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Living with Schizoaffective Disorder

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Writing as a Symptom of Mental Illness

Nothing comforts me when I'm anxious the way writing does, and I have never been so anxious as I have been in Vancouver.

Michael David Crawford, Consulting Software Engineer
Solving The Software Problem
mdcrawford@gmail.com

September 17, 2006

Copyright © 2006, 2012 Michael David Crawford. All Rights Reserved.

Kuro5hin's MrHanky suggested that my notoriously one-dimensional writing style may be a symptom of my schizoaffective disorder. In fact it is a symptom, and I have known that for several years. It's a common topic of discussion when I see my doctors, as well as with my wife Bonita. But you have absolutely no idea of the profound extent to which it is a symptom.

It is a symptom, but not of my schizoaffective disorder. Psychiatrists describe mental illness as having five axes of diagnosis; schizoaffective disorder is my biological or biochemical axis.

The biological axis diagnoses are usually genetic in origin, although there is some reason to believe that schizophrenia may also be caused by influenza infection while the future schizophrenic is in his mother's womb. Recent research indicates it might also be caused by childhood exposure to the same parasite commonly found in cat feces that causes toxoplasmosis.

The biological axis illnesses can often be treated but never cured.

There is also a neurotic axis that is always of psychological origin, usually some kind of unresolved childhood trauma. It can also result from adult trauma such as fighting in a war.


Contents

Why Yes, I Am In Fact A Butthead

[Top]

Not all or even most of The Vancouver Diaries will be about mental illness, whether my own or that of others. But this diary and the previous one have been because my own thoughts and feelings have been weighing heavily on my mind in recent days.

I haven't said anything yet about my new job and very little about Vancouver, but I certainly intend to. My wife and I are now both completely certain I made the right decision to take my new job in Gastown despite the year we will be apart until she graduates from art school. I just love living in Vancouver, my new job is with a very successful firm that is managed better than any software company I have ever known. All my new coworkers think I'm the best thing since sliced bread.

But I have a message for every Kuron who is sick of hearing about my mental illness: Deal With It.

I write for those who have no voice, and who suffer in silence as I once did. I will go to my death rather than quit proclaiming my batshit insanity from every rooftop, soapbox and edit queue that I can force myself upon.

Why?

Because I know just how bad it feels to get the living crap beat out of me by hired goons, to be evicted my home, to be expelled from my school and fired from my job just because I happened to offend someone who hates the mentally ill.

And don't even get me started about what it's like for the mentally ill to try to get a date with a member of the attractive sex, let alone married someday.

I'll discuss it in more detail in a future diary, but for now the great Kurt Vonnegut can talk for me:

Take a flying fuck at a rolling donut. Take a flying fuck at the Mooooooooooon!

Fuck you buddy. You are not a member of my target audience. I'm not writing The Vancouver Diaries for your comfortably well-off, middle class and quite likely lily-white ass. I'm writing them for my people: The Forgotten Ones.

Thanks for your help in inspiring me to say so.

Kurt Vonnegut is no stranger to mental illness, by the way: his mother committed suicide when he was a young man, his son Mark is schizophrenic and Vonnegut himself has suffered from profound depression his entire life, culminating in a suicide attempt in 1984.

The same page where I learned of his suicide attempt said that Vonnegut writes for much the same reason I do:

To find some way to make sense of a world that makes no sense.

The Five Axes of Diagnosis

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While one can relieve the symptoms of neurosis with drugs, medication may actually be counterproductive as they reduce the neurotic's motivation to get better. Neurosis can almost always be cured by psychotherapy without the use of any medication at all, but it takes a long time and is astronomically expensive. While I'm not yet cured I am a great deal healthier than I was to start with. My psychotherapy has required twenty years so far and has cost me over sixty thousand dollars.

Other examples of biological axis diagnoses are schizophrenia and manic depression. Some neurotic axis diagnoses include Borderline Personality Disorder, Paranoid Personality Disorder and Dissociative Personality Disorder, previously known as Multiple Personality Disorder.

While Borderline Personality Disorder is one hundred percent curable, successful cures are rare and BPD clients are universally despised by clinical psychologists because BPDs adamantly and resoundingly refuse to take responsibility for their own lives, preferring instead to blame all their problems on everybody else.

The third axis of diagnosis is one's external stressors, which in my case was until recently my problems with money.

My life problems are considered an aspect of my mental illness rather than simply a part of my environment because the problems faced by neurotics are mostly of our own creation. To accept and deal with this fact must be the very first step in the recovery of every neurotic, but despite having had this insight for decades I still find myself unable to lead a stress-free life:

It's just like playing a game of Whack-a-Mole. As quickly as I can solve my problems more of them spring up again. My salary at my new job is so high that with the income I still earn from Google AdSense Bonita and I were quite hopeful that our despair would soon be a thing of the past. But it seems the first class ticket my company bought me was not from Ottawa to Vancouver: no, it was from the frying pan into the fire.

The fourth axis is one's physical health, which in my case is quite good. Physical health is an axis of psychological diagnosis because of the way feeling bad in our bodies can make us feel bad in our minds. But poor physical health can paradoxically benifit one's mind in a positive way:

In Flow: the Psychology of Optimal Experience, Mihaly Csikszentmihalyi reports that the participants in a study of Italian paraplegics unanimously asserted that losing the use of their legs was the best thing that ever happened to them, because their spinal injuries helped them understand just how precious life really is. Each paraplegic thus became motivated to learn to live each day to its very fullest.

I agree with them one-hundred percent: my crackup at Caltech in 1984, while painful and debilating, was definitely for the best. I have been neurotic since I was eight years old and so never knew true happiness until my therapist had shrunk my head to the size of a walnut in my late twenties.

The fifth and final axis of diagnosis is one's overall level of functioning.

I am what is known as a "high-functioning adult": I have a professional career and can look after myself. Low-functioning patients must often live in group homes for the mentally ill that are staffed full-time by psychiatric social workers. Extremely low-functioning patients may have to be institutionalized for years at a time.

But the fact that I'm high-functioning doesn't make me any less crazy. It just means I'm fortunate enough to be able to do well for myself despite symptoms that most other people would find debilitating. Two of history's most famous high functioning paranoids are Josef Stalin and Adolf Hitler.

What Makes Mike Tick

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My neurotic axis diagnosis is known as Obsessive-Compulsive Style. It's quite a different thing from the more well-known Obsessive-Compulsive Disorder. It's described by David Shapiro in his book Neurotic Styles. You can buy it online from Powells City of Books as well as from Amazon.

The book is inexpensive and not hard to find in brick-and-mortar bookstores. If you invest in a copy and read it, you will come to understand what was once described to me as "Kuro5hin's most beloved member" in a deeply intimate and profound way. I ordered copies for both my therapist and psychiatrist back in Truro, and will be taking the bus to the University of British Columbia to check it out of their library so I can lend it to my psychiatrist at the St. Paul's Hospital Two-North Mental Health Unit, where I am now a patient. If they don't sell library cards to the public I'll just photocopy the relevant chapter.

(While I may be crackers, I'm just rational enough to be trusted with two three-hour passes from my locked unit each day.)

Shapiro says it's common for those with Obsessive-Compulsive Style to work as technicians: I have a degree in Physics and taught myself to program computers well enough to have a successful career as a software engineer. I also have reason to believe that many of the colleagues I've met in the software industry over the years share my neurosis.

He also says we pay painstaking attention to detail; I can confidently claim that I am one of the very best in the industry at software debugging:

My expertise with the MacsBug assembly code debugger for the Macintosh qualified me for a Senior Engineering position as a "Debug Meister" on an elite Apple Computer system software trouble-shooting team known as The Blue Meanies. I also once reverse-engineered an undocumented database format, and was awarded a ten-pound Toblerone chocolate bar by my boss Dave Johnson for fixing a single nearly unreproducible crash bug.

Furthermore, Shapiro says that folks like me are notoriously obstinate and unwilling to listen to reason. Does that sound like anyone you know?

Allow me to demonstrate:

Why do we have to hide from the police, Daddy?

Because we use vi son. They use emacs.

If you still don't believe me, try asking Richard Stallman his opinion on C++ sometime.

The therapist who diagnosed my neurosis presented me with a photocopy of Shapiro's chapter on Obsessive-Compulsive Style the day she revealed her diagnosis to me. I'm certain she diagnosed me years before but had to wait until I was ready to accept the Truth. You can no doubt imagine the hilarity that ensued when I discovered that my entire life history was written down in one chapter of a book published when I was just one year old:

I was hospitalized for psychosis two weeks later. I guess my therapist should have waited another year or two before she gave me that photocopy.

Bound and Determined

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One thing Obsessive-Compulsive Style does have in common with Obsessive-Compulsive Disorder is obsession.

Us Obsessive-Compulsives are driven by anxiety. I get so anxious sometimes I want to crawl out of my own skin. My first hospitalization in November 1984 was for acute anxiety so profound I was unable to speak. I was admitted to the Intensive Care Unit at a psychiatric hospital and prescribed large doses of the tranquilizer Xanax.

Since moving to Canada in 2003 I have gone to the emergency room five times, each time demanding to see a psychiatrist. All but the first one were for anxiety. At three of my visits for anxiety they paged psychiatrists who gave me the powerful antipsychotic Zyprexa. The other time the emergency room physician prescribed the tranquilizer Librium.

Later that same day my psychiatrist finally returned my phone call and I told him what happened. He said:

If you're having some kind of psychotherapeutic breakthrough, taking medication for anxiety will lessen the benefit of it.

You see, acute anxiety can be a sign that a deep psychological wound is just about to heal. While it's excruciatingly painful, it's the same good kind of pain as the pain a mother feels when giving birth.

Not wanting to waste such a precious opportunity, I only took two of the twenty-one Librium capsules I was prescribed. It was a very challenging experience.

(Zyprexa's the shit, I tell you: it doesn't matter how fucked up I am, all it takes is one or two tablets and some sleep and I'm right as rain. Too bad it's been demonstrated to cause diabetes, even in people who aren't overweight. That's why I only take it when I have to.

For routine use I take Risperdal. When I first took it I described it as "A breath of fresh air blowing through my mind". Risperdal allowed me to be discharged from the hospital just four days after I was admitted because of my obsession with the North Korean nuclear weapons program . I was back to work just a week after that.)

Carrying out our chosen obsessive behaviours soothes our anxiety.

I have a fairly uncommon obsession, so uncommon that most people don't regard it as one, but you will instantly agree I am obsessed with it when I reveal it in a moment. You will also then understand why some of who share my obsession were made fabulously rich and famous by our symptom.

More common obsessions include biting one's fingernails until they are bloody, overeating until one is as big as a house, pulling one's own hair out until one is bald, picking at scabs until one's whole body is covered with open sores - this is a common symptom of crytal meth addiction - and gambling addiction, especially with video lotto machines, because their visually- and acoustically-dazzling software is carefully contrived to feed every gambling addict's obsession. It's a problem of epidemic proportions these days back in Nova Scotia. And I mustn't forget compulsive masturbation.

Chemical addiction is an Obsessive-Compulsive behaviour in which one's anxiety is caused by the pain of drug withdrawal, and anxiety is eased by consuming the object of one's desire.

One doesn't have to be addicted to crack or crystal meth for addiction to be life threatening or for one to be willing to kill to satisfy one's craving. It's quite common for purely psychological obsessions to be just as bad. They're just not illegal and, except for gambling, are generally more affordable. One of my obsessions is inexpensive, the other costs me nothing but my time.

I could go on, but you get the picture. Everyone can see obsessions can be self-destructive. But there are adaptive obsessions too, although they always come at a cost, for example the workaholic who rises through the ranks to become president of a big company only to find his wife divorces him and his children disown him, then he dies at an early age of a stress-induced heart attack.

Obesity as a Positive Lifestyle Choice

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I have two primary obsessions, a maladaptive one and an adaptive one:

The maladaptive one is that I eat ice cream when I'm anxious, a chocolate sundae at the Fair Trade Country Cafe in Truro every day for two months while I was looking for a job until I got the one I have now. When I was out West looking for work last Fall, money was so tight and I was so lonely and despondent that I ate a whole tub of mint chip every single day and gained fifteen pounds in just three weeks.

When we lived in Maine, Bonita often asked me to go to the store in the middle of the night to get her a bottle of pop. Every single time I secretly bought a Ben and Jerry's or Haagen-Dasz bar to eat on the way home. But there were no trash cans anywhere on the road back to our house where I could dispose of the ice cream stick. I'd put it in my pocket to conceal it until I could bury it deep in the kitchen trash can where Bonita would never find it. I don't know why I never just threw it out the window. But that would have been littering.

Too bad I'm terribly absent-minded: Bonita sometimes found the sticks in my pockets while doing the laundry. One time I sat down to work at my computer only to find a used Ben and Jerry's stick stuck to my monitor with a Post-It note that read:

I See All.

But I actually managed to lose fifty pounds through low-carb dieting; my one forbidden fruit was an occasional ice cream. Say what you will about Atkins, but having to wear my wedding ring on my middle finger because it won't stay on my ring finger anymore is a great deal preferable to weighing two hundred and fifty pounds, my weight on the day of our wedding.

I lost so much weight that the fine oilcloth coat Bonita gave me for Christmas of '99 was way too big for me. The cold Winter wind would blow up from underneath and I'd freeze, so we gave it to our friend Big Jim. When Bonita went through the pockets before she gave it to him she was astounded to discover dozens of ice cream sticks.

Stop Me Before I Post Again!

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My adaptive obsession is that I like to write. Nothing comforts me when I am anxious the way writing does, and the more anxious I get the more prolific my writing gets.

I wrote what I'm pretty sure is Kuro5hin's longest diary ever when Bonita discovered on a trip to Spain with her schoolmates that the exchange rate gave her half the value for her money than she was told to expect, we had very little money left, I was running low on food and my Google AdSense check was late. If I hadn't received my check the very day after I stayed up all night writing that diary, not only Bonita and I and our two dogs and my cat would have been completely fucked.

I obsess over editing as well: I find comfort by taking pride in a job well done. That's why I have been able to average over three thousand dollars a month in AdSense revenue for two years now from ads published on a single web page. I wrote it when I underbid an embedded systems development contract by sixty thousand dollars yet completed the contract successfully because I had no other hope whatsoever providing for my wife and myself.

When I achieved and got paid for one of the project's milestones, I had to rush out to buy a cashiers check then take it to another bank because we were five days away from that bank foreclosing on our house.

I was so anxious about making that milestone that I slaved over Links To Tens Of Thousands Of Legal Music Downloads for an entire month before submitting it to Kuro5hin. It rocketed to front-page in record time and has been Google's top hit for legal music downloads for three solid years.

I have many reasons to be anxious these days. That's why I'm working so hard at writing The Vancouver Diaries:

I decided to write them the night I arrived because it's my first regular job after eight years of self-employment, I had never been to Vancouver before, I didn't know where I was going to live, I didn't know a soul before I got here, we were nearly penniless and would have been screwed had I not got the job when I did. Furthermore, I'm three thousand miles from the woman I love. She won't be able to join me until a year from now when she graduates from art school.

When Bonita finally moves to Vancouver and I move out of my current apartment to hopefully buy a new home with her, my plan is to end The Vancouver Diaries and publish them as a dead-tree book.

I have quite a bit of reason to believe the dead-tree edition of The Vancouver Diaries will be a huge hit.

I hope that clears everything up for you.

Shapiro says in his book that some symptoms of neurosis are adaptive, that is they help the neurotic in some way rather than harming him. For example he says paranoids have keen powers of observation and those of us with Obsessive-Compulsive Style have what he calls "a hypertrophied capacity for work".

And friends, that's the Gospel Truth as it is quite common for me to work twenty-hour days with no breaks except to pee or grab a quick bite to eat. On several occasions I've worked forty-hour shifts, and one time when a client was pressuring me to ship his product I worked for an entire month twenty-four hours on and eight hours off.

Because I made such tremendous progress and sent so many progress reports timestamped at all hours of the day and night, my client had no qualms about paying my twenty-one thousand dollar invoice. Twenty-one grand for a single month's work: yeah, I'd say my capacity for work is hypertrophied alright.

(That was back in the good old dot-com days when clients were still willing to pay me hourly; the dot-com crash forced me to accept fixed-bid work which nearly cost me my sanity and caused Bonita no end of heartache and despair.)

One reason my ambition is to be a musician rather than a professional writer someday is that my music comforts me but it has never been an obsession. But my psychiatrist back in Nova Scotia sternly warned me that it could become one someday if I weren't careful.

I'm willing to take that risk. I'm pretty sure that if I were to make a career of writing, they'd end up locking me in the quiet room and throwing away the key.

Why I Write

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Why did I choose writing for my obsession, when there are so many to choose from? I wrote in I Have So Many Questions About Music:

We Love You MichaelCrawford!

Imagine that: a paranoid mood-swinging (almost) Canadian who often fails to dedicate himself to the work that's (barely) putting bread on his table, because he's too busy necking with muses and exporting mountains of data from his sparky brain because it brings a high drugs can't top.

Myself, I cannot relate. Not. One. Bit.
-- CheeseBurgerBrown

Long before I ever considered changing my career to music, I considered writing for a living. I feel that I write well, and I enjoy the time I spend at my PC writing essays like this one. I have been writing much longer, and much more than I have ever played music. I learned the alphabet when I was four, and read my first novel, a Hardy Boys mystery, when I was six. In my senior year of high school I received University credit for scoring 5, the highest possible score, on the Advanced Placement English exam.

But there is a problem, one that I have struggled to understand for quite some time, and only recently feel I have come to understand, but not yet found the solution to: I am only able to write sporadically, when a topic seizes me somehow. I cannot write when I choose, or on any topic I choose. I cannot write to deadlines. Each year I write hundreds of pages, but on widely scattered topics. I have started but failed to finish several books. I was offerred a monthly column in a computer magazine once and did a good job with my first article, but failed to write any more. I finally published it on my own website, just so it would see the light of day.

My writing sometimes causes trouble, and has caused such grief in the past that Bonita often gets anxious when I tell her I have an idea for a new article. When I get a bug up my ass to write about something, I cannot stop writing until I am done. I write obsessively, throwing to the wind all my responsibilities, caution, and even common sense.

Bonita had to visit Truro for a week just as we were preparing to move there. I was to work on repairs to our house that were needed before we could sell it, in particular installing linoleum tile in three rooms. Upon her return, Bonita found only two rows of tile installed, and me lying exhausted on the couch with a week's beard stubble on my face, wearing filthy clothes and smelling ripe from not having showered.

"What happened? Why didn't you lay the tile?" she demanded to know.

"Please, for the love of God, leave me be! I've been up all night!"

"What have you been doing?"

"Working on an article."

Bonita brought a friend from Canada with the intention to have a nice visit. Instead the two of them laid the tile while I slept in the dog house.

Why?

It has taken me several years to figure it out. As I said, I have not yet arrived at a solution, not one that enables me to write for a living anyway.

When I write, when I write so obsessively, I write because I have a question, a question that has been bothering me, usually for a long time, a question whose answer is unclear to me, unable to quite express, or at first even guess at.

But I am able to ask these questions more clearly, and to work out the answers by writing. Writing articles, essays, rants and manifestoes then publishing them all over the Internet from horizon to horizon, over fifty that I have been able to find again so far, as well as countless Usenet, mailing list and community website posts.

When I have a particularly important question, and feel I am on the verge of an answer, I work at it for days or even weeks at a time, writing, rewriting and editing meticulously, obsessively and compulsively. I post it on my website, and ask for help from friends via email, and in my Kuro5hin and Advogato diaries. The last couple years, when I have been close to the answers I sought, I submit them to edit at Kuro5hin, asked for help, and finally submit them to voting.

Sometimes I just toss off a k5 article in a couple hours of work that just makes section, but when I have a really important question, nothing but +1, Front Page will do. I give it the time it needs.

These questions gestate inside me for months, years, even decades, until the questions themselves, and not I, decide their time has come and I labor painfully to bear my answer into life, and having written, I collapse, spent and exhausted.

I have so many questions about music.

Is that why I feel this essay is so important that I have worked so long and hard, and have plead for help from so many? Well, yes, I do have a lot of musical questions. I care a lot about music. I am frustrated that I am so far from my goal of composing music.

My question might be, what am I going to do when I grow up?

But that is not my question. Not at all. I have some idea of what my question might be, but its time has not yet come.

I can at least tell you why I am not able to write on any topic I choose: they are not about a question I have, at least not one that is important to me. Maybe they are, but they do not express the answer I seek. Maybe the answer is not ready to see the light of day.

When Bonita read the above, she said " You're chasing a White Rabbit. If you follow him down his rabbit-hole, you're going to end up in Wonderland".

And friends, she was right. A few days later I woke up before Bonita did, then took a shower. When she came around I said:

I want to be the best husband to you I can possibly be.

Then I called the mental health clinic and left a message for my psychiatrist to call me. When I didn't hear from him after a couple hours I drove to the mental health clinic and asked the receptionist if my doctor could fit me in that day somehow. She said that if I was feeling bad I should just go to emergency, so I did.

I said to my emergency physician:

Every time I've felt this way before I have required inpatient admission to a psychiatric unit.

He sent me on my way with a prescription for enough Librium to stun an ox. But when my psychiatrist finally returned my call he said:

If you're having some kind of psychotherapeutic breakthrough, taking medication for anxiety will lessen the benefit of it.

Not wanting to waste such a precious opportunity, in the end I only took two of my twenty-one Librium capsules. But it was for naught; the answer I had so long sought slipped yet again through my grasp.

I meant to submit I Have So Many Questions About Music to Kuro5hin when I finished writing it, but when Bonita warned me about The White Rabbit, I just stopped. My essay has sat there, aborted halfway through, for a year and a half now. I have some idea now as to how to finish it, but not yet. The answers to my questions about music will just have to wait.

Through The Looking Glass

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I had been seeing The White Rabbit on every streetcorner since coming to Vancouver a couple weeks ago. About eleven-thirty last Saturday morning I finally decided to give his rabbit-hole a try.

Walking down West Cordova street a few minutes later I noticed that while the city still looked the same as it did before I grabbed The White Rabbit's tail for our short journey, it felt completely different somehow. I figured I should call my psychiatrist back in Truro.

But it was the weekend and the hospital wouldn't have paged him. I considered calling Truro's crisis hotline to see if R. might be on duty. We've spoken before not just on the phone but in the emergency room, and I always found her a great comfort.

"Excuse me sir, can you tell me where a hospital is?"

"No, I've only been in town a few days."

"Ma'am, can you tell me where I might find a hospital?"

"I'm sorry, but I'm from New Zealand."

Vancouver! It's a city of immigrants. I knew then what I must do. I walked as fast as I could to the Waterfront Station.

9-1-1. "Emergency. How can I help you?"

"My name is Mike. I'm at the Waterfront Station. I have a psychiatric emergency. I need an ambulance to take me to a psychiatric hospital. I'm wearing a khaki hat with both sides pinned up and a gray T-shirt that says 'Dal Law'. I'll wait for the ambulance in front of the Waterfront Station."

I had to repeat myself several times so they could write it all down, but they agreed to send an ambulance. I waited on the bench on the street in front of the station. And waited. And Waited. I tried to hail a cab but it just drove by - it already had a fare.

Those few minutes were some of the most awful loneliest times of my entire life. I went back inside and walked up to a security guard who was talking to someone.

"Excuse me Sir..."

"Not now. Give me a minute."

"No, Now! I have a psychiatric emergency. I need you to call an ambulance to take me to a psychiatric hospital."

He punched the button on his walkie-talkie: "Code Blue".

A long time passed, but at least I didn't have to spend it all alone.

I held my hand out to shake that of the ambulance attendant and said "Hi, My name is Mike and I have schizoaffective disorder". Inside the ambulance he asked "So why are you feeling so bad?"

"Do you know what it means when a deeply neurotic patient goes Through The Looking Glass?"

He did. He was trained to deal with disturbed patients. He knew just what to do:

My midwife grabbed me by the ankles, held me upside-down and slapped me hard on my bare ass.

I took my first breath Real World Air and began to cry. Suddenly the air I breathed tasted fresh and clean, no longer choking me as the Southern California smog had for so many years. That Rabbit hadn't been trying to lead me into Wonderland, he was trying to lead me out of it!

I'll tell you know the question I have sought to answer for so many years. Actually there are two:

  1. What is Truth?
  2. What is Delusion?

I'm happy to tell you the answers, but they will have to wait until another day. I have to stop now. I'm very tired. I have been in the mental hospital for a week sweeping up Looking-Glass shards and it's been a great deal of work. But I wouldn't want anyone to cut their feet on my account.

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