Monday, November 25, 2013

Three South: A short Essay on my time at PRMC

The cold, bright lights pierce my eyes as I came to. I remember checking myself in, but I don’t remember anything else. I have to try. Remember damnit. My thoughts are racing, I can’t focus on anything right now except the smells and how scared I am. This room smells sterile, like bleach and fear; the sterile smell seeps into my nostrils and stays there, mixed with uncontrollable sense of terror. I’m having a full blown anxiety attack, it’s hard to explain how those feel unless you have one so I’ll try: it’s an uncontrollable fear that grips your soul, your hands are shaky and sweaty, and your heart is pounding so loud that you can hear it ringing in your head like a bass drum, your stomach is in knots and you’re nauseated. The anxiety is so powerful that I can’t control my thoughts, all I can remember is I started to feel the depression envelop me as the anxiety set in; because my thoughts were racing I couldn’t think logically which led to this attack. I wanted to kill myself; I wanted to go home and take a knife and slit my wrists or hang myself in a doorway. I didn’t want to but I couldn’t control what my brain was saying. That’s why I’m here. I became a danger to myself.
My only companion at the moment is the camera in the corner that watches me, it’s making sure I’m not going to try to attempt to follow the suicidal thoughts that are plaguing me; they’ve made it nearly impossible for someone who is suicidal to commit to their actions in here: there’s no interior doorknob, the bed has no guard rails unlike other hospital beds, and the chair has no arm rests. The room is fucking freezing, even the blanket they gave me is cold and I’m trembling; of course at the moment I can’t tell if the trembling is from the cold or from the fear. They took all of my things: my purse, my phone, even my jewelry—all except my necklace with my mother’s initials on it, I told them it was the only thing that was keeping me sane. I fidgeted with it, tracing the initials with my fingertips, feeling the smooth gold underneath. It was all starting to become clear now; I was beginning to remember what led me to the ER.
I was walking back from class; it had been a particularly hard day. See when you have depression your days start weird. It’s almost like they start when you’re asleep, (at least for me anyway) if you have nightmares or don’t sleep well then you wake up feeling like shit already. For someone who’s “normal” they just grumble about it and have an extra cup of coffee, but for me it makes the fight to stay balanced even harder. Nothing feels right and nothing makes sense; you’re in a fog, you can’t concentrate, you can’t think, you can’t eat or drink, you can’t even see straight. All you can think about is how fucked everything is, especially you—you, you worthless piece of shit who can’t do anything right, who can’t understand even the simplest concept because your brain is all discombobulated. The struggle for me was that I knew that I could be better. I knew that I wasn’t worthless and that my family was proud of me and I could do this—but my mind was at a constant war with itself. It was almost like there were two different people living inside my brain. I even gave them personalities: One was gentle and compassionate, had the patience of a saint and would always try to build me up (which was a job in itself because I had a very low self-confidence rating anyway). The other was evil, my dark side that manipulated me into thinking that I was all of those things I mentioned. They would tell me to take the knife and slit my wrists, or take the rope and string myself up; they reminded me constantly of the darkness in the shadows at night.
The “darkness” I refer to is the face of the man—the teacher—who molested me—the man who caused me to be this way, who gave me my anxiety and constant fear. He did it when I was at my weakest: five fucking months after the death of my mom. He groomed me, led me to believe he was harmless when really he was the monster that I had always been warned about. It started when I was taking his class, I never thought that the extra attention he paid me was more than just sympathy. I was a stupid fourteen year old girl wrought with grief over losing her mother, what the hell did I know about things like that? It was at a time where that sort of stuff just didn’t happen, people didn’t talk about it.
Anyway back to the present.
As I mentioned before my day was shit already, I had nightmares all night and I was just tired, so tired. I didn’t remember what happened in class, and I felt so heavy, like someone had placed a boulder or something on my shoulders; I was walking back to the parking garage and I kept thinking “Something’s not right…I feel so overwhelmed. Something isn’t right! SOMETHING ISN’T RIGHT!” I wanted to cry out and scream and cry all at once, I managed to make it to my car and I just lost it. My eyes were so full of tears that I couldn’t see, I couldn’t think, my throat was closing up so I was having trouble breathing, every fiber in my body was trembling. The anxiety was so bad that I could almost feel a noose tightening around my throat, constricting me like a massive boa constrictor. I looked down and could see the blood streaming from slices on my wrists even though there was nothing there. I was in deep shit. I knew if I went home I would try to kill myself, even though deep down I wanted to live so bad—I just was so tired. It was so loud.
So that’s how I got here. I remember now. I’ve finally fallen off of this great precipice that I had been struggling to stay on for years. I thought I had finally gone insane and they were going to ship me off to that hospital in Cambridge where they send all of the other crazy people. I was terrified.
The nurse comes in and starts asking me questions about my family history, and then proceeds to get into why I was here:
“How long have you been feeling this way?”
“A couple of days…it just got really bad and I just couldn’t take it anymore.”
“Have you ever tried to kill yourself?”
“No ma’am…just thought about it…”
“That’s good. You’ve taken the first step you know, the first step towards healing.”
“Then why am I so scared? I’m terrified, I can’t think—“
That’s when the tears came; I don’t remember what I said or even what happened after that. I know from my sister working in the ER that they most likely admitted me and were waiting for confirmation from the South wing of the hospital. They weren’t going to send me away, they were going to keep me here and treat me.
Three South. Has a nice ring to it doesn’t it? The official name is the Mental Health Ward, it’s called Three South because it’s on the third floor in the southernmost wing of the hospital. It’s a place where people can recollect themselves, it’s not a One Flew Over the Cuckoo’s Nest situation, the most people stay there is a week. Because PRMC is small, the ward itself isn’t exactly spacious; it only has about ten to twelve rooms and each patient has to share a room with a patient with a similar condition and the same gender depending on the number of patients that were there at the time. After about two hours and one visit with my father later, I was whisked away to Three South. My dad came as soon as he could and we talked about why I checked myself in and what I would need in the coming days. He went home to pack my things and try to wrap his head around why his daughter finally went off the deep end. I wondered what he was thinking; was he blaming himself? I hope not, as a matter of fact he was the reason why I was still alive. I wanted so much for my brain to shut up, to stop confusing me by telling me I was worthless and I should just end it; it was because of him that the knife always fell to the floor or the noose was never tied. I didn’t want him to have to bury his daughter after having to bury his wife just twelve years before.
They go through all of your things when you get admitted, mainly to see if you’re carrying anything dangerous and to see if you’ll need anything out of your bags. They don’t let you keep a bag or anything in the ward, it’s considered a safety hazard because you or someone else could strangle themselves (remember we are in a mental health facility) with the strap or someone could steal your shit. So they keep your bags behind the nurses’ station which is a large, glass enclosed area across from the patient’s rooms. It was the central nervous system of the ward; it contained patient information, medication, and of course the most important element of the ward: the nurses. I was shown to my room and saw that they had taken a few things out of my bag and left them on a desk that was across from my bed. Along with my clothing, she had left my journal and a copy of T.S. Eliot’s poetry. The nurse that had checked me in was a tall, white-haired woman with gentle eyes but a stern disposition (I found that most of the nurses here had to have a firm, empathetic, and gentle disposition), she didn’t intimidate me but I wouldn’t cross her. She meant business but she also was patient and kind, she didn’t take any shit but she earnestly listened to you. She weighed me in (why in God’s name you needed to get on a scale is beyond me) and as she was doing so, a large black woman came up to us.
“Hi. I’m (insert name here), what’s your name?”
“Now (Patient name), let her get settled and then you two can introduce yourselves okay?” the nurse said
I was relieved that the nurse said that because I really wasn’t in any frame of mind to communicate with another patient at the moment. As she was completing the weigh-in, I got a good look at part of her chart:
Patient name: Lauren Ellen Wilson
Diagnosis: Severe Depression with suicidal ideation; severe anxiety.
Medications: Lexapro (10mg); Ativan (.05mg)
I was shown to my room, I would be rooming with another girl who had been here for two days and had the same condition I did and was around the same age. I was relieved to know that, and even more relieved when I met her:
            “Hi, I’m  (patient name). Looks like we’ll be roomies, you don’t snore do you?” she smiled
            “Not to my knowledge.” I laughed. She was funny and charming, with red hair and big blue eyes and freckles. Her presence was soothing, and I felt myself calming down.
            “Good. I think we’re going to be cool.”
I began to talk with her about the other patients, she told me that your room was really the only place where you didn’t have to deal with anyone except your roommate. The patients were all grouped together in the common area; it was where we watched TV, ate and off to the right was a separate room where group therapy was held. It was controlled, she told me that the nurses were really great and they kept things civil. She said that the food was…okay, but she could not wait to eat what she wanted. The patients were given a menu each day with breakfast, lunch, and dinner selections; you made your choice and that was it.
She introduced me to two other patients that came here at about the same time that she did. One was a man, who had an athletic build, like he played football, and he was real easygoing; despite this, he had a nervous breakdown and ended up here. Like my roommate, he didn’t seem like the type of person you would typically find here; it goes to show that a mental breakdown can happen to anyone. The other was a very sweet older lady who I later learned was manic, meaning she had extreme mood swings, going from elated to depressed in a blink of an eye, but she had no idea that’s what it was. My roommate proceeded to point out other patients and tell me their stories. There was a black man who was a manic depressant and an addict—he was addicted to pills and cough medicine. A guy who had made it all the way from Wilmington on a bus who smelled real bad when he arrived, she wasn’t sure what his issue was but he definitely wasn’t all there. He would sit and stare, fidgeting his left hand and leg while his bottom lip hung from his mouth and trembled. There was a woman who had severe depression; she spent her days in her sleeping clothes, wrapped in a blanket. There were days when she wouldn’t come out of her room, not even to eat; she would just be locked in her room with the curtains drawn and waiting for the darkness to take her. My roommate told me that she had been here almost two weeks. There was another girl who was about my age, possibly older, that just stood and stared; she just stood there staring off into oblivion as if the pain of a thousand sorrows weighed upon her mind. Occasionally she would stare at the wall and randomly bang her head, it was sad—she was trapped within the confines of her illness. Then there was the large black woman I mentioned earlier. We weren’t quite sure what her issue was—we knew that it had a lot to do with hallucinations and delusions—but we did know that we tried our best to avoid her. Not that she was dangerous or anything, she was just so damn annoying. She was loud, often obnoxious, had no sense of personal boundaries, and her comments were often lewd, inappropriate, and outrageous. She talked of her nonexistent husband and how she didn’t need him, she would often sing gospel songs at ungodly hours of the night, and she would often take the food right off of your tray if you weren’t careful. Despite all of this, I still maintained a feeling of empathy because her case was a tragic one; she was not really that person, the person she is and desires to be is trapped within the walls of the illness. That could be said for anyone here, including myself, the person that you want to be and the person that you are is trapped within and you have to figure out how exactly to release them.
My first night was not a successful one. I slept badly. The unfamiliarity of the place, the goddamned construction going on, and the fact that I was terrified beyond any sort of description all contributed to my poor sleep. I refused to take the Ativan that I was prescribed that night, mainly because I was too lazy to get out of bed to go get the pill—I was exhausted and was not leaving that bed unless there was a fire. Another reason was that I'm obstinate, I hate medicine—I was one of those kids that my mom had to literally sit on my chest in order for me to take it. I knew when my anxiety became uncontrollable, and though it hadn't reached the point that I described earlier, I could feel it getting there so I committed myself to my breathing exercises; they took a while but eventually worked. The obstinacy and persistence had seen me through my ailment, and it had kept me off of Lexapro for a while—it also taught me when the meds were necessary, and I learned the hard way to never lie to myself about these things.
My second day there I had my first breakdown. I knew it was going to be a bad morning when I reacted to someone's outburst that led to him becoming highly agitated. It was the manic depressant addict, though I wouldn’t call him an addict to his face as that’s what set him off. He began to scream and swear, banging on the walls and saying how he “wasn’t addicted to any fucking thing.” He was a far cry from the tranquil man I had met just yesterday. The nurses were trying to calm him but their task was a hard one, he was inconsolable. His eyes were wild and he just kept screaming how he wasn’t addicted, he was laughing like a mad man.
I began to immediately feel a Level 10 anxiety attack coming on—the tightening of the throat and stomach, the sheer, unsettled, urgency and terror—I was upset to say the least. I went for the Ativan first—something I never do, this was the sign of my breaking point. The nurse wanted to talk to me and calm me down, she was unaware that I had Ativan in addition to my Lexapro. You see Ativan is in the same family as Xanax, and is classified as highly addictive if you're not careful with the distribution and usage of it—which explains why the nurse was so hesitant about giving me the pill. She took me aside into one of the conference rooms where I told her what brought me here after she asked:
 “What made you feel this hurt?”
“My mom died when I was thirteen you see…and then after that I was molested by my schools bible teacher…I—I just—I’m so damn tired of it all. I feel disgusted and raw, I hate myself, I miss my mom, I know that her being here would make this so much easier. I am just so…tired of everything.”
I did hate myself, I hated that I couldn’t be the person that I wanted to be because of my depression and anxiety. I wanted to be stronger but I wasn’t, I wanted to be more than what I was, which was still that fourteen year old girl who was scared and alone. I had locked her away for so long, trying so hard to be “strong” and “brave” that the shackles that held her finally broke, which lead to my being here in this room with this amazing nurse who doubled as a counselor. She talked with me for an hour, listening and verifying my feelings. I never really had a chance to deal with all that had happened to me, after all it happened so fast: my mother was dead within a month of her diagnosis and not even a year after that I was molested. I suppressed it, not wanting to deal with it—I couldn’t deal with it—after all what does a fourteen year old know? How can someone who isn’t an adult deal with adult things?
After I calmed down a bit she said that I could still have the Ativan if I needed it; I found I didn't need it after all. I retreated to my room to write and read.
Even though I was locked away—the real world was still there, all I could think about was school and the fact that if I missed too many classes my graduation date would be pushed back to December. I tried to put it out of my mind; after all I was here for me. It was just before dinner—I was staring out the window, marveling at the “glorious” view: the graveled rooftop and the piece of sky that the tall buildings allowed me to see; I was watching the sunset—it was almost like I had a front row seat in Monet's studio, watching him paint his latest masterpiece. I know it's cliché but I'm in the mental health unit so I'm allowed to use such clichés.
I began to feel a sense of calm; things were starting to clear up I began to feel like things were starting to make sense. I had made great progress in these two days—I haven’t had one suicidal thought since the first time I was checked in, my desire to live was becoming more and more prevalent as my family came to visit each day. They loved me back to life; I wouldn’t be here if it wasn’t for them, they reminded me of how much I had to live for and how great I could be. For the first time since I came here, I felt, on that second day, that I was going to be okay.

Day three: I was discharged at noon. How do I remember that? Well my sister told me it was lunchtime and she wanted to take me to get “real” food. We went to Chipotle.