Listening to Paxil

The gloom? Someone on the radio said there was nothing wrong with middle-age, except the age that follows it. Alleviated by a course of Prozac several years ago, my depression had now wormed its way back. But today I was older. Late middle age, I guess, is my new seniority category, although it, too, is creeping ahead. As a result, I can now number among the usual depression-causing suspects a new one—the approach of old age. It wasn't the fear of dying. It was wondering if I could afford to live to be elderly. What, in short, was the cost/benefit ratio of such prolongation? Harry the Wise would point out that by posing this purportedly economic question, I was really intellectualizing a suicidal impulse.

Harry knew another thing about me, that I'd suffered a heart attack five years ago. That explained why over the last year I drank a couple of glasses of red Bordeaux daily, believing devoutly the findings of French researchers that such a regimen reduces the risk of another attack. Never a quantifier, I paid scant attention to dosage. Two glasses became three, and so on. The more Bordeaux, the better for the heart, no? Wrong, other scientists said, for the heart as well as the liver and brain. But I denied it. In any case, as my "cardiac therapy" addiction grew, the depression recurred, pickled in wine like one of those dead worms in a tequila bottle, but suddenly revivified.

The Screening Process

In reality, Harry's Bar turned out to be a depression outpatient clinic in a prestigious university hospital. Given one of my old/new symptoms, low self-esteem, I doubted I'd get accepted into the program, which I knew was topflight and free of charge.

On the long subway ride to the screening session, I felt as tense as a high school junior hoping to get into a good college but fearing he wouldn't do well on the SATs. So I crammed on the train, trying to recall every symptom that might qualify me as a true depressive—anxiety, insomnia, agoraphobia, careless grooming, apathy, dwelling on the past, the whole kit and caboodle. The only thing that made me feel less isolated was noticing that everyone else on the train seemed depressed as hell. I spotted a few good downcast looks and practiced them as we rode along, hope rising that I would overwhelm my interviewers with the legitimacy of my affliction.

I was right about the SATs, or DATs as I now call them—Depression Aptitude Tests. First I saw a social worker who was also a trained psychotherapist, then a psychiatrist of the pharmacological persuasion. They asked similar questions. Did my moods swing (Not widely), how much did I drink (Too much, probably), had I ever attempted suicide (If so, not successfully), did I experience blackouts (Once, at a hell of a party in Madrid), did I go on wild spending sprees (With what?), do I ever think someone's after me (The IRS, every April), do I wash my hands all the time (Only in the morning and after I've gone to the bathroom), do I often feel blue (Night and day), how's my libido (On vacation), and more of the same. Afterward, the interviewers were noncommittal.

The written test followed the orals, a questionnaire maybe 200 pages long, true and false and yes and no. Many of the questions appeared the same as those on the orals, but others seemed intended to search for applicants with mental problems of a different stripe. Do you ever think you're God? Ever hear voices telling you to do bad things? Do you sometimes think you're invisible? Do you wipe doorknobs all the time because you think they're covered with germs? Have you ever been abducted by aliens from another planet?

The only truly difficult question came around number 600: How often did you lie on the previous questions?

After I surrendered a urine sample and underwent a quickie physical exam (including an EKG), I was ushered back to the psychiatrist's office. Let's call him Dr. Fontana, and the social worker Mr. Whiteside.

"Congratulations," offered Dr. Fontana, "You've been accepted." In lieu of a certificate of admission, I was given a consent form to sign, a copy of which I have since framed and hung in my study. Then Dr. Fontana escorted me to the dispensary where an extremely attractive nurse handed me a vial of Paxil. "One a day," she said radiantly, "with food. See you in a week."

I found myself depressed on the way home. What if I wasn't a "good responder?" Or—though I knew they were rare with Paxil—I suffered some ghastly side effects: nausea, headaches, or even greater sexual dysfunction? I tried to smile at my reflection in the train window, cheer myself up, but I didn't look at all convincing. Why wasn't I even a little happy, now that I was back at Harry's Bar, so to speak?