There’s something in my eye

I think it’s a tear.  Shoulda been a hook for a country song.  Maybe I’ll write one.  But right now, all I can do is try to conjure up some tools out of my vast Bipolar Toolbox to deal with this latest version of Sharp Stick in the Eye.

Sundays in Amerika have come to be “family day,” in the short time I have been here.  I moved to this tiny community in the mountains of Western North Carolina emergently last January to help my very elderly parents, who were floundering without help.  It’s a long story and I might tell it in some other post.  Suffice it to say that I moved here from Jerusalem, which is, for me, a very easy place to live because everyone else there is crazy too. It’s the only place on earth that I actually feel normal.

I did live here in Western North Carolina one other time, in the late ’90’s and early 2000’s, and ended up on the psych ward twice, which had never happened before and I hope does not happen again.   I have a few more tools in the toolbox now, and one of them is this blog.

Since today is supposed to be “family day,” I called the house around noon to see what was happening over there.  Dad moves very slowly and is often just getting around to breakfast at noontime, so when the phone kicked over to the machine I left a long and leisurely message because it takes Dad a long time to get to the phone and he is always grateful if I wait for him to pick up by talking to the machine for a while.

When no one answered the machine, I got a bit concerned and called my mom’s cell phone.

“Hi, Honey, we’re just winding up at Dad’s birthday brunch up at School,” Mom chirped.  Huh?  Birthday brunch?  My dad did, B”H, have his 87th birthday last week.  We had all gone out for dinner.

“Oh, I have to go, there go Caramel and Krunchie and I have to thank them for coming.”

“Wait a minute,” I commanded.  “How is it that there’s a party for Dad and I wasn’t invited?”

“Oh, Muppim and Tuppim organized it.  They probably just didn’t think of you.”

“So why is it that you didn’t remind them that I am here and would probably appreciate being invited to my father’s birthday brunch?”

“Oh, Laurie, you know the brunches at Endland are VERY EXPENSIVE and they paid for everyone–oh, there go the Singletrees, I have to go, call you back, bye!”

She did call me back half an hour later.  There, I thought when I saw her number on my phone, she’ll be contrite and tell me how sorry she is that she didn’t think of some way of including her only child who has recently given up her happy life on the other side of the world in order to help her parents, in a festive event that might have broken up the otherwise dreary isolation of this G-d-forsaken part of the Universe.

“Oh, Laurie, you know those Israeli antacid pills you gave Dad?  They really work.  Could you please look and see if you have some more?  No rush, you can bring them over next time you come, in a day or two.”  Yup. Yeah, sure.  Glad to know they helped.

I groped around for something that might catch me from the fall I was in, falling, falling into the spinning dark  of the rabbit hole of my illness, just wishing there was something handy to break that I wouldn’t regret later, and my eye rested upon my little dog.  No, I would never think of breaking my DOG, chas v’shalom!  My dog Noga is my short-stop.  She stops me short when I feel like smashing every window in the room, slamming the single door so hard the glass shatters, bashing all the chairs to smithereens, stuff like that.  I have never actually done anything like that, but the older I get the more I want to.  Having a dog helps, because I know anything in that vein would terrify the poor little thing and I don’t want to do that.  So I don’t.

Instead, I pull out the tool that goes, “think back, feel back and back till you remember the earliest time you felt like this.   Where were you?  What was happening then?”

The time machine zoomed me instantly into a clear glass box in a dimly lit room, soft footsteps squishing to and fro on rubber soles, and I am wide awake and aware.  I am in the premie nursery, where I lived the first month of my life, alone in a box in the dark.

The exact medical details of why I ended up in the preemie nursery have never been clear.   What is known is that 1) I was born by emergency Cesarian due to fetal distress;  2) I was under four pounds at birth;  3) my mother was medicated with Dexadrine prescribed by her doctor to prevent excessive weight gain, and supplemented with Maxwell House and Marlboros.  She gained fifteen pounds, which all went away after the C-section, in the form of me and my accompaniments.  She doesn’t know whether I was early or just small.

Soon after birth my lungs went bad.  Family legend has it that the nurse took me out of the incubator and gave me a bath, and  I “caught pneumonia.”  More likely, I was just small and had immature lungs, as might be expected.  Anyway, they stuck me back in the incubator and cranked up the oxygen.  Something must have been leaky, thank G-d, because I didn’t come out of there blind like so many babies in the ’50s.  Paradoxically, oxygen in high concentrations is toxic to the eyes (and the lungs).

So there I lay, in a glass box, in a dark room.  No one was allowed to touch me.  That’s the way it was back then.  And I lay there and watched the lights go on and off, and listened to the soft nursery sounds, and sucked my thumb.  The plan was that when my weight reached 5 pounds, I could go home.  But things kept going the other way instead.  I dropped to three pounds, and started creeping even lower.  Until one day my Nana had enough of my imprisonment, and according to legend, blew into the nursery under full sail, announced that she was taking me home, and did.

My mother, who was well along in a crushing postpartum depression, suddenly hand her hands full of a wide-awake, worldly-wise munchkin who had already learned to rely on only one person:  her infant self.  It was a mutually unsatisfying arrangement.  Still is.

Labels and Identity: Part Two

Medical school was a blast.  I kid you not, I have never had such fun since I was seven years old.

That was the time that my pet baby turtle died.  I have never once heard of a pet baby turtle that did not die young, but instead grew up to be an adult turtle giving rides to children in the zoo.  But I digress.

My baby turtle died, the kind that children are not allowed to have anymore because of Salmonella.  And I buried it in my mom’s flower bed behind the L-shaped brick house we rented, way far away from the road, down a dirt driveway half a mile long.

It wasn’t two or three days until I realized what a blunder I had made.  I had passed up a stellar opportunity to further my scientific education.  So I dug up Mr. Turtle and laid him out upon my little bed, took up my X-Act-O knife and began the postmortem by separating the plastron from the carapace.

Just as soon as I lifted the lid of the turtle’s front shell, some horrible stinking greenish black slime poured out directly on my bedspread.  I jumped back, gagging, fighting off waves of panic.  That has always been my motto, “Do Not Panic.”  It has served me well in many situations.

The hideous stench of the decomposed turtle innards drove me to quick action.  I snatched up the bedspread, turtle swathed within, and ran out the back door.  My chief concern of course was what my mother was going to do when she noticed that my bedspread was gone and that the house smelled like rotten turtle guts.

I dumped the turtle remains back in the flower bed and dragged the bedspread into the garage where the old wringer washing machine stood.  There was a handy half gallon of chlorine bleach within reach, so I spread out the bedspread and emptied the contents of the bleach bottle onto the black slime place in the middle.  Then I wadded the whole thing up and stuffed it into the washing machine and went away from there.

From this it should be clear to anyone that I was destined to be a surgeon.

Anyway.  I loved medical school.  I did not encounter one single dead turtle there, but that was because I went to human medical school instead of veterinary medical school.  I often wonder why I didn’t think of that when filling out my application forms.  But that is water over the dam.

I was far, far too busy being a medical student to think about identity issues.  At first, there was a lot of course work, and a whole new system to learn.  The school I chose turned out to be what I later came to think of as “The Hippy Medical School,” because it was a center for innovation in medical education.  The Dean at that time was a Social Scientist and not even a physician.  The faculty were all top level experts in their fields, but they were also critical thinkers and often quite eccentric.  The most common word I heard during my six years there was:  Inquiry.

The immediate impact as far as I was concerned was that they honed in on my past as a traditional healer (no, I have not written anything about that yet, aside from the turtle), and proposed that I join the new phalanx of the Medical Scholars Program in Social Sciences.  The Medical Scholars Program means you do your four years of medical school, and then somehow or other you manage to do a full graduate program in some other discipline, with the aim of coming out of it with the letters MD, Ph.D after your name.  The accepted second discipline had traditionally been in “hard science,” like microbiology or biophysics, but since our Dean was a Social Scientist she was stumping to get the Social Sciences represented in there too, and I came along at just the right time.  So I became the first MSP student in Anthropology.

Somehow I convinced them to let me “just” go for a Master’s Degree in Anthropology instead of a Ph.D., for the same reason I didn’t become a surgeon:  I wanted to have a family.  Anthro Ph.D’s are known to drag on for seven, eight years on the average, and always involve one full year of fieldwork in some primitive place where one is quite likely to contract some dramatic tropical disease, excellent for bragging about at annual meetings but not so great if you have plans to reproduce someday, and I did.

One of the things that one does as a first year medical student is to dissect a human cadaver.  That is taken for granted;  it is a rite of passage.  Every medical school does it a little differently, but we all need to know what goes on underneath the outer carapace and plastron of the human body.

In our school, one cadaver was assigned to a pair of students, who then alternated dissecting and observing.  Through a series of happenstances, there ended up being an odd number of students and an extra cadaver, and she was assigned to me alone.  Yup, just she and I.  We were the outliers.

My poor cadaver!  I will never forget her.  She was an old, old lady.  She was curled up in the fetal position, and from the condition of her muscles and tendons, it looked like she had been that way for years.  I couldn’t help thinking of an old lady just like her that I had met years before, when I worked as an itinerant phlebotomist and was sent to a “convalescent hospital” to draw all of the patients’ blood there.  The poor little old lady looked up at me in terror from within her blue, blue eyes, her silky white hair combed neatly in a French twist on the back of her head.  She made little whimpering noises as I tried to straighten her arm out to draw her blood the normal way….but she had been curled up like a snail for so long, her muscles were all contracted and it could not be done.  So I drew the blood from her hand.

And there she was, or someone very like her, lying on my dissecting table, all crumpled up.  And I was supposed to be dissecting her armpit.  The armpit is a fascinating place.  It contains an electrical switchbox that operates the whole arm, including the hand.  So it’s essential to open it up and examine its contents.

But my lady was not able to cooperate in even the clumsy way the other cadavers did, and I was wondering how I would ever get the job done.  It didn’t help that I had come into the anatomy lab alone, late on a Saturday night, having no date.  Needing inspiration, I headed over to the lab’s radio to try to find a classical music station.  I have always found that classical music helps, as long as it is not Benjamin Britton.

Just as I arrived at the radio, I nearly collided with another ghoul in a white coat and plastic gloves.  “Oh, excuse me!  I was just looking for a classical station!”  we said, in unison.  And grinned sheepishly, realizing we were without question the two geekiest geeks on the planet, spending their solitary Saturday nights in the cadaver lab, looking for a classical music station.  Neither of us had noticed the other was there, even though we were just a few cadavers down from each other.  We found a good classical station.

“Oh, uh, well, since you’re here, could you help me with Madame Pretzel (I had named her) over here?  I can’t seem to access her axilla.”

“Mmmmm, why, I’d be delighted to!”  hummed the geek-boy, and he came over and helped me.

I though he must certainly be gay, because he was adorable, had good manners, and liked classical music.  But I took a risk and asked him out for coffee, and he eagerly accepted.  I found out he wasn’t the least bit gay, just highly cultured.  We got married.

By then I had accumulated so many Labels and Identities that I actually hyperventilated if I thought about them.  So I avoided thinking about them, and instead continued running three miles a day as I always had, and added two dance aerobics classes a day plus a weight training session three times a week, just to keep all the identities from running into each other and getting knocked down.

Labels and Identity: Part One

In recent months the question, “What do you do?” has become a recurring theme.   In our society, “what you do” is equivalent to “who you are.”  On a deeper level, it means, “What is your worth to society?”

Now don’t start:  I know that  even now you are opening your mouth to say:  Oh, no, your worth to society is not dependent upon what you do;  and what you do does not define who you are.  “Who you are” is who you are on the inside, a soul, a PERSON, a LIFE.

Bullshit.  In our society, “what you do” IS “who you are.”  You are a teacher.  A student.  A mother.  A lawyer.  A prisoner.  A doctor.  A patient.  You. Are. A.

10 years ago it was easy for me to answer that question. I was a physician. I was a pediatrician. I had my own pediatric practice. A solo practice, in a small rural mountain community. I was the only pediatrician in three counties. It was a big identity. It was an identity that I was proud to announce, in answer to the question “what do you do?”

I was proud of what I had built. Life had never been easy for me. I dropped out of high school as a teenager, ran away from home, did a lot of drugs, lived on the streets for a while. I never went back to high school.   Instead, I took a battery of tests that qualified me to apply to college. I wrote my way into the University of Chicago, and worked my way through. From 9 PM to 4 AM I cocktail waitressed at a snazzy disco on the Northeast side, and then went to my real job in a microbiology laboratory at the University, where I worked on projects until it was time to go to class at 10 AM.  Between classes I crashed on the couches in the quiet grad school libraries.  There was even a special room called the “Womb Room” that was filled with foam cushions of various sizes and shapes that could be arranged in the perfect configuration for one’s customized nap.  I lived on yogurt and donuts from the myriad campus coffee shops, and the occasional meal bought by a wealthier-than-me friend.  At the end of the day I’d run up to my apartment, shower, change into my work clothes, and take the El north to work.

One day I saw an ad in the school newspaper newspaper soliciting subjects for a study on a new psychoactive drug.  If selected, subjects would receive either the study drug or a placebo, and be paid for their time.   Get paid to take free drugs!  Amazing!  I went right in and applied.

The study was under the auspices of the Department of Psychiatry.  The application process consisted of sitting for a day’s worth of psychological tests, exhaustive and exhausting.  But I marched off afterward, feeling quite confident I’d landed the job, as I’d answered all the questions completely and honestly.

A week later I got a letter from the Department of Psychiatry that said I should call them immediately.  Oh boy, I thought, I’ve got the job!

Not so.  The earnest young man on the other end of the telephone told me that the testing indicated that I was in the clutches of a major depressive episode, and I needed to report to Student Mental Health at once.  He gave me an appointment then and there.

Nuts, I thought.  There go my free drugs and money.  And what is this garbage about major depression?  I didn’t feel any worse than I ever did.  In fact, there had been times in the past when I’d felt far, far worse, and had managed to get through them one way or another.  But now?  I was just going along, doing what I needed to do to get by and do well in college, so that I could go to medical school and be a doctor.

I dutifully showed up at my appointment at Student Mental Health.  A bland, nondescript woman sat behind the desk, radiating benevolence.

“What brings you here today, Laura?”  she beamed.

I told her my story about applying for the job taking drugs and being sent to her instead.  I told her that the young man on the phone said I was having a Major Depressive Episode, but that I didn’t know what he was talking about, because I felt the same as I always felt.

The benevolent lady’s face fell,  suddenly all sympathetic.

“Why, Laura!  You’re attractive!  You’re a straight “A” student!  Why are you depressed?”

I stood up.  “Thank you for your time,” I said, as I made my way out of her office.

That was Psychiatric Label Identity Number One.  But I ignored it.  It was ridiculous.  It didn’t fit.

On the other hand, it might have explained a few things.  Quite a few things.  But the lady behind the desk had been so insipid and without skill, that the opportunity for connecting at least a few of my dots slipped by for that while, and was lost.

I threw that label in the trash, put my shoulder to the wheel, and met my goal.  I finished college, was accepted to medical school, and began my new identity:  Medical Student.

New Moon in Scorpio

Oh boy.  If you’re anywhere near my age, and even if you’re not, if you’ve read your fill of R. Crumb comix, you’ll know that Scorpio is a heavy sign.  And the New Moon is the darkest time of the lunar cycle, nothin’ shining out there in the night, ‘cept some stars, and those stars are gonna be…Scorpio.  Of course, the usual culprits are all out there too:  Castor, Pollux, the Milky Way.  But you catch my drift.  We have a Darker Than Usual Dark of the Moon event going on tonight.

Could be why my neighbor’s dogs are hysterically howling.  I hope they stop soon, very soon.  I am comforted by the fact that I have no weapons at all, for I would be sorely tempted to lob a grenade into their yard.  Alas, I am without grenades.

As for my mind, why, it seems oddly balanced tonight.  I had a couple of heroism opportunities earlier in the evening that cheered me up considerably.  I love being a hero.  Swooping in and saving somebody’s day just juices the heck out of my day too.  I have to be careful with that, though.  Grandiosity lurks behind the Superhero cape, drat it all.  Do you think Superman was manic?  Green Lantern?  Spiderman, fer cryin’ out loud???   Dude goes creeping around headfirst down walls, now that guy has got to be oozing some serious mania juice.  Does he get labeled, lose his job?  Heck no, he gets famous, makes movies, gets the girl!  This proves that real life is all wrong.

Scorpio.  A deep, deep water sign.  It’s my father’s sign.  And tomorrow is his 87th birthday, in the deep black waters of the New Scorpio Moon.  I noticed today that he’s in his Scorpio mind tripping mode, where he flows through mental images in gorgeous non-sequiturs that drive my mother mad (she’s a very practical Sagittarius) and make me grin.

Dad found his place in life and kept it.  His mind is all images:  he’s an artist.  He got to be exactly who he is in life, got to do it almost right up until the end.  I know that is an enigmatic sentence.  I will explain it.

Most people spend a considerable part of their lives trying to figure out who they are and what they want to be when they grow up.  My dad fell into his field on one of the first tries, and unintentionally at that.  He’s a clay artist, has been since around 1950.  Just fell into it, fell in love with it, and has done it all his life.  He’s managed to engineer his life such that even through a few major bumps in life’s road, he still managed to keep his clay life between the ditches.

I’m curious about this, because even though I have always known who I am and what my life’s work is, I have had little success at keeping myself from careening straight into those ditches.  I have known many tow trucks.  I am no stranger to the lonely walk on the side of the road, in the days before cell phones.

Early on, it seemed that the art of life lay in the grace of picking one’s self up and dusting one’s self off, and climbing back in the saddle.  I did that a lot.  I still do, but the saddle has moved a lot closer to the ground, or so it seems.  On one hand, it’s easier to climb back on.  On the other, falling off hurts more.

A muzzy fuzzy day

This will be a short post.  Last night was a “mixed state” night.  I will fill you in at length on what a “mixed state” is in another post, but suffice it to say on this extremely fuzzy, muzzy day that it required a noxious cocktail of medications to get me settled down to the point where I could lie down in my bed.  Finally, after enough drugging, I fell into what might be categorized as sleep.  I often wonder what these drug induced episodes of somnolence look like on EEG.  I no longer have the inside connections that would make it possible to spend a night in a sleep lab just for fun, to see what it does in fact look like in EEG-land, so I guess that will stay in imagination-land.

Noga the dog-a woke me up at 11 am, having very patiently sublimated the needs of her bowels and bladder in my service until then.  I staggered to the door and let her out.  She bolted into the yard.  Her Lhasa Apso face radiated AAAAAAAHHHHHH!!!!! as she relieved herself, then trotted gaily in for her morning cuddle.  Normally she wants cuddles first, outside second, and only if I come too.  But today she had outdone herself waiting for me to wake up.

It was good that she forced me to haul my carcass out of the bed.  Otherwise I might have slept all day and then had to deal with THAT tonight.  Sleep hygiene is critical in my disease management.  It’s one of the reasons I don’t hang out with people in the evenings, other than the fact that I don’t like most people.  But even if I DID enjoy other people’s company I would still have to go home at 9 pm to start my bedtime medication sequence and preparations for drug-induced sleep.

My sleep-drug induction sequence is negotiated between myself and my neuropsychiatrist, who puts a great deal of trust in my judgement.  My Ph.D. psychotherapist, who works alongside my shrink to keep me right-side-up, assures me that he is not that way with everyone.  This does give me a modicum of pride, in that he trusts me to twiddle with these potentially dangerous drugs and self-regulate in this way.  But he tells me that the actual doses I am using are so piddlingly small that it’s virtually impossible to get into trouble with them.

Nevertheless I feel a bit like Elvis or Michael Jackson, with this sort of anesthetic induction sequence that I use.  Except I don’t use narcotics, or Propofol, or any of the big nasties that they used.  But I tell you right now that I entirely understand why they did what they did.  The tremendous high energy that fueled their creativity had to have had a good dose of mania rocket fuel to it, and that chases sleep way, way far away.  And yet, after a certain point, the body and the mind become so exhausted that they will do literally anything for sleep, blessed sleep!

At more than one point in my life I have decided that perhaps it would be a good thing to simply acknowledge the fact that I am not a good sleeper, and work at night.  That’s fine, I’m a good night worker.  My clearest thinking and my best creative work happen between one and four in the morning.  There’s only one problem:   I can’t sleep in the daytime either.  So I would go along for a while, whizzing through my nights and spending my days lying in bed in a stupor, yet awake, until something would happen to interrupt that cycle.  For instance, my immune system might be the one to violently object, resulting in pneumonia.  Or I might get utterly disgusted with my boss and quit my job.  Or I might decide that I hated the part of the country I lived in, and move to the opposite coast.

In between, there might be all kinds of havoc of more minor varieties, such as relationship dramas, parking on the wrong side of the street and having to spend a sleepless day dealing with getting the car out of wherever they had towed it, and things like that.  I’m not sure any of it was actually abnormal.

But eventually, inexorably, these episodes of sleeplessness would slide down the slippery slope into the black hole of depression of the major sort.

And that is why I must, must, must stay vigilant on the sleep hygiene front.

And I am so fuzzy today from last night’s pharmacologic assault….I hope tonight is better.

And here we begin

After one of my hospitalizations, I was sent to a “partial hospitalization” program that was part 12-step something-or-other and part Cognitive Behavioral Therapy. Even though my insurance had booted me out of the hospital, I was still so deeply depressed that my brain just couldn’t follow what the leader was talking about, and when called upon to speak, I said as much.

“Well, let’s just take it one day at a time!” the jovial fellow chortled. I was incensed. Outraged.

“One day at a time…..” I mumbled, forcing the words out, “One day at a time….? One SECOND at a time is too much for me sometimes!!!!!”  The words rang in my mind, but they did not manage to make it out of my mouth. I was too exhausted, with the sheer effort of continuing to exist. So I let it go.

But it’s true. Sometimes one day is just too much to expect of oneself. One hour. One minute. One second. A millisecond. Sometimes that’s all it takes, one millisecond, to let the roaring of the demons pass. Those of you who know, will know. Those of you who don’t…please stop a moment and imagine what it might be like, to struggle each millisecond to stay alive, all the while suffering unutterable pain.

Time itself is our ally, in this game of cat-and-mouse we play with our very lives.

The important question is, how?  How do we convince ourselves that no matter how terrible the pain, we must continue to live these seconds, minutes, hours?  Each one of us must find our own sets of reasons and inscribe them on the insides of our eyelids (figuratively, now!), so that in the dark times we don’t have to work to think about them.

I’ll tell you what mine are:  My son, whose life would be destroyed if I were to take mine.  My aged parents, who would be devastated and would live in misery till they died.  And then I have an ace in the hole, a little helper, for those times when even these enormous deterrents do not seem reason enough.

I have a dog.  A very special little dog. She’s my Psychiatric Service Dog, and she knows how to reach me when the whole world turns black.  She knows how to sit down when I’m spinning out of control.   She doesn’t mind if I hold her and cry into her fur, even if I squeeze her a little too hard.  She just looks up into my face and licks the salt off my cheeks.  And slowly, time begins to have meaning again.  There are seconds, because she’s licking my face.  There are minutes, because I’m sitting down stroking her fur.  There are hours, because she parks herself at my feet wherever I go, and whenever I look down, there she is.

We all need to find a strategy that works for us, both to keep ourselves oriented in time, and to keep ourselves here on earth for our allotted time. What’s yours?