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The Death of Small Creatures

Page 20

by Trisha Cull


  Will I know myself when it is done?

  Clinical Note:

  Seen by Dr. Miller, as Dr. P is away. She is currently in hospital due to depression phase of Bipolar II disorder. Mood low. Pet rabbit died yesterday. Feels anxious as day goes on. Paces and putters around. Early morning wakening. Appetite low. Denies active suicide ideation at this time. Poor impulse control.

  Continue with current meds.

  Await ECT.

  On waitlist for tomorrow.

  December 20, 2011

  Early this morning I received my first electroshock therapy treatment.

  The nurse, Janet, came in at 8:20 am and said that there had been a cancellation, that they could fit me in. “The porter will be here in ten minutes to pick you up and take you over,” she said.

  I said, “What’s a porter?”

  Janet said I had to put on a hospital robe, one of those that opens in the back. I fumbled with the ties in the darkness. My hands were shaking.

  Janet came in and said, “The porter is here.”

  “I can’t seem to tie these,” I said, so she kindly tied them for me.

  When I walked into the bright hallway the porter was there in blue scrubs, standing behind a wheelchair.

  “Oh, I can walk,” I said.

  Janet said, “No, you’re going to need this afterward.”

  The porter wheeled me past a few fellow patients who were already waiting around for breakfast. I felt embarrassed to be in a wheelchair. But the porter and I soon disappeared into the elevator. He punched in floor three and up we went.

  He wheeled me through various corridors, through a maze of sterile hallways and rooms, and I was grateful for the ride, realizing that had I been walking the back of my robe would have been flailing in the air, my ass and purple panties exposed for everyone to see.

  Finally we entered the ECT waiting room, a drab brown room with no windows, some inner vortex of the hospital that never sees the light of day.

  I just sat there, making mental notes of the room, wanting to remember the details: the shabby Christmas decorations (cheap gold and silver garland draped along the shelf on the opposite side of the room, a red foil three-dimensional star hanging from the ceiling and a red felt stocking laid upon the end of one of the shelves); old framed paintings of lakes and ducks, oceans and gulls flying in flocks above the oceans.

  There was an old black woman with dreadlocks sitting directly across from me. She kept staring at me.

  Two nurses came through another door, escorting a red-haired lady to a chair. The lady had just had shock treatment. She appeared stunned and shaken, her face was white, her lips protruding slightly, and her gaze was wide and vacant.

  Then my turn came.

  (I can’t remember if I was all this time still sitting in the wheelchair or if I had moved to a waiting room chair. For the life of me I can’t remember.)

  But I walked to a cot in an adjacent room. A nurse and Dr. S, the doctor administering the ECT, escorted me.

  Suddenly, there were people everywhere, all around me. I manoeuvred myself onto the cot, tried to keep the back of my gown shut, didn’t want to expose myself to Dr. S, was shy about my body, embarrassed by my lack of physical conditioning, my lack of muscle tone, my generally soft body bulging at the edges.

  The nurse placed a blanket over me. Only my toes stuck out at the end. The nurses and both doctors all commented on my nicely painted red toenails.

  Dr. S gave me some oxygen and placed gel on my temples, followed by electrodes on my temples, on my chest and behind my ears, which I thought was weird.

  This was going to happen fast.

  I enjoyed Dr. S’s hands on my body, the application of gel. The combination of gel and the pressure of his fingers felt surprisingly soothing. The gel was cool on my skin.

  A nurse inserted a needle for the IV into my right arm, forcing me to expose my upturned wrist and the razor cuts on it.

  The anaesthesiologist said, “You’re just going to go to sleep for a while now.”

  I nodded.

  The next thing I knew I was waking up from the anaesthetic in a row of cots upon which laid other people who had just had shock treatment. A nurse was there with me. She placed a warm blanket over me. It felt glorious.

  We all lay there, cocooned under white sheets, one after the other, everyone groggy or still asleep, some people lolling their heads to one side, others seemingly wide-eyed and alert.

  I blinked, rubbed my eyes. I stared off into the distance, had the strangest feeling that something was wrong, that I was still waiting to have my shock treatment, not realizing for some time, until it dawned on me, that it had already been done, so quickly and uneventfully it’s like it hadn’t even happened.

  Surely it had happened to another person. Surely they had forgotten about me.

  I felt dazed and cold. After an hour or so the nurse escorted me back out into the waiting room and sat me down in a chair, then she brought me a warm bran muffin with butter. The butter was glorious, melting into the muffin. The muffin was warm in my hands. I devoured it.

  Electricity had just passed through my body. I was beginning to feel the effects: a tightened jaw and sore throat muscles. And I wanted that wholesome warm bran muffin in my body.

  Bran muffins do not conduct electricity.

  December 21, 2011

  The effects of the ECT from Monday have hit me hard today. I woke up stiff, my body aching as if I had just run a marathon. The back of my throat was raw. It’s hard to swallow.

  I will have a hot bath tonight.

  I have not cut myself in days now, and I don’t feel compelled to. Is the ECT already working?

  I can’t believe Caravaggio is gone, dead and buried in my sister’s front yard underneath the blueberry bush. Caravaggio loved blueberries. I looked for blueberries for him in the grocery store a day or two before he died, but I ended up not getting any. I went home without blueberries.

  I saw Dr. Miller again today. She is still filling in for Dr. P while he is on Christmas holidays. She said we should wait until Dr. P returns before making any rash decisions about my discharge. Dr. P is back in a week. I suspect I will be discharged shortly after his return, and in the interim I will have a seventy-two-hour pass for this Christmas weekend, leaving the hospital early Saturday morning and returning on Boxing Day.

  December 22, 2011

  I had my second ECT session this morning, was already awake when the nurse came in to take my blood pressure and to give me a muscle relaxant. I woke up at 4 am, tossed and turned until 5 am, finally got out of bed, went to the washroom to splash water on my face and to brush my teeth, comb my hair. Such vanity. Was I honestly trying to look good for ECT? I realized after the last session that I had not brushed my teeth beforehand and wondered if I had had bad breath when the doctor inserted the rubber guard into my mouth. I wanted to be better prepared this time.

  The porter came and wheeled me once more through a maze of corridors to the guts of the hospital, into that little waiting room with no windows. I tried to make mental notes of my surroundings again.

  A rope of silver garland lined a shelf on the left side of the room across from me, and a rope of silver garland lined a shelf on the right. In between these two shelves was a painting of a house surrounded by some sad shrubbery. A dirt path led away from the house into a milky blue horizon, a few pale, almost translucent, clouds in the sky. The house was beautiful, lit from within as if swathed in sunlight.

  I focused on the orange house as I thought about my forthcoming ECT treatment, trying to block out the various goings-on in the room: an obsessive girl who kept harassing the secretary about appointment times; a fidgety older woman on the couch next to me whose general disposition—her inability to keep still and the worried expression on her face—bothered me greatly; another forlorn woman with sparse
, short blonde hair and a double chin directly across from me; and the secretary herself who seemed a lot nicer than the temp from last time, but who busied herself with the constant rifling of paper.

  I wanted the stillness of the room from last time, the blankness of detail, the bland gestalt that beheld me as I gazed off into dead space awaiting my electrocution.

  Set amid the silver garland on the right was a snow globe. Inside the globe stood a woman in white. I don’t know if there was snow in the globe or not. I wanted to walk across the room and peer inside the globe, take it in my hands and look into it, shake up the snow (if indeed there was snow) and study the woman in white, that stolid figure, so composed, frozen in space and time forever, her universe a glass bubble.

  My turn came.

  It struck me only when the nurse came to retrieve me that I had in fact been waiting eagerly, to feel the cool sheet of the cot under my back, the warm blanket they place over me, the tiny prick of the needle in my arm (on the top right hand this time), to feel the oxygen mask cover my mouth and nose and to breathe it in deeply (that cool blue air), and the burn of the anesthetic as it flows up my veins into my bloodstream, into my heart, to feel the sensors on my body, on my chest, beneath my breasts and behind my ears, and the cool, sticky gel rubbed into my temples and to at last not feel anything as I drift off into the ether.

  The anaesthesiologist asked me to take deep breaths and said again, “You’re going to go to sleep now.” I nodded, imagined Caravaggio tangled under my couch, the feeling slowly dissolving from his hindquarters, his body going numb.

  Part of me wanted to prove him wrong, to fight it, to stay awake and alert as the electrical impulses entered my head and into my brain, to feel my body seize and seize and seize.

  This is my most masochistic self, my most curious self, the part of me that wants to be privy to my every bodily impulse, to not be fooled, to not be had, to not be taken asunder beyond my will, the part of me that holds on tight in a wild desire to be free.

  But I fell under. The battle had not even begun and I was out.

  I wish I could know, tabulate, the exact instance of my departure, to somehow be conscious of it as it happens. But I cannot. It’s like trying to tabulate the instance a penny tossed into a well breaches the meniscus of the water before falling under.

  I just fell, and when I came to, it had been done.

  I wonder what mechanism is at work inside my brain as the electricity passes through it, what channel opens. Or is it like a camera shutter opening and closing at the moment of the flash, a quick snap, and I am reset?

  I think of you, Dr. P, the pain and anguish I feel because of you, wanting your love, and I think yes, let me be reconfigured, reset, realigned, so that I don’t have to feel this way anymore, so that my love for you can be extinguished and replaced with a soft blue light—the fading resonance of shock, the lingering heat of the blaze turned cool.

  Clinical Note:

  ECT # 2 yesterday. Calmer. No suicidal ideation. Sleep is fair. Trisha has not told her family about the ECT as they may disapprove and she doesn’t want to deal with the drama.

  December 28, 2011

  I have had three ECT sessions. I think my mood is elevated. My heart seems to be residing a little higher in my chest. My body moves more fluidly as I walk these beige corridors.

  The forgetfulness, though, is startling.

  While talking to you this morning I forgot what day it is, could have sworn it was Thursday. I couldn’t remember what I did for Christmas, could not remember spending the weekend with Sandy and I could not remember that I am due to spend New Year’s Eve at my oldest sister Tammy’s place just outside of Seattle, even though the trip has been planned for weeks.

  I have not experienced any more headaches or nausea.

  I emailed you this morning to ask what time I am meant to leave on Friday, and you didn’t email me back.

  Clinical Note:

  Mood improved. Affect bright. Improved impulse control. Voluntary status. No cutting. No psychosis. Some short-term memory issues that are expected right after anaesthesia and ECT. “My memory is there but it’s slow.”

  December 29, 2011

  I am going home tomorrow after an early morning ECT appointment. I sit here on this cot, writing to you: my psychiatrist and the man I have fallen in love with.

  I stare at the whiteboard. My nurse today is Janet.

  A nurse wrote my name on the board one month ago, and it has stayed there the whole duration of my stay. I like to be called: Trisha. The “a” at the end of my name is partially worn off. Only now have I noticed the word “please” at the bottom of the board. How could I have not noticed it before now?

  I think:

  Please let me be okay when I leave here.

  Please let me not drink when I leave here.

  Please let me not be in love with you anymore.

  Please let the anguish go away.

  Clinical Note/Discharge:

  Zero suicidal ideation.

  Zero homicidal ideation.

  Rapid cycling mood stable.

  Zero psychosis.

  Affect bright.

  Zero distress.

  Zero agitation.

  Sober.

  Decreased impulsivity.

  ECT.

  Follow-up with me January 3, 2012, 3 pm

  Lamictal as outpatient.

  January 1, 2012

  The skin on the back of my ears is burnt, blistered on the left ear and scalded on the right. I scratch behind my ears and flecks of skin come off. This is where they put the electrodes. (The scalding is either a result of the electrodes or a coincidence.) I imagine currents of electricity, lightning bolts, travelling through my head, through my brain, from one ear to the other and smoke coming out of my ears. Frankenstein.

  Dr. S asked me last time as he walked me into the ECT room, “Are you feeling better?”

  I said, “I don’t know, I can’t tell.”

  He seemed to scoff at this, laughed, “Well that doesn’t sound very good.”

  The truth is Christmas is over. New Year’s is over. I have been clean and sober from alcohol since checking into the hospital over a month ago. I am worried about going home, back to my apartment, back to Marcello, my one remaining bunny. I’m afraid of the loneliness, that I will now feel the impact of Caravaggio’s death, my beautiful boy, paralyzed in his hindquarters, a vertebrae cracked, his life over, his body gone.

  I have my remaining ECT sessions in the coming days and weeks, but I have no memory of these. Dr. P cuts me off at nine sessions because my memory is so badly affected. I have no memory of anything surrounding my sessions. It’s a complete blank except for little bits and pieces here and there: cuddling Marcello, crying night after night over the loss of Caravaggio, a few more intimate emails sent to Dr. P, a few more declarations of love, walking along the ocean some days, a few outings with friends and the picture of Africa on the hallway leading into the ECT waiting room.

  I worry that I won’t be able to find my way to the waiting room, that I’ll miss my appointments. Leigh drops me off, says, “Turn left at Africa.”

  I am due to return back to work in early January, but I show up eight hours late for my first shift. My boss calls me, says, “You missed your shift, Trish.” I apologize profusely: “I’m so sorry,” I say. “It won’t happen again.”

  The next day, I miss my shift again.

  A few days later, I break up with Leigh, for good.

  For years my life has been a nightmare: years of alcoholism, a toxic relationship, a false marriage, running away and returning, never knowing where I was, where I had been or where I was running to.

  My diagnosis, Bipolar with Borderline Tendencies:

  Bipolar-affective disorder, manic-depressive disorder, manic-depression is a mood disorder, characterized b
y episodes of an elevated or agitated mood known as mania that often alternates with episodes of depression. Mania: rapid, uninterruptible speech, significant distractibility, racing thoughts, an increase in goal-oriented activities or feelings of agitation, or behaviours characterized as impulsive or high-risk such as hypersexuality or excessive money spending. Depression: persistent feelings of sadness, anxiety, guilt, anger, isolation or hopelessness; disturbances in sleep and appetite; fatigue and loss of interest in usually enjoyable activities; problems concentrating; loneliness, self-loathing, apathy or indifference; depersonalization; loss of interest in sexual activity; shyness or social anxiety; irritability, chronic pain (with or without a known cause); lack of motivation; and morbid suicidal thoughts. In severe cases, the individual may become psychotic, a condition also known as severe bipolar depression with psychotic features.

  Borderline personality disorder: emotionally unstable personality disorder or emotional intensity disorder whose essential features are a pattern of marked impulsivity and instability of affects, interpersonal relationships, and self-image. The pattern is present by early adulthood and occurs across a variety of situations and contexts. Other symptoms may include intense fears of abandonment and intense anger and irritability, the reason for which others have difficulty understanding. People with BPD often engage in idealization and devaluation of others, alternating between high positive regard and great disappointment. Self-harm and suicidal behaviour are common.

  I remember walking for hours at night when I was sixteen, my boots crunching over ice and snow on the quiet streets of Cranbrook, street lights gleaming off asphalt, snow falling softly upon me. I stayed out for so long sometimes Mom or Warren would come looking for me. I’d hear the car ease up beside me and slow down, the window roll down and Mom’s gentle voice say, “You lookin’ for a ride, sweetie?”

  I said nothing, just opened the door, got inside and rode home silently because it hurt to speak, but I loved her for this act of kindness and believed, if only briefly, I would get out of that town, that one day I would leave and never look back.

 

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