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What Psychiatric Wards Teach Us About the Nature of Reality

Novelist and author Yiyun Li tells stories from her stay in a psychiatric hospital: "Sometimes it's the irrational that is real. Sometimes it's the unreal that leads to the most rational response."

Yiyun Li: A few months ago my teenage son told me, he said, “I had an exhausting dream.” And I said, “Oh? What happened?” And he said, “I dreamed that I was a negative number and I couldn’t figure out my square root.” And to comfort him, and also to alleviate this existential crisis, I said, “Well there is a way. Wait until you know the imaginary number.” And he said, “Mom, I’m not stupid. I know imaginary numbers.” He said, “But I just don’t like that troublesome ‘i’.” And I thought, “You know, that troublesome ‘i’, who would blame him?”
So, during the 16th and 17th centuries, when imaginary numbers were first introduced, some of the mathematicians looked down upon imaginary numbers as fictitious or useless. So here’s a cartoon I borrowed from my younger son’s math room. It says: Pi says, “Get real.” And the imaginary number says, “Be rational.”

I feel like—I’m sorry, I just have to add—I feel like Sean Spicer now, you know. 
Rational versus real. This is, of course—there is a lot to say about that pair. We can go to philosophy. We can go to psychology, neuroscience and many other branches to study this confrontation. The conflict and the affinity between the two.

Coming from a writer’s point of view I want to share a few stories. A few years ago I was hospitalized twice for suicide attempts. And here are a few stories I brought from the hospital.
The first woman I saw when I entered the ward, I’ll give her a name: Lena. She was in her late twenties and she had a budding career in the fashion industry. My first impression of her was that she moved very slowly. Every gesture, every step. Why, I didn’t know. And in a place where people are oftentimes cloaked in paper gowns carelessly, she dressed as impeccably as she could. But Lena was the quietest, most un-self-assuming, and most elegant person there.
During the following weeks we befriended each other and she told me a little about her childhood. She was born in a family of five siblings. He father was in the Serbian army. Her mother was an Albanian orphan from Kosovo and was said to walk around begging until she met Lena’s father and married him.

After the Kosovo war Lena’s mother disappeared. “Where did she go?” I asked her. And she said they thought her mother, without telling them, returned to Kosovo. “Did your father think of looking for her?” I asked. And Lena said no. Why did Lena’s mother leave? I didn’t ask her. It’s one of those big whys we’ll never find an answer to. Instead we talked about other things. As an aspiring designer, Lena would give me fashion advice and prescribe to me all the outfits I should get when I leave the hospital and how to wear them. At the time I thought, “Why do I want to think about how to roll my sleeves up elegantly when I can see little point in living?”
I never asked Lena why she was in the hospital. I don’t think that’s a question anyone asks of anyone unless information is volunteered. Then one day shortly before she left, she said to me, “Do you think there’s anything wrong with me? What’s wrong with me is I have a broken heart. That is not enough reason to put me in the hospital on those medications.”

A broken heart. We can’t ask Lena, “Why is your heart broken?” We can’t ask her, “Why is it other people with broken hearts don’t end up here when broken hearts are an everyday phenomena?” Because that is as if to say, “There’s something the matter with how your heart is broken. Perhaps it’s done wrongly.” It’s as though to say, “There are rational reactions when a heart is broken, and your reactions are not rational.”

In fact her whole existence reminds me of one of my most favorite characters of all time, Charlie Brown. Charlie Brown had the most “Whys?,” and I like this one question—even though it’s not a why question, it is a why question: “How can we lose when we are so sincere?” That’s the precious question. “How can people not love me when I’m so sincere, and when I love them?”
And the second story, I’ll call this young woman Elise. She was deeply depressed and sometimes she would stay for hours in bed without moving. And this is a place where all the doors are open to everybody, so you could see these things. And the only time she came out of her room was to be on the phone, and those were the pay phones, the old-style pay phones with metal buttons you could punch. And when she was on the phone you could see her come alive in a most desperate way.

My understanding of her story came from hearing her talk on the phone, and there was a domestic partner out there in the world who had threatened to cut her head off if he ever saw her again. She did not want to leave the hospital. The doctors wanted to release her and she said, “No, no.” She said she was depressed, but she was not delusional.

And a doctor from a different ward had to come and assess her. The question, of course, was: “Was she telling the truth or was she only imagining the unreal?” And one day she said on the phone to someone listening on the other side, she said, “I don’t care. Send me to a state hospital. Lock me up in prison. Do anything! Can’t you see I don’t want to go out to the world because I don’t want to die?!”

That sounded like the most compelling plea to me. But the confrontation between the real and the rational is murky in life, even more so in a psychiatric hospital.
Sometimes it’s the irrational that is the real. Sometimes it’s the unreal that leads to the most rational response.

Novelist and author Yiyun Li tells deeply felt stories from her stay in a psychiatric hospital, after two suicide attempts. The patients Li shared space with taught her a great deal about living in a world that is sometimes lacking in apparent meaning, and how close reality and unreality truly are. For anyone who has ever felt that "patients running the asylum" is an apt analogy for human society, Li shares the stories behind individuals too readily dismissed or forgotten about. Whether in the field of psychology or politics, tension between orthodoxy and imagination will continue to exist. But if we can find ways to keep our imagination alive, we can thrive in a world that is calling out for answers. Yiyun Li's newest book is Dear Friend, from My Life I Write to You in Your Life


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