March 31st, 2020

March 31st, 2020

Comorbidity

by Todd Richardson

My brother’s skin felt like a lukewarm dish towel as I held him against the wall. It took two palms pressed into his chest to keep him from bouncing all over his bedroom. I was 17. My brother, two years older, had been diagnosed with schizophrenia a few years before. We were friends oncebackyard brothers pretending to be Huck Finn and Tom Sawyer, building rafts, dreaming of freedom and riding the Mississipp’—until his psychotic break. After that, there was always something wrong: voices, screaming, drugs. Tonight, Robbie seemed especially fucked.

“How much did you take, Robert?” Dad asked. He pointed to the TV tray that stood in the center of the room. On it lay a pocketknife and line of white dust.

“Trying to finish that eight ball, bro,” Robbie said. “I’ll show you.” He leaned forward, I pushed him back. His movements were strong, but uncoordinated. Robbie thudded against the plaster-white wall, wriggling. I might have kept my cool had it not been for his eyes. They were black and full, like a shark’s.

Mom, a nurse practitioner by profession, appeared over my shoulder with a penlight. “How you feeling, buddy?” she said. She pressed a cone of yellow light toward Robbie’s face. His pupils did not react.

“I could use a beer,” Robbie said. Mom placed two fingers against my older brother’s pulse, counting silently to herself.

“Heart rate is getting faster,” Mom said. “Hold up your hand for me, babe.” Robbie lifted a palm up sideways, fingers rattled in the air. “Yup, I think we’re going to the ER. Get the insurance card, would you?” She spoke over her shoulder to Dad, who nodded and left.

“What’s happening?”

“Your brother is having an overdose.” Mom’s voice was even, calm, factual.

“What do I do?”

“Just keep him there.”

“Like this?”

“However.”

“It’s snowing in summer, bro.” Robbie leaned into me, rested his chin on my shoulder. I shoved him away and his head plunked against the wall.

“Hey, watch it,” Mom said. The dark pools of my brother’s eyes gawked at the ceiling. His mouth stretched open.

“Let’s call an ambulance,” I said.

“Our last name is Richardson, not Rockefeller,” Mom said.

“We’re just going to wait?”

“Don’t be so dramatic.”

I dropped my hands and let my brother crumple forward onto the floor. Mom yelled. I ignored her.

“Where are you going?”

“It’s Wednesday,” I said.

“What?”

“I shouldn’t be here. I should be writing a fucking paper or getting laid or other normal teenager things.”

“None of us want to be here,” Mom said. She propped Robbie up with his back against his mattress.

“This is fucked up.” I took a few steps toward the door. I ran into Dad as he made his way back into the room.

“Hey,” he said and grabbed me by the shoulder. “Go take a break.”

I left, squeezed my eyes shut and pressed my palms into my temples until they hurt. My parents were idiots, my older brother was a fuck. I hated them for making me feel like the asshole for panicking during my brother’s OD. In a family with a schizophrenic addict, normal reactions seem crazy to everyone else.

I went back into Robbie’s bedroom. Mom sat monitoring his pulse. Dad was on hold with the insurance company. Robbie swung his head from side to side.

“You guys need anything?” I asked.

“Representative,” Dad said into his phone.

“Get some stuff together for Robbie. You know, the essentials,” Mom said.

“Representative,” Dad said again, louder.

“Hey,” Robbie said, bobbing from side to side. “Hey, man.”

“What is it?” I edged closer to where he sat on the mattress. Robbie cupped his hands in front of his face, black shark eyes locked on mine. Grinning, he vomited into his upturned palms.

“Goddamnit, rep-re-sen-ta-tive.”

 


 

Years later, Robbie and I walked the grounds of Mark Houston Recovery Center, west of Austin, Texas. I was 22, he was 24. The sun sank low into the pinkish blue sky striped with cotton candy clouds as he and I ambled down a crushed gravel path. The trail wound downhill, toward a creek bed—a manila-colored summer scar that ran between the folds of opposing hillsides. Despite the parched waterway, the land was green with a fresh rain—yellow blossoms donned prickly pear cacti, wheatgrass swayed tall and ripe, the scent of mountain laurels filtered through the breeze. There was a sensation akin to springtime, a sense of rekindled potential that floated over the property line.

Robbie had been rehabbing at Mark Houston’s for six weeks, the longest sober stint he’d managed since his psychotic break at 17. It was also the first sanctioned family visitation at the recovery center. Mom, Dad, and I spent the afternoon touring the grounds, attending planned meetings, listening to sermons about the self-discipline required by addicts and the tumultuous path ahead of each recovering individual. “It ain’t easy,” said the half-balding man at the front of the room. “Somewhere between forty and sixty percent of users experience relapse.” He warned us that the next step—the halfway house—would be the hardest. “There’s a lot of freedom for a person in recovery there.” Next to me, Dad bounced one knee, nervous. He raised his hand.

“My son has schizophrenia,” Dad said. “What about him?” The man up front shook his head.

“Can’t imagine it’ll make things any easier.”

Back on the grounds next to Robbie, I pushed those concerns from my mind. I felt happy, hopeful even. I was going to college. I had proposed to Christina, my longtime girlfriend, three months earlier. We decided we weren’t going to get married until after we graduated, at least two years away. Life felt like it had turned a corner. I was in love. Robbie was on the mend—he looked healthier than he ever had since his diagnosis. His shirt sleeves squeezed his biceps. His skin glowed golden brown, darkened from working in the Texas sun. He appeared healthy, kempt, rested. More than any other change, I remember my brother’s eyes. They held an electricity in them, a keenness that they had lost. They didn’t dart around the room or glare beneath the bottoms of his brow. He was calm, cogent, clear. He was like the brother I used to know, the guy I went to punk shows with late at night, lived as mallrats with on Saturday afternoons, talked with about girls. We walked in silence, side by side. Mom and Dad stayed behind at the few picnic tables at the top of the hill. I had something I wanted to ask him.

“I’m sorry about all this,” Robbie said as we reached the dry creek bed. “I really am.”

“We’re here now.”

“I’m not saying it because it’s just one of the steps.” Robbie spat into the dusty creek, wiped his mouth with the back of his hand.

“For sure.”

“I want to be a good brother.” He swatted a mosquito that strayed too close to his nostril.

“Just keep working the steps.”

Robbie nodded, remained silent. I wanted to tell him that he was a good brother, that he wasn’t a piece of shit, but I knew it wouldn’t sound genuine, not after everything that had happened.

“I know we’ve all turned a page, or a corner, or whatever,” I said. Robbie looked away, nudged his chin toward the path, and urged us onward.

“You don’t know what it’s like,” Robbie said. “The voices come out, and I’m so small, naked. Everybody sees me, knows I’m crazy. They think I’m a psycho.”

“Listen.” I rested a hand on his shoulder. “You know that I proposed to Christina?”

“Yeah.”

“I want you to be my best man.”

“Is that a good idea?”

“You’re gonna be good. For me, for the family.”

“I’ll do what I can.” Robbie stuck his hand out for me to shake. I took it, squeezed hard so that he knew that I cared.

“You’ll do great,” I said. “It’ll be just like old times.”

 


 

Robbie left Mark Houston to continue his recovery at a halfway house in Austin. He didn’t make it one whole day in sober living before he packed up his truck and drove away. Mom and Dad endured a frantic three days of radio silence from my brother. They asked me to stay near the house, be on call in case he rang. I lived with my phone at the ready, jumped at every buzz, fretted over every missed call. He did, eventually, show up. He appeared one evening at Mom and Dad’s front door because he ran out of money. Dad called me the night he came back.

“He’s home,” Dad said.

“So, what’s next?” I asked. When Robbie ditched the assisted living, he’d voided the nonrefundable 25 grand Mom and Dad forked out for his three-month stint at rehab, plus got himself banned from Mark Houston facilities. We held a family meeting about how to stop enabling him. We decided that we’d only allow Robbie home if he accepted treatment. No conditions, no middle ground. Sobriety or exile. I pushed for my parents to drain the funds in Robbie’s bank account, but they thought that measure too extreme. They didn’t understand the tactics of siege warfare. Starve him, I urged. Unconditional surrender.

“He’s coming home,” Dad said.

“What about enabling?”

“We’ll cross that bridge when we need to.”

“We need to now.” I could feel the crackling frustration through my father’s silence on the other end of the line.

“You know what happens to people like him out on the street?”

“You know what happens to people like us when he’s at home?

“What do you want me to do?”

“Choose me instead of him.”

“He’s your brother.”

I thought of the overdose, the nights of fearing if Robbie would come home, the weekday evenings where I stood sentry and waited until—if—Robbie came home. I thought of my older brother’s trips to the psych ward, and all the yelling, swearing, kicking, biting, and frothing he did when he was high and psychotic. “He’s not my brother, not when he’s using,” I said. I hung up and threw the phone across the room.

Robbie came home, life went back to the perpetual shit show. He started in with Mom the first weekend he was back. I decided to stay at my parents’ house for a while, in case things got heated, which they did. I listened to the fight through my bedroom door.

“Give me my fucking keys, bitch,” Robbie said.

“You think you’d leave rehab without any consequences?” said Mom.

“Make this bitch give me my fucking keys!”

I hated hearing them like this, hated that Dad wouldn’t stand his ground, hated that they would eventually cave and give Robbie his keys back. I wanted to do something, to fight, to cry, to move, to turn my back and never see them again.

“I don’t give a shit about your rules, fuck off, Nazi.”

I couldn’t take the screaming anymore. I slung a wad of clothes into a bag, nabbed my keys, and walked out the door. I wasn’t sure where I was going, just that I had to get out. I don’t remember driving or thinking or navigating. I remember slipping my car beneath the halogen lamps in the empty Walmart parking lot. The light blared overhead as my eyes settled on the yellow glow of the automatic glass doors with the dumbass yellow smiley flipping a thumbs-up. The lot was nearly deserted. The only other vehicles in the lot were two sports cars parked in the far back corner, noses facing in opposite directions. I tried to imagine what kind of drug they dealt. Meth? Brown? Blow? I wondered if one of those hot rods with their flipped fenders and growling mufflers would find my brother, or if he’d find them. I imagined them as thugs, illiterate crooks slinging slang and corrupting youths. For a moment, I thought I might switch on my ignition, gun the engine, and burn rubber right through those shady drivers in their shifty rides. I’d send their bodies flying, spinning out of the windows, spiraling through the air until they landed with a splat. I changed my mind, because it would be better to drive the car back home, through the front door, into the living room, and send my dysfunctional family through the night air with a hard-bumper thump.

I wrapped my hands around the steering wheel, screamed at the yellow smile, the halogen lamp, the double-muscle-car drug deal at the far end of the parking lot. When I ran out of breath, I refilled and screamed again. I crashed my fist into the windshield, which flowered in crystal wires outward, like a web that I was trapped in.

 


 

At my wedding reception two years later, I watched from across the room as Robbie pounded whiskey at the bar. I’d told Robbie that he couldn’t be my best man if he wasn’t sober, and I told Dad I didn’t want my brother at my wedding if he was using. Neither one of them cared. Across the room, Dad stood next to Robbie. I could see Dad talking to him, nodding his head, rubbing his back as Robbie took another shot. It was all about Robbie. His voices, his medicine, his sobriety. I wanted Dad to laugh and dance and celebrate at my wedding, and instead he was all wrapped up in Robbie. At the rate he was going, Robbie’d be puking into a trash bin before long. Con-gratu-fucking-lations to me.

I wished I could leave, like I had that night at home, drive my car to some forlorn parking lot, blast my fists through safety glass. But I couldn’t, because it was my wedding and I had to save face. Nobody would understand why my brother getting smashed at my wedding was a problem. I stared at Dad—rubbing Robbie’s back to soothe him while he drowned in his whiskey glass—when he should’ve been slapping my back and saying, Congrats, I’m proud of you.

When I think back on that night, I am glad that I didn’t have a car to drive. Otherwise, I might have ridden the two of them down, just like I’d wanted to in the back corner of that Walmart parking lot beneath the glow of its towering halogen lamps.

 


 

The clear glass of the phone booth turned bloody as the sun sank behind distant Bavarian Alps. A breeze carried with it the scent of ripe August air—cigarette sweat and grilled kebab. It should’ve been a good night. It was my 24th birthday. Christina and I were on our honeymoon in Garmisch, Germany. Beer by the liter, my wife waiting back in the hotel for me, mountains in every direction. I hadn’t yet called my parents, and it was too expensive for them to call me. I walked to the crimson-hued kiosk, calling card in hand, and dialed the number. The tone was funny, a series of beeps instead of the normal clang. I hoped Mom and Dad picked up, fingers crossed I didn’t have to talk to Robbie. On the fifth ring, Dad answered the line.

“Hello?” Something was off in his voice, like he’d been tugging his hair out by the roots all day.

“It’s me,” I said. “Thought I’d call, you know. It’s my birthday.”

“Right. Happy birthday.” I expected him to ask me how my day was, or what I planned to do, or tell me to have fun but not too much fun. Instead, I listened to the vapid buzz in the payphone while the color inside the booth darkened.

“How you guys doing?”

“It’s been a hell of a lot better,” he said.

“Is Grandma okay?” I asked, though I knew Grandma was fine. Dad didn’t answer. “Rob?” Dad grunted. The tips of my fingers went cold as the booth slipped into black.

“He’s in the hospital,” Dad said. I crushed the calling card in my fist.

“Overdose?”

“Suicide.”

“Coke or heroine?”

“Knife.”

I couldn’t absorb the word.

I fought the urge to ask him if he was sure, if Robbie wasn’t high and if he hadn’t cut himself in some chemically infused accident. I’d already accepted that my brother’s death would be an overdose. He’d be too careless, too thoughtless, too selfish to make himself stop. In my mind, my brother would lean over a pile of crushed coke, red vessels popping in the whites of his eyes, his last thought “Just one more hit” before his heart exploded beneath his sternum. A knife though, that spoke of misery, pain. He’d have to ignore the steel pressed to the underside of his arm, the bite of the blade as it parted the dermis, the sound it made—like the slicing of plastic sheeting—and finally the blood, the numb, the sinking into death. A blade said that he’d meant to die, that there was no misstep or crazed binge.

“I’m sorry,” I said. A streetlamp pinged on overhead, white and merciless, and the whole booth turned sallow. “Is he ok? Where’s Mom?”

“No. Mom is with Robbie. She sent me home to rest.” Again, he let the conversation die. I knew I would cry soon, but not until after I’d hung up.

“Did Rob say anything?” I asked.

“Yeah.” Dad cleared his throat. “That it was better for everyone if he was dead.”

“Fuck.”

“He said to tell you he was sorry.” A sound like a tiny bell tolled between my ears. I leaned against the grimed plexiglass, curled forward, said something like “Oh jeez.” I couldn’t shake the feeling like I’d driven my brother to it, that I’d finally won our protracted siege. I felt blame radiating out of the receiver, filling the booth like poison gas. It was choking me, that guilt—darkening the edges of my vision. I stuck my head between my knees, clanged into the wall of the booth when I did, panted into my jean-clad thighs.

“He’s safe now,” Dad said. “He’s in the hospital, where he needs to be. Happy birthday,” There was a click followed by a soft buzz, and I knew he’d hung up.

 


 

Schizophrenics are 13 times more likely to kill themselves than the average person. Those that face the greatest risk of suicide: young, white, male, unmarried, multiple psychotic relapses, history of substance abuse. One study interviewed schizophrenic survivors of suicide. Most patients believed that death was the only way to end their illness, that the illness would defeat them. Many felt shame for the hardship their mental condition wrought on their families.

My brother is white, unmarried, a man of continual relapse, experiences relentless psychosis, lives a history of substance abuse. He’d tried to die several times, but it wasn’t until he tried with a knife that I considered he might be sick. It was easier to see his pain as his own fault. Blame provides the illusion of power. The act of scolding my brother justified my need to punish, a self-righteous pursuit of projecting the anguish he’d laid at my feet. A knife is cold, hard, real. That night in the phone booth, I finally realized that my brother was no more a monster than I. Yet the knife told me his pain was worse. I could fly to Germany, explore the Alps, guzzle liters of beer to escape my agony. His pain would follow him no matter where he went, and all he wanted was to languish no longer. I wasn’t ready to love him again, not yet, but I could choose not to add to his misery.

 


 

Christina and I road-tripped back to our parents’ house from our new home out of state.  She and I had been away two years, at jobs out of grad school, carved out a slice of life for ourselves. We had no plans to return that summer, but our second miscarriage in a row sent us hightailing it back. It had been six years since Robbie’s suicide attempt, and I was nearly 30. He’d been clean for five years, had been on his medicine just as long. You could see the effect the substances had taken on him. Scars on his wrists, a protuberance of a gut from the weight gain of the antipsychotics, eyes cowlike and lolled, drool dragging down his lips. He was stable, finally. We spent the first evening home drinking beer, Robbie sipping his near-beer, at my parents’ house, out back on the porch where Dad smoked meat.

“Glad you guys are here,” Mom said. She took a sip of Shiner Bock.

“I just wanted to hold her,” I said. “Just once.”

“She was my baby,” Christina said. “I want to feel her again.”

“It’s a tough thing,” Dad said.

“I lit a candle for your baby,” Robbie said. He sank his cigarette butt into his empty alcohol-free beer. “The first one too.”

“It’s not fair. I loved her. I wanted to be a father,” I said. Dad reached over, patted me on the shoulder. I strangled my left thumb in my right hand till it began to tingle.

“Sometimes shit happens. Has nothing to do with fair.” Robbie lit another cigarette. “Wanna go play pool tomorrow?”

I wanted to tell him no, that I planned to curl up on the twin bed my parents had made and let myself rot until it was time to drive back. I lifted my head, ready to tell him as much, but he spoke before I got the chance.

“Might be nice, you, me, Dad. Just what you need,” Robbie said. I looked at him, his face like a kid begging for a puppy. All he’d wanted since he’d gotten sober was to get into my good graces. I’d yet to let him. Then I pictured him in a small Catholic church with my grandmother, a row of red candles lined near a side altar, Robbie’s hands shaking as he bent down, careful, lighting a candle for the children I never knew.

“Sure,” I said.

“You like where you live?” Robbie asked.

“It’s ok. Barbecue blows, but the seafood’s legit.”

“I heard they have a heroin problem up there,” Robbie said. Dad’s eyes slid towards my older brother at the mention of narcotics.

“Yeah,” I said. “It’s everywhere.”

“Think I’ll be ok up there?” Robbie said.

“Sure, I guess. Why?”

“I wanna be good for when I’m an uncle,” he said. “Don’t want any temptations when it’s time to visit.”

“It’ll be great,” said Dad.

“I’m sure it will be fine,” I said. In my belly, a little flame of the old suspicion burned hot.

 


 

We left that summer, drove back across the country, and by chance Christina and I were pregnant again before we made it home. There was no “trying,” no plan for the future except to finish grieving. Christina was nauseous one morning, took a test, popped positive. We had no choice but to accept our gift, to hold in our hands the darkness and the light, the joy and sorrow.

My family flew up after the birth of our little girl, Elizabeth, named after my mother. Mom came up first to help in the chaotic adjustment to diapers and wipes and cluster feeding. Dad and Robbie came up later, just for a weekend. I held my daughter in my arms and extended her pink, wrinkled body out toward my brother.

“No,” he said. “I might drop her.” He held up a hand, it quivered. A side effect of his meds.

“Wanna try sitting?”

“I don’t ever want to hurt her.” He reached a finger out, placed it against my infant daughter’s tiny palm. It closed in reflex, squeezed around his digit. “She’s got me good.”

I looked at my brother, now Uncle Robbie, and for the first time in many years felt hope.

Todd Richardson received his MFA from Southern New Hampshire University’s Mountainview Creative Writing Program and his MA in history from Texas State University. He writes nonfiction, primarily about his reflections on his brother’s ongoing struggle with schizophrenia. He lives in New Hampshire with his beloved wife and daughter, whom he is thankful for with every word he writes.

Header image by Marilyn Hallett Granzyk