1 INITIAL DOSAGE: 0.5 mg. Adam Petrazelli, 16 years old, is a subject of the clinical trial for ToZaPrex. He is reluctant to engage during therapy sessions. Nonverbal communication only. Not uncommon, given his reluctance to participate in therapy aspect of the drug trial. August 15, 2012 My first doctor said it was unusual for the symptoms to manifest in someone so young. Schizophrenic males are more commonly diagnosed in their early to late twenties. I remember thinking, Well, shit, that's awesome. I'm unusual. I'm probably not supposed to swear in these entries. Shit. But you did say to treat them as confidential and that they would never be used against me, so I don't see any reason why I shouldn't use whatever language I'm comfortable with. I'm also not going to worry about ending sentences with a preposition. Or starting sentences with a conjunction. If this is, as you put it, "a safe space for me to express myself," then I'm going to write what I'm thinking exactly as I'm thinking it. I'll answer your questions, but I won't do it during our sessions. I'll do it here, on paper, where I can look at what I write before I hand it over to you. So I can edit what you see, and avoid saying anything that might get me kicked out of the drug trial. I don't always say the things I mean to say when I talk to someone. It's impossible to swallow words after letting them out, so it's better for me not to speak at all if I can help it. You'll just have to deal with that. But I get that you have questions about my illness. Once people find out, it's all they can talk about. You probably know that it's the reason my mom and stepdad picked you. Because you have experience. Fair enough. I've got to say you handled it pretty well. There were maybe two minutes of silence before you handed me a notepad and told me to write about our sessions afterward if I didn't want to talk, which I don't. And it's not because I don't want to get better--it's because I don't want to be here. More specifically, I don't want this to be real. I'd like to treat therapy the way I treat everything else I'd like to ignore. Like it doesn't exist. Because I already know that being here isn't going to fix anything. The drug might, though. You asked me when I first noticed that something was not quite normal. A change of some kind. In the beginning I thought it was my glasses. No, not glasses. Spectacles. I like that word better. I got them when I turned twelve because I couldn't stop squinting and it drove my mom nuts. Dr. Leung is the one doctor I actually like, because he fixed a problem by giving me something fairly simple. Spectacles. Problem solved. I could see and my mom was happy. But that was also when I realized I was seeing things other people couldn't see. I was the only one jerking my head or squinting my eyes to get a better look. Everyone else was looking at me, not the birds that flew through the open window or the strange people who just sort of appeared in the living room. So I stopped wearing my spectacles and told my mom I'd lost them. For a while that worked and I could pretend, but eventually, she bought so many pairs there was no excuse. I was screwed. I didn't tell her I was seeing things for a long time. She'd just married my stepdad and they were happy. When I did finally tell her, it was because I didn't have a choice. The principal called, and when Mom hung up the phone, she looked at me as if she were seeing me for the first time. "Mrs. Brizeno said you looked up in the chemistry lab, started screaming, and fell to the floor." I remember how calm she was. My mom has this Jedi voice that sort of washes over you when she's trying to get information. "What did you see?" I didn't answer her right away. I took off my spectacles and tried to pretend she wasn't there, that she had faded out of the room after asking the question. I'm good at making myself believe these things, but it was harder this time. She just stood there, waiting for an answer. "Bats," I said, looking down at my shoes. "Huge black bats." I didn't tell her that they were twice the size of regular bats or that they had human eyes or that their tiny fangs hung like needles from their mouths. When she started crying, I wished the bats had been real. That the creepy little bastards had eaten me in the chemistry lab and I'd never had to see the way my mom looked at me in that moment: like I was crazy. I really didn't want to be crazy. Nobody wants to be crazy, but now that I know what's happening to me, now that I understand what's going on in my head, I don't want to think about what it means to know you're crazy. To know that your family knows you're crazy. My stepdad, Paul, is a nice guy. He's good for my mom. They dated for years before they got married, and he always made the effort to keep up with my life, ask me about school, etc. He's an attorney who can give her the things she's had to do without since my dad left. Now that he knows about me, about the illness, things are different. He doesn't know what to do with me anymore. We'll still sit and watch TV, but I can almost hear him thinking when I'm in the room. The weirdest feeling, aside from seeing things that aren't actually there, is sitting on the couch next to a grown man who is suddenly afraid of me. He didn't used to be afraid. It's hard not to take that personally. What am I afraid of? Pass. I'm sure you'll figure it out soon enough. The good thing is that he actually does love my mom. And since my mom loves me, he makes an effort. He was the one who suggested the new private school instead of tossing me back into a school where all the kids knew there was something wrong with me. In two weeks, I start my junior year at St. Agatha's. It's a K-12 school. My mom and Paul made the staff aware of my "condition," and because it's Catholic, they can't exactly turn me away. That would be pretty hypocritical. From what I know about the guy, Jesus wouldn't turn me away. Paul also made sure that my new school knows not to talk about my illness. As a lawyer, he explained that legally they aren't allowed to tell anyone what I have, which I appreciate. It's hard starting as a junior in a new school. It's significantly more difficult to make friends when people know you see things you shouldn't be able to see. 2 Dosage: 0.5 mg. Same dosage. Adam still unwilling to speak. August 22, 2012 I became an expert on my condition the second I was diagnosed. I can tell anyone who wants to know all the drugs, the most recent studies, the positive and negative symptoms. When I say "positive" and "negative," I don't mean "good" and "bad." It basically all sucks. "Positive" refers to symptoms caused by the disorder. Like delusions. "Negative" symptoms are reduced by the disorder. Like lack of initiative and motivation. There really is no clear path for the disease to travel. Some people have visions. Some people hear voices. And some people just get paranoid. My mom would also want me to take a minute to tell you about the huge strides in medicine to help people cope with the side effects. She's a glass-half-full kind of woman. The whole seeing and hearing things that other people can't is like something straight out of Harry Potter. Like in The Chamber of Secrets when he heard the voice through the walls. Keeping it a secret made me feel privileged, like waiting for my letter from Hogwarts to arrive. I thought maybe it would mean something. But then Ron ruins that possibility when he says, "Hearing voices no one else can hear isn't a good sign, even in the wizarding world." Harry ended up being fine. Nobody sent him to therapy or tried to give him pills. He just got to live in a world where everything he thought he'd heard and seen turned out to be real. Lucky bastard. I can't really complain about pills, though. Things have gotten better since I started the new drug. We won't know how it really affects me until I've been on the full dosage for a while. They're easing me into it, which you already know. Part of the reason I'm required to sit in your office once a week is so you can spot any problems and report back to the clinical trial doctors. You asked what I know about my treatment. So I'll tell you all the stuff you already know. The drug is called ToZaPrex, which, according to the label, can cause, among other things, (1) decreased white blood cell count (which hinders the body's ability to combat disease), (2) seizures, (3) severely low blood pressure, (4) dizziness, (5) trouble breathing, and (6) severe headaches. My doctors have assured my mother that the worst side effects are really rare. And not to worry. Ha. Yeah. Don't worry. I've experienced some of the side effects. Headaches mostly. The kind that sort of nest in your brain and throb for a while until they get bored and leave you alone. I don't feel compelled to act out everything that runs through my mind, which is nice. But it doesn't make the visions go away. I still see things I know I shouldn't be seeing. The difference is that I know I shouldn't be seeing them. What do I see? Well, let's start with who. I see Rebecca. I know now that she isn't real because she never changes. She's beautiful and tall--like Amazon tall--with huge blue eyes and long hair that falls to her waist. And she's sweet and never says a word. As far as hallucinations go, she's completely harmless. I've only ever seen her cry once, the day my mom found out about me. When it happened, I still thought Rebecca was real. I didn't understand that she was crying because I was crying. And no, Rebecca isn't the only one I see, but I don't like to talk about the others. The more I think about them, the more likely they are to appear, and they . . . ruin things. It's like they wait for my mind to quiet down before they show up. Anyway, the visions usually start with something small, something moving out of the corner of my eye or a voice that sounds familiar and then stays with me for hours. And sometimes it's just a feeling that someone somewhere is watching me, which I know is ridiculous. Why would anyone bother, right? But I still keep the blinds drawn. I don't really know why. I guess it's just the need for privacy. I'd like to, for once, feel properly alone. A month ago, before I started taking ToZaPrex, I couldn't tell when I was slipping out of control. I would be afraid for no reason. Everything I saw was real to me. Once the hallucinations started, there was no switching them off. I could be lost in them for hours. Now, when my mind starts misbehaving, I can at least watch its projections like a movie. Real CGI shit. Sometimes it's actually kind of beautiful. I can watch a whole field of grass erupt into a cloud of butterflies. Sometimes voices serenade me to sleep, and now that I know they're not real, I'm not afraid of them. So that's nice. It's the stuff that jumps out at me that makes me look like a spaz. No, I'm not nervous about starting school. I got my new uniform. White polo shirt, red wool vest with school insignia, and butt-ugly navy-blue shorts that flare out from my waist and hang like elephant skin. And I've done all the required reading for my classes, so I guess I'm as ready as I'll ever be. You know something, though? I honestly don't get how you can sit there, read my journal entries aloud, and then ask questions for an entire hour while I say nothing. That's weird. I'm crazy, and I think that's weird. 3 Dosage: 0.5 mg. Same dosage. Adam starts new school. Still unwilling to speak. Perhaps new environment will act as catalyst for progress in therapy. August 29, 2012 It's pretty shitty to start school before Labor Day. I mean, like, really shitty. But I guess the first week back sucks no matter what. And it's not even over yet. I don't have my driver's license, and I have no intention of getting it anytime soon because it just seems like one more thing I have to figure out and be responsible for. And it's just not worth it. At my last school, I usually walked, but my mom insisted on driving me on my first day at St. Agatha's. There was something manic in the way she drove, like she wanted it to be casual but she was way too nervous to actually pull that off. But when we finally got to the line of cars outside school, she just smiled and said, "Have a good day." I could tell she wanted to kiss me goodbye, but once, when I was eight, I got mad at her for doing that in front of people, and she's restrained herself ever since. I wish I hadn't done that. Pretty sure I just trudged out of the car with my backpack. I meant to smile at her reassuringly but forgot at the last minute. So she probably thought I was nervous when I actually wasn't. You had questions about my first day. Let's focus on those, shall we? You asked how it was different from my last school. It wasn't, really, aside from the uniforms. Everyone still looked miserable. No one was awake yet. And there was a definite feeling of Why me? So there was some solidarity in that, I suppose. My first mission after finding my locker and putting my stuff down was to meet with my school ambassador, Ian Stone. Apparently, all new kids are assigned a school ambassador who is responsible for showing them the school and walking them to class. He was waiting in the front office when I got there, and I knew immediately that he was a douche. It wasn't the hair or the way he looked me up and down when we shook hands or the fact that he was chewing gum with his mouth open. It was just something about the air around him. It was like he was taking up more space than was strictly necessary. His grin never quite reached his eyes as he scanned the room. Excerpted from Words on Bathroom Walls by Julia Walton All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.