Talking About Things That Hurt…

I think that for the most part, people mean well.  Even with blinding avoidance of some topics, I don’t think malice is behind what seems like apathy, or even repulsion.  My guess is that it’s more a matter of just not knowing how to approach some topics, especially if that topic is linked to some sort of instability or potential ‘trigger’ for harm.  In my life, that applies to anything related to my hospitalizations for being suicidal, or having attempted suicide (though I never really wanted to die…I just didn’t know how to get out of the pain associated with eating disorders).  It’s just not something that is covered in “Social Conversation 101”, and add a church background that repels any sort of mental pain as some type of spiritual weakness, and the doors and mouths are shut when the exact opposite is needed.

I love that I grew up in a church that was a great social and spiritual setting. The kids’ and high school programs were a lot of fun, and the place where most of my friends hung out.  I have deep gratitude for being raised in a church, and while I haven’t been to any particular building for many years (related to my job for a lot of that time, and otherwise my health limitations), my belief in God and Christianity are strong.  I’m not ‘rigid’, as is often associated with evangelicalism.  When I was growing up, the beliefs I learned were just how it was.  I then spent time as an adult reading through the Bible on my own, and found so much less judgement and hostility towards ‘non-believers’…that those who hurt are who the Bible is meant to attract, as well as give guidance to those who do believe. It’s not meant to be  a ‘weapon’ of pompous piety.  I was embarrassed at the narrow-minded acceptance parameters that I’d grown up with, and I also felt that I understood being on the ‘wrong’ side of what was acceptable.  My high school and  post-high school years were an intense period of  general unrest, eating disorders, and suicidal depression that never happened unless I wasn’t eating properly. During those years, suicide was something that came up more than once… yet I couldn’t really discuss it with anybody who knew me very well.  My parents found out I was mentioning some dark topics, and then chastised me for ever talking about such a thing; I had nothing to be all that upset about, why did I want to make THEM look bad?  All about them.  So I didn’t talk anymore. Until I got away from home.

I had worked at a wonderful church camp during the summers before my senior year in high school, freshman year of college, and half of the following summer. I’d met some incredibly caring people, and I’d disclosed a bit about the depths of despair I’d felt with the eating disorders and accompanying depression with a select few of them.  I did talk about suicide with one of them, that I remember, during a semester break when I was working at a missions conference that she attended at the University of Illinois, where I went to school.  She was also quite young at the time  (though older than I was, so I was sure she knew just about everything, being in her 20s !), and she was a major source of encouragement.  When someone is in the midst of not knowing if they even want to live, it’s not that helpful to tell them they’re not doing something ‘right’, and she didn’t do that. She did focus my thinking towards the lies in my head, and more on my/our Christian belief system.   I adore this friend to this day, and while  it  wasn’t her ‘job’ to be my counselor, she did the best she could.  Now, many years past those miserable early adulthood years, I do agree that focusing more on being what Christ wants of me, and less on the superficial things like weight  and human perception (at least how it was then) is very much what I want to do, and needed to do back then.  But as a scared, malnourished, ashamed, and depressed eighteen year old, I didn’t really get it.  But at least she talked to me at all… I didn’t feel safe talking to about %99.9 of people I knew (or didn’t know, such as therapists).  And she listened, which was ‘enough’ to help me hang on.  She gave me her time.

Sometimes,  just having something to hang on to is ‘enough’ to get through another day, and maybe that next day isn’t so bad, so it’s easier to see making it through the day after that.  I don’t think it’s a sin to have ‘negative’ emotions. I think that there can be sinful choices in how they’re handled sometimes, and I also think that there are times when people are so deep in the weeds that they need someone to look to while they try and climb back to tended ground.  I also don’t think that mental illness is a sin or sign of spiritual weakness.  It’s an illness,  and those who suffer from it (and it is suffering) are seen as being spiritually weak  in many church settings.  That is SO sad.

I can only imagine Jesus looking down at those who are hurting emotionally, and wanting those who claim to know Him to reach over and encourage and gently nudge the ones in pain so they  keep adding days to their lives until the oppressive clouds lift, and they  see daylight again.  I don’t see Jesus adding shame and judgement to someone who is already struggling to see that the next breath is worth taking.

There is a time and place for instructional discipleship, and a time and place for compassionate encouragement.  But silence in the middle of a rotating thunderstorm just doesn’t make sense.  It’s that silence that can be the last opportunity to reach out to someone who is spiraling out of control, and into a place of absolute helplessness and hopelessness, and ultimately suffocating darkness.  Even ‘just’ asking if someone wants to talk, and ‘just’ sitting with them can be enough to let them know that they matter enough to keep taking up space on the planet.  Nobody has to know all of the answers.  And it’s possible to have more questions than answers and still be a temporary rock in the middle of pain that feels like it’s going to last forever.  Being so afraid of doing something wrong that nothing is done is sometimes beyond useless. To someone who hurts, being glossed over by those who know them is worse than having something not be ‘perfectly’ helpful.  Perception in the middle of pain is often very ego-centric and inaccurate.  But a kind word in a gentle tone can ease so much.

There is nothing wrong with saying “I really don’t know how to help you, but I am so afraid for how much pain I see you in.  What can I do? I am here for you. You matter to me.”.   Having human limitations isn’t going to cause irreparable damage to someone. But apathy and inaction might.  I don’t think that anybody is ever the ’cause’ for someone else taking their own life.  If someone is resolute in their decision to at least try and end their life, they will do so. But when there are signs that something is wrong, I do believe that at least offering some human compassion and understanding can’t hurt.  And, no matter what, I’d rather know I at least tried.

 

 

Suicide Attempt: Those Who Knew Never Asked…

…why I attempted suicide in September 1982.  I later found out that it was a big secret from  family (or close friends) who seemed like they’d be obvious to inform (as in why I’d suddenly dropped off the face of the earth and was no longer at the University of Illinois, Urbana-Champaign campus).  And, for the most part, it seemed  like nobody really gave a rats tail.  I did have an uncle who had visited me at the psych hospital the semester before, God bless him.  He wasn’t afraid to see whether or not I was drooling in a corner somewhere (I wasn’t – in fact, back in those days, I was downright intact compared to many there, and it was a private facility in the days where  you either went to a state hospital – like ‘One Flew Over the Cuckoo’s Nest’- or to a private facility that was essentially a hotel with nurses and a lot of pills; there were no ‘treatment centers’).  There was the friend of another uncle who befriended me (strange situation).  But that was the extent of asking me WHY I was there.  My parents were the most silent.  Nobody ever asked me why I’d tried to end my own life.

That seems a bit odd. Maybe it was some sort of bizarre form of ‘manners’ to not ask.  But if there’s ever a scream from a mountain top that someone needs to say something about SOMETHING, it’s a premature, unnatural attempt to die. During that time, my mom was going through radiation, post-mastectomy, and I’d been dropped off at school a week early to accommodate her radiation schedule (I was fine with being at school early- though the dorms were kind of spooky without everybody there- there were about 10 of us in a 12-story dorm).  I don’t remember dealing with my mom’s cancer at all. I’d been in such a rush to ‘look normal’ after having to leave school the semester earlier… I know I’d never have wanted to ’cause trouble’.

Looking back, I’m not sure I know all of the reasons for the overdose, and only remember the first part of it when I mechanically took sleeping pills one after another with the only conscious thought being how much I just wanted some rest.  I don’t remember any actual ‘death wish’. I  ‘just’ wanted relief from so much pressure of being back on that campus after being ‘removed’ the semester before because of deteriorating anorexia, bulimia, and depression with a suicide ‘plan’ (that was pretty dang lethal).  I was trying SO hard to ‘look OK’, and that pressure was unbelievable. SO when I started taking those sleeping pills, one after another, I was only wanting relief from the pressure. I had intended to wake up, from what I remember. When I woke up after nearly 3 days in a coma, I was confused.  I also didn’t believe that they’d found the remnants of fifty antidepressant tablets when they pumped my stomach.  I don’t remember that at all. I eventually sent for the hospital and university health center records.  I needed gaps filled in.

I also wrote to my roommate years later, who told me that I’d been out at a local bar (underage), and came back to the room drunk before dinner. She hadn’t seen me actually take the sleeping pills (I do remember her being in the room, but I was sitting at my desk, my back to her; being drunk explains the impulsivity and lack of planning for consequences of my actions- and why the drugs ‘took’ so intensely). But she said I went to sleep and didn’t get up the next morning. She said I’d mumbled something about not going to class because I was so tired. When she got back late that afternoon, I was still out of it, and she couldn’t wake me up. At all.  She got one of my floor-mates from the last semester who knew me better, and she looked at me and called the ambulance (about 24 hours after taking the pills…it’s amazing that I survived that long). I was taken to the university health clinic, who sent me on to a regular medical hospital/trauma center with a blood pressure that was nearly meeting in the middle. (Not good).

In looking at the records, my ‘coma scale’ couldn’t go any lower. I responded to nothing. Zip.  And, understandably- but frighteningly, I remember none of that. I don’t know when I took the bottle of antidepressants.  I don’t remember having my stomach pumped (and used to get so uneasy later in my nursing career when OD patients were often ‘threatened’ with having their stomachs pumped as some sort of punishment; they were seen as deliberately causing unpleasant work for the ER staff who had ‘real’ patients to take care of- those who hadn’t put themselves in that position- never mind that the person was in so much emotional pain that they felt they had no other options).  I never told anybody that I planned to overdose. I don’t think I knew I would OD.   I’d been trying to fit in and be social (not something that came easily outside of my home church group setting). I wanted to be in school.

I do remember asking the nurse in ICU what I had been wearing when I was brought in, as that would tell me what day it had been. I’d been brought in on a Wednesday.  I had been wearing a red gingham shirt and overalls- I did remember putting those on on Tuesday- brought to the ER on Wednesday.  I probably looked like a dead farmer.  I was very close to not making it.  I sent for my medical records years later, and my vital signs were very bad- as in not much difference between the top and bottom numbers of my blood pressure, a heart arrhythmia, and very slow respirations.  I was given some resuscitative drugs to maintain my heart rhythm, and fluids to maintain my blood pressure, and over a few days, I woke up.  Freaked. Out.

My first recollection is of someone moving an oxygen mask to ask me a question, so they could see me talking.  Then fade to black again.  Then, I clearly remember a nurse going towards my crotch with a syringe (no explanation that she was removing the catheter). I’d never been in a real medical hospital before. From there on, it was a bunch of blips of memory, finally getting back to a ‘slow’ normal. I remember being very confused by the Saturday cartoons.  I’d been propped up in a chair with the cartoons on (at age 18?), and it was hard to follow them. Bugs Bunny was too ‘deep’. For a while, there was concern about permanent brain damage, and the psychiatrist I went back to was surprised I wasn’t impaired.  I also remember the charcoal diarrhea… I didn’t know the ‘rules’ in ICU about not disconnecting the EKG leads without help before getting out of bed ( I didn’t want to bother anybody), so it would look like I’d flatlined when I was just in a hurry to get to the bathroom.  They didn’t like that very much. I felt the bruising on my breastbone where I’d been ‘knuckle-rubbed’ to wake me up, and the scratchy feeling in my throat where tubes had been.  And it all confused me.

While I don’t remember a lot about the overall overdose, I do know I didn’t want to leave school! I wanted to do well !  I wanted to show my friends that I was OK ! (And with that, I had some desert property in the Everglades for anybody who was on board with that idea). I didn’t want to be a failure.  I have to admit, that at 18 years old, in an ICU room in Urbana, IL, I had a serious meltdown when I was told I’d be sent back to the nut farm I’d spent February through mid-April earlier that same year.  My parents had been called (that was like ramming a dagger into my heart- how could they call them? I especially didn’t want to disappoint them… but  how could they NOT call them?  I was a huge liability at that point). Everything was falling apart.  I was hysterically crying when I saw my mom and dad show up later that day (?Sunday- no cartoons, and mom had to be at radiation on Monday) after clearing out my dorm room and selling my books back to the bookstore– for some reason, losing those books was almost like the ultimate ‘proof’ that nobody believed in me… I’d been ‘removed’ from school. Again.  For weeks, I cried about that.

My therapist from the previous and current semester had been called in (she was recovering from a blood clot in her leg, and having a semi-miserable first months of pregnancy).  She explained that there were no other choices.  I couldn’t remember the overdose- that was almost worse than planning it out.  They couldn’t ensure my safety. Forest Hospital in Des Plaines, IL had already been notified, and since I was as medically stable as I was going to get, I was being discharged from the ICU to be driven back up to the suburbs of Chicago.  I was devastated.  I was horribly ashamed.  I’d failed. Again.  I didn’t see the ‘illness’ part of what was going on. I just saw failure.

It was almost a bit of a relief to be around people who knew me, who didn’t think I was a lost cause (though the next several months- September 1982 through early January 1983 weren’t exactly smooth at the hospital… I was a train wreck, and things got worse before they got better, in the days of endless insurance days inpatient; ‘losing’ school was absolutely devastating, and stirred up a lot).  I spent a total of 7 months in the hospital over 2 admissions.  I was tested (I’m reasonably intelligent, so they said- LOL) from one end to another, and I tested them. I’d always been pathologically well-behaved (confirmed years later by my folks), and at the nut farm, I blew through some rules.  I also tried to escape (going where?) and hurdled the gardner and his wheelbarrow only to collapse on the sidewalk about 1/2 a block from the hospital, in full view of a busy road…. nice to have that on my resumé. *rolling eyes*  At any rate, I was in a place to work on whatever was the immediate problem, which was making sure I didn’t blindly go on some life-ending rampage.  I was never a ‘danger to others’… it was always ‘danger to self’.  I’d give the shirt off my back to ‘others’.   Whatever had happened in that dorm room in Urbana couldn’t happen again.

In some ways I don’t know if I’ll ever know what was going through my ethanol laced brain that Tuesday afternoon when I started eating sleeping pills.  Maybe the booze was a huge part of that horrendous time.  It does explain a lot- but there had to be enough going on to ‘set up’ what happened.  What I did.  The memory loss has always been really hard to deal with. There are days that are just ‘gone’.  No matter how hard I try to figure it out, it’s just not there.  But I always wondered why nobody asked me if I’d really wanted to die.  The answer is no.

Sad and Scary Magnet

Sometimes I’ve wondered if I’ve got a sign on my forehead that screams “ALL FREAKS, C’mon over” !  I’m sure that everybody has experienced the same sorts of people in different ways…and some days I’m not so sure.  Maybe some of it has to do with being a nurse. People see nurses as helpful and nurturing, when we’re just as weird as everybody else- we just get paid to take care of the lost and vulnerable. And then there are the folks who would fit nicely  on the side of ‘Criminal Minds’ that either gets shot or lengthy prison sentences. The spooky people.  Not all are dangerous to others, but the danger to self thing eeks in there. Regardless, they don’t fit well into a ‘normal’ life.

Let me start with a director of nurses (DON) who had been one in a line of them at a very nice nursing home after the ‘good’ DON had gone on maternity leave. He happened to come along during a time when a new administrator was also getting used to all of us.  Initially, he seemed a bit intense, but not pathological.  One of my duties when I was working on the weekends as the RN Supervisor was to log in the discontinued medications that did little but take up room in the storage cabinets in locked medication rooms. I counted each pill on each card of pills (packaged at the pharmacy for nursing home med carts), bottle of loose pills, or made sure injectable medication vials had a reasonable amount left for what the sign-out sheet said it should have.  Narcotics (or ‘scheduled’ drugs) had to be accounted for separately and documented on specific forms.  It was mundane, but necessary. At one point, the DON asked me for the keys to the file cabinet  in his office where we kept the ‘logged’ drugs.  He was the boss, so I handed them over- no problem.

A few weeks went by, and the nurses on the floors said that nobody had picked up the growing piles of discontinued cards and bottles of medication for a while; they wanted them out of the way. I asked the DON if he wanted me to log the meds in that coming weekend ( I think this was either a Thursday or Friday). He looked at me and closed the door behind me in his office.  Gulp.  He then pulled out a .44 semi-automatic handgun out of the desk. That alone was a huge, HUGE problem. Texas was pretty gun-friendly, but in 1994, guns and old folks weren’t a good pairing.  He pointed the barrel at me as I sat down (which I decided to do before I keeled over), and asked me if I was going to tell anybody about our little talk.  Nope. My lips were sealed. Everything was very cool (as I’m imagining my body being found after the weekend, ripe and smelling up the place).  He handed me the keys and told me to go ahead and log in the meds that were piling up.  NO problem. Happy to do so.  Can’t wait to get started. Did he want coffee with that?

But that weekend, I noticed that every last narcotic form I’d filled out had been rewritten in his handwriting, with no way to figure out what had been removed from the lists I’d been keeping. I had a very specific way of tying the bags when I was done, and how I kept the narcotic sheets separate.  It was a federal law that this all be done according to the rules. I liked following the rules 🙂   I didn’t like having my work screwed with by a gun-weilding nutjob of a boss.

I  didn’t like even knowing about the gun. But I was also initially scared enough that he would shoot me, run off with piles of drugs, and nobody know why I was found belly up until they start looking at the paperwork. By then, he’d be on some uncharted island in the South Pacific, in some hut powered by a bamboo bicycle generator and drinking coconut drinks. The new administrator didn’t know any of us that well, and I wasn’t super tight with the assistant DON, but I had to tell someone. The ADON ‘G’ was outside smoking late that next Monday afternoon after nearly everyone had gone home. I told her about the gun.   She knew me well enough to know I wouldn’t come up with some sordid story about someone.  We agreed that we’d both go to the new administrator in the morning, before the gunslinger got to work.  We did, and told the newbie administrator. By that time, the DON had turned in his resignation, and it was decided he need not complete the two-week notice. He was free as a bird.  I have no idea what else was done about reporting him to the board of nurses (not sure if mandatory reporting was in place at that time), but I was told (after he left)  that before he left, he’d taken it upon himself to just stop some lady’s order for morphine- pills and injectable- and they were never seen again.  That created a HUGE mess with calling the doctor and getting the stuff reordered from the pharmacy for the poor little lady who still needed the stuff. The floor nurses were going nuts counting everything that wasn’t nailed down, and making sure their names were clear (they were).  I’ll never forget the business end of that .44 charcoal gray gun ‘looking’ at me.  “Two in the chamber, ten in the clip”…. whatever that means, it didn’t sound good.

Another time at this same facility, there was a sweet certified nurses assistant who was noticeably quiet, but she got her work done and wasn’t an attendance issue. Those sorts tended to fly under the radar. She was probably in her early 20s, and a member of the ‘fashion isn’t my thing’ club (I also belonged to that club- no judgement from me). We all worse scrubs while working, so looked pretty much the same (in different colors and prints, depending on the department), but when she came to get her paycheck, she dressed ‘depressed’. That was my first clue. I’d talked to her several times, and we had a decent rapport. I could tell there were things going on, but didn’t have any reason to pry. Her work was acceptable. I was part of the nursing management bunch, but did patient assessments and staff training/infection control- not the hiring/firing/counseling stuff.  Anyway, I kept an eye on her.

One afternoon, I got a call from the next door emergency room. They had the CNA there. Her friend wanted to talk to me.  Seems this CNA had slit her wrists. I wasn’t sure why I was being called, but the friend asked if I could talk to the staffing nurse (ADON) and let her know that ‘L’ wasn’t going to be there for her next shift; ‘L’ didn’t want to talk to anybody. I asked where she was going when she was done at the ER (as in what psych facility is going to evaluate her?). She was being discharged home.  With sharp things. By herself.  I didn’t like that at all. I knew ‘L’ lived alone. She never mentioned any family or support system.  OK, not good.   When they left there, I needed to see ‘L’ with my own eyes, so asked them to come over to work, and I’d talk to her.  She agreed via her friend.

In the meantime, I tracked down the social worker (from hell, normally) who was still there; I needed help with this one. And she got nice about it all, which I was thankful for. She got on the phone and started making calls re: acute psychiatric facilities who would do an impromptu assessment as soon as we got ‘L’ over to their facility.  I don’t remember who the DON was at that time, but I think she was gone for the day (it wasn’t gun-boy).  ‘L’ got over to the nursing home in a little while (wrists wrapped in gauze), and agreed to go with the social worker and me to the psych hospital, just to see ‘what her options were’.  I was hoping they’d keep her for a few days, so she’d be safe.  She was worried about losing her job if she checked in to a psych facility, but I told her that being checked out, and getting help was going to help her keep her job. Our administrator (before the one with gun-boy) was very compassionate.  ‘L’  agreed, and the psych facility did decide to admit her. She was in and out of there over the next few months (once after I sent the police looking for her as she had uncharacteristically not shown up for work), and ended up getting shock treatments.  She came back to work eventually, and while a bit subdued, she was doing better.  I learned more about her past, and she had reason to feel overwhelmed and hopeless.  Everybody has a history…

Another coworker (an LVN at an acute care hospital working on the neuro floor) had some ‘issues’.  At work, she was fine.  Not employee-of-the-month, but she did OK when she was there. We were both fairly ‘young’ nurses- as far as time out of school, and also just plain young, in our early 20s.  ‘A’ had all sorts of respiratory problems- mostly asthma. She had some attendance issues as a result, and the hospital had a ruthless attendance policy. She could be admitted in the hospital on oxygen, and it counted against her attendance record.  Anyway, a few months after I’d been raped and beaten in a very publicized case, ‘A’ calls me and says she had been attacked overnight by a former boyfriend, and needed help getting her dog to the vet. Fido had been cut by the boyfriend’s knife per her report.  I immediately agreed and went to pick them up.  Something seemed ‘off’.  Fido was frisky and happy to see me (his  usual goofy, non-traumatized behavior). There was a tiny cut  on his paw (more worthy of a bandaid than a trip to the vet), and ‘A’ had some odd looking cuts on her neck…the depth wasn’t something I’d expect from someone who had been seriously sliced by a rabid ex-boyfriend, and the way it went from deeper to more shallow from left to right looked kinda self-inflicted to me (she was right handed). But I didn’t want to believe that.

‘A’ told me she’d been whacked in the head, and felt horrible, but after going to the vet, how about we go get some lunch and maybe do some shopping.  😮 Everyone deals with stress differently…but another piece of the puzzle wasn’t fitting well. But, I agreed.  We spent most of the day together, and during that time she told me that the police had asked her for this guy’s photo- but she didn’t feel like getting it for them. WHAT? Not helping to apprehend this guy?  I had no ability to understand that ‘reasoning’ at all.  I’d been held in my apartment for 6 hours, finally escaped and called 911, and police ended up shooting the guy in my bedroom when I’d been attacked less than 7 months earlier. Why was she doing this?

I decided I needed to get home, and she suddenly begins to have symptoms of a concussion.  Puking, head pounding, vision a bit blurry…. so she now needs a ride to the ER for a CT scan and neuro evaluation.  The day was getting so very long (and more and more weird). She ended up being cleared for any sort of head injury, and told that basically she was fine.  I dropped her off at her apartment, drove like a bat out of hell to get home, and turned my answering machine off when I got there. She could dial 911 in a real emergency when she was going to cooperate with an investigation.  I was done.  I was no longer working at the same hospital by that time, so rarely saw her… I’ll never think that she was telling me the whole story- OR stop wondering if the police had ever actually been notified of the ‘attack’.  What made me even more mad was that the dog had been involved.

I got much more jaded when crises came up with some coworkers.  I had my own stuff to deal with, and had also become much better at sorting through when someone needed  help that was appropriate for a friend or coworker to handle.  I had times when coworkers helped me through some lousy times, and most of that was when they offered; I didn’t seek them out.  I was always very thankful for their time.  But,  I got careful about that as well, as crises junkies also like to be on the ‘helper’ end, not just the ‘helpee’.  One in particular had been a huge support system during some eating disorder stuff that was pretty serious, but when I got better, she wanted nothing to do with me. That hurt a lot.  There are a lot of people out there who are taking care of people who need keepers themselves.  Or who help to fulfill their own self worth needs.  There’s nothing wrong with finding satisfaction with helping people (professionally or on a friendship level), as long as the needs of  those being helped are the first consideration- not some twisted need for being needed.  Sometimes it’s a fine line.

I can think of others… these just stood out tonight.  Stay tuned for the continued saga of the  wacky side of nursing, and whacked nurses. :/