Read More: A brief interview with Charisse Coleman
O, what a noble mind is here o’erthrown!…
Like sweet bells jangled, out of tune and harsh;
That unmatch’d form and feature of blown youth
Blasted with ecstasy…
— Ophelia Hamlet Act III Sc 1
I remember two things from my mother’s pregnancy when I was four: her announcement that the baby’s name would be “Cameron,” whether it turned out to be a girl or a boy, and feeling the baby kick. My mother called me over to where she sat. “Do you want to feel? Go ahead.” Had I ever touched my mother’s swollen belly before this? Surely I had. Yet my sharpest recollection is of surprise: what I laid my hands on was startlingly hard and strong. And then that astonishing, felt-hammer-against-a-drum sensation under my palms. My first encounter with my soon-to-be baby brother, Cameron.
Cameron came into the world much as I had: Mama made an appointment for surgery, checked into the hospital the night before, got prepped by a nurse, and early the next morning, with the help of an anesthesiologist, slid into unconsciousness. A surgeon cut the thin melon skin of her flesh, then the thick rind of muscle, and finally, reached elbow-deep into her body and pulled the baby of the family free.
Babies get taken to the doctor a lot to make sure everything is developing as it should. Length, weight, circumference of head are all measured and the measurements charted in percentiles. When Cameron was fifteen months old, my mother noticed that Dr. Schwab seemed to take longer measuring Cameron’s head than he had with either of her two older children. Was there a problem? Well, the circumference of Cameron’s head had grown faster than most, and it was quite large. Within the normal range, but just barely. “Somebody has to be at the top of the chart,” the pediatrician said equably. Still, he wanted Cameron to see a neurologist.
Cameron’s head was noticeably large. But it was also gracefully rounded above his tiny shoulders and reed-like bones. Neither size nor shape gave hint of anything amiss. With his large head, cornsilk hair, and impossibly slight body, he resembled a drawing from a children’s book. Birdwing shoulder blades fluttered energetically beneath his t-shirts, a pink buttonhole mouth crimped into tiny smiles, his big blue eyes often turned on you with a seriousness unsettling in a child just over a year old.
The neurosurgeon diagnosed hydrocephalus and scheduled Cameron for surgery.
What is Hydrocephalus?
Hydrocephalus is commonly referred to as “water on the brain.”
The so-called “water” is actually cerebrospinal fluid (CSF)… .
CSF…circulates down and up the spinal column and over the
outside of the brain. It provides nourishment to the brain,
carries away debris, and protects the brain and spinal cord
from injury. …[E]xcess fluid [places]… pressure on the brain
at the skull, causing neurological problems… .
— National Hydrocephalus Foundation
Cameron’s neurosurgeon implanted a shunt to regulate the amount of cerebrospinal fluid in Cameron’s skull; fluid that would otherwise continue to fill that locked, bony room containing his brain until the pressure first crippled and then killed him. The tube ran behind the delicate curve of his right ear and emptied excess fluid into his jugular vein, where it would be safely absorbed into his bloodstream. As Cameron grew, the shunt might need to be lengthened. The mechanism would be part of him for the rest of his life.
In the fall, my parents went to great lengths to find a school that would, in the late 60s, take a child not quite two years old. They wanted to know as soon as possible if Cameron had suffered any brain damage that might cause mental retardation or other handicaps. The European-style Montessori school he attended from the time he got out of diapers through the fifth grade determined very quickly that he hadn’t. Much to my folks’ relief, Cameron turned out to be quite a bit brighter than the average bear. Also more furious.
What did Cameron and I fight about when he was two, three, four, and I was seven, eight, nine? I only remember the ferocity with which we both went at it. And how Cameron would hit. A lot. And hard. It’s easy for grownups to roll their eyes at the bitterness of a young girl’s complaints of being pounded by a boy so much smaller. The adults’ view, as far as I could tell, was: Cameron was wrong to hit, but if he kept it up long enough to draw the attention of the nearest adult, the hitting somehow became my fault. I ought to be able to prevent his hitting entirely; failing that, I should at least be able to put a quick end to it.
Mostly, this was impossible. Clearly, slugging him back as hard as I could, strong as such an urge might be, was not an option, given my five years’ seniority. Having to play Gandhi to Cameron’s Muhammad Ali made me crazy, and so did having my objection to being whaled on by my baby brother dismissed as melodramatic fits of pique, as if the problem were simply a matter of my having the wrong attitude, an attitude I could change, if I really wanted to.
Once Cameron got going, the only thing I could think of was to grab his wrists and hold tight. This, I felt, made fair use of my greater size and strength. But once you’ve got the tempest bottled up, using your hand as the stopper, then what? I’d be clamped onto his arms, arched over like Martha Graham to keep his now-flashing feet from connecting with my shinbones. His face would flush an alarming red and then darken to purple. The veins at his temples and in his neck would rise into blue, pulsing tendrils.
What if, as I repeated my mantra: “I’ll let you go if you promise you won’t hit,” he suddenly collapsed? What if his shunt blew up inside his skull or tore loose from its vein? What would I do?
Shunt Malfunction
Some of the problems which cause a shunt malfunction are:
Breakage of the catheters
Separation (catheters may disconnect from the valve and reservoir unit)
Valve is broken or stuck
The most common signs of shunt malfunction are:
Irritability
Distended scalp veins
Enlarged and bulging fontanel
“Sunset Eyes” (downward gaze)
Cameron’s rages scared me witless. It seemed perfectly plausible that he might one day suffer serious, lasting, physical harm. If only I were better at being the big sister, then I wouldn’t have to worry about his having a seizure or rupturing anything.
December, 1989, Cincinnati, Ohio. I was twenty-eight and not long married; Cameron was twenty-three. I sat in the passenger seat of my mother’s car. She had pulled up in front of a convenience store and gone inside to buy a carton of cigarettes and a 12-pack of Cokes. We were on our way to the state mental hospital to visit Cameron, and these were the things he’d asked us to bring.
Throughout his teens my brother had abused marijuana, then cocaine for awhile, and sometimes hallucinogens. I’d been on rescue or supply runs for Cameron before. After he’d withdrawn from one high school and then been kicked out of another. During one of his two residential drug rehab programs. Through other, less well-defined crises. And then he got sober and stayed that way for over five years. So determinedly sober that he’d missed my wedding two years before to attend something he called “Ikky-pah”: the International Conference for the Young People of Alcoholics Anonymous (ICYPAA).
In those years of meetings and sponsors and admitting his powerlessness over his disease, Cameron wrote letters. A card on a bouquet of flowers to his mom read: “Not because it is Easter, but for loving me when I could not love myself, for tolerating me when no one could possibly do so, and because I love you.” An invitation to her to join him in quitting smoking: “Just make a decision to quit. Ask God to relieve your obsession if you think it will help. I think it will help me. I’m the most important person in my life and you are definitely second, so let’s try because we love ourselves and each other very much.” A note to me in California acknowledged the common state of “riding on a pink cloud” that came with the early days of sobriety, and professed his earnest belief in his ability to keep sober even after the euphoria dimmed. He loved this new clarity and his family and being unashamed of himself too much to slip.
And now — after five years of keeping it together one day at a time — he’d relapsed.
I sat, staring through the windshield at the hand-drawn-in-magic-marker signs taped to the convenience store plate glass, and saw the seemingly immutable rondo of the rest of my life: my kid brother would always be out of control; my mother would always be in charge of the rescue; and I would always be riding shotgun. Godot would never arrive; there would be no exit.
By the time of his admittance to the state psych hospital a few days after Christmas, Cameron was enjoying a full-blown mania, and had gone without sleep for several days. A hit of acid he’d dropped at some indeterminate point in the past week had led to what a doctor later called “a toxic psychotic reaction” to LSD.
Is it schizophrenia or an LSD psychosis?
Poole and Brabbins (1996) argue that psychiatry has no
consistent definition of a ‘drug-induced psychosis’…
[They] argue that this stems from the lack of personal
experience of psychiatrists in the drug subculture.
— From A Critical Review of Theories & Research Concerning
Lysergic Acid Diethlyamide and Mental Health, by David Abrahart
My mother and I had spent a good portion of Christmas Eve haunting nearly-deserted government offices and courthouses, investigating the legal procedure for committing someone to a state mental institution. Not that we wanted to have Cameron declared mentally unfit, or insane, or whatever designation would have gotten him carted off to the loony bin. But we were worried about how much that six-foot tall, 140-lb. body of his could take, not to mention the brain that floated above it. How much faster could everything go before it simply disintegrated? How many consecutive hours of being awake before irreparable damage is done? It’s no secret that sleep deprivation has long been a method of torture, or that going without sleep can, in itself, induce psychosis.
Fortunately, involuntary commitment proved next to impossible, and we gave up the whole, disturbing plan with a heave of relief.
Cameron had been walking around in sub-freezing temperatures wearing only a thin cotton shirt (he’d never been one for undershirts; or underwear of any kind, for that matter) because, as he later said, he wanted to really experience cold — he wanted to feel an intense purity of sensation, the quintessence, the ultimate, of cold.
Cameron was over eighteen, and there was no law against not sleeping for days on end; or running around in wintertime without a coat; or talking a blue streak, unable to stop or to listen, so fast and furious were the ideas and insights and plans and revelations spewing from your brain. No law demanded that anyone else be able to understand the connections between those thoughts, or why they excited you to rapturous breathlessness.
Bewildered by the touch of madness that had rung in our holiday season, my mother cursed our not being wealthy enough to command any reassuring options — in this case, a private psychiatric hospital. So we worried, and wondered what else we could do to get my brother some kind of treatment.
GUILDENSTERN
The queen, your mother, in most great affliction of
spirit, hath sent me to you…
HAMLET
Sir, I cannot… [m]ake you a wholesome answer.
My wit’s diseased… Therefore no more,
but to the matter. My mother, you say, —
ROSENCRANTZ
Then thus she says; your behavior hath struck her
into amazement and admiration.
HAMLET
O wonderful son, that can so astonish a mother!
— Hamlet Act III Sc 2
Zing, zang, zoom went his neurons; hither, thither, and yon went his body. Cameron’s roommate phoned in reports on where Cameron had last been seen. Sometimes we’d talk to Cameron himself — or listen to him, since mania had severely diminished his receptivity. Idiosyncratically selective fascination seemed the governing force. However accelerated and inaccessible his attention and experience were to us, he clearly felt an expansive, intensified awareness of — well, everything, apparently, including consciousness itself.
If we’d known for certain that he’d soon be back to rights, we might have laughed at the clichés streaming from his mouth, how he finally, finally for the first time ever, could see how everything was connected, and where he fit in, and it really was so amazing, and we should all just relax and be happy, because everything, everything was everything else, it was all one and we were all one with it and the harmony of that — the huge, huge, amazing truth of that — was so great and there wasn’t anything to worry about once we saw that, once we knew that, and he wanted us to know it the way he was knowing it, everything was so so obvious once you did.
If one equates euphoria with happiness, then Cameron was very, very happy.
He also sounded crazy. He sounded gone. He sounded like some 60s sci-fi movie character who’s been replaced by a pod person from outer space and begun to malfunction. I caught only glimpses of the brother I knew as he flashed by in a tangle of mania. We didn’t want Cameron committed. We wanted him safe. We wanted to get him treatment, whatever that might mean.
The laws were less concerned with Cameron’s being taken care of than with protecting his civil rights. So, even though we were frightened for him, and worried that the parts of him being flung into orbit as if by centrifuge might never reassemble themselves, we couldn’t force him to get help. And then, somehow, we discovered that the police could pick someone up and take them in for a 36-hour hospital psych evaluation. They were very nice to my anguished mother when she called the local precinct to ask exactly what we needed to do. They were sorry, they said, but they couldn’t bring him in without clear evidence that he was “a danger to himself or others.” My mother’s face drooped from tense concern to defeated weariness.
Quarantine and Due Process
At stake in these proceedings are, on one side, the right of the
community to be protected, and the duty to care for people
who may not be able to care for themselves. … On the other side
are the constitutionally protected liberties of individuals… The
community may not deprive individuals of liberty without
substantial reasons demonstrated through convincing evidence…
— Paula Mindes, “Tuberculosis Quarantine: a Review of Legal Issues in Ohio
and Other States,” 10 Journal of Law and Health
The reality is that a police force is not a preventive body: they are there to clean up messes after they’re made. Only rarely can they act to keep a toxic spill from happening in the first place. But they didn’t leave us entirely without recourse. Keep an eye on him, they said. If he does or says anything, anything at all, that could be construed as dangerous or self-harming, call them back, and they’d come.
In the end, it was Cameron’s quest to experience extreme sensations that gave us our opportunity. His roommate phoned to say he’d come home and found the thermostat turned up as far as it would go, the oven at 500̊ and its door open, and Cameron turning all the stove top’s gas burners on high flame at once. The good news was that a kitchen towel had caught fire. Was it readily put out? Yes. Did any of us actually think that Cameron had endangered himself or anyone else? Not really, no. Theoretically, could it have burned the apartment building down? Maybe. Was a slightly charred kitchen towel enough to get the police to pick him up? You bet.
So we had what we officially needed for Cameron to be taken in for the psych evaluation, but first, we had to find him. We called the police. They said to let them know when we’d caught up with him, if and when we did. And so began one of the most painful deceptions I’ve ever convinced myself to perpetrate.
In full dark and bitter cold, my husband, Bill, and I accompanied my mother as she drove to the shops and restaurants that huddled together near the university. Cameron often hung out there, though the odds of actually spotting him, even if he were around, seemed laughably low. My mother crawled as slowly and as close to cars parked against the curb as she dared. We stared at the people on the sidewalks, swivelled our heads to watch when someone loped across the street, stared deep into the narrow shadows between buildings.
Then suddenly, before we’d even gotten started, there he was. Coatless. Bouncing up a short flight of steps that led to a parking lot behind the buildings. I hopped out of the car. “Hey! Cameron!” Why was I frightened? Why did I half expect him to run away the moment he saw me? The guilt of knowing that we were hunting for him — not just to find him, but to capture him?
Cameron showed no surprise that I should materialize in his path, only delight. “Hey! What are you doing here? This is so cool!” He ducked down to look inside the car. “Hey! Hi!” he said to them, raising his hand in an outstretched wave. He turned to me, eyes buzzing and bright. Even standing still, Cameron seemed hyper, as if the constant shimmy of his body’s molecules had been rendered visible. “Where are you guys going? I’m headed up to Perkins, you want to meet there?” Sure, that’d be great, yes, we’d love to. I worried he’d disappear in the time it took us to park the car.
In the yellow light of the all-night pancake house, the four of us slid into a vinyl booth. Waitresses wearing polyester stuck pens in their hairdos, poured refills of caff and decaf for a crowd that might sit for hours ordering little else. We drank a thin, bitter-tasting brew from thick china cups and saucers. A metal pitcher with a sprung lid poured half-and-half that turned the coffee blond, viscous, and lukewarm.
My mom sat next to her manic, euphoric, unreachable youngest child. She did not speak, maybe because she did not trust herself not to cry. I imagine she fought every conceivable impulse: to sob, to yell in rage and fright, to throw her whole self around her son and hold him until he quieted. Or maybe she could only wait, knowing that Bill and I would do what had to be done.
When I think of us there, all is silence. My mother, Bill, and I are not quite motionless, but we seem momentarily suspended. In my mind, only Cameron moves — vivid and quick. He is, of course, talking talking talking, though I can’t remember a thing he said. In my memory, Cameron sits in a pool of gold light; the rest of us are shaded a murky, pond water green.
I was nervous about what we were about to do next, now that we had him inside, in a corner against the wall, suspecting nothing. Cameron’s good cheer — his happy surprise at seeing us — made me wish all this were not so serious. Couldn’t we simply sit here drinking coffee, out of the cold for a spell, and marvel over the rapid bounty of Cameron’s ideas, riding with him the wave that must, eventually — surely it must — recede? Without explanation, my husband excused himself from the booth.
My mother looked as if she’d tightened her grip — on what, I couldn’t guess. She also looked closer to tears. She knew that Bill had gone to the payphone at the front of the restaurant to call the police. He’d meet them in the glassed-in vestibule, where they would wait for us to bring Cameron to them. Assuming we could. Otherwise, I guessed, several policemen would appear, firk Cameron out of his corner and walk him down the long aisle between the booths and the counter, and out the door.
My husband returned. The police must be out front, then. For the first time, I thought my mother looked frightened. “Mom?” I said to her. “Bill and I need to talk to Cameron. Would it be all right if we left you here for a minute? And then we’ll come right back.” I don’t know how this idea came to me, or how I managed to keep my voice sounding so reasonable and even. “Cameron? Could we talk to you in private for a sec?” Sure, no problem. […]
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Charisse Coleman’s essays have appeared or are forthcoming in Ascent, Water~Stone Review, Witness, Sou’wester, and Hunger Mountain, among others. She is a two-time recipient of NC State Arts Council Fellowships for nonfiction. Formerly a professional actor, Charisse has also worked successfully as a gypsy house painter, office temp, babysitter, dog walker and legal proofreader, and very badly as a legal secretary and cocktail waitress (unfortunately, not at the same time, which would have improved things immeasurably). She now has a small psychotherapy practice in Durham, NC, where she lives with her husband and three very vocal shelter cats.
“Riding Shotgun,” first appeared in Passages North magazine, was chosen as a Notable Essay in the Best American Essays Series, was nominated for a Pushcart Prize, and was first-prize selection for the 2015 Editor’s Reprint Award.