all mad here

Caitlin McDermott-Murphy

December 2019, three days before Christmas, and my 80-year-old father is following his usual routine: Wake, shuffle downstairs, sit at the dining table. Greta, his old German Shepherd, slumps against his shins. He flips to the sports section. He takes sips of coffee. He watches my mother hustle in circles in the kitchen, boiling oats.

Then the thing happens.

Greta feels fuzzy against his bare ankles. Or is the coffee fuzzy? Something is fuzzy. He puts his hands out like he’s playing zombie.

“I can’t see,” he says to no one in particular. Maybe to himself.

He flexes his fingers from fist to high five and back. He squints at those supposedly familiar things. And then the rest of whatever stuck around to watch the slippage betrays him, too, and leaves. He babbles now. He shoots forward like his biology whipped him. He shoots back in the chair, stiff. Possessed. But no, my mother realizes, rushing from the kitchen just in time for the coffee to spill all over the dog, this is so much worse than a ghost.

What we see

When I was in middle school, my father told me stories of a great grandfather and a great uncle who lost their minds—that’s how his family described it—lost them like jobs. The great grandfather got locked in his room and was never let out. Or so the story goes. The great uncle was gifted with a diagnosis: schizophrenia. His story ended there. My grandmother (on my mother’s side) endured round after round of electric shock therapy to treat something never defined. Never fixed, either.

The term psychosis feels heavy, like a ball and chain, but the official definition from the National Institute of Mental Health is vague stuff: “conditions that affect the mind, where there has been some loss of contact with reality.”

These days, my mother visits the grocery store in the swampy heat of New England’s August wearing: a green raincoat that engulfs her from chin to ankle, two layers of latex gloves, a cloth mask beneath a surgical mask, and a winter hat. A mad hatter. Personally, I open doors with my feet now, performing acrobatics with a handle until I kick it open and scramble through. Some people attend parties (with bare faces). Some drink bleach (diluted). Some think it’s all a corrupt joke. So, whose reality? How much loss?

We see but cannot experience anything beyond our own.

Dancing shoes

Turns out my father’s fuzzy whiplash was a stroke amped up with seizures. The electric bombs short-circuited his memory and ability to read or retrieve words from the wreckage. Each morning, he asked us—faces without names—why he was in the hospital. What happened to him? How much time had passed? A day? A week? He never waited for answers, which zipped past him like a black fly, and filled the gaps with science fiction. Has it been years? Where have I been? Who have I been?

One morning, while my father mopped his naked body with a damp towel and I held him too tight and explained the stroke, the seizures, everything again, the only nurse he liked came to say hello. She wore a red hoodie over her scrubs. She was short and loud and shouted aphorisms (“Accept where you are!”) with the infectious warmth of an oracle.

“You got your dancing shoes on?” my father asked her. “I told you I’d be ready to get dancing today.”

“I’m always wearing my dancing shoes, honey,” she said, showing off with a little jig. “You better hurry and get yourself pretty.”

“Give me five minutes—I’ll dance your ass off.”

For a few gorgeous minutes, they danced. Not really, of course, but that’s beside the point.

The not real

As a child, I was a serial sleepwalker. My father, watching the Celtics late at night, would jump when I appeared in an oversized T-shirt (his) standing droopy-headed in the doorjamb, babbling nonsense. I talked in my sleep, too. Once, near midnight, I explained to my parents that I could not, as hard as I tried, get my window open so I could traverse the night sky and land on the ledge of their window.

Once, midday, I told my best friend she shouldn’t worry about skinning her knee or losing at Kick the Can—this world was created just for me. Her knee wasn’t real. She wasn’t real, except as a form of entertainment for me. She never responded; she just looked at me for a long time. Then we built a house from sticks and dead leaves and pretended to be witches from The Crucible.

Dirty chicken

My father recovered. The reading stayed gone but the rest of him returned, like a mirage that actually is an oasis.

Then in March, he fell down the stairs and, just like that, two fresh brain hemorrhages spread like poisonous flowers across his brain. Back in the hospital, as the coronavirus crept around like something fantastical—a ghoul or a demon or a pandemic—the delusions started.

My wife, my father explained to his wife, is the only woman I’ve ever loved.

The chicken, he said, was dirty. He wanted to bring it to the family dinner, but alas. Too dirty.

I left the kids (which kids, we’ll never know) at the dry cleaners or gas station, he said as he tried to get up from the chair with nothing but bone and flesh, his muscles sucked dry. “I have to go get them!” He screamed at us, his enemies, the monsters who refused to clean chicken or rescue abandoned children.

I laughed at the delusions, which seemed easier than any alternative.

I laughed, too, during the toilet paper frenzy (of 2020—I wasn’t alive to see the original frenzy of 1973 in which fear of a toilet paper shortage caused a toilet paper shortage). I laughed when a friend’s father instructed her to chug water to cleanse her of the virus. I laughed when social media bled miraculous cures: diluted bleach, chlorine, bananas. Avoid cookies, they said, and rice and Chinese red bull—they’re contaminated. Gargle vinegar and rose water, they said. Drink cow urine. Eat cow dung.

One man and then another 5,875 people ended up in the hospital after drinking highly-concentrated alcohol. One man touched his face while grocery shopping, so glug, down went a whole bottle of 90 percent. He was lucky; he survived (without some neurons). Between March and August, 800 people died doing the exact same thing.

Reality vs. reality

In April, my father transferred to a rehab facility. No one could visit him. No one could visit anyone.

The staff plunked him in front of a TV that went on and on about a pandemic, in front of a window that looked out on a garden that could be anywhere, any decade. His family members’ faces appeared on a rectangular screen he couldn’t name before the stroke. 

When we Face Timed, I could see only a diagonal forehead and half his eyes.

“How are you feeling?” I’d ask.

“Fine. Tired. I don’t know,” he’d say. “When are you coming to get me? You can’t leave me here forever.”

“I can’t,” I’d say. “I’m sorry.” Then I’d launch the hundredth explanation about how a virus had spread across the world. It’s too dangerous, I told him. I could get you sick. The phone started to wobble as he got more and more agitated. That black fly was back and wouldn’t leave—zooming around his head.

“How long have you kept me here? Years?”

I looked out my second-story apartment window and saw stacks of toilet paper—24 roll packs—inside my neighbor’s white Subaru SUV. A playground cordoned off with caution tape. Masks. Not years but an era.

“Say you’ll come get me right now, or I don’t want to talk to you anymore.”

War

Maybe the constant pressure of unknowable facts broke him. Or maybe it was the virus, which finally crept in without anyone noticing. Back home, finally, he refused to eat, his body ached, he lost taste and smell (the Centers for Disease Control added that symptom to their official list a week later). He called my mother names she refused (still refuses) to repeat to me. “You’re all a bunch of jerks” was a favorite. Jerks because there were soldiers after him, trying to kill him. And we, like jerks, forced him to stay put like bait.

Over and over and over we explained the stroke, the fall, the virus. No soldiers. Please eat. No one’s coming to kill you. A pandemic, that’s all.

We were trying to say, “Come back to us,” but what he heard was, “You’re crazy.”

Psychosis

According to weak data sets (the only ones we have so far), 0.9 to 4% of COVID-19-positive patients develop psychosis. My father won’t be one of those stats. When he asked to go to the hospital, he had a mild fever and weak pain in his chest. We thought heart attack; the doctors thought pneumonia and shot him up with antibiotics. They threw in a COVID test as a precaution but then, poof, a day later, everything—the fever, chest pain, psychosis—disappeared. Out of the fox hole. No psych exam necessary. A day later, his COVID test came back positive.

At the time, none of us knew the virus could cause psychosis, though it shouldn’t have been a surprise: The 1918 Spanish influenza pandemic carried a wave of hysteria, melancholy, and insanity. Data from later flu pandemics confirmed this body-brain connection, leading one scientist to invent the term “psychoses of influenza,” the first evidence that viruses can creep farther than the lungs. In 2020, something new happened: COVID-19 caused a 25% increase in acute psychosis in people it never touched. Physically, at least.

My father recovered; he regained every faculty but reading. But almost every day, he tells us (or himself by proxy of us), “I won’t become that person again. I promise. I’m done with him.” Then, he apologizes for the way that other man treated us, for allowing him entry in the first place.

“That wasn’t you,” I tell him. “That was the stroke, the virus,” which is both true and not. For him, the memories of our battles—those attempts to convince him his experience was wrong, bad, destructive—either turns him against that man (who is both him and not) or us.

We see but cannot experience other people’s realities. But what happens when we try?

All those nights of my childhood, when my father found me babbling at the TV room door, he’d tiptoe so as not to wake me and guide me gently back to bed. Couldn’t I have cleaned some chicken? Rescued children? Battled some soldiers? It’s my world, anyhow—what’s so hard about that?

Caitlin McDermott-Murphy earned her BA in English from Amherst College where she studied poetry and is working on a master's in journalism at the Harvard Extension School. She is also a full-time writer and science journalist for the Harvard Gazette and Department of Chemistry & Chemical Biology at Harvard University. She considers both Boulder, CO (where she lives with her jazz guitar-playing partner) and Dedham, MA (where all her family lives) her two homes.