Among the Lost

Ranchi, India, was notorious for one thing - its lunatic asylum. People used the word "Ranchi" as a sort of synecdoche - "you belong in Ranchi," "He looks like he's escaped from Ranchi." They said that many of those in Ranchi weren't even insane; they might be women or older relatives who had become a burden; so they were labeled insane and dumped in the living hell that was the asylum in Ranchi.

Indians are terrible with mental illness. Mentally ill people, unless monied - in which case protection and help can yet be had - get little sympathy, and ostracism, ridicule, and cruelty are common. Psychiatrists make - or, until recently, used to make - little money. Students who have passed the medical entrance exam with marks too low to get them into regular medical college opt for psychiatry or dentistry - "dental" and "mental" as they are called. Now, however, with increasing wealth, it seems that both the awareness and the incidence of mental illness has received a shot in the arm. There are therapists on street corners; my parents say "depression" and "anxiety" with assurance, and TV pundits expound on the social ills and wells responsible for all this unhappiness. But the most common explanations for mental illness are: she's making it up; get him married, he'll settle down, and c'mon, pull yourself together, you nancy.

The nancy explanation, I think, is the one his relatives favour for my neighbour M. M. has been ill ten years, almost as soon as he immigrated from his native Pakistan. He has a wife and four children, one of whom is a severely disabled daughter. Soon after his marriage M. became depressed; he began sleeping all day and eventually lost his job. Since he had no health insurance, he received no effective treatment. The family began to collect welfare from the government. During his illness, two more children - the last of the four, twin boys, were born to him.

In Pakistan M. would very likely have been kept at home, but here in North America he expected to be able to get better. His relatives' reaction was much the same as it would have been back home. They berated his laziness and said he ought to snap out of it. Some blamed his wife for not being able to make him work. They suggested that she indulged his malingering, and that if she went about it the right way, he would be obliged to stop lounging around the house and would get back to work. M's wife, too, found it hard to believe in this mysterious illness that was so hard to see. She lamented that M. slept all day and woke up at night to chat on the internet; she threatened to go out to work if he did not take up a job. M. did not like the idea of his wife going out to work. It became a bit of a game between them; M.'s wife threatening to work, and M. pleading with her not to because he said it would humiliate him in front of their relatives. Meanwhile, they continued to get their meagre welfare cheques.

When M and his family moved into this county, they received a long list of mental health professionals whom M. could see. But the list was deceptive; it was dated 2004, and M. received it in the latter half of 2006. It said that the list might not be accurate, and, in the language of advertisements, advised M. to confirm for himself if the practitioners listed therein were still part of the Medi Cal insurance. M. remained lethargic, and when C. and I called to find out, we were told that only two places existed where M. could see a doctor (as opposed to a psychotherapist). One was called the Schumann-Liles clinic, the other Pathways to Wellness. We decided to try the first one, and made an appointment for a Saturday afternoon, since M. had now started to wake up in the afternoons.

On the way to the clinic I found that we were lost; the clinic was not quite where we had thought it would be. C. called them on his cell, and asked where they were. Then he said, "You can't see us? What do you mean?"

It turned out that the receptionist was saying just that; the doctor couldn't see us, and the clinic did not take new patients. She did not deny that we had an appointment, and offered no explanation for why we had not been told before, or indeed why the doctor would not keep the appointment. I lost my temper, and asked them where they were located, so that I could come in person and talk with them. But they wouldn't say where they were located; they repeated that the doctor couldn't see us, and that there was no need for us to come. When I said that there certainly was, and that they could depend upon seeing us in short order, they threatened to call the police.

Finally, with me barking into the cell phone and C. trying to get me to stop the car in case there was an accident, we pulled up in front of the clinic. Three doors that appeared to be entrances were closed. We walked over a narrow path of wilted grass that led around to the back of the building where these was an entrance that seemed to be open. The sign said "Schumann-Liles" and at the door two black men stood talking together. One of them asked me the date.

We walked into a room the size of a walk-in closet. Small as it was, it was crammed with people, some of whom were sitting on the floor, some standing, like my interlocutor, at the door, as though reluctant to come in at all. A woman sat on her haunches, her long, straggly hair falling over her face; she rocked her head in her hands and spoke quietly to herself. Another woman, red of face and nervous of manner, twittered uneasily in a corner. "Voices," she said. " I hear them all the time."

The receptionist in the tiny window waved to me to sign in, and then went and peeped into the doorway of an office down the passage, which could not have been more than four feet in length. I heard her say "The patient is threatening us, and we'll probably have to call the cops." And "When she does come here, don't let her in."

It was plain they were talking about me, so I walked up behind them and announced "I'm already here, and I've not threatened you at any time. I just want my brother to be seen, and if you think that means you need to call the police, please don't let me stop you." I thought it was better to simply call M. my brother, rather than waste time on the complexities of my relationship with his family.

They turned and looked at us in dismay- clearly, this was unexpected. They were even more disturbed when I decided to inform the waiting patients, in a loud, carrying voice, what had happened to us on our way to the clinic. One of the staff - the only well-dressed and well-groomed one among them - scurried to get us chairs. I learned later that she was the doctor on duty for that day.

But my heroic stand had no befitting end - after I sat down triumphant, the feeling of vindication began to ebb. The red-faced woman, whose name, it turned out, was Clara, sat down beside me.
"I don't hear them so much as I used to," she murmured confidentially. "They come less now, but I still can't get to sleep at night. I take lots of Seroquil, you know."

"Oh, yes?"
"Yes. But I still spend most nights just walkin' around, you know."
"That's a shame."
"Yes," she said. She slurred her words a little. I looked over at M. He sat with his head sunk upon his chest, his unshaven face covered with little white hairs. I remembered that one of M's chief complaints was that he could not sleep.

Clara grew bored with me and began talking to the woman on the floor, who told us how she couldn't live without junk food.

As we sat there, I became less and less sure I wanted M. seen here at all. It was clear no-one here was getting much help, and the murmurings and sighs around me began to seem Hadesian in their resignation and despair. They would never get out, I thought to myself, and it did not seem very likely that we would, either. The very receptionists, with their put-upon faces and eloquent disinterest, were reluctant Charons who wished their replacement would hurry up and relieve them of their oars. I looked down at the spotted dark blue carpet, frayed and almost black with repeated visits to this waiting room of the lost and fumbling.

Finally I spoke to a Mrs. Barnett, who said doctors left rather frequently, and that the doctor with whom the original appointment had been set up was no longer with the clinic. She apologized, I think, but to me the news sounded by this time like a reprieve. I agreed, hurriedly, to another appointment in a branch of the same clinic in Oakland, because I felt somehow that if I did not I would not have done my best by M., but I knew this was the last time I was entering Schumann-Liles, here or anywhere else. I gathered my little party and fairly shot out the door.

On the following Monday I called Mrs. Barnett to cancel M.'s appointment. She asked if I wanted to reschedule, but I said we wanted to try Pathways to Wellness next because it was closer, so no, I was canceling.

"Good news," she said. I did not ask her what she meant.

Charu and friends

I met Charu when she was completing a Ph.D in Linguistics at Delhi University. She was at that time almost finished; she only needed to defend her final dissertation. I would walk into her room sometimes when mine got too sunny; she lived on the north side and her room hardly got any sunlight. The floor was piled with journals and hardbacks for her dissertation. Charu was very keen on her subject; tribal languages of Orissa - she wanted to write a book on the subject. She wrote to Professors in North America about her interests; they answered; sometimes they came to see her when they were in Delhi. Charu planned to take up teaching at the university; her prospects seemed good. She was already teaching part-time.

Charu was older than I was by a few years, so I suppose by Indian standards the time was ripe for her marriage. I knew that was what it must be when she mysteriously disappeared back home, to the seatown of Puri. These mysterious disappearances of female friends had begun as far back as the first year of my Bachelor's degree. They would go home at odd times, sometimes during semester, and return with flushed and beaming faces, and a streak of sindoor reaching down to the middle of their foreheads. They would walk with grace and poise; they had a place in the world, a future. They got phone calls at night, and had long whispered conversations. Unknown truths seemed revealed to them.

Here then was Charu too, bound for the same destination. Chetan, it appeared, had an M.B.A. and a job in marketing in Bombay, two things that made him hot property in the marriage market. I met them for lunch at a restaurant near the University, and he seemed affable enough. But later Charu told me that his parents had demanded a dowry of one lakh rupees. But you can't pay someone to marry you, I said, a little tactlessly. That's just absurd. Charu said well, it isn't Chetan who's asking for it you know. It's his parents and he does not want to offend them. Chetan was an obedient young man who was very careful not to hurt his parents' feelings. Besides, Charu said, it's not that much. Do you know what the going rate for an M.B.A. is?

So Charu got married, and now it's been ten years. She had a son within the first year of her marriage. In the second year, Chetan hit her; in the third he slept with another woman; the following year he asked her to stop working. Or perhaps he did all these things in a different order, and it was all more confusing than I am making it sound. They lived here in the U.S. for a while, then returned to India because Chetan's contract expired. Charu told me she had learned to drive, but never actually got around to getting a license; she was always a little nervous picking her son up from school lest a policeman question her. She even got a tentative job offer from Delaware, but Chetan said she needed to adjust her priorities.

After Charu returned to India, her condition deteriorated somewhat. At first she tried Prozac, but it didn't help, she said, to ignore what was happening to her. So she tried part-time jobs, some in Puri, some out. Chetan and she now led almost entirely separate lives. Chetan wanted a divorce, Charu told me, so he could devote more time to a mistress he had in the more affluent quarter of town. She was just managing to stay in his home by keeping out of his way and avoiding confrontation. She told me she was looking for work in training business professionals in "personality development," she seemed to be moving away from her linguistics background. She spoke of American visitors who wanted to open business schools in Puri. If she waited her time, she would be a Professor in a Business Studies Department. She said once she had a permanent job, she would move out on her own.

When I next spoke to Charu she sounded upset. She said there was a conspiracy against her at her workplace; several people had demanded that she sleep with them and been vindictive when she declined. An I.A.S. officer, someone high-up in the administration, had also been pursuing her and on being rebuffed had spread rumours about her. Charu said she was feeling stressed; later she said she thought that there might be a plot to kill her. Her son was being sexually abused. She spoke to a psychiatrist who said the stress was affecting her sense of reality. He wanted her to take medication for schizophrenia or depression, she wasn't sure which, and she had not returned to him. She could not leave; children needed both parents. She would leave when she got a full-time job, but she could not bring herself to accept any because what about Rahul's future, and how could she move to a different town with her son all by herself?

But you know Delhi so well, I said. I mean, we did do our Masters there.
Yes, but it will mean burning all my bridges, she replied. I bought a rope the other day and kept it in my handbag all day. In the evening I washed and folded my saris and put them away, and packed all my books and papers in a trunk. But then I decided to go walking on the beach and when I returned it was almost dawn; the stars were still there but the newspaperman was already cycling down the drive with the papers. And I had to teach a class.

I lost touch with Charu over time, and apart from an occasional email at Christmas we have not corresponded. But I have met other old friends; Deba, whose science experiments always turned out successful while I had to cheat to get my results to match, is now living with her in-laws and says they don't really like her all that much, and that no-one is really pleased that her only child has been a daughter. And Alka, who says her husband would be fine with her if it wasn't for his parents, who are devils and have total influence over Girish. Like Charu, she believes that children need both parents and that children of broken families end up psychologically scarred. Girish goes away to his parents' home whenever they fight, and seems to agree with his mother that Alka is mentally unstable, and that her parents hid the fact at the time of the negotiations. Alka still gets panic attacks; they started after her first pregnancy, but she knows to hide in her kitchen or bathroom when she feels them coming on. But she says she will wait it out; eventually the in-laws will die, and then her husband will have no-one to turn to to but herself and the kids, and things will shape up.

I might have more to write eventually about Charu or Deba or Alka, but the events in their lives follow a pattern, so none of it is likely to be surprising. Somehow when I was at school I became imbued with the idea that all my classmates were going to have jobs and careers; that only women in my mother's generation had no choice but to become housewives. Indian law does not really protect women; neither does the society as a whole. A woman on her own is a joke, a spectacle for amusement and contempt, like a monkey in tights. Women with very stable sources of income are less vulnerable, but still subject to some censure, though they may be able to ignore it with impunity. Women with lesser means have no such choices. Still, parents in India continue to cripple their daughters, denying them access to education, to property, and most of all, to independent thought. In this they only continue the natural order of things, because to be female is itself a defect, a malformation which can never be corrected. Girls in India are still a cursed, blighted tribe who straggle along as society's afterthoughts. Even when grown, they still remain prisoners of the mindset their parents and their society instill into them; they stay captive with hypnotized single-mindedness, like a fowl with beak bent over a chalk line, thinking it to be a rope to which she is forever fastened.