Current mood: Tired and headachey.
Exciting news: Today I feasted upon three whole snap peas harvested from my garden (and therefore, kind of, made from scratch!), and they were delicious. My poor body has not had that many vegetables in weeks. It's about time I actually got to reap a little bit of all that I've been sowing this Spring. Though using 'reap' as a verb makes me feel fairly creepy.
Also: Just got home from work after my nearly two week vacation, and found it to be tolerable if tiring. I also invented a new game, whereby I rank my evenings according to the number of different bodily fluids I have cleaned up, kneeled in, or otherwise been exposed to in an uncomfortably intimate way. Tonight was a three star evening. Four stars are unusual, but I've certainly had them before. Five stars would involve exposure to a new and exciting bodily fluid (our centre is all women), or perhaps a loogey fight, which has happened once or twice before.
Mission of the day: Convincing Google that I don't have a self esteem problem. I recently monetized my blog, enabling ads to be placed on the sidebar which are catered to my readership based on the site content...and every single one of those twenty or so ads is advertising a counselling service of one type or other. This is made all the more confusing by the fact that nowhere on my site do I mention self esteem directly...Google clearly knows something I don't, and it is trying to send me a not-so-subtle message.
Also: while I'm not going to quit my day job, which is actually a night job, it would be nice to make a few extra cents here and there from the writing I already do simply because I like to write. Fractions of cents should, theoretically, be sent my way every time someone views the site or clicks on an ad. Those that do these activities often are then rewarded with karma and my eternal gratitude. In case you were wondering.
And finally:
Mustard the Amazing Puppy, A True Story (take that, Google)
I go in my backyard and what to do I see
A puppy named Mustard is climbing a tree!
He’s wiggly and wobbly, I fear he will fall
But Mustard, six inches, desires to be tall.
He reaches the top and I give him a frown
Now how, silly pup, are you going to get down?
But Mustard is clever, he’s planned for this too
And he looks at my face and he says: I’ll use you!
Mustard cries, then he yelps, and I rush to his side
And he jumps in my arms
And I take him inside.
Fin.
Saturday, June 13, 2009
Friday, June 12, 2009
Ivy, Interrupted
I went to the nurse and could feel myself shaking.
“I’m thinking about suicide.” I said this into a microphone mounted against a glass wall and acting as a translator and portal to the nurse, seated quietly and looking rather impatient.
She nodded, gravely, and pushed a button. A door to my left slid open and the nurse pointed me inside. She followed, through her own door, and met me in a small cavity with two chairs, where she ordered me to roll up my sleeve.
“I’m going to take your blood pressure.” She informed me, and I took off a hoody to reveal a bare arm.
I have yet to have a single doctor’s appointment where my blood pressure has not been taken – it seems to be a standard medical facility introduction. I’ve heard women talk this way about breast exams; no matter what the complaint, the (always male) doctor demanded a breast exam. Sore throat? Let’s feel your breasts. For my father, a diabetic, blood sugar needed to be taken, no matter what was wrong. He could have been stabbed and rapidly losing blood – a medic alert band, once discovered, would lead every physician to say: Oh my, you’re looking a little pale! I’ll bet it’s your sugar, let’s order some tests.
This was made more frustrating by the fact that my father, who had been diagnosed with diabetes at the tender age of two, could have told them his sugar levels without a single test. Years and years of daily tests had been a training in biofeedback – he knew exactly what the reader (or the doctor) was going to say, down to the decimal point. I understood the perspective of the doctors, who were only trying to be thorough, horse hooves, not zebra hooves, and all that.
This had even saved my father’s life, during times when his sugar had traveled too high or too low to allow for rational thought. Paramedics saw the medic alert bracelet and knew to give him sugar, despite slurred aggressive protests (I’ll give you some sugar!), and his sugar, insulin, and health had been stabilized. This, of course, was a good thing.
In the real world, my temperature was taken, and blood tests were ordered, though the blood test didn’t check for much except alcohol. I suppose a breathalyser would not have been subtle enough and might upset an already fragile patient. The nurse looked at my health insurance card, which was from out of province (and therefore more complicated to bill). It was always the source of paperwork problems, which I braced for when presenting it, preparing an apology in advance: I’m from Ontario. I’m a student here. I’m so, so very sorry.
The nurse didn’t really listen – she was busy writing something down.
“Were things better there, in Ontario?” She looked at me intently, cocking her head to the side, and I felt her concern as it blurred into pity.
“I don’t know.” I shrugged, which offset the cuff still attached to my upper arm. My blood pressure had been normal, as it has always been. The nurse briefly asked me what I’d meant by ‘feeling suicidal,’ and I explained. She went to deliver paperwork, and I glanced at her scribbled writing on my chart. In big letters it read ‘INTENT, PLAN AND MEANS.’ The ‘means’ felt unnecessary - doesn’t everyone have ‘means’? Do people live in worlds without tall buildings, bodies of water, kitchen knives, daisy razors, plastic bags, lengths of rope or shoe laces…the list of everyday objects that could kill seemed endless. I supposed some people grew attached to specific modes of suicide – for example, death by gun would be nice, though guns can be hard to come by. And so if I’d mentioned really wanting to die via bullet wounds, they could have left the ‘means’ out…though if that were the case, and I was unwilling to procure my means, I wouldn’t have come to the hospital at all, because I wouldn’t have been really suicidal. Wanting to die only via gun and not being willing to research a way to get a gun for yourself didn’t seem especially noteworthy in the long continuum of suicidality.
The nurse returned. She was holding something cloth, shaded in the pukiest compromise of orange and yellow.
“I’ve brought some pyjamas you can relax in.” She said, and then directed me to an interview room where I could get changed. It had a door, which was shut, and a smaller side door that could be opened to allow extra space for a bed or wheelchair to pass through. This had been propped open, before, and the nurse didn’t shut it. The small breach of privacy was jarring, especially after a different nurse wandered in as I undressed, asked who I was, and then left, looking suspicious. I kept my body covered as I changed.
My nurse appeared a few seconds after I left the room, and ushered me into a hallway near the entrance of the emergency area. I could see the waiting room, through the sliding glass doors controlled by the nurses’ station, and the door that paramedics entered through. I sat down on a stretcher labelled ‘Bed B’ and was told to wait.
“And you know, you can’t leave.” The nurse walked, briskly, away.
This hallway, I would learn, was for psychiatric patients only – those that needed to be monitored, and thus could not retreat to a curtained space, out of sight and out of mind, like regular patients. It was uncomfortable and always busy. I watched as other people lined up to meet the nurse behind the glass, waited, got called in to get their blood pressure taken, sent back outside, and the lucky few who made it into an interview room to see a doctor.
The doctors were the most interesting.
“You’re walking with a wide step,” A female doctor said, politely, concerned. “Are you feeling dizzy again?” This told me that the female doctor was intelligent and observant, and had managed to be both of those things without becoming an Asshole, which is often hard to do.
“You knew this was going to happen. You choose to take cocaine. I can’t help you.” This doctor was older, portly, and male. He didn’t seem to ascribe to a disease model of addiction or believe in harm reduction, or the value of human dignity. His patient was also male, though middle aged, thin, and looking fairly dishevelled. The patient said something callous under his breath, and the doctor began to yell. After a few seconds it was over, and the doctor and patient each walked away with an air of ‘did you see that guy?’
On a visit to the same hospital a year later, the same doctor would come to see me, staring at my chart and briefly looking up in impersonal glances which never looked at my face, or eyes, but took in my general form.
“You are depressed.” He paused, waiting for an answer, though I didn’t hear a question. I gave in a few seconds later, rambling about a talk with my psychiatrist and my decision to be hospitalized-
“No, your psychiatrist sent you here.” He stared, expecting me to challenge him, raising an eyebrow in an ‘ah-ha’ expression, as though he’d just discover a previously overlooked psychosis.
“Yes, she did, but I’d come to her office wanting to go to the hospital. I led the conversation. I’d packed a bag.” I gestured to my backpack, with seemed to make him nervous. I placed my hands on my legs and waited.
“Your psychiatrist admitted you because you are suicidal.” He said this as though I didn’t already know it and as though he hadn’t heard my previous statement, which I don’t suppose he had. It was a psychiatrist’s job to diagnose, to question, to perceive danger to self and others, and to hospitalize. I was simply a patient. I was an inert and dangerous lump.
He asked me to describe how I was feeling, interrupting me for details that didn’t seem relevant, and then pausing me midsentence so that he could take notes. He asked if I was planning to kill myself in hospital, and I said no. He asked again, saying I sounded insincere. I was sincere, and said so. He looked unconvinced.
“There wouldn’t be a point.” I said, frustrated and tired. “I would just be revived, there’s doctors everywhere. What would be the point?”
My logic hadn’t made much of an impression.
“So you do want to kill yourself?”
“Well, generally, yes. That’s why I came into the hospital.”
I wondered if he would protest this and say that no, I was in hospital because my psychiatrist had put me here. Instead, he asked me to describe any and all suicidal plans.
In the middle of his request, a nurse wandered in to draw my blood (though this was only to test for alcohol). I paused uncomfortably as the unfamiliar woman tied a turnicate. The psychiatrist asked me to continue, and I didn’t want to. I gestured with my chin at the nurse, hoping he’d understand.
He stared at me, frustrated by my defiance, seemingly unaware of the person jabbing a needle into my arm. After a few seconds spent willing me to combust, he left, slamming my chart down at a desk with a stormy thwat.
I felt too tired to feel violated and upset.
A third doctor entered an interview room, saying something generic like “Let’s go in here.” This told me nothing. After a few minutes he left, shaking the hand of his patient, and then he smiled. This doctor was male, in his thirties, with brown curly hair. I found him stunningly attractive.
Smart doctor, fat doctor, and hot doctor made their way in and out of interview rooms, passing their charts off to nurses, who buzzed about everywhere and were simply too numerous to be identified as individuals. I had lost sight of my nurse, the one who had at one point felt sorry for me and taken my blood pressure. I assumed she must have gone home.
The ambulance doors opened and police wandered in.
Paramedics and a stretcher followed, a semiconscious girl laying there with a hand cuffed to the railing. She was muttering something and rhythmically swinging her hand so that the cuffs banged lightly on the metal. Her skin was dark and I wondered at her ethnic origin; this was before I’d worked downtown. Now, I would instantly assume she was native.
A police officer sat down in a small plastic chair in the hall, waiting, bored, and looking at his laptop. The laptops police carried were meant to be indestructible. I’d heard they could withstand bullets and being run over by a car. This seemed an excessive amount of armour, and the laptops looked heavy. They had handles and looked like a solid metal briefcase.
Whenever I’m near a police officer, I feel an intense urge to provoke, to act out, to call names and inevitably get myself arrested or tasered. It’s probably just a basic urge to defy authority, neatly packaged and put on display in a uniform. Stuck next to him in the hall, I wanted to steal this officer’s gun, and kick his hat (which I probably could have done from where I was laying). I wanted to try to break his laptop.
A nurse asked if I was cold and ran to get me a pre-warmed blanket. A paramedic, stuck awkwardly standing in the hallway as he waited for a patient, helped me to adjust the angle on my bed. The police officer stared at his laptop, doing nothing.
I’d left this hallway about four different times to find a bathroom, which was located on the opposite side of a different room, full of medical patients with curtains and families. The first two times I’d asked permission, and then I’d stopped asking. The nurses were too busy to notice or care, and this comforted me – I liked the vague possibility of an exit plan.
On my fifth trip to the washroom, the girl handcuffed to the stretcher called out as I passed: “I need to go to the bathroom!” Her cry was desperate, slurred, and sad.
I turned to her police officer: She needs to go the bathroom.
He looked up slowly and uncomprehending, until he took in the sight of my orange-yellow jumpsuit. With a sneer, he looked back down. I wandered away, to the other room, feeling hurt but not quite understanding, until, suddenly, I did. The medical patients were wearing white pyjamas, blue pyjamas, striped pyjamas, all faded and worn into a blur. The psychiatric patients wore yellow-orange, and this was what the officer had seen.
The colour of my pyjamas grew to feel like an intentional slight. Colour coding was fine and sensible (though, to be fair, all patients should then be been coded this way). Bright, noticeable colours were even okay – we could have all been dressed like canaries, or in solid purple, and it would have been fine. But the colour of puke lined with coffee-grounds or partially digested blood, the hue of painful diarrhea, and all of it mixed with muddy clay – that was what I objected to. It told me that I was not valued, and that people should know this the moment I entered a room. It said I was a little worse than nothing.
Finally, it was my turn to see the doctor.
Hot Doctor asked me into the interview room, and I felt thrilled. I tipped my hat to God, luck, and karma, who had felt like sending me a little good in the midst of my bad (instead of more bad in the midst of bad, or insult to injury, which happens fairly often). He was sympathetic and didn’t seem to notice my crush, which I appreciated. I suppose a lot of patients gave him a similar vibe.
“So, you’re feeling suicidal, and you came in on your own. I assume that’s because you want to talk about it…?” He trailed off gently, welcoming me to pick up where he left off or to start over, correcting him. I paused somewhat awkwardly and wondered if I should correct him. I didn’t want to talk about it. I didn’t not want to talk, either, so maybe it didn’t matter. I took in a deep breath, and started with the previous night.
I had been to a meeting with my boss. One of my coworkers was in trouble for taking a night off. I was vicariously in trouble because I had witnessed her asking to take the night off. But the only person who should have been in trouble was our supervisor, who had been asked and then gave her permission to take the night off. The injustice was upsetting. I felt my eyes start to mist as I explained this for the fifth time.
“Laura,” She said, tersely, “You need to keep it together.”
The shock was jarring, and I felt like I’d been slapped. It distracted me enough to blink, and I didn’t cry, sitting silently as my boss lectured me on all I’d done wrong, including a stubborn reluctance to accept responsibility. Her words whooshed past me like a train, and when it was over I couldn’t speak. I wandered home, praying my roommates wouldn’t be there. They weren’t. I melted on the entrance-way carpet.
After two hours of undulated crying, I had made my way to my bedroom closet and tried to strangle myself, hanging on a knotted scarf tied to the door handle, stopping after my face had swollen and my vision blurred. I hadn’t wanted to stop, but I was afraid that I might want to, seconds later, at which point I’d be too weak, and so this fear of being unable to stop made me stop, which all seemed stupid. I explained this and I sighed.
I had even tried to tell a friend about it that night, describing my method, depersonalized, in accurate detail. He didn’t look to see if my neck was bruised or red, and it wasn’t, really. I asked my friend if what I (or rather, she) had done would constitute a suicide attempt. I wondered if I or she should be in the hospital.
My friend had been listening, though midterms had largely turned his brain to mush. Nothing serious had registered, and then he said, “I don’t think that’s possible.” It wasn’t what I’d been expecting.
“A person couldn’t do that – hang themselves off a closet door. It couldn’t be done.”
But the weight of the body would tighten the scarf, I said, so long as the person didn’t stand up. If they sat there, suspended by their neck and the scarf, then eventually-
“No.” My friend said, and I felt a little defensive of my plan. “A person wouldn’t to sit there, waiting to die, and not stand up. The body has a million reflexes to protect itself. They would have to stand up.”
I didn’t contradict him. I didn’t have any evidence. I myself had stood up, though I’d felt no reflexive urge to do so. I wondered where to go from here.
“Okay, but if someone, in theory, did this thing, regardless of whether it would work...” I trailed off. I wondered what he thought I was talking about. “Would that be a suicide attempt, really? Should that person be in the hospital?”
He didn’t pause or look up – he was highlighting the margins of his textbook.
“Oh, yeah, I guess.” I didn’t know which ‘yes’ he meant – most likely, he meant both. “But, Laura, seriously. Anyone that messed up would already be in the hospital.”
And that had decided my fate.
After our study session, I had gone home. I barely slept, filled with an intense indefinable fear of the psychiatric world and the doctors there, poking and prodding and laying out my every thought and emotion and then sifting for validity.
I was afraid my unravelling, and felt myself egging on my growing insanity, a catalyst and willing conspirator. I was the only conspirator, really, and the helmsman of my own, sinking, ship. Except I wasn’t really sinking at all, I was just...not floating? This was endlessly tiring to think about, and still I didn’t sleep.
I had taken myself to a counsellor, and I had cried into her tissues. I had taken myself to a doctor where I had suggested I might be depressed. I had filled the prescription for cymbalta, and then more cymbalta, and the celexa, and then more celexa, and then celexa augmented with clonazapam or seroquil…I don’t remember.
A friend had warned me against doing this: Doctors always want to diagnose depression, and they give out antidepressants way too easily. You’re smart, you’ve studied psychology, and you know just what you’d have to say.
This thought haunted me as I began to take higher doses of increasingly complex pills. Maybe I wasn’t depressed at all. Maybe I was just seeking attention. Maybe I kept on pushing against the dotted lines of acceptable behaviour until I had created an entire persona of me, as a depressed person, and that person wasn’t me at all.
I felt this way when I went to the doctor, and the counsellor, and the pharmacy. I felt this when I skipped class to stay in bed and didn’t hand in my homework. I felt this when I told friends that I had been diagnosed, and that I should be saying “I got myself diagnosed with depression. I knew all the DSM criteria, and I presented them to a doctor, and I asked if she thought I was depressed,” and that’s exactly what I had done.
Truth became entirely relative when discussing your own behaviour.
Yes, I didn’t eat very much and slept all day. Hours? Eleven or twelve, give or take. But I let myself do all those things. I chose to turn off my alarm. I chose not to eat more. I even chose to feel nauseous, really. I was writing my own song and dance, and it led me back to bed, and away from friends, and eventually to my closet door handle, hanging from my scarf.
It all seemed so silly and transparent and desperate, like a grounded teenager who hates the world and declares that she could just die, or a two year old throwing a tantrum then holding his breath. I was just seeking attention. I wasn’t really depressed. This thought made me sad, and the sadness made me cry, and the crying made me feel like I was still playing the same part. Playing a depressed version of myself made me hate myself. Hating myself made me feel depressed. Cry, rinse, repeat.
But this paradoxical paradigm was a little comforting, too. I had made myself depressed, and so I could make myself not depressed. Cognitive-behavioural therapy seemed entirely based on this principle: I could just stop acting like I was depressed. I could keep it together and I could cancel my appointments. I could go to class in the morning, and I could work on assignments at night. No one was making me fill out prescriptions and no one was making me stay in my bed. It could all simply stop, whenever I wanted.
This had been true, up until that morning.
In the hospital, I was not my own inept puppeteer. This song and dance could not simply stop at will.
I trailed off in my story as I told it to the hot doctor.
He decided I needed a psychiatric consult and then we said goodbye. I wondered why this was not an automatic thing – I had gotten the pyjamas and the stretcher in the hall. I wasn’t ill or needing bandaging, and I wasn’t allowed to leave. A psychiatric consult was the only logical reason for my being there, and yet such a referral, apparently, could only be made by a doctor. Doctors were few and far between. Still, I was lucky to have gotten the hot one.
I went back to my stretcher and I didn’t see the hot doctor again – I guess his shift must have ended and he was allowed to go home. I was brought a sandwich: wonder bread, thick margarine, and bright orange waxy cheese. I wondered who would create such an abomination, and who would want a buttered cheese sandwich, and if it was possible to create such a horrible meal by accident. There was a tea bag and a small mug of cold water. Cream of wheat or former vegetable formed sticky globules inside a plastic dome, unidentifiable by smell. I had a plastic fork and spoon, with no napkin, and no knife.
I wondered if that was because I was suicidal.
I was beginning to get a headache, which could have been stress or lack of sleep. My body was used to loads of sleep – it’s a wonder I wasn’t comatose. I wondered, too, if I was withdrawing from caffeine. I drank diet coke every day in litre quantities – it eroded my teeth and made my friends squirm with distain. I couldn’t help it. Coffee made my stomach hurt and tea made me nauseous. Neither seemed to really wake me up. I’d tried other substitutes, but I’d always got headaches – my body wanted diet coke. I gave in, every day.
I wanted diet coke, desperately, and remembered that they weren’t even letting patients smoke these days – if you wanted to go out for a cigarette, they would give you a patch instead. The entire ten block radius of the hospital, including its grounds and the sidewalk, were designated ‘smoke free’ – a patient would have to be well enough to drive, or run, and drag their IV. I wondered if this happened – I suspected it did. Psychiatric patients didn’t have that option, though. I had change, but I didn’t see a vending machine.
I had finally grown tired and scared and headachy enough that the only solution was sleep. I closed my eyes and didn’t feel like I could, but I kept them closed. The opening and closing of automatic doors and the din of multiple conversations eventually faded to a tolerable lull, and then a white noise, and I could feel my consciousness dissolving into a pool of nothing.
Someone shook at my shoulder.
I startled awake, as I always did. Nurses always startled back, and then grew to hate waking me. This woman was not a nurse. She was a medical student pretending to be a psychiatrist.
“Can we talk?” She asked, sweetly, her tone bouncing with energy and her manners maintained. She was sympathetic in that removed way that sympathetic doctors can be, and she wore this sympathy so completely that I suspected she practiced it at home, and on the weekends, with a fervent enthusiasm.
She suggested we go to a better room, for privacy, and then led me to a door down the hall which was marked PAU. This was a Psychiatric Assessment Unit, and I was surprised I hadn’t noticed it, as it was located less than ten feet from my bed. I walked in and saw a bored nurse, standing behind an ill lit desk. As I rounded the corner I could see what he was staring at – there were monitors, everywhere, and each told four different stories on tiny, black-and-white video screens. Patients shuffled, and ate, and slept, and the bored nurse watched.
I walked past rooms containing a urinal and mattress, and a sad man sitting on the mattress with his bare feet on the ground. Another such room was empty. I wondered where they’d put me.
I was taken to an office with a large glass window in the door. A piece of cardboard was mounted there, against the glass, though that was never explained. Inside, there was a big chalkboard, and behind it a window to another office which could be accessed by sliding the chalkboard aside.
There was a desk and two chairs.
I sat down.
The woman read off criteria for depression, translating them into layman’s terms. Anorexia or lack of appetite was ‘never feeling hungry.’ Fatigue and lack of concentration were ‘feeling sluggish and tired all the time’ and ‘not being able to read the newspaper.’ I wondered if people still read newspapers.
“Do you sometimes feel like activities that should make you feel happy don’t, and that you usually should feel happier, or used to?” This confused me.
“Are you asking if I’m anhedonic?” I asked, and she laughed. She was surprised I knew that word. I was surprised that she was so lousy at explaining ‘persistent lack of feeling pleasure or happiness,’ but I didn’t say that. She continued.
She asked about my family, and my childhood, and my sex life. She asked if there was stress at school – yes. She asked about work, and if it was stressful – yes. She asked about my other job (I was working two), and if it was stressful, and if working two jobs was stressful, and if juggling work and school was stressful – yes, yes, yes, of course. She asked about my housing, and I explained how it was dependant on one of my jobs. That job was dependant on my being a student. Being a student was dependant on paying tuition, which was dependant on my second job.
“I can’t afford to live off campus, and I can’t afford to be a student. But I can’t afford not to be a student.” I felt like I was describing a vortex of doom.
If I finished my courses that semester, and went full tilt into the next, I would be done by spring. It would be over, and I’d be free. Free did not have to be defined, and so it avoided nasty connotations, like being unemployed, paying rent, and the government collecting on student loans. If I finished my courses, I’d be free. But at this point it was November, and I was not doing well in my courses. Exams were less than two weeks away, and I had only written one midterm and handed in a single essay. I was too far behind to attend a lecture without a sense of panic – and so I didn’t attend my lectures. This did not improve things.
If I didn’t complete my courses, then the pain of school extended on, spreading out and swallowing up the horizon. I wanted ‘free,’ and school wanted to take it away. So far, school was winning, and I was just too tired to fight back.
The medical student made notes, and then she smiled, and then she let me go back to my stretcher, where I found that I could not sleep.
Finally, the psychiatrist came, and he asked if he could talk to me. The medical student trailed behind him, but now it seemed she was only observing and not allowed to speak. He did not explain her presence, but the two sat down in plastic chairs in the interview room where I’d once tried to change.
He muttered, and read over the medical student’s notes. I wondered if my presence was really necessary.
“So, you’re depressed.” He said this more to himself, though his statement addressed me directly. He scanned my chart further. “It looks like you have atypical depression.” He finally made eye contact, his voice louder, his speech slowed. “In normal depression, people don’t sleep very much, but they feel tired. You sleep all the time.”
I nodded. I knew this already. I knew my own symptoms. I wondered if my chart said I was a psychology student.
Atypical depression usually means you eat more, but I hardly ate at all. And atypical depression sometimes meant you had more ups and downs, whereas melancholic depression features a flat-line, miserable mood. But then some people thought that this might be ‘female’ vs. ‘male’ presentations of depression. ‘Atypical’ was certainly a misleading name, because it was the most common depression subtype. I didn’t fit it, exactly, and it didn’t really matter. Normal depression doesn’t exist. I don’t say any of this out loud.
The doctor described the previous night’s ‘attempt’ in another person’s words, followed by some deep, contemplative muttering.
“So, I think we’re going to keep you.”
He didn’t explain what this meant.
I had volunteered as a crisis line counsellor and as a resident peer advisor. Both had covered suicide intervention, and suicide screening, and suicide warning signs. I knew the training and the various scenarios, and how they led down a windy path to a single decree: call 911, get them to an emergency room, call an ambulance or the police, get them HELP! There the training ended, and no one said what happened next. No one said what help entailed, or what the doctors would do to the depressed person. No one asked.
I knew the answers better in Ontario, where I went to high school and had seen various friends end up in the hospital. There, any suicidal threat was grounds for a seventy-two hour psychiatric hold for observation, after which the doctors usually gave you some feedback and sent you on your merry way. You seem a little depressed, you should probably talk to a counsellor. That sort of thing. Finite and manageable. Here I did not have a script.
“Is it a hold for a certain number of hours, or days?”
“Kind of like that.” He didn’t elaborate.
“I mean…” I didn’t know how to phrase the questions, though I knew exactly what I wanted to ask: Are you keeping me long enough that people will have to Know? “How long do you think I’ll be here for?”
“It’s hard to say.” He paused, and maybe then realized he was being cruel and evasive. “It might be a few days, until you’re feeling a bit better. But then again, maybe you’ll end up in a ward where you can stabilize and get some intensive treatment. That can take a few weeks.”
The thought of weeks made me panic. I could skip school on Monday and call in sick to work, but weeks took me into December. Weeks took me barrelling towards the end of the semester, and then Christmas.
I nodded.
It was night time now, and I thought of how I’d gotten up early that morning, tired of lying on my bed, anxious and awake. I wanted to go to the hospital at a reasonable hour, and 8 a.m. had finally qualified. I showered. I bussed. I went. It was now nearly 10 p.m..
If I’d had emotional and mental energy to spare, I would have wondered if I should have come at all. I could have slept, at home, or read a book. I could have tried to hang myself again. I could have led the life of a non-depressed person, vowing to forget that I was ever taking pills and talking to doctors. The possibilities seemed endless.
Endless was how it all felt, as I shuffled through the hallway and back to my stretcher, waiting patiently for another nurse to take me away and put me away in a corner of the PAU.
“I’m thinking about suicide.” I said this into a microphone mounted against a glass wall and acting as a translator and portal to the nurse, seated quietly and looking rather impatient.
She nodded, gravely, and pushed a button. A door to my left slid open and the nurse pointed me inside. She followed, through her own door, and met me in a small cavity with two chairs, where she ordered me to roll up my sleeve.
“I’m going to take your blood pressure.” She informed me, and I took off a hoody to reveal a bare arm.
I have yet to have a single doctor’s appointment where my blood pressure has not been taken – it seems to be a standard medical facility introduction. I’ve heard women talk this way about breast exams; no matter what the complaint, the (always male) doctor demanded a breast exam. Sore throat? Let’s feel your breasts. For my father, a diabetic, blood sugar needed to be taken, no matter what was wrong. He could have been stabbed and rapidly losing blood – a medic alert band, once discovered, would lead every physician to say: Oh my, you’re looking a little pale! I’ll bet it’s your sugar, let’s order some tests.
This was made more frustrating by the fact that my father, who had been diagnosed with diabetes at the tender age of two, could have told them his sugar levels without a single test. Years and years of daily tests had been a training in biofeedback – he knew exactly what the reader (or the doctor) was going to say, down to the decimal point. I understood the perspective of the doctors, who were only trying to be thorough, horse hooves, not zebra hooves, and all that.
This had even saved my father’s life, during times when his sugar had traveled too high or too low to allow for rational thought. Paramedics saw the medic alert bracelet and knew to give him sugar, despite slurred aggressive protests (I’ll give you some sugar!), and his sugar, insulin, and health had been stabilized. This, of course, was a good thing.
In the real world, my temperature was taken, and blood tests were ordered, though the blood test didn’t check for much except alcohol. I suppose a breathalyser would not have been subtle enough and might upset an already fragile patient. The nurse looked at my health insurance card, which was from out of province (and therefore more complicated to bill). It was always the source of paperwork problems, which I braced for when presenting it, preparing an apology in advance: I’m from Ontario. I’m a student here. I’m so, so very sorry.
The nurse didn’t really listen – she was busy writing something down.
“Were things better there, in Ontario?” She looked at me intently, cocking her head to the side, and I felt her concern as it blurred into pity.
“I don’t know.” I shrugged, which offset the cuff still attached to my upper arm. My blood pressure had been normal, as it has always been. The nurse briefly asked me what I’d meant by ‘feeling suicidal,’ and I explained. She went to deliver paperwork, and I glanced at her scribbled writing on my chart. In big letters it read ‘INTENT, PLAN AND MEANS.’ The ‘means’ felt unnecessary - doesn’t everyone have ‘means’? Do people live in worlds without tall buildings, bodies of water, kitchen knives, daisy razors, plastic bags, lengths of rope or shoe laces…the list of everyday objects that could kill seemed endless. I supposed some people grew attached to specific modes of suicide – for example, death by gun would be nice, though guns can be hard to come by. And so if I’d mentioned really wanting to die via bullet wounds, they could have left the ‘means’ out…though if that were the case, and I was unwilling to procure my means, I wouldn’t have come to the hospital at all, because I wouldn’t have been really suicidal. Wanting to die only via gun and not being willing to research a way to get a gun for yourself didn’t seem especially noteworthy in the long continuum of suicidality.
The nurse returned. She was holding something cloth, shaded in the pukiest compromise of orange and yellow.
“I’ve brought some pyjamas you can relax in.” She said, and then directed me to an interview room where I could get changed. It had a door, which was shut, and a smaller side door that could be opened to allow extra space for a bed or wheelchair to pass through. This had been propped open, before, and the nurse didn’t shut it. The small breach of privacy was jarring, especially after a different nurse wandered in as I undressed, asked who I was, and then left, looking suspicious. I kept my body covered as I changed.
My nurse appeared a few seconds after I left the room, and ushered me into a hallway near the entrance of the emergency area. I could see the waiting room, through the sliding glass doors controlled by the nurses’ station, and the door that paramedics entered through. I sat down on a stretcher labelled ‘Bed B’ and was told to wait.
“And you know, you can’t leave.” The nurse walked, briskly, away.
This hallway, I would learn, was for psychiatric patients only – those that needed to be monitored, and thus could not retreat to a curtained space, out of sight and out of mind, like regular patients. It was uncomfortable and always busy. I watched as other people lined up to meet the nurse behind the glass, waited, got called in to get their blood pressure taken, sent back outside, and the lucky few who made it into an interview room to see a doctor.
The doctors were the most interesting.
“You’re walking with a wide step,” A female doctor said, politely, concerned. “Are you feeling dizzy again?” This told me that the female doctor was intelligent and observant, and had managed to be both of those things without becoming an Asshole, which is often hard to do.
“You knew this was going to happen. You choose to take cocaine. I can’t help you.” This doctor was older, portly, and male. He didn’t seem to ascribe to a disease model of addiction or believe in harm reduction, or the value of human dignity. His patient was also male, though middle aged, thin, and looking fairly dishevelled. The patient said something callous under his breath, and the doctor began to yell. After a few seconds it was over, and the doctor and patient each walked away with an air of ‘did you see that guy?’
On a visit to the same hospital a year later, the same doctor would come to see me, staring at my chart and briefly looking up in impersonal glances which never looked at my face, or eyes, but took in my general form.
“You are depressed.” He paused, waiting for an answer, though I didn’t hear a question. I gave in a few seconds later, rambling about a talk with my psychiatrist and my decision to be hospitalized-
“No, your psychiatrist sent you here.” He stared, expecting me to challenge him, raising an eyebrow in an ‘ah-ha’ expression, as though he’d just discover a previously overlooked psychosis.
“Yes, she did, but I’d come to her office wanting to go to the hospital. I led the conversation. I’d packed a bag.” I gestured to my backpack, with seemed to make him nervous. I placed my hands on my legs and waited.
“Your psychiatrist admitted you because you are suicidal.” He said this as though I didn’t already know it and as though he hadn’t heard my previous statement, which I don’t suppose he had. It was a psychiatrist’s job to diagnose, to question, to perceive danger to self and others, and to hospitalize. I was simply a patient. I was an inert and dangerous lump.
He asked me to describe how I was feeling, interrupting me for details that didn’t seem relevant, and then pausing me midsentence so that he could take notes. He asked if I was planning to kill myself in hospital, and I said no. He asked again, saying I sounded insincere. I was sincere, and said so. He looked unconvinced.
“There wouldn’t be a point.” I said, frustrated and tired. “I would just be revived, there’s doctors everywhere. What would be the point?”
My logic hadn’t made much of an impression.
“So you do want to kill yourself?”
“Well, generally, yes. That’s why I came into the hospital.”
I wondered if he would protest this and say that no, I was in hospital because my psychiatrist had put me here. Instead, he asked me to describe any and all suicidal plans.
In the middle of his request, a nurse wandered in to draw my blood (though this was only to test for alcohol). I paused uncomfortably as the unfamiliar woman tied a turnicate. The psychiatrist asked me to continue, and I didn’t want to. I gestured with my chin at the nurse, hoping he’d understand.
He stared at me, frustrated by my defiance, seemingly unaware of the person jabbing a needle into my arm. After a few seconds spent willing me to combust, he left, slamming my chart down at a desk with a stormy thwat.
I felt too tired to feel violated and upset.
A third doctor entered an interview room, saying something generic like “Let’s go in here.” This told me nothing. After a few minutes he left, shaking the hand of his patient, and then he smiled. This doctor was male, in his thirties, with brown curly hair. I found him stunningly attractive.
Smart doctor, fat doctor, and hot doctor made their way in and out of interview rooms, passing their charts off to nurses, who buzzed about everywhere and were simply too numerous to be identified as individuals. I had lost sight of my nurse, the one who had at one point felt sorry for me and taken my blood pressure. I assumed she must have gone home.
The ambulance doors opened and police wandered in.
Paramedics and a stretcher followed, a semiconscious girl laying there with a hand cuffed to the railing. She was muttering something and rhythmically swinging her hand so that the cuffs banged lightly on the metal. Her skin was dark and I wondered at her ethnic origin; this was before I’d worked downtown. Now, I would instantly assume she was native.
A police officer sat down in a small plastic chair in the hall, waiting, bored, and looking at his laptop. The laptops police carried were meant to be indestructible. I’d heard they could withstand bullets and being run over by a car. This seemed an excessive amount of armour, and the laptops looked heavy. They had handles and looked like a solid metal briefcase.
Whenever I’m near a police officer, I feel an intense urge to provoke, to act out, to call names and inevitably get myself arrested or tasered. It’s probably just a basic urge to defy authority, neatly packaged and put on display in a uniform. Stuck next to him in the hall, I wanted to steal this officer’s gun, and kick his hat (which I probably could have done from where I was laying). I wanted to try to break his laptop.
A nurse asked if I was cold and ran to get me a pre-warmed blanket. A paramedic, stuck awkwardly standing in the hallway as he waited for a patient, helped me to adjust the angle on my bed. The police officer stared at his laptop, doing nothing.
I’d left this hallway about four different times to find a bathroom, which was located on the opposite side of a different room, full of medical patients with curtains and families. The first two times I’d asked permission, and then I’d stopped asking. The nurses were too busy to notice or care, and this comforted me – I liked the vague possibility of an exit plan.
On my fifth trip to the washroom, the girl handcuffed to the stretcher called out as I passed: “I need to go to the bathroom!” Her cry was desperate, slurred, and sad.
I turned to her police officer: She needs to go the bathroom.
He looked up slowly and uncomprehending, until he took in the sight of my orange-yellow jumpsuit. With a sneer, he looked back down. I wandered away, to the other room, feeling hurt but not quite understanding, until, suddenly, I did. The medical patients were wearing white pyjamas, blue pyjamas, striped pyjamas, all faded and worn into a blur. The psychiatric patients wore yellow-orange, and this was what the officer had seen.
The colour of my pyjamas grew to feel like an intentional slight. Colour coding was fine and sensible (though, to be fair, all patients should then be been coded this way). Bright, noticeable colours were even okay – we could have all been dressed like canaries, or in solid purple, and it would have been fine. But the colour of puke lined with coffee-grounds or partially digested blood, the hue of painful diarrhea, and all of it mixed with muddy clay – that was what I objected to. It told me that I was not valued, and that people should know this the moment I entered a room. It said I was a little worse than nothing.
Finally, it was my turn to see the doctor.
Hot Doctor asked me into the interview room, and I felt thrilled. I tipped my hat to God, luck, and karma, who had felt like sending me a little good in the midst of my bad (instead of more bad in the midst of bad, or insult to injury, which happens fairly often). He was sympathetic and didn’t seem to notice my crush, which I appreciated. I suppose a lot of patients gave him a similar vibe.
“So, you’re feeling suicidal, and you came in on your own. I assume that’s because you want to talk about it…?” He trailed off gently, welcoming me to pick up where he left off or to start over, correcting him. I paused somewhat awkwardly and wondered if I should correct him. I didn’t want to talk about it. I didn’t not want to talk, either, so maybe it didn’t matter. I took in a deep breath, and started with the previous night.
I had been to a meeting with my boss. One of my coworkers was in trouble for taking a night off. I was vicariously in trouble because I had witnessed her asking to take the night off. But the only person who should have been in trouble was our supervisor, who had been asked and then gave her permission to take the night off. The injustice was upsetting. I felt my eyes start to mist as I explained this for the fifth time.
“Laura,” She said, tersely, “You need to keep it together.”
The shock was jarring, and I felt like I’d been slapped. It distracted me enough to blink, and I didn’t cry, sitting silently as my boss lectured me on all I’d done wrong, including a stubborn reluctance to accept responsibility. Her words whooshed past me like a train, and when it was over I couldn’t speak. I wandered home, praying my roommates wouldn’t be there. They weren’t. I melted on the entrance-way carpet.
After two hours of undulated crying, I had made my way to my bedroom closet and tried to strangle myself, hanging on a knotted scarf tied to the door handle, stopping after my face had swollen and my vision blurred. I hadn’t wanted to stop, but I was afraid that I might want to, seconds later, at which point I’d be too weak, and so this fear of being unable to stop made me stop, which all seemed stupid. I explained this and I sighed.
I had even tried to tell a friend about it that night, describing my method, depersonalized, in accurate detail. He didn’t look to see if my neck was bruised or red, and it wasn’t, really. I asked my friend if what I (or rather, she) had done would constitute a suicide attempt. I wondered if I or she should be in the hospital.
My friend had been listening, though midterms had largely turned his brain to mush. Nothing serious had registered, and then he said, “I don’t think that’s possible.” It wasn’t what I’d been expecting.
“A person couldn’t do that – hang themselves off a closet door. It couldn’t be done.”
But the weight of the body would tighten the scarf, I said, so long as the person didn’t stand up. If they sat there, suspended by their neck and the scarf, then eventually-
“No.” My friend said, and I felt a little defensive of my plan. “A person wouldn’t to sit there, waiting to die, and not stand up. The body has a million reflexes to protect itself. They would have to stand up.”
I didn’t contradict him. I didn’t have any evidence. I myself had stood up, though I’d felt no reflexive urge to do so. I wondered where to go from here.
“Okay, but if someone, in theory, did this thing, regardless of whether it would work...” I trailed off. I wondered what he thought I was talking about. “Would that be a suicide attempt, really? Should that person be in the hospital?”
He didn’t pause or look up – he was highlighting the margins of his textbook.
“Oh, yeah, I guess.” I didn’t know which ‘yes’ he meant – most likely, he meant both. “But, Laura, seriously. Anyone that messed up would already be in the hospital.”
And that had decided my fate.
After our study session, I had gone home. I barely slept, filled with an intense indefinable fear of the psychiatric world and the doctors there, poking and prodding and laying out my every thought and emotion and then sifting for validity.
I was afraid my unravelling, and felt myself egging on my growing insanity, a catalyst and willing conspirator. I was the only conspirator, really, and the helmsman of my own, sinking, ship. Except I wasn’t really sinking at all, I was just...not floating? This was endlessly tiring to think about, and still I didn’t sleep.
I had taken myself to a counsellor, and I had cried into her tissues. I had taken myself to a doctor where I had suggested I might be depressed. I had filled the prescription for cymbalta, and then more cymbalta, and the celexa, and then more celexa, and then celexa augmented with clonazapam or seroquil…I don’t remember.
A friend had warned me against doing this: Doctors always want to diagnose depression, and they give out antidepressants way too easily. You’re smart, you’ve studied psychology, and you know just what you’d have to say.
This thought haunted me as I began to take higher doses of increasingly complex pills. Maybe I wasn’t depressed at all. Maybe I was just seeking attention. Maybe I kept on pushing against the dotted lines of acceptable behaviour until I had created an entire persona of me, as a depressed person, and that person wasn’t me at all.
I felt this way when I went to the doctor, and the counsellor, and the pharmacy. I felt this when I skipped class to stay in bed and didn’t hand in my homework. I felt this when I told friends that I had been diagnosed, and that I should be saying “I got myself diagnosed with depression. I knew all the DSM criteria, and I presented them to a doctor, and I asked if she thought I was depressed,” and that’s exactly what I had done.
Truth became entirely relative when discussing your own behaviour.
Yes, I didn’t eat very much and slept all day. Hours? Eleven or twelve, give or take. But I let myself do all those things. I chose to turn off my alarm. I chose not to eat more. I even chose to feel nauseous, really. I was writing my own song and dance, and it led me back to bed, and away from friends, and eventually to my closet door handle, hanging from my scarf.
It all seemed so silly and transparent and desperate, like a grounded teenager who hates the world and declares that she could just die, or a two year old throwing a tantrum then holding his breath. I was just seeking attention. I wasn’t really depressed. This thought made me sad, and the sadness made me cry, and the crying made me feel like I was still playing the same part. Playing a depressed version of myself made me hate myself. Hating myself made me feel depressed. Cry, rinse, repeat.
But this paradoxical paradigm was a little comforting, too. I had made myself depressed, and so I could make myself not depressed. Cognitive-behavioural therapy seemed entirely based on this principle: I could just stop acting like I was depressed. I could keep it together and I could cancel my appointments. I could go to class in the morning, and I could work on assignments at night. No one was making me fill out prescriptions and no one was making me stay in my bed. It could all simply stop, whenever I wanted.
This had been true, up until that morning.
In the hospital, I was not my own inept puppeteer. This song and dance could not simply stop at will.
I trailed off in my story as I told it to the hot doctor.
He decided I needed a psychiatric consult and then we said goodbye. I wondered why this was not an automatic thing – I had gotten the pyjamas and the stretcher in the hall. I wasn’t ill or needing bandaging, and I wasn’t allowed to leave. A psychiatric consult was the only logical reason for my being there, and yet such a referral, apparently, could only be made by a doctor. Doctors were few and far between. Still, I was lucky to have gotten the hot one.
I went back to my stretcher and I didn’t see the hot doctor again – I guess his shift must have ended and he was allowed to go home. I was brought a sandwich: wonder bread, thick margarine, and bright orange waxy cheese. I wondered who would create such an abomination, and who would want a buttered cheese sandwich, and if it was possible to create such a horrible meal by accident. There was a tea bag and a small mug of cold water. Cream of wheat or former vegetable formed sticky globules inside a plastic dome, unidentifiable by smell. I had a plastic fork and spoon, with no napkin, and no knife.
I wondered if that was because I was suicidal.
I was beginning to get a headache, which could have been stress or lack of sleep. My body was used to loads of sleep – it’s a wonder I wasn’t comatose. I wondered, too, if I was withdrawing from caffeine. I drank diet coke every day in litre quantities – it eroded my teeth and made my friends squirm with distain. I couldn’t help it. Coffee made my stomach hurt and tea made me nauseous. Neither seemed to really wake me up. I’d tried other substitutes, but I’d always got headaches – my body wanted diet coke. I gave in, every day.
I wanted diet coke, desperately, and remembered that they weren’t even letting patients smoke these days – if you wanted to go out for a cigarette, they would give you a patch instead. The entire ten block radius of the hospital, including its grounds and the sidewalk, were designated ‘smoke free’ – a patient would have to be well enough to drive, or run, and drag their IV. I wondered if this happened – I suspected it did. Psychiatric patients didn’t have that option, though. I had change, but I didn’t see a vending machine.
I had finally grown tired and scared and headachy enough that the only solution was sleep. I closed my eyes and didn’t feel like I could, but I kept them closed. The opening and closing of automatic doors and the din of multiple conversations eventually faded to a tolerable lull, and then a white noise, and I could feel my consciousness dissolving into a pool of nothing.
Someone shook at my shoulder.
I startled awake, as I always did. Nurses always startled back, and then grew to hate waking me. This woman was not a nurse. She was a medical student pretending to be a psychiatrist.
“Can we talk?” She asked, sweetly, her tone bouncing with energy and her manners maintained. She was sympathetic in that removed way that sympathetic doctors can be, and she wore this sympathy so completely that I suspected she practiced it at home, and on the weekends, with a fervent enthusiasm.
She suggested we go to a better room, for privacy, and then led me to a door down the hall which was marked PAU. This was a Psychiatric Assessment Unit, and I was surprised I hadn’t noticed it, as it was located less than ten feet from my bed. I walked in and saw a bored nurse, standing behind an ill lit desk. As I rounded the corner I could see what he was staring at – there were monitors, everywhere, and each told four different stories on tiny, black-and-white video screens. Patients shuffled, and ate, and slept, and the bored nurse watched.
I walked past rooms containing a urinal and mattress, and a sad man sitting on the mattress with his bare feet on the ground. Another such room was empty. I wondered where they’d put me.
I was taken to an office with a large glass window in the door. A piece of cardboard was mounted there, against the glass, though that was never explained. Inside, there was a big chalkboard, and behind it a window to another office which could be accessed by sliding the chalkboard aside.
There was a desk and two chairs.
I sat down.
The woman read off criteria for depression, translating them into layman’s terms. Anorexia or lack of appetite was ‘never feeling hungry.’ Fatigue and lack of concentration were ‘feeling sluggish and tired all the time’ and ‘not being able to read the newspaper.’ I wondered if people still read newspapers.
“Do you sometimes feel like activities that should make you feel happy don’t, and that you usually should feel happier, or used to?” This confused me.
“Are you asking if I’m anhedonic?” I asked, and she laughed. She was surprised I knew that word. I was surprised that she was so lousy at explaining ‘persistent lack of feeling pleasure or happiness,’ but I didn’t say that. She continued.
She asked about my family, and my childhood, and my sex life. She asked if there was stress at school – yes. She asked about work, and if it was stressful – yes. She asked about my other job (I was working two), and if it was stressful, and if working two jobs was stressful, and if juggling work and school was stressful – yes, yes, yes, of course. She asked about my housing, and I explained how it was dependant on one of my jobs. That job was dependant on my being a student. Being a student was dependant on paying tuition, which was dependant on my second job.
“I can’t afford to live off campus, and I can’t afford to be a student. But I can’t afford not to be a student.” I felt like I was describing a vortex of doom.
If I finished my courses that semester, and went full tilt into the next, I would be done by spring. It would be over, and I’d be free. Free did not have to be defined, and so it avoided nasty connotations, like being unemployed, paying rent, and the government collecting on student loans. If I finished my courses, I’d be free. But at this point it was November, and I was not doing well in my courses. Exams were less than two weeks away, and I had only written one midterm and handed in a single essay. I was too far behind to attend a lecture without a sense of panic – and so I didn’t attend my lectures. This did not improve things.
If I didn’t complete my courses, then the pain of school extended on, spreading out and swallowing up the horizon. I wanted ‘free,’ and school wanted to take it away. So far, school was winning, and I was just too tired to fight back.
The medical student made notes, and then she smiled, and then she let me go back to my stretcher, where I found that I could not sleep.
Finally, the psychiatrist came, and he asked if he could talk to me. The medical student trailed behind him, but now it seemed she was only observing and not allowed to speak. He did not explain her presence, but the two sat down in plastic chairs in the interview room where I’d once tried to change.
He muttered, and read over the medical student’s notes. I wondered if my presence was really necessary.
“So, you’re depressed.” He said this more to himself, though his statement addressed me directly. He scanned my chart further. “It looks like you have atypical depression.” He finally made eye contact, his voice louder, his speech slowed. “In normal depression, people don’t sleep very much, but they feel tired. You sleep all the time.”
I nodded. I knew this already. I knew my own symptoms. I wondered if my chart said I was a psychology student.
Atypical depression usually means you eat more, but I hardly ate at all. And atypical depression sometimes meant you had more ups and downs, whereas melancholic depression features a flat-line, miserable mood. But then some people thought that this might be ‘female’ vs. ‘male’ presentations of depression. ‘Atypical’ was certainly a misleading name, because it was the most common depression subtype. I didn’t fit it, exactly, and it didn’t really matter. Normal depression doesn’t exist. I don’t say any of this out loud.
The doctor described the previous night’s ‘attempt’ in another person’s words, followed by some deep, contemplative muttering.
“So, I think we’re going to keep you.”
He didn’t explain what this meant.
I had volunteered as a crisis line counsellor and as a resident peer advisor. Both had covered suicide intervention, and suicide screening, and suicide warning signs. I knew the training and the various scenarios, and how they led down a windy path to a single decree: call 911, get them to an emergency room, call an ambulance or the police, get them HELP! There the training ended, and no one said what happened next. No one said what help entailed, or what the doctors would do to the depressed person. No one asked.
I knew the answers better in Ontario, where I went to high school and had seen various friends end up in the hospital. There, any suicidal threat was grounds for a seventy-two hour psychiatric hold for observation, after which the doctors usually gave you some feedback and sent you on your merry way. You seem a little depressed, you should probably talk to a counsellor. That sort of thing. Finite and manageable. Here I did not have a script.
“Is it a hold for a certain number of hours, or days?”
“Kind of like that.” He didn’t elaborate.
“I mean…” I didn’t know how to phrase the questions, though I knew exactly what I wanted to ask: Are you keeping me long enough that people will have to Know? “How long do you think I’ll be here for?”
“It’s hard to say.” He paused, and maybe then realized he was being cruel and evasive. “It might be a few days, until you’re feeling a bit better. But then again, maybe you’ll end up in a ward where you can stabilize and get some intensive treatment. That can take a few weeks.”
The thought of weeks made me panic. I could skip school on Monday and call in sick to work, but weeks took me into December. Weeks took me barrelling towards the end of the semester, and then Christmas.
I nodded.
It was night time now, and I thought of how I’d gotten up early that morning, tired of lying on my bed, anxious and awake. I wanted to go to the hospital at a reasonable hour, and 8 a.m. had finally qualified. I showered. I bussed. I went. It was now nearly 10 p.m..
If I’d had emotional and mental energy to spare, I would have wondered if I should have come at all. I could have slept, at home, or read a book. I could have tried to hang myself again. I could have led the life of a non-depressed person, vowing to forget that I was ever taking pills and talking to doctors. The possibilities seemed endless.
Endless was how it all felt, as I shuffled through the hallway and back to my stretcher, waiting patiently for another nurse to take me away and put me away in a corner of the PAU.
Thursday, June 11, 2009
The Hair
The second time my hair was lopped to an unflattering bob, it was because my mother was torturing me.
She would yank, and I would squirm and scream. “You’re hurting me!” “You’re whiny and ungrateful!” “I hate you!” This was a regular morning routine.
Little did I know that other children could find the act of hair-brushing to be pleasurable. Little did I know that it could be anything but a tugging match that made one’s eyes water. When I pulled a brush through unruly hair in high school, in front of friends, their eyes bugged.
“No, you start at the bottom to work out the tangles. Gently.” They said, a little shell-shocked, as if they’d just watch me put out a cigarette on my arm. “That way it doesn’t hurt.”
I took this in slowly. But I’d always yanked fiercely at my hair - it didn’t even really hurt any more. Perhaps I had killed all the nerve endings. Perhaps I’d grown used to the torture. Perhaps I was genetically resilient.
I thought of the mornings, and the yelling, and the tears, and suddenly it all made perfect sense.
When brushing through a terrible tat at the age of thirteen, and then again at sixteen, and once more at twenty-two, I found myself staring at a brush full of broken and disembodied hair, and then realized what I’d done. Feeling along my scalp, especially after the hair had sprouted back, I knew I’d created a bald patch (thankfully hidden deep inside my mane), and I knew that my high school friends had been right all along. Things didn’t have to be so hard.
But the first time my hair had been cut, it was me who was torturing my mother.
The single parent of a three and five year old, my mother had left us downstairs, playing nicely together, while she took a much needed nap. My brother and I, though not always friends, were doing well - he had a small car with self-spinning wheels and a battery pack, and it was occupying both of our attention.
Unfortunately, as we ran it along the carpeted stairs and I leaned down to get a better look, a wheel of the car sucked up a great chunk of my hair and I found myself stuck.
My brother, being five years old and wise in the ways of the world, knew just what to do to rescue me.
He went to the kitchen and emerged with the scissors and quickly freed me from the entrapping vehicle. I was grateful. And then he paused, glinting scissors in hand, and considered his accomplishment.
“Do you want me to cut off the whole thing?” He asked, regarding the rest of my mid-back, dark-blond hair.
“Okay!” I replied, agreeably. And so my brother, in my living room, crafted an almost-pixie cut.
Unable to contain ourselves, we bounded up the stairs to wake our mother.
“Look what we’ve done!” We cried, beaming, and our mother, groggy and terrified, did her best not to quash our enthusiasm.
“Oh, oh!” She cried, gulping, tears forming in her eyes. “Wow. Ivy. Don’t you look...pretty!”
Bless her - my brother and I never suspected a thing.
***
This post is dedicated to my tiny rat dog, Mustard, whose hair I attempted to trim last night. Things did not go according to my perfect plan, and now he is one fifth the size he was, and mangy, and, bless him, does not suspect a thing.
She would yank, and I would squirm and scream. “You’re hurting me!” “You’re whiny and ungrateful!” “I hate you!” This was a regular morning routine.
Little did I know that other children could find the act of hair-brushing to be pleasurable. Little did I know that it could be anything but a tugging match that made one’s eyes water. When I pulled a brush through unruly hair in high school, in front of friends, their eyes bugged.
“No, you start at the bottom to work out the tangles. Gently.” They said, a little shell-shocked, as if they’d just watch me put out a cigarette on my arm. “That way it doesn’t hurt.”
I took this in slowly. But I’d always yanked fiercely at my hair - it didn’t even really hurt any more. Perhaps I had killed all the nerve endings. Perhaps I’d grown used to the torture. Perhaps I was genetically resilient.
I thought of the mornings, and the yelling, and the tears, and suddenly it all made perfect sense.
When brushing through a terrible tat at the age of thirteen, and then again at sixteen, and once more at twenty-two, I found myself staring at a brush full of broken and disembodied hair, and then realized what I’d done. Feeling along my scalp, especially after the hair had sprouted back, I knew I’d created a bald patch (thankfully hidden deep inside my mane), and I knew that my high school friends had been right all along. Things didn’t have to be so hard.
But the first time my hair had been cut, it was me who was torturing my mother.
The single parent of a three and five year old, my mother had left us downstairs, playing nicely together, while she took a much needed nap. My brother and I, though not always friends, were doing well - he had a small car with self-spinning wheels and a battery pack, and it was occupying both of our attention.
Unfortunately, as we ran it along the carpeted stairs and I leaned down to get a better look, a wheel of the car sucked up a great chunk of my hair and I found myself stuck.
My brother, being five years old and wise in the ways of the world, knew just what to do to rescue me.
He went to the kitchen and emerged with the scissors and quickly freed me from the entrapping vehicle. I was grateful. And then he paused, glinting scissors in hand, and considered his accomplishment.
“Do you want me to cut off the whole thing?” He asked, regarding the rest of my mid-back, dark-blond hair.
“Okay!” I replied, agreeably. And so my brother, in my living room, crafted an almost-pixie cut.
Unable to contain ourselves, we bounded up the stairs to wake our mother.
“Look what we’ve done!” We cried, beaming, and our mother, groggy and terrified, did her best not to quash our enthusiasm.
“Oh, oh!” She cried, gulping, tears forming in her eyes. “Wow. Ivy. Don’t you look...pretty!”
Bless her - my brother and I never suspected a thing.
***
This post is dedicated to my tiny rat dog, Mustard, whose hair I attempted to trim last night. Things did not go according to my perfect plan, and now he is one fifth the size he was, and mangy, and, bless him, does not suspect a thing.
Wednesday, June 10, 2009
Police, Force, and Chocolate Frogs
At work, I opened the box labeled only ‘dessert’ to reveal rows upon rows of identical, adorable, tiny chocolate frogs.
“Look!” I declared to others who happened to be in the kitchen. “It’s a little army of chocolate frogs.”
“Awww.” The others gazed, admiring the tiny amphibians of deliciousness. Then one volunteer coughed uncomfortably.
“Does it have to be an army?” She asked, quietly. Others nodded and cocked their heads. I thought on this.
“Look!” I declared. “It’s a grass-roots movement of chocolate frogs, marching for housing rights in front of their local city hall! What a triumphant turnout! …Better?”
“Better.” She nodded, approvingly.
***
Dear Vancouver Police Force and RCMP,
People, apparently, do not like armies.
This has always been the case with foreign armies (who are always a scary sight to behold). But even domestic armies have been declining in popularity fairly steadily since World War II. People like the idea of negotiation, of using words before fists, of democracy and consensus, instead of blindly following orders and blowing the bad guys up on sight. People recognize the need for muscle and force, but only as a last, regrettable resort. The steps leading there need not feature land mines, or stun guns, or bullets of any kind.
Perhaps you see what I’m saying here. Then again, perhaps you don’t.
I’ll be more clear: Your structure imitates that of an army. You wear uniforms and hold ranks. You carry guns and tasers and beating batons. You employ these weapons regularly and sometimes illegally. You see yourselves as crusaders for order and warriors against chaos. You are enforcers, and you are muscle, and you advertise yourselves through posters selling fear.
(Case and point: the poster I see when I ride the bus on main street, featuring three blurry uniformed men, one shining a flashlight towards the viewers eyes, and another holding a vicious looking German shepherd, teeth bared and jaws open to bite…with a caption of ‘we’ll get you.’ The poster is targeted towards car thieves, or would-be car thieves, or anyone not thinking long and hard before they jay walk.)
You claim this is not what you want. What you want is an understanding police force. What you want are officers who communicate, empathize, and relate to the public they serve - even the public they occasionally arrest. You want officers who can handle crisis without sacrificing the dignity and lives of others. You want officers who can explain the law and support the law - and work to change the law when it doesn’t make sense.
Your recruiting site lists the traits of a lot of people I know - people drawn into social work, public health, and housing, mental health, and addiction work. People who lobby the government and intern with Pivot, trying to fight injustice where they see it and protect those who cannot protect themselves. People who understand the fiscal superiority of prevention over punishment, and the human benefit of investing positively in their community. People who rally together in grass-roots movements, marching for housing rights on their local city hall.
People who cringe at the thought of an army.
And so, if your recruitment campaign is not simply an attempt to assuage a growingly concerned public, and if you truly do want to recruit those who would rather work as a public servant than a bouncer at a club, then perhaps you can guess what you have to do. Or, maybe, probably, you can’t.
Police: Give up the uniforms. They’re ugly. Give up the ranks, and a structure which forces all recruits to work in ‘general policing’ for five to seven years. Develop specialized task forces and allow them to recruit and train separately. Give up the tasers, and learn non-violent crisis intervention. Use it when you can, and when you can’t, be transparent about what happened with the public. Stop lying to the public. Stop investigating your own crimes. Consider whether all officers should carry guns - in England, no one does, except for specialized SWAT teams. Develop police-and-public boards and community groups to brainstorm solutions for ongoing concerns. Stop poster campaigns based on fear, and start poster campaigns based on empowerment and a positive future with police as community representatives, instead of just a force.
Take down your scary poster. Apologize to Dziekanski’s mother. Call me if you need further suggestions.
Sincerely,
Concerned Vancouver Resident
by the name of Ivy Donegal
“Look!” I declared to others who happened to be in the kitchen. “It’s a little army of chocolate frogs.”
“Awww.” The others gazed, admiring the tiny amphibians of deliciousness. Then one volunteer coughed uncomfortably.
“Does it have to be an army?” She asked, quietly. Others nodded and cocked their heads. I thought on this.
“Look!” I declared. “It’s a grass-roots movement of chocolate frogs, marching for housing rights in front of their local city hall! What a triumphant turnout! …Better?”
“Better.” She nodded, approvingly.
***
Dear Vancouver Police Force and RCMP,
People, apparently, do not like armies.
This has always been the case with foreign armies (who are always a scary sight to behold). But even domestic armies have been declining in popularity fairly steadily since World War II. People like the idea of negotiation, of using words before fists, of democracy and consensus, instead of blindly following orders and blowing the bad guys up on sight. People recognize the need for muscle and force, but only as a last, regrettable resort. The steps leading there need not feature land mines, or stun guns, or bullets of any kind.
Perhaps you see what I’m saying here. Then again, perhaps you don’t.
I’ll be more clear: Your structure imitates that of an army. You wear uniforms and hold ranks. You carry guns and tasers and beating batons. You employ these weapons regularly and sometimes illegally. You see yourselves as crusaders for order and warriors against chaos. You are enforcers, and you are muscle, and you advertise yourselves through posters selling fear.
(Case and point: the poster I see when I ride the bus on main street, featuring three blurry uniformed men, one shining a flashlight towards the viewers eyes, and another holding a vicious looking German shepherd, teeth bared and jaws open to bite…with a caption of ‘we’ll get you.’ The poster is targeted towards car thieves, or would-be car thieves, or anyone not thinking long and hard before they jay walk.)
You claim this is not what you want. What you want is an understanding police force. What you want are officers who communicate, empathize, and relate to the public they serve - even the public they occasionally arrest. You want officers who can handle crisis without sacrificing the dignity and lives of others. You want officers who can explain the law and support the law - and work to change the law when it doesn’t make sense.
Your recruiting site lists the traits of a lot of people I know - people drawn into social work, public health, and housing, mental health, and addiction work. People who lobby the government and intern with Pivot, trying to fight injustice where they see it and protect those who cannot protect themselves. People who understand the fiscal superiority of prevention over punishment, and the human benefit of investing positively in their community. People who rally together in grass-roots movements, marching for housing rights on their local city hall.
People who cringe at the thought of an army.
And so, if your recruitment campaign is not simply an attempt to assuage a growingly concerned public, and if you truly do want to recruit those who would rather work as a public servant than a bouncer at a club, then perhaps you can guess what you have to do. Or, maybe, probably, you can’t.
Police: Give up the uniforms. They’re ugly. Give up the ranks, and a structure which forces all recruits to work in ‘general policing’ for five to seven years. Develop specialized task forces and allow them to recruit and train separately. Give up the tasers, and learn non-violent crisis intervention. Use it when you can, and when you can’t, be transparent about what happened with the public. Stop lying to the public. Stop investigating your own crimes. Consider whether all officers should carry guns - in England, no one does, except for specialized SWAT teams. Develop police-and-public boards and community groups to brainstorm solutions for ongoing concerns. Stop poster campaigns based on fear, and start poster campaigns based on empowerment and a positive future with police as community representatives, instead of just a force.
Take down your scary poster. Apologize to Dziekanski’s mother. Call me if you need further suggestions.
Sincerely,
Concerned Vancouver Resident
by the name of Ivy Donegal
Sunday, June 7, 2009
Me of the Day
Current mood: Content, with a touch of itchiness
Greatest malady: My nose, which has become red and infected following the switching of my nose ring. My old ring was pretty and I'd worn it for almost a year - it was a small, silver stud, with a little blue stone. Last week, I lost the stone. This made me sad, but I replaced it with a little flower shaped black stud...and then I'd lost a stone from that one, too. I finally replaced the stud with a flimsy silver ring, and my nose sprouted an infection. ...My nose and I hate everything.
Also of interest: I currently have no roommates, which is an odd sensation. I like the space and the privacy, and my rent is exactly the same, which is always nice. But I have no one to blame if the house is looking messy, and thus have been forced into chores like toilet cleaning and dusting the top of the refrigerator (which hadn't been dusted in years). Cleaning toilets and refrigerators are not my favorite things.
Happy note: My bean poles have flowered, and several of the flowers are now sprouting actual pea pods. This is endlessly exciting, since the only thing I've been able to harvest from my garden has been strawberries (they were delicious). Eventually, I will drown in zucchinis, but in the meantime I would like my garden to get busy producing actual food.
Hmph. I want to go back to work. My life is boring and stupid.
Greatest malady: My nose, which has become red and infected following the switching of my nose ring. My old ring was pretty and I'd worn it for almost a year - it was a small, silver stud, with a little blue stone. Last week, I lost the stone. This made me sad, but I replaced it with a little flower shaped black stud...and then I'd lost a stone from that one, too. I finally replaced the stud with a flimsy silver ring, and my nose sprouted an infection. ...My nose and I hate everything.
Also of interest: I currently have no roommates, which is an odd sensation. I like the space and the privacy, and my rent is exactly the same, which is always nice. But I have no one to blame if the house is looking messy, and thus have been forced into chores like toilet cleaning and dusting the top of the refrigerator (which hadn't been dusted in years). Cleaning toilets and refrigerators are not my favorite things.
Happy note: My bean poles have flowered, and several of the flowers are now sprouting actual pea pods. This is endlessly exciting, since the only thing I've been able to harvest from my garden has been strawberries (they were delicious). Eventually, I will drown in zucchinis, but in the meantime I would like my garden to get busy producing actual food.
Hmph. I want to go back to work. My life is boring and stupid.
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