DPchallenge video: The Tarantula and the Tarantula Hawk Wasp

This is a really horrifying video, so if you’re arachnophobic or queasy in general, you might want to skip it.  I was strolling down my driveway in the Blue Ridge Mountains when I witnessed this drama.  A dramatically beautiful wasp with red and blue iridescent wings had been hanging around my shrubbery for a few days.  I am very glad now that I did not try to catch it, because its sting is said to be so painful that all you can do is lie there and scream, sort of like a taser.  So I’m walking down my driveway and I see this wasp doing sort of a victory dance, and next to it is….a TARANTULA????  In Western North Carolina?  Camouflaged like the forest floor???  About two inches long?? I pinched myself.  Ok.  I have seen this drama played out in New Mexico, where the tarantula was, you know, tarantula size, and the wasp was as big as the tarantula.  They fought together, the wasp dive-bombing the tarantula until it goaded the spider into standing up, exposing its abdomen, and the wasp swooped in and stung it in the abdomen.  In a matter of moments, the spider was paralyzed, and the wasp triumphantly hauled it off under a rock, where it–she, really, would lay her eggs in the paralyzed but still alive spider’s abdomen.  The eggs hatch into larvae, which live on the still-living spider’s juices until the spider dies and the newly-molted wasps emerge from its body.  Awful, huh?

I made the video on a Galaxy Tab which I happened to have in my hand when I saw it.  The trailer was made in iMovie.

PTSD, Asperger’s, Therapy, and Therapists

I’ve been in therapy since 1984, with a few breaks.  That’s longer than some of my readers have been alive!  I first entered therapy in a panic in 1984 when I was 5 months pregnant with my son.  I had had a miscarriage the previous year, and I was very connected with my 5 month old fetus baby.  One night I realized with a bang that if I didn’t do something to end the generational pattern of abuse, it might continue in my generation–and I would be the abuser!  I was horrified by that thought, and the next day began looking for a therapist.

I had no idea how to find a therapist, so I picked one out of the Yellow Pages.  I will NOT go to a male therapist because of my history of serial rape and sexual exploitation, so I chose the only female one in the book, called up and made an appointment, and showed up at the appointed time.  She had a kind of icy exterior, but I was used to that, being in academia at the time, where everyone was in competition with everyone else and even the feminists with whom I worked tended to circle one another like female dogs sizing one another up.  So I thought that’s what it was.

Now, I didn’t realize at the time that my inability to judge character was in large part due to the fact that I am an Aspie (person with Asperger’s).  I’m notoriously bad at reading people, and it has caused me a lot of grief.  I should have just turned around and walked out of her office.  But I stayed, and answered her angry questions.  Since it was my first experience with therapy, I though perhaps that’s what therapists are like, and I should try it out for a while before I made any judgements.

As I was walking down the street on my way to my second appointment with The Cold Bitch, I suddenly doubled over in pain.  I knew what it was: a Round Ligament spasm.  The Round Ligament is part of the apparatus that holds up the uterus, and when the uterus is growing, it sometimes goes into a spasm that can be excruciating.  Mine was.

Since there were no cell phones at that time, I crawled the block back to my house–luckily it was only a block–and called The Icy Bitch to tell her that I was unable to arrive at her office because I couldn’t ambulate.  She scolded me for breaking the appointment–for ANY reason–and told me she would be sending me a bill.  I told her she was fired.

The next day, I did a more sensible thing and called up Student Mental Health, since I was a student.  They gave me an appointment with the most wonderful therapist I have ever had.  She explained to me that I am deeply wounded by the abuse I lived with as a child, and still lived with whenever I had anything to do with my mother.  She helped me immensely, and I stayed with her until I graduated from med school/grad school in 1987.  Leaving her felt like pulling a wisdom tooth without anesthesia.

After med school I started my residency, with a husband and two year old in tow.  The two year old was having trouble with his mom working 120 hours a week, which was standard in those days.  And the husband, who was emotionally a two year old (I have never been a good judge of character, but he had seemed very benign), was completely lost, as he suddenly became a single parent, essentially.  It took me two years to get him to go to therapy with me.  I told my husband that I felt we were having problems in our marriage; he asserted that I was the one with the problem.  It’s true that working 120 hours a week is very bad for bipolar disorder, which had not yet been diagnosed.  I had been diagnosed with Major Depressive Disorder and was on medication for that, but it seemed to me that that made it even more important that we get couples counseling.  I had to choose between individual and couples counseling, because working 120 hours a week did not leave time for both.

So we went to the Ph.D. psychologist that Student Mental Health gave us.  She was a very strange one.  She dressed in low-cut, short dresses with dark stockings and high heels, not your usual professional attire; but I didn’t judge her on that.  She also had a love-seat instead of a chair, and no desk, and she sort of curled up on the love-seat during our sessions, which made my husband very uncomfortable because he became involuntarily aroused by this behavior, and to tell you the truth I did too.  I didn’t know what to think of it, myself, and tried to focus on what she was saying.

After a few months of this she announced that she felt our marriage was unsaveable.  I had been sure of that for quite some time, but it felt validating to hear her say it, even if she was a bit unconventional.  We stopped seeing her and tried to work things out on our own,  but the marriage eventually disintegrated.

Therapists came and went after that.  I experimented with my bisexual identity, and got a Lesbian therapist for a while, who completely confused me.  A succession of unmemorable ones followed.

Then in 1998, I moved to my present location (from which I have moved several times, but am now back due to filial duties) and over a three year period had a complete breakdown in slow motion.  I was in an insane relationship with another bipolar person at the time (I had been diagnosed, at last, and taking Lithium), and we were planning to get married because when things were good (meaning when we were both hypomanic at the same time), things were outrageously good, and we thought that we could weather the bad times.  But we wanted to get some premarital counseling so that we would be better equipped for our predictably rocky marriage.  I asked my shrink for a referral, and he sent us to B_, who specializes in couples counseling.

We had one session with her, and as we were walking out the door she asked if she could see me alone for a minute.  I stayed and she shut the door on A_.  She pulled herself up to her full four-feet-eleven and said, “I normally don’t do this, but I would like to see you individually.”  I made an appointment.

Predictably, the marriage plans did not work out (that’s another story), and I have continued to see B_ ever since.  That’s a long time.  All of this time I have been the good patient and spilled my guts weekly; but for some reason, for the past few months she has been pissing me off, and I have felt my PTSD kicking in, and dissociating.  I don’t know if that’s a good thing or a bad thing.  My conditioning as an abused child causes me to just want to run.  The thought of telling her how I am feeling about her makes my hair stand on end.  And yet, I know that’s exactly what I need to do: tell her that for some reason, suddenly she is pissing me off.  I just have to screw up the courage to do it, somehow.

Beggar’s Lice and Cat-Briar; or, Don’t Take the Short Cut!

See that mass of green below the barn?  That's where we were hiking.

See that mass of green below the barn? That’s where we were hiking.

No, no, no!  How many times have I told you never, never, ever to take the short cut?  It never turns out to be the shorter way, always the long way around, and bound to be fraught with dangers unknown.

Yes, I know we had that premonition:  there will be a locust tree down across the path a few metres around that bend, and so there was.  It didn’t look like much to climb over from here, but when we got up closer it was clearly covered with the new red shoots of poison ivy vines: no chance of crawling over THAT.  And we certainly did not want our little Noga in her six-inch winter Lhasa Apso coat clambering over a poison ivy covered log, did we?  Out of the question.

Poison Ivy Vines Winter

Poison Ivy Vines are Hairy

Now for the map.  By the landmarks, of which there were plenty, we were a quarter mile from the car on the loop trail through the old apple orchard.  This part of the trail had left the green lanes of the working orchard terraces and dipped down into the wooded side of the mountain, right on the spine of the Blue Ridge.  Table Rock Mountain was in clear view to the north-east.  Just below us on the slope was the CSX railroad grade.  We had an hour of sun before it would dip below the horizon.

We could have just turned around at that point and followed the damn trail back where it came from.  But that would have been too easy, wouldn’t it?  So instead we looked up-hill toward the working orchard and found that there were maybe two or three terraces that had been left to go back to nature, which in this part of the country means getting filled up with cat-briars and multiflora rose.  But there were clear game trails, where the deer and other citizens of the forest made their way up the mountainside.

So up we clambered, digging our sneaker toes into the damp mossy bank, getting hand-holds in places that turned out to be briars more often than not, and getting stabbed and cut up in the first thirty seconds.  Well, that was brilliant, wasn’t it?  The deer have fur and thick hides to protects them from this cutlery growing out of the earth. And now we are standing on the first terrace, in a sea of briar canes sporting thorns the size of our head, and where do we think we are going from here?  Down?  I think not.  We are not that easily stymied.  Onward and upward is the only way!  But how the hell are we going to get through this sea of thorns to that next game trail, seen dimly through the thicket?

Ouch! Ouch!

Ouch! Ouch!

Bushwhack!  Is how.  Pull the sleeves of our fleece over our hands, since we didn’t bring gloves, the day being warm and not having anticipated that we’d end up wrestling around in a sea of briar canes.  So we did, and pushing the canes and twining tangles of cats’claw briar aside (getting slashed bloody in the process) at last arrived at the next game trail, which was clearly steeper than the first one, and slicker, and muddier, and not as nice.  And where is little Noga?  Gamely pushing her way through at floor level.  There’s a champ, what a good dog.

Noga, warm and dry

Noga, warm and dry

Tackling the second game trail requires going on hands and knees, being nearly vertical.  Time to lay aside our pride now, since we have clearly made the wrong decision.  Panting and cursing, we arrive at the top of the second terrace, and looking upwards we are gravely disappointed to see that this is definitely not much nearer to where we wanted to be.  Turning to look down from whence we’ve come, it is all the more clear that going down is NOT an option.  The briars and rose bushes are all growing in the upwards direction, toward the sun, as plants are wont to do, stabbing sharp fingers in the direction of our eyes.  So if we thought we’d had some fun tangling with them going UP, the idea of trying to fight our way DOWN through them without a machete or, better, a chain saw, brought to mind a picture I’d once seen of a hapless sparrow that had been spitted on a spike of an acacia tree by a shrike.  No, we are now firmly committed.  We check the sun again.

A Shrike Impales its Dinner

A Shrike Impales its Dinner

The irony of the situation is that we happen to be certified Wilderness Search-and-Rescue workers, who know how people get lost and how they behave when they discover that they are lost.  We have to know “lost person behavior” so that we will know where to look for them, or for their dead bodies :(.  We remember with a remorseful grimace that 90% of lost-in-the-woods fatalities are found within one mile of their car.  We squeeze out a grim smile and turn uphill.  The main thing is to remain calm, and to avoid going in circles, which is what often happens to people who are lost in the woods.  Luckily we know where we are, and where we want to end up: it’s a matter of getting there in one piece, and before the sun sets.  Freezing rain is predicted for tonight.  So let’s find that next game trail and get our increasingly tired arse up it.

This one wasn’t so bad, except that as we were clambering on hands and toes we could not help but notice the thick viney roots covered with hairy tendrils that criss-crossed the bank.  Damn it, poison ivy.  That was the entire reason we had taken this blasted short cut in the first place!  And now the dog, the wonderful hairy dog, was scampering right up through the thick of it, giving herself a good coating of urushiol, the nasty oil that binds to your skin and causes weeks of red blistering itching misery.  Great.

Ouch, Itch, Ouch

A Terrible Case of Poison Ivy!

This terrace wasn’t as wild as the others, but it wasn’t home either.  It took two more slithers up game trails to hit the lane that led back to the orchard barn, and the car.  By that time one of us was exhausted and dragging.  The other was frisking about wagging her tail, ready to do it again.

She wasn’t so pleased when we had to spend an hour picking beggar’s lice out of her fur upon our return home.  These sticky triangular seed pods are also called “hitch-hikers,” but we prefer to call them beggar’s lice, because our beggar is so poor that she can’t even afford real lice, but must crawl through thickets of briar and cat’s-claw to get hers.

Beggar's lice a.k.a. hitchhikers

Beggar’s lice a.k.a. hitchhikers

Maybe now we’ll remember not to take the short cut….

Photo credits: Creative Commons, except for the thorn tree which is pxleyes, and the one of Noga, which is mine!

Do Mad People Fall Sick?

“Do mad people fall sick” was one of the search terms that somehow landed someone at my blog today. Oh I know, it must have been because I mentioned yesterday that I was feeling ill. This is a fascinating question, and I look forward to exploring it.

First there is the premise that there is something called “madness (“the quality or condition of being insane,”–The Free Dictionary).” The word “madness” instantly whisks my brain to the infamous insane asylum, or “madhouse,” called Bedlam, as the Bethlem Royal Hospital (founded 1330 c.e.) was called. The very word “bedlam” has made its way into the common parlance as a descriptor of an out-of-control chaotic situation, e.g., “my five-year-old’s birthday party was complete bedlam.”

So madness, by association, must be connected with chaos: a chaos of the mind that extends beyond what is considered “within normal limits.”

A term that was used to describe the profession now know as psychiatry was “alienist,” right up to the middle of the 20th century. Psychiatric hospitals were known as “Alien Asylums.” Brings up images of little green people peering anxiously out of barred windows, eh?

If mad people are aliens, that means that they are so completely different from “normal”people as to be considered to be in another class entirely, perhaps even another species.

But what about the “asylum” part? Asylum is a place of refuge from pursuit. The word actually goes all the way back to the Old Testament, where God commanded Moses to create cities of refuge in the Holy Land for people who had accidentally killed someone. Once in the City of Refuge, they were protected from being killed by the relatives of the accidentally slain one. So like the biblical City of Refuge or the Hotel California, you could check in, but you couldn’t check out.

So having established that mad people are aliens, and aliens are not normal, we can very well ask the question “do mad people fall sick?”

To answer this we must look at a more modern, but politically incorrect except for legalistic use, term: insanity. Breaking the word “insane” down etymologically we have in=not and sane, which come from the Latin word “sanitas”=healthy. So “insane”=not healthy. But we knew that already. That is why we call it “mental illness.”

So what the search question above seems to mean in this context is, “Can a mentally ill person, who is perceived (by the searcher) to be so alien that I do not even consider them to be part of my universe, be subject to the common physical ailments that we normal humans fall sick with?”

The answer, O ignorant one, is yes.

Just Too Tired; Mommie Dearest

I don’t know what’s going on.  Maybe it’s a replay of the Cytomegalovirus Mono Follies.  Yes, that’s what it feels like.  Drained.  No appetite.  Last night I was shivering uncontrollably, thought perhaps had fever, took temperature with my Israeli thermometer and it was 35 degrees Centigrade.  That’s 95 Fahrenheit.  Hypothermic as all hell.  I think this virus does something bad to my thyroid.

So that was about 8 pm.  I put on my skiing thermals, took my nighttime meds and crawled in under a down puff and two fleece blankets with the heat turned up to 70.  Slept till noon today.  Spent the day in bed watching Mommie Dearest.  No, not the best thing for me to spend my day doing, but my psychologist has been after me to watch it, and I had time, and now I know why she wanted me to watch it.  For those of  you who haven’t seen it, I apologize for not summarizing it here; I’m just too tired.  Here, I’ll do it in one line:  Joan Crawford is a sickass narcissistic maniac who adopts two children so that she will have “something to love” and “someone to love her.”  She scapegoats the elder, Christine, smothering her with luxuries one moment and making her scrub the floors the next.  The girl turns out to be beautiful and intelligent, and Crawford’s jealousy spirals into violence.  There.

It’s a good thing, I think, that I was sick as a dog while watching Mommie Dearest, because when I am sick I become emotionally unhinged, and I was unable to slam all the doors and batten down the hatches to keep my heart out of harm’s way.  Or healing’s way, really.

I don’t think my mother ever beat me with a coat hanger likeJoan did Christine.  She preferred the fly swatter: it didn’t leave marks.

I just so relate to Christine’s conflict when viewing her mother’s glamorously fitted-out dead body: she really did love her, and yet she was so thankful for the pain to be over.

Now I finally  “get it,”  that a narcissistic person can want to have a child so that a) they have someone who HAS to love them; b) they have someone whom they can manipulate any way they want to, and whatever the outcome, it’s the child’s fault (in the narcissist’s mind).   But c) to their dismay they find themselves feeling threatened by the child’s beauty/talents, and feeling compelled to compete with them, whatever it takes.  Therein lies the trap.

I was interested to see that “Mommie Dearest” made a point to cut her two adopted children out of her will.  That took a lot of forethought and planning, more than I would expect out of your average narcissist.  But then Joan Crawford wasn’t your average narcissist.  What she did not foresee was that her brilliant and talented daughter Christine would write a memoir called Mommie Dearest that would become a hit movie starring Faye Dunaway.   That certainly turned out to be one case where outliving one’s abuser was the first step in sweet revenge.  The second was writing the book.

Daily Prompt: Nightmares

Dearest Readers, I almost never lack for blogging fodder; but today I am feeling a bit ill, so I am going to latch onto the WP Daily Prompt as an opportunity to showcase a particularly nasty nightmare I had some years ago.  It was recently published in the “Noir” eZine Close 2 the Bone.  The Daily Prompt peeps would love it if I were to interpret this dream for them; unfortunately, the dream speaks for itself and needs no interpretation.

N.B. It is my usual policy NOT to post TRIGGER WARNINGS but since this nightmare is truly terrifying, I am making a one-time exception.  And now, without further ramblings from yours truly, I present my scariest nightmare.

Vascular Surgery

There’s a good reason women make the best surgeons, she thought.  Quick, deft hands, single-pointed concentration, focus.  She thought of the women jet engine mechanics she had met in the Air Force.  Not that she had been in the Air Force; but in the course of her duties as a civilian surgeon under contract, she had met them.

Now, reining in her reverie, she was intent on the task at hand.  Drat this light, she thought.  She really needed a more direct light source, but one has to work with what one has at hand.

Slowly, painstakingly, she drew the outlines with a surgical marker:  carotid triangle; carotid vein;  carotid artery.  This, the artery, was what she wanted.

She steadied the syringe she had readied with an oh-so-fine 27-gauge needle.  2% lidocaine with epinephrine should be enough analgesia for comfort, and enough epinephrine to ensure a relatively bloodless field.  She couldn’t help chuckling: bloodless indeed.

Squinting in the insufficient light, she injected the layers:  first the skin, then the loose fascia of the neck; lastly, the layer surrounding the vessels of the neck, careful to avoid direct injection into the wall of the vessel, which might cause a spasm.

Now it was time to cut.  She picked up the number 11 scalpel and steadied her hand.  Carefully, carefully she opened the delicate skin of the neck, noting with satisfaction that the epinephrine had done its job.  There was no need for the tiny hemostats she had ready in case of superficial bleeders.  The next layer, the loose fascia, pulsated bluish, overlying the great vessels of the neck.  These she would blunt dissect with the larger curved hemostats.  She injected a bit more of the anesthetic, just to be sure.  No need to cause discomfort, which might result in unwanted movement.

At last the artery was exposed.  She marveled at its pulsations, at the tiny arteries that nourished the big one itself, and the miniscule veins that issued from it, carrying its waste into the larger system of veins, to be cleansed by the liver and kidneys downstream.

Holding her breath, she slid the first hemostat, jaws open, under the artery.  Clamp.  The vessel, trapped in the jaws of the hemostat, stopped pulsing abruptly.  There was no going back now.  Now the second hemostat, exactly one and a half centimeters below the first: clamp.  She raised the surgical scissors, poised for the definitive cut between the clamps.

Tilting her head to see better in the mirror, she cursed the dim light in that bathroom again.  And then, the definitive cut!  In a single motion, she swiftly removed the two clamps and was instantly drenched in red liquid.

A scream of agony split the night as she sat bolt upright in the bed, heart pounding, drenched in sweat, clutching the sodden bedclothes as she struggled, locked in the arms of the Angel of Death like biblical Jacob.

Frantically clutching her throat, she rushed to the bathroom, the very same bathroom, and strained toward the mirror in the same dim light.

Nothing.  Her throat, graceful and bluish white as ever, shone back at her from the reflection.

Sucking in a deep gulp of air, letting it out in a sigh that brought the dog running, she splashed water on her face and neck, toweling off the sweat.

“It’s OK, buddy,” she whispered to her whining canine companion. “Just another nightmare.”  The dog smiled anxiously, wagged his tail tentatively, and licked her calf.  She reached down and patted his faithful head.

“Good thing I have you, she murmured.  Stripping off her sweat-soaked nightgown, she rinsed off in the shower before throwing on a fresh one.  She sank into the recliner with a book: sleep would not visit again, not tonight.

© Soul Survivor 2013 All Rights Reserved

After the Hypomania Attack

Now I am exhausted.  I’m trying to do some research for an article to post here, but my brain won’t work.  I have to force myself to read each word, and then I can’t put the words together; and if I can, they seem meaningless.

What happened?  Only a few hours ago I was all fired up, making lists of topics to write about, designing an actual syllabus that I wanted to cover.  I still love the idea, but even the act of typing is wearing me out.

That’s how it is with me.  I guess it’s called ultra-rapid cycling.  Rapid cycling means you switch between depression and hypomania/mania several times a year.  Ultra-rapid means more often than that.  I think there’s even a term for people like me, who cycle several times a day.  It’s really a drag.

I did manage to do some reading on circadian rhythm and bipolar, and sure enough, there’s a gene (or more) that regulate circadian rhythm, and if you take mice that have been designed to have mutations on those genes, their circadian rhythm is messed up.  If you then give those mice lithium, they go to sleep and wake up when they’re supposed to.  So the authors concluded that there could be a connection between genetic malfunction of circadian rhythm and bipolar illness, which may explain the sleep problems many bipolar people have.  Maybe if I was one of those mice I could get some sleep, because the lithium does help with the cycling, or at least with the emotional reaction to the cycling, and that’s a good thing.

I also found out that I’m probably Bipolar I instead of BP II, because when I was untreated and working nights, I was also going to 6 am aerobics class, then going skiing for a couple of hours, then riding my horse for a couple of hours, then going back to work, and sometimes taking a nap.  I have never held a job for more than two years in my life, because they have all ended the same way:  I knew way, way, way more than the people in charge, and it always came down to “I quit/you’re fired.”  And I have never had a successful relationship either.  They’ve all ended in different dramatic ways, though, even though I don’t consider myself a drama queen, particularly.  The article said that BP I is characterized by hyperactivity, grandiosity, dysfunction at work, and dysfunctional relationships.  Oh, and hypersexuality.  That was fun, but since the relationships were fucked up it was just another battleground.  So I guess I’m BP I.  It was obscured, I think, by the treatment-resistant BP depression I had before rTMS.  Not that I’m no longer depressed; it’s just that the volume has been turned down on it (thank G-d), and now I can see all the other stuff that had been overrun by the enormity of the depression.

Ah me.  I am so tired, and yet I can’t sleep.  I think I might watch a movie, since I finished the four-volume set of Mary Stewart’s wonderful series on Merlin and the rise and fall of King Arthur.  Maybe tomorrow I’ll be coherent again, and get a decent start on what I hope to write.

Sleep PTSD

Michael Jackson died of sleep.  More correctly, he died of trying to get a good night’s sleep.  Notice the expression:  Good Night’s Sleep.  Not a Bad Night’s Sleep, or even a Night’s Sleep.  A Good Night’s Sleep.  That is important, and I’ll tell you why later.  First I have to say that thankfully, the only thing I have in common with Michael Jackson is off-the-charts insomnia.  Michael Jackson was a sad, sorry, probably bad, person.  He was a great singer, a brilliant choreographer and dancer, an insomniac, and a pedophile.  He was horribly abused as a child, but that does not excuse his pedophilia.  Now I am ranting about Michael Jackson.  I will stop now.

I don’t know.  Maybe I do have something else in common with MJ.  I think something happened to both of us when we were little children, before the age of talking.  I have noticed in my life as a pediatrician and specialist in child abuse, focusing on child sexual abuse, that things that happen to preverbal children often cannot be healed, because there is no way to access them.  Sometimes you can get to it through modalities like hypnotherapy and NLP; I’ve done them both.  In fact, I’m a certified NLP practitioner, and during my year’s training I had many hypnotherapy and NLP sessions focused on my inability to sleep, and all of them made sense, and none of them worked.

You see, I am a professional non-sleeper.  When I was a child I often took a book and a flashlight with me under the covers and read till dawn, then went out to enjoy the morning birds’ chorus until it was time to go in the house and pretend I’d been asleep.  Not sleeping was a sin, in my house.  “You go to sleep right now!”  As if that were something voluntary.  I don’t know, maybe it is, for some people.

Sometimes I would get so scared at night that I would cry, and my dad would sometimes come in and make me “an Army Bedroll.”  (He is a World War II veteran.)  He would make me a tight cocoon with my covers, a comforting blanket embrace.  Then he would like down on the floor next to my bed and fall asleep.  He can sleep anytime, anywhere.  How I envy that.  I would listen to him snore, and find myself awake in the dawn, having slept soundly, and he had gone back to bed with my mom.  (For the record, I will say here that my father never, ever did anything that could be remotely considered to be inappropriate with me.  Ever.)

From the Army Bedroll I learned to make a mummy case out of my bedding.  I would get all the covers tucked under me as tight as I could, including over my head.  I do not know how I breathed, but since I am still alive that is proof that I did (hmmm, maybe my brain dysfunction is due to chronic nocturnal hypoxia).  This seemed to work for a while, but soon it wore off and I found myself just lying there mummified until early morning, when I would drift off to sleep until the alarm clock of my mother’s screech “Get up, it’s time for school!” would wake me and I would struggle out of my tangled prison.

(Aside: When I was ten I got hit by a car and spent a week in the hospital in a minor coma.  When they moved me into a regular room my parents came to visit.  I was trying to get some sleep, so I had mummified myself.  I was rudely awakened by my mother’s shrieks when she saw me lying there with the white sheets over my head.  I still get a satisfied snort out of that.)

The hormonal armageddon of puberty seemed to bring about a welcome shift in the sleep department.  Instead of being permanently wired, I became permanently sleepy.  That was nice.  I had a few years’ respite from the night-time nasties.

Then I ran away from home, and endured a series of nocturnal intruders in my bed.  No more sleeping at night for me.  Night was not a safe time to sleep.  It was a time to be vigilant.  And so my nocturnal PTSD reawakened.

As those of you who read my blog with any regularity know, when I am not writing about electric toilets or outhouses, I generally write about my own boring alphabet soup of psychiatric diagnoses: BP, PTSD, OCD (what, I haven’t written about that one yet?  Oversight.  Note to self.), ASD, MDD, blah blah blah, boring.  I’m just so sick of it.  I just want to go back to work and have fun being a doctor like I used to, not sit around being ashamed of my life, the way it’s turned out.

Yes, I am ashamed that I have to take four different kinds of medicine in order to fall asleep (read: pass out from drugs).  Seroquel, which also helps me not feel anything the rest of the time; clonazepam, which helps with the night terrors; lorazepam, which helps calm me down so I don’t leap out of bed and run out the door if I hear a noise; and zolpidem, which has recently had some very bad press in the medical literature, but since I don’t seem to be able to sleep without it, and since bipolar disorder is known to be worsened by lack of sleep, I am stuck.

I just read a great article on how to retrain yourself out of insomnia, using a combination of NLP and DBT techniques.  It looks like it would work for anybody who has “normal” insomnia.  The problem is with me, sleep is associated with being raped, so I don’t think it’s going to work.  I’m going to give it a try, though.  Nothing to lose but a few drugs, and a great deal to gain.

Donut Hole? Black Hole!

So after a two-year long low-grade struggle with the  American Social Security system, which ground through the process of initial rejection, denial of my appeal, and then finally a cameo appearance before a federal judge, I am Officially Disabled.  I was Disabled before that, according to my “Own Occupation” disability insurance policy (which was the only good financial decision I have ever made;  it has literally saved my life), but that applies only to the practice of Pediatrics and Adolescent Medicine and does not apply, say, to “Greeter At Walmart.”  Coincidentally, the Walmarts in my area have fired their greeters.  Perhaps the sales of Ol’ Roy Dog Food was flagging, and they needed to create a few more desperately poor elderly who might be able to spring for the 33 cent cans.  (Damn it, why does the “cent” sign no longer show up on keyboards?  Another of my conspiracy theories: the government is going to melt down all the pennies for the copper.  Think about it: we are walking around with FORTUNES worth of precious metals in our pockets and don’t even think about it!  N.B. it is a federal crime to melt down pennies, in case the idea should enter your head, as it did mine.

Where was I?  Oh yes. Normally when one gets Social Security Disability, there is a two-year waiting period before you can get Medicare health insurance.  So if you are trying to live on the approximately $1000 per month that most people are rolling in on SSD, what are you supposed to do in the meantime?  Medicaid, I guess, if you qualify.  But if you don’t qualify because your spouse had the good fortune to land a part-time job at McDonald’s with no benefits, well, you are just shit out of luck.  There is a very hole-y network of nonprofits that try to help people in this situation, but the need far exceeds the demand; thus we have an increasingly sick population, growing sicker all the time.

Should you happen to live through two years of being uninsured, then you get Medicare!  Yay!  I was extra lucky: because the Social Security system denied my claim automatically instead of looking at it, the judge ruled that my Medicare eligibility was up for “time served,” to begin not only immediately, but retroactively.  I got my hearing in December, and my benefits started ticking the previous October.  Confused?  Me too.

Strangely enough, the Social Security system does not give you a choice about federal insurance plans.  Previous to becoming Officially Disabled, I had a fairly expensive but pretty darn good plan through the Federal High Risk Pool, which is YES, PART OF OBAMACARE, which made it possible for me to get insurance after I had been denied by private insurers.  It was a standard choose-your-own deductible, then copays for doctor visits and 80-20 for hospital stuff up to a reasonably low out-of-pocket, which I found quite livable.  The drug plan was good, rarely demanded precerts, and had pretty standard copays.

And then.  And then….I am suddenly catapulted into the murky and confusing world of Medicare, because if you’re on SSD you have to be on Medicare. So at first gasp it doesn’t look too daunting:  there’s only part A, B, C, and D to worry about finding providers for.  I said to my therapist, whose idea this whole rat’s nest was in the first place (thank you, B__), um, don’t you think I should go and see a social worker to help guide me through the system?  Oh, no, she chirps, just call up the AARP.  They’ll walk you through it.  They have the best supplemental plans.  Oh. Er, what’s a “supplemental plan”?  That’s Part C, which pays for doctor visits, and Part D, which is your drug plan.  Parts A and B have to do with hospital care.

OK.  So I get my Medicare card, which automatically means my Federal Risk Pool insurance is cancelled.  So now I have to QUICKLY do something about transferring pharmacies, because I have my brand-new Part D card for medicines, and they have a mail-order pharmacy through which you can get three months’ worth of medicine with only one copay instead of three.  YEE-HAH!  So, off I go on the merry-go-round of chasing down doctors’ assistants and nurses to call my prescriptions in to the new pharmacy, because no, you CAN’T just transfer them from the one you already have.

One of my meds, the one I use to digest all my food with because for some reason my body doesn’t make those enzymes, took FIVE phone calls from the long-suffering physician assistant to get it right.  Ay-ay-ay, I’m having visions of chimpanzees in puffy white caps pouring pills into bottles.  Not encouraging.  So finally they managed to get everything right, and in the meantime I’m surviving on my hoard of meds that I brought back from Israel in October.  Had it not been for them, I would have been up shit creek without a paddle.

So the nice lady calls from the pharmacy and we go over the Rx’s one last time to make sure she’s got them right, and then we place the order, putting all the copays on my American Express Card that gets the mileage points for every dollar you spend, and…”Oh dear, are you sure you want this entire order?  It puts you into the Donut Hole right away.”  The what?  Donut Hole?  Isn’t that something you get with coffee?

Oh no.  That’s what you get with Medicare when the retail (I repeat, RETAIL, because that’s the part they don’t explain to you up front) expenditure hits $1950 (plus or minus a bit, I don’t have it in front of me.)  So here’s how it works:  You pay a premium of about $40 per month for prescription drug coverage.  When you buy a prescription, you pay a pretty normal copay based on a tiered system, anywhere from $3 to 1/3 of the actual cost of the drug if it is a specialty drug.  After the plan has bought you $1950 worth of drug, then the plan pays NOTHING until you have paid $4,750 out of your pocket (if you have one), at which point the plan goes into hyperdrive (“Catastrophic,” they call it, just for drama) and you pay almost nothing until the whole sonofabitching thing resets itself at the top of the year.

So what, I ask in my innocence, do you do if you do not happen to have nearly $5000 kicking around?  Oh, Medicare has a program for “Assistance,” but almost nobody qualifies for it.

There are community programs (in some communities) that help.   If you are indigent according to the Medicaid standards, you can just get Medicaid.

Otherwise you’re screwed.  Many disabled and elderly persons find themselves with too much money to qualify for assistance programs but not enough money to buy their medicines.  So let’s see, what happens when someone can’t afford their expensive blood pressure medicine and (G-d forbid) have a stroke?  Well then, Medicare Parts A and B kick in then.  No worries there, got you covered.  So if you can’t afford to take your medicine, don’t fret, because Big Government is gonna take care of you in the hospital after the heart attack you get when you can’t afford your Plavix (very expensive anti-platelet drug that sounds like a kind of mouthwash).

So what am I going to do about this?  Luckily, I just got one of those packets of checks from the credit card company where I can write myself an interest-free loan for a year.  That’s what I’ll do, because I don’t have any other choice.  And I’ll pay it off in installments over the year.  I’m damned grateful to have opened that packet instead of chucking it directly in the paper recycle like I usually do.  Must have been that guardian angel again.

And speaking of guardian angels, the one that convinced me back in 1992 when I was hale and healthy except for the occasional skiing wreck, and making what was for me a freakin’ lot of money, THAT guardian angel who convinced me to sign on the bottom line of a very expensive, very comprehensive private disability plan….THAT guardian angel gets a set of gilded wings from me, today and every day, because if not for that policy I would be, well, to tell you the truth I would probably be dead, because I would not have been able to support both my life and my diseases.

My blessings are many, many, many.  This whole SSD process has opened my eyes to the heinous and disgusting devaluation of the disabled and elderly that has become a legacy of shame in this country.  I want to do something, but don’t have a clue where to begin.  I can’t even go to Washington and set myself on fire on the White House steps because I’m terrified of fire.  But one thing is certain: with the aging of our population, if Medicare doesn’t get fixed, there will be many of our ill and elderly going not only into the donut hole, but into the black hole, never to emerge.

A Quandary: Mental Illness, Public Safety (reblogged from A Canvas of the Minds)

A great post from Angel Fractured. I, too, am concerned that there seems to be a funnel developing around this series of mass killings, a funnel leading right down the drain and into the nut-hatch (sorry, DeeDee). For crying out loud, that last one didn’t even have a DSM diagnosis: just a lot of conjecture about a “weird kid.” Now they’re going to have to put “weird” into the DSM, just to fit him in. And all “weird” kids will be watched for signs of impending violence. Dart guns filled with Haldol will be trained on them at all times.

For as long as I have been capable of forming thoughts, I have thought that the aim of society is homogenization. Anyone who sticks out in a crowd is apt to get labeled and hauled off quietly (or not) to the looney bin.

It’s a good thing Big Brother has been a bit slow on the draw. He’s missed some important threats to society like Einstein, Beethoven, Sylvia Plath, Charles Dickens, Virginia Woolf….but on the other hand, if I had to go hang out in the nut house with people of their (and OUR) ilk, it might not be so bad, assuming the food was good.