Li Berating

The writer felt unusually anxious in the psychiatrist's waiting area. He anticipated some kind of scolding. Dr. Ryan beckoned him into the consultation room. As they faced each other across the desk the psychiatrist began. "You know why I sent for you?" "I think so" replied
Karl apprehensively. "Your last lithium levels were far too low." Karl accepted he was a manic-depressive. He rejected the pusillanimous term "Bipolar Disorder". His depressive phases were crushing, stuporose, suicidal. There was nothing "hypo" about his manic phases; full-blown, chaotic, dangerously disinhibited rampages. Oral lithium therapy had been
transformative. His last major episode was three years ago when Dr. Ryan's expert testimony forestalled a prison sentence for "assaulting a police officer."
"How are you, anyway?" asked the psychiatrist
"OK" came the cautious reply. "But..." prompted Dr. Ryan
"No highs or lows. Just a bit..."
The psychiatrist completed the sentence: "flat?"
"Look, Doc" said the writer.
"I respect you, but I can't write. It's my livelihood. I sit in front of a blank screen and nothing happens. No inspiration. Zilch. Nada."
The shrink knew that lithium could cause mental dulling.
He also recalled Karl saying that he loved, craved the "highs" when words
and phrases cascaded effortlessly from an over-excited brain despite when revisited in a euthymic state much of the writing was "crap."
"So you stopped taking them" challenged the shrink.
"What can I say?" was the reply. "You've sussed me, Doc."

"You know its almost certain they'll come back" advised Dr. Ryan. "The crucifying, self-hating troughs; the reckless explosions of hyperbolic craziness."
Silence.
"Can I say anything to change your mind?"
Karl slowly shook his head. "I've got to do this for me, my self-respect. To liberate my creativity. Writing is essential to my identity. Without that I'm an empty shell."

They parted amicably, the shrink extracting a promise that Karl would attend more frequently to enable Dr. Ryan to spot any early warning signs of impending mood shift.

Karl kept his word. The next dozen monthly reviews were uneventful although writing remained a challenge.

Then Dr. Ryan received a postal package. He recognised the hand although the serifs and flourishes were uncharacteristic. Inside, four foolscap sheets were engulfed by spidery scrawls with no punctuation. It "read" like a mescaline-induced stream of consciousness. The last line screamed: "I luv you doc you're a star a tsar a supercar best caviar cos doctor ryan you've got me flyin!!!!!"

When the Clinic ended Dr. Ryan set off to do a home visit to the writer, alarm bells sounding. His stride was broken by a newspaper billboard headline.

"Well-known local author plummets to death from 10th story apartment."



"Christ" breathed the psychiatrist. He bought a copy and turned to the relevant page. Karl's cleaner was quoted as saying: "Mr. Jones was a lovely man but he seemed to go crazy. He was roaring with laughter as he threw himself out of the window. His last words were: "don't worry Conchita, now I really know how to fly!"