Saturday, January 16, 2010

Maloxilin

Maloxilin

He didn't remember precisely what she had said, but the twist in her face, the anger, the vehemence fueled the trajectory of his fist long before she had finished saying it. Now Michael was seated in the principal's office, looking at desk paraphernalia, the motes of dust in the air highlighted by the afternoon sun, and listening to the principal's subtle nose whistling as they both waited for Michael's mother. He felt regret. He and Jamie had been together for two months. He was afraid of losing her, and now he had. Anger surged up in him once more but he forced his face to remain expressionless.

"Now, Mike, I know this is hard, but--"

"It's Michael," said Michael.

"What...oh, yes. Alright," the Principal looked somewhat dazed.

"I didn't mean to do it."

"Well, you did, and now there are consequences."

"I know it was wrong, I didn't mean it."

"Yes, well, when your parents get here--" There was a knock on the door. "Come in," Yolanda, Michael's mother, entered looking angry. She looked somewhat disheveled, she had been running at some point in the last few minutes. She avoided looking at Michael.

"Sorry I'm late. I'm Michael's mother," said Yolanda. She reached out a hand to the Principal. He took it slowly.

"And the father?" He didn't presume that Michael's parents were married, but with the new laws in place over the past decade or so, more fathers were in the picture. There had been such a dramatic reduction in poverty.

"He's in prison," said Yolanda bluntly.

"Oh...oooh. I've very sorry," said the Principal.

"I'm not." Yolanda squeezed the Principal's hand tightly before dropping it.

"Well, then, please sit down. As you know Mike here hit a girl, Jamie Kiederson," Yolanda furrowed her brow. She knew that things had been rocky, knew it before Michael knew it, but she never thought that it would come to this. "--gave her a bloody nose, but she's fine. Mike has fully admitted to punching her, and there are several witnesses. There is no doubt about what happened. We have a zero tolerance policy for this behavior. So you have two choices--"

"But don't you care why I did it? Doesn't that matter?" asked Michael. He moved to the edge of his seat and looked pleadingly at his mother. She cast her gaze down.

"No, Michael, it doesn't matter. That's what zero tolerance means," said Yolanda.

"But that's not fair! You don't even care what she did to me?" Michael stood up, his face was furious. "Why do women always get treated better? Why? They do just as much wrong! She cheated on me! That's worse than being punched in the face!"

"Michael! Shut up! This doesn't help! It does not matter. It does not matter baby, I'm sorry." Yolanda looked at her son. "Sit down. Let's get this over with," she turned back to the principal. "Please continue."

"As I said, you have two choices. First, we can expel Michael. He may have to go to court if Jamie decides to press charges. If that doesn't happen, you can try homeschooling, but he will not be admitted to any other high school in this state, although I do believe public schools Rhode Island and Vermont would accept him if you moved there. His chances at attending college will be grim. I think you know the other option."

"Maloxilin," whispered Yolanda.

"Correct. If you get him a prescription, he will be allowed back into the school as if nothing happened. He will never be violent, and we won't need to worry about him."

"I'm not taking that crap!" yelled Michael. "That shit fucks you up permanently!"

"Language, young man," said the Principal.

"We'll look into it," Yolanda just wanted to be out of that room. "Is that all?"

"Yes. You may both go. Remember that Michael is not allowed back on school grounds until we have a copy of the prescription on file. There will be some other paperwork to fill out."

"Alright. Thank you." Yolanda got up, and tugged on Michael's shirt. He stared venom at the Principal. Yolanda grabbed Michael's elbow and steered him out of the room. They walked quickly through the administrative offices which had brown carpeting. Yolanda's face was flushed, Michael's was ashen. When they got out into the parking lot, Michael couldn't contain himself any longer.

"Mom, why didn't you defend me?!"

"Michael, you decided to hit somebody. That's YOUR choice, not mine. I thought I raised you right, I thought I thoroughly informed you about what could happen if you did that. I thought you were paying attention to what your father did all those years, but apparently not!!" Yolanda was marching briskly towards her car, a beat-up, decade-old hybrid.

"It was one punch! I didn't mean to, she made me!"

"She didn't make you do nothing! You did it! Got it?!"

"But I--"

"But nothing Michael. NOTHING. Now I have a horrible decision to make. I don't know what we've come to that we do this. It might have been bad in the past, but we let people be people." She stopped abruptly. "I don't want to lose you. You're a part of me."

"I don't want to take that stuff." Michael looked at his mother. Both found tears forming in their eyes.

"I really don't have much of a choice. We can't move, and I can't afford to homeschool you, and I couldn't do a good job anyway."

"I'm not...I don't want...mom I'm sorry."

"I know baby. Let's go to the doctor tomorrow." Yolanda put her arm around her son as he started to cry.

***

The doctor's office featured a poster describing the warning signs of depression. "Do you feel more than down?" it read. "Have you given up your favorite activities?" Below that it listed several antidepressants and how they are used. At the bottom was the logo of large pharmaceutical company. It was the same one that made Maloxilin. Michael's mother sat in a chair, checking her email on her phone. Michael sat on the examining table, trying not to crinkle the paper. He hated the sound. His hands were sweating, and he rubbed them down his jeans.

There were voices on the other side of the door. Yolanda looked up. The file in the holder on the other side was removed. There was a burst of laughter, then more low talking. Finally the doctor opened the door. He was tall and young. He wore glasses. They were probably a prescriptionless affectation, since he could certain afford eye surgery. Almost everyone could. He has a bit of a swagger to him. Michael instantly hated him. He seemed like the iconic male ideal perpetuated in the media. The doctor introduced himself, even shaking Michael's hand. Then he sat down on his rolling stool.

"As you know I'm required by law to assess your MAO levels. Unfortunately there is no current way to test these level directly as they are in the living brain. We will start with some questions. Can you tell me a bit about what happened?" he addressed Yolanda.

"Well, he punched his girlfriend yesterday between classes." Michael wanted to say that he was right there, that he could talk to him, but his mother had coached him not to react, to be docile. She was hoping to get a note from the doctor stating that Michael didn't need Maloxilin.

"I see. Was this provoked?"

"Well, she apparently cheated on Michael with another boy, and was being verbally abusive."

"Really? Well that's too bad." He turned to Michael and attempted to look sympathetic.

"She's not a very nice girl." In fact Yolanda liked her, but was trying to paint her in the worst possible like.

"What did she say exactly?" he asked Michael.

"I don't remember."

"Really? You can't remember exactly why you--"

"She was angry at me, I saw that she hated my guts."

"What did you feel when you started to punch her?"

"I uh, I felt angry. Sort of numb."

"Umhum. Okay." The doctor wrote something down. "How angry were you?"

"Uh, I don't know. I was quite angry."

"On a scale of one to ten, with one being completely at peace, and ten being as angry as you've ever been, how angry would you say you were?"

"Uh," Michael wasn't sure how to answer. Was this a trap? "Maybe an eight?"

"I see." He wrote some more. "Do you often feel angry?"

"No, not always."

"How many times a day do you feel angry?"

"Um, I don't know. Not often."

"Do you feel angry more often now that you are a teenager than when you were a child?"

"Uh, no. I felt angrier then. On average."

"I see. And why is that?"

"My dad. I was angry a lot at my dad."

"Why don't you feel angry towards him now?"

"He's in prison," said Yolanda.

"What is he in for?"

"He robbed a convenience store and got caught," said Yolanda.

"Hmm. I assume he was frequently involved with crime. Is that why you were angry at him Michael?"

"No."

"Why then? Why were you angry with him?"

"He used to hit me. Nearly every night, there were arguments. Michael saw it all when he was little. He tried to defend me," said Yolanda.

"But he didn't go to prison for this?"

"No," said Yolanda.

"So, you didn't bother to bring this to the attention of the authorities."

"No, apparently I did not." Yolanda bristled.

"Well then. This suggests there may be a genetic component. Alright. MAO levels can vary significantly between individuals. Very high levels lead to anxiety and phobias, and ironically, risky behavior such as skydiving or gambling in some people. Low levels are associated with violence. Overall, women tend to have higher levels than men, and older people have higher levels than younger people."

"Yes, we know," said Yolanda.

"And I assume you know something about Maloxilin."

"Yes, a bit. It's very addicting."

"Well, yes, that is a side-effect, but Maloxilin is an extremely effective drug that curbs violence. In the last decade, violent crime has become virtually nonexistent in countries that have approved it's use. Those that have not still suffer from high levels of crime and violence, particularly domestic abuse. Maloxilin is generally safe to take, and it's impossible to have a fatal overdose. That's why the additive properties are, uh, overlooked. Really it's one of the safest drugs on the market."

"But I could die if I stopped taking it, isn't that right?" asked Michael.

"Yes, that's possible. Withdrawal is extreme, and anyway, you wouldn't want to stop taking it. Who want's to be violent?"

"Doctor, do you take it?" asked Yolanda.

"Well, haha, no, I don't. But I know many people who do. They lead perfectly normal lives."

"Do any of them take risks?"

"Well, not really. Maloxilin does not increase risky behavior."

"But if Maloxilin increases MAO levels, and increased MAO levels can lead to risky behavior, why aren't people on Maloxilin risktakers? At least some of them?"

"Well, uh, um, for many of these drugs, we're not entirely sure how they work. The brain is a complicated organ, and many different chemicals interact. MAO, or monoamine oxidase is a chemical active in the chemical lifecycles of several different neurotransmitters. We are not sure how all of these interact to affect overall behavior."

"So this drug is widely used even though we're not really sure what it does?"

"Well, I wouldn't say that, exactly. But it is an effective drug for curing violence in society?"

"But doctor, violence is not a disease--"

"I disagree with you there, ma'am. Violence is a disease that's affected humanity as long as we've been human. We've always wanted to be rid of it, now we can be. And the price is so little."

"Death if I stop taking it?" Michael looked intently at the doctor.

"Overall, a few patients here and there, but it would be extremely unlikely you'd run out of a supply. It's paid for by the government after all."

"But what about a natural disaster? What happens if he runs out of it then?"

"As I said, it's unlikely. Ma'am, do you realize that your son is effectively relegated to second class citizenship if he does not take it? Having shown violent tendencies, and may I add, having a violent father, no one will want to hire him. No woman will want to be with him. He has to take it."

"How many people are on this drug? How many would you say are on it in the United States alone?"

"Uh, fifty million, give or take. Mostly men. Some women, but mostly men."

"And would you say that these men on this drug are wealthy men? Or are they poor?" asked Yolanda. The doctor tapped his pen on his desk.

"I see that you're against this drug. Really, this isn't the place for politics. I don't understand why some people like to politicize this Maloxilin. The benefits have been astronomical."

"I want to know more about the side-effects," said Michael. "What does it feel like?"

"Well, I've been told by patients that there is a feeling of peace, of well-being. That you will feel more empathy towards others. You will become more a more loving individual."

"I heard that you feel like a zombie--"

"Well no. That's not true. You will feel calm."

"Will I still be able to feel angry?"

"To be honest, no. You will never feel angry again. But that's a good thing right, young man? You'll never have to worry about anger again."

"Please write the prescription," said Yolanda.

"Mom!"

"Hush. You're taking it. I'm convinced it's the best thing. I may not like it, but it's the best thing for you. I want the best for you. Write it doctor."

"Alright," said the doctor, relieved. He scribbled on his prescription pad. "This will be for the once a day version. You can get patches, but they can cause skin irritation. About a week after you start you will begin to notice some changes in how you feel. You will have no problem remembering to take it, so yes, that's when the addiction kicks in." He ripped the paper off the pad and handed it to Yolanda. "I'd like to follow up a month from now to see how you are doing, but I think everything will be okay. Let me know if you have any questions."

The doctor stood up and opened the door, motioning for Yolanda and Michael to leave. Once they were in her car, Michael burst into tears.

"Now baby, stop, it's not that bad."

"Yes it is. I can't believe you did that."

"It's for your own good. Actually I'm glad we got that out of the way now, and you won't have to deal with it alone when you're an adult."

"Mom! You're making me take something that's going to dumb me down and not feel anything! I know anger is bad but I don't want to not feel it ever again! That's just wrong!"

"Okay just stop. I couldn't tell you in there, but you're not going to be taking it alright?"

"What?"

"I just wanted to get him to write the prescription. They don't need actually proof that you've taken the drug. Everyone just assumes that if you get a prescription you're taking the drug. There's no way you can stop on your own."

"But--"

"Look, we'll just fill out the prescription every month, and flush the pills down the toilet."

"Really?"

"But you have to always pretend that you are taking it. There's no way you can be violent. If the authorities find out you've never taken it, both of us could go to prison. This is serious stuff."

"Why didn't you just pretend you were all for it?"

"It's not in me. The very idea that they are shoving a whole host of societal problems under the carpet with a dangerous drug, really rubs me the wrong way. It's all about profit! The government pays and that pharmaceutical company get's rich. They say they are turning the profits into research into drugs for serious diseases, but I'm not so sure. Anyway, that's no excuse to use the poorest segment of the population as disposable guinea pigs.

"You know when you were very little, I saw a man die from Maloxilin withdrawal. He was homeless. I don't know why he didn't have access to it, maybe he refused. He lived in that park across the street, when we lived in the yellow house, do you remember? Anyway, he wasn't taking it. The first day he was fine. The next day he was pacing around a lot, grumbling, bothering people. The police came once to see what was up. I don't know if they gave him more pills or what. The next day he was screaming in agony for about twenty minutes. He died right there, before the police or ambulance could come. It was really quick."

"That's why you brought up natural disasters..."

"Look, everything is fine. Just pretend you're taking it." Yolanda started the ignition with a press of a button. The car purred gently.

"Is that why, is that why you never ratted out dad? You took all that because you didn't want him to risk taking it? You didn't want him to die?"

Yolanda didn't say anything. She put the car in drive and turned out onto the road. Michael fell silent too.

---

A lot of this story is inspired by my experience with anti-drepressants. I've had good results with them and I've also had very bad results. When I found out that scientists don't really know exactly how they work, and why they may be effective in some people and be really bad for others, a began to see that they, and many other drugs, are not panaceas. Not every disease needs a cure, and there are ways to manage and cope without pharmaceuticals (that's not to say I don't they have a place or that some are valuable, but just that not every medical problem is best solved with a drug).

Coupled with that, I've often thought a lot about how men are more violent than women, and wish, on occasion, that there were fewer men in the world (horribly misanthropic, I know). I basically ran with a form of this idea for this story. I should probably expand this in the future in order to explore more of the societal implications (the doctor's office scene is a total cop-out. All of that could be described more viscerally).

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