Philip Roth: Operation Shylock

What he gave me was a framed five-by-seven portrait photo taken by a Metropolitan Life photographer some forty-five years earlier, on the occasion of my father’s Newark district’s winning one of the company’s coveted sales awards. There, as I could barely remember him now, was the striving, undeflectable insurance man out of my early grade school years, conventionally stolid-looking in the American style of the Depression era: neatly knotted conservative tie; double-breasted business suit; thinning hair closely cut; level, steady gaze; congenial, sober, restrained smile — the man that the boss wants on his team and that the customer can believe is a balanced person, a card-carrying member of the everyday world. “Trust me,” the face in the portrait proclaimed. “Work me. Promote me. You will not be let down.”

When I telephoned from Connecticut the next morning, planning to tell him all too truthfully how the gift of that old picture had buoyed me, my father suddenly heard his fifty-four-year-old son sobbing as he hadn’t sobbed since his infancy. I was astonished by how unalarmed his reaction was to what must have sounded like nothing short of a complete collapse. “Go ahead,” he said, as though he knew everything I’d been hiding from him and, just because he knew everything, had decided, seemingly out of the blue, to give me that photograph picturing him at his most steadfast and determined. “Let it all out,” he said very softly, “whatever it is, let it all come out.…”

I’m told that all the misery I’ve just described was caused by the sleeping pill that I was taking every night, the benzodiazepine triazolam marketed as Halcion, the pill that has lately begun to be charged with driving people crazy all over the globe. In Holland, distribution of Halcion had been prohibited entirely since 1979, two years after it was introduced there and eight years before it was prescribed for me; in France and Germany, doses of the size I was taking nightly had been removed from the pharmacies in the 1980s; and in Britain it was banned outright following a BBC television exposé aired in the fall of 1991. The revelation — which came as less than a revelation to someone like me — occurred in January 1992, with a long article in The New York Times whose opening paragraphs were featured prominently on the front page. “For two decades,” the piece began, “the drug company that makes Halcion, the world’s best-selling sleeping pill, concealed data from the Food and Drug Administration showing that it caused significant numbers of serious psychiatric side effects.…”

It was eighteen months after my breakdown that I first read a comprehensive indictment of Halcion — and a description of what the author called “Halcion madness” — in a popular American magazine. The article quoted from a letter in The Lancet , the British medical journal, in which a Dutch psychiatrist listed symptoms associated with Halcion that he had discovered in a study of psychiatric patients who had been prescribed the drug; the list read like a textbook summary of my catastrophe: “… severe malaise; depersonalization and derealization; paranoid reactions; acute and chronic anxiety; continuous fear of going insane; … patients often feel desperate and have to fight an almost irresistible impulse to commit suicide. I know of one patient who did commit suicide.”

It was only through a lucky break that instead of having eventually to be hospitalized myself — or perhaps even buried — I came to withdraw from Halcion and my symptoms began to subside and disappear. One weekend early in the summer of 1987, my friend Bernie Avishai drove down from Boston to visit me after having become alarmed by my suicidal maunderings over the phone. I was by then three months into the suffering and I told him, when we were alone together in my studio, that I had decided to commit myself to a mental institution. Holding me back, however, was my fear that once I went in I’d never come out. Somebody had to convince me otherwise — I wanted Bernie to. He interrupted to ask a question whose irrelevance irritated me terribly: “What are you on?” I reminded him that I didn’t take drugs and was “on” nothing, only some pills to help me sleep and to calm me down. Angered by his failure to grasp the severity of my situation, I confessed the shameful truth about myself as forthrightly as I could. “I’ve cracked up. I’ve broken down. Your friend here is mentally ill!” “Which pills?” he replied.

A few minutes later he had me on the phone to the Boston psychopharmacologist who just the previous year, I later learned, had saved Bernie from a Halcion-induced breakdown very much like mine. The doctor asked me first how I was feeling; when I told him, he, in turn, told me what I was taking to make me feel that way. I refused at first to accept that all this pain stemmed simply from a sleeping pill and insisted that he, like Bernie, was failing to understand the ghastliness of what I was going through. Eventually, with my permission, he telephoned my local doctor and, under their joint supervision, I began that night to come off the drug, a process that I wouldn’t care to repeat a second time and that I didn’t think I’d live through the first. “Sometimes,” the Dutch psychiatrist, Dr. C. van der Kroef, had written in The Lancet , “there are withdrawal symptoms, such as rapidly mounting panic and heavy sweating.” My withdrawal symptoms were unremitting for seventy-two hours.

Elsewhere, enumerating the cases of Halcion madness that he had observed in the Netherlands, Dr. van der Kroef remarked, “Without exception, the patients themselves described this period as hell.”

For the next four weeks, feelings of extreme vulnerability, though no longer quite disemboweling me, still chaperoned me everywhere, especially as I was virtually unable to sleep and so was bleary with exhaustion throughout the day and then, during the insomniac, Halcionless nights, weighed down by the leaden thought of how I had disgraced myself before Claire and my brother and those friends who had drawn close to us during my hundred miserable days. I was abashed, and a good thing it was, too, since mortification seemed to me as promising a sign as any of the return of the person I formerly had been, more concerned, for better or worse, with something as pedestrian as his self-respect than with carnivorous snakes needling through the mud floor of his pond.

But much of the time I didn’t believe it was Halcion that had done me in. Despite the speed with which I recovered my mental, then my emotional equilibrium and looked to be ordering daily life as competently as I ever had before, I privately remained half-convinced that, though the drug perhaps intensified my collapse, it was I who had made the worst happen, after having been derailed by nothing more cataclysmic than a botched knee operation and a siege of protracted physical pain; half-convinced that I owed my transformation — my deformation — not to any pharmaceutical agent but to something concealed, obscured, masked, suppressed, or maybe simply uncreated in me until I was fifty-four but as much me and mine as my prose style, my childhood, or my intestines; half-convinced that whatever else I might imagine myself to be, I was that too and, if the circumstances were trying enough, I could be again, a shamefully dependent, meaninglessly deviant, transparently pitiable, brazenly defective that , deranged as opposed to incisive, diabolical as opposed to reliable, without introspection, without serenity, without any of the ordinary boldness that makes life feel like such a great thing — a frenzied, maniacal, repulsive, anguished, odious, hallucinatory that whose existence is one long tremor.