So Much For My Salmon!

Yesterday I shared my horror at discovering that the guvvy is mucking about with the food supply again–this time in the form of “GMO” giantized salmon.

At the very moment of that writing, a fillet of what looked to be perfectly normal Atlantic salmon reposed in my fridge.  I purchased this, mind you, before I had any idea that Frankensalmon could be even now glaring at me through the fish counter window.

After reading the GMO fish article I reflected a moment, then decided not to pitch it based on its petite proportions.  After all, I am petite (?). 

So this evening I decided to eat it, despite the fact that I was not at all hungry.  I have been struggling with this damn depression for many months now, which has ruined my appetite and made me even more petite.  But I gathered my resolve.  I must eat if I am to have strength to fight this monkey off my back, right?

So I took a pack of this yummy gluten free rice ramen, which tastes like cardboard soaked in hot pee.  A nice piece of fresh salmon will flavorize it, right?

Removing the fillet from its brown paper wrapping, I inspected it for signs of illegitimacy.  There were none.  I smelled it.  It smelled like fresh salmon.

Atina, my now-20-month-old Belgian Malinois, was driving me crazy humping her fleece blanket.  She does that.  Often.  She is a sex-crazed teenager.

So, to get her mind off of humping for two minutes, I cut a strip of raw salmon skin into tiny bits, made her sit and look deeeply into my eyes, and handed her a bit of salmon.

You would think that any dog would be in ecstatic transports, being the lucky recipient of a piece of salmon, no?

No.

Atina rolled it around on her palate, gave it a cursory chew, and spit it out on the floor with a look that said, “Awww, wadja do THAT for?”

“Girl,” says I, “You have just become the Royal Tasteress.”

I threw the rest of that fucking fish in the freezer, to be disposed of next time I go to the dump. 

I really think this is a sign that after our Thanksgiving duck I need to become a better vegetarian.

My main problem is motivation.  No, wait.  My main problem is that I’m too fucking depressed to care whether I eat or not.  It’s a vicious cycle, because the less I eat, the more my nutrition suffers, my body falls apart, my brain doesn’t work right, and everything sucks more.

If I had a lovely dark skinned South Indian kitchen staff cooking for me, I bet I’d eat.  There is nothing that will make my senses happier than dosai (a crepe made out of lentil paste) filled with spiced potatoes, with sambar (a piquant soup served with dosai and related dishes), coconut/green chili chutney, tamarind chutney, and slurping it up gloriously with the hands.

I think of my beautiful brown friends in South India who fed me so lovingly, and begged me to stop crying because it was making them sad.  But I couldn’t stop crying because no one had ever been so kind to me before.

One woman in particular touches my heart to its core.

She is a big woman in a culture that values petiteness, and she feels this acutely.  Also she is very dark, and Indian women are obsessed with trying to make themselves fair.

I think she is the most beautiful woman in the world.  When she wraps you up in her soft-strong hug, chuckling from somewhere in her soul, you feel embraced by the Cosmic Mother.

When she confided her sadnesses to me, I said, only half joking, “Oh my dear, you are so beautiful, can I come and live at your house?”

She looked very seriously and long, her deep brown eyes into my mood-ring blue hazel ones, and said,

“Yes.”

Unlike myself, who live in a tin can with a bathroom in it, my friend lives in a mud hut with no bathroom in it.  Cooking is done over an open fire.  Panthers, tigers, snakes and rabid domestic animals are the local hazards, not counting the men.  My friend’s husband beat her because she miscarried her baby, then he left her for another girl.

I have to think of her more.  A large part of me wishes I hadn’t left.  Another, larger piece of me wants to go back and find her.   I would learn how to cook dosai, iddlies, vadas, biryani…anything to make those deep brown eyes light up.

But no salmon.

I don’t believe my friend has tasted salmon.

The Shunamite Woman and The Rejection of Suffering

I often get replies and emails from people telling me how fortunate I am to have a life rife with unfortunate events.  I usually trash these well-meaning yet invasive, even brazen, suggestions that my suffering is in fact a blessing.

First I would say that compared to most of the suffering people I know and interact with, mine is petty, and I know it.  But it’s MY suffering, and I will not abrogate my right to express how I feel about it.

I would like to draw your attention to an illustration in the Bible that shows us that even the strong can suffer greatly, although they might not show it to everyone.  There are many such illustrations in Scripture, but this one has always caught my attention: the story of the prophet Elisha (student of Elijah) and the Shunamite woman (Shunam is a place-name): Kings II 4:11-37

True to a common theme in the Bible, the Shunamite woman was childless, and the Man of God (Elisha) caused her to conceive and bear a son.  The son grew and went to the fields with his father, and suddenly cried out “My head, my head!”  And fell down senseless, and his father’s attendant carried him to his mother.  His mother held him on her lap until he died, and then she carried his body to the attic room where Elisha was accustomed to stay, and she laid him on Elisha’s bed.

Then she took a donkey and rode up to the cave of Elijah in Carmel (I have been there and it is on the side of a cliff, no small feat to arrive there).  She called out Elisha and said, “Why did you give me a child if it was just going to be taken from me?”  And she threw her arms around his knees and vowed that she would not let go until Elisha came with her.

Which he did, and found the dead boy lying on his bed.  First Elisha told his servant Gehazi to lay Elisha’s staff across the child’s face, but nothing happened, so Elisha stretched himself out on top of the boy and blew into his mouth.  Nothing happened, so he walked around the house, first one way, then the other, and then repeated the mouth-to-mouth until the boy sneezed seven times and sat up.  Elisha said, “Pick up your son!”  So she fell at his feet in gratitude, after which she “picked up her son and left.” 4:37

This story illustrates that suffering does not always show on the outside.  Elisha knew that the Shunamite woman suffered because she had no child; and when her child died and she went to Elisha, she said, “Did I ever ask for a child?  Did you give me a child just to mock me?”

“What, is this some cruel joke you have played on me?”  says the Shunamite woman.   Elisha had nothing to say to that, so he had to come with her.

This is all very mysterious, and full of implied questions and gaps in logic.  The answers to the many questions raised here are addressed in the Gemara, the huge library of Jewish commentary and law.  One set of the books of the Gemara take up entire walls.

The Gemara is full of stories like the one about the woman whose child dies on Friday afternoon (the Sabbath begins at sundown on Friday nights).  Not wanting to destroy her husband’s joy in the Sabbath, she waited to tell him about their son’s death until after the Sabbath, all the while acting as if there was nothing wrong.

I heard of a great scholar in my neighborhood whose wife died on Friday afternoon, and when the Sabbath came in he rejoiced, ate and drank and sang like usual, until the end of the Sabbath, at which time he sat down on a low stool and mourned bitterly.  This he did for the Shivah week, the week after her death, and the following Friday (for Shabbat is not counted in the seven days of Shivah) he got up from his stool, bathed and changed his clothes (part of the intense mourning of the Shivah week is that we don’t do these things), and rejoiced in the Shabbat when it came in.

There is a book put out by the Breslov brand of Hassidim called the “Garden of Emunah.” emunah meaning “faith.”  Since the Breslov sect’s founder, Rebbi Nachman of Breslov, taught (in the 17th century C.E.) that we must never despair, his followers often interpret that to mean “always be happy, never be sad, and depression is a depraved state of mind.”  This book, “The Garden of Emunah,” is filled with anecdotes about horrible things happening to children, and awful illnesses happening to mothers of 12, and the theme is that they all took it as a blessing from God that they got to suffer in these ways.

I am not that holy.

If that’s what it takes to get to….wherever…..it’s like, OK God, these humans are telling me that You don’t give me anything I can’t bear.

Um, let me let you in on a secret.

You made me, right?  And You made the shoulders that are supposed to bear my burden.

Yeah, yeah, I’ve heard the part about how You have wide shoulders, and all I have to do is give my burdens over to You, let go and let God, etc., but let me tell You, Boss, how long to I have to throw myself on the ground and cry out to You before something gives?  Am I a cruel joke, that you’ve created me and now you play with me like a cat plays with a toy?

Elisha, Elisha, where are you?  They say that Elijah the Prophet can appear anytime, disguised as anyone, especially a beggar.  I am certainly a beggar, but I am no Elijah.

I climbed up the cliff path to his cave in Carmel, and I inserted myself into a niche in the deepest part of the cave, and I prayed, and I went into another world.  I lost track of time, and almost missed my ride.  Four years later, I received a healing from something physical, Hallelu-Yah.

I have given up praying for my mental illness to be taken away.  I think of King David and King Saul, both of whom were mentally ill until their deaths.  Saul lost his kingship because of a manic act of disobedience to God.  David’s cycles of elation and crashing depression are clearly written in the Psalms.  Samuel I also illustrates the craziness of both Saul and David, as elaborated in the link above.

So to all you bearers of Sweetness-And-Light, please enjoy your easy lives and don’t envy those whose burdens appear to be heavier than yours.  As a physically disabled friend of mine says, “You are all Temporarily Able-bodied.”

I would add, “You are all Temporarily Sane.”

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.

The Letters After My Name

Laura P. Schulman, MD, MA, FAAP.  What do these letters mean, of themselves, and what do they mean to me?  Why do I use them, here on Bipolar For Life?  What, if anything, do they have to do with bipolar-ness?  And most importantly, why do I insist upon using them when the professional qualifications they symbolize are now meaningless?

MD: Medical Doctor.  A passion since childhood, hard-won.  I put myself through college (oh yes, another set of letters: BA, Bachelor of Arts) by holding down three jobs while taking a full course load.  I know, I know, hypomania.  But it was fun, and I would have graduated with honors except that the required Honors Seminar conflicted with one of my jobs.  Oh well.

The MD turned into a combined degree program in Medicine and Medical Anthropology, six years.  Graduated with a perfect grade point average, 5.0.  Number One in my class (actually shared with my then-husband, who also had a 5.0), inducted into the Alpha Omega Alpha Medical Honor Society.

My first year in practice as a Pediatric Emergency Physician, I was inducted as a Fellow of the American Association of Pediatrics, and added FAAP to the collection.

All that stuff, including the wisdom garnered while cocktail waitressing as an undergraduate:  I used it until that very bad day, April 4, 2000, when I locked my office door for the last time, drove home, and went into a catatonic depression that resulted in my permanent disability.

All those letters, lost.

OK, yes, I did earn them, every one of them.  And it could be argued that in so doing, I earned the right to keep them after my name, forever.  No one can ever take them from me.

On the other hand, I feel lost when I look at them.  It’s as if–no, it isn’t as if–it’s the reality, cold and hard, that I am no longer who I once was.  I no longer go to the ER or the office every day.  I no longer practice Pediatrics, or anything else.  I live moment to moment.  My energy goes into keeping my mind in a reasonably healthy trajectory, and it takes every once of energy I have just to keep living from one moment to the next.

For a long time I used the letters after my name as a reminder of what I have achieved in this life.  But now I feel that they have become a burden.  I look at them and cringe.  This is not what I wanted for a life.  This is not what I worked 20 hours a day during my undergraduate years, who knows how much during my Medical and Graduate School years, 120 hours a week during internship and residency–I did not work all those hours to be sitting around like a bump on a log just trying to keep my shit together so I don’t start screaming and scare the dog.

I look at those letters, and I start to cry.  I think about the people who read this blog, or my comments, and think I am a practicing physician with oodles of money, knowledge, and perhaps power.  And I think I am misleading them.  In fact, I know that’s the case sometimes, from comments I’ve received.

Those letters weigh upon my soul.  They sit on me like an elephant.

It’s not that I don’t want them anymore.  I earned them with my sweat, blood, and tears, dammit.  They’re mine.

It’s just that right now I’m feeling the grief of my lost life, and I don’t want them staring me in the face every time I look at my blog or my email signature.

So I think you will see the letters after my name disappear.  Not today; I don’t have the energy for it.  But soon.  Maybe tomorrow.

The Best Christmas Gift of All

Everybody knows I’m Jewish.  But.  I grew up being the only Jew in a world of Christians.  My teenage years were mostly in New England, in Southeast Massachusetts where people really do trace their family lineages back to the Mayflower, the ship that landed at Plymouth Rock in 1620.  I have been to Plymouth Rock and it is a disappointment.  All this hubbub about Plymouth Rock This and Plymouth Rock That, and all it is is a medium size boulder sticking out of the sand, with no distinguishing features save a bronze plaque:The Pilgrims Landed Here.  No mention of the Indians, turkeys, Indian corn, nothing.

With the exception of my parents, I had no other Jews to celebrate Jewish holidays with; and since my parents themselves did not have much exposure to Judaism, we bumbled through the two Jewish holidays we knew about (Hanukah and Passover) by rote: did the things we knew to do, ate the foods we knew to eat, but otherwise did not have any particular understanding of the significance of the festivals.  Since it was only the three of us, none of it lasted very long.

We moved to New England when I was twelve.  The other children were quick to let me know that “their ancestors got off the Mayflower,” meaning, “and you will never belong here or be one of us.”‘

On the other hand, since I had never belonged anywhere anyway, being from another planet etc., I got used to it and poked around to find families that would tolerate me crashing their Christmas traditions.

With the exception of Old England, I doubt there is any place on earth that takes Christmas so seriously as New England.  By “seriously,” I mean Serious Fun.  In those days you could count on two or three feet of snow on the ground and often more coming down, the night turned blue by the refraction of the snow so that the fields looked like vast undulating blue bosoms.

Over these blue bosoms we would tramp on Christmas Eve, freezing in galoshes, boiled-wool pea coats, and hand-knitted hats, gloves, and mittens, the latter so caked with snow from snowball fights that the wet wool threatened frostbitten fingers.

On arrival to our destination we would stand outside the two or three hundred year old clapboarded or shake-shingled house and sing our hearts out: the standards, O Holy Night, O Come All Ye Faithful, Joy To The World, like that.  The family would come to the door , backlit from the roaring Yule log in the great open fireplace.  After grinning through our performance, they would invite us in to warm up around the fire.  Mittens came off and steamed on the hearth while we were immersed in great mugs of hot chocolate floating with marshmallows.  The cookies went ’round, inquiries made after the health of Aunt Bessie, and after we were warm, dry, and refreshed, we said our “thank-you’s” and “Merry Christmases” and set off across the fields to our next destination.

Most families did not put up their tree until Christmas Eve, unlike the current trend that used to begin with after Thanksgiving and now seems to be encroaching on Halloween.  The suspense leading up to that joyous hour when the big Balsam fir (no one used anything else, for the Balsam’s delicious fragrance permeates the house and no potpourri is needed) was hauled upright in the bay window.  There really is no better place for a Christmas tree than a bay window, because there’s plenty of room to move all around the tree to decorate, and the window seats make great places to sit while opening presents.  And of course, anyone happening by gets a spectacular view of the tree!

I don’t know about today’s decorations, but in those days there were two kinds: home-made, and heirlooms.  The home-made kind ranged from little felt Santas, elves, and angels made by first-graders, to paper chains made by us, to popcorn-and-cranberry swags that we made on the spot with a felting needle and a lot of popcorn and fresh cranberries (being New England, where cranberries come from, and all), to gingerbread cookies made of a special recipe that hardens and you wouldn’t want to really eat them but they look great, and of course the candy canes, which we did eat.

Then the box of heirloom decorations was opened, and a hush fell on the room, succeeded by excited exclamations as each precious piece was unveiled from its tissue wrapping, where it had slept, dormant, since last Christmas.

The Star, of course, came out first.  New England Stars are often made of hand-crafted tin with whirly things and tinkly things.  Some of them are lanterns that you put a candle in, if your ceiling is high enough.  Getting it on the tip of the tree involved ladders and gymnastics and usually brothers.

The icicles were of drawn crystal.  Real crystal, that danced with light.

The balls included clear ones with snow scenes inside, and ones with red-cheeked Santa faces hand-painted on, and each one had its own story: who it had belonged to, to whom it had been passed down to, and how it came to be in this box.  There was a reverence to hanging each and every memory, connecting generations, on the fragrant branches.

Nothing was done without a rich egg nog, or a wassail, to cheer along the festivities; and the cookies that were meant for eating came out.  Every year someone made pfefferneuse, those abominable pepper cookies that look deceptively delicious, but taste so evil that one is forced to seek out a discreet trash can to spit them out.  Likewise the obligatory fruit cake, made at least a year ago and packed away soaking in rum.  Does anybody really like fruitcake?  Please.  I want to know.  And please send me your address.

In my experience, fruitcakes are a great gift to receive, because you can pack them up in a different tin and give them right straight to somebody else–just make sure you don’t give it back to the person who made it–which can be a little tricky in a small town like ours.

Now.  New England Brown Bread.  THAT is a horse of a different color.  Who has had it?  It is a moist, molasses-filled cake spiced with cloves and cinnamon, bristling with raisins, baked inside a number-something (I forget, but I think it might be twelve) tin can, in a water bath.  That makes it officially a pudding, I think, according to English culinary nomenclature, but in New England we just call it Brown Bread, and it is the most delicious thing of all, especially eaten warm, splashed with brandy and dolloped with vanilla ice cream or heavy whipped cream (not the kind in a can), or both.  And it is BROWN.  Whenever I have been the lucky recipient of a can of Brown Bread I have never recycled it like I do the fruit cakes, but hoarded it until I could enjoy it properly.

Roll forward many years, and I am in Seattle.  How I got there is another story, but let’s just say I was alone, without family or friends.  I was exploring my Jewish roots at the time, and bit by bit learning the how’s and why’s, but really between the worlds, and terribly lonely and depressed.

As everybody knows, the holidays can turn a normal everyday depression into a catastrophic one, so I did some advance planning and came up with a solution: rather than stay home and entertain myself by running movies in my head about the brilliant and elegant ways I would off myself, I would go to the mission food kitchen and take my mind off my troubles by running my ass off serving meals to people who didn’t have the luxury of a home in which to sit and contemplate suicide.

I showed up on Christmas morning.  Even though dinner wasn’t to be served till noon, the dining room was packed with people holding down their seats, eagerly awaiting one of the few real meals they would get this year.  It was cold outside, too, and of course raining, being Seattle, so they got to wait in a warm, dry place.  My heart opened to all these souls: there but for the grace of God go I.

Tables were set, the dinner gong “went” at noon, and we waiters began to scurry with heavy plates steaming full of turkey, dressing, mashed potatoes, canned yams, canned green beans, cranberry sauce….there was a bit of confusion when some of the guests decided to “help” with the table-waiting in order to procure seconds for themselves….an announcement was made that seconds would be available after everybody had “firsts,” providing we didn’t run out of food.  Everyone sat down again.

A sudden wave of panic broke out in the kitchen: the cook had fallen ill–now what to do?  I mentioned that I had been a chef some years back, and was instantly drafted and in fact, shoved physically into the huge stainless steel institutional kitchen.

To tell you the truth, it wasn’t a difficult job to fall into, since much of the food was already prepared and just needed to be heated up.  But there was a herd of turkeys sizzling in gigantic ovens, and pots of mashed potatoes that I needed  a ladder to even see into, and such pans of dressing, that needed two people to hoist out of their oven compartments!  And oceans of gravy hot enough to scald to death the unfortunate who fell into the gargantuan pots.

I was very fortunate to have a small army of kitchen assistants who knew what they were doing, so all I had to do was ask questions and do what they said.  In two sweat-drenched hours we fed well over 400 souls.

I helped to serve the pumpkin pie, since by that time there was no further chef-ing to be done.  I could barely make it from one diner to another, due to the fervent hand-squeezings and embraces and blessings from people I would not have previously thought of getting that close to, but somehow, and I think you’ll understand, a blessing from someone who lives in the cold, wet, filthy, dangerous, hungry world of the streets is worth more than a blessing from the Pope.  It is a blessing from a fallen angel.

That Christmas, I felt that (even though I am not a Christian in the conventional sense) if someone had asked Baby Jesus what he wanted for Christmas, he would have said: Take care of the poor, the destitute, the hungry, the sick, the outcast, the prostituted.  This is what I want for my birthday….for Christmas!

Turn the Lights On, Will You?

Hey everybody, this is Chattery the Chipmunk here with an Arctic News Blast from Canada.  No, really!  Some of you may know that I’ve been down in the Black Hole for a long, long, long, long…..time.  I keep going to my psychiatrist and he manages to make me laugh somehow, so he knows I’m not hospital material yet.  But since I’m maxed out on the meds, there really hasn’t been anything to do except for hang on tight and think about my son and my dog and some other people who might be seriously bummed if I checked out.

Last week, though, Shrink-O-Matic had a brilliant idea!  Light therapy!  He gave me a “prescription” for a 10,000 Lux blue spectrum light made in Canada, where they really know from Seasonal Affective Disorder.  It mimics the light of a beautiful blue sky!

Now, I am so sensitive to light that my mood changes for the worse if a cloud even covers the sun for a few seconds.  I think one of the reasons I love to be in Israel (one of the many, many reasons) is that if I’m feeling down all I have to do is step outside into the Mediterranean Middle East blue sunny skies and I’m much better.

The instructions that came with the lamp say to use it for 20-30 minutes once a day in the morning.  So I’ve been doing that, and it has been helping some.  Then my therapist on Thursday had the bright idea that I should try using it twice a day.

So today I used it first thing in the morning, and again around 2 pm.  So far I have gone for a long walk with The Dog, swept and vacuumed the entire house (if you can call this a house–it’s actually an unimproved barn-like structure, but it keeps the rain out and has heat), and redid my fan page on ReverbNation, and tried to learn something about investing in stocks, and…I am not at all tired, and it’s 10 pm, and I don’t think I’ll do that again.

It feels something like being on steroids, which is why I hated being on steroids when I had to take them because of inflammation.  I think it could definitely lead to mania if continued.

So, tomorrow will be a one-dose day.  Nevertheless, it is such a relief to NOT be depressed–you know what I mean–that I’ll take a hypomanic episode every now and then if that’s the way it has to work.  I just have to write it on the inside of my eyelids: don’t buy stocks when hypomanic!!! 

Breaking The Silence of Stigma: Lunch Sketch

Today’s edition of Breaking The Silence of Stigma/Voices of Mental Illness is honored to have Jared of Lunch Sketch as our interviewee.  If you haven’t seen Jared’s amazing art blog, Lunch Sketch, I advise you to hop right over there as soon as you finish reading this wonderful interview!  So let’s dive right in!

BSS: How long have you known that you are living with a mental illness?

LS: Almost 10 years now.

BSS: Can you share with us your diagnosis/diagnoses?

LS: Generalised Anxiety Disorder, Social Anxiety Disorder, and Depression.

BSS: When were you diagnosed with these?

LS: Almost 10 years ago.

BSS: How were they diagnosed?  Did you have any special testing?

LS: I had a series of health scares, starting with Bell’s Palsy which I never recovered from and underwent many tests to ensure it was not a tumor. I then had a case of pericarditis misdiagnosed as a heart attack – this included prepping me with morphine drips and calling my next of kin (my wife who was 7 months pregnant with our third, Emma) up to the hospital. Next I saw a doctor about a lesion on my lip and was told it was cancerous and that I would need a large portion of my lower lip removed – fortunately family forced me to get a second opinion with a dermatological specialist who informed me it was (if anything) “pre-pre-cancerous” and nothing I couldn’t keep on top of with a tube of lip balm.

Haha. So special testing? Hmmm … maybe too much testing 😉

In addition to all of the above, I was constantly sick and tired. For almost a year, during all of this, I never wanted to go out, I would just go into our bedroom after work (spending no time with my family) and slept through most weekends.

I ended up crying in my doctor’s office like a little kid. I told her I was going to die!  I had a “Final Destination” style idea that all these near misses meant it was my time … and eventually something would stick. I distinctly remember sobbing, “I am sick and tired of always being sick and tired”. I think I remember those words best, because they are lyrics from Anastacia’s hit song and I was embarrassed to say them, but had no other words to describe my feelings.

My GP asked me a series of questions and then told me she thought I have health related anxiety, which was causing me to be depressed. I did not believe her and was frustrated she could not see I just needed tests to find whatever was going to get me next!

She gave me a book (Taming the Black Dog – by Bev Aisbett) and a video, insisting I read and watch them.  I did, and it did not take me very long to realize she was right. The book and video described “me” … even though I really didn’t want it to.  It was undeniable.

BSS: Have you ever been hospitalized due to your illness?

LS: No.

BSS: Are you on medications for your illness?  Do they help?  What about side effects?

LS: I was on fluoxetine for 12months and in that time really worked hard at getting my diet, mental health and physical health in order. I was fortunate enough to have work pay for a psychologist at that time and she helped me also with some cognitive training and other coping tools.

I was happy on the fluoxetine (after the initial nausea), but part of me worried that the medication was desensitizing me to health problems (lumps, sores, aches and pains) which I would get looked at if I wasn’t on medication. The worry grew and my doctor and I decided maybe now that I knew about my mental illness and had more training and awareness in managing it, I should try going without.

I have not been back on it since, but there have been times I considered seeing my doctor for another script. It absolutely does help and I would not hesitate to go back on it if I felt myself getting too lost for too long.

Not so much a stigma for me with the medication. It just increases my anxiety in a strange way, which I hope I explained well enough.

BSS: What other things do you do to help with your illness?  Do you go to individual therapy?  Group? Other things?  What, if anything, seems to help?

LS:  I eat well and exercise frequently. Not gym exercise so much (although have recently joined one), but outdoors stuff like ocean kayaking, bike riding, hiking and jogging. Knowing I am looking after myself physically helps me to rationalize risk with my irrational health anxieties.

To manage my social anxiety I avoid too much socializing. Being a fairly solid introvert who married a very strong extravert, we were going out and had people over almost every night and weekend. We no longer do this. My wife still enjoys a very busy social life with her girlfriends and we also go out together as often as we can. But she knows I cannot do too much in a row and will make sure a busy weekend is followed by a very quiet weekend (even if just for me). I am not comfortable in crowds and social environments. I get an overwhelming feeling of needing to escape (like how I imagine claustrophobia would feel).

One evening recently when visiting friends – my wife was not ready to go, but I was – I left her the car and walked the 1km trip home (with my youngest on my shoulders). My wife understood, but I am sure our friends thought I was odd … “can’t he just wait another 30 minutes?” No I couldn’t!

I guess for us it has been about understanding and balancing our needs.

For my depression I ensure I get enough sleep (but not too much).  But I also sketch, write and have lots of “me” time. Sketching calms me and focuses my mind on just one thing. I find sketching particularly good for me to process feelings at times. I can spend hours and hours on a single piece related to a feeling I am trying to process and the time sketching is uniquely therapeutic … almost like an acceptance or deeper understanding of myself and my thoughts, without all the negativity and depressive thinking and behaviours that would otherwise result. I hope that makes sense …

I don’t do any social media except for my WordPress blog. No FB, no Twitter, no Instagram. Yet over the past 2 years I have discovered a sense of community here. Becoming one of the authors for Canvas of the Minds has furthered this sense of belonging and made me not feel so alone and strange. Not just the other authors on that blog, but readers also have helped me immensely (some who probably will never know how much they did). I guess for now, that is my “Group”.

BSS: How has your illness impacted your life (jobs, education, relationships, children, alcohol, drug abuse…..

LS: Negatively in all areas (except substance abuse) I would have to say.

Job: I could get so much further in my career and would pursue such a path if I was not aware of my limitations and the effects of additional stress on my mental health. I am content to just hold my own in my current role. Our CEO recently mentioned to me that he thinks some of the Managers are point scoring because they want to be his successor. I told him to count me out, because I am not interested in his job at all. Again, he probably thinks I am lazy or lacking ambition, but I have been learning to care less about the judgments of others.

Education: A few years ago, I attempted an MBA whilst working. Got through 3 subjects before realizing I could not do it. The study was taking up what time I had left and needed for “me” to cope. Work needs me, my family needs me, and in between those I find and need time for me.

Relationships: The doctor visit I mentioned above was a week after my wife said she could not cope with me anymore. I reached a point where I was disconnected from her and our kids. I was always down and took them down with me. So yeah … had I not been diagnosed and treated accordingly … they may not be with me now as I type this … or to be even more brutally honest I may not have been here to type this … I considered suicide several times, but never went beyond ideation.

BSS: Have you ever felt discriminated against because of your illness, or had to deal with disparaging comments, denied a job or other opportunities?

LS: I guess I discussed my self-imposed denial of job opportunities above. Have not had to deal with direct disparaging comments … but am frustrated every time I hear people at work and socially refer negatively to what they see as depressive or bipolar behaviours in others.

I think it is the dismissiveness of insensitive people that bugs me the most. There is no care in the words of someone who says things like, “I dunno, maybe she’s depressed or something weird like that” … or … “God! It’s like he’s bipolar or something!”

If she is depressed … if he is bipolar … they need your friendship, understanding and support … not your sarcastic wit!

BSS: If you could give advice to someone else struggling with mental illness, what would it be?

LS: Get support. Whether it is just one person or many people … do not go it alone.

Read good literature and learn as much as you can about your illness. Understanding my personality, my past and the nature of my illness has been so important in holding my ground and even gaining some ground over time.

LSJared

 

Feeling Suicidal? Change the Channel.

Things have been going in a dismal spiral that has been threatening to turn into a full-blown tailspin.  For the last three days I have ruminated night and day about death: fervent wishes for a speedy natural death, and in the absence of that, turning to my old faithful suicide plan, painless, tidy, nothing to clean up and nobody’s trauma.

There is no good reason for this, if you discount the deep spell of depression.  Here I am in the Holy City of Jerusalem at the holiest time of year, and especially now that it’s sukkot:  the happiest time of the year for us Jews.  So what’s the deal?

OK, so I have had to move twice in two months because of the bedbug plague that is sweeping the city.  Bedbugs get me down.  They give me more than the creeps, little bastards sucking your blood all night and hiding out in your underwear drawer during the day!  Chutzpeh!

I had the second apartment exterminated three times, each time involving leaving for 10 hours, then scrubbing the floors and all the surfaces multiple times so as not to poison myself and my dog.  Nevertheless I have had a nasty headache for weeks, which has gone away after moving to the third apartment which so far (please G-d) does not have bedbugs like the first two.

Along with all the other bedbug mitigation work, I have to wash and dry everything over and over.  Right now everything I own is on the roof baking in the sun (they can’t stand heat and drying), which was fine until it rained the other night.  I have not had the strength or ambition to climb back up on the roof and undertake damage control.

So circumstances are getting me down, yes.  It’s an overlay on the bipolar depressive phase.  But it could be deadly, because just a few hours ago I was planning when and where.

And then I broke my policy of strict isolation (because when I’m like this I am such a zombie, flat affect, flat voice, no reactions) that it freaks people out and is very unpleasant for me.  And if they’re people I like, I might just burst out crying and that just makes things worse.  So isolation it is, and yeah, I know, it’s not good.

So this evening a very special event was planned in my congregation in honor of this day being the passing of Rebbe Nachman of Breslov, in the year 1810, who was a revered spiritual leader, and is the guiding spirit of many members of our congregation.  I had to go.  I wanted to see everybody, hear what the rabbi had to say (even though I only understand about every third word of his Hebrew) and generally be with my peeps.  I did not set myself a time limit: if I got uncomfortable, I gave myself permission to leave at any time.

Not only that: since my Hebrew birthday falls out tomorrow, I booked myself a massage tonight.  Yeah.

When I got to the party I was feeling pretty low and didn’t know if I would be able to handle it.  But there was singing and someone was playing a djembe (African hand drum) badly, and I saw another djembe that didn’t have anyone playing it.  Now, I happen to have studied djembe for four or five years, and played with an African dance troupe.   I have stopped playing because of severe issues with my hands, but since I was planning to die I didn’t care if I fucked up my hands more so I picked up the free djembe and warmed up quietly, getting the feel, and then the old feeling came back and I popped right back into the common West African dance rhythm BADA bada BADA bam, working the bass and the slaps and tones and rim shots just like old times.  And for some reason, I didn’t break blood vessels in my hands or hurt my two bad wrists or any of that.  And feeling the groove of the people singing and getting underneath the inexperienced drummer and giving him a boost so he could ride my wave was intoxicating.

I forgot all about suicide.

Then I went and had a 90 minute massage.

Now I’ve taken my meds and am going to bed, with a lot to think about.

I’ll think about it in the morning.  At Tara.  Or maybe in the Old City.

The End of The End

I stood on the deck of the single-wide trailer, watching the repossessors hauling off my car (the one I leased for my now-defunct business) and my three-horse trailer with the full living quarters, self-contained.  That one hurt.  So many memories of the west desert of Utah, the High Uinta Mountains where I got stalked by a Basque shepherd, almost getting hit by a tornado while camping in a Navaho fairgrounds….it hurt.

My big diesel truck I had sold to my dad the day after I picked up the red letter.  I see it as a red letter, no matter what color it really was.  It was red to me.  Dad almost got in trouble for collusion, but I cooked up a story that Dad’s truck had “tore up,” as they say down here, and he needed a replacement, and I still had the little car at that time.  Thankfully nobody got in trouble for that, and the instant the whole mess was over he gave me back the truck.  I don’t remember what I drove in the meantime, after they hauled the car away.  Doesn’t matter.

The red letter started it all.  I got a notice in my mailbox that there was a registered letter at the post office for me.  I wasn’t feeling too great, being in the process of shutting down my pediatrics practice and all, so I just tossed it aside and forgot about it.

A few days later, there it was again in my mailbox.  Shoot, I thought.  Maybe Publisher’s Clearing House has finally caught up with me.  I’m a millionaire!  Or maybe Old Uncle Mordechai, whom I never met but heard many stories about his eccentricities, has finally come into my life bearing a will that he left as he passed out of his.

So I took the piece of paper and drove the truck, full of dogs, to the post office.  I handed the slip to the postmaster and he handed me an envelope that I had to sign for.  On the face of the envelope was a red spanch that said: REGISTERED MAIL.  My self-control lasted until I got to the car.  I tore it open.  It contained another envelope.  The return address was printed in that self-aggrandizing font that legal firms use.  “Winken, Blinken, Nod, & Assoc., Attorneys At Law.”  I tore that one open too.

Inside was a court order saying that I had been accused of stealing just short of $500,000, half a million, from St. Elsewhere’s Hospital in Armpit, Ohio.  I had indeed worked in a clinic affiliated with that hospital, but since I had never actually worked there, and certainly had never stolen a red cent from them or anybody else, I was mystified as well as stumped.

I rushed home and picked up the phone and dialed the number for the law firm.  Was there some mistake?  How could I be implicated in something of which I had no possibility of participating in?  They confirmed that yes, the summons was for me, and that I was accused of stealing half a million dollars from that hospital.

I had set foot in that hospital exactly once.  The Chief Financial Officer, whom I shall call Chuck, called me up one day at the clinic at which I was an employee.  Laura, he said, I need you to come and see me.  Now.

It was lunch break, so I was able to run over to the hospital, a block away, to see what Chuck needed to talk to me about so urgently.

When I found his office, he was looking mighty grim.  Laura, he says, I want you to look at this stack of papers.  It was a tall stack.  Laura, says Chuck, these papers are all invoices that came from your office.  You may or may not know, and it’s better for you not to know, that this hospital pays for all supplies ordered by your office.  This stack of invoices is just from this month, and it’s all billed to your account number.  I know, I know.  You didn’t know you had an account number.  But you do.  And billed to your account number are things like copier toner, staples, chart paper, coffee….mostly office supplies that have no connection with your practice, since you are a salaried staff member.  All of these invoices should be billed under the practice’s account number, not yours.  The total billings from your account number for this year are $97,000 and change.

When I could get my mouth to work again I said, Chuck, what do I do about this?  Isn’t this, like, illegal?

Chuck says yeah, it’s illegal as hell.  But you know what?  Your boss just sold a high-rise building in downtown Bombay, and even if we filed criminal charges against him, this town is so crooked you know what would happen.

Yeah, I knew what would happen.  I’d seen it happen before in that town.  The county prosecutor’s office was crooked as hell.  The right amount of palm-grease would get anybody off of anything.

So what do I do?  I ask Chuck.

I’d advise you to turn around, walk out of here, and find yourself another job.

Well, what do I do about the money it appears that I owe?

Don’t worry about that, says Chuck.  I’ll take care of that.

I didn’t get it in writing.

After getting the Red Letter, I did a lot of research.  It turned out that Dr. Crooked had continued to use my billing number for several years after I left his practice.

A few years after that, the hospital went T.U. (that’s Tits Up, a medical term) and was acquired by a huge “healthcare corporation,” whose team of lawyers set busily to work combing through the accounts looking for irregularities in the accounts receivables.  And they found the pile of invoices accredited to me, which by now had mounted to nearly half a million dollars.

Now what I have not told you yet is that at the time I got the Red Letter, I was suffering from a suicidal depression.  I had already been hospitalized once, and was barely able to get up out of my recliner to let the dogs out, and again to let them back in.  I just kept on losing weight, because I had no appetite and no one to feed me, so I just didn’t eat.  The combination of the depression, the malnutrition, and the wrong medication had me paralyzed.

So I had to rally myself around somehow to deal with the Red Letter.  I called the American Medical Association’s legal advice department.  They were used to advising people about malpractice, but this wasn’t malpractice.  They gave me the numbers of three lawyers who dealt with hospital law.  I called them all, and read each one the Red Letter.  Each one said the same thing: 1) you have no liability whatsoever in this case, i.e., it is bullshit;  2) you will without a doubt be acquitted, and then be able to sue them for falsely accusing you; 3) we require $20,000 as a retainer, plus travel fees, plus hourly fees of $275 per hour.

I was numb.  I had cashed out my retirement to build my pediatrics practice, which had been taken from me by Big Medicine and depression.  The remainder of my savings had gone to pay for my son’s residential treatment at a therapeutic boarding school.  I was living on disability.  I had nothing, and I was so depressed my brain could not even gather itself up to rise to the occasion.  I put the phone down and dissociated.

Finally it occurred to me that the only way to get out of this bind was to go and see a bankruptcy lawyer.  I did, and he said the case against me was dischargeable through bankruptcy.  I was too depressed to think of any other solution, so to bankruptcy court I went, and the case was discharged, and I lost everything I had that was not tied down.

After the tow trucks got done hauling off the vehicles, I stood there till it got dark.  Then I began to scream.  I screamed at God.  Why, God?  Why did you give me these talents and then take them away from me?  Why did you give me this brain and then make it sick?  Why, when all of my life I have never stolen as much as a piece of gum,  did you make someone accuse me of stealing some huge amount of money, and then take away the few things I had left that I worked so hard to earn?  Why, God?

Vascular Surgery

This piece was previously published in Close2TheBone.

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.

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.

 

 © Laura P. Schulman, MD, MA 2012 All Rights Reserved