I’m lying in bed with my negative self-talk (stupid-ugly-stupid-fat-weak-stupid-unlovable) dreaming up the best way to kill myself. I can see my limp body hanging from the rafters in the garage by vertical words (bills-work-stupid-weak-stroke-pedi-drowned). I pick up the phone. “I’m not ok.” “Where are you? I’m coming over. We’re going to the ER.” She knows not to take any risks. She’s a Paramedic too and she knows that psych patients who have a history of past suicide attempts are at a greater risk for succeeding the second time. She also knows that this would be my third time. And she’s watched me try to keep my head above water in this tsunami for 3 months. But now I’m sinking with my anchor of hope.
I know the drill. I know where I’m going. I pack some clothes that won’t constrict tighter than the anxiety. I pack my toothpaste to wash the bad words out of my mouth. My deodorant to get the stench of stupid-ugly-weak-awkward off my body. My journal to get the monsters out of my head.
A panicked knock on the door. “I know I need to go but what if one of the nurses recognizes me?” My voice is small, meek, trembling at the thought of becoming part of the stigma. I know what they say about psych patients. What we say. I’ve heard them say it. About the low life dead beat leeches on the system. The patients no one wants to deal with who fill ambulances with awkward silences and avoiding eyes. All the while they’re thinking, “Who doesn’t get sad? Why can’t they just deal with it?” “If you’re gonna try, get it right the first time,” “Crazy people are so fun to mess with.” No, I didn’t want to see anyone I knew. I couldn’t go back to work without a brown paper bag over my head if I did.
When she suggests a hospital in the neighboring town where I wouldn’t run into anyone I work with I think she’s a genius. I need a cigarette before we get in the car. I need her to pull over for another before we pull into the parking lot. I know I won’t get another one until I’m dropped off at the psych ward and I’ll need an IV drip of Xanax to get through this. When I call into work for the next three days I need two more nicotine fixes.
She walks in behind me in case I’m a flight risk. I’m not. I don’t want to be here but I don’t want to be dead either. I walk up to the reception desk and scribble on a slip of paper. Patient privacy requires that you write your chief complaint. I chicken scratch “suicidal ideation” in minuscule letters. What I don’t write is I’m mortified at the need to ask for help. That I’m embarrassed and anxious and trembling and coming apart and feel like shattered glass and it hurts to breathe because my heart is so swollen from aching that it slams against my rib cage with every beat. I don’t write that my monsters are bigger than me and I’m too weak to fight my battle by myself anymore. I’m drowning.
A nurse calls me to triage and a faraway voice tells me my blood pressure is good. It’s actually high for me. He asks what brings me in and I throw a few PVC’s. Words. We use words to speak. My lead tongue miraculously forms sounds that whisper, “I want to kill myself” to the floor. He escorts me to a room and brings in some scratchy blue paper scrubs, yellow socks and a urine cup. I’ve traded my gold patch for a scarlet letter. Been kicked out of the elite group allowed behind the nurses’ station and reduced to being babysat by security. I recognize a paramedic who walks in for a transfer and have to suppress the urge to claw my face to unrecognizable shreds. Instead I cover my head with the sheet.
A nurse practitioner strolls in all confidence to talk to the puddle on the bed. A detached voice I don’t recognize lists my depression since age 11, my two previous suicide attempts and three hospitalizations. My recent increasing anxiety and crippling depression. She signs the PEC and says they will start looking for a facility. Six hours go by before they find an open bed and arrange my transfer. I arrive at the short term psych hospital just in time for bedtime snack. They dig through my bag for contraband and lock up my toiletries. I get my first cigarette since the ER parking lot. I’ve been to this place before, but never on this side of the glass. I need pills to sleep; byproduct of the night shift.
I see the doctor in the morning. I detach from him too. I hear antidepressant and mood stabilizer and my eyes snap into focus, really seeing him for the first time. He has ridiculously long nose hairs. “Are you diagnosing me with bipolar? I don’t have bipolar.” Apparently I have the prejudice too. Everyone gets a little sad sometimes and some people just need a little boost coming out of it. But bipolar is REALLY crazy. Like crazy crazy. It’s a hard pill to swallow. The paramedic in me takes it hard. She’s in denial. The doctor says it’s probably why no treatment has ever worked long term for my depression—I was misdiagnosed. The monsters say they knew it all along. That I’ve never been truly happy; just phases of manic. That I don’t even really know how to be happy. It’s a tough blow. Who will I be if I’m neither depression nor joy? Will this person be able to function at work? In the world? I don’t want to be one of the stigmatized indigents on disability and food stamps. I want to be a productive member of society. Bipolar patients are zombied up on mood stabilizers and antipsychotics. Drugs that come with warning labels like “do not drink alcohol while taking this medication” and “don’t drive or operate heavy machinery on this medication until you know how it affects you.” This can’t be happening to me.
It takes nine days for me to adjust to this diagnosis. To swallow my pride. Nine days to play Russian Roulette and find the right formula to regulate my moods. Nine days before the doctor is comfortable enough to let me return to work. Jumping back in like I never left is terrifying. Do I look different? Is it noticeable? Did I escape the rumor mill? It’s not just a different label. It’s a different way of life. Am I really in a good mood or just manic? How long until the next crash? I’ve become a watchdog of my moods. The higher the high, the lower the following low. And it’s the lows I have to worry about.
It’s been an adjustment, this learning how to ride a roller coaster. But I’m still me. I’m working through the stigma and bipolar isn’t crazy crazy. It’s just an imbalance. And psych patients are people too. Would you tell an MI patient to make sure they get the LAD next time? Or a hypoglycemic to snap out of it? Would you make fun of the dysphagic stroke patient? Psych patients are just that…patients. Talk to them. If you’re uncomfortable talking to them about their illness then talk to them about football or the Grammys. It’s ok; their crazy isn’t catching. But show them some compassion. The experience they’re about to have in our health care system is a frightening, belittling and humiliating one.
– Story written by anonymous paramedic. 3 years in EMS.