace. Words I write on the board in my classroom.
I am putting the words from this book around my imaginary fireplace. I am piecing together the story of how I fell apart. There is then and there is now. There is the me that did not believe I was ill, and the me that was ashamed it was true, and now there is the me that would not have my brain any other way. I cannot make the words fit in the squares—leaps in time, missing time, confusion, contradiction. Writing this book makes me jolt, sputter, makes me click on a turn of phrase, makes me check a transition in the middle of the night, makes me close my eyes right now because it is wrong, but because being wrong may also be right. It is hard to put these words around my fireplace. But I’ll get there.
Rumpus original art by Lisa Lee Herrick
Excerpted from Quite Mad: An American Pharma Memoir by Sarah Fawn Montgomery and forthcoming from Mad Creek Books. Copyright © 2018 by Sarah Fawn Montgomery. Reprinted by permission, courtesy of Mad Creek Books.