The Battle but Not the War

   As I began moving towards some semblance of my previous life I found myself stuck in a rather awkward situation. Reconnecting with my friends and family made me feel like I was leading a double life. The general assumption people had was that I was feeling better than I was before. This was both true and a lie all at once. I didn't have to sleep at a hospital most of the time, which was obviously better than before. I was getting back to school again, though which much difficulty. I wasn't on morphine, and so regained the ability to reason enough that I knew 1+1 doesn't equal fish. I wasn't actively trying to bring about my own death (though it was always on my mind) which I think we can all agree was an improvement. And yet, despite all this, I couldn't shake the feeling that I was exactly where I was just before my suicide attempt. My pain wasn't any better, and we still didn't have a clue what the hell was wrong with me. One might focus on my mental state and say that's what was important. Maybe it was, but I felt doomed to repeating a cycle of being unable to bear my unrelenting pain any longer and losing my mind every year or two. I felt that as long as my pain remained untouched my mind would inevitably crack under the pressure which made the whole "recovery" thing seem rather pointless. So my friends would ask me, "How are you doing?" and I'd say, "Better," because what else am I supposed to say? "Well, friend, I think I've got about 12 months before I disappear  again due to a third suicide attempt. I seem to be closer to the mark every time I try so I'm sure it'll work out one of these days. But no, I'm fine for now, really. Where are you going? Please put down the phone, no, no need to call the cops." See? Like I said: awkward situation.

    Let's be clear here though. When you have a debilitating chronic illness such as mine, suicide isn't an impulsive decision. I didn't say, "Well, today was more than I could handle, time to take all these pills." No, it is something that is built up to over months and years. It's a thought of escape that gnaws at your mind with increasing occurrence. Every time I felt so shitty that I'd rather be dead, the thought and ideation of death becomes more familiar. Death, and the lack of pain or joy it brings, eventually becomes a constant companion. It becomes something that brings you more comfort than fear. Despite this, no matter how far your will has broken, a part of you reflexively fights these thoughts, screaming at you to live. It's something built into all of us biologically. With a chronic debilitating condition this innate will to live crumbles over time until instead of a scream it manifests itself as a barely audible whisper. Also built into our bodies is a reflex to avoid pain since in most cases pain represents an imminent danger. Ironically in my specific situation pain is itself most of the danger, but the reflex to avoid it remains. So you've got two opposing biological and psychological forces: the will to live and the need to avoid pain. This kind of war does not take place over days or weeks. In fact, a part of me felt the tide begin to turn against life as early as the summer of 2010. I was at summer camp, which of course involves extensive amounts of walking and therefore extensive amounts of pain. This tipped the mental balance to favour the need to avoid pain and in tearful desperation I called a suicide hotline. I was only 15 and had never done such a thing before so I didn't really know what to expect. The man who picked up the phone seemed almost as desperate as me, because there wasn't much he could say to comfort me. I explained my situation and it clearly wasn't one he was familiar with. I was a teenager at camp with a mystifying chronic pain condition, so there wasn't much reassurance he could give me. He suggested I talk to my parents and asked if I would be fine and I decided I would be, for awhile at least. I found venting to someone who didn't know me and so couldn't possibly judge me was therapeutic. It didn't make me feel any less physically shitty, but the venting helped. Unfortunately a camp staffer saw me on my phone and told me I wasn't allowed to use it and needed to go to the activity that was going on. I imagine all they saw was a kid skipping out on stuff to break the no phone calls rule. I suppose that is exactly what I was doing, but this just goes to show when you know someone is hurting physically and/or mentally the benefit of the doubt can go a long way. That interaction upset me somewhat, but with some Advil and rest I made it through the day. The battle was won, with my will to live emerging as the victor. Unfortunately, as I learned, battles and wars are different things entirely.

The Slippery Road to Recovery

    Before starting this chapter I want to introduce a new idea I had for this blog that will help convey my thoughts and feelings of the moments I write about with sounds as well as words. As I'm sure you all know music can be a great coping mechanism for tough times. I personally am the time of person who listens to music they relate to and therefore am constantly changing that music based on my thoughts and feelings at the time. My idea for the blog is to link songs that I listened to in the time period I am writing about to allow for a better understanding of the state I was in at the time. I realize this idea won't interest everyone and so feel free to simply skip the link and accompanying contextual words when I choose to include them and read the blog as you normally would. In regards to my first example, if you've been following along you know that I'm currently writing about a very dark period in my life. As a result the music I listened to during my stay in the psych ward was rather dark and gloomy. Here's one such song: https://www.youtube.com/watch?v=4N3N1MlvVc4

Previously: I started having sit-downs with my doctors and parents.

     Something that everyone involved in my care could at least agree on was that my pain, whatever the cause, was preventing me from having even a half-decent sleep. This led to my psychiatrist adding some additional sleeping medications which became a turning point in my road to recovery at the hospital. He had started me on antidepressants some weeks after taking me off all my medications at once but my mood wouldn't improve as long as my sleep remained at such poor quality. Thankfully the new medication worked and it no longer took me hours to fall asleep at night. The quality of sleep still sucked, but it was a start.

     My parents visited once again and this time were allowed to bring my only few months old puppy with. Seeing her again was pretty emotional for me because before I purposefully overdosed she was the only living thing I could say goodbye to without being stopped from taking all those pills. It was to the point where for months whenever I saw her I would have flashbacks of what I thought at the time was my last goodbye. I understood these were ghosts that needed to be confronted eventually and would simply have to make new, fresh, and more pleasant memories with her to replace the sad one. 

    I continued to meet with my parents and doctors because I wouldn't be able to return home until some kind of mutual understanding was reached. I spoke of events in the past that show I am the type of person who is their own best motivator. If I can do something I'll do it without urging, whether it be physiotherapy or getting to school. If I'm not doing something that is expected of me that essentially means I can't do it whether it's because of pain, a bad night's sleep, or both. Therefore, urging me to do something like go to school on a bad pain day by pleading, yelling, or coercion, is counterproductive. As someone who is motivated to do things like exercise or go out with friends I am already upset by not being able to to do these things very often in the first place. Others getting upset at me for not being able to do them as well simply adds stress to all parties which makes it harder to deal with my pain and fatigue and makes it harder for me to do the things everyone, including myself,  wants me to do. For a lot of people, especially teenagers, this isn't the case but I'm sure developing a debilitating illness at age 13 caused me to mature quickly in this regard. If anything I would push myself too hard and simply make my situation worse. Examples of this would be pushing myself to get to school despite feeling horrible and then fainting in class. Or going to school when I couldn't sleep at all the night before and falling asleep in class or in the hallway. These things aren't helpful and I had to be trusted to know my limits to prevent them from occurring. Many times this trust wasn't placed in me. There were many mornings when others were trying to wake me up for school that I would be made extremely uncomfortable until I was forced to get up. Methods for such acts included filling plastic baggies with ice water and dipping my feet in, tickling, or simply yelling that I'm wasting my life away. There's points here for creativity but it's wasted effort and counterproductive if I'm woken up just to faint in class or fall asleep in the hallway. This is why it was so important for there to be a mutual understanding between myself, my parents, my doctors, my teachers, and my friends. Focus needed to be put on improving my health so I could get myself to do the everyday activities of life rather than trying to have me do them before my health was improved and putting the cart before the horse. As the talks made progress it was decided I would have a sort of test run of normal life by being allowed to stay back at home on the weekends. There was still some inter-familial tension but no especially notable incidents.

   These long emotional talks did their job and the focus shifted to improving my sleep so I could increase my functioning. Improving the pain would have been ideal since the pain causes the sleep issues, but I had just come off of morphine and that hadn't exactly gone well. Playing with the dosages and types of sleeping medications for a little got me alert enough to be able to start preparing for a return to school. I hadn't been discharged from the hospital yet, so my options were limited to starting off slowly. I used their computer room to begin an online careers course, easy stuff to get me back in the swing of things. The course went well, and I had started to get my capacity for thought back after the dampening effect caused by morphine. My mood improving followed suit as my confidence to be able to think and work started to come back. The doctor was pleased with my marks, mood, and energy to the point where he said it was time for me to be partially discharged. I would be allowed to sleep at home every night again assuming all went well but would come back to the hospital during the day to continue my careers course. This also involved slowly transitioning back into having a social life as I began attending family shabbat dinners and explaining to close friends where I had been for the past few months. It had been a long hard journey both physically and mentally, but I was now in the home stretch. 

Which Came First, The Chicken or the Egg?

   It was soon time to meet start meeting with my parents and my psychiatrist together. This also meant the psych ward nurse started caring about my appearance. I had gotten my clothes and ditched the hospital gown, so next on the "Important Things for Me To Do List" was asking me to shave. Now I still wasn't what you would call a particularly "happy" person and so this request annoyed me a lot more than it should have. Surely they knew I was at such a point in my life where the last thing I could possibly care about was shaving. Maybe to them shaving simply gave the appearance I cared which is what mattered. Perhaps if I shaved enough they thought I would start to care. Regardless of their thinking, I was observant enough to know doing tasks like these without complaint assisted in getting you discharged sooner and so I complied. When I was done I was even more angry than before because as I stared into the mirror I saw a gaunt, pale, and hollow cheeked version of myself starting back. I thought, "Maybe if they did something about me throwing up everything I ate from morphine withdrawal shaving would've made sense." Consequently I had the appearance that I cared enough to shave but didn't care enough to eat or go in the sun. Mission accomplished, nurse.

   It was time to have the big sit-down with my parents and my new psychiatrist. It was very tense, and tears on both sides flowed frequently. My sour mood led me to being very frank in explaining my feelings as the psychiatrist wanted to get to the bottom of my attempt on my own life. I explained that too often I felt more was expected of me than I could preform. My pain and fatigue would keep me from family events, sports, and now even school. This alone was very depressing, but it became unbearable when others got angry with me for being unable to do these things I desperately want to do but simply can't. More than once I had been told to get back to school since I couldn't stay at home my whole life. Furthermore I had been given passive aggressive advice that it's simply a case of mind over matter and all that is required is the will to find a way. My psychiatrist supported me on some points, but any of these moments were eclipsed by my rage when he suggested I have a Conversion Disorder. If you don't know what this is, it's basically a mentally ill person converting their mental stresses into physical symptoms. This made absolutely no sense to me; the main reason being that I had no mental health issues until six months after my pain had started. I got sick, I had pain, I realized the pain wasn't going away, and then I got depressed. I did not immediately develop depression after my pain started. Sure, you could argue my pain started out from a physical source and continued due to mental stress conversion but that would still mean there's no easy fix for the pain. Regardless, I was still angry about going cold turkey on medications. He began putting me back on antidepressants but I stayed off any pain medication. I felt at the time this was because of the belief from others that the primary problem is in my head, rather than in my legs.

  Hostility and blame continued for a while. I think something I wrote about the situation at the time can explain my thoughts and feelings better than current reflection can, so here's a little note I wrote down back then that I'm unsure anyone other than me has ever seen:
"I want you to imagine a scenario where someone is suffering for four years. Suffering to the point where they can't take it. To the point where they don't enjoy life anymore, so they tried to kill themselves twice. They want to die. But despite what they want, all through those four years they've been trying their best for those they love, but those they love aren't satisfied. They want more than their best. So they give up, because what's the point in trying if their best isn't good enough. Now imagine how they person would feel. That's how I feel." This tension and fundamental disagreement on my mood and pain problems dominated these meetings. Everyone had a different opinion on the cause and effect and which came first, the chicken or the egg/which came first, the depression or the pain. My viewpoint was such that I normally wouldn't care what others think, but I felt that the difference of opinion would hamper finding a working treatment for my chronic pain. I knew that my pain led me to attempt suicide twice and so if we just focused on my mood rather than the pain inevitably a third attempt would occur. Paradoxically this realization disheartened me and darkened my mood further.

Being Alone Together

   In the psych ward for adolescents there were two types of patients. Both types were miserable and wanted to get out; the difference was how they went about this goal. One group thought they could fight their way out. They broke the rules, fought with the patients and staff, and generally tried to be such troublemakers that they hoped the hospital would kick them out so they could leave. The other type of patient realized that the more antisocial you are the longer the psych ward will hold on to you. These patients kept their head down, smiled and nodded hen answering questions and did what was asked of them while waiting to be discharged. This is the group I belonged to. Most of the time, anyway.

   While most patients proved volatile enough to warrant avoidance, I made friends with two other patients around my age, one from each previously mentioned group. We bonded over what we had in common, namely our crummy situations. All of us were stuck somewhere we didn't want to be and didn't know anyone who was with us and in most cases didn't want to. We'd mostly sit on the floor playing cards or watch the TV that would always be playing Degrassi, my favourite show ever (not really, I hated it). Our little clique had a general, "Don't ask don't tell," rule where we silently accepted whatever the others were going through and didn't poke or prod about each other's dirty secrets. One was a girl who was quiet and friendly, but sad. She had been in the hospital longer than me and seemed very accepting of the situation she was in and so was waiting patiently for her release. The other was more angry than sad. Not at us or at herself, but at the staff. She would regularly have mental breakdowns involving fits of rage that required nurses and security personnel to restrain and sedate her. There was a special locked room that she would be put in until she calmed down. Failing that, the room had what looked like a bed featuring medical restraints. It doesn't sound very pleasant, and it didn't look that way either. On at least one occasion she was screaming that she wanted to go home but when the nurse grabbed her to put her in the room she started hitting them. The security guards were called and I glimpsed them holding her against a wall while the nurse injected her with a needle containing sedatives. The other patients including myself were always ushered into our rooms when these events started but we could hear the screaming and fighting even from there. There was one night where someone pounding against a wall was keeping me awake. The next day the girl had a cast on her hand. When we saw her the unspoken rule stayed in effect: don't ask, don't tell.

   Then there were the other patients; the ones who I avoided. Some were always looking for a fight and would channel their inner asshole until they found one. It didn't take much observation on my part to realize that fighting wasn't getting them out of the hospital any sooner and so I avoided such confrontations as best I could. Still... if you know me you know that sometimes I can't help myself. It was nothing physical, but one of these trouble making kids was being chastised by a staff member for making trouble. This staff was what I guess you would call my social worker, and he was always very soft-spoken and calm. He was also a really nice guy and by far my favourite staff member in the psych ward. The kid (a year or two younger than me) didn't apologize for whatever he was doing and responded by calling the staff member gay. The staff member asked why he was gay, and the kid said he's gay because he's weird. I assume that he thought he was weird because of how soft spoken and mild mannered he was. I asked the kid what's wrong with being gay and he proceeded to tell me what was weird about the social worker, in front of the social worker, as if that answered my question. The poor social worker seemed to appreciate my efforts but separated us before I we could escalate the situation, for which I am grateful. I've got to hand it to the kid though, because he was able to up himself by not returning to the hospital after his home leave ended. As is protocol the police were called and they apparently found him at a bus stop near his home heading to McDonald's or something. It was hard not to laugh when I saw him escorted by the police back into the psych ward, and the incident easily postponed his discharge for a month.

  The final notable patient was another kid a few years younger than me. He spent most of his time denying his use of drugs to the staff members and then bragging about his drug test being positive after they confronted him about his lying. He'd avoid mandatory activities as best he could, and when he found himself forced to participate he disrupted said activities to the best of his ability. One group activity that was repeated every week focused on our individual future goals. Boring stuff, especially since I personally don't change my future goals on a weekly basis. When I brought this up they told me to write them down anyway. Back to the kid, he seemed especially proud of his personal future goals. When it was his turn to discuss them he revealed to everyone's lack of surprise they involved smoking weed. When he was forced to re-imagine his future he changed it to the much more admirable goal of graduating middle school since he was apparently expelled from several schools for fighting people and using drugs and using drugs while fighting people. He later became my best friend ever. That was a lie, though I did eventually accept I would be spending the next few months of my life with this colourful character, and that is basically the same thing.
 

Out of Place

    The cards were set, the chips were dealt, and the Mitch was stuck. As I mentioned before, a psych ward is the last place you want to be when going through opioid withdrawal. They have very strict schedules and procedures. They don't have doctors but instead have staff who have had training in mental health, not in withdrawal and chronic pain. To make matters worse the worst night of my withdrawal happened to be the night when the worst nurse was on duty.

    My withdrawal symptoms had reached their peak. Sweating, vomiting, trembling. I spent the entire night vomiting into the tiny kidney basin they gave me then and cleaning it up. I wasn't allowed to turn the lights on to read or see where I was vomiting so I was stuck in the dark, bored and delirious. Eventually I quit this to go to the toilet instead, since I wasn't going to be able to sleep anyway. This was the usual routine, but the problem was the sheer amount of times I was vomiting. My stomach was starting to take some damage, and I started vomiting up blood. I felt a weird tenderness in my stomach and was worried I was going to get an ulcer if I kept vomiting. I felt an impending sense of doom for the second time in my life, the other being when I had swine flu and couldn't stop coughing to breath. If you're not familiar with this, it's a really weird feeling of dread that you're about to die, kind of like a panic attack but specifically about death. I left my room and went to the nurse for help. You can picture the nurse as a really old woman who hates her job. As she looked up at me when I walked up to her she immediately got a look of impatience on her face. I explained what was happening, but the nurse wasn't impressed. She told me to go back to my room and that vomiting is normal during withdrawal. I told her I know vomiting is normal but I was starting to vomit up blood and so need to see a doctor. She told me to show her the blood-vomit. I told her I can't because I flushed it down the toilet. She gave me this smirk that said, "I don't believe you," and once again ordered me back to my room. I pleaded and I begged to see a doctor to ensure I wasn't in danger all to no avail. I wanted to be in sight of an adult in case I really was in danger but also wanted to get out of my room because the stench of puke was overpowering. I asked if I could just sit outside the room she was in until the current bout of withdrawal receded but she denied me that as well. I went back into my room to endure withdrawal... alone.

    Nights were hard. Without my medications I couldn't sleep much. When I did, I had nightmares and flashbacks, mostly about myself waking up in the hospital from my coma. Specifically those first few seconds when I open my eyes and look around to see 4-6 doctors including my dad looking down at me concerned. Then the realization that I wasn't dead. The realization that my pain would continue, causing me to break down in tears and ask to no one in particular: "Why am I ALIVE?!?" This memory will stay with me forever, and I wonder if it even caused some form of post traumatic stress disorder. I'd have plenty of time to ponder such things as I laid awake in bed. Mornings would come, and I'd always be woken with everyone else at 8:15 AM. This is a big change from when I was waking up at 2 PM when I was at home, causing exhaustion to be my constant companion. I was still expected to partake in all the daily events. All the kids/teenagers would sit down with a counselor and talk about lovely things like our future goals and aspirations. We'd be forced to bake cookies and make coffee (not for us) and go just outside the ward to set up a stand in the hospital to raise money for the hospital. Thankfully they gave me back my normal clothes to replace the hospital gown before this.  We'd do certain sporty things that I couldn't take part in because of my legs, but that I still had to be present for. Some of the kids were real pieces of work that I managed to deftly avoid. It wasn't all bad though, because I managed to make a couple of friends. There's nothing that brings people together like being collectively stuck in a place you don't want to be.