hard times: the emergency room

I need to mention this so I can talk about it, because it was one of those surreal experiences my heart wants to dissect in a million different ways, but I’ve been waiting until I can look back on it from a positive place.

Monday was my therapist appointment with the new therapist, but Sunday night and Monday morning was when I found out more about the undergrad John had a crush on who kind of kicked off all of his doubts and his midlife crisis type thing. While he didn’t cross any physical lines and didn’t engage with her romantically as far as I can tell, they did have really inappropriate flirty/sexual conversations. They also hung out more (and differently) than he’d let on — I’d thought he was just tutoring her, but their meetings weren’t all academic. He seemed hugely affected by this interaction with this girl.

To say I was a mess is a huge understatement. I felt old, ugly, worthless. If he knew he could get girls like that, why would he want me? And since he’s already been wondering aloud if he stayed with me during the hard times in the past because of a dysfunctional need to take care of me, what if he realizes that’s the only reason he’s here now?  My abandonment meter was just going bonkers.

I showed up in my therapist’s office with unwashed hair, no makeup, no bra, no forms. I sat down trying to hold my I’m-a-sane-person look together (uh, good luck?) but just immediately started sobbing, because I had to say, “I don’t know if I should be here or if this is an emergency and I need to go to the hospital. So I might need your help figuring that out.”

(possible triggering information behind the jump to the rest of this post: mentions of self-harm, suicide, etc.)

Over the course of our appointment (during which I recovered and was able to pull myself together a bit — and she was great about not making me feel weird), she made it clear that if I felt like I might hurt myself, I should indeed go to the psychiatric emergency room. She gave me a list of steps to take: go to the ER, get medicated, call a doctor Tuesday to set up a primary care physician, make a psychiatrist appointment and decide how to proceed with therapy on Tuesday (turns out she’ll be on vacation for three weeks, so she wants me to see someone else. I’m paranoid that this is because of the bad first impression, but I guess it doesn’t matter.)

I left her office and went to get a fountain coke zero. I sat at a cafe and googled directions for the ER. I felt weird about going, but I tried to look at the facts: I knew that if I went home and sat alone, I would be in a very dangerous place. I also knew that over the past couple of months I’ve repeatedly become suicidal and a few times actually tried to go through with it. I suddenly (because of her echoing and supporting my feelings, I think) realized that it was ridiculous for me to sit at home alone and wait for it to be too much, and that I needed to be on medication immediately. I drove to the ER and had myself admitted.

John called while I was in the outer waiting room and I told him where I was. That morning he’d been in my city (he lives 3 hours away) and I’d indicated to him that I wished he’d stay, since I thought I might need to go to the hospital. He was determined to leave, though, and he did. I don’t think he really thought I was going to go to the hospital — I know it seems weird, but I think he thought I was just exaggerating how off-balance I was feeling. I don’t think he really believes in my thoughts/feelings, and I think that’s a big reason why I minimize and criticize my OWN thoughts and feelings so much.

Anyway, when he found out I was, indeed, in the ER, he felt bad and texted me kind things and I told him it was fine that he’d left and he hadn’t done anything wrong. It was enough to know he cared about what was going on. I didn’t know that two days later he’d be back to keeping me at arm’s distance, feeling exasperated with me, etc., but I try to live in the moment. Ha.

I was honest about my feelings with the triage nurse, but also careful not to mention any current suicidal intentions, since I didn’t want to be involuntarily committed, but just put on medicine. She asked if I’d tried to kill myself recently, though, and I acknowledged that I had. After waiting a bit longer, the nurses took me to the back and the doors locked behind me. I wasn’t sure if this was something that happened with every patient or if I’d answered a question wrong. I now know it was because of the suicide risk, but I still don’t think I did the wrong thing being truthful. I wanted the doctor to know where I was mentally when he was prescribing medication to me.

In the back, they took all my belongings and clothes — even my shoes. I had to undress in front of a nurse, who then had to chronicle all my scars and bruises. It was humiliating, but even though I was initially worried I was overreacting (I wanted to kill myself! So of course I was not overreacting! But my heavy, persistent self-check is always worried I’m being unreasonable), I knew in my heart I needed outside help immediately. And the kind that shouldn’t come from John or even a therapist. I needed medication and I needed to be in a place where there were people who knew how dangerous I was REALLY feeling and were trained to deal with that.

(And actually, though I’m messing up the continuity of the story here, a sweet lady called me on Tuesday from the behavioral health center where the ER is. She wanted to ask how I was doing and if I had any questions, and seemed genuinely honest-to-God thrilled when I said I was doing so much better. I know this is silly, but I’m getting teary just saying: it really felt like even though she didn’t know me, she was in my corner.)

In the back, clad in scrubs and socks with rubber tread, I alternated between a baseline nervousness and near-panic. All while keeping a bubbly, pleasant veneer so that the staff would be able to see that I really wasn’t psychotic, I was just Having a Hard Time. It was like talking in your phone voice for 7 hours straight. Because yes, I was there for 7 hours. They took me to a waiting room with others in varying stages of… awareness. Some of them seemed to have more severe mental difficulties than others. Ice Age was playing on the TV and I tried to just let it distract me — little Scrat running after his nut, the mammoth who thinks she’s a possum, etc.

There was a lady named Tara there who figured out she could get me to help her. I think she wanted attention more than help, but it was so easy to put myself in her place and realize that acts of service as love right now would probably mean a lot to her. So I tended to anything she wanted: tucking her blanket around her, asking the nurse if there were anymore pineapple, taking her tray for her. I’m pathologizing it in my head and saying I needed to feel benevolent to help me feel better about myself and blah blah blah, but who cares if it made me feel good to be kind to her? Who cares why I felt beholden to help her? It was nice to be nice, and so I did it.

In the back waiting room, I suddenly started to realize I might be trapped. I got up to use the phone (since they’d taken my cell phone, I had to use the one on the wall) and the nurse got up calling, “Jane? Jane?”

I said, “Yes? Do you need me?”

He responded, “Just have to keep an eye on you.”

That was the first moment I really started to worry that I was not free to move around/leave as I wanted. I tried to suppress the panic, but when it surged again, I asked another nurse if I’d be able to leave after I saw the doctor and got medicine. She said it depended on what the doctor recommended. I was scared, but also felt like he would SURELY let me go. Surely?! So I waited, waited, waited.

At one point I called my parents to tell my little brother I couldn’t pick him up to go to dinner after all. I fully intended to just say something vague like, “I’ve gotten tied up in work and am so busy; can we reschedule for tomorrow?” but I forgot that my parents’ landline has caller ID. Who has that anymore?! So my dad seemed worried and asked, “Where are you?!” I had no idea how he could have an inkling, but he said, “The phone says [City] healthcare — are you okay??”

While mentally kicking myself as hard as I could for not realizing this would happen, I laughed it off and said, “Oh, I didn’t realize it would say that. My phone’s just being weird. I’m at the doctor’s office, but I’m fine!”

He said, “You sure?”

I responded, “Dad! I would tell you if something were wrong! I’m fine!” That seemed to placate him, but I still felt so stupid. They never asked about it or acted weird, so I think all’s well on that front.

At one point, the dinner cart came and everyone in the waiting room was so excited. I remember feeling a mixture of surprise, confusion, disgust (and then guilt because of the disgust) at how greedily they ran out for this gooey, pale hospital dinner. It seemed like they had accepted the ebb and flow of this place, made the best of it, while I was still resisting with all I had. I was just here because I was Having a Hard Time. I wasn’t like them. I know this is horrible, but I didn’t feel it in a certain/privileged way, but in a desperate/hoping way. “Surely, surely I don’t belong here?!” This still seems messed up, but I want to chronicle it.

Part of me also felt like eating dinner was some sort of acceptance of the fact that I had been “committed,” that I was staying there. I was resolute that I was just waiting to see the doctor and then to be discharged, so I didn’t want to eat. At one point Tara asked, in her heavily medicated drawl, “What room are you in?” I answered back, maybe a little too quickly, “I don’t have a room. I’m not staying; I’m going home.” She seemed to not have realized this was an option for some people.

At any rate, though I hadn’t eaten anything all day, I wasn’t hungry at all. I felt nauseous just watching/smelling/hearing them eat dinner. And in this germy hospital environment, even. I focused with all my might on Ice Age. But then the nurse called me out and said, “Listen, I know you may not feel like eating, but you’re going to be getting medications and things, and it would really be good for you if you could eat something.” Another nurse asked if I at least wanted some crackers. I acquiesced and ended up eating — and almost gagging my way through — two packs of graham crackers. I realized I WAS hungry somewhere, under my disgust and panic, and I DID need food on my stomach just in case.

After waiting a bit longer, I saw another counselor and was also honest with her — being emphatic because of my terror about being involuntarily committed that I did NOT have a immediate urge to kill myself. This was even more true than it had been earlier, in part because I’d had time to calm down and had evidence that John cared for me, and in part because I knew that I would feel MUCH better — joyful even — if they actually let me go.

Back to the waiting room after that. Finally, a doctor called me in. He finally revealed that yes, I was in the back room because of the suicide risk, and that I could either stay or — upon promising that I could avoid doing any self-damage — he would be okay with letting me go. I promised immediately, and was almost tearful with relief. I don’t know why it was so terrifying to be stuck there, but I think it had to do with claustrophobia (unable to get out), the hospital feel/smell. I actually started questioning whether I really was “sane” or not while I was there.

He talked about the different types of drugs and, after ruling out bipolar disorder, focused on antidepressants and mood stabilizers. He leaned heavily toward the mood stabilizers given my self-harm and discussion about the immediacy and scale of my emotions. It was probably another hour before I had my prescription and they were finally, finally letting me out the door. I was teary as I walked to my car, breathing the outside air deeply and letting myself plunge into gratitude. The joy of leaving did stamp out the sadness for that night, at least. And I have NEVER been so grateful to see my dog.

And despite the fact that I know a horrendous bill is probably coming, I am so, so grateful that I got the medicine I needed immediately. Psychiatrist appointments are usually unavailable for months at a time, and I simply don’t have the luxury of waiting that long. No matter what my heavy self-check says about, “Do you really need to burden others with this? Do you really need to go into the ER like you’re in some sort of real emergency? Do you really need to…,” I know from the relief I feel and the medicine I’m taking that it was the right choice. Just one of my first steps, maybe, along with trying to find a therapist and starting DBT, but an important step.

(And I want to emphasize to you that if you feel like hurting or killing yourself, going to a psychiatric emergency room is the right choice for you, too. They can help in ways others can’t: they can provide you with a safe environment, immediate medication, and routine care that you may not be able to accomplish by yourself right now. If you need to go, go. Don’t make excuses and remain in a dangerous situation.)

All day, everyone I met mentioned how I was “hilarious,” “smart,” “bubbly,” “obviously college educated” (this was the counselor as she filled out level of education info), as though they were surprised I was there. It almost made me sad. Because I know those things seem true — are true in a way — but they’re carefully practiced, carefully executed “phone voices,” so to speak. And it’s good but also sad that they are so effective. It’s sad that I have this huge broiling chasm in my identity that I almost cannot unpack, even for a professional who I’m not worried about impressing or being friends with. When people DO get a peek into what’s really going on in my emotions/heart, I worry that they’ll label me crazy (a worry that has been confirmed by John and Dr. Deville, and maybe even by the fact that it’s hard to find a therapist now after mentioning BPD — something I won’t do anymore). But when my compensation for that (the veneer) works, I worry that I’ll never be able to communicate what’s going on to anyone and will never get appropriate help.

Anyway, as I said in the beginning, I am in a positive place now. I feel my medicine working and whether it’s a placebo effect or the actual medicinal benefits, I have generally been more able to handle things. I feel okay. Sometimes things aren’t great, but I still feel able to handle them. I’m having trouble thinking of how I’m going to accomplish actual WORK. I just get so tired thinking about it. But I don’t have to think about it all right now, and I shouldn’t. I should just go one day at a time. And today I’m going to exercise, I’m going to meditate with my swanky new Tibetan singing bell (more on this later), I’m going to eat dinner, I’m going to pick up the rest of my medicine, take my medicine again, and get to sleep at a good hour. Today I’m doing okay.

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