I do not know much about schizophrenia at all. I am a lucky person. I have known very few people in my life who have had serious mental health problems. Those people I have known who were mentally ill were at best acquaintances or relatives of people I knew, maybe some friend's uncle or cousin that wasn't talked about much. Of course, that day we met I didn't ask Phil why he seemed so sickly. He himself does not like to talk about his condition, a choice I understand and respect. Almost all that I know about his diagnosis and what had transpired since then was told to me by Noi.
Phil first experienced a psychotic episode when he was at—of all places—a Buddhist temple for a meditation retreat. He was about thirty-four years old, and hadn't had any symptoms of schizophrenia before then. Basically, he just began hearing voices and commands in his head. Voices that were loud and spoke with an authority that he could not ignore. He would also see visions and imagery that were pure hallucinations.
Sometimes the voices would urge him to do things that were harmless, but nonetheless removed from reality. He would try and enter buildings the voices told him to enter, to speak with people that the voices were telling him to talk to. He was urged to get on trains and busses to go places that didn't exist, or meet people who never were. He thought the kites that children would fly in the park were trying to spell words in the sky warning him to escape from impending rain.
But sometimes the voices urged him to do reckless things. Things that easily could have resulted in injury or far worse. One time he was walking through the old part of town, and the voices screamed at him to jump off a footbridge into the canal below.
The canals of Bangkok have to be among the most polluted waterways in the world. They flow with human waste and heaps of garbage, and you can catch glimpses of oil-covered rats the size of bloated house cats swirling through them. To think he was jumping in and swimming in those canals was horrifying.
Noi was of course absolutely terrified. I cannot imagine what it must have been like for her those first few weeks, when his delusions first started erupting. She desperately tried to get him to see a doctor, but Phil refused at first, not wanting to believe that anything was wrong when in fact things were reeling wildly out of control. When she did manage to get him to see a doctor, he was vehement in not accepting his diagnosis. The drugs purchased at the pharmacy were ignored and left in the desk drawer. After a few more weeks, and at the advice of the doctor, Noi began slipping the medication into his drinks. Eventually, he would begin taking the drugs voluntarily, but only after a long period of denial and frequent arguments with Noi.
Although the medication stopped most of the psychotic episodes Phil was experiencing, the side effects of the drugs were, sadly, very powerful. He slept at least ten hours a day, every day, without exception. When he was awake, he was still sluggish and had little energy. His reaction time had become very slow. It was almost as if the drugs permanently lulled him into a lethargic daze. Consequently, Phil couldn't really engage in any sort of hard physical activity. Playing sports was out of the question. He became both overweight and weak. His days of waking up early for a run through the park were over long ago.
Six months after his diagnosis, Phil was fired from his job after working there for over a decade. His performance as both an editor and writer had gone rapidly downhill as a result of his illness and the side-effects of his medications. Things had clearly taken a turn for the worse.
The last time I was in Bangkok—and the last time I saw Phil—was in December. Phil and Noi had settled in a new apartment in the outskirts of the city, reasonably close to the office where he had secured a part-time job as an editor for a business magazine. Despite the fact that his schizophrenia was no better than it had been before, his multi-year stint at the newspaper still carried a lot of prestige, and was enough for him to get the job despite the fact that Phil himself had little knowledge of business or finance.
They were quite lucky. Noi's family had become very successful buying and selling real estate in Bangkok, and she was helping them manage and advertise condominiums online. It was a job that was both profitable and one that allowed her to do much of her work from home, making it easy for her to take care of Phil. They were able to squeak by on their combined incomes, a good deal of which was used to purchase Phil's medication. Different doctors prescribed different doses and combinations of drugs for him, some working better than others. But most of the time Phil still lacked any active amount of energy, and still spent long hours dozing in bed until midday.
Noi tended to him faithfully, making sure that every morning he would wake to a plate of fruit and bread, with a glass of water and his pill regimen laid-out. "They un-fuck me," were Phil's words, confessing his dependence on his drugs to keep him straight.
I had rented a cheap hotel room not far from where he and Noi lived. Bangkok was still an addiction for me, and I had begun returning on an almost yearly basis to try and, perhaps fruitlessly, relive some of my early twenties' wildness. Yet a good portion of my time was spent hanging out with Phil and Noi at their apartment. I would venture there in the mornings, carefully meandering past the Honda and Toyota sedans that were densely packed along the side alley by their place.
Sitting in the blanched shop houses across from his apartment, Phil and I would spend hours together reminiscing about the past, or discussing politics or regional news. Despite his illness he still had a keen intellect and could maintain a good conversation. Depending on the time of day, we would muse over an iced coffee, or bowls of noodles with balls of fish meat slathered in chili oil and red pepper flakes.
At night the same alley would transform as a new collection of food stalls would appear. Fluorescent lamps covering displays of fresh seafood or steaming kettles of fatty broth lit up the streets. Phil and I would huddle around folding metal tables with cheap plastic chairs, cooling off with sodas or a flask of cheap rice whiskey and a tin of ice. Despite his condition and his medication, like many farang expatriates in Bangkok, Phil still drank enough beer and whiskey to float a small battleship.
Sometimes Noi would join us, doting over Phil and ordering his food for him as his Thai was still not good enough to talk with the food stall merchants. "He wouldn't survive without me," she said one day, privately to me.
She was a remarkable woman, and I wondered why she stayed with him. They didn't have children, a decision which likely did not reflect well upon her. I suspected she felt—and likely he knew—that his condition would render him a fairly poor parent.
Yet Noi was committed to Phil, and he, both committed and dependent on Noi. When they were together, I sensed both a tremendous love for each other, as well as a sense of sadness. It was a powerful feeling that would still linger with me when we parted company. "I love you so much, my wife," he would say to her with remarkable frequency on our outings together, albeit often plied with several beers.
Yet his romantic words were more driven by vulnerability than anything else. I would often stumble back to my hotel room after long nights out with Phil, half wondering how in God's name he could make it if she ever left him.