Frumkin Subcontinental-Lithiation pt-1

1/8/2020 Your Prescribing Doctor: Dispatches from the Psycho-pharmaceutical Complex: Subcontinental Lithiation, Part 1 - McSweeney’s Internet T…
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OCTOBER 17, 2014
YOUR PRESCRIBING DOCTOR :

D I S PAT C H E S F R O M T H E P S Y C H O - P H A R M A C E U T I C A L
COMPLEX
S U B C O N T I N E N TA L L I T H I AT I O N ,
PA RT 1
by R E B E K A H F R U M K I N
“Lithium carbonate is a white, light, alkaline powder that was rst used to dissol e urate
crystals in the bloodstreams of rats…You are being prescribed lithium because you have
experienced a manic or hypomanic episode.”
— “Lithium: A Patient Information Lea et”
---
Not that long ago, I was in the backseat of an

autorickshaw in Jaipur, India, hurtling towards a
psychiatric practice in the distant neighborhood of
Malviya Nagar. I had slept roughly eight hours in ve
nights and was in a state that’s probably best described
as “the perfect stillness resulting from zombi ed
excitement.” Next to me was the avuncular Shyam Ji1 , " is is not a book to simply read in total and digest--yes,
do that--but it is also a work to return to in parts
who was intently focused on a printout he was holding. whenever necessary. It's a book to ingest like medicine."
—Rion Scott
e printout was badly waterlogged from a ash
downpour earlier that morning and contained, among
https://www.mcsweeneys.net/articles/subcontinental-lithiation-part-1 1/11
other things, my TSH and creatine levels. Written at the bottom of the printout was:
Blood work indicates patient well enough to take lithium. e entire thing was in English
for some reason. Shyam Ji knew almost no English. I knew marginally more Hindi.
Between the two of us, we were typically able to scrape together conversations in Hindi
about the weather and our respective families. Shyam Ji would ask politely detailed
questions like “Do your mother and father enjoy living in Chicago, or would they rather
move elsewhere?” and I’d respond: “ ey like it — Chicago. It is a nice and big city.”
e fact that he was pretending to understand what must’ve looked like Runic symbols
to him demonstrated his extreme concern for me, and I appreciated it. I wanted to return
the gesture but I couldn’t think of how. Any socially intelligible behavior was beyond me.
e thing I could do really well was atten myself against my seat and let my eyes go wide
and think some really obtuse thoughts, thirty to sixty per minute. e autorickshaw
driver was cutting o motorcycles, trucks, and other rickshaws, pu ng up his chest and
yelling Kya!?2 when anyone objected. I thought: OK, yes, now here’s someone who’s
keeping pace with my mental state.
It was desert-hot, somewhere around 117 degrees. Shyam Ji ipped the printout over and
began to stare at the very neat handwriting on the back side. He scratched his forehead
with his thumb and I could see that he’d begun sweating o his tilak.3 He’d clearly never
seen anything like this: he was the administrative assistant at the Hindi school where I
studied, typically deployed to o ciate nal exams or take students to the Foreigner
Regional Registration O ce. is was the rst time in the history of his job that he was
looking at someone’s blood work. e owner of the very neat handwriting had been a
Cambridge-educated Specialist in Mental Disease who’d looked barely older than me.
When I told her I did not under any circumstances want to leave the country, she smiled,
readjusted her glasses, and said: “Come on, of course you don’t. You love India -– it is
very good for you to be here, better than home.” en she’d taken a vial of my blood and
referred me to the psychiatrist in Malviya Nagar.
I began to read her handwriting myself — Rebekah Frumkin 24/F History of Disorder;
First diagnosis: No ember 28th, 2013, Patient’s self-reportage of drug use: — then looked
away promptly, not because I didn’t want to continue reading, but because I’d seen out of
the corner of my eye a peacock sitting on the Rajasthan University gate. “Peacock” was
one of the few English words Shyam Ji could generate without help, for reasons that
probably had to do with his interest in the goddess Lakshmi4 . Seeing a peacock in India
is more fun than seeing a peacock stateside because you get to watch everyone be really
nonchalant about a phosphorescent bird that’s just another part of their daily commute.
I pointed out the peacock to Shyam Ji and he regarded it with glancing half-interest,
saying “peacock” and nodding the encouraging nod adults use for children who are
beginning to grasp basic concepts. en he leaned forward so he was basically speaking
in the driver’s ear: “Zyada jaldi5! ” He checked his cell phone, which displayed two
missed calls from D.C. We were in trouble with the U.S. Department of State. Or really
only I was.
To backtrack, here were the mistakes I’d made so far:
1. Failed to disclose to the DoS, which was paying for

me to learn Hindi in India, the fact that I’d received
the diagnosis of Bipolar II multiple times and in
multiple settings, one of which was in the psychiatric
" is is not a book to simply read in total and digest--yes,
ward of Iowa City’s Mercy Hospital. is information do that--but it is also a work to return to in parts
hadn’t seemed relevant at the time. whenever necessary. It's a book to ingest like medicine."
—Rion Scott
2. Traveled to India without the lithium prescribed to me for Bipolar II. In fact I’d
ushed most of the pills down the toilet a month before I le . I’d done this because
lithium made me feel like a thirsty caveperson sprayed with formaldehyde and trapped
behind glass. Also I was really committed to not having a problem that needed lithium.
3. Gone out for beers with my friend T and stayed awake until two in the morning on a
roo op bar chain-smoking bidis and making a tenuous pact to stay in India a er our
course of study. T wanted to do this because she was a scientist and athletically gi ed and
interested in somehow running across India to study its water supply. I wanted to do this
because the person I was in India — or at least the person I was regarded as — was better
and saner than the person I was stateside. Our conversation was the tipping point: I’d
gotten so worked up about the possibility of expatriation that I stopped sleeping for
almost a week a erward, rendering myself un t to represent the United States on foreign
soil.
I had come to India on the following whim: I would

like to learn Hindi. When this whim rst occurred to
me, I was at grad school in Iowa meeting with a ction
student of mine named Miles. We were going to
discuss a short story he had written. I was a few months
out of the psych ward and starting to sleep two hours a
night again. Even though Miles was a nineteen-year- " is is not a book to simply read in total and digest--yes,
do that--but it is also a work to return to in parts
old male, he and I were dressed as each other’s mirror whenever necessary. It's a book to ingest like medicine."
—Rion Scott
image: beanies, silk-screened sweatshirts (his featured a
burrito, mine a Great Pyrenees), black jeans. Miles had
written a story from the point of view of the various animals slaughtered in the
manufacture of the semi-meat Spam. One of the animals—the one who nally defeats
the slaughtering farmer, spoiler alert — was called Jagannath. I asked him how he’d
thought of the name.
“Oh, Jagannath?” he asked, trying to play it o . “ at’s a Hindi word. It means the Lord
of the Universe. It’s where we get the English word ‘juggernaut’ from.”
“OK, OK,” I said, nodding, realizing I knew nothing about what he was saying. “ at’s
amazing, Miles.”
And it really was amazing. But to be fair, a lot of things were amazing at that point in
time.
In a few minutes I was home at my desk, the surface of which was glutted with the
following: my laptop (dried peanut butter in the keys), an act of Faust I had to annotate
in German by the next morning, a jar of peanut butter (my only food for the past two
days), a book claiming to make the reader an expert ESL teacher overnight, a thrice-
edited story, a postcard from an Alabamian pen pal I’d

forgotten I had, an overdue ER bill, a lm of whitish
powder that could’ve been one of three types of
amphetamine, a bendable Gumby doll, and a plastic
tra c cone with the words I HATE MONDAYS
printed on the surface. I looked up Jagannath, Lord of
"It's going to take lots of energy for us to grapple with the
the Universe (a Hindu god classically depicted as a challenge we're facing, and some of it is on vivid display
in these pages." —Bill McKibben
giant-eyed wooden stump), then I redoubled my
e orts and researched Hindu mythology, which led to
a quick-and-dirty introduction to the Hindi writing system (Devanagari). By dawn I’d
found out that the DoS ran a program that paid for American graduate students to study
“critical languages” abroad: “critical” here meaning something like “the United States will
derive economic or intelligence-related bene ts from Americans knowing how to speak
this language.” Hindi happened to be one such language. By sundown the next day, I’d
dra ed an application. It goes without saying that I failed the Faust assignment.
is method of living is something I call “dust to the wind,” a er the scene in e Big
Lebowski where Walter and the Dude try to scatter Donny’s ashes in the Paci c only to
su er some blowback in the facial area. At that point, I was throwing some twenty
projects to the wind and doing whatever blew back. India blew back, incredibly. And
because of my zealot’s faith in dust to the wind, I became obsessed with going to India. I
brushed up on Partition-era history, got some nosebleeds, and took Benadryl to induce
sleep. I was the shining model of productivity. Still, there was a toothless hissing at the
edge of my psyche that something was really very wrong with this behavior, promising me
I’d crash (as I o en did) and be exposed as an individual unable to function normally.
I was in India for less than a week when I realized this wasn’t going to happen. In Jaipur
there was no context for my weird behavior. I hung out with university students,
language professors, and the Sonis, a family of tailors whose vacant roo op apartment I
was renting. I would bring up mental idiosyncrasies on the sly, careful not to mention my
personal experience. For almost everyone I spoke to, psychiatric medication was an
unheard-of thing. As was the concept of being “unable to function normally.” Changes in
mood, no matter how paralyzing, were not regarded as symptoms of a disease that
prevented someone from maximizing their utility — instead they were frequent and
reparable side e ects of being human. In fact, the maximization of one’s utility didn’t
seem to be the Big Social Goal at all. My good friend Mumal,6 a psychology student and
my lifestyle foil (engaged to my very-much-not-engaged, perennially substance-free to
my “I’ve snorted horse tranquilizer,” lover of sherbet), told me point-blank that the
psychotherapeutic model was a purely Western importation, as were categories of mental
illness like depression, bipolar, and PTSD and the prescription medications used to treat
them. I objected that while there were de nitely distinct cultural di erences at play,
mental unease had to be a cross-cultural absolute. To say otherwise would be to risk
erasing the experiences of the mentally ill.
She clucked her tongue and gave me her you’re-acting-so-stupid-wow look. “No, no! It’s
not what I’m saying here. I mean you people7 think of it di erently. Of course you feel a
certain awful way sometimes. But you make it into a disease where there is none.”
is was a thrilling prospect. I was in love with it. e kind of head-over-heels love that
makes you immune to the e ects of Benadryl or Trazodone8 .
You’re right, Mumal, I thought, pacing the Sonis’ roof one night at 4:00am. is is
conclusive proof that I’m de nitely not brain-sick. All I have to do is stay in India with T
forever and I’ll not be bipolar.
at’s almost certainly right, rejoined Chili, the dangerously fat family dog who basically
lived on the roof and spoke perfect British English.
Here was the catch-22 as I very dimly saw it: realizing that bipolar may be a social
construct was causing me to act like a bipolar person. Acting like a bipolar person at the
rate I was acting like a bipolar person would get me sent home from the place that had
birthed this tremendous realization. So in order to not get sent home, I would need to
head the situation o at the pass and take lithium like a bipolar person. at way I could
nish out my study, get a visa, and continue living in India as a non-bipolar person.
Out of what I told myself was my loyalty to India, I fell on my sword and admitted my
non-lithiation to school o cials. Emails were sent, government bureaucrats were
incensed, and a deadline was established: get lithium in my system within thirty-six
hours or be returned to U.S. soil. I had recklessly endangered myself in a foreign country.
And now it was Shyam Ji’s problem. As the autorickshaw ew over potholes on J.L.N.
Marg, I turned to him and surprised myself by being able to speak:
“Mor bahut sundor hain.”

(Peacocks are very beautiful.)
He nodded and looked worried.
“Maaf kijiye,” I said lamely.

(I’m so incredibly sorry.)
“Koi baat nahi.”

(Don’t worry about it.)
e doctor’s o ce was humid and tightly packed. Most of the occupants wore the cheap
saris and kurtas that marked them as dalit, or sub-caste “untouchables.”9 ere were two
waiting rooms: an ante-waiting room and a main waiting room where patients had
formed a line in front of the doctor’s o ce that was roughly ten people deep. In the ante-
waiting room, a skeletal woman sweated and shook in the arms of a man who looked like
he could be her father. e man and I made accidental eye contact. I looked away,
guessing she was in opium withdrawal. Shyam Ji kept standing up to speak rapid- re
Hindi with a henna-haired clerk in the main waiting room. eir exchanges usually
resulted in Shyam Ji returning to his seat dejectedly while the clerk re-shu ed some
papers he’d already shu ed. It took a while for me to get it through my shriveled brain
that Shyam Ji was trying to make an exception for me. e skeletal woman eventually
passed out from exhaustion. By the time we were standing in the doctor’s doorway, the
ante-waiting room’s main player was a teenaged autistic boy who screeched and slapped
himself in pained response to his mother’s constant questioning.
e doctor’s o ce was as crowded as both waiting rooms. Shyam Ji and I sat on a urine-
smelling couch with four other patients until we were called to approach the desk for a
consultation. e doctor greeted me in English; the other patients looked on
inquisitively. He read my printout.
“According to this you have bipolar disorder type two,” he said. “You need lithium.”
I said nothing. Shyam Ji smiled at me encouragingly.
“So tell me what’s going on.”
I told him what I’d told the Specialist in Mental Disease: that I couldn’t go home because
I realized home made me sick.
“But you are sick here.”
“Right, I know,” I said. “But the — it’s just the thought of going home is what’s gotten me
into this situation. I don’t think I’m really bipolar at all, really.”
“You are bipolar no matter where you are,” he said. “Why do you want to stay here? It’s
worse for you here.”
“I don’t think so.”
He squinted at me in disbelief. e autistic boy shrieked in the background. A man on

the couch behind us began to cry. Shyam Ji said something to the doctor in Hindi that
began with “Woh samajti… ”10 e doctor listened, looking at me in silent judgment.
en he sighed, shook his head, and pulled out his prescription pad.
“Delusions,” he muttered, writing out my dosage. “You’ll take this lithium and I think
then you’ll see how much you really want to go home.”
I took the prescription from him. Game on, doctor.
Game on.
---
1
Honori c used in Hindi and other Indian languages to denote age, level of
accomplishment, and authority. Can also be used ironically: viz. “Rebekah Ji.”
2
“What!?”
3
A mark typically painted on the forehead to represent sectarian a liation in the Hindu
religion.
4
Hindu goddess of love, prosperity, and beauty; wife of Vishnu; o en associated with
peacocks. Bringer of centeredness and joy to the life of Shyam Ji.
5
“Faster!”
6
e only one of my interlocutors who’d actually heard the clinical term “bipolar”
before and knew what it meant.
7
One of my favorite Hindi-to-English malapropisms. In Hindi the second person plural
is “aap log,” which literally translates to “you people” – there’s no “you” or “you all.”
English speakers are always getting so up in arms about this verbal tic, but I love it.
8
Tranquilizing SSRI for treatment of major depressive disorder; used when Benadryl
isn’t cutting it but you don’t want to mess with barbiturates. Sometimes referred to as
“traz” or “trazosaurus rex” (the second is my own).
9 Although discrimination based on caste was abolished by the 1955 Protection of Civil
Rights Act and plenty of a rmative action programs have since been put into play, dalits
remain an oppressed lower class.
10 “She understands…”
TAGS: Lithium Mental Health Essays Bipolar
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1/8/2020 Your Prescribing Doctor: Dispatches from the Psycho-pharmaceutical Complex: Subcontinental Lithiation, Part 1 - McSweeney’s Internet T…

M C S W E E N E Y ' S I N T E R N E T T E N D E N C Y ' S PAT R E O N

OCTOBER 17, 2014

YOUR PRESCRIBING DOCTOR :

— “Lithium: A Patient Information Lea et”

Not that long ago, I was in the backseat of an

To backtrack, here were the mistakes I’d made so far:

1. Failed to disclose to the DoS, which was paying for

I had come to India on the following whim: I would

edited story, a postcard from an Alabamian pen pal I’d

“Mor bahut sundor hain.”

He nodded and looked worried.

“Maaf kijiye,” I said lamely.

“Koi baat nahi.”

I said nothing. Shyam Ji smiled at me encouragingly.

“So tell me what’s going on.”

“But you are sick here.”

“I don’t think so.”

He squinted at me in disbelief. e autistic boy shrieked in the background. A man on

I took the prescription from him. Game on, doctor.

TAGS: Lithium Mental Health Essays Bipolar

McSweeney’s is an independent nonpro t publishing company based in San Francisco.

INTE R NET TENDENCY

Copyright © 1998–2020, McSweeney’s Publishing LLC.

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