The Quiet Room: A Journey Out of the Torment of Madness

Marvin opens this chapter by narrating his experience on the night that Lori overdosed. On that night, he received a call from a distraught Lori Winters, who informed him that his daughter had intentionally overdosed and was being taken to the hospital by both paramedics and the police. Nancy immediately begins to cry and shake, so Marvin downplays the news. Both he and Nancy are eager to console themselves with the thought that the entire episode is merely a misunderstanding and a simple medication error on the part of their daughter. The notion that she has actually attempted suicide is unthinkable.

Marvin reflects on Lori’s life, and her identity, thus far. He concedes that while he did know that Lori had been having difficulties, he had always dismissed these difficulties as the normal stressors of being a young student. He saw nothing wrong with Lori seeing a counselor, and trusted the psychiatrist she was currently seeing, who was a respected member of his community. He feels sure that Lori will resolve her problems with the psychiatrist’s help.

By the time Marvin and Nancy arrive at the hospital, Lori has been given medication to induce vomiting, and her stomach has been pumped. Lori is also basically coherent again—and very contrite. She cries, telling her father that she didn’t mean to commit suicide, and promising that she will never do such a thing again.

Lori Winters pulls Marvin aside and tells him that Lori violently resisted the police officers who tried to take her out of the apartment. She tells Marvin that Lori even tried to take one of their guns. Marvin, however, cannot reconcile his shaken and cowering daughter with Lori Winters’s story. He also reflects that finding Lori in the seedy and chaotic Bellevue Hospital—a public hospital that becomes dicey in the late hours of the night—feels surreal.

Lori Schilling’s psychiatrist arrives, and Lori Winters berates him for his callousness so loudly that it seems as though she wants Marvin to hear her. Marvin, however, finds no use for recriminations, and is eager to resolve everything and leave the entire episode behind.

Hospital personnel refuse to release Lori, citing the fact that attempted suicide is a serious deed. Marvin, knowing that a commitment would place a label on Lori that could follow and stigmatize her, perhaps forever, knows that he must act quickly in order to extricate his daughter from the hospital bureaucracy. As he and Nancy argue with hospital staff in the hall, a doctor that he knows from his country club in Scarsdale happens to pass by. This friend pulls unknown strings in order to arrange for Lori’s release into an overnight medical (as opposed to psychiatric) ward. He tells Lori, “It’s better this way, lovey, […] This way you can put this whole thing behind you, and no one will ever need to know you were here. It will all be over” (42). He continues to believe that Lori’s problems are temporary.

Marvin then reflects on the way he raised his children. He intimates that he always pushed his children to reach for perfection. He reveals that his father was born in 1901 “in territory that was sometimes Poland and sometimes Russia”, and that his father “fled a brutal military service, and found passage to America on a cattle ship” (42). His mother, for her part, arrived in America from Austria at the age of six months. She worked in a sweatshop when she was a child.

Marvin attests to the fact that he grew up very poor, and that he learned very early in his life that his smarts and sense of determination would ultimately be his tools to escape poverty. He therefore graduated from high school at the age of 15, and started college at Queens College when he was 16. Military service then intruded on his studies, but when he returned, he graduated with honors. He then speedily obtained both his Master’s and Ph.D. degrees and immediately began to work. He started as a management consultant to business at A.T. Kearney, and very quickly began obtaining promotions. By the latter end of the 1970s, he was very wealthy and comfortable.

However, during the spring of 1982, “when Lori was having her problems,” his firm was re-structuring, and the country was in the midst of a recession, Marvin suddenly found his 22-year-long career at A.T. Kearney endangered. However, he banded together with other veteran employees. They staged a successful coup that secured his position. Marvin also remarks that both he and Nancy never spoke of Lori’s troubles to their colleagues, as he believed that only ill could come from mixing the personal and professional realms.

Back in the present moment, Nancy and Marvin bring a contrite Lori back to their home in Scarsdale for a few days. Marvin telephones Lori’s boss at the insurance company and asks for a few days of sick leave on her behalf. After those few days, Lori returns to her apartment, but is unable to return to work. Marvin observes Lori’s unpredictable mood swings, as she bounces between seemingly frantic to almost catatonically depressed without warning.

Lori Winters moves out, and Nancy begins to make frequent trips to the city to check on her daughter. She sees Lori’s apartment become increasingly disordered and witnesses Lori’s panicked, chain-smoking moods. Lori has also stopped seeing her psychiatrist, who telephoned the Schillers shortly after Lori’s suicide attempt to tell them that her issues were beyond his scope. He also recommended that the Schillers find a different doctor, and stated that Lori was seriously ill—a fact that Marvin still could not bring himself to accept. Marvin cites his own hopeful expectations for Lori’s life, as well as his own professional background in psychology, as the main reasons for his inability to face the music. He does, however, seek the help of a Dr. Nathan Kline, who had garnered a good reputation for treating young psychiatric patients with experimental psychopharmacology. After a few weeks under Dr. Kline’s care, Marvin believes Lori is improving, but Nancy believes that the drugs have transformed Lori into a shell of herself.

In mid-June, Marvin gets another phone call: Lori is once again in New York Hospital after a suicide attempt. Once again, the hospital pushes for Lori’s admission to a psychiatric unit. This time, Lori’s brother, Mark, accompanies Marvin to the hospital, as Nancy is too distraught. When they arrive, they are told that Lori had ingested a handful of Ativan—the tranquilizer prescribed to her by Dr. Kline—and then walked thirty blocks to Dr. Kline’s office. She had arrived babbling incoherently. The nurses, suspecting an overdose, called for an ambulance, which transported Lori to New York Hospital.

Lori is again contrite. She pleads with her father, telling him that she was only trying to calm herself down, not kill herself. Marvin leaves Mark in the room with Lori while he argues with the doctors in the hall, trying to convince them to believe Lori’s story. However, when he returns to the room, he finds a blanched and shocked Mark, who reports that Lori had been cursing at him, telling him she had always hated him, and attempting to take off her clothes and leave the hospital. This is a turning point for Marvin. Because he knows that Lori is a very modest person who would never take her clothes off in front of Mark, nor try to proceed naked and barefoot into the rain that poured outside of the hospital, he finally becomes convinced that her issues are very serious.

Marvin tries to reason with Lori. He tells her that if she signs herself into the psychiatric ward, she will be able to voluntarily leave, but that if she does not, they will be able to forcibly keep her there. He promises her that she will only spend a few days at the Payne Whitney Clinic of New York Hospital, which is the acute care facility that has been chosen for her. Because Lori trusts her father, she ultimately agrees to voluntarily enter the facility.

On the way home, Marvin knows that Mark is shaken and in need of consoling, but he cannot focus on anything but his own worries and shock about Lori, and his preoccupation with telling himself that her stay in the psychiatric ward will only be temporary. He also cannot keep away the thought that Lori’s situation is his own fault.

Marvin and Nancy go to visit Lori at the Payne Whitney Clinic. It is clearly a locked-down facility, and worse than what Marvin had ever imagined. He finds Lori among a horde of “blank-faced people, muttering strange things to themselves, or knitting jittery patterns in the air with restless fingers, or pacing or rocking incessantly in their chairs” (49). Worse than that, Lori has transformed into “a stranger, a person who [seems] to be living in some faraway world of her own making. There [are] no more apologies, no more pleas to let her out. The illness [has] captured her, and [is] a part of her” (49).

Lori unironically tells her father that she can fly. When he invites her to show him his ability, she initially tries to demonstrate by standing on a couch, and then says that the couch is not high enough. She then tells her father that if he takes her to the window, she’ll be able to properly show him. He can see that, if he were to take her to a window, she would immediately go plunging to her death. He changes the subject, but her declaration that she can fly haunts him.

This chapter is composed of excerpts from Lori’s medical records. Lori is referred to as “patient” throughout these notes.

On 6/17/82, a Primary Therapist Note states that Lori heard voices on the day of her admission, and was afraid that she would destroy her apartment with a hammer.

A Nursing Note on 6/17/82 states that Lori had a 10-minute “episode of severe auditory hallucinations” which was accompanied by “intense psychomotor agitation” (51). It reports that Lori initially did not want to speak about the episode, but later admitted to hearing voices. It states that she felt “ashamed and hopeless” about the auditory hallucinations, and that speaking about the voices makes them harder to fight.

A Nursing Note on 6/21/82 states that Lori appeared distracted and angry. It also states that Lori has said that she knows what to say to the doctors in order to manipulate them into letting her go. She wants to leave Payne Whitney very much, and states that the only reason she is still there is because her parents brought her there.

A Primary Therapist Note on 6/23/82 states that Lori has stayed “agitated and intermittently hallucinating” (52). It also states that she has intimated that the voices threaten to kill her if she speaks to hospital staff about them.

Steven, Lori’s brother, writes that he was 16 years old when Lori was committed for the first time. At the time, he became enraged at his parents, telling them that they were wrong for committing his sister. He felt that they were trying to sweep Lori’s problems under the rug in the same way that the various wealthy parents in their community hushed up their family’s assorted scandals. The truth is that his parents kept him mostly in the dark about Lori’s problems, and that he was a child at the time of her first suicide attempt.

He reveals that his response to her commitment was also borne out of his own loneliness and sense of abandonment: his mother had returned to work a few years earlier, and he was still sore about it, and both of his parents had grown preoccupied with their own worries and activities, rather than with caring for him. His mother began coming home later and later, to the point that he was starting to cook dinner on his own. This new phase, in which his mother was not preparing every meal, seemed to mark the end of his family’s days of happiness. And with both Lori and Mark out of the house, the dinner table felt empty. When his mother comes home crying, as she does often, he always assumes it is about a tiff at work. It never registers that she is crying because she has gone to visit Lori.

However, he professes that, beneath his recriminations, there was fear. He had heard that Lori’s problems were genetic, and he was afraid that the same fate would befall him. This fear is intensified by the fact that he had always looked up to Lori as a role model. Her efforts at rousing him from his adolescent depression when she would come home during her college years, and his ability to witness her glamorous and carefree college life during his visits to her, had especially invigorated his sense that he wanted to take a path just like hers, and now he felt inevitably doomed.

Mark also notices that once Lori’s illness became a reality, his father began to treat him differently. Whereas his father had once always pushed him to take the hardest classes, he suddenly began to encourage Mark to take easier ones. Marvin was clearly afraid of causing mental illness in Mark, and so he lowered his standards drastically.

Mark even once told his father that he needed to see a psychiatrist, just to test his reaction. Marvin responded that Mark could definitely go see a psychiatrist, but that he felt that it was unnecessary.

Lastly, Mark reveals that his own fears of becoming like Lori prevented him from going to see her at Payne Whitney.

Nancy writes that she determinedly put on a brave face when she went to visit Lori every night at Payne Whitney. She coaches herself in order to stay in control, and in order to be able to convince her sick daughter, and herself, that life is worth living (59). She poignantly reveals that she often brings Lori ice cream, in a call-back to happier days that they shared, while simultaneously feeling that ice cream is an absurd answer to Lori’s current situation.

Nancy intimates that Lori was more than simply her daughter: “she was everything [Nancy] had ever wanted” (60). She reveals that, when she was young, she would fantasize about her future life: she’d be thin and gorgeous, have a doctor for a husband, and a small daughter: “I would sing to her, laugh with her, dress her, cuddle her, play with her and shower her with all the love that I craved so much” (60).

Nancy reveals that her parents rarely expressed any affection for her while she was growing up. She believed that her coldly-calculating father had married her “very beautiful, very wealthy, and very scattered” mother for her money (60). She remembers her mother, an artist, as nervous, chaotic, and ill-equipped to both discipline herself and her sister and to manage the household. At night, when she heard her parents bitterly arguing, she would run to her only place of solace—her German nanny’s bedroom. In the morning, her mother would berate her, blaming Nancy for all of her unhappiness, calling her fat and loud, and confessing that she had never wanted children.

Nancy worshipped her father and did everything she could to win his love. She tried to act like the son he wished she was, but nothing ever helped her to secure his love. “Was it any wonder, then,” she muses, “that [Nancy] married the first man who was good to [her]?” (61). Marvin Schilling was an older, sophisticated graduate student when she met him at a fraternity dance. She knew immediately that she was going to marry him. Indeed, they were married just a month shy of her nineteenth birthday. Although their differences could have doomed them, she used her pampered upbringing to educate him about the conventions of the moneyed. With him on his way to obtaining his Ph.D., he would be the doctor-husband of her fantasies. And, when Lori was born, Nancy “loved her more than anything on the face of the earth” (61); “[b]right, funny, alive, beautiful, giving, warm and lovely,” Lori was everything she could have ever hoped for (62). Nancy and Lori didn’t even fight when Lori entered her teen years.

Yet now, suddenly, Nancy finds her beloved daughter ripped away from her. The Lori she visits in the hospital is a stranger. And Lori’s pleas for Nancy to take her home at the end of their visits are like torture.

Nancy does not speak of Lori’s problems to anyone: Marvin has explicitly forbidden her from doing so. He has done this in order to clear the way for Lori’s stigma-free recovery, but Nancy takes his attitude as a sign that he has not accepted how serious Lori’s condition is. Although Nancy feels the need to reach out to her friends for support, Marvin’s mandate bars her from doing so. Their bond begins to fray. Marvin, who had always been able to solve problems for both of them, finds himself helpless and ineffectual in the face of Lori’s illness. He buries himself in his work as a result. He goes on frequent business trips, and although he is always caring and patient on the phone, Nancy ultimately feels lonely and abandoned.

Marvin explicitly blames himself and his relentlessly-high standards for Lori’s illness, and Nancy does not contradict him. While she does not blame herself and knows that she was an excellent, attentive mother, she does feel guilt due to her failure to detect Lori’s serious issues. It was Mark and his depression that would keep her up at night, not Lori, with her picture-perfect achievements and attitude. She wonders if she was too passive when she finally learned that Lori was truly sick, and regrets placing her under Dr. Kline’s care:

Just a few weeks after [Lori] began seeing [Dr. Kline], her eyes became glassy and vacant, and she began to move like she was sleepwalking. She put on nearly twenty pounds. Her skin began to break out, and her chestnut hair turned grey overnight (66).

Nancy had even failed to recognize her daughter in the street one day when she had gone to New York to visit her, mistaking Lori for a “street person” (66).

Meanwhile, the hospital seems to be getting frustrated with Lori. As Payne Whitney is a teaching hospital, Lori is being seen by “earnest young students doing their rotation through a psychiatric clinic” (67). Nancy and Marvin must begin the narrative of her treatment anew with each new student assigned to Lori. Finally, a young female staff member informs the Schillings that they are considering bipolar, also known as manic-depression, as a diagnosis for Lori. She also “drops a bombshell”: Lori is hallucinating (67). Nancy dissolves into tears, while Marvin refuses to believe it, chiding that Lori could control the hallucinations with a bit of encouragement. Still, they are both shattered by the news, and consequently give their consent for Lori to begin electroshock therapy. After months of electroshock therapy, however, they see no lasting healing effects. The staff at Payne Whitney seems to be at their wit’s end with Lori’s treatment. Nonetheless, the Schillings see Lori’s internment in a long-term care facility for the profoundly ill as an utter impossibility.

Suddenly, however, they are summoned by Lori’s medical team, which presently consists of the young woman whom they spoke to earlier about bipolar, and an unidentified young man. The woman tells her that they believe that Lori has schizo-affective disorder. Marvin, in a prickly and confrontational mood, becomes incredulous. When the Schillings are told that the disorder is a mixture of manic-depression and schizophrenia, Marvin fires back that this mixture must mean that the hospital actually does not know what is going on with Lori. This accusation is shrugged off, and the Schillings are informed that Payne Whitney, a hospital that specializes in short-term care, is unprepared to deal with Lori’s very serious problems. They recommend that Lori be transferred to another hospital in Westchester, closer to Scarsdale.

Marvin cannot accept this, and claims that he has been led to believe that Lori’s problems would resolve themselves quickly. He tries to argue that it is difficult to sort out Lori’s actual symptoms from the side effects of the medication and electroshock therapy, and also that he could bring Lori home under his own psychiatric supervision. Nancy and the young man remain silent, until the young man suddenly cuts in: “Schizophrenia is a very serious illness […] [i]t may be a very long time—if ever—before she will get better. She will probably never be able to live on her own again. It would be better for both of you if you faced facts” (70). Nancy and Marvin find themselves shocked and heartbroken.

While Marvin retreats into himself, Nancy finds herself isolated. She buys three books about mental illness, and corrects her initial assumption that schizophrenia meant that a person had multiple personalities. She learns that schizophrenia is a chemical imbalance which usually begins in young adulthood, and causes delusions and auditory hallucinations. She learns that, sometimes, sufferers of the disease use medication to get their symptoms under control, but, other times, medications do not help at all. She learns that some people with schizophrenia spend their entire lives committed in institutions. She writes, “Suddenly I seemed to understand why they would want to transfer [Lori] out of Payne Whitney, to turn her over to some other hospital. All of my suspicions were correct. They were telling us there was no hope” (72).

This chapter contains excerpts from Lori’s hospital records, which state that she was admitted to the Westchester Division of New York Hospital on September 24, 1982.

The records state her date of birth as 4/26/59. She is aged 23 at her time of admission. She is Jewish, white, upper middle class, and was living alone in an apartment in Manhattan and working as an insurance salesperson at the time of her admission. The records list Lori as an unreliable informant, and her parents as reliable ones. The records state that Lori (again referred to as “the patient”) was feeling confused at the time of her transfer from the Payne Whitney Clinic. She attributed this confusion to the electroshock treatments she received.

The records state that Lori appeared normal at the time of her admission, with “no formal thought disorder,” although her long-term memory was poor (74).

The record also states that Lori has been diagnosed as bipolar in the past, but that there are “conflicting signs that would indicate a schizophrenic illness” (74).

A Nursing Note dated 9/27/82 states that Lori is experiencing auditory hallucinations frequently. These hallucinations include the voices that tell her to fly out of windows. It states that Lori is often in a distressed and depressed mood, and that she rejects medications because “they don’t help take away the voices” (75). Lori did, however, appear happy when her parents visited her.

A Nursing Note dated 10/1/82 states that Lori tried to escape the facility while the front door was open for a different patient. Lori was, however, detained before she could make it through the threshold. Hospital workers then took her shoes away and forced her to wear hospital pajamas.

A Nursing Note dated 10/3/82 states that Lori hears two male voices regularly, although she cannot identify the voices. These voices order her to jump out of windows, and also that she ought to leave the hospital. Lori feels that the voices come from a “radio inside [her] head” (75). She says that she deserves death because she is “no good,” and that dying would solve her problems (75).

Other Nursing Notes record Lori’s ongoing suicidal depression, and the fact that, while the voices do prod her to hurt herself, she sometimes feels that she should hurt herself without their influence. Also, Lori believes that she went skydiving twice during college—once with a parachute and once without. The memory of landing on her feet without a parachute grounds her belief that she can fly.

Nancy Schiller begins the chapter by noting the differences between New York Hospital’s Cornell Medical Center, Westchester Division, in White Plains (Lori’s current treatment facility), and Payne Whitney in Manhattan (Lori’s former treatment facility). While Payne Whitney is a dirty urban hospital, New York Hospital, Westchester Division, is a posh and well-kept facility located within one of New York’s most affluent suburbs. Although both hospitals are teaching hospitals, the medical staff at New York Hospital seem more professional and desirous to help Lori.

However, Nancy also intimates that she and her husband are angry. She writes: “In the last weeks of [Lori’s] stay at Payne Whitney, our anguish at her harsh diagnosis and prognosis turned to rage at the messengers” (78). She feels resentment toward the young man who told her to “face facts” during their last conversation with medical staff at Payne Whitney: resentment of his insensitivity and indelicacy. She also feels that the patients at that facility are used as guinea pigs for the novice students. She admits that she and Marvin “took our anger from Payne Whitney, and dropped it right on the staff at New York Hospital” (79).

Nancy notes that at New York Hospital, the social worker assigned to Lori’s case, named Jody Shachnow, asserts with “professional concern” that “[Nancy and Marvin] weren’t ‘accepting’ Lori’s illness,” and that “by pressuring Lori to get better…[they] were denying the reality of her disease” (79). Shachnow also asserts that “Everyone would be better off…when [Marvin and Nancy] came to [accept] that Lori was profoundly ill” (79).

While Marvin and Nancy undoubtedly know that Lori is extremely sick, Marvin cannot accept that Lori is permanently ill and without prospect of recovery.

Social workers also ask Marvin and Nancy to cease putting pressure on Lori. They assert that Lori’s worship of her parents masks a deep, repressed anger that provokes her symptoms. Within this assertion, Nancy hears echoes of old recriminations that she and Marvin have already asserted against themselves, and the cruel humiliation of having strangers in on their dirty laundry.

Marvin and Nancy simply do not wish to engage with the hospital social workers. They maneuver to stymie them at every turn, whether it be through missing appointments or being verbally combative and evasive during conversation.

Lori’s condition, in the meantime, worsens. She is plainly hallucinating. She has been taken off of all medication so that her symptoms, untouched, can be observed. She therefore becomes severely scared by the chorus of voices that take up their refrains in the absence of medication. Nancy observes how Lori goes in and out of coherence—sometimes within the stretch of a single sentence—in the absence of the medication.

Then, one day, Nancy recognizes the look that comes over Lori’s eyes when her disease takes hold: “My memories of those vacant eyes were much older…I had seen eyes like that—distant, remote, pitying, all-knowing, superior, preoccupied eyes—all the time when I was growing up. I had seen eyes like that on my mother” (82).

Nancy recognizes Lori in her own mother’s strange behavior: in her scattered consciousness, fainting spells, and her regular disappearances that were always explained away as visits to a “cousin” in Florida. Nancy remembers the way her mother would greet her friends oddly and then “suddenly [fadeout] while she was talking, and the all-knowing, superior grin as she retreated into a world of her own” (82). Nancy also remembers her cousin, Sylvia, as an overweight, slovenly and repulsive person who was deemed crazy by her family. She also remembers the acute sense of shame and embarrassment that she felt regarding both Sylvia and her mother, and realizes that when she looked at Lori at her worst, she saw both Sylvia and her own mother. She then also becomes worried that schizophrenia could come to affect her two sons.

With time and medication, Lori begins to improve. She begins to be present for selected hospital activities. She even improves enough to go out to dinner with her parents, and to be able to spend an odd weekend with them at home. Marvin pushes hard for Lori’s release. He asserts that she needs to busy herself with “activity, a job, friends, [and] a social life” (85). Lori, for her part, also pleads to come home. While Nancy feels that Lori is not yet well enough to leave the hospital, she defers to Marvin’s more expert opinion, and to Lori’s pleas. On April 22, 1983—shortly before her twenty-fourth birthday—Lori is released from New York Hospital.