Sarah Dealy
Cards Against Insanity
There are two groups of people in the psych ward: shufflers and high-functioners.
Us high-functioners stick together, we’re a little club. We eat meals together. We talk about what we’ll do when we get out. We gossip about the nurses.
We made up a game based on Cards Against Humanity. The object of the game is to make the funniest sentence out of a white card and a black card. The white cards are things, and the black cards are statements with words blanked out - kinda like Madlibs. We call our game Cards Against Insanity. We laugh and we make fun. This is what high-functioners do.
I am in charge of making the white cards. Here’s what I come up with:
Us high-functioners stick together, we’re a little club. We eat meals together. We talk about what we’ll do when we get out. We gossip about the nurses.
We made up a game based on Cards Against Humanity. The object of the game is to make the funniest sentence out of a white card and a black card. The white cards are things, and the black cards are statements with words blanked out - kinda like Madlibs. We call our game Cards Against Insanity. We laugh and we make fun. This is what high-functioners do.
I am in charge of making the white cards. Here’s what I come up with:
I made a key for people on the outside, in case the game ever goes public:
plastic pillows (the pillows are plastic, so they are easier to disinfect)
cold cold blankets (the blankets are made of one tiny, scratchy, layer of wool, and they do nothing to protect against the industrial air conditioning of the hospital)
sadness (self-explanatory)
the shower ending when shampoo is still in your hair (the shower is controlled by a button, you push it and it runs for thirty seconds at a time, you do not get to decide the temperature, on average, I push it sixteen times per shower)
shuffling (what shufflers do)
the long-distance code (what we need to use the phone, it is usually something ridiculous like 199578#)
faint screams (when I was on the phone with my therapist, the woman down the hall was screaming FUCKING CUNTS in her room)
decaf coffee (we aren’t allowed caffeine)
phantom social worker (we were all assigned a social worker at the beginning of our stay here, but none of us have ever met our social worker and we seem to always just have missed her)
We are not allowed to share our contact info with each other but other high-functioners secretly write their email addresses down in my notebook. As a high-functioner, I am already preparing for the hilarious slice-of-life radio story I will make about Cards Against Insanity. It will be featured on This American Life, Cards Against Humanity will retweet it. That tweet will be retweeted and retweeted right to the top of the ladder of success until I am considered a high-functioner to people who aren’t in the psych ward. Until I am the highest-functioner.
Truthfully, we’re high-functioners because we’re not shufflers. We are always making sure not to be shufflers. Some days, it’s easy.
Like the other day at snack, a new guy came in and started screaming,
“They’re all hedons, I’m gonna kill ‘em all. Flame thrower, flame thrower, flame thrower. Don’t touch their hands, they’ll give you aids.”
Us high-functioners, of course, gave each other eyebrows over our butterscotch puddings until the man’s voice grew louder and we hightailed it out of there, SnakPak’s half full.
But some days, it is less easy.
We have a few cuspers in our group. People who seem like high-functioners but if you shake ‘em hard enough, you can see the shadow of a shuffler under their smile.
Like John, who seems normal. He’s in his mid-twenties and seems like you could make jokes about suicide attempts with him. But, in the middle of the day, he screams into his pillow and, it seems—because his voice is muffled—that he is saying, “I can’t kill myself,” and then he shuffles around his room and around the nurse’s station until he’s sedated. His parents wait for him in the visitation room, and they have to do a puzzle by themselves for half an hour until he comes out of his sedation haze. In the waiting room, his mom sat next to my girlfriend and cried.
Then there’s Kristen, who is very pretty. So pretty when I sit across from her and eat my previously frozen cookies n’ cream pie, I feel like I’m in high school at the popular girls’ table. She talks a lot and it’s nice because I just want to listen. She says her sister drove her here because she hadn’t left her room in four days; she says that when she leaves, she’s going to a residential facility with a pool; she says she is pretty sure one of the nurses put a recording device under her bed.
My girlfriend drove me here. On the way, she drove me through Portillo’s and bought me a cheeseburger. I think she wanted to make sure I would get dinner that night. But I wondered if she was curious, experimenting. Maybe, she thought, I was just hungry? Maybe if she gave me the cheeseburger, I would realize I didn’t actually want to kill myself, I just wanted to eat.
I threw the cheeseburger out the window of the car and regretted it when she left me there. Intake took 4 hours. The wrist is such an awkward place to put a bandage. I knew this from my previous DIY gauze wraps, but the people at the hospital aren’t much better at covering the odd appendage. My first night in the ward, I slept until 3 pm. When I woke up, my bandage had fallen off and there were scabs all over my pillow.
Shuffler behavior if you ask me.
This is my sixth time in a mental health treatment facility.
The psych ER waiting room is separate from the regular ER waiting room. It’s in its own area off to the side with beds and curtains to keep patients away from one another, and—most importantly—two nurses watching over everyone. You are still allowed to have your phone but mine died in the first hour of my four-hour wait. The family of the girl next to me waited with her, and she was admitted hours before me. Once we were in the ward, she only stayed for 36 hours. Unheard of. The high-functioners and I scoff at her. She is not one of us. She is something else entirely. She isn’t supposed to be here—we are.
Every day, high-functioners are given a schedule while shufflers are given a loose list of suggested activities like art therapy and seated yoga. My first morning, I am on the shuffler track. In seated yoga, the man across from me weeps openly while we swirl our arms in pinwheels. Later in the afternoon, I join the high-functioner group. We are given handouts about when to take our medication if we accidentally miss a dose. I realize I will not get the chance to finish the jewelry box that I started painting in art therapy with the shufflers that morning.
For my first three days, my girlfriend doesn’t call. She won’t answer my calls. And—to twist the knife—she posts on Facebook that she is really needing a night out with her friends and is hoping to do some karaoke. It takes me 24 hours to tell my mom I am in the psych ward but when I do, she immediately gets on a plane. She can only visit me for an hour a day, so she spends the rest of her time redecorating my apartment while my roommate smokes pot out of her window. On the fourth day, my mom brings my girlfriend to visitation. When we get time alone, we make out a little over the table and I am too relieved and astonished by her presence to feel self-conscious.
After visitation, the high-fuctioners and I work on our little game in the computer lounge, which is just a couch and a chair by the nurse’s station. Peter and Josiah are the defacto-heads of the high-functioners and the ones who are leading the charge on the card game initiative.
Josiah stopped taking his medication and crashed his car into a tree. He has never been in treatment before. He says he probably isn’t going to go to residential after this, he just needs to find the right medication. One that doesn’t make him drool. Peter is a dad, and he is evasive about why he is here. He will not be going to residential either. He has responsibilities; he is the Dungeon Master for his D&D group, and his wife is taking care of their kids alone now.
I am too distracted by thoughts of visitation to write cards, so Josiah takes over my duties while I half-watch CNN on the wall-mounted TV. They giggle to themselves. Peter holds a white card that Josiah has written, they both look at me and hand it over.
plastic pillows (the pillows are plastic, so they are easier to disinfect)
cold cold blankets (the blankets are made of one tiny, scratchy, layer of wool, and they do nothing to protect against the industrial air conditioning of the hospital)
sadness (self-explanatory)
the shower ending when shampoo is still in your hair (the shower is controlled by a button, you push it and it runs for thirty seconds at a time, you do not get to decide the temperature, on average, I push it sixteen times per shower)
shuffling (what shufflers do)
the long-distance code (what we need to use the phone, it is usually something ridiculous like 199578#)
faint screams (when I was on the phone with my therapist, the woman down the hall was screaming FUCKING CUNTS in her room)
decaf coffee (we aren’t allowed caffeine)
phantom social worker (we were all assigned a social worker at the beginning of our stay here, but none of us have ever met our social worker and we seem to always just have missed her)
We are not allowed to share our contact info with each other but other high-functioners secretly write their email addresses down in my notebook. As a high-functioner, I am already preparing for the hilarious slice-of-life radio story I will make about Cards Against Insanity. It will be featured on This American Life, Cards Against Humanity will retweet it. That tweet will be retweeted and retweeted right to the top of the ladder of success until I am considered a high-functioner to people who aren’t in the psych ward. Until I am the highest-functioner.
Truthfully, we’re high-functioners because we’re not shufflers. We are always making sure not to be shufflers. Some days, it’s easy.
Like the other day at snack, a new guy came in and started screaming,
“They’re all hedons, I’m gonna kill ‘em all. Flame thrower, flame thrower, flame thrower. Don’t touch their hands, they’ll give you aids.”
Us high-functioners, of course, gave each other eyebrows over our butterscotch puddings until the man’s voice grew louder and we hightailed it out of there, SnakPak’s half full.
But some days, it is less easy.
We have a few cuspers in our group. People who seem like high-functioners but if you shake ‘em hard enough, you can see the shadow of a shuffler under their smile.
Like John, who seems normal. He’s in his mid-twenties and seems like you could make jokes about suicide attempts with him. But, in the middle of the day, he screams into his pillow and, it seems—because his voice is muffled—that he is saying, “I can’t kill myself,” and then he shuffles around his room and around the nurse’s station until he’s sedated. His parents wait for him in the visitation room, and they have to do a puzzle by themselves for half an hour until he comes out of his sedation haze. In the waiting room, his mom sat next to my girlfriend and cried.
Then there’s Kristen, who is very pretty. So pretty when I sit across from her and eat my previously frozen cookies n’ cream pie, I feel like I’m in high school at the popular girls’ table. She talks a lot and it’s nice because I just want to listen. She says her sister drove her here because she hadn’t left her room in four days; she says that when she leaves, she’s going to a residential facility with a pool; she says she is pretty sure one of the nurses put a recording device under her bed.
My girlfriend drove me here. On the way, she drove me through Portillo’s and bought me a cheeseburger. I think she wanted to make sure I would get dinner that night. But I wondered if she was curious, experimenting. Maybe, she thought, I was just hungry? Maybe if she gave me the cheeseburger, I would realize I didn’t actually want to kill myself, I just wanted to eat.
I threw the cheeseburger out the window of the car and regretted it when she left me there. Intake took 4 hours. The wrist is such an awkward place to put a bandage. I knew this from my previous DIY gauze wraps, but the people at the hospital aren’t much better at covering the odd appendage. My first night in the ward, I slept until 3 pm. When I woke up, my bandage had fallen off and there were scabs all over my pillow.
Shuffler behavior if you ask me.
This is my sixth time in a mental health treatment facility.
The psych ER waiting room is separate from the regular ER waiting room. It’s in its own area off to the side with beds and curtains to keep patients away from one another, and—most importantly—two nurses watching over everyone. You are still allowed to have your phone but mine died in the first hour of my four-hour wait. The family of the girl next to me waited with her, and she was admitted hours before me. Once we were in the ward, she only stayed for 36 hours. Unheard of. The high-functioners and I scoff at her. She is not one of us. She is something else entirely. She isn’t supposed to be here—we are.
Every day, high-functioners are given a schedule while shufflers are given a loose list of suggested activities like art therapy and seated yoga. My first morning, I am on the shuffler track. In seated yoga, the man across from me weeps openly while we swirl our arms in pinwheels. Later in the afternoon, I join the high-functioner group. We are given handouts about when to take our medication if we accidentally miss a dose. I realize I will not get the chance to finish the jewelry box that I started painting in art therapy with the shufflers that morning.
For my first three days, my girlfriend doesn’t call. She won’t answer my calls. And—to twist the knife—she posts on Facebook that she is really needing a night out with her friends and is hoping to do some karaoke. It takes me 24 hours to tell my mom I am in the psych ward but when I do, she immediately gets on a plane. She can only visit me for an hour a day, so she spends the rest of her time redecorating my apartment while my roommate smokes pot out of her window. On the fourth day, my mom brings my girlfriend to visitation. When we get time alone, we make out a little over the table and I am too relieved and astonished by her presence to feel self-conscious.
After visitation, the high-fuctioners and I work on our little game in the computer lounge, which is just a couch and a chair by the nurse’s station. Peter and Josiah are the defacto-heads of the high-functioners and the ones who are leading the charge on the card game initiative.
Josiah stopped taking his medication and crashed his car into a tree. He has never been in treatment before. He says he probably isn’t going to go to residential after this, he just needs to find the right medication. One that doesn’t make him drool. Peter is a dad, and he is evasive about why he is here. He will not be going to residential either. He has responsibilities; he is the Dungeon Master for his D&D group, and his wife is taking care of their kids alone now.
I am too distracted by thoughts of visitation to write cards, so Josiah takes over my duties while I half-watch CNN on the wall-mounted TV. They giggle to themselves. Peter holds a white card that Josiah has written, they both look at me and hand it over.
They laugh. I laugh.
But I can’t help but feel like a shuffler. Isn’t that what being crazy is? An inability to keep things meant to be intimate in, until it pours out all over society.
I was smart enough to bring a notebook with no spiral binding, but I have three books and no change of clothes. I won’t wear the hospital gown.
Only shufflers wear the hospital gown.
There is a man here who, I think, defies category. He is bald because he is here doing electroshock. It is his third or fourth time, the last go was just two weeks ago. I end up next to him at snack. He tells me that two years ago he married his partner of twenty-seven years. He is usually quiet and keeps to himself, but it is so easy to talk to him, I feel my whole chest open up and unfold like a pop-up book. I want to hold his hand. I wonder if my group thinks that he is a shuffler. But when I talk to him - for a moment - I wonder if we are all shufflers or if none of us are.
My first time in treatment was at a wilderness therapy program in Utah. The kind where you send troubled teens into the woods so that they learn self-sufficiency. My mom didn’t want me there. She thought that sending me to treatment would unlock some secret trap door and I would fall into the land of the stigmatized (shufflers) and that my life would never be the same. We talked to the admin lady on speakerphone and my mother asked how long I would have to stay.
“An average stay is five to twelve weeks,” you could hear her fake smile through the phone.
After we hung up, I sat up on the marble kitchen counter and swung my legs around like I used to do as a child.
“You’ll probably stay for five weeks, I think.” My mom’s voice shook, “I think you’re five weeks fucked up.”
And so, “five weeks fucked up” became our motto. We said it to each other in the car on the way to the airport and on the last call I could make before I had to turn my phone off. I was five weeks fucked up. A high-functioner, not a shuffler. I ended up staying in the wilderness for twelve weeks. I end up staying in the psych ward for seven days.
On the seventh day, I am escorted two blocks down the road to a residential treatment facility. The difference there is we are not allowed to sleep in until 3 pm. There is strict programming all day. There are no shufflers. Or - we are all shufflers.
It is my second stay at this particular facility. The first stay, in my little free time, I did yoga in a glorified closet called “the serenity room.” This stay, I leave lunch early most days so I can sob into a meditation pillow. So, I guess I still use the serenity room just as much this time.
After three weeks there, I leave. I go home.
I break up with my girlfriend. Or she breaks up with me, then I break up with her, then she breaks up with me until eventually, it's over.
I have a new life now. In a new city with a new partner, who gets along with my family and doesn’t like karaoke. At Christmas, we play Cards Against Humanity. Me, my partner, my siblings, my ninety-two-year-old grandfather, the whole family.
“Did you guys know that when I was in the psych ward, we made up a card game called Cards Against Insanity?” I say, dealing.
“You’ve mentioned!” my eighteen-year-old brother cuts in.
My sixteen-year-old sister looks up from her phone, “Yeah, we’ve heard that one a lot.”
“Excuse me,” I say, “I just think it’s a good anecdote.”
That’s one of the main differences between high-functioners and shufflers. To a high-functioner, this is all just an anecdote.
But what does it mean if they are most of your anecdotes? If the majority of tiny details about you, the ones you repeat so much your family is tired of hearing, what if those are mostly set in psych wards, in rehabs, in serenity rooms of residential facilities?
What does it mean if you can package up the anecdotes with little buttons (little winks) that say - I am doing okay now. Oh god. I am okay. I almost never cry in the bathtub until the water sits cold around my body. I brush my hair. I floss my teeth. If I leave a dish by my bed, it is a cup of water (tea, maybe). I eat three meals (take my medication after breakfast). I am not starving. I am not too full. I have been through it and out the other side and the other side is sweet. The other side is easy. The other side looks just like we thought it would. On the other side everything is beautiful and no one, especially not me, thinks of death.
I never emailed Peter or Josiah or made a radio story. But I did look them up and I visited Peter’s LinkedIn before remembering that he would receive a notification that I was there. He is a teacher, and he is not dead. Josiah, a father, also not dead.
I am not dead either.
Maybe, we are all on the other side. Our anecdotes in our pockets, our cards in our hands, and when we walk, you better bet that we pick up our feet.
But I can’t help but feel like a shuffler. Isn’t that what being crazy is? An inability to keep things meant to be intimate in, until it pours out all over society.
I was smart enough to bring a notebook with no spiral binding, but I have three books and no change of clothes. I won’t wear the hospital gown.
Only shufflers wear the hospital gown.
There is a man here who, I think, defies category. He is bald because he is here doing electroshock. It is his third or fourth time, the last go was just two weeks ago. I end up next to him at snack. He tells me that two years ago he married his partner of twenty-seven years. He is usually quiet and keeps to himself, but it is so easy to talk to him, I feel my whole chest open up and unfold like a pop-up book. I want to hold his hand. I wonder if my group thinks that he is a shuffler. But when I talk to him - for a moment - I wonder if we are all shufflers or if none of us are.
My first time in treatment was at a wilderness therapy program in Utah. The kind where you send troubled teens into the woods so that they learn self-sufficiency. My mom didn’t want me there. She thought that sending me to treatment would unlock some secret trap door and I would fall into the land of the stigmatized (shufflers) and that my life would never be the same. We talked to the admin lady on speakerphone and my mother asked how long I would have to stay.
“An average stay is five to twelve weeks,” you could hear her fake smile through the phone.
After we hung up, I sat up on the marble kitchen counter and swung my legs around like I used to do as a child.
“You’ll probably stay for five weeks, I think.” My mom’s voice shook, “I think you’re five weeks fucked up.”
And so, “five weeks fucked up” became our motto. We said it to each other in the car on the way to the airport and on the last call I could make before I had to turn my phone off. I was five weeks fucked up. A high-functioner, not a shuffler. I ended up staying in the wilderness for twelve weeks. I end up staying in the psych ward for seven days.
On the seventh day, I am escorted two blocks down the road to a residential treatment facility. The difference there is we are not allowed to sleep in until 3 pm. There is strict programming all day. There are no shufflers. Or - we are all shufflers.
It is my second stay at this particular facility. The first stay, in my little free time, I did yoga in a glorified closet called “the serenity room.” This stay, I leave lunch early most days so I can sob into a meditation pillow. So, I guess I still use the serenity room just as much this time.
After three weeks there, I leave. I go home.
I break up with my girlfriend. Or she breaks up with me, then I break up with her, then she breaks up with me until eventually, it's over.
I have a new life now. In a new city with a new partner, who gets along with my family and doesn’t like karaoke. At Christmas, we play Cards Against Humanity. Me, my partner, my siblings, my ninety-two-year-old grandfather, the whole family.
“Did you guys know that when I was in the psych ward, we made up a card game called Cards Against Insanity?” I say, dealing.
“You’ve mentioned!” my eighteen-year-old brother cuts in.
My sixteen-year-old sister looks up from her phone, “Yeah, we’ve heard that one a lot.”
“Excuse me,” I say, “I just think it’s a good anecdote.”
That’s one of the main differences between high-functioners and shufflers. To a high-functioner, this is all just an anecdote.
But what does it mean if they are most of your anecdotes? If the majority of tiny details about you, the ones you repeat so much your family is tired of hearing, what if those are mostly set in psych wards, in rehabs, in serenity rooms of residential facilities?
What does it mean if you can package up the anecdotes with little buttons (little winks) that say - I am doing okay now. Oh god. I am okay. I almost never cry in the bathtub until the water sits cold around my body. I brush my hair. I floss my teeth. If I leave a dish by my bed, it is a cup of water (tea, maybe). I eat three meals (take my medication after breakfast). I am not starving. I am not too full. I have been through it and out the other side and the other side is sweet. The other side is easy. The other side looks just like we thought it would. On the other side everything is beautiful and no one, especially not me, thinks of death.
I never emailed Peter or Josiah or made a radio story. But I did look them up and I visited Peter’s LinkedIn before remembering that he would receive a notification that I was there. He is a teacher, and he is not dead. Josiah, a father, also not dead.
I am not dead either.
Maybe, we are all on the other side. Our anecdotes in our pockets, our cards in our hands, and when we walk, you better bet that we pick up our feet.
Sarah Dealy is a writer and radio producer living in Los Angeles. She was the recipient of the inaugural Gotham Variety Audio Honors for a piece she made about attending another mental health treatment facility. She writes the weekly webcomic "Zatanna and the Ripper" for DC Comics and WEBTOON, forthcoming in print (October 2023). She has produced audio for Death, Sex & Money, and Articles of Interest, among others. She has a dog named Ira. You can find her at these places: instragram: @bookcrone | twitter: @bookcronetweets | website: https://www.sarahdealy.com/