How Stigma Compromises My Medical Care

I don’t know what to do.

I can bet that most of you will say, “Just be yourself, Laura.  Fuck ’em if they can’t relate to you as the awesome human being you are.”

Well, yeah.  I appreciate that.

However.

I have this service dog, see, and she’s neither little nor cute.  Well, she’s cute to me, but a 75 pound Belgian Malinois is automatically not cute to most people, especially the uptight assholes that tend to go into “the medical field” these days.  Even my therapist does not think she’s cute.  Even when Atina climbed into her lap and gave her kisses, because she could see that the dear lady was clearly in distress, it did not help.  My poor therapist could do nothing except beg me to get the monster off of her, which I did, and Atina reluctantly obeyed but was still of the opinion that the lady needed her attention.

On the flip side, if Atina perceives that someone is potentially a threat to me, she stations herself sideways in front of me, giving the unsafe party the hard-eye, which is dog language for “come over here and make my day.”

This is why I have a Service Dog:

I have a perfect storm of Asperger Syndrome, PTSD, and Bipolar illness.  My judgement about people is shot to hell.  I lost it on April 22, 1970, the very first Earth Day, when I was drugged, dragged into a dark basement, and brutally robbed of my virginity.  That, and the prolonged months and years of running from one frying pan into another fire, robbed me of my ability to read people’s intentions.  I think it’s because I simply dissociate every time I have to interact with other people.  So now that I’m on the far side of sixty and no longer give a shit, I’ve stopped making myself do painful things, and aside from the inconveniences of not having friends, family, or a partner when I have a medical emergency, I feel much better.

Have you noticed that sometimes your fridge, washing machine, microwave, computer, and automobile all crash at the same time?  So now you have to get a ride to the Big Box store, to the bank to get quarters for the laundromat, and a ride back and forth to the laundromat, to the convenience store for ice until the new fridge comes, and while you’re on the phone with Tech Support your phone is giving your ear a second degree burn and probably giving you brain cancer as well….

This is what I call a Wear Cycle.  When everything wears out at once.  It generally falls out when you’re between jobs, or just before those gift-giving occasions, or your wedding.

So as some of you are aware, I am in the throes of a Wear Cycle of the most annoying sort.  My body is falling apart.  I thought it just needed a tune-up and maybe a brake job, but it turns out to be the transmission, the universal joints, the head gasket; and every time they fix one thing, another one turns up bad.

The result is a seemingly endless procession of doctors, PAs, Nurse Practitioners, lab techs, snotty Front Office People, sadistic MRI techs who put me in Positions Of Stress for upwards of twenty minutes while further damaging my hearing with the various hammerings and clangings of that infernal magnetic tube, being told that I need surgery for this, surgery for that, and they all worry about my blood pressure.  Surely not!

You must understand that my relationship with The Medical Field is a mine field.  The minute I leave my van in the parking lot of the doctors’ building, the hospital, the lab, I dissociate.  I am terrified.

But you’re a doctor, you say.  How could you not be comfortable in this oh-so-familiar milieu?

That’s just it.  I’m all too familiar with it.  I know exactly what goes on behind the scenes, and it disgusted me while I was in it, and it terrifies me now.

Because I am…one of those patients.

You know, the aging female with so many complaints it throws your schedule off, and she’s slight dotty, and might be amusing if you weren’t running so far behind, and of course–of course, she has to be a doctor, at least she says she is, and she does know the lingo…and she has Medicare and doesn’t seem to have a job, so she must be disabled, but for what?  She’s not saying, and if you ask, she’ll say something vague.

I know this, because I’ve been on their side of the white coat.

So imagine what the reaction would be if they walked into the exam room and there I was with my Service Wolf Dog.

The entire visit would revolve around whether the person who Works In The Medical Field was comfortable with the Doggess, and whether she thought they were Safe.

And of course she would pick up on my instant dissociation because I dissociate whenever I run into One Of Those People, because of the abuse I suffered when I was working In The Medical Field, and the abuse I have suffered as a patient dependent upon these people’s power.

And the shame of being disabled, which is, according to the ancient tenets of The Medical Field, weak; and even worse, crazy.

I just rediscovered a former mentor who was hugely influential to me when I was a medical student.  She was my supervisor in the Public Health Clinic.  We became good friends, and she helped me crystallize my medical practice world view, which is based on compassion and empowerment of the patient to take charge of her own health and well-being.

It turns out that this amazing woman had a terrible crisis, which lead to a suicide attempt.

Rather than supporting her and helping her to rebuild her life, the medical establishment brought criminal charges against her for lowering the esteem of the medical profession in the eyes of the public.

They drove her out of the profession.  It didn’t matter to them that this heinous act might push her over that very precipice she had dragged herself back from.

It didn’t matter that they were persecuting one of the finest physicians on the face of the earth, for the crime of being human.

All that mattered was that she had “failed” to complete her suicide.  If she had died, she would have been another tragic physician suicide; but since she managed to survive, she was pronounced a disgrace to the profession.

Fortunately she is a strong and resourceful woman.  She cleaned houses in order to feed her children.  She struggled her way back onto her feet, and reinvented herself.  Blessed be.

So I know very well what the result would be, even if the Doggess didn’t bite the Assistant (you hardly ever get to see The Doctor anymore):  “Did you get a load of that lady with the dog?  What a crock!”

Yes, fuck ’em.  They’ve no right, legally or otherwise, to prevent me from having my dog with me.  She’s Durable Medical Equipment, just like a wheelchair.

The only thing is…being mentally ill automatically discredits anything I say.  I’ve tried it both ways.  And unfortunately, whenever I’m honest and disclose that I have DSM diagnoses, I get my case dismissed.  No contest.  No service.  Goodbye, and put some ice on that.  It will feel better in seven to ten days.  No need for follow-up.

In awful contrast, when I have withheld my diagnoses, it’s all sympathy and MRIs.

Hell, I even got a few tramadol tablets for my torn shoulder, when I begged the doctor because my left wrist is in a brace awaiting surgery and my right shoulder is so painful that I can’t even get out of bed without fainting if I forget and try to push myself up with my right arm.  (How do I get out of bed?  By wriggling on my tummy until my feet touch the floor.)

You think she would have given me that prescription for thirty, no refills, if she knew that I’m bipolar?

Nope.  Bipolar people are categorically drug seekers.  Even though I asked for tramadol and not Percocet.  Drug seeker, no way.

I’m stuck.

I’m terrified of those places, and I need my dog.  But the presence of my dog would set off such alarms in the mind of The Medical Field Person that my actual medical issues would be eclipsed by Prejudice.  Stigma.

If I showed up in an electric wheelchair, they would be all ears.

But a crazy person with a dog?

So Long, Pluto

By one of those curious twists of the state of time, space, and matter, it seemed good in my eyes on Thursday night to seek the reliable shelter of a State Park, in which to interrupt my trajectory while hurtling across the awe-inspiring hugeness of the State of Texas.
_________________________

A Texan went to visit Ireland.

He saw an Irish farmer out working in his potato field, got out of his rented Cadillac and approached the fellow, and hollered:

(Texas accent): Say, pal, is this your land?

The Irishman cuts the engine on his ancient tractor, removes his battered hat, scratches his balding red head, mops his pate with his tatty handkerchief, jams his hat back on.

(Irish accent, with pride):  Sure and it is, Mester.  Been in my family for a hunnerd years. (Beams, gap-toothed, at the Texan, who is now standing in the dirt road in his cowboy boots, dove-grey Western suit, string tie, rocking with his thumbs hooked over his tooled leather belt with its garish silver buckle.  Door of Cadillac stands open.)

Texan:  Why, that’s mighty fine, mighty fine.  How much land have you got, if you don’t mind my askin’ ? (Chews a toothpick)

Irishman, with pride:  No, I don’t mind a wee bit, sence you’re askin’.  You see that tree stump off there in the distance?  Why, our land goes all the way from that stump, back aways past the house and farmyard, barns, horse pasture, to that stoon fence, ye can just barely see it from here.  (Scratches head again.)

Texan:  I declare.  That’s a right purty leetle piece.  You know, Farmer, back in Texas where’n Ah come from, Ah kin git in mah truck an drahve from sunrise to sunset, and Ah will still be drahvin’ on mah own land.  (Air of superior self-satisfaction)

Irishman: (Shaking head sadly)  Ach!  I had a truck like that meself, once.
__________________________________

The twist of fate is made curious by a happenstance: the first Texas State Park I spied on my map happened to be full, but the sweet and adorable Mescalero Apache ranger at the park office told me that there was plenty of room at the next park down the road, which happened to be right down the road again from the famed McDonald Observatory, home of the second biggest and most scientifically unique telescope in the world.  Yowie zowie, I love space stuff!  And my knowledge base is terrible, so I got all hot and sweaty at the thought of increasing it in such a majestic way.

I scuttled down the ranchy road, reaching the park just about closing time.  Picked myself out a choice spot and settled in, nervous about the javelinas (pecaries, a nasty species of wild pig that stinks and had it in for dogs) and wild boars, that can tusk up a dog or small human faster than you can say “Old Yeller.”  We have seen a lot of their poop, fresh, in our campsite, and if they only come sniffing around of a night, that’s fine, as long as they respect the rules.

The next day I mounted Old Jenny and climbed up the twisty road to the Observatory.  They were having a program on Sun Spots, but since I regularly check the Solar Weather I wasn’t so interested in that.  I wanted Deep Space.  Wormholes, Dark Energy, you know, cool space stuff.  I wanted to see the giant telescopes, but the next available date is a couple of weeks from now and I don’t plan to be here then.  Plus it costs $115, which would be money well spent, but that’s a week’s worth of camping money, so.

But they have “Star Parties,” interpretive viewings of the heavens both aided by normal size telescopes, and with the naked eye, so that one comes away with greatly augmented knowledge of celestial bodies and visible galaxies and nebulae (one, beside the Milky Way: the Orion Nebula.  I was hoping to get a glimpse of the Horsehead Nebula, but you need a higher power telescope for that).

The McDonald Observatory is located on top of a mountain situated above the Sonoran Desert, and is one of the darkest places in the world (at night, and not a cave).  Thus, I was tremendously exited at the prospect of guided stargazing in that spectacular location.  I bought a ticket for $15 and returned to my campsite to do a bit of dog hair mitigation and await the appointed hour.

We got there early (“we,” unless otherwise noted, means my dog and I) and cooled our heels till show time.

Big tour buses pulled up.  I noted them, then blocked them out of my consciousness.

With the approach of show time, I took Atina out for a potty break and put her in the van, ignoring her rueful expression.  It’s tough being a dog.

When I entered the lobby my heart went splat on the floor, then went into a run of sinus tachycardia.  Panic attack. 

Hundreds of lovely young people wearing Texas Tech and University of Texas and Texas A&M sweatshirts milled and shouted in the lobby.

I bailed into the gift shop, which was geared toward children, with book after book after book on the constellations…fer krissake, how many books on the constellations do they need?

I perused the wall charts, the glow in the dark universes that I stuck on my erstwhile son’s ceiling, to give him something to do while he wasn’t sleeping….and noticed something odd.

There were only eight planets.

That is wrong.  There are nine.  Everyone knows there are nine planets!

Then I remembered: Pluto has been decommissioned as a planet, because it is made of frozen water and no rocks.  You have to be made of rocks to be a planet.

It’s not fair.  Other planets are made of weird shit, so why, after all this time, could they not make Pluto at least an HONORARY planet?

I bought a placemat of the Periodic Table, which has picked up a number of new elements since the last time I studied it, and bolted for my van.

The rest of the evening was devoted to doctoring my crushing panic attack.

It wasn’t merely the prospect of standing in loud lines with droves of college students.

It was the sudden realization that I, too, have been decommissioned, like Pluto, and for the same reason: lack of a solid core. 

In our last bitter conversation, my son made it clear that I am not the mother he wanted…or, in his opinion, needed.  He needed stability.  He needed a rock core, not just some object made of frozen gasses.

Pluto and I are no longer welcome in his universe.

Well.

Since I have cried all the way across the enormous state of Texas, I have very clean eyes.  It seems that tears do not simply run out.  The body just keeps making more.

And since my decommission I have had plenty of time to reflect on the universe of mistakes I have made in my life.  Mistake after mistake after mistake.

And all boiling down to what?

Well, at least I have money, for a couple more years, to pay my expenses.  That’s a plus.

See, me and Pluto just keep going around and around and around, but the end is interincluded in the beginning, so there is no getting off this particular merry-go-round.

So me and Pluto and Atina will go ’round until it all winds down and it’s time to bail out.  That’s what happens to stars before we blow up and become Something Else.

So Long, Pluto

By one of those curious twists of the state of time, space, and matter, it seemed good in my eyes on Thursday night to seek the reliable shelter of a State Park, in which to interrupt my trajectory while hurtling across the awe-inspiring hugeness of the State of Texas.
__________________________________

A Texan went to visit Ireland.

He saw an Irish farmer out working in his potato field, got out of his rented Cadillac and approached the fellow, and hollered:

(Texas accent): Say, pal, is this your land?

The Irishman cuts the engine on his ancient tractor, removes his battered hat, scratches his balding red head, mops his pate with his tatty handkerchief, jams his hat back on.

(Irish accent, with pride):  Sure and it is, Mester.  Been in my family for a hunnerd years. (Beams, gap-toothed, at the Texan, who is now standing in the dirt road in his cowboy boots, dove-grey Western suit, string tie, rocking with his thumbs hooked over his tooled leather belt with its garish silver buckle.  Door of Cadillac stands open.)

Texan:  Why, that’s mighty fine, mighty fine.  How much land have you got, if you don’t mind my askin’ ? (Chews a toothpick)

Irishman, with pride:  No, I don’t mind a wee bit, sence you’re askin’.  You see that tree stump off there in the distance?  Why, our land goes all the way from that stump, back aways past the house and farmyard, barns, horse pasture, to that stoon fence, ye can just barely see it from here.  (Scratches head again.)

Texan:  I declare.  That’s a right purty leetle piece.  You know, Farmer, back in Texas where’n Ah come from, Ah kin git in mah truck an drahve from sunrise to sunset, and Ah will still be drahvin’ on mah own land.  (Air of superior self-satisfaction)

Irishman: (Shaking head sadly)  Ach!  I had a truck like that meself, once.
__________________________________

The twist of fate is made curious by a happenstance: the first Texas State Park I spied on my map happened to be full, but the sweet and adorable Mescalero Apache ranger at the park office told me that there was plenty of room at the next park down the road, which happened to be right down the road again from the famed McDonald Observatory, home of the second biggest and most scientifically unique telescope in the world.  Yowie zowie, I love space stuff!  And my knowledge base is terrible, so I got all hot and sweaty at the thought of increasing it in such a majestic way.

I scuttled down the ranchy road, reaching the park just about closing time.  Picked myself out a choice spot and settled in, nervous about the javelinas (pecaries, a nasty species of wild pig that stinks and had it in for dogs) and wild boars, that can tusk up a dog or small human faster than you can say “Old Yeller.”  We have seen a lot of their poop, fresh, in our campsite, and if they only come sniffing around of a night, that’s fine, as long as they respect the rules.

The next day I mounted Old Jenny and climbed up the twisty road to the Observatory.  They were having a program on Sun Spots, but since I regularly check the Solar Weather I wasn’t so interested in that.  I wanted Deep Space.  Wormholes, Dark Energy, you know, cool space stuff.  I wanted to see the giant telescopes, but the next available date is a couple of weeks from now and I don’t plan to be here then.  Plus it costs $115, which would be money well spent, but that’s a week’s worth of camping money, so.

But they have “Star Parties,” interpretive viewings of the heavens both aided by normal size telescopes, and with the naked eye, so that one comes away with greatly augmented knowledge of celestial bodies and visible galaxies and nebulae (one, beside the Milky Way: the Orion Nebula.  I was hoping to get a glimpse of the Horsehead Nebula, but you need a higher power telescope for that).

The McDonald Observatory is located on top of a mountain situated above the Sonoran Desert, and is one of the darkest places in the world (at night, and not a cave).  Thus, I was tremendously exited at the prospect of guided stargazing in that spectacular location.  I bought a ticket for $15 and returned to my campsite to do a bit of dog hair mitigation and await the appointed hour.

We got there early (“we,” unless otherwise noted, means my dog and I) and cooled our heels till show time.

Big tour buses pulled up.  I noted them, then blocked them out of my consciousness.

With the approach of show time, I took Atina out for a potty break and put her in the van, ignoring her rueful expression.  It’s tough being a dog.

When I entered the lobby my heart went splat on the floor, then went into a run of sinus tachycardia.  Panic attack. 

Hundreds of lovely young people wearing Texas Tech and University of Texas and Texas A&M sweatshirts milled and shouted in the lobby.

I bailed into the gift shop, which was geared toward children, with book after book after book on the constellations…fer krissake, how many books on the constellations do they need?

I perused the wall charts, the glow in the dark universes that I stuck on my erstwhile son’s ceiling, to give him something to do while he wasn’t sleeping….and noticed something odd.

There were only eight planets.

That is wrong.  There are nine.  Everyone knows there are nine planets!

Then I remembered: Pluto has been decommissioned as a planet, because it is made of frozen water and no rocks.  You have to be made of rocks to be a planet.

It’s not fair.  Other planets are made of weird shit, so why, after all this time, could they not make Pluto at least an HONORARY planet?

I bought a placemat of the Periodic Table, which has picked up a number of new elements since the last time I studied it, and bolted for my van.

The rest of the evening was devoted to doctoring my crushing panic attack.

It wasn’t merely the prospect of standing in loud lines with droves of college students.

It was the sudden realization that I, too, have been decommissioned, like Pluto, and for the same reason: lack of a solid core. 

In our last bitter conversation, my son made it clear that I am not the mother he wanted…or, in his opinion, needed.  He needed stability.  He needed a rock core, not just some object made of frozen gasses.

Pluto and I are no longer welcome in his universe.

Well.

Since I have cried all the way across the enormous state of Texas, I have very clean eyes.  It seems that tears do not simply run out.  The body just keeps making more.

And since my decommission I have had plenty of time to reflect on the universe of mistakes I have made in my life.  Mistake after mistake after mistake.

And all boiling down to what?

Well, at least I have money, for a couple more years, to pay my expenses.  That’s a plus.

See, me and Pluto just keep going around and around and around, but the end is interincluded in the beginning, so there is no getting off this particular merry-go-round.

So me and Pluto and Atina will go ’round until it all winds down and it’s time to bail out.  That’s what happens to stars before we blow up and become Something Else.

Jets Are Circling: War Trauma

Here I sit in my safe little corner of America.

But jets are circling overhead.

Why?

If I were back in Israel it would mean only one thing:  war.

Israel is a very tiny country, surrounded by hostile nations on all sides.

Our greatest love, as the Jewish People, is our Holy City, Jerusalem. 

Three times a day, in our regular prayers, and after eating bread, we pray:

“U’vanay Yerushalayim, ir ha’kodesh, bi’m-hayrah u’vyameynu, ahmein.”

And (please, God,) rebuild Jerusalem (and the Holy Temple that is the definition of Jerusalem,) the Holy City, quickly and in our days, amen.”

In times of threat, the Israel Air Force jets circle Jerusalem endlessly, protecting her from harm.  Jews, Christians, Muslims, all protected by the IAF.

No other air traffic flies over Jerusalem airspace.  If it does, it gets promptly escorted out by IAF jets.  Sometimes it’s an innocent mistake, but even a private plane owner (of whom there are very few) will find himself in big trouble for inadvertently flying over the Holy City.

The jets have left now but I’m still shaking.

I think of those unfortunate people who live in countries where jets overhead mean bombs and death.

During the 2009 war with Gaza, which is such a complicated situation that I can’t begin explaining it here, my windows were in just the right position to hear the mortars and missiles coming out of Gaza, and the bombs dropped on the tunnels and munitions dumps roaring, columns of smoke belching into the air as the cached explosives went up.

And I knew, each time, that innocent lives were being torn apart, killed, burned, limbs lost….And the jets circling, always circling, and the mortars going “whump…whump…”

One day I was sitting learning Torah in my yeshiva (house of Jewish learning, study hall), when the air raid siren went off.  We students did what we were trained to do: head for the nearest miklat, bomb shelter.

But when we got to the door of our yeshiva, we ran into a group of IDF soldiers.

“Where are you going?” They asked us.

“To the miklat!  What are you doing here?”

“We came to sit and learn.  That’s the best bomb shelter!”

So we all sat down to learn together.

But still, when the jets circle over overhead, my heart pounds, my mouth gets dry…

Phantom Limb Pain

There’s a crazy phenomenon that sometimes happens when a person loses a limb. The nervous system thinks the limb is still there, so that the person continues to have the sensation of having it.  I mean, to the point of the former owner freaking out because they want to put on a sock because the foot is cold, but the foot persists in not being present.  This is called a Phantom Limb.

But since the limb has really been amputated, the limb also feels the pain of that, and of the injury or disease that lead to the amputation.  This can become a terrible situation if the limb doesn’t get used to being amputated and settle down.  How can you relieve the pain of something that doesn’t exist?

I just realized that I am suffering from Phantom Limb Pain.

Some of my readers know that I am caring for my beautiful Belgian Malinois, Atina, who is dying of kidney disease.  She is now 19 months old, and starting to slow way down.  I’m enjoying her delightful self for now, and I will take care of her until it is time for her to go.

I just received the final pathology report.  It is terrible.

For those who don’t toss around medical terminology on a daily basis, let me give you your word of the day:  nephron.

A nephron is the basic operating unit of the kidney.  It has three parts, which all have different essential tasks in maintaining the balance of fluids and electrolytes (like sodium and potassium) in our bodies.  In addition, special cells called podocytes keep our serum proteins from leaking out.  These are the parts of the kidney that maintain fluid and electrolyte homeostasis, in a delicate and incredibly intelligent system of checks and balances.  Any disturbance of kidney function can lead to a disruption in the system, depending upon which area of the kidney is damaged.  And that can lead to illness and death.

Atina’s biopsy shows that 90% of her nephrons are fetal, which means that kidney development was arrested before three weeks of life.  The pathologist writes that this could be due to disease or toxins being transmitted to the pup through the mom’s milk.  The remaining 10% of normal nephrons are becoming ballooned out of shape from having to process all that pee by themselves, and their podocytes are starting to detach, which is why her urine is full of protein.  Soon those few functioning nephrons will die, and then Atina will die.

I stopped by the vet’s yesterday for another reason, and just for kicks had Atina stand on the scale.  She’s gained three more pounds…of fluid.

When I first got her, she weighed 55 pounds of skin and bones.  She looked like a sick cow.  With treatment and lots of love, she put on ten pounds and was looking and acting like a normal, healthy, happy, bratty adolescent Malinois.  I started her in Service Dog training and she was doing great.  I had this spark of hope…

Then she started looking weird and puffy.  Despite treatment, her blood pressure was sky high (another kidney function thing), and she went back to drinking gallon after gallon of water, and peeing like a waterfall many times a day, and even needing to go out at night sometimes.  And her weight keeps creeping up, and her appetite keeps slowing down…

I’m glad she’s with me, and that I’ve had the honor to be her very own human and caregiver, friend and mutual aid society.  We are passionately in love.  She’s asleep now, but if she knew that I am crying she would rush to my bed and throw herself on top of me, causing various injuries.  Since I know that they are love bites, scratches, and bruises, I take them in the spirit in which they were inflicted.  And once her initial exuberance settles down, she cuddles and kisses and lets me cry in her fur.

Aside from the love injuries, I have been injured in many ways since becoming Atina’s personal angel.

I needed a service dog to guide me through the next ten or so years of my life.  Instead I got a very sweet invalid dog, with whom I fell in love, from whom I will be parted very soon.

This beautiful sick girl of mine cost me $12,000 up front, and more than $10,000 in medical expenses so far.  I have used up most of my financial and emotional resources, and at the end of the day, I won’t have a dog, and I won’t have the money, and since even now I keep myself alive by force of will, Atina’s death may sever the thread I’m hanging on.

Everyone says, “Sue the bitch (who sold you the dog)!”  Easier said than done.

Yesterday I had a telephone consultation with an attorney from the State Bar Association’s referral service.  He listened to the “short version,” told me he had no experience with cases like this but would be happy to litigate it, outlined the essential steps, reminded me that his hourly fee is $210 (a bargain, actually), that the case would cost a minimum of $20,000 to litigate, that we would surely win, that the first thing he needs to do is to examine the purchase contact and look at some other things, and that in order to do so he needs a $5,000 retainer.

Phantom Limb Pain.

Before I became a disabled person, back in the days when I went to work every evening, relished in healing the sick, lame, and halt, and also in bringing home the bacon and frying it in the pan: if someone needed a legal spanking I had only to pick up the phone, and if my own attorney couldn’t do it, he knew someone who could.  Retainer fees?  Not a problem.  Not a question.  Not required!  Don’t even offer!  They knew I was good for it, and besides, they might need my expert witness services one day…or their kid might need to be sewed up on a Sunday… But now all I have to offer is

Phantom Limb Pain

as I am cut off from myself, and I can’t get back what is gone

I can feel it, even see it, but it’s gone

And now I have to beg some abogado, please, please

If you think my case is so straight-forward, please take it on contingency, or reduced fees, or even pro bono

I have Phantom Limb Pain, don’t you see

I’m not what I once was
I find myself in reduced

circumstances

I am among the lame and halt now
As one day you yourself might be

As odd as that might seem

No one ever dreams it will be them
Believe me, Mr. Esquire, Sir, The Hon.,

no one ever

believes that it can get worse

But it can get worse

And then it can turn into

Phantom Limb Pain

Holy Shit

It happened.

What I was waiting for, and dreading, and avoiding, and otherwise side-stepping.

The confrontation with my mother.

She started it.  She wanted to know if she had said or done anything to offend me, since of late I have seemed to be avoiding her.

She got that right.  All of it.

The only reason I am camping out in my father’s former studio, complete with no facilities, is that I gave up my gorgeous, wonderful life in Jerusalem to come and be with Dad in his last years.  I am immensely happy that I did that.  It gave a richness to Dad’s and my already very deep relationship that left a delicious taste when he departed, enhanced by the salt of my tears.

So, he having gone to his Place, I no longer have a reason to be here.  I am making plans to leave, and soon.

And when my mother asked a second time if I was avoiding her for some reason, the answer was “yes,” but of course I said “no,” because I knew what sort of scene would follow if I said “yes.”  So I said, “of course not,” while avoiding the laser gaze.

“How about a cup of tea?” She asked.  I obliged, and she made tea.  We sat down, and I wondered what in the world we were going to talk about.

“Well, are you still planning to…go galavanting around?”  She smirked.

“Are you talking about the RV?”  I am in the process of buying a small motorhome and living in it for who knows how long.  I have been a virtual gypsy all of my life, so I’d like to see what happens if I do it on purpose, with intention.

“If you’re talking about the RV, it’s in its final stages of the purchase.”

We chatted about the whole RV thing, and I allowed as how I would be back through here every 3 months or so, to check on her and see how things are going.  I didn’t tell her that the truth is, she’s showing signs of dementia, and I want to keep my finger on that pulse.

Oh, no, that isn’t necessary, to come all the way across the country to check on her.  She’ll be just fine, she says.

“Yes,” I said, “And I’ve also got a son…”  Didn’t get to finish that sentence.

“Oh, and where was he last week?  I thought he was supposed to come here for the weekend.”  My parents have always had this thing about my son, that he never took it upon himself to call or visit them.  They took it very personally.  God knows, if I took it personally that he never calls me either, I’d drive myself crazy.  That’s simply who is is: he’s an Aspie like his mom and dad, and if I want to talk to him I give him a buzz; he may or may not answer depending on what’s happening at the time.

“He’s at his father’s family reunion.”

“Oh yes, his father always made sure that he went to HIS family reunions.”  Not that WE ever had a family reunion.  No, I’m wrong.  Last year they had one, the family of my mother’s generation, but the children and grandchildren, all of whom are adults, were not invited.  By that I mean, they were explicitly told they were unwelcome.  Me too, and I thought it was a shame, but I don’t like to go places where I am not welcome, so I let that go.  BUT her side HAD had a family reunion, and none of us cousins and grandchildren were welcome.  So what’s to argue about?

Then came a volley of accusations on my part regarding whether my parents had bothered building a relationship with him, and of course she said they did, but I know for a fact not much. Perhaps she forgot how he came on birthdays, holidays, art show openings, and every other important happening on my side of the family.

Plus, I reminded her, he has a lot of cousins on his father’s side, and they are such a large family that having reunions is part of their tradition.

“Yes, of course HIS FATHER makes sure he has a good relationship with his family.”  Meaning, clearly, that it was MY fault that my son did not have a close relationship with THEM.

Then she started in on him in general, how he’s just inconsiderate, selfish, etc. etc.

That’s when I lost it.

I unloaded on her with both barrels, so to speak.  How she had no right to insult my son.  How the reason he doesn’t come around is because she belittles me right in front of him, and he won’t see his mother abused.

“Stop screaming,” she said, using her smooth persuasive courtroom voice (she is a guardian ad litem, which in her case means she specializes in taking children away from their parents).

By that time I was in a state I have never been in before.  Part of the gall that I have carried around with me for 61 years came pouring out.  I thought I was going to vomit.

“I am not screaming!  Every time I open my mouth you attack me with your sarcasm, your mocking, your belittling–you want to know why I avoid you, that’s why!”  My head felt like it was about to blow up.  My brains would spatter all over the spotlessly clean furniture.  Ever since my dad died she’s been compulsively cleaning the house, trying to rid it of his former presence.

“You stop your fucking screaming!”  She screamed, casting a furtive glance upward, worried that the three carpenters who were in the act of replacing the roof had heard.  I don’t know how the could not have.

“That’s it!  I’m done!  Good-bye!”  And I picked up my walking sticks, my dog behind me, and stomped though the gravel back yard, spewing obscenities that I’m sure the carpenters heard.

I made my way down the path to the studio, watching out for the knees of rhododendron roots that stick up out of the path, waiting to trip the novice or the careless.  I got “home,”–every time we move I tell my dog, “This is Home now,” so she will know to go “home,” if we get separated for any reason.  I guess this is more “home” than any of them, because it is my dad’s and he gave it to me.

I wonder if she’ll think of the motorhome as a home that has changes of scenery fairly regularly.  I guess that’s how it’s been for her anyway, except that she will get all territorial about this new home on wheels.

I grabbed half a joint and a little bit of wine, and sat out on the deck with my dog and watched the river for a while.

The Agony Of Pregnancy Loss

This is going to be another heavy hitter, Dear Readers.  Please consider whether this is good for you to read before proceeding.  It contains graphic descriptions of a miscarriage, surgery, and references to abortion.

I’ve given myself away, but then this is not fiction.

My medical school had an agreement with a VA (Veterans Administration) hospital, where third- and fourth-year medical students could rotate through and get some up-close-and-personal experience being on the front lines.  Rather than standing on a stool (if you were short like me) holding retractors in the operating room, we were taught to actually operate.

And in the medical wing, we learned by doing, and by working closely with the attending physician.  This was much better than standing at the back of a crowd of students, interns, and residents on ward rounds in the private hospital.

I had lots of harrowing adventures at the VA.  I loved it.  Everything was edgy and often dicey.  The patients were high morbidity.  The doctors were all foreign medical graduates, some of whom were the best docs I’ve ever worked with, and some of whom…well, I sure wouldn’t want them working on me.  You just never knew, from day to day, what you would end up in the middle of.

I loved surgery.  Part of that was Dr. Duy, a brilliant Vietnamese surgeon who taught me how to tie one-handed knots down in a hole (in those days, gall bladder surgery was done through an open incision, and you were literally working in a hole up to your wrist).  He taught me how to amputate a gangrenous leg–we had to do that a lot because of the diabetic veterans who were “drinking men” and didn’t take care of themselves.  (That was one of the intake questions:  “Are you a drinking man?”  It was crucial to know, because if he was, if deprived of his alcohol he might go into DT’s and die on us.  For “drinking men,” part of the admission orders were two beers or two shots of rye whiskey per day, more if indicated.)

I dreaded operating with Dr. Chung, a Korean doc who didn’t speak much English and was a clumsy brute compared to Dr. Duy. He did a lot of abdominal surgeries looking for metastatic cancer.  In those days the way you did that was by opening somebody up from top to bottom, and taking biopsies from all the major organs, to send to Pathology.  Then you would stand around in the freezing OR, hugging yourself and jumping up and down until the frozen section came back.  After that you either did or did not take out more stuff, and finally you closed the abdomen and took an x-ray to make sure you hadn’t left anything in there.

My job was to close the abdomen.  There weren’t surgical staples back then, or any of a million conveniences we have now–just a bunch of different sizes of suture material, either dissolving or non-dissolving.

Dr. Chung would walk away, stripping off his gloves, and I knew that I was going to close.  It was no easy task for a small person, especially if the patient was large, pulling the wound together and tying the knots, with nobody to put their finger on it to keep it from slipping.  Yes, it was that simple.

Dr. Chung used to tell me to hurry up and just to make sure I did, he would tell the anesthesiologist to wake the patient up while I was still working!

The reason I’ve gone into all this is: One day I walked into the operating suite and smelled the distinctive odor of halothane gas.  That is what we used in those days as the anesthetic.  I’m sure some or even most of you have smelled that smell.  There is nothing like it.  It triggers my PTSD just thinking about it.

I walked into the OR and asked the scrub nurse, who was scurrying around setting up for the next case, what the deal was with the gas.

“Oh, the anesthesia machine is leaking,” she said in mid-scurry.  “We have a requisition in.”

Uh-oh.  That meant it might get fixed today, or next week, or next month…

So we operated with the doors open.  I tell you, we were all half-anesthetized.  I hope those patients did all right, because I don’t remember a thing.  I spent two weeks half-gassed to death, and then my rotation ended and I could breathe again.

But not the baby I was carrying.  I was married, and this was my first planned pregnancy.  I was 16 weeks along, and I loved the little flutter in my tummy with all my heart.

Then one day, at the end of my surgery rotation, the fluttering stopped.  The bleeding began.

I called my OB doc.  He put me on strict bed rest.  I was torn between being panicked at the prospect of losing my baby, and being panicked because my own OB rotation was supposed to start in a few days.  But the bleeding got heavier, and finally waves of pain had me curled into the fetal position, panting.  Then something warm and wet came out in a gush of blood.

I sat up and looked.  It was a little alien, wrapped in its delicate capsule.  All of it was there.  I could see the tiny limbs, and the beginnings of a face….I wrapped it up in plastic wrap and took it to my OB.  I don’t know what they did with it.

I can’t begin to describe the grief.  I think losing this pregnancy unleashed all the grieving I hadn’t been able to do for the abortion I had suffered 13 years before.  I was overcome, and could do nothing but sob for two weeks.  Then I picked myself up, put on my whites and went to my OB-GYN rotation.

I knocked gingerly on the attending’s office door.  She was the daughter of an OB with whom I had done a rotation as a 3rd year student, and we mutually hated each other.  The daughter was worse than her father.

“Yes, come in,” she said to my knock.  I entered.  She did not offer me a chair.  In fact, she did not even look up from her charting.

“I heard what happened.  It won’t affect your grade,” was all she said.  Then, awkwardly waiting for some other utterance, I perceived that there wasn’t going to be any, so I left her office.

I was met by a nurse in scrubs, who said “Come with me.”  I followed her into a room where a woman was lying on a table, her feet up in stirrups, a stainless steel bucket on the floor between her legs, and what looked like a large suction hose…..

“Go ahead, sit down,” commanded a senior student.  “You’re going to do this one.”  I looked from the apparatus at the bottom of the table to the ashen face of the Hispanic woman at the top…

“Is this what I think it is?” I whispered.  The senior student nodded.  I threw up in the bucket and ran out.  I ran all the way home and collapsed on the bed, hysterical.  My husband came home and found me that way.  It was the only time I ever saw him in a fury.  I know that he went to the dean, because on another occasion when I was stuck holding retractors for the OB father and daughter combo (I had to repeat OB after that episode), they skewered me about my husband going to the dean.

All these years later, I just can’t, in my wildest nightmares, imagine expecting a woman who had just lost a wanted pregnancy, to go on abortion detail.  I know there are many things more cruel than that in this world, but for me, at that moment, I would rather have suffered a horrible death than to perform an abortion.

All the while I was thinking of that woman.  I found out her history, why she was there to get an abortion: she was a Mexican migrant worker, she already had six children, and her husband had threatened to punch her in the stomach if she didn’t abort, because six children was enough for him.  Birth control pills were beyond her reach financially, and her husband refused to use condoms.  So it was she who bore the consequences.

I firmly believe in a woman’s right to control over her own body.  If that includes abortion, who am I to judge?  When Rebecca, who was childless at the time, said “Give me children or I will die!”  Isaac replied, “Am I instead of G-d, that I can give life?  Go and pray!”  I too feel that way:  Am I instead of G-d, who gives life and brings death?  I am just a mortal human, trying to feel my way as best I can.

As it says in Ethics of the Fathers (a Jewish text), “Judge not, lest you also be judged.”

Don’t Make Any Noise And You Won’t Get Hurt

My policy on this blog is not to post trigger warnings; in this case, I make an exception.

If you are a survivor of sexual violence, think carefully about reading this post.  It contains graphic images of sexual predation, and could be triggering to anyone who has suffered sexual violence.  Please be careful.

Some of the following is included in my upcoming memoir, A Runaway Life, and in my novel-in-progress, The Beanbag Chair.  I’m sharing it with you here because I know that for every survivor of sexual violence who seeks treatment, there are untold numbers who don’t, and who live with the horror, shame, and destruction of the integrity of the self and the soul that sexual violence begets.

My first personal encounter with a Male-factor–as we used to call them during my tenure as expert examiner on child sexual abuse cases for a State District Attorney’s Office in a Northeastern state in America–was at age sixteen.

Earth Day, April 22, 1970.

I knew nothing about sex beyond veiled inferences gleaned from “Lady Chatterly’s Lover,” swiped from my parents’ library and read over and over, to try to figure out what all that language was referring to.  I had seen the heifers in heat mounting each other in the pasture next door, but had no idea what they were trying to accomplish.  I had no frame of reference.

I was sixteen.  My interests were Latin, natural science, poetry, music, and art.  At sixteen I was permitted to date, but the boys in the country backwater school I attended were either brutish dolts or eggheads like myself who tended to stay at home trying to teach themselves Greek.

My mother continued her perennial assault on my self-image via an uninterrupted stream of verbal, psychological, and sometimes physical abuse.  My depressions grew blacker, my desire for relief by any means more intense, until finally I despaired of ever finding truth in living, and debated within myself whether this life was actual reality, or perhaps was a construct by some demonic mind for whom I was a toy.

An older man I met in the burger joint where I worked on the weekends admired my legs and asked me for a date.  I was flattered.  Someone thought I was attractive.  I got my mother’s permission–she was thrilled–and I went with him.

The details of that date have been published elsewhere.

“Don’t make any noise and you won’t get hurt.”

I woke up to those words, still muzzy from the drug he had slipped me.  In the dark basement, his hand clamped over my mouth, my back squashed painfully into the cold concrete floor covered with moldy carpeting…..and the searing pain jolting through my body until at last he tore through, not through my hymen, but to the side of it, so that for many years I had not one but two openings there.  (At last in my 40’s I had the courage to take at least some of my body back, and had that part surgically removed.  Later I had a second surgery to try to repair the damage to the muscle between my vagina and my rectum, but that has mostly failed.)

After he finished with me, he bundled me back into his car and let me out in the dirt circle that stood in for my parents’ driveway, my blood soaking through my new spring coat.

That was my initiation into the cold, dark terrorism that is rape.  My virgin sex, shredded beyond repair.

I ran away from “home,” hoping to find relief, but ended up homeless, being raped when I asked for bread, for shelter, for medical care.

I look at the few pictures of myself from that time.  I was so young.  I looked thirteen at the most.  I had no figure, even though my mother’s pet name for me was “fat-ass.”  The eyes looking out of the delicate triangular face were hollow and haunted.

Fast forward two years, and I was living with a kind and honest couple who had taken an interest in helping me pull myself out of the life on the street.

The Viet Nam war was still raging, and I was a dedicated anti-war activist, a still-passionate Peacenik who believed that Good could triumph over Evil if only The People would shout it out loud enough.

Young Mr. Doctor-To-Be frequently managed to take time out from his medical studies at Boston University to help organize rallies.  We were Peace Rally Comrades, nothing more.

That time, I had incapacitating menstrual cramps in the midst of a rally on Boston Common.  The rally had such a huge turn-out that the riot cops were exercising their batons.  I was fainting and nauseous.  Mr. Not Yet Doctor fanned my sweaty face with his poster and proposed that we go to his apartment, where he had some medicine that would relieve my cramps.  Even though I had recently come off the streets, I did not doubt his intentions.  Have I told you that I’m Autistic?  I’m Autistic.  I can’t read intentions.

He half-carried me to his apartment.  I remember a dark stairwell, and being “helped” up the stairs.  I remember the small white bedroom with its unremarkable furnishings.  I remember being told to take off my panties and lie down.  I remember wondering why that was necessary, but he must certainly know because he was the Almost-Doctor.

I remember his voice as he hissed in my ear:

“Don’t make any noise and you won’t get hurt.”

He took something out of his shirt pocket: a penlight, such as all doctors have in their pockets.  I thought he was going to look at me with it, and froze.

He raped me with it, and as he did, he masturbated, and when he was finished he told me to go.

I climbed down from his bed, numb and bleeding, fumbled my way down the dark stairway and into the bright-white sunlight, dazed, blood running into my sandals, squish, squish.

I was in a part of Boston I had never seen before.  I managed to get home somehow, my long skirts hiding the blood.

Fast forward three years and many events less dramatic than those.

Irish flute master classes with a famous and now dead Irish flute master.  (NOT James Galway, thanks to G-d.  And NOT Cathal McConnell.)

One day he refused my payment for my lesson.  I thought that was odd, but did not understand the implications.  I Am Autistic.

He got his tween coat, and off we went to the Custom House Tap, where we played duets for Black-And-Tans until we were both solidly drunk.  He invited himself to my place for tea.  We had not even got off the sidewalk when it started.  This part I cannot write, for it is too triggering for me even to remember.  But I didn’t run away.  I was like a rabbit transfixed by the hard gaze of the wolf.  I went along.  I let him into my apartment.  It got worse.  Then it got horrible.  Then he left me, gagging and bleeding, and I never heard anything more from him.  Several years ago I went about trying to find his whereabouts.  No purpose in mind; I just wanted to know.

The obituary said he had drowned while taking a swim off his private dock in Martha’s Vineyard.  The pit of my stomach was cold: just as cold as that night that he rammed himself down my throat until I lost consciousness, waking choking on my own blood and his disgusting fluids.

Why do I wonder that it’s so hard to trust?  Why do I feel as if around every corner there is something huge waiting for me, a muddy black smudge beckoning, threatening to take me over and obliterate me again and again and again?

Why do I feel a terror of closed spaces, a dread of not being able to escape?  Why must I always have my back to a wall, facing the door, and know every escape route?

Why, when I think of being imprisoned, does the panic rise in my throat, and thoughts of suicide race through my head?

“Don’t make any noise and you won’t get hurt.”

 

 

Enter The Black Dog

Normally I’m pretty good at cloaking my moods.  I’m trained in the art of dissembling.  One of the hidden maxims of medical training is, “Control your face.”  Don’t let the patient know that you’ve just found a….you’ve just done a……and barely got yourself out of it….your surgical assistant is the most beautiful thing in the world…you just farted.  Etc.

One thing it’s hard to conceal is The Black Dog’s visits: depression.  I’ve never been good at it.  I cry at the drop of a hat anyway.  So I’ve gotten good at noting which exam rooms are empty, so as to duck into one for a good bawl, and exit red-eyed.

“What’s wrong with your eyes?”

“Allergies.”

Yesterday I woke up feeling like somebody had clubbed me over the head.  I couldn’t tell where I was in time or space.  My brain felt like chocolate pudding, but not at all tasty.  Actually, I didn’t wake up at all.  If a friend hadn’t texted me at 1:45 pm, I would probably still be asleep.  Poor starving Noga lay next to my head, resolute.  If I had kept right on sleeping, I don’t think she would wake me up to feed her.  I don’t know if that’s good or bad.

I felt kind of like I felt when I took my bedtime medicines in the morning, except this was even worse.  I was hoping it would wear off as the day (what was left of it) wore on, but no.  At bedtime last night I resolved only to take those medications which if you do not take them you might get a seizure, which happened to be the same meds I go to sleep by.  How convenient.

I was quite sure that after a good day’s/night’s sleep, certainly whatever I had taken would have worn off, but no.  Well, it did, to some extent, but then I started feeling cross and weepy.  I yelled at my dog.  I’m very relieved that she seems to understand, and cuddled up with me for a lie-down-not-nap after I got from the grocery store.  I’m amazed that I got back, since I really, really should not be driving in this condition.

I still have not put away the groceries, six hours later.  I have not put away the enormous piles of laundry that I took to the laundromat the day before the day before.  And I just read an article about the habits of Brown Recluse spiders, that they sequester themselves in the fingers of your work gloves (!) and in piles of laundry left on the floor (!!).  Well, these are in black plastic bags, if that helps.  (The reason I was reading up on Brown Recluse spiders is that I found one uncomfortably close to where I sleep, the other day.)

Last night, the night between Days One and Two of the Feel-bads, I had one of my thankfully rare episodes of chest pain.  They occur sometime in the middle of the night, and are so intense that I can’t move.  Even if I thought it was a heart attack, I would not be able to move to call the ambulance.  So I have learned to have the attitude that if it’s my time to go, it’s my time to go, and I am a Do Not Resuscitate specimen anyway.  I toy with having that tattooed across my chest, but my religion specifically forbids tattooing.  I mean, come on, like 5,000 years ago there was a law against tattooing?  What, Moses was afraid we would all become, like, Goths?

Where was I.  Oh yes.  This episode of chest pain occurred between Days One an Two of the Feel-bads, and I was not at all sure I was going to wake up at all, but in fact my alarm did rouse me, as it hadn’t on the previous morning.  I rose, feeling hopeful, but a wave of nausea washed over me and I sat down on my bed again, uncertain, until I remembered that my mother had to go and have some tests at the hospital and I was supposed to go and sit with Dad so that the morning caregiver could go to his second job.

I managed to crawl out of the house at noon, after waking at nine.  Given that I don’t even have a shower to loiter in, which I would have done had I had one, I can’t account for the time at all.

My mother was at home already, triumphant that even though they had done the wrong test, it was negative and therefore she knows more than me.  But she needed tomatoes, so if I were going to the store, would I get her two?

I hadn’t really been planning to go anywhere, given my foggy mental condition, but I caved in to her request and got in my car, very slowly and carefully, and in that condition drove to the store, where I discovered that I needed at lot more than just her two tomatoes.

On my return to the P’s house I caught my wrist in the tailgate of the Outback as I was closing it, and my paper-like skin split over the back of my right wrist.  I didn’t notice the blood until I got home, though, which is what prompted yelling at the dog, because I was bleeding all over the place and she was blocking the passage between myself and the sink full of dishes, where I wanted to wash my wound and see how bad it was.  It could be that she knew something was up and was concerned about me.  That is probably the case.

As you see, I have diverted you from thinking about the fact that somehow or other, The Black Dog has made his way to my doorstep.  Ah, that was what Noga was bugging me about!  It was really as if it hit me right as I walked in the door: the wall of depression.  Smack.

I don’t know what triggered what, in the Feel-bads scenario.  Could have been either one, doesn’t matter.  This morning I took my meds as usual, and I think I did on The Lost Day before that.  If I don’t feel better tomorrow I’ll increase my Lamectil by 50 mg.  My shrink, who has been my shrink since 2001, he and I have protocols for everything.  Depressed?  Add more Lamectil.   Psychotic and/or manic?  Seroquel.  Anxiety?  Clonazepam or Lorazepam.  And so on.

But tomorrow is another day, and this one ain’t over yet.  My lie-down with Noga helped, and I know she’ll want to cuddle at bedtime–she always does.  She’s very predictable.  She runs on ritual, on routine.  And by default, she causes me to have a modicum of routine, which I would not otherwise have, being unemployed and an undisciplined writer.  She has just had her evening bit of obedience training–she demands this every evening at 8:30, not because she so much enjoys the training as she does the treats that accompany it.

And now it’s time for evening meds, brush the teeth etc., arrange the nighttime necessary things in the sleeping area: tissues in case of crying and its accompanying snot, bottle of seltzer (I really like my water to sparkle on the palate) bottle of Ouzo (I like a little Ouzo before sleep, if I don’t fall asleep from the meds before I have a chance to drink it), pee bottles (pee bottles?  Right.  I don’t have a toilet).  And one little fuzzy golden Lhasa Apso, who will no doubt jump up in the spot where my feet are supposed to go and give me the “Apso Look,” which is indescribable; if you have seen it you’ll know what I mean.  But what she means is: “Show me that you love me and haul my 13 pounds up to your face and give me kisses and hugs.”

Which, of course, I will be delighted to do, at the peril of soaking portions of her fur with my tears.

Sleep, Precious Sleep

Yesterday morning my phone rang way too early.  It was a friend who probably though I get up at a normal time for a human being; but I don’t.

You see, my meds last twelve hours, and I have to sleep them off if I want to be functional the next day.

More than that.

If I don’t get the right amount of sleep, I turn manic.  Pretty simple, eh?  Meds>sleep>functional.  Not enough sleep (even with meds)>manic.

I needed to get up earlier than usual today, because there is a lot to do in preparation for Passover, and I needed a full day in which to do it.  This can usually be engineered by taking my night-time meds early.

So I did.

But nothing happened.  I didn’t get sleepy.  Instead I started feeling wired.

Uh-oh.

I thought, maybe I actually forgot to take my meds.  I looked in my pill box: tonight’s meds gone.  So I did take them, after all.

So I did what my shrink tells me to do under those circumstances: I took an extra Seroquel.  That usually knocks me down.

But not last night.  May as well have taken a sugar pill.

I took another, and a milligram of Ativan to keep it company.

Nothing.

By the way, in case you’re wondering, I left an hour between doses, sufficient to feel the effects of the drugs.

I was getting very concerned by this time.

So I took yet another Seroquel, an Ativan, and another Ambien (those are in my usual bedtime hammer cocktail).

Not one fucking bit of “sleepy” coming my way.

So I got out of bed, where I had been passing the time by watching Betty Boop flicks on Youtube, and began doing my Passover chores, since it was clear that I was going to have a short and shit day.  I got everything ready for cooking, chopped mountains of veggies, did all my prep work so all I would have to do is throw the brisket in the slow-cooker, throw the veggies on top, and not worry about it.

Finally the sledge-hammer anti-mania drugs took effect (oh for a few milligrams of Haldol, for quick knock-down) and I managed to get in bed before the blessed drugged sleep overcame me.

I still had to wake up earlier than usual this morning, to call the clinic and cancel my 11 am appointment for ER follow-up with my primary care doc.  I woke to my alarm, made the call, and lay back down to go back to sleep for a couple hours, since I’d already done my prep work and had the time for a longer sleep.

Nothing.

Not gonna happen.

So I got up, feeling cross and speedy, and made my oat matzah (gluten free), singed the meat, sauteed the veggies, made a sauce, threw it all in the slow cooker and sat down to write this.

I really want a beer, but now they’re assur, forbidden, because of being made with yeast.  Anything leavened is forbidden for one week.  Damn.  Oh well, maybe I’ll get up and clean.