Electroconvulsive Therapy, Part 4

banner_sylvia plath flickr“The hardest thing is to live richly in the present without letting it be tainted out of fear for the future or regret for the past.” Sylvia Plath (Poet & Short Story Writer)

“And then the anxiety set in. If you told me that I’d have to be depressed for the next month, I would say, ‘As long I know it’ll be over in November, I can do it.’ But if you said to me, ‘You have to have acute anxiety for the next month,’ I would rather slit my wrist than go through it.” (Depression, the Secret We Share by Andrew Solomon, TED Talk, delivered Dec., 2013)

Anxiety is a self-centered landlord who evicts you from your mind. Eviction is by occupation. He wants the house. You don’t realize you’re homeless until the living room set is on the front lawn. You can’t move back in because anxiety is a hoarder who fills each room from floor to ceiling and from wall to wall. My anxiety resists description. I was so anxious that anxiety was all l could think about. There was no room for other thoughts. And it was my anxiety that was cruel company on the long ride from behavioral health to outpatient surgery. I spend the ride staring at my oversized grippy-socks. I wish that all I had to do was click my heels together to awake and find myself back with Summer and Sophie. It’d all had been a dream. My girls would laugh as I share, “And you were there. And you were there.” Grippy socks don’t become ruby slippers. Recall and death and amnesia…oh, my! Patient transport is in the business of function, not hospitality. It is a long quiet ride from behavioral health to outpatient surgery.

Fear tightens to a choke as the automatic doors to outpatient surgery open exhaling its sterile breath into the hallway. Surgical staging is a pageant of color-coded scrubs. The only souls not in a uniform are “loved ones.” They wear street clothes assuring they aren’t mistaken for one of us. The chant of “recall and death and amnesia” slurs into a polysyllabic murmur that my heart matches. I think, “What if it literally beats out of my chest? It’s nearly 9. Can my ribs hold out another hour? Taking my pulse might prove difficult. Can nurses count in nanoseconds?” My eyes take in the pageant as I pant in shallow breaths tasting of rubbing alcohol and bleach.

“Good morning! I’m Jo. Are you Mr. Henson?” Jo has a perkiness chemically-enhanced beyond the capabilities of any latte, iced or otherwise. Jo sports a pixie-cut. It suits her Tinkerbell energy. Starbucks and Pixie Dust. “Good morning! Mr. Henson?” How long has she been talking to me? I nod yes offering her my ID bracelet as evidence. She tells my “Chauffeur” to park me behind curtain 13. Really? Was curtain 666 unavailable? The curtain proves unnecessary as I was already dressed for the occasion. Jo helps me on to a gurney. She disappears only to reappear with a warm blanket offering a toasted variation of rubbing alcohol and bleach. Once under that blanket I become aware of just how cold it was in the hallways on the way to surgery. Jo disappears again. This time she returns with a tangle of wires and tubes. A pulse-ox soon adorns my right index finger like a cursed engagement ring. Jo never proposes to me. No, “Would you make me the luckiest girl in the hospital?” She goes with a surprising, “So how’s your day going?” I think, “How’s my day going? I’m having electroshock! How the hell do you think my day is going?” Jo leaves little pause. “Well, you have a pulse. Congratulations.” (Great.) “It’s so high! Why is it so high?” (I know, right? I’m usually so relaxed when facing elective electrocution. Sarcasm is the official language of depression.) Jo makes with the Witch Hazel applying it liberally. “Got to get clean you up to wire you up!” Dear God, Sartre was right. Hell is other people. EKG sensors and wires interrupt the lines between my warm blanket and my drafty gown. My EKG harmonizes with my pulse-ox. I’m terrified. I’m terrified and alone. I’m inpatient, so no “Loved Ones.” Just Jo. I feel that my loneliness goes unnoticed by procedure-driven professionals. I am a checklist. I want to scream, “There’s a person attached to your checklist! Look at me! Hold my hand. Hug me. I’m scared.” Jo starts an IV, “You know that my putting this IV in your arm is the worst part of it.” I think, “No, the ‘getting electrocuted while paralyzed’ is the worst part of it.” Jo is joined by my anesthesiologist. I’m going to call him Jokey for reasons that will become clear. There are more checklists. He asks, “Did you take your morning meds?” I nod yes. “And you’ve only had small sips of water to take those pills?” I nod yes. “Nothing to eat or drink otherwise?”  I nod yes. “Though unlikely…you could experience recall and/or death?” “So I’ve heard.” (How do you experience death firsthand? How is recall and death even possible?) “Wow, you’re a big one. You’ll need glycol. I’m going to need all the help I can get helping you breath.” “Come again…help me breathe?” “Mr. Henson, you’ll be paralyzed for part of the procedure.” My EKG’s beeps quicken. Terrified and fat is no way to go through life. Glycol temporarily relieves you of any and all excess mucus and saliva. It’s clinical cottonmouth. Jo and Jokey are joined by a familiar doorframe-sized man in scrubs and a lab coat. His coat is long. He’s important. He’s the doctor from the ECT video. Jo and Jokey repeat their respective checklists.

The waiting begins. Across the room in a less forebodingly numbered curtain there is this kid from NC State. Technically, he’s not a kid. I figure he is at least 19, maybe 20. We talked to each other a little up on the unit. By we, I mean us and his voices. I recoil, thinking, “He’s going to give me schizophrenia.” Of all the ills “that flesh is heir” hypochondria proves the worst. Will I start hearing voices? What would my life be like if I began hearing voices in my sophomore year? The kid passes his time in staging visibly ignoring his invisible company. He is oblivious to an old man laying in the bed to his left. The old man stares with glassed-over eyes deeply faceted in an expressionless face. He is catatonic. I find their juxtaposition striking.

The curtains each lose their patients until it is just me and Jo. Jo introduces me to my OR RN who checks her paperwork against my wristband. She asks me if I am me. “I am.” “Good. First treatment?” I nod yes. “We’re going to take good care of you.” She rubs my right shoulder. She fluffs and repositions the pillow under my head. She reclines my gurney. She releases the park break. It clicks. I startle. I lose my breath.  I am sweating. The cold air of the staging area stirs over me as she pushes my bed to the OR. I count the ceiling tiles from curtain 13 to the OR. We reach the OR. She moves to the foot of my bed. She enters a code to open the door. We’re in. It’s a small windowless square of a room. For some reason two of the ceiling tiles are painted with Bob Ross fluffy little clouds. The room is lit by four offensively bright fluorescent bulbs shaded by textured translucent covers. I scan the room. It is forgettably ordinary, all seamless drywall with white paint. My feet point towards the door. I memorize the grain of its wood. I guess at the combination to the lock. On my right there is a whiteboard with a list of surnames under today’s date. Henson is the last one. The others are marked through. I am the last thing on their checklist. My bed is wheeled and locked in place. I quit looking at the walls and focus on the fluffy little clouds. The OR RN asks, “Where are the tunes?” Come again? Tunes? ECT at Baptist has a soundtrack and it is Van Morrison. (Over a year of treatment I never once heard “Brown-Eyed Girl.” It was always “Moondance,” “Domino,” or “Jackie Wilson Said.”) Van croons over an unseen PA system. I wonder if they take requests. Given to gallows-humor, I’d go with Metallica’s “Ride the Lighting.” The music functions as white noise as no one sings or even hums. The only hum comes from the light fixtures.

There is another click. It too startles me. The OR RN lays me flat. Flat is frightening. The nervous tightness in my chest feels worse. My anesthesiologist puts a hand on my chest. He isn’t trying to comfort me, but restrain me. He then covers my nose and mouth with an oxygen mask. I wrinkle my nose in protest to the smell of sanitized plastic. Jokey tells me, “Now, I’m going to be give you some fresh mountain air. Take deep breaths, OK?” Really? (Jokey shares this same joke for the entirety of my year of treatments.) OR RN says, “I’m putting a blood pressure cuff on your calf. You’ll feel it squeeze. It will loosen.” She connects my EKG leads to their monitors. Dr. G. speaks into an unseen recorder, “We have a 37 years old male, a Mr. Henson. It is Monday, November 18, 2013. Mr. Henson is here for unilateral ECT.” He then lists the drugs that will guarantee the best possible seizure. There are varying milligrams of brevital, ketamine, and propofol. He attaches a pad the size of a saltine cracker to my right temple. The pad is cold and sticky. My medical team works like a pit-crew, purposeful and practiced. The last touch is the gel Dr. G. puts on my head. He tells me that it improves conductivity. I think of the “Green Mile” when Percy forgets to wet Del’s sponge. I think of McMurphy in “One Flew Over the Cuckoo’s Nest.” My familiarity with popular movies is not helping. Jokey begins pushing my meds. Enter the sandman. The drugs drop and I’m warm. The warm burns through my veins starting in my core then reaching my extremities. It’s happening. I stare at the ceiling. Jokey says, “We’ll see you on the other side.” Other side of what? The Styx? The Jordan? The Veil? My ears ring and then go deaf. My eyes close. All is black.

Amnesia. I’m pissed. I start yelling. “Jo! When the hell are they going to take me back? I’ve been her all damn morning!” “You’ve been out for over an hour now Mr. Henson.” In disbelief I scratch my head only to find my fingers covered in the still cold conductivity-improving surgical snot. Jo hands me a few paper napkins. I have a slight headache. I’m a little nauseous. All total, it feels like a mild hang-over. A, “I shouldn’t have had that last one” level hangover. The IV going in was the worst of it. Jo says, “I got Pepsi products. What do you want?” “Pepsi.” She returns with a short white styrofoam coffee cup full of crushed ice nearly overflowing with the taste born in the Carolinas. Baptist is pro-mental health, but is decidedly anti-Coke. I return to the behavioral health unit. I would spend two more weeks or six treatments inpatient.

It took a year to amass the previous bits and pieces motivated by what proved to be an unnecessary effort to prevent amnesia. Over that year, my anxiety became frustration each time I had another treatment. Over that year, the time between doses of Van Morrison followed by Pepsi grew. In time I, in fact, did walk out of that behavioral health unit. I walked out on my own two feet.

One response to “Electroconvulsive Therapy, Part 4

  1. Those of us who are depressives often struggle to explain to non-depressives the difference between being depressed and having depression. There is very little the two have in common that most analogies do not work. This post is a beginning. One difference between being depressed and having depression is willingly (if depressives ever do anything “willingly”) go through this experience, repeatedly, in the hope of feeling better.

    Here is another explanation that might help. The difference between being depressed and having depression is the difference between wondering in the fog and wondering in the smog. Fog is a natural occurrence; smog is chemical. The fog may obscure your vision and confuse your way, but you are comforted by the knowledge that the fog will eventually lift. Smog, well just take a look at Beijing. Fog is just water vapor and, other than getting you a little damp, does not cause any physical harm. Smog burns your eyes and chokes your lungs: continued exposure will shorten your life.

    Fog, an occasional annoyance; smog, life-threatening danger. I think you get the point.

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