Come Out as Gold
by Piper Gourley
Intake/
A psychiatrist asks me, in a voice like a prayer, what death means to me; if I know that I am real. I am no stranger to the confessional of psychiatric surrender, yet this is my first attendance at a residential placement, transplanted a hundred miles from home. I am sixteen. I have spent the prior year in treatment facilities, flattening my life into a shifting blue binder of unstable diagnoses, storying myself for insurance companies and hospital heads. Each time, the intake process affirms its promise: The facility prepares to take you in—you are a moment away from capture.
This psychiatrist is old. He is a tree growing sideways, a man blown back by the wind of life. Something has narrowed in him. His lips are chapped, hair brittle at its ends. Life peels away from him. Our shared insanity invites a brief peace. I study his office, a coffin of bookshelves, filled with therapy manuals and DSMs and Neruda collections, waiting for a fuze to set the place ablaze. As he speaks, I imagine fire consuming the narrow room.
Fwoooop. There goes the poetry. Fwooop. There goes the cure.
The fire dies. He pries.
Do you see things? Hear things? Do you hurt yourself?
He tries to puzzle away the sickness, whatever species of diagnosis he can hang against me. Doctors have not yet decided on a perfect illness, throwing darts at my swinging moods, my high anxiety, my aversion to food. The psychiatrist’s voice (like all those before him) is kind, yet damning: he has dreamed me insane. He must. I am a terrible kid; an emotional hurricane; a great new project.
In-take: I resist. I am taken.
In the unit/
There are sixteen chairs—one for each adolescent patient. A staff desk with a landline phone. Two Isolation desks, shoved into the thin halls. A Quiet Room, a concrete box stitched into the plaster. Cold tile runs through the halls, a chill levitating from the ground. Posters interrupt the dayroom walls. Their platitudes scratch at my brain:
If you are depressed, you are living in the past!
If you are anxious, you are living in the future!
If you are at peace, you are living in the present!
The present is full of nails. The nesting doll of confinement measures is familiar, but this is a world all its own. Residential is my last stop. My last psychiatrist (a young man staffed at a hospital that funneled into this one) assured me that this facility boasted an eighty-eight percent success rate. It’s like a college campus, he told me. You’ll love it.
I don’t know how long I’ll stay here. At sixteen, this uncertainty is as good as forever.
Nurse Diana, a brunette with veiny hands, pulls me into the staff office to steal my blood. I curl into a wooden chair and surrender my arm. One vial, two. I cry. Diana asks me to stop. She speaks with a stilted tone, yet she hums gently, watching the blood leave the crook of my arm.
She was an opera singer, once. Now, Diana is a sheep.
The charge nurse sweeps in. Her name is Kit. She is rail-thin, severe at every angle, with bleach-blonde hair that tears past her hips. She’s got a smile like a crooked wire. She asks my full name, studying me with the coolness of someone deciding the best way to bury me. I have known many irate staff in shadowed hospital halls, yet the brightness in her eyes—the joy she takes in the dimness of this place—chills me. Charge nurse: yes, she charges.
“You aren’t going to give me any trouble, are you?” Kit asks me.
“No, ma’am.”
“Polite,” she says. “I like this one, Di.”
Within the early hours of this new confinement, I don’t like her. Kit wrangles the rules, the forbidden values—
In the handbook/
Forbidden: Touch. Hugs. Queerness. Transness. Nicknames, pet names, names we dig from our chests. Kisses. Air kisses. Tossing sunlight between our mouths. Dangerous words, hearty ones: I love you and I see you. Singing. Dancing. Cussing. Inappropriate laughter. Boundless, beautiful, inappropriate laughter. Friends (“peer” only). Comforting a peer. Weeping. Discussions of death, news, pop culture. Red clothing. Black clothing. Speaking without permission. Moving without permission. Break enough forbidden values, and—
In Isolation/
You belong to a desk. The staff’s walkie-talkie statics breaks against you, washes out. Kit’s voice hammers against the back of your head, willing you deeper into the hole of yourself. Pseudo-therapy groups chatter in the distance, an empty link. You do not speak; are not spoken to. Your thoughts crystalize, shatter against the back of your skull. The wood is cool under your palms.
You don’t pray. You are not real; death is a fire escape.
(I watch the latest victim melt into the wood, as much a shadow as a girl. Her eyes are like two medallions, glowing gently through the hallway, begging for a response. Many have been here for months, going mad, empty-eyed, empty-headed. I have known Isolation in other wards—I will not survive another round. I cannot let the desk take me.)
In the bedrooms/
Four beds in each room. Across from mine, a stuffed rabbit curls up on a comforter, a clenched fist. A flashlight scans the space like a lighthouse, then disappears. Footsteps trail up the hall. After a week, my body still jolts with each thump.
A fourteen-year-old veteran of residential whispers jokes to a kid newer than me; the new kid cries hard, heartache echoing against the walls. The sound makes my stomach hurt. When exhaustion arrives, I welcome it. Sleep hits me like an anvil.
Dream sequence: I hang from the bedroom curtains, my body a windless flag. Nurse Diana sings in the distance. I emerge from the fabric and wander a catacomb of halls, my shadow chasing itself. All lead to the dayroom, to Kit’s wild tongue.
In the night/
The psychiatrist assigns pills, pastel morsels of prescriptions, a holy blend. Medication is a given. This doesn’t frighten me. I have known pills like these. But I have not known compliance like this: compulsory, mechanical, punishable. My fellow patients demonstrate their sanity for the staff, wearing program-approved, Fisher Price smiles.
We line up, palms out. Diana distributes our drugs with gentle, veiny hands. She watches us take them, watches them take us. Tongue up, tongue down, swallow—no cheeking.
I ingest two: a round peach, a half-moon. When the pills go down, they go down hard. In minutes, my body becomes ghostly. My eyes fill with static. As the dayroom melts, light splinters through the front windows into our fishbowl of a ward, casting my shadow in a thousand directions. The sinking becomes serene, inviting life into a new stage of softness.
In chemical euphoria, these pills bring a false belief: this ward will save my life. These rules. These strangers, blown smooth against the wind of themselves. I put stock into goodness; I imagine this as grace. I do not know any better.
In time/
As the days unfold, life gets smaller, bound to the business of restriction. I cycle through chaotic therapy groups, endear myself to the psychiatrist, and attend remedial courses in makeshift classrooms, encircled in their haunted routine. The forbidden values of residential wrap around me like a cold glove, paralyzing me in the program’s language. We have done this to ourselves; the consequence, the fear, is proof that we are healing.
I adopt the beliefs of the program, unwilling to accept the slow burn of Isolation. Other girls end up at the desk, flattened into the walls, their programmed goodness evaporating in a glimmer.
Their crimes:
A thirteen-year-old weeps on the phone with her mother.
A fourteen-year-old passes a smiley-faced sticky note to a boy in another unit.
A fifteen-year-old calls Kit a bitch.
Two sixteen-year-olds share a kiss in the laundry room.
In their guilt, the desk swallows them alive.
(They have done this to themselves; they are healing.)
Given time, my empathy sputters out. I unlearn my humanity. I do not sing in the shower. I do not foster friendships. I do not love. I feel nothing as our world folds in, our shadows collapsing on themselves, my compassion burning off the bone.
There is comfort in the shrinking, a beauty in being wiped clean. Yes, I am living in the present. (I imagine) I am at peace. Healing. Light enough to set ablaze. Fwoop.
In the dayroom/
A new girl sleeps on the floor. Her name is April. A panic attack (forbidden) has made her a target. On consequence (a state of being), she is fossilized, aching to solidify into the confetti tile. She cannot speak. Cannot leave the unit. She refuses food for days—the most polite way she can think to kill herself.
Tonight, in exhaustion, she hides beneath her sheets, seeking privacy from the fluorescents. The Wednesday nurse, Darcy—a warm-faced mother of two—summons her walkie-talkie.
Code Yellow. Unit disturbance. Clinical, clean language.
Footsteps tear inside—gunshots of toes, heels. Men pry April’s limbs apart, one at a time; her hands, digit by digit. I recognize one of them as the ward’s history teacher. They are dividing April from herself; dividing us from her.
“Focus on yourselves,” Darcy says.
Her voice is honeyed, a mother’s tone. April does not respond. She does not scream. No proof of life. Dead in the head, in the eyes.
When they are done ripping April apart, April will rip herself apart. Right now, in the weak struggle, the overhead lights throw electricity against her pale frame, unshowered and sweaty and starved, her whole body a tuning rod of terror. She is stretched in four directions, ready to be crucified.
(Forbidden: I love her. Don’t I? How can I not?)
In the morning/
Sunlight whispers through the unit. Dust trickles through the air like snow. A behavioral tech plays “Hotel California” while we clean: You can check out anytime you like, but you can never leave…
We scrub the toilets, the tile, the walls. The sour smell of mildew hugs our skin, cut with the burn of bleach spray, but it is Sunday, so there is stillness, a false peace. I sing along.
Later, during free time on the front lawn, Grace, a diagnosed genius, sits with me in the dirt. Grace has a metal laugh and a Chicklet smile, her teeth plastered into a faultless white row. I like Grace. I do not know her last name, but I know when her childhood home burned down, and how she felt when the ash of her adolescence hit the toes of her shoes. This is normal. We are peers. Close peers, best peers—not forbidden.
April is inside, at the desk, but we are not. We are selfish. We forget her. I teach Grace some sign language from an old class: Iloveyou and friend and music.
“What’s the sign for a peer?” she asks. I don’t have a clue.
We stick garden snails on our faces and watch them ascend the bridges of one another’s noses, the early spring air driving them up, up, in search of warmth.
I laugh (appropriate). Bethany, another staff, calls us disgusting. She is teasing. She is right.
In the field/
A girl runs through the yellow field surrounding our unit. A set of stolen keys shatters on the concrete behind her. A few of us watch from the windows. Someone restrains a cheer. The overcast sky wrinkles like tin foil, obscuring her sprint. Her name, Hadya, means well-behaved. Hadya cares for April; she runs because April, malnourished and insane, cannot. (If this is not love.) A walkie crackles its aluminum tune. Staff run, plowing through the cool burn of early spring.
If you are at peace—
I look away. Do not wait for the tackle. Imagine Hadya as an angel, levitating, disappearing into the glimmering silver.
When she is dragged back, I do not protest. I am well-behaved. I focus on myself.
Hadya earns a desk. She bleeds, weeping (forbidden), cursing (forbidden). Crucified.
Something tugs at me. A glimmer of sense: A child is sleeping on the floor, bleeding on the desk, weeping in the corner. This is not normal. This is not safe. But this truth is not safe to acknowledge, not within the burn of the present. I cling to apathy, and the hollowness returns, buzzing like a low-grade fever. This is the grace of losing your mind: once you’re empty, you’re free. You are moments away from escape.
In my mind/
I skate across the electric landscape of my childhood roller rink, the light of the disco ball slicing my figure into a million pieces.
My twin brother pulls me through a bluebonnet field, compressed by gentle footsteps. I weep, afraid of rattlesnakes; danger and beauty feel interchangeable.
I sit with my first cat, Princess, abandoned on the road, clawless and mournful—but not yet. She is in my bedroom, fur warmer than a lit match. We are home. We have always been home.
In the aftermath/
After two weeks on the floor, April tries to rip herself apart. Her nails invoke new wounds, her forearms weeping against themselves. The staff takes us outside, trying their hand at relief. Spring grass has arrived. It is lush. Beautiful. April screams. Green. Full of flowers. Screams. Birdsong.
Kate, a repeat admit, has a thousand-yard stare. Miles past terror.
“Are you okay?” I ask.
“We just watched her do that to herself,” she says, flat, as if relaying an event on the television.
Bethany tells us to shut up. I do.
Quietly, I study the wide lawn. The freckles of flowers, colorful blobs on the ground, like God knocked over a pill bottle. My hands start to shake, then my ankles, my body transforming into a tuning rod. The fear is so helpless, so complete. Inside, I hear a plastic clatter—ch, ch, ch. A psychotropic rattlesnake.
“I have a cat,” I tell Kate. “Do you have pets?”
No answer. A thousand yards away.
Inside/
April is alive. Bandaged. Crumpled up on her mattress, a wounded bird. For the first time in weeks, my heart is a loose bolt, rattling in my chest. Grief arrives, ready to plant its stake. Emptiness evaporates, leaving me raw. We line up for nighttime medication, snaking around the scene. My turn.
“Hey, Piper,” Nurse Darcy says. “Was it nice to get out for a bit?”
I laugh (inappropriate). I imagine hugging Darcy, then killing Darcy, the light of my rage slicing her apart. At once, shame pummels me. Darcy means well, or means to mean well. She is as human as us, if not more so, now; somehow, this truth is the worst thing about her.
“Yes,” I say. “It was.”
I smile. Take the tablets. Tongue up, tongue down, swallow: my pills, my words, my will. In the static of the drugs, there is no April. No Kit, Darcy, Bethany. No shadows. As the walls melt, in comes the roller rink, the bluebonnet field, a home with no end—
In an instant/
During a crafting group, a pair of scissors go missing. Apple-handled, too weak to cut an eyelash. Kit retrieves an industrial trash can and orders us into stillness. We are guilty until proven innocent. In the dayroom, we surrender our backpacks. She throws out photographs, artwork, family relics. Someone cries (focus on yourself). Pale light breaks through the windows, a taunt.
In the bedrooms, our belongings hit the floor, a hail of fury. Mattresses are flipped, surfing the tile. Shoes go flying. The stuffed rabbit is concussed.
The staff return, empty-handed. Kit steels herself.
“We are never going outside again,” she says. “Never, ever, ever…”
She begins to scream, her voice turning into a vibration, a suggestion of a sound. I am grateful. I know there is a version of this in which we are all dead.
In consequence/
For several weeks, at Kit’s insistence, we cannot speak freely. Words gain a new currency—they will cost you a bedframe, a meal, a family visit. In the mornings, birdsong is a lifeline. The din of the staff’s voice erupts from the office, full of accusations not worth countering. They will hang us with our language.
The emptiness is useless, now. We are all on consequence. All in Isolation. My heart fills with water. To cope, I imagine the antithetical: a burning. Fwoop. Imagine flames and ash tearing through the psychiatric glass, melting through the metal doors, the posters peeling like dying leaves.
If you are anxious…
In our quiet, the Quiet Room digests. (Forbidden: I pray. Don’t I? Don’t let me be next.)
From the office, Kit laughs and laughs, a metal, jagged laugh. We are the punchline.
In time II/
April’s insurance runs out. She discharges. She becomes Past Peer A. One night, Past Peer A calls the staff phone. She plans to die, soon, become a bridge jumper. Past Peer A hangs up.
(Forbidden: Bethany weeps. She weeps as if she loves us. Does she?)
In my mind II/
I take the scissors. Swallow them whole. They melt through me, come out as gold.
I watch Hadya’s collapse. Bear witness: I see you.
I start a fire. Collect a match from a smoker staff’s pocket, and fwoop.
I weep.
I take the scissors, but don’t swallow them. I shred April’s mattress. We run, the trampled field becoming a memory of our departure. We sprint until we hit the streets of the nearest city, electric, the skyscrapers splicing us into a million pieces.
April and I sit in a restaurant full of beautiful, boundless strangers. Words crowd the air. April eats and eats—multiplies herself.
“How many bridges have you stood on?” I ask. “One, two?”
“None,” she says, mouth full. “They’re dangerous.”
We laugh. I tell April I love her. I call her my friend.
Piper Gourley is a professional ghostwriter from Houston, Texas, currently residing in Southern California. They are published in The Rumpus, Joyland, Quarterly West, Michigan Quarterly Review: Mixtape, and elsewhere. You can find them at their website, https://pipergourleywriting.carrd.co/.