Bloodletting (5 page)
Authors: Victoria Leatham
Tags: #Medical, #Mental Health, #Psychology, #Psychopathology, #General
5
I was fine for a couple of weeks. Fine in the sense that I didn’t injure myself, not that I was well. Or well-adjusted. In fact, I was finding it more and more difficult to do even ordinary things like grocery shop
ping and laundry.My relationship with Alex was still structured around alcohol and sporadic 3 am visits, followed by daylight rejection. Even through my haze I could see it was pretty awful, and certainly not helping.
What I really wanted was some peace: a respite from everything.
Then one afternoon I remembered that I had some Stelazine in the house, and I recalled being told to take it if I felt like hurting myself. Normally the desire to hurt myself overrode the desire to take something that might stop it, so I’d not used the medication before. I’d thrown the bottle, like so many other things, onto my desk.There weren’t very many pills in it and I didn’t take them all, just a few. Not even a handful. I didn’t want to accidentally overdose.
Just after I’d swallowed them Alex called.I told him I’d taken something to knock me out.‘Not too much I hope?’ he said, half-serious.
‘No, not too much.’
When I put down the phone it was about five in the afternoon. Iwent to bed.
My alarm went off the next morning and I forced myself to get up, feeling like I did most Sunday mornings: hung-over. As I sat on the bus on the way to my part-time job at the gallery, I ate my toast and stared out of the window, registering nothing.
There was a big surrealist exhibition on so it was bound to be busy.There’d be queues of people.‘At least’, I said to one of the girls I worked with in the shop,‘the time’ll go faster’.
Just after we’d opened the doors, my eyes started rolling upwards. I’d roll them down, and immediately, they’d go up again. It was as though they were drawn to a magnet somewhere above my head. I had no idea what was happening, and no memory of the previous evening.
Thinking something to drink might help, I took my mid-morning break early and walked quietly over to the temporary exhibition café where I bought a cup of tea.After several attempts,it became obvious that I couldn’t drink it, not without spilling it. There was nothing to do but go back to the shop. I didn’t feel faint, I didn’t feel sick and I was being paid by the hour, so I kept working.
After another thirty minutes of serving people who politely ignored my problem, I realised that it was getting worse. My neck began to tilt back, just like my eyes.The only way to hold it down was with my hands, which made working the cash register very difficult. Perhaps, I thought, if I go on my lunch break and have some food, it will stop.
My colleagues didn’t argue and I was soon outside in the park, in the fresh air.After buying my regular lunch—a small carrot muffin and a bottle of water—I found a secluded place and sat down to eat. Strangely, although I had no idea what was happening to me, I was quite calm. I was embarrassed though, particularly when a group of schoolboys plonked themselves down less than two metres away.They furtively lit up. It just wasn’t fair. All I wanted was a little privacy and thinking space. Sighing, I picked up my bag and went back inside.The truth was I knew that something wasn’t quite right. I couldn’t eat, I couldn’t drink and I couldn’t control my neck and eye muscles. It was time to try lying down.
I asked at the information desk about a sick room. The woman told me to wait for a guard downstairs, that the door was next to the women’s loos. After letting the girls in the shop know where I was, I stood, holding my head still, waiting for the guard with the key. People streamed past, going to the bathrooms, to the exhibition and to the shop. They tried not to look at me. Eventually, the guard arrived and opened the door into a small white room with a bed against one wall and a few boxes against another.There were no windows.
Lying down seemed to help and for a while I felt a little better. One of my colleagues brought in a glass of water and asked if I was okay. Not exactly, I told her, then thanked her for asking. I just needed a bit more time. I’d be out soon.
And then, just as I thought I was going to fall asleep, the muscles in my back began to spasm. My back started arching. It was as though I was having some kind of slow motion fit. This obviously wasn’t a good sign.
Another of the girls came in. She frowned. ‘You really don’t look well,Vic.Would a Panadol help?’
I shook my head and she left.
The problem was that I didn’t know what would help. If I could just work out what was happening, then maybe I’d know what to do. As Iwas thinking, my boss came in. She usually didn’t work weekends, and given that she could be very scary, we liked it that way.What was she doing here now?
‘What have you taken?’ she asked.
Bloody hell, I thought, what did she think of me? Did I look like adrug addict? I thought I hid things pretty well.
‘Nothing. I haven’t taken anything.’ I said.
She didn’t believe me. ‘Well, whatever the problem is, you need to see a doctor.I’ll call you a taxi.’And then she paused.‘Can you actually walk?’
I now realised that I wasn’t even going to be able to stand up.Walking would be impossible. It was also becoming more difficult to speak. ‘No. No.’
‘Then I’m going to call you an ambulance.’ She walked out, quietly shutting the door behind her.
Within minutes a paramedic arrived.The first thing he asked was what I’d taken. I didn’t understand, why was everyone so convinced I’d taken something? ‘Nothing’ was all I could say. As the paramedic was taking my pulse, two ambulance officers came in.The room was getting crowded.
‘What’s she taken?’ one of them asked.
‘Don’t know, she won’t say. Looks like a dystonic reaction.’
As the ambos helped me onto the stretcher, one of them suggested they put a sheet over my head.We were going to have to walk through the exhibition crowds to get out, and it might save me a bit of embarrassment. I must have looked stunned, as he quickly added, ‘Just joking’. It was humiliating, but I did feel better. At least I was being looked after. And they seemed to know what was wrong.
As I lay in the back of the ambulance trying not to convulse, the officers chatted to me, relentlessly cheerful.‘Life can’t be that bad luv.’ Had I really overdosed? I was confused. It wasn’t as though you’d forget something like that, was it?
Suddenly I remembered something.‘I took a Prozac this morning.’
‘Do you take them regularly?’ one of the officers asked.
‘Yep.’
On reaching the hospital I was transferred to a bed in the emergency ward.The place was quiet.A young doctor came over to me and asked what I’d taken. I was getting sick of this question.
This time I made a huge effort. ‘Beyond a Prozac this morning, nothing. I don’t remember taking anything.’
He confirmed what the paramedic had said: I was having a dystonic reaction. He then said there was an antidote available and was sure it would work. He left for a minute and then came back with a syringe. ‘This should calm things down,’ he said. He then pulled the curtains and I was left alone.
A little while later a nurse looked in.‘Feeling any better?’
My back arched again.
‘Right, well, don’t worry, it should start to work soon.’
Later still, I began to think that maybe this was it. Maybe my muscles would be in permanent spasm. Perhaps this was the onset of some kind of disease. Or perhaps I had taken something, as they were all suggesting, and had brought it on myself. Maybe it was like when I was a child and made a face. My mother used to say the wind might change and then I’d be stuck looking like that.Was this to be it?
As I lay there, my mind lurching from one awful possibility to another, the doctor returned. He smiled, before telling me that he was going to give me another injection. I wasn’t responding in quite the way he’d hoped. I knew he really meant ‘You’re not responding at all’.
Ten or so minutes later, the doctor appeared again. Still my head was tilting backwards by itself. He looked more serious this time, as though he were making a decision.‘Let’s give things a little bit longer, shall we?’ It was a rhetorical question. I wasn’t in any position to argue.
As I lay there, I desperately tried to remember the evening before but nothing came to me. Nothing at all. And then I realised that the tension had gone. I tentatively moved my head from side to side. It did as I wanted. My eyes and back seemed fine. It was over.
The doctor clearly looked relieved. ‘Ah, you’re looking better at last. How are you feeling?’
I smiled weakly,‘Okay, thanks. Just tired.’
He then asked for the name of my doctor, and, if I had one, my psychiatrist. He wanted to notify both of them. I gave him their names, for once not worried about being scheduled, as I was still convinced that this wasn’t my fault.
‘I’ll get the nurse to change the dressing on your wrist as well. Although you should be okay now, I’d suggest that you stay here for a while until you feel stronger.’ He turned to leave, and then stopped. ‘Of course if the symptoms return, come back immediately.’
Come back? I lay on the cot in the emergency ward for a couple of hours worrying about the doctor’s parting comment. I didn’t know what had brought this on so how did I know that it wouldn’t happen again? When I was sure that I felt okay, I left and caught a bus home. As I sat next to the window, trying not to cry, I remembered the Stelazine. I also remembered the other prescription I had been given with it, but had never bothered to have filled.They’d given it to me in case the drug gave me any side effects.
I found out much later that Stelazine wasn’t an ordinary tranquilliser but an antipsychotic. Later still I was told that this medication wasn’t just prescribed for hallucinations, but to control aggression.
During the worst periods, when my mind seemed to be seething with destructive images, I avoided people. It was too difficult to pretend I was coping, and I was determined not to burden anyone I cared about with my problems. Besides, most people I knew were wary of me now—they thought I was mad, sick or dangerous. Just because I didn’t talk about things,it didn’t mean other people didn’t hear of them.Alex and Peter, and sometimes an old family friend, Catherine, were the exceptions.All were practical,pragmatic and difficult to shock.I could rely on them not to make me feel guilty about what I was doing—or at least no more guilty than I already felt.
The one person I was supposed to be able to confide in fully was my psychiatrist, Dr G.
Every week I would catch the train across the bridge and walk down to his rooms from the station. I’d sit, hiding behind a pot plant pretending to read old copies of
National Geographic
in order not to have to look at the other people waiting.When he opened the door and asked me to come in, I always stood up with a slight feeling of excitement. Every week I went in with the expectation that at the end of the 50minute session I would be cured without ever having to do anything, that magically, I would walk out content, confident and happy, with no interest in harming myself.
There was a complication that made this unlikely: I treated him as an opponent, not a resource, and I didn’t trust him.There were two reasons for this. He maintained that antidepressants were the only way to fix me—and they evidently weren’t helping—and I found him patronising. This meant I behaved uncharacteristically childishly and wasn’t honest in my weekly therapy sessions. I told him about my urges to hurt myself, but not about Alex. He advised me to keep up with friends and go out, to keep doing normal things, no matter how hard it felt. I told him I was doing this. Lying was easier than arguing.
Then one day, I visited Dr G in an unusually cheerful mood.
After what seemed like an eternity sitting in his waiting room, he asked me into his office. I looked around. I fidgeted in my chair, staring at my purple stockings and tiny blue suede miniskirt, watching my left foot with the green shoe swinging. I smiled at him.‘What’s up?’
He raised an eyebrow warily. ‘You seem cheerful. What have you been doing?’
‘I don’t know.This and that. Shopping, going out, drinking, seeing people.The usual stuff.’ I shrugged and noticed for the first time the view outside his window. It was of a graveyard.
‘Not for you,Vic. Not since I’ve known you. Can you tell me a little more about how you feel?’ He seemed almost suspicious.
‘How I feel? How I feel. How do I feel? It’s a good question.’The words tumbled out. ‘Fine. I feel fine. I feel very well, in fact. Better than I have for a long time. I’ve got energy. I don’t feel tired and pathetic. I do feel a bit jittery and it’s pretty hard to sleep. But hey, I wrote a 10,000 word essay overnight a couple of days ago.’ I was proud of myself, though I had printed it out and handed it in without re-reading it, as usual.‘And I bought a piano accordian.’
‘Can you play it?’ he asked.
‘Well no, not yet,’ I said.
‘Have you felt like this before?’ he said, seriously.
‘Sometimes, I guess. Not nearly often enough! It’s great.’
He asked a few more questions and then said I should come back for another appointment in two days’ time. I didn’t understand it, I was feeling well for once.Why would he want to see me again so soon?
‘Just humour me,Vic,’ he said patiently.
‘Okay, just for you, but only because I’m such a nice and obliging patient.’ And with that, I stood up and walked out.
The following week, I was back in Dr G’s office.
‘So how are you?’ he asked.
‘Okay.’ There was silence for a while, as I dug my fingernails into my arms, not looking at him.
‘How were you last week?’ he continued.
‘I had a lot of energy. A lot more than now.’ I looked down at my faded black jeans and the black men’s boots I’d bought second-hand at a market. I sighed.
‘And does that kind of burst of energy happen a lot?’ he asked.
‘No, not a lot. Sometimes. It’s a bit like being on speed I guess. People say that my voice changes. Peter says that I’m irritating when I’m upbeat—like an Energizer bunny you can’t turn off. When he first told me that, I wouldn’t speak to him for a month.’ I smiled.‘I was really hurt. It was the first time in ages that I’d felt good, and all he could say was that I was annoying.And brittle,he said I seemed brittle.’
He then asked me if I’d ever had any periods when I thought I was invincible, or when I thought I had special powers.That I could fly, for instance. Had I ever thought I was someone powerful?
‘You mean have I ever had a psychotic episode?’ I said. ‘Not as far as I know. I’m as sane as you are.’
He gave me a wry smile before asking about my thoughts.
I wasn’t sure where he was going with this, so I chose my next words carefully.‘Sometimes I do find that I have a lot of thoughts at once, that they tumble out over one another. It coincides with the times I have a lot of energy. I don’t always feel better, sometimes just really twitchy.’
‘Is there a reason you haven’t mentioned this before?’ He raised his eyebrows and looked at me over the top of his glasses.‘It’s important.’
There were so many things I hadn’t told him: how was I to know which were important? ‘I’d forgotten,I guess.Besides,it doesn’t bother me the way the other things do. My problem is self-harm.’
‘I don’t agree.That’s just one of your problems.’ He then explained that he thought it would be useful for me to try taking a drug called Lithium. It was used to control mood swings, particularly in bipolar disorder, or what used to be known as manic-depression. He scribbled out a prescription. I was to take it in addition to the Prozac. Since the Stelazine episode, I hadn’t been prescribed any other medication. When I looked doubtful he explained that Lithium had been used to treat mania and depression for a long time, successfully. It was a salt that was already found naturally in small quantities in the body. He thought I suffered from the occasional manic episode but agreed with me that it was currently the depression that was causing my problems. Nevertheless, he didn’t think the mood swings were helping.
‘I think this is worth a try.What do you think?’ Dr G then asked.
‘Do I have a choice? I’ve evidently got a problem. I don’t know how to deal with it so I’m going to hope that you know what you’re doing.’ I then added,‘As long as it won’t do me any harm’.
He shook his head and told me the main side effect was that it makes you thirsty. I would also need to have a blood test every three months to monitor my levels. The main thing was to take the prescribed amount.
If it was harmless, why would I need a blood test? I wondered. But at least I now had a label for my condition. I couldn’t see how this explained the self-harm but it didn’t matter. Now when people asked what was wrong with me, I could say, ‘It’s manic-depression’ rather than,‘I sometimes get this inexplicable urge to cut myself with razor blades’.This diagnosis was also confirmation that my condition wasn’t my fault: I was sick.
Weeks later, I sat in Dr G’s office and began to cry. I couldn’t stop. I was taking my medication, I was attending lectures, I wasn’t drinking, I was getting enough exercise and I wasn’t even seeing Alex.Yet this wasn’t enough. I was constantly tired, slow and sick of desperately trying not to hurt myself.
Dr G had me readmitted to the Clinic that evening.
In hospital you don’t have to cook, clean, wash up, answer the phone, or even open your mail.You don’t have to deal with everyday life. But you do have to be considerate of other patients, you have to eat dinner at what feels like mid-afternoon, and you also have to attend group therapy sessions. I knew from my previous stay that these didn’t work for me.
The main problem with the therapy groups at N_ was that they were attended by a large number of people with different problems who were both self-obsessed and lacking insight. I was one of them. I used to sit there either thinking about other things, or alternating between wanting to talk and wanting the others to stop talking.These groups were exhausting, and, as I didn’t believe I could benefit from them, I didn’t.Who cared about anger management and dealing with anxiety? Certainly not me.
As I was ostensibly in hospital in order not to injure myself, I agreed to sign a contract again. I was confident that I could argue my way out of being scheduled, should I accidentally ‘slip up’.
The nurse carried out a rather haphazard check of my belongings and then left me alone to unpack. I put away my socks and T-shirts. Took out my shoes and put them on the floor under my bed. I left the razor blade where I’d originally hidden it, at the bottom of my bag.
As the days passed, I became more and more tempted by the thought of the razor, and how easy it would be to use it. I was frustrated that I still wasn’t getting any better, and I had way, way too much time on my hands.
There really was little to do beyond attending a couple of hours of group therapy or individual sessions each day, eating, smoking and watching dull TV in the common room. I wasn’t able to read properly, so spent a lot of time either chatting to people or flicking through the pages of glossy magazines. This time, I also spent a lot of time lying on my bed staring at the ceiling, trying to decide if I should use the blade or not.The trouble was, it was there.As the weeks began to run into each other, I became more and more obsessed with it.The world shrank. Soon there was just the institution, the routines and a small razor blade at the bottom of an old overnight bag in the cupboard by my bed.
One quiet afternoon I retrieved it. My hands trembling, I walked slowly to the closest bathroom—I didn’t want to stain the carpet— and carefully unwrapped the new blade. Cleanliness had become increasingly important, as I didn’t want an infection, so after that initial trial with the breadknife, I only ever used fresh blades.
I felt an odd mixture of dismay and excitement.The reason I was in hospital was to avoid doing this. It had been explained very clearly to me that if I felt tempted, it was my responsibility to talk to one of the nurses.The trouble was, I knew this didn’t help. Because I didn’t really understand what I was doing I couldn’t talk about it. I couldn’t get beyond the very basic,‘I want to cut myself’. It was this inexpressible gulf between what I did, what I thought, and what little I could put into words, that made things so much more difficult.
I pulled the razor across my wrist and for a minute I just watched as the flesh opened up and the dark red blood began to leak out. It didn’t matter if it was deep: I was already in hospital. If I miscalculated they would probably have found me before it was too late.
I then wrapped my arm in a towel and walked calmly out to the nurses’ station.‘I’ve cut myself,’ I said.
A rather tough older woman was on duty and she looked at me impassively.‘Let me see that.’As I unwrapped my forearm,she added, ‘You’re on a contract, aren’t you Vic?’
I hadn’t forgotten I was on a contract but suddenly felt nervous. What if they decided to schedule me? The other girl had been scheduled for just scratching her arms—she hadn’t smuggled in a weapon and then used it. Fuck. I hadn’t miscalculated how hard I needed to press to cut my arm but perhaps I had misjudged the hospital’s likely response to my action. It finally occurred to me that the contract wasn’t just about protecting me.What if someone else had found my razor?
The news of what I’d done travelled quickly around the ward. Soon I was sitting on my bed, holding my roughly bandaged wrist, surrounded by other patients.We were all waiting to hear what was going to happen to me. Everyone spoke quietly, offering a range of opinions.
‘I don’t see that they have a choice: you’ve broken your contract and you obviously shouldn’t go home. They’ve got to schedule you.’ This was from a doctor who had been suffering from severe depression but didn’t know it until she began to cry hysterically, for no reason, in front of one of her patients.
‘But you won’t cope. State mental hospitals aren’t like this place. I know, I’ve been in several of them.’ And this woman was trying to be supportive?