September, 1994. “Give me my fucking oranges!” a voice outside was yelling.

“Fuck you, you took my shoes!” came another voice. It was 2:00 AM, and I was wide awake, listening to homeless people arguing in the street, their voices carrying up to my open window on the Lower East Side’s Avenue B. But the noise outside was drowned out by the chatter inside my mind.

Like a toothache, my head was pulsating, pounding, with a never-ending monologue about what a horrible person I was. About all the shameful things I’d done.

In the past, a few shots of vodka would help when I experienced nightly “shame attacks,” but I had been going to a recovery program, and was trying to stay sober. I dragged myself off my futon and went to the bathroom, and when I looked in the mirror, I heard a new voice, like a staticky radio announcer.

“Cut your arms, cut your arms, cut your arms,” it taunted. I had flirted with cutting myself before, but had been afraid to sink the razor under the skin. This time, I felt compelled to follow the direction to cut.

I took a razor out of the medicine cabinet and stared at it for a moment. I broke the plastic handle and pulled the blade out of it. I took a deep breath and plunged the razor across my wrist.

I watched the blood seep out of the shallow cut and drain into the sink. It didn’t really hurt. In fact, it felt good. As I watched the blood drip, I felt a sense of calm and peace come over me. The radio voice and self-hating thoughts slowed down. I realized I was out of the mental shame cycle.

After a while, I held a washcloth to the wound until the bleeding stopped. I got back in bed. I felt drowsy. I drifted off to sleep.

But the next night, my mind was spinning again. I knew what to do. I went into the bathroom, picked up the razor, and sliced open my right wrist. This time I’d cut a little deeper. There was more blood. But it still felt good. Relief washed over me as the blood spiraled down the drain.

Cutting became a nightly routine. After a couple of weeks, my arms were covered with scabbing cuts.

I made sure to wear long sleeved shirts to my recovery meeting. I didn’t want anyone to know what I was doing. I knew my sober friends would disapprove.

But one day at the meeting, I absentmindedly pushed my sleeves above my elbows, and I saw my friend Jimmy look at my arms. He raised his eyebrows and frowned at me. I saw him whisper in Diana’s ear, and then she was looking at my arms, too. I shoved my sleeves down again and tried to focus on the meeting, but both my friends looked upset and worried.

When the meeting was over, Jimmy and Diana backed me into a corner and demanded to see my arms. I reluctantly rolled my sleeves up and they each grabbed an arm, looking at the cuts and newly formed scars.

“When did this start?” Jimmy asked. I didn’t want to talk about it.

“It’s no big deal,” I said.

“This is really bad,” Diana said. “I know someone who cut herself so badly she punctured an artery and bled to death.”

I wanted to get them off my back, so I made a promise.

“I will stop,” I said half-heartedly.

“If you don’t, we need to start thinking about you checking into a hospital to deal with this,” Jimmy said seriously.

“But I don’t have insurance anymore,” I said. My COBRA insurance from the teaching job I had lost due to my alcoholism had long since expired.

“That’s what public hospitals are for,” Diana said.

I had been hospitalized three times before, when I had insurance, in New York Hospital. I thought back to the patients on Ward 5S, talking about the horrors of state and public hospitals. Winding up in a place like that was my worst fear. So, I vowed to stop cutting.

But that night, I struggled with Jimmy and Diana’s voices arguing with the radio voice.

“You have to go to the hospital if you keep cutting,” Jimmy’s voice echoed in my head.

Fuck Jimmy and Diana, they can’t make you do anything, said the radio announcer through the static. Cut your arm. Cut your arm. Cut your arm.

I pulled the razor out of the medicine cabinet and saw it had started to rust. Dried blood stuck to the blade.

I put it to my left wrist, took a breath, and made a shallow cut. But I didn’t get the rush of relief I’d grown used to. I would have to cut deeper. I held the blade to my wrist again and then quickly sliced.

The familiar rush came over me, and I stood there in the bathroom bleeding into the sink as my mind and body became numb. After a few minutes, I had bled enough. I held the washcloth to my arm, but this time I couldn’t get the bleeding to stop. I thought about what Diana said, about her friend dying from a cut artery. I pressed harder, and finally the bleeding slowed down.

“How’s it going with stopping the cutting?” Jimmy asked me the next day before the meeting.

“Good,” I lied. “I’ve stopped.”

But halfway through the meeting, I saw blood from my arm seeping onto the sleeve of my white sweater. The cut from the previous night had opened up again. And I wasn’t the only one who noticed it. Jimmy grabbed my arm and looked at the growing red-brown stain.

“That’s it, you’re going to Bellevue,” he told me after the meeting.

As much as I was afraid of being locked up in a public hospital, I was equally afraid of where this new addiction was heading. I didn’t want to end up like Diana’s friend. And I was aware that my cuts were getting deeper every time I gave in and sliced open my skin.

So, I agreed to go to Bellevue.

 

The following morning, Jimmy and Diana arrived to take me to the hospital. They helped me fill a backpack with a few pairs of socks and underwear, t-shirts, and a toothbrush. We didn’t pack anything which might be contraband in yet another psych ward.

I looked around my apartment before heading out the door. Who knew when I’d be back.

As we walked up 1^st Avenue, I was full of trepidation. But Jimmy distracted me from my fear by rambling about how pissed he was at his boss, the superintendent of the co-op where Jimmy was an elevator operator.

“That Hungarian asshole is going down,” he was spewing venom. “Look what I brought.” I looked at his hand, and I saw that he had a pair of brass knuckles.

“What are you doing with those?” I asked, incredulous.

“I’m going to beat the shit out of him,” he said.

The tough Jimmy from his days living on the street and growing up in the Far Rockaway projects had taken over the compassionate, kind Jimmy who was helping me stay sober.

“And you think I’m the one who needs to check into a psych ward?” I asked.

When we arrived at Bellevue, I saw a collection of homeless people out front, amputees in wheelchairs and one woman smoking a cigarette through a tracheotomy hole in her neck.

We entered the hospital and found our way to the Psych ER, which was jampacked with people waiting to be assessed and admitted.

I saw the front desk admissions nurse, a pretty black woman in scrubs. I approached her hesitantly, unsure if I really wanted to go through with this.

“Show her your arms,” Jimmy ordered. I reluctantly lifted my sleeves and showed her my cuts. She didn’t blink an eye. She looked excruciatingly bored, as if mentally she was somewhere else. She took my bag, slapped a hospital bracelet on my scabbing wrist, and directed me to the waiting area.

Jimmy and Diana were allowed to wait with me, and they were allowed to come and go, get coffee, or go out to smoke a cigarette. But I was marked as a patient with the hospital bracelet, and I wasn’t allowed to leave.

The walls in this shabby ER were painted a shade of puke green. Why were so many psych wards this color? We sat on folding chairs and waited to see the doctor. Within a few moments, we were gagging from the strong smell of body odor and alcohol, seeping out the pores of many of the patients.

We were surrounded by all the people one moves to another subway car to avoid, now trapped in a room together. My New Yorker “danger antenna” detected a lot of people to stay the hell away from.  But there was nowhere to go.

In front of us was a man handcuffed to a gurney. Every few minutes he started screaming and rattling his chains.

Then there was the guy pacing back and forth yelling “Kill Whitey! Kill Whitey!” He kept lunging toward me, getting in my face, and doing jazz hands as he laughed hysterically.

The ER staff did nothing to stop him from intimidating me, and so Jimmy took it upon himself to tell the guy to back off. The brass knuckles came in handy: when Jimmy showed them to him, Jazz Hands Man moved on to another target.

There was also a dirty, smelly woman wearing tattered black clothing who screamed at the top of her lungs at the rest of us every few minutes.

And, just when I thought this situation couldn’t get any worse, a man with dreadlocks and a heavy beard dropped his pants and pooped right in front of me.

The admissions nurse, along with another staff member, angrily grabbed the pooper, pulled his pants up and picked up the poop wearing plastic gloves. They didn’t seem surprised.

Suddenly my cutting addiction seemed less frightening than being admitted, sent upstairs and locked on a ward with potentially violent people, without protection from staff.

And yet, as much as I was afraid of these people, I realized how sad it was that they had to be so severely decompensated to get help. I had already experienced how difficult it was to navigate the mental health care system, and I had my mother and my friends to help me get the treatment I needed. My mother had even been paying for me to see a psychiatrist, Dr. Mas, who had been working with me to find the right cocktail of medication to relieve my Bipolar I Disorder symptoms.

But these people had no one, and they clearly couldn’t afford a doctor like Dr. Mas. They were relegated to a life of paranoia, pain and degradation. Finally winding up in the Bellevue Psych ER, would they get the help they needed? Or would the hospital just put a band-aid on their symptoms and then return them to the streets, where they would have difficulty getting their medication and wouldn’t be monitored, only to wind up severely ill again and back at Bellevue?

I was filled with gratitude that my situation was so drastically better than these lost souls. I was an addict, like many of them, and I was mentally ill. The only difference between us was that I was blessed with resources these people were denied. In fact, I felt guilty that I had the financial and emotional support from my mother and others as I battled these illnesses, unlike my fellow patients here at Bellevue.

But I have to admit that I was still afraid. Based on my experience so far in the ER, I wasn’t convinced that Bellevue staff would be able to protect me if anyone became violent toward me on the ward.

“I don’t want to do this,” I told my friends in a panic. “I can stop on my own.”

Jimmy and Diana seemed just as dismayed by the situation as I was.

“I didn’t think it would be this bad,” Jimmy said.

“Maybe this wasn’t such a good idea,” Diana admitted. But it was too late. I was a prisoner there with my hospital bracelet. I wasn’t leaving unless I could convince a doctor to let me go.

I had to go to the bathroom, but when I asked its location, the admissions nurse informed me I was considered a “Self-Harm Risk” and had to be escorted to the toilet by a staff member. She led me to the bathroom, which smelled even worse than the waiting area. There were splashes of urine and skid marks of poop on the toilet and floor. She watched as I sat, bladder shy under her gaze.  When I returned to my chair, the handcuffed man yelled, “Hey Blondie!” and rattled his chains.

“Alison?” a man in a white coat, presumably a doctor, called my name. “Come this way please.” Jazz Hands Man laughed hysterically as I passed him on my way to follow the doctor.

The physician, a thin man with a huge Adam’s apple, asked to see my arms, and as I reluctantly showed him my cuts, I started a campaign to get him to let me out of there.

“See, they’re really not too bad,” I said. “I know I can stop. I’ll get my therapist to help me. My friends can stay with me. This has all been a terrible mistake.”

The doctor looked skeptical but agreed to talk to Jimmy and Diana.

While Diana was talking to Dr. Adams Apple, Jimmy kept me entertained by telling me about what he was planning to do to torture his boss that afternoon. I kept wondering if the staff were going to overhear him admitting he was a “danger to others” and slap a hospital bracelet on him, too.

When Diana came out of the doctor’s office, she gave me a thumbs up and told Jimmy it was his turn.

With Jimmy gone, Jazz Hands Man came back to harass me and Diana. He kept yelling in my face, his hot breath smelling of onions. I looked at the bored admissions nurse and the other staff milling around, but none of them seemed to notice or care that this man was frightening us.

“We’re going to get you out of here,” Diana assured me. And then Jimmy came out.

“Ms. Morris,” Dr. Adams Apple said. “You’re going to have to talk to Dr. Gregory, the supervising psychiatrist, who will make the final decision about your admission. In the meantime, we’re going to call your therapist, Xena Hoffman.”

I was relieved. I knew Xena would tell them to release me into her care.

Hours went by. Diana had to leave to pick up her son from school. Soon after, Jimmy had to leave to go to work. As he exited the ER, I wondered if he would actually beat up his boss. I didn’t think so. His experience at Bellevue seemed to have put things in perspective for him.

I had now been in the Bellevue Psych ER for seven hours. No one had offered me so much as a cup of water.

The characters sharing the room with me were relocated, one after another, to the ward upstairs. Handcuffs Man was unlocked from his gurney, placed in a straitjacket, and led out the door. Jazz Hands Man soon followed him.

The screaming woman left, and then the pooper, who had been given hospital pajamas to wear after shitting on himself.

But even as these people left, more candidates for admission came in, one sicker than the next. There was another man handcuffed to a gurney, and he was even angrier than the previous prisoner. He yelled obscenities at the staff and the rest of us waiting. And several people who clearly had not bathed in months, reeked of urine and body odor, many of them talking to themselves or laughing at some unknown joke.

Finally, a doctor came into the ER and introduced himself to me.

“I’m Dr. Gregory,” he said. “Follow me.” We walked into the little office I had been in with Dr. Adams Apple earlier, and he listened to my plea.

“This has all been a terrible mistake. I can stop. I’ll work with my therapist. My friends in my recovery program will help me,” I said.

“I’ve spoken to your therapist,” Dr. Gregory said. “She agrees you will be better off as an outpatient, working with her and Dr. Mas.”

A rush of relief came over me as Dr. Gregory’s mouth moved and formed words to the effect that I was going to be released.

“But you will need to sign a self-care contract with your psychiatric team stating that you will refrain from self-harm.”

“Sure,” I said. “Anything you say.”

I didn’t know if Dr. Gregory really thought I was going to be okay, or if he just didn’t want to bill the taxpayers for my treatment when I didn’t seem as bad off as some of the other patients.

In any case, Dr. Gregory unceremoniously led me to the admissions nurse with discharge papers and took off my plastic bracelet. I was reunited with my bag, and the door opened. I was allowed to step out the door, into the main hospital, and out onto the street.

I was elated as I rushed down 1^st Avenue. The air was surprisingly crisp for early September, and I was free. I had a feeling of triumph.

But I also had a pang of sadness and guilt, thinking about the other patients who had experienced the Bellevue ER with me. Most of them had probably been admitted, and I had my doubts that they would find the help they needed. Maybe some of them were just as scared as I had been. Maybe they only pretended to be aggressive to ward off those who were actually violent.

“I am okay,” I said out loud. “This experience scared me straight. I won’t cut ever again.”

But two nights later, I found my mind spinning again in a shame spiral. The radio announcer told me to cut myself, while another voice told me to call Jimmy and Diana and ask for their help. I picked up the phone, then realized it was 3:00 AM. They weren’t nightbirds like I was.

I put the phone down, and then, knowing I was doing the wrong thing, went into the bathroom, picked up the rusty razor, and cut inside my left elbow.

This time the blood spurted rhythmically with every beat of my heart. Did I cut an artery? I wasn’t getting a rush. And I couldn’t stop the bleeding with the washcloth. The blood kept spurting.

I held the cloth to my wound and rushed out the door to go to the ER a few blocks away. The streets were quiet, other than the drug dealers hanging out in front of the open-all-night bodegas.

The ER wasn’t crowded, and I was quickly escorted to a curtained area, where a bald doctor informed me, I would need three or four stitches. As he pulled out the catgut and a needle, he asked me how this happened.

“It was an accident,” I said as he numbed my arm with a shot. He didn’t press me for more information. He just sat quietly and stitched up my wound. When he was done, he told me to be more careful and left the curtained area.

I was amazed he didn’t refer me to the hospital psychiatric staff. I left the hospital in a daze.

Clearly it was a mistake for Bellevue to release me.

 

I would struggle with self-harm, off and on, for years. I would be hospitalized again for cutting. It would be as tempting to pull out my old trusty razor blade as it sometimes was to pick up a drink.

But when I finally found the right medication to treat my |Bipolar Disorder, when I started to progress emotionally thanks to help in recovery, the temptation to cut began to fade away.

It has been over twenty years since my last slice, and I rarely have the urge.

All I have to do, if that familiar voice ever whispers “cut…” again, is look down at all the scars on my arms, and reflect on how far I’ve come. And how lucky I am to have gotten the help I needed. I always wonder how many of my fellow Bellevue ER patients can say the same.

Alison Watson is a memoirist who writes about overcoming mental illness, addiction, and being an adoptee, among other issues. She is currently shopping her full-length manuscript, “A Psychotic’s Journey Through Eastern Seaboard Psych Wards,” with publishers. “Cutting” is an excerpt from her memoir. Her work has also been published in The Sun Magazine. Alison calls Brooklyn, NY home, where she lives with her husband of 22 years (the same Jimmy as in the essay!) and their shelter mutt, Cindy Loo Who. To read more of her writing, please visit her website, alisonmorriswatson.com.