Rain On The Brain

It’s raining again in Grand Rapids, Michigan.  I left my precious Arizona, hot but at least high and dry, to trade in my trusty Jenny the Chevy camper for the 24 foot house on wheels that I ordered back in November. 

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I’ve been sick ever since my arrival last Thursday.  Stress is a bitch!  And for me there is nothing more stressful than moving, even if it’s from one mobile dwelling to another.  I get completely disoriented with all my personal shit strewn around.  Disorder breeds more disorder. 

Speaking of disorder, my dear doggy is completely discombobulated.  All her two favorite hangout places in our previous van are gone.  Like moi, she’s having to adjust to this new space and new lifestyle, all of a sudden. There’s lots more room for her to stretch out in the aisle, but I’ve configured the bed in a way that is unacceptable to her, so she is sleeping in the driver’s seat in protest.

I’ve been in awful, unremitting pain ever since I left the lovely dry Southwest.  Humidity kills me.  My spine is screaming; likewise my shoulders, hands, and hips: all the arthritic places.  And wouldn’t you know it, I had a Crohn’s flare-up start the day I moved my stuff from Jenny into my new rig (whose name might be Betsy).  I finally got the blood stains out of my brand new plastic toilet this morning.  That’s one of the lovely things that come with a Crohn’s flare: shitting blood.  I’ve got a sore throat, headache, and spent last night alternately chilling and sweating.  Fucking immune system, where are you when I need you?  Either running hot or on vacation, and sometimes both at the same time.

My sweet doggie came to see me about dawn.  She must have been listening to me shifting uncomfortably around in the bed, trying unsuccessfully to find a pain-free position.  She tried to worm her way into bed with me, but she is still a puppy, albeit a large one; and in the process of her thrashing around trying to cuddle up with me, she accidentally slashed my throat with one of her claws, and razored me up pretty good. 

My sleep deprived, paining self overflowed and I began to wail.  Poor Atina fled to the driver’s seat, and required a great deal of comforting for the rest of the morning.  She feels terrible when she hurts me.  She knows I am fragile, and tries her best to take care of me. But she is large and ungainly.  Accidents are bound to happen.

After applying first aid to my gashed and bleeding throat, I sat down with my new vaporizer and medicated.  I felt better.  I started the day.

Yesterday it rained.  Today it rained.  I’ve grown accustomed to places that don’t steam all the time.  I intend to make my way back West, where I feel good.  A friend called me a little while ago, from Glacier National Park.  He is not a formally religious man, but he said that Glacier felt to him like knowing God.

God and I have been on the outs for some time, so I think I’ll head over to Glacier and see what my friend is talking about.  I wouldn’t mind having a God experience.  My mind needs a jump start.

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This far corner of Montana is 1,713 miles from where I currently sit.  And that doesn’t take account of my planned side trip to Michigan’s Upper Peninsula.

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The arrow is supposed to point to the Upper Peninsula.  The little blue dot at the bottom is where I am now. So the whole trip will be a big adventure with my new motorhome as I learn its ins and outs. 

I’m glad I temporarily have the ability to do this kind of gypsying.  I won’t always.  Finances and ill health will eventually clip my wings; but I’ll keep on as long as life lets me.  I’ll go as long and as hard as I can, and be gentle with myself too.

That’s my spiritual discipline now: giving myself permission not to do, but to be.  I get depressed.  I say, OK, I’m depressed.  It will pass.  I use cannabis as part of my medication regimen.  It works.  It helps me get through the depressions.  It helps me feel better.  Isn’t that the point of medication?

None of the meds we take for brain pain are “disease modifying.”  They don’t work unless we take them.  If we stop taking them, they stop working.

Cannabis will break me out of a suicidal depression.  It helps me engage with the world, with my environment.  I feel creative.  I can cook and clean up, take a shower, talk to people.  I don’t lie around crying all day.  I’m still depressed, but I’m more functional and less likely to hole up isolated.

Sometimes I’m just too sick though, like last night when I couldn’t even think well enough to pick up the vaporizer till my dog broke me out of it by slashing my throat.  Well, it was over the top, but it changed my state, so I guess it was all right.  Hope the wound heals.  The skin right there is awfully thin.

I hate it that I’m too disabled to work.  All I want to do is to be in my own office, healing the sick.  But I’m too sick to heal anyone, not even myself.  This mobile lifestyle helps me to not go crazy mourning my lost calling.  It’s a distraction, true, and that’s what I need.

It’s interesting to see how campgrounds are places of refuge for the mentally ill and physically disabled.  Of course no one you meet will say, “My name is Doris, and I’m mentally ill.”  Nope, she will say she has a bad knee, or something legit like that.  All the talk about getting rid of the stigma surrounding mental illness has done absolutely nothing compared to the speculation about the “mental health” of the various recent shooters.  Hell, if I were to tell some campground owner that I’m bipolar, you can bet they would be fresh out of campsites.  Mental cases not welcome anywhere…not openly, anyway.  But we’re here.  We are transient; we float from place to place.  We keep quiet and don’t cause trouble.  But we don’t disclose. 

When will the Mentally Ill Matter? 

Maybe never.  We’re the Invisible Minority.

Tired Puppy

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We had a big day today and both of us are beat.  However, if you look at the above photo you will see two squiggly lines.  The red one on the right points to Atina’s “squirrel.”  She has to have it in order to sleep.

The blue line on the left points to my foot.  She is using it for a pillow.  This means that I cannot move, or else I will wake up Sleeping Beauty and then what would happen?

What I want to know is why I get all excited about some new Bipolar management strategy that’s working, and immediately get rid of one of my drugs.  I do that frequently, and frequently pay the price.

For instance, I just started Clonidine for my blood pressure, and it has the side effect of relaxation.  I was getting over-sedated from the benzos I take plus the Clonidine, so I decided to start weaning on the benzos because I hate them anyway.

So after a couple of nights of half doses, last night I skipped the lorazepam entirely.

All well and good, I fell asleep just fine.  But it turns out the Clonidine has a very short duration of action, so I found myself irritability awake and looking for someone to kill at 4:30 in the morning.  Well, the only person I found at that time of the a.m. was me, so I lay in bed till it got light, and then I remembered that someone did me the favor of stealing all my camp furniture yesterday.  Kill!  Kill!!  But I had to wait till the office opened, so I guzzled coffee and planned my angle of attack.

It didn’t work any better than the last time I got robbed in that particular campground, which unfortunately has many advantages, which is why I stay there a lot. 

Last time, someone stole my one good pair of chinos and six pairs of blue Smartwool socks, only a couple of years old.  Fuck, fuck, fuck.  That was the find of a lifetime, Smartwool socks in the most lovely shade of blue.  I guess somebody else thought that too.

I told the incredibly rude cunt bitch fuckhead office person about it, and she just sneered at me, so I asked to see the manager, who was very nice and promised to look into it for me but I doubt she will.

I don’t know why, but the office staff all treat me like I have leprosy even though I’ve been paying to stay there intermittently since February.  I stay there when it’s really cold so I can plug in my little electric heater instead of using the propane furnace, which makes these unholy clicking noises all night.  I don’t think I do anything weirder than any of the other weird campers.  I don’t even allow myself to go around having a running conversation with myself like I normally do.  I think they’re all afraid of my dog, who wouldn’t even bite them unless they threatened me, which is one of the reasons I have her.  The other reason is that she’s sweet, sweet, sweet.  Maybe I’m creepy without knowing it.  Oh well, I’m paying them, and all they have to do is take my money, so I get to be myself.  But I miss my camp furniture and socks.

Tonight I’m in a way over my head expensive and chic campground that is far too near Sedona, which is why.  That’s OK though, because tomorrow I’m off to the Mogollon Rim.  I’ll explain more about that later.  I can’t look down to write anymore tonight.  My neck is killing me. 

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.

Mania Strikes Again

Why does it always happen the night before I have an appointment?  Not even an anxiety-inducing appointment, just a regular one that I simply need to get myself to and show up for.

Last night I took my bedtime meds at the usual time, did my whole pre-bedtime ritual: take meds, brush teeth, give Noga the Wonder Dog her brief nightly training session and resultant treats; get into bed with a book.

In general, by the time I make it into bed, I’m crashing, and sometimes don’t even make it through the “putting on pajamas” stage, but wake up in the morning to find myself half naked and freezing. The nights here are still chilly and I might not have got to far along as to pull up the covers.

The important part out of all of this is sleep.  I have never been good at sleeping.  Even as a child I spent many nights wide awake reading by flashlight under the covers.  At about dawn when the birds were waking up and sleepily cheeping, I might fall asleep for the two or three hours before it was time to get up for school.

Last night there were warning signs.  An hour after my bedtime cocktail of 50 mg. Seroquel, 1 mg Clonazepam, 1 mg Lorazepam, 10 mg Ambien, plus 300 mg Lithium, I was not remotely sleepy.  Not good.  I waited another hour.  No dice.  The book I was reading became hilariously funny, and I convulsed with laughter.  My Psychiatric Service Dog, Noga, alerted, and left her spot at the foot of the bed.  She peered into my face, assessing my condition.  She parked herself nearby, keeping an eye on me.

Noga, the Angel Puppy

Noga, the Angel Puppy

I started my prescribed protocol for incipient mania.  First try to knock it down with benzos: a couple more milligrams of Lorazepam, another milligram of Clonazapam.  Wait another hour.  Nothing.  I’m starting to look for a wall to climb.

Time to pull out bigger guns.  Another 50 mg of Seroquel.  Wait another hour.  Nothing.  Another 50 mg.  Nope.  Another 50 mg.

All this while, I am feeling like I have bugs under my skin.  Antsy, fearful that this is going to go into full-blown mania with hallucinations and everything.

It has started to pour down the rain, buckets.  By morning my rain gauge would measure two inches, and the river below my dwelling raging out of its banks.

My whole-body arthritis, aggravated by the weather, is making it hard to play solitaire on the iPad.  That’s my usual ticket to boredom leading to sleep, but after a couple hours of painfully tapping cards, I give up and take a pain pill–a very mild one, ten mg. codeine and 500 mg. acetaminophen.  Not enough to dangerously interact with the piles of pills I have already ingested, but by this time the only thing that concerned me was what would happen to my dog if I died.

Meanwhile, Noga the Wonder Dog has glued herself to my side and won’t budge, even when I jockey for more room in the bed.  I move her over and slide over myself so I won’t fall out when the drugs finally (hopefully) hit. She immediately sticks herself back in position against my body, licking whatever parts of me are exposed.  We snuggle and smooch for what seems hours.  She loves snuggles and smooches.  She is my Angel Doggie!

I send my morning appointment an email apologizing for canceling.  Of course I lie, saying that I was sick due to something I ate.  I turn my alarm off.

It’s three o’clock and I’m finally slowing down and getting sleepy.  Noga is cuddled up by my head.

I wake up around noon.  Fine, except that I really do have to go into town today (town is an hour away) to get some things for Friday night dinner.  I struggle out of bed, make a strong cup of coffee, get into my recliner under my “happy light.”  I’ll go as soon as I’m safe to drive, when the muzzy druggy feeling wears off.

Noga starts vomiting.  Why do they always have to throw up on the carpet when there is a perfectly good expanse of bare floor available?  I catch her before it comes up and place her on the floor, petting her while she pukes.  Lhasa Apsos routinely vomit when their stomachs are empty for a long time.  She’s been watching over me for 14 hours now, setting her own needs aside in favor of taking care of me.

After she gets done puking I call her over to the “treat station” and put a few yummy things into her tummy.  Her food is in her dish, but she ignores it until her dog treat hors d’oeuvre piques her appetite. She gobbles down her breakfast and hops up to her usual place on the left arm of my recliner, where she is now firmly established.

She literally stuck with me all night, watching over me and caring for me as if I was a sick puppy (I was).  And now she’s back on the job, after a bit of breakfast and a drink.

Through depression, through mania, she is my Psychiatric Service Dog, always on the job. She takes her job seriously.  I would love her anyway, even if she weren’t my Service Dog Angel, but the psychic connection between us is so strong that she’s like an extension of me.

I wish everyone could be so blessed.

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.

 

What. A. Day.

To most of you, having to be somewhere at 10 am might not seem like a crisis.  Far from it.  Many of you have “real jobs” and have to be there at 8, or even 7, in the morning.

I have never been a morning person.  If I’m up at 7, it’s because I’ve been working since 4 pm the day before.  I have always crafted my jobs that way.  Since I don’t sleep anyway, it works out for me.

But.  The “not sleeping anyway” part turned out to be part and parcel of my bipolar, so in the end it contributed to my professional downfall and eventual total disability.

Now I do sleep, thanks to the handful of drugs I take at bedtime.  And those drugs take at least 12 hours to wear off.

I have also developed a strict program of sleep hygiene.  I take my drugs at 9:30, am asleep by 11, and wake between 9:30 and 10 am.  Works for me.

But today I had to see the orthopedist about the crunching noise and pain in my right shoulder, due to the fall I took on September 9 in Israel.  The shoulder bit was part of the damage incurred in the fall that also gave me a nice concussion and a scar that runs from my elbow to my wrist.  Very nice.

So I managed to drag my sorry butt out of bed at 8, and got to the orthopod’s office right on time so I could wait another two hours during which I could have been asleep in my cozy bed.

Once again, I chose not to disclose my mental illness or medications on the intake form.  It has been my unfortunate experience that once the medical personnel see that one has a mental illness, they immediately assume that one is a drug-seeking crank.  So I have adopted the policy of disclosing on a need-to-know basis, and they didn’t need to know.  So much for abolishing stigma in the field of medicine.

The ortho examined my shoulder and of course cranked it in a way that caused me to say (actually scream) bad words, but judging by his non-reaction I guess he hears a lot of that.  He confirmed my impression that something is going “crunch” and “clunk” in there–never a good sign.  Then he proposed injecting it with steroid.  I proposed that we get an MRI before performing any interim treatment measures.  I hate to deprive him of an extra procedure charge to Medicare, but hey, I didn’t go to med school for nothing.  My motto is “first diagnosis–then treatment.”

So he good-naturedly signed me up for an MRI, to be carried out sometime in the next few days.  And he wrote me a script for some pain medication that is way, way too strong for me.  He was astonished when I asked for a specific med that is much less potent, and hesitated to write it for me because he thought it wouldn’t be strong enough.  I told him that if it wasn’t, I could always take a Tylenol with it.  So much for drug-seeking.

My next stop was the Subaru dealer.  Ever since my car was stolen and wrecked, careening into four other cars before running off the road, and despite the extensive repairs that had it in the shop for over a month, the steering has been squirrelly.

In the US, I live in a mountainous area.  Squirrelly steering is just not OK here.  In fact, it could mean the difference between staying nicely on the road and plunging down a rocky ravine.  So I took the car to the Subaru dealer where I bought it, on the advice of the insurance adjuster who has been allegedly supervising the resurrection of my 2011 Subaru.

The dealer’s mechanics also thought the steering was squirrelly, but they refused to fix it because they were not the ones that did the original work.  The shop that did the original work is a body shop 2 1/2 hours away, that deals in American cars, not Subarus.  Why the body shop was allowed to do the mechanical work (the entire front end was caved in in the wreck), I will never understand.

So I asked the service manager at Subaru to please call the insurance adjuster and tell him that they also thought the steering was squirrelly but that they refuse to fix it because somebody else did the original work.

The insurance adjuster called me and said that he saw no reason why they shouldn’t fix it, since they are a Subaru dealer and all this and that.  I told him I thought the same but since I seem to be powerless in this situation that I would let him deal with it, since he is the insurance adjuster and all this and that.

So now I am faced with a fair probability of needing surgical repair on my bum shoulder, and further surgery on my bum car.  Quite the pair, we are.

And just to sweeten the pot, I got a summons for jury duty.  What a day.

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…..

Sometimes A Scream

Photo on 2013-04-20 at 21.37

 

Sometimes a scream

Gets stuck behind

My breastbone

It’s the one for when

I gave my dog away

130 pounds of

Black Alsatian sweetness

He didn’t like my boyfriend

I should have kept the dog

That dog knew my heart

And now my heart is hurt

And that scream, stuck behind

My breastbone

Has no way to get out

Sometimes a scream

Gets jammed in my windpipe

In my voicebox, really.

It’s the one for when

I closed the office door

For the last time:

Children’s Health Care

Office Closed.

I locked that door myself

But I left something inside

A chunk of bleeding flesh

It looks like a piece of my liver,

The one that is stuck in my windpipe

Trying to scream.

Sometimes a scream

Struggles with my lips,

As I fill the compartments

Of my medication boxes

One, two, three, seven

Pills for tonight

More for the morning

All to keep me from

Screaming and screaming and screaming.

DPchallenge: 2 AM Photo

Sleep is always a challenge for me.  To achieve it, I take five (5) medications: Seroquel, clonazepam, lorazepam, zolpidem, and lithium.  Yes, I know there are six pills in the picture.  That is because of the two Seroquel.  For those who are new to my blog, I take all these poisons due to PTSD incurred courtesy of childhood abuse and a stint on the streets as a teenage runaway, complete with serial rapes.  You can read all about it here.

Nighttime Knockout Pills

Nighttime Knockout Pills

And as if all those pills weren’t enough, I use about half an ounce of some kind of liquor as an adjuvant (enhancer).  My favorite is Ouzo, as it leaves a lovely trace of anise on my palate, as my knockout pills waft me to sleep.  Thats one of the reasons I don’t practice medicine anymore: you just can’t field nighttime medical emergencies while hammered on six kinds of meds (I regard the Ouzo as one of them).

Adjuvant

Adjuvant

If something manages to wake me at night, an earthquake for instance, or the part of the ceiling directly above my bed falling down, or a painfully full bladder (thank God I do wake up for that), I stumble through whatever is necessary to remove myself from the annoyance.  I imagine I would look, to an innocent observer, rather like a hapless zombie that has feasted upon too many alcoholics, or perhaps upon me: too full of sedatives to even try to escape.

So imagine my annoyance when my Galaxy SIII, only slightly smaller than an iPad, rumbled to life at 2 AM, buzzing and tinkling its bell tone indicating an incoming text.

I must have been in the light part of my sleep cycle (otherwise it could have hit me in the head and I wouldn’t have turned a hair), because I awoke with a start that sent Noga, my Lhasa Apso, scurrying to the foot of the bed, as I sat bolt upright as if on springs.

Noga refuses to get out of bed on a rainy morning!

Noga the Lhasa Apso 

My first thought was it must be some mother who had fed her baby strawberry jello, and now its diaper was shockingly red.  Then I remembered: I am no longer in practice as a pediatrician, due to my mental illness and its Machiavellian treatments.  Then a more chilling thought occurred to me: what if something had happened to some family member, God forbid?  But that would entail a phone call from the appropriate authorities, not a text.

At last I wrenched myself far enough away from drugged stupor to actually look at the phone.  MMS, it said.  I touched the “view” button.

Oh fer cryin’ out loud.  This had to be from Floyd, my pervy neighbor.  Who else would send me a photo of his large and rampant, uh, you know….in the middle of the fricking night?  He must have been pickled.  Deleted the goddam thing and lay back down.

Then I sat up again.  I was thirsty.  All these drugs make my mouth dry.  I felt around for my bottle of Gerolsteiner that I usually keep by the bed.  I love Gerolsteiner:  it has lots of minerals in it, good for your body.  And it tastes good, too.  Shit, it wasn’t anywhere around.  I got out of bed and stumped into the dark kitchen.  Ah, there was the bottle: right next to the sink.  Why the hell did I leave it there?  Must have got distracted while brushing my teeth.  Ah well.  Here it was, anyway.

Gerolsteiner, yum

Gerolsteiner, yum!

 

I unscrewed the cap and took a deep chug.

Jeezus Christ and all his disciples, what the hell was this!?  Oh fuck, it was the Ouzo!  What was is doing next to the sink?? What am I gonna do now?  I musta just ingested a cup of it.  And on top of all these meds….should I make myself throw up?  That’s what I would tell someone else.  I hate to throw up.  I’ll do anything to avoid it.

Well shit, if I’m gonna die I may as well go back to bed.  But now I really need the Gerolsteiner, to quell the burning in my stomach.  I found a new bottle on the shelf and drank as much of it as I could, hoping to dilute the Ouzo enough so I wouldn’t die immediately of drug interactions.  Maybe gently in my sleep, to be found some days later when I didn’t answer my phone.  Morbid thoughts.  Damn phone.

I stumbled toward the bed, holding onto the furniture to keep from falling down.

Damn.  Now my bladder was grumbling and required immediate attention.  I looked outside.  Raining cats and dogs.  No effing way I was going to make my way to the outhouse in this storm, especially in my present compromised condition.  For you newbies, just to let you know, my plumbing situation is non-standard.  ‘Nuff said.

2012-10-25 09.13.51

I got out the pee jar, which I keep under the bed for such emergencies.  (No picture of the pee jar, sorry.  Too personal.)

Squatting over the pee jar, I let the excess water drain out with relief.  Shit, shit, and more shit!  Apparently I had not remembered to empty the pee jar since its last use, and now there was pee all over the floor.  Time to get the mop.  (No picture of this either.)

After cleaning up as much of the mess as I could in my present condition, I fell into bed and drifted into a semi-comatose state resembling sleep.  But not for long.  “Brrrr, bling!” went my phone.  I picked the damn thing up and threw it across the room.  It smashed into the closet door.  Good thing I bought the insurance.

http://dailypost.wordpress.com/2013/03/18/writing-challenge-nighttime-photo/

This Is My Brain, Love It Or Leave It

Right in the middle of last night, my phone rings.  When my phone rings it is impossible to ignore, because my ringtone is the intro to Queen’s “We Will Rock You.”  I know, right, it’s more than a little extreme, but the idea is to get my attention and make me answer it so it will stop going, “boom boom BAH, boom boom BAH!”  And Freddy Mercury singing “Buddy you’re a boy,” etc.  

Where was I?  Oh, right.  So my phone goes off in the middle of the eff’ing night, and I pick it up, and it’s my longest bestest buddy friend from forever, with whom I used to go on adventures and get into high-jinks.  So I’m like, wow, what’s up, is everything OK?  I mean, I always wanna talk with you, but did you know it’s like, 2:30 am?   And he’s all like, yeah, I’m really sorry to call you at this hour, but I’ve got something to discuss with you that can’t wait.

And I’m like, wow, what’s the problem, baby?

So he’s like, look, I don’t know what it is or how it happened, but through you I contracted some kind of virus, and I passed it on to my eldest son, and now he is sterile.  He can’t have children.  And all this time, I have known it, and I’ve never said anything about it because I love you so much and I didn’t want to hurt your feelings.  And the virus is incurable, and I know you didn’t know you had it, because if you did you would have told me.

Silence.  I’m sitting there in the dark gripping the phone, devastated by this news.

And I’m like, wow, what kind of virus is he talking about?  I don’t know of any viruses that cause the second generation to become sterile.  And my brain starts going Whirrr,  Whirrr, like a hard drive that’s gone sick, I’m sure you’ve all heard that sound.

Then I open my eyes and everything is black.  I’m lying on my back.  Noga, my little dog, is curled up next to my left ear same as always.

And I’m like, what the f*ck?  I turn on the light.  My phone is lying there on the bedside table.  The screen is dark.  I pick it up, look at the recent calls log.  None since yesterday, and none from him.  Oh shit, not again.

This Is My Brain On Drugs

This Is My Brain On Drugs

These drugs I take–the ones that keep me from doing harm to myself, the ones that keep me right-side-up enough to write this and other stuff–oy vey, are they a double-edged sword.  On the one hand, they keep me sane (sort of).  On the other, they make me crazy!  That middle of the night phone conversation was so crystal-clear real, that if it had not been for the bizarre content I would have just shrugged it off and called my friend the next day and said, Hey man, what’s with the 2 am phone calls?  I mean, I love you, man, but you know I don’t keep those hours anymore.

As it is, I did call him today, at a civilized hour, and told him the whole story.  We got a good larf out of it, anyway.  Then I went to my therapy session and told my therapist, and after she got all done laughing and wiping her eyes she said, “WHAT drugs are you taking now?”

“The usual,” I said.  We both shrugged.