I have a secret

This is the kind of thing I never admit. Not hardhearted, icy, witchy I.

Now, unmedicated, working so hard late into the night and into the madrugada, when I feel desparate, tired, worn-out and broken down at not even thirty, late in the dark, sometimes when I close my eyes but am too tired to sleep, I’ve been seeing your face. I don’t know if it is because I still love you – I actually am pretty sure I don’t – but I see in my mind a glimpse of you, your white blond hair (I, ironically, prefer dark men but the only man I ever loved was Nordic blond), shining in the sun, your head thrown back, laughing a little, innocent in the light at the river’s edge of some summer afternoon. I am not sure I cry for you, exactly, more likely I cry for a more innocent time, before I saw all that I have seen and have been as broken and put back together and broken again.

When I am alone late at night in the on-call room, alone alone, frightened at all I have seen and done in the emergency room, the broken hearts and broken bodies and broken lives, mine included, when I am shocked at how old, how hard I’ve become, it is your face, laughing, in the light, that I see, that brings me to tears.

I don’t think I really want you back. But I want back our time together, that age, when I only suspected how bad it could get and didn’t know, didn’t have the proof on my own bloody hands. I hope you are happy with your new wife, your baby, or, most likely by now babies. I know you don’t talk to me for her sake. And I am not still in love with you, but somewhere, like you said, we’re still making love in my secret life, and in my real life ya no respondo como antes…I never have.

So this is for you, Dale, even though you don’t read this, no one I know reads this, and you don’t read anything from me anymore, somewhere, just know that your face on some summer day is burned into my mind and that I wish you well and thank you for everything.

Te acuerdas de mi
no soy as que el mismo flaco
de siempre
con un conato de panza
que me esta haciendo lucir
como luce una soga
cuando en medio
tiene un nudo

El pelo un poco mas corto
y una tos de cigarro
que me despierta en las noches
vivo en el mismo lugar
calle màrtires 28
y aun conservo la cama
que fermenta tu humedad

El mismo lunar
en el sitio donde tu ya conoces
voy al mismo bar
para ver si asesino mis noches
y entre una nueva cana
y el deseo de encontrarte
se me gasta la vida

Pero te extraño a rabiar
al extremo de que nuestra cama
no le ha vuelto a usar
y si me cae una aventura
la revuelco en el sofa
por no herir al recuerdo
que se anida entre el colchon

Soy el mismo de ayer
aunque ya no respondo como antes
me tendria que ver
cuando ya no se encumbra el deseo
y entre charlas de Borges y de Garcia Marquez
busco un mejor momento


Holding on, waiting for the thunder

So far, med free. The shrink called and is back from vacation, but I’m debating whether to go back or not. I really only need to if I decide to try meds again. So far, I don’t feel so great, and STILL having some withdrawal issues, but it is a little bit nice to remember who I am underneath all the medication.

I guess I should return the call to at least inform him. Why is this like breaking up? Why is the worst, most dysfunctional relationship in my life the one I have with my shrink?

I didn’t get my nice hypomanic buzz at coming off any of these. And my hypersensitivity is setting back in – every little touch feels like pain, clothes are uncomfortable, etc. But this is who I am, raw and pure. I will take it for as long as I can.

Since this is another piece of self-indulgent bullshit, if you have been following Purple Dog at all, be sure to update and offer Jon some support right now, having lost a son to this illness in a most unexpected way.

How I Cured My Personality Disorder Without Even Trying

…Quit going to a psychiatrist! And voila: Borderline-be-gone!

(Yuk yuk)

Seriously, since he took a vacation and I went off that fucking Cymbalta, I’ve been feeling really good. Not manic too good, but just okay. I’ve evened out. I still wake up sometimes at 3 AM, but I don’t wake up sobbing and wanting to just die. Mornings are hard, but some coffee gets me going and it gets better as the day goes on. For god’s sake, I even am running again – and I guess I also have the shrink to thank for the fitness I’ve lost over the last 9 months. I’m smarter at work, back on my game, not looking like an idiot. Getting along better with people – patients and even the wang doctors.

Problems are starting to not seem insurmountable, even if they are big, even overwhelming at times.

And two things that always happen when I start to rise out of a depression happened: one, I wanted to read e.e. cummings again – the thankful, God-love poems, and two, I had my reflexive horror at how low I had been.

The second thing always happens when I finally come out of a depression. At some point, I’m so thankfully glad to be alive that the realization that I actually considered suicide becomes as horrific and unthinkable as if I had considered murder. When the episode finally has passed, leaving me wrung out and wan, but alive, I can never quite recapture the state of mind in which suicide would have been an option.

This weekend on cable, Of Mice and Men, the one with John Malkovitch and Gary Sinise was on. The moment that caught me was when the woman is dead, with her neck snapped, and she’s just limp, lifeless. I thought of all the horrors I have seen in my medical career. It is hard to describe the feeling that came over me – mostly a massive distaste for the ugliness of death, for the strange limpness and stiffness of a body. When I think that this is what I had, not long ago, wanted to do to myself, a wave of sickness washes over me.

Now I’m faced with the task of moving on. The other day, I was writing the millionth patient note, and writing the date for the millionth time, and I realized that it is almost September. What began as a month’s experiment, and became three, and then six, is now almost nine months of crazy. Nine months of life lost.

This is another thing I think I hate about the shrink: no appreciation for this. He sees me alright now, and doesn’t understand that just because I am okay now doesn’t mean that there was no fallout, no structural damage. Just like back in one of those other freak drug experiments in the Spring, I had a two or three week block of being okay, and he said there was no reason I should delay starting a new job, no reason to take another month to catch my breath. There are few people on earth less willing to take a “sick role” than I am, but can’t anyone understand that I possibly have a right to feel bad about those nine months? Nine months is a long time. Enough time to make a new life from conception to birth. 1% of an average lifespan.

* * *

Here’s another question for the readers: a couple of weeks ago, we had an inpatient, young guy, with a chronic disease which he let get totally out of control, most likely because of depression or some other psych issues. He’ll probably end up pretty fucked up physically out of neglect.

Once when I examined him, I saw a small X-shaped scar on his wrist. Not deep, really, just one small cut X. If it had been a suicide attempt, it was a lame one. If nonsuicidal self-harm, well, also looked like a one-time thing.

I wanted to ask him about it. But it wasn’t really relevant to the stuff I was treating him for, and if I asked and all that, I’d have to document in the physical exam and, knowing how docs view anyone with anything less than perfect mental health, I didn’t want him to have to carry that on his medical record forever, to be judged by ever single person who would ever treat him. And I think I really wanted to ask him just because I was curious.

I, if not made obvious by the previous paragraph, have never self-harmed or really even seen much of it from a medical perspective. But from a lot of the blogs I read and those who link here, I see that it is incredibly common.  So I guess I’m just asking: if it were you, do you want your doctor (not necessarily psychiatrist, who has to) to ask? Or would you rather they politely ignore it?

Off All Meds, Cymbalta Withdrawal, and Waiting for Disaster

The shrink took a vacation (oh, August, the shrink vacation month…could anything be more irritatingly stereotypical?), thus leaving me with the worst physical withdrawal I could imagine. Seriously, could heroin be worse than this? The lesson out of all of this: never, ever quit Cymbalta! For the past few days, I have been having complete autonomic failure. The idea is to go back on my good cocktail, sunburn be damned. Then maybe try lamotrigine. So my skin can all fall off, you know.

The first morning that the withdrawal started, I got the day off on the right foot by arising at my usual crack of dawn hour and promptly passing out. Due to this, I was two hours late to work, which resulted in my being yelled at for another hour and a half.

Follow that with random attacks of true vertigo (walking down halls of hospital – suddenly I’m totally off balance and everything spins), vomiting, shivering, diarrhea, and sweat flashes, and that is quitting Cymbalta in a nutshell. Every time it starts back up, I take a little bit, just so I can function. I have to open the capsules, use the little pellets inside. It is like cutting lines, but a lot less fun, and, I suspect, much more ridiculous.

But – I can sleep, god, sleep after weeks of no sleep, nightmares, and waking up sobbing and suicidal at 3 AM every single night. No more scrounging through Lear and Pale Fire for consolation. This is what the shrink called improvement. Because I was nice. Last time I was in his office, he kept going on about the nice pleasant conversation I was making. I was chatting about nothing because honestly, I was too depressed and suicidal and sick of myself and my misery to even carry on about it. I did what I always do – faked a happy face. But do I really need a shrink for that?

Although the drug did take a certain edge off. Last night I yelled at the partner for overwatering a plant. All of that kind of rage had disappeared. I suspect, though, that that was due to the massive amounts of Valium he had pumped into me to try to fix the sleep problem.

I also totally lost it on a patient the other day. True, the patient was particularly nasty, but on the other hand, was also terminal (I did not know this at the time). After this, I called the shrink (before he left) and told him I was not fit to practice, that he would need to write me some sick days. Mostly wanting to get off to his holiday, he said fine.

But I didn’t call in sick. Arbeit Macht Frei and all that. And I would feel damaged and broken forever and never forgive myself if I ever called in sick over mental illness, no matter how severe.

Everyone around keeps asking me what the hell is wrong, at work, that is. Today I finally made some vague allusions to health problems and let it go at that. It always makes me uncomfortable when people show a personal interest in me, are nice to me. Somehow, I feel better keeping things cold and bastardly.

Despite the horrible physical withdrawal, the suicidality has dropped way off, I can actually sleep, I am somewhat interested in medicine again, learning a bit as I go along seeing patients – opening books, asking colleagues. Today I ran, realizing that I lost almost all my physical conditioning in these last few months. I feel alive. Soon, I hope that feeling of coming back to life, of rising from the grave delighted and full of energy and thrilled to the core, flirtatious and funny and fun will be back.

I am also perversely glad that if I slip into mania, the shrink will not be around to witness it and insist on more drugs. It has been so long since I could write, want to fuck, feel alive at all…I don’t want to quite give that up, no matter what the cost. I need, from time to time, to remember who I am, what I want, to know where I am unhappy in my life.

I also realized, holy shit, it is almost September. I realized that this episode, the idea of changing meds, has been going on for almost 9 months. At first it was a month lost, then three – a season, a delayed start at my new job, and now I am 9 months down the road, having been through hell, sicker than I have been in five years, with no end in sight. This is terrifying. How much more of my life will I have to sacrifice to this cruel master? Soon, it will be a full year, another lost year. I do not want to be sick. I want to be me, thorny and obstinate and moody. I do not want to spend my life in a psychiatric-drug-induced haze. Even if it means I am a bitch. Is that so wrong?

And now that my old self, the one that can save herself, is back…well, now I’ll finally be ballsy enough to quit this stupid shrink. Which, of course, is a sign that I am not medicated well…

How the fuck did this get to be a blog only about therapy? That fucking blows. No more of this. I need my life back. I need my pen. I need my cunt. I need blood.