---

---

 

The nurse processing my intake at the psychiatric hospital looked like the kind of person with whom I would strike up a conversation while waiting for a drag show. Everything about her seemed to match, down to the color of her irises. I envied her lace front wig and her acrylic nails on which were tiny rhinestones that glistened as she handled my paperwork.

When the nurse asked why I had come for an assessment, I didn’t immediately know how to respond. For almost nine months, elation and frantic energy had been so woven into my behaviors and patterns that “baseline” felt as fantastical as Narnia. Mania imbued every place with magic. At the post office, dressed to the nines, I flirted with a goddess of a woman wearing sandals with straps that went all the way up to her knees, as I licked the envelope that I was mailing to the Social Security Office of Disability. Outside Safeway, I engaged in an hour-long conversation with a train hopper who was panhandling while flashing his firearm. Little stories from my life felt like the only way I knew how to communicate what was wrong. It felt humiliating and slightly pathetic to simply say, “I’m doing dangerous things. I’m taking risks. I’m not myself.”

Eventually, I settled on a different one-sentence story. “Two weeks ago, I cut off all my hair with safety scissors during a layover at the Anchorage airport.”

“It’s cute,” she said.

This was not the response I had expected, and it made me momentarily question my reality. We stared at each other for several beats before I said, “Well, a stylist had to fix it. It wasn’t cute when I did it.”

She wrote something down on her clipboard and then returned to her script. Was I suicidal? Was I hearing voices, seeing shadows? Was I thinking of harming myself or others? I answered no for most questions, but I knew that the real answers would be more nuanced. She may have known, too, based on my hesitation—the mental gymnastics it took to reach that simple response. I started feeling like I was wasting the nurse’s time until certain statements began sparking her interest. “You said you’ve only been sleeping for two hours at a time?” she asked me. She wanted to know when I had become unable to work and when I had stopped driving.

“Give me three reasons you’re alive.”

This question took me aback. I knew that my actual answer would seem bizarre to the nurse, and also that it was private. Maybe even too private for me to acknowledge to myself. The nurse wanted collateral, something to reference later if I was teetering, ready to jump off a metaphorical rooftop, a metric with which to gauge how much of a risk I posed to myself in this moment. I spat out three reasons, like a gumball dispenser.

“My wife. My friends. My art.”

She nodded, made a note, and then asked me to explain why I had cut off my hair in Anchorage. It wasn’t clear whether this line of inquiry was part of the assessment.

“Have you ever been in a crowd of strangers and you’re convinced that you’ve met all of them before—that your lives have intersected in the past? Have you ever felt that everybody knows you?”

With every second of silence that passed after I finished speaking, I became more certain that I had miscalculated my response. In weekly therapy, I had fine-tuned the skill of sharing enough information that I could get help without divulging enough to get hospitalized, but lately I seemed to be losing my touch. In the wake of some of my recent sessions, my therapist had started using the phrase “light psychosis,” like it was a low-calorie ranch dressing.

“No,” she said, slowly. “I don’t know that feeling. What does that have to do with cutting your hair?”

“I just didn’t want to be recognizable anymore,” I said. “I just didn’t want to be perceived.”

The nurse asked if she could present my case to the doctor for a recommendation about how to proceed. I said yes and that I needed to use the bathroom. It wasn’t until the woman followed me into the bathroom and locked the door behind us that I realized she hadn’t escorted me there to be nice.

“Do you have to be in here?” I asked.

“You can go number two in front of me,” she said.

---

The verdict that was delivered to me in the intake room with the nailed-down chairs was the one I had expected: the doctor recommended immediate inpatient hospitalization. I consented for several reasons, two of which were exhaustion and fear. A year of mania had taken its toll on my body, my thought patterns, and every single one of my relationships. It seemed plausible that soon, the “light psychosis” could become full strength.

After our bathroom foray, I didn’t even care that the nurse was watching as my wife struggled to help me push out my nose ring and then slide off my wedding ring. The nurse hovered above us as I wrote down the names of ten people who would be able to call me while I was in the hospital. Once I said goodbye, she was joined by another nurse, and I was guided into a large, single-stall bathroom. They instructed me to get naked, and the nurse I had just met said, “We’re all just one big, happy family here.” In a static jumping jack position, the two women made note of all my tattoos and scars. They didn’t touch me. They talked about and pointed to my body as though I were a museum artifact. It was like being present for my own autopsy. As I played dead, I considered everything they were seeing: my thick, unruly body hair that inspired jealousy in my friends taking T; the chipped, pink nail polish on my toes; my big breasts and wide shoulders. Some friends thought I was making some sort of fashion statement, but the truth was, my body and facial hair were simply too difficult to tame. My desire for bright colors on my nails and lips, for shiny earrings and glitter eyeshadow, was as ingrained in my character as my preference for the winter season and fried eggs over scrambled. To those who didn’t know me, it may have even seemed like I was seeking attention—and maybe, by extension, that I wanted all those strangers in the Anchorage airport to look at me. But they weren’t looking at you, a voice in the back of my mind reminded me. You just thought they were.

When the women examining my body were done, they handed me a pair of paper scrubs and cotton underwear thinner than a Bible page. The nurse who had done my intake guided me back to the unit, where a tech took my vitals and offered to show me my room. He said he needed to make sure one of my three roommates, Melinda, was still alive. I laughed, thinking he was joking, until we crossed the threshold and I saw her. Aside from the fact that she was sitting upright on the side of the bed with her socked feet on the ground, she did appear recently deceased. Her mouth was half-open, her eyes were closed, and her head was slumped over, stringy blond hair partially covering her pockmarked face. Looking at her ragged brown teeth felt like an invasion of her privacy.

The tech approached Melinda and put a finger to her neck, and then nodded at me as if to say, “Still alive.” Then, he stepped back, put his hands on his hips in an almost mock display of authority, and began loudly addressing the sleeping woman.

“Melinda,” he said. I could tell he had spoken her name many times. “Melinda. No smoke break unless you clean up all those dirty tampons on the floor of the bathroom.”

Melinda made no indication that she had heard the man. He looked back at me, and then began speaking louder. “I’m warning you, Melinda. No smoke break.”

On his way out, the tech said, “That goes for you too.” I wanted to point out that I hadn’t yet had time to contribute to what sounded like a biohazard in the bathroom, and that I also didn’t smoke.

The door hadn’t even shut when a woman I had barely noticed in the bed kitty-corner to mine screamed, at the top of her lungs, “FUCK!” She ripped off the threadbare sheet and pounded her legs like a toddler having a tantrum. The bed, which was only about a foot off the ground and nailed to the floor, shook with each kick.

The tech didn’t return, and the woman began violently vomiting into a paper bag. The sounds and smell forced me out of the room, where I encountered a man who was staggering through the hallways. “Do you have security on all floors?” he asked the nurses. “They took my daughter right out of this facility. I’m going to sue you all if you don’t give me my cell phone. They took my daughter!”

Hearing this man’s pleas and witnessing his consternation had a peculiar effect on my body. It was like the fear that had been nesting there, blockaded or numbed, was suddenly activated and released. It spread like a contagion through my cells. It lit me up like my daily run-ins with the construction workers in New York City when I lived there at nineteen. They worked for months outside my apartment complex, and every time I entered or left the building, they pantomimed chasing me, arms outstretched, to grope me. Their catcalls became a kind of mad lib that varied only slightly from day to day. “There’s my little (noun) with her (adjective) little (noun). I can’t wait to get my hands on her and (verb) her so good I (verb) all over her (noun) and her (adjective) (noun).”

In front of the nurse’s station was an old-fashioned phone with a cord so short that after I dialed, I had to turn my body in toward the wall to reach the earpiece. When my wife answered, I didn’t greet her. I didn’t ask about her drive home or if she was even there yet. “I need to get out of here,” I said. “There are so many people detoxing.”

“Well, didn’t you expect that?” she asked. “It’s the detox unit.”

Disbelief washed over me as I surveyed my surroundings. The man with the missing daughter walked past me, sideways and skittish like a crab, peering behind all corners before proceeding. A handwritten sign posted on the nurses’ station read No Visitations Until You Finish Your Detox.

When I finally spoke again, my question had calcified into a statement.

“I’m in the detox unit.”

“Yes…” she said, her voice tinny and unsure. “They didn’t tell you?”

The first emotion I experienced was indignation, but that was quickly replaced by something else, which was akin to what I used to feel as a small child in confession. A horrifying thought slid through my ears into my skull: if mania was my addiction, maybe this was exactly where I was supposed to be.

After we hung up, I found what I yearned for in the dayroom: paper in the form of a composition notebook and a cup of dull pencils no bigger than my index finger. I tried not to let my gaze linger on any of the people whose eyes were fixed to the television screen, but there was one person who caught my interest. Although there were no discernable indicators, nothing definitive or even very suggestive, I was certain he was trans. I wanted to talk to him. I wanted to know his favorite shape of noodle and whether he had imaginary friends growing up. These were the types of questions I usually asked strangers when I was manic, but being in the hospital together made his answers seem more urgent. “Have you ever felt too visible and invisible at the same time?” I wanted to ask. “Have you ever cut your own hair?” The man made eye contact for a brief moment, and then I gathered my supplies and returned to my room where I drew in my notebook by moonlight until my eyelids fell like stage curtains.

---

In the morning, a tech delivered my paper cup of pills with a sticky note on which was scrawled a queer friend’s name and number.

“She tried to call you last night,” the tech said. Groggily, I stumbled to the phone in the hallway and dialed the number.

“Oh my god,” the friend said. “I’ve been so worried.” She reminded me that she’d been admitted to this very hospital a few years ago for her depression. “If they try to take you anywhere, always ask where you’re going. Ask what they’re doing. I woke up one night with a needle in my arm. They were drawing blood and didn’t tell me. I had a full-blown panic attack.”

I tried to steer the conversation to the drag bar where we met—a queen we both knew had recently had her $300 wig stolen from the dressing room and #wiggate had commenced all over Facebook—but my friend resumed her tips about the hospital like she was reading from a list.

“Breakfast and lunch should be your two biggest meals of the day. Dinners are mostly shit, but the spicy spaghetti kind of slaps. Call me at literally any time; I’ll have my ringer on all night.”

I briefly considered telling her that we could only use the phone between 7 a.m. and 10 p.m., but decided to thank her instead. It also occurred to me to bring up the conversation from the day before that I’d had with the social worker assigned my case. “What are you,” she had asked me. “She? He? It?” In response, I had just stared at her in stunned silence wishing I felt even a tiny bit enraged.

Even though I was glad to talk to my friend, I was relieved when another person lined up behind me to make a call. After I hung up the phone, a tech wheeled by a cart full of medicine, handed me a small cup, and told me to sit in front of the closed door by the nurse’s station for the psychiatrist to call me back into her office. There was nothing to look at except for the whiteboard that ranked, in nearly transparent green marker, everybody on the unit according to the risk of suicide.

The psychiatrist at the hospital criticized my previous doctors, prescribed me two new medications to slow my manic thoughts, and took me off of almost every drug I was on when I arrived. I expected her to taper me off the others, but she insisted on the cold turkey approach. Within a few hours, I started experiencing head zaps. Over the next day, they got increasingly worse. Every time one hit me like an electrical current, it felt like my eyes were rolling back in my head and I would lose track of where my body was in space. If I was standing, I would lean dangerously to the side. If I was walking, I would stumble. The only place that felt even remotely safe was my bed, despite the fact that Melinda never left the room, and the tech with the impossible job of checking her vitals every few hours would often wake me up in the process.

For three days, it felt like I was caught in a fever dream with a goal I could neither remember nor achieve. Occasionally, I’d have a flash of the man from the dayroom who I was convinced was trans and it seemed plausible that my goal was to speak to him, but my legs were weighed down. My lungs were filled with water. On my third day in the unit, the tech who brought me my medicine in bed said, “You know, you’re never going to get discharged if you remain this antisocial.”

I stared at her. Blinked once. Other than the trans man, who could I possibly befriend? Did she expect me to invite Melinda into my cot to be the big spoon? Play Battleship in the dayroom with the nameless man who was convinced his daughter had been abducted from the facility? Maybe she thought my other roommate with the periodic tantrums could teach me the art of expressing all of my emotions through different inflections of the word fuck?

In a way, the tech’s statement woke me up. It gave me three new goals that were crystal clear in my mind: get out of detox, get discharged, get better. I wanted a bathroom door that locked, a room of my own, a way to quell my perpetual hunger that wasn’t soggy fish sticks and green beans. The threat of suffering from psychotic hallucinations rattled me, but worse was the possibility of becoming part of somebody else’s. For a few minutes, I briefly considered leaving against medical advice, but I was told that if I did that, my insurance company could refuse to pay for the time I spent in the hospital and I’d be rocketed into massive debt from medical bills.

On the evening of the third day, a spot opened up in the regular adult unit, and I was moved right before bedtime. In the middle of the night, I heard the door to my room creak open. Waking up felt like being wrenched from the catacombs. Two figures entered, one of whom made the bed quickly and then left. The other stood motionless in front of the window.

“They moved you out of detox too?” I heard myself say. It was the trans man.

“Yeah,” he replied. “Yeah. Sorry to wake you.”

“Why aren’t you on the men’s side?”

“Good question,” he said. “I guess because it’s not official.”

I felt a jolt. I was right.

“You mean on your paperwork?” I asked.

“Yeah,” he said. “That pesky little F.”

I nodded even though he couldn’t see me. We were both quiet for a minute, and then he told me I should go back to sleep. Briefly, I worried that he wouldn’t open up to me again in the morning, and that whatever spell he was under that made him want to talk to me would be over. But as we lined up for breakfast together the next morning, we slid easily into conversation. He told me his name was Flynn, and that he was a high school substitute teacher. We talked about how impossible it felt to navigate the mental healthcare system, especially as people with identities and bodies like ours. We exchanged memories about being treated by doctors who couldn’t think of any reason we were so sure we weren’t pregnant if we weren’t using protection. We commiserated about doctors who blamed all our problems on our size, our unruly bodies leading to BMIs that were deemed catastrophic. He told me what it had been like to be a pregnant man—the confusion his presence elicited from strangers, the scorn. Then, he told me what it was like to confess to his mom that he was making plans to kill himself and to ask if she could watch his kids for a couple weeks so he could get help.

“Want to know something funny?” he asked, as we served ourselves cold scrambled eggs. “Back on detox, I had my own room. A four-person room. They didn’t know what to make of me. Didn’t want to put me with the men or the women. Didn’t want to make anybody uncomfortable. But they must’ve seen you and thought ‘There’s the perfect roommate.’”

“I am the perfect roommate,” I said.

“You might be if you can get your hands on a CPAP machine,” he said, grinning.

---

After Flynn and I started talking, everything shifted. The deep intimacy and trust that would typically take months to achieve in the real world took only a few days in the hospital setting. It wasn’t long before we started attracting others. The first was an alcoholic dance mom who had just gotten out of a week-long coma in which she had been pronounced dead for a total of six minutes. Second was an elderly woman who accidently killed her Yorkie by giving her a Xanax. Then came a man with a teardrop tattooed on his left cheekbone who had slit his father’s throat at age seven. “He deserved it,” was all he said, in a pitch that was barely audible.

What everyone craved, it seemed, was someone’s investment—someone’s attention—and turning to each other was just a consequence of realizing the hospital staff couldn’t provide that. There were too many of us: an army of embodied needs in orange scrubs. Techs and nurses moved urgently around the unit like they were trying to catch a bus, and it was never fast enough. It was also impossible for them to remember our names, so they identified us by room number. In the mornings, the nurse barely looked up at us to ask if we knew where we were and the approximate time of our last bowel movement.

Apart from my newly formed group of misfits and my wife’s presence on visitation nights, one of the only comforts in the psych ward was the composition notebook in which I was drawing nearly nonstop. I rendered cartoons of my underwear at my ankles in the strip search, geometric patterns inspired by the cafeteria floor, cubist renditions of patients sitting campfire-style around the TV in the detox unit. I drew Flynn taking his shot of T in our shared bathroom and the long corridors with speech bubbles hovering in the air that said things like “Alert, alert,” and “Code green.”

One night, Flynn and I lingered in the dayroom until 11:00 p.m. when it closed. He was reading A Brief History of Time by Stephen Hawking—one of the only books available to us besides Old Yeller—and I was coloring with two broken crayons.

When the tech told us to leave, we walked slowly back to our room on the women’s side of the unit. In our room, the moonlight filtering through the blinds cast stripes onto our bedsheets. Flynn retrieved the cheap toothbrush from the small bin of toiletries we’d been given upon our arrival. I sat down on the stiff mattress and spoke softly.

“Can I ask you a question?”

He stuck the toothbrush into his mouth and nodded.

“Has anyone at the hospital asked you why you want to kill yourself?”

Flynn hesitated, stopped brushing. A brief jolt. Then, he spit.

“No,” he said. “No one has, I guess.”

“No one’s really asked about my mania either,” I said. “I keep wanting someone to ask what’s driving me, or if I know what’s at the bottom of it.”

“What would you say if someone actually did ask you that?”

“I’d probably say something about how addictive it is. It feels like a superpower and it feels like I’m being electrocuted and it feels like it’s ruining my life. Every single one of those things are true.”

Flynn said nothing in response, so I posed another question.

“When you were admitted, did they ask you to list three reasons to stay alive?”

He nodded. “I could only come up with one. My kids.”

“That’s probably the only one you need.”

“What about you?” he countered.

“I said something that I figured they expected,” I told him. “I don’t even remember now. I wish they would ask me again. I have a better answer. I think I’m alive for curiosity. I’m not sure if that’s the mania talking or not. Do I sound crazy if I say I’m alive for all the art I haven’t seen or made? All the conversations I haven’t had yet? All the things I haven’t experienced or gotten to appreciate?”

There was a brief pause, then he answered.

“Do you ever think maybe it’s just you?” For a moment, he looked frightened, then rushed to finish his thought. “I think all the time that maybe this isn’t depression. Maybe this is just me. Maybe this is just part of being a trans man living in Podunk, Missouri, trying to raise two small kids with a spouse who left me, $100K of debt, and a job where I’m constantly told I’m a freak and a faggot by the kinds of kids who used to beat me up in high school. Maybe it makes sense I want to kill myself. Maybe I’m not crazy.”

I nodded even though Flynn wasn’t facing me.

“I don’t think you’re crazy,” I said. It was a flimsy response, but he accepted it.

“That’s what I’m trying to say to you too.”

---

On the morning of the sixth day, I realized I could peel an orange tenderly without ripping into its skin with my nails. My thoughts, I noticed, were less like a flurry of startled birds and more like a train traversing a prairie. For the first time since I was admitted, I went outside into the courtyard with the smokers just to sit on a bench under a bus stop and observe. It had struck me as odd the first day I arrived—a city bus stop in the middle of a landscaped yard in a suburban psych hospital—but at some point, during the many hours I had spent staring out the window, it had started to seem normal.

By the eighth day, I begged to be discharged. The nurse practitioner and social worker both signed the necessary paperwork, but I needed the doctor’s approval too. We had only met once—the day she started me on a new protocol and took me off all the previous drugs—and her gaze had felt like an X-ray. No one at the nurses’ station knew when she would arrive. When she finally did, it was nighttime. We had already returned from dinner and I could feel the slab of pork and cold peas sitting in my belly as I sat numbly watching reality TV in the dayroom.

When it was my turn, I leapt to my feet. A minute later, perched in front of the doctor who would decide my fate, my hope flatlined.

“I don’t do discharges at night,” she said, stone-faced.

Tears welled up in my eyes as I pleaded, sentences like staccatos. “I feel better. I don’t feel manic. I feel good. I miss my wife. I need to go home. Please, let me go home.”

“You’re just saying what you think I want to hear,” she said. I didn’t reply, and we sat in silence for several tense seconds. Then, she sighed, clearly exasperated. I could almost see the wheels turning in her head. Arguing with me would take time that she didn’t have. There were dark circles under her eyes and a dozen other patients in the dayroom waiting to be seen.

“Fine,” she said. She signed my discharge paperwork aggressively and slid it to me. “But this is how you slip through the cracks. I’ve seen it a million times. You’re going to slip through the cracks.”

“I already have,” I said.

---

When I emerged from the small office, all the other patients were outside for one final smoke break before bed. I returned to my room to retrieve my notebook and put my sock full of vending machine quarters on Flynn’s pillow. A tech beckoned for me to follow her to the lobby where my wife would be waiting to drive me home.

I hadn’t realized it was raining until we passed a large window with a view of the yard. I had grown fond of this window. We walked by it three times a day on our way to the cafeteria. This would be my last view of the psych ward, I realized: the darkness, the droplets, the bus stop where everyone was clustered to talk and smoke. Without much searching, I saw Flynn midconversation, gesturing with both hands. The woman who had just awakened from the coma was nodding in agreement. The man who had killed his own father sucked on a slim cigarette while staring pensively at the old oak tree.

I tried to push away the two thoughts that came to me next, but they arrived in my head solid and fully formed. How little shelter a city bus stop provided to a group of people in some kind of crisis, needing something they might never get. What small amount of safety it gave to people waiting in the dark for a bus that would never come.

 

---

GABE MONTESANTI is the author of Brace for Impact: A Memoir (2022), which chronicles her time skating for Arch Rival Roller Derby. Gabe earned her bachelor’s degree in mathematics and studio art at Kalamazoo College and her MFA at Washington University in St. Louis. Her work has been published in places like HuffPost, Los Angeles Times, Literary Hub, Creative Nonfiction, Electric Literature, and Brevity. She has been granted artist residencies from the Kimmel Harding Nelson Center for the Arts in Nebraska City, Nebraska, and Storyknife Writers Retreat in Homer, Alaska. In 2023, she captured the inaugural title of Mx. Pride St. Louis and is at work on a second memoir about her time performing drag. Find her on Instagram at @gabemontesantiauthor.

 

Featured image by Marius Matuschzik, courtesy of Unsplash.