Ogallala Afternoon

You might be wondering where, or what, Ogallala is. 

Ogallala is a smallish city in Nebraska, USA.  It’s named for the Ogallala band of Lakota (Sioux) Indians, who once roamed freely in the Plains, but like all Native Americans were rounded up and planted on reservations during the Westward expansion of white Americans.  Ogallala, Nebraska, is now a corn town.

I’ve been on the road or off the grid now for weeks.  Lots of thoughts, some jotted down, some evaporated, and some that maddeningly recirculate, playing themselves over and over until they are drowned out by the urge to drag my malfunctioning brain out of its bone box and fry it on the sizzling pavement of I-80.

In particular: the thoughts that forced me to bivouac early in bucolic Ogallala, as I was pelting down the blazing Interstate, trying to get to Michigan to meet a deadline.

I am haunted by the spectre of losing my son.  I believe I have lost him.  I believe I never had him.

This adult child of mine has never been happy with much, for long, particularly if it had anything to do with me.

He was miserable as a baby, except when eating or preparing food.  He learned to cook by watching over my shoulder from his vantage point in the backpack.  Since he screamed for whatever chunk of time he was put down, hours at a time, and I mean hours and hours, of necessity for my health and his life, I put him in the backpack and wore him.  If he screamed in the backpack, I put him to bed (clean, dry, and fed, of course) and turned on the vacuum cleaner and put in ear plugs and turned up the stereo and went outside and walked around in the yard and wished I still smoked, until his father came home. 

“Clap hands, clap hands
Till Daddy comes home
Daddy has money and Mommy has none…”

But his father objected to being handed a screaming baby even before he was properly through the door.  In retrospect I don’t blame him. 

As a pediatrician, having a “difficult child” proved helpful.  It increased my Compassion Quotient.

I’m sure you’ve heard of awful cases where someone shook the baby, or threw it, or did some other act of violence because the baby wouldn’t stop crying.  Most of us recoil in horror from these news items, and frequently judge the mother harshly.  How could she?  How could she?

Thankfully, I never did violence to my perpetually screaming baby.  I took him to the doctor every week, sometimes more.  My pediatrician patiently explained that he had “colic” (rubbish! colic is what they say when they don’t know why the baby cries) and that it would go away when he grew up (it hasn’t).

I remember even at the time, walking around the back yard in the middle of the night, thinking how grateful I was that I had the emotional resources not to simply throw him into somebody else’s trash bin.  Later on, when I turned into the Director of several Pediatric Emergency Departments, I would draw upon that experience when the babies of other, less resourceful parents came in with grievous injuries or worse.  As much as I hurt for those babies, I hurt for the parent who loved their child, yet in an instant of just-too-much-over-the-top screaming, snapped, and hurt their own flesh and blood.

Apart from myself, I think no one pities a parent who has hurt, or even killed, their child, in a moment of unpremeditated rage.  In fact, I don’t even think it’s rage.  I think it’s more simply end of the rope, no more self control, just shut up!  Type of thing.

Maybe they didn’t have a back yard, vacuum cleaner, stereo, teeth to grind, nerves of steel.  Maybe they didn’t have those resources.

I was grateful for mine.

Looking back, I’m also grateful that it wasn’t just me.  Who couldn’t pacify this child, I mean.  I feel vindicated.

When I went back to work and school after five months at home, I left the backpack with the babysitter, who muttered something about knowing how to take care of spoiled babies.

When I picked him up at the end of the day, she had that backpack on!  She muttered something about weaning him off it by the end of the week.

She wore it, and him, for about two more years.  Then we moved.

As far as I can tell, that’s when our troubles first began.

This person to whom I gave birth and did not kill, resents me with a passion.  I resent my own mother, for far different reasons, yet I have compassion for her because I am a hated mother.  I will not tell her I love her, because I don’t.  I don’t confide in her, because whatever I say can and will be used against me.

I have tried to be a good listener to my son.  I know I have been, because he has always come to me with his troubles, and I have felt a bit of guilty pleasure in listening: guilty for being pleased that he came to me in his time of trouble, wishing he didn’t have the troubles that brought him to me, yet pleased that he felt comfortable in coming to me for help.

I did my best to help him to become self-sufficient, since that, in my experience, is the best gift one can give a child, second only to unconditional love.

When he got into trouble, I let him flounder a good long while before I bailed him out.  And I didn’t just let him off the hook.  I got him out of mortal danger, and after that, he had a lot of meaningful work to do. 

I feel now as though I’m explaining, justifying, trying to talk myself into believing that I wasn’t a horrible harpy mother like mine was.  I’m picking through my brain, finding reasons to believe I did OK.

But more often, I’m picking through my brain, finding every little particle of doubt, possibility of abusive behavior, coldness, emotional distance, unavailability, what?

What happened?  Or, more probably, what didn’t happen?

Through the decade of his twenties, it seemed we got along fine.  Then came last Thanksgiving.  I got gobsmacked, blindsided. 

He invited me for dinner.  No one else, just me.  I thought that was strange, suggested we invite somebody else, or go to someone else’s dinner.  No, he didn’t want to.

And he didn’t want help cooking, because he gets impatient with someone else in the kitchen.  So I sat on the couch and smoked his weed. 

He presented the meal.  It looked lovely.  He asked me to take a picture of him with his beautiful dishes all arranged on the table.  I did.

After dinner I went out and slept in my camper in his parking lot.  The next morning I came in and showered while he went to work for a while.  When he returned, he made it clear he expected me to leave: immediately.

There was the old threatening feeling I knew so well, the feeling of dark clouds, anger, intimidation, that he had used to get his way as a young adolescent.  I hadn’t seen that in twenty years. 

I didn’t want to leave just then.  I was nursing a migraine, was exhausted from the many hour drive to his place, and I didn’t want to be bullied.  I wanted to curl up on the couch and drink coffee and smoke weed and watch cartoons in my pajamas.  But it was, after all, his place.  Not mine.

He showed me the door. 

“I really need my space back, Mom,” was how he put it, and opened the door for me, so I could go through it.

We’ve spoken four times since then.  They haven’t been pleasant times.  When I ask what happened, what changed, I get a tirade about how I dragged him around when he was a kid, how I wasn’t available emotionally or physically, and I apologize.  And he is angry, and doesn’t want to hear how I feel. 

And I get all confused.  Here is my son, angry at me.  I didn’t kill him when he was an angry, inconsolable baby.  Why isn’t he grateful?  Isn’t he happy that he’s now a successful adult, with a promising career, lots of nice friends, no lack of women friends, enough money for his needs?

My own mother used to tell me I was “shit,” burn me with match heads, just to see me cry.  Then she’d laugh and tell me I should grow a thicker skin.  And she wonders why I avoid her.

I tried my best to be another kind of mother, the mother I would have chosen if I could have had my choice.

I guess it doesn’t work that way.

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 Beginning of the End, Part 2

I stood in front of the giant mahogany desk, watching the man on the other side.  He was sitting down.  His mouth was moving, but I couldn’t hear what he was saying, due to the roaring in my ears.  I wrestled my consciousness back into my body just long enough to say, “Yes, I understand.”

The man smiled, stood up, reached over the vast expanse of desk and extended his hand.  I shook it.  It bit me, leaving two holes in the palm.  After it released my hand I put it behind my back, surreptitiously rubbing the bite.  He sat down, beaming.  I turned and walked carefully out of the office.  He shouted after me.

“Please have your accounts in by the end of the month!”

The jerk.  I always did.  Never missed. Struggling to get my physical and astral bodies aligned, I walked down the hill to my office.  Now the tears burned.  How would I tell Lorna, my nurse, and Della, my receptionist, that we had been eliminated?  Collectively discontinued?  Replaced by a newer, slicker model of practice than our old, warm, welcoming country doctor’s office?

It wasn’t just us: our little old struggling small-town hospital had finally caved in and accepted a buy-out by a looming juggernaut of a healthcare corporation.  Hell, my own mother was on the board of directors of our hospital, and even she had voted for the takeover, knowing she was signing the death warrent for my practice.  Her daughter’s practice.  Everyone’s practice, for the new corporate entity brought in its own doctors.

To their credit, they did offer me a position in their corporation, as a staff pediatrician in a city an hour and a half away.  I would be working under a director with whom I had already had some clashes over the care of my patients whom I had transferred to his hospital for a higher level of care than we could offer in East Bumfuck.  I had no choice but to decline, under the circumstances.

I was on medication at the time, but it was the wrong one, and couldn’t protect me from what was to come.  The stress of knowing that my practice was doomed threw me into a deep depression.  Added to that was the knowledge that I would not be able to start anew on my own: I had cashed out my retirement fund to start that practice.  Put all my eggs in one basket.

I did approach the juggernaut about actually buying my practice rather than stealing it, but they just out with a giant juggernaut belly-laugh and informed me that they’d take it for free, thank you very much.  So I was sitting high and dry.

Aside from my lifelong dream of being a country doctor, there was the issue of “not playing well with others” that had limited my tenure at all of my previous jobs to two years, before the powers-that-were and I started getting on each other’s nerves and throwing spitballs at each other.  From my perspective many years and medicines down the line, I can see that my hypomanic episodes might have had something to do with my feelings that I knew how to do things better than they did; or even if I did, I was unable to keep from running my mouth and offending the powers-that-were, and having an “I quit/you’re fired” moment, or a convenient lateral move to another practice.

So it was that I realized that my best chance for success was to be my own boss; and for two years it worked just fine, and was getting finer by the moment, until the juggernaut dropped a wrecking ball on my present and my future.

I dragged my tail home from the office that bitter January day, to find a Registered Mail notice in the mailbox.  Whoopee, I though, maybe Publisher’s Clearinghouse has finally come through and I’ll be able to buy back my horse farm and open another practice in Horse Heaven Acres.  I stuck it in my parka pocket and drove up the icy dirt road to my single-wide trailer.

I had been planning to live in that trailer while I built my log home on my 14 acres, but that didn’t look too likely any more.  I set my face grim and parked in the dirt turn-around. Joyous clamor roused me from my sour reverie: the two German Shepherds, the ancient yellow Lab, and the young Great Pyrenees leaped and bounced off the wire mesh of the dog lot.  I opened the door and let them out, and they cut all kinds of comic capers, each coming over to slobber on me again and again until I was good and slimy and cheered up.  I trod carefully up the icy steps to the deck and let them in.  The trailer was full of dog.  I shut the storm door, noting that the deck was covered with goat shit again.  Damn goats.  They were always trying to get into the house.  What did they think was in there?

I fed the dogs.  I fed me.  Then I settled into my recliner to have a good cry and sink into a suicidal depression.  I stayed that way until time to take the nighttime knock-out drops, did so, and fell into an unsettled nightmarish half-sleep.

The phone rang.  It was a mother whose baby had a fever.  I asked the usual questions.  It didn’t seem bad, but I gave her the guidelines.  If it got to a certain point, she was to take the child to the emergency department at what was still our small-town hospital.  If it didn’t get that far, I would see her first thing in the morning at the office.  At least I still had the office, for another four months until the wrecking ball came down for the last time. To Be Continued…..

Losing It

Dr. Dina watched with dull interest as the repossessors hauled off her car and her RV and her luxurious horse trailer with the full living quarters.  She watched out the window of the house trailer she had rented after the bank took the real house.

She told herself it wasn’t her fault that she had lost her medical practice, her pride and joy and the pinnacle of her career and of her whole life.  But she knew that it really had been her own fault.  She had stopped taking her medications because in that small town there was no such thing as confidentiality, and she didn’t want her family  doctor telling her colleagues about how Dr. Dina was taking lithium and a whole alphabet’s worth of antianxiety, antidepressant, and antiepileptic drugs, to treat her bipolar disorder.

When she had moved to East Bumfuck, as she now preferred to call it grimly in her mind, she had intended to get a psychiatrist in the nearest city.  But things got busy quickly, and the only time she thought about it was in the middle of the night when she was wide-awake because of hypomania.  She always planned to do it the next day; but the next day was just as busy, and she forgot again.

Soon she found herself crying for no reason; and during office hours she sometimes had to slip into her private office to cry between patients.  Her office nurse would knock on the door to see if she was all right, but Dr. Dina did not answer, or snuffled through her tears that she was on a phone call.

She thought maybe a lover might help.  But how was one to acquire a lover in East Bumfuck?

In the Appalachian county where she had set up her practice, there was a lively music scene, and Dr. Dina happened to be a banjo player. Although she felt uncomfortable around people in general, she forced herself to go to jam sessions and dances and found herself welcome in the community of old-time musicians.

One of them, a guitarist, took interest in her.  He was married, to Dr. Dina’s disappointment.  But she found herself intensely attracted to him.  His guitar style thrilled her to the bones and planted a smoldering fire in her innards.  She loved his ready wit, and found his bulging overall-ed belly endearing.

It was a known fact that his marriage was on the rocks.  Soon he began inventing reasons to do things with Dr. Dina, “just the two of us,” and before long he had filed for divorce and they were sharing a bed.

As a musical duo, they were hot.  Fancy resorts had them on their regular entertainment lists. They used the money for expensive hotel rooms and champaign. Their lovemaking was so hot it threatened to burn up the beds. They fell into hysterics over the image of the hotel manager staring at the charred and smoking bed the next day,

They lived with a furious intensity.  During the high times, it was martinis and champaign, and Dr. Dina would dance naked in the kitchen while Mr. Man played Django on the guitar with joyous ferocity.  But when one or both was bottomed out, they lived together inside the firebox of the inner furnace of hell.

They stayed together because of the ups, and because they genuinely loved each other.  He was a carpenter by profession. She had some experience with wood.  So they built a bed together, a marriage bed.  It was a dream they had, to build the bed that would hold and surround their love, an impenetrable cocoon to protect them from the world. But something in the building of it went wrong: what should have been a warm and loving creation turned out raspy with bickering and stony silences.  It got into the bed.

After a few years of roller-coaster elation and devastation fueled by alcohol-saturated mutual bipolar illness, Dr. Dina threw Mr. Man out.  The night he left, she dragged the  chainsaw into the bedroom and hacked the bed into pieces.

She dragged the ragged chunks out into the driveway and stacked the remnants up teepee-style.  She drenched the thing with kerosene and threw in a match.  WHOOF!  The fire roared into the night sky.  Dr. Dina shivered in the cold, wracked with sobs, watching their bed go shooting up in flames and showers of sparks. She fed the hardwood fire with dry pine boughs until all that was left was a pile of charred remnants of their former love nest.  The next day when it was cool Dr. Dina took the shovel and buried the ashes, and spread new gravel over the scorched earth of their love.