She was young. Younger than i was for sure.
Kind looking, quiet, responsible.
The type of person I would like to oversee my mental health care.




The doctor will see you in a bit. I'm just getting settled - first day and all...


The Allan Memorial - an old turn of the century mansion that was transformed in the 1950's to become Canada's leading psychiatric hospital.


Project MK Ultra was conceived and carried out here. Despite it's old world eclectic charm, and the fact that it does not look like a hospital, only the ghosts of tormented minds and their terrifying secrets haunt the hallways. 




I wait and scour the library - journals on pharmapsychology, lots of books by Jung, on topics such as behavioral therapy, addiction, mixed in with volumes of textbooks on the deep tentacles of mental illness and its many faces. Fascinating and terrifying...






There is a book on the table, thin white pages, the kind that are almost transparent. Similar to a bible, this is a sacred text of another sort. Complicated details behind the mystery of sleep, a look into the brain of a somnambulist, replete with medications that have over 20 letters and black and white etched drawings of EEGs with interesting wave patterns.






Sleep. 
What I would not do to have enough of that...


Last night, i was hounded by images of 911: the twin towers crumbling like dead rose petals from the sky, people leaping to their death, tears. 
So many tears.


Survivor guilt. Deep seated paranoia. Death. Like a tidal wave, these thoughts picked up momentum and pieces of my fragmented psyche until i was staring at an illuminated 5am notice. 2 more hours until i was supposed to get up. 4 more until I was to meet the doctor that would be the one to "refer" me to the next level of a medicated bipolar haze.




Come on in and have a seat.


The room was white, stark yet the antique charm of the old mansion welcomed me. I began to relax.


I'm going to take some notes while we talk, is that okay with you?


You better get out an extra pen, you'll run out of ink before I get to my medical history in my 20's...




Standard questions: what medication are you on now, how are you feeling? Side effects?


Then they gradually became more detailed: can you tell me when this all started? How old were you? What kind of medications have you been on? Have you ever heard voices? Seen things that were not there? Thoughts or actual suicide attempts in the past? Any family history of mental illness?




I started with the side effects. 


The list was long and detailed. Every one that came into my mind and out of my mouth seemed surreal, silly, incidental in the grand scheme of things. In the light of what happened 10 years ago yesterday. 9/11  = 911.


Weight gain, foggy mental state, body aches, restless sleep, and apathy. I think apathy has to be the biggest and most troublesome one.


Can you explain?


How can you explain apathy when you are yourself, apathetic? Why should I care? Why do you care? Who cares?


Continuing seemed pointless,  but i pushed through, rambling off the litany of adjectives and adverbs that had become the lexicon of my state of mind over the past year.


Can you please explain?


My mind flashed back to the lonely narrative in my film. "Sleep was my escape, and I did that often. Getting up in the morning and having to face the day was an awful thought..."




How far did I actually come from those paralyzing moments? Full circle. 20 years later, it is all a revival of painful memories that I'm living on a different level. More aware, but none the more cured.




Going back to those memories was difficult. There were several instances when I stopped, took a breath and brought myself back to the whiteness of the room because for an instant, i was walking downtown alone in a snow storm, hoping that I would spontaneously disappear because my brain was stretching the limit of how I saw reality and life around me. My head hurt. My eyes hurt. My soul ached and there was nothing I could do about it. Wandering around the medical system in a waiting game limbo took its toll on me, but this time, was coming in for a crash landing.




And here i am again, barely making it, stable, but scraping the bottom of a shallow existence of a dead end decade, treading water, barely afloat in an ocean of selective serotonin reuptake inhibitors.


I've tried almost everything. I was once on 3 anti-depressants and 3 mood stabilizers all at once. Nothing works anymore. Now I fear that no chemical soup will be able to cure me.


There was a slight hint of pleading in my voice, hoping that this young resident, fresh out of medical school, still carrying a backpack, not yet jaded by hospital bureaucracy and suffering burnout would be able to understand, sympathize.






An hour had passed along with the 200 questions about my mental state, family history, recollections of manic and depressive episodes past, the extent of my extended vocabulary/lexicon of anti-psychotic/anti-seizure medications. I watched as she furiously scribbled notes, picking out key phrases, antidotes, flags, perhaps the relics of what was once a sane human being.


I will review your case with the doctor and will be with you shortly.


And shortly it was.
Abruptly so that i wondered if the doctor had even taken the time to let the intern finish the story of my life as I am barely living it now.




Middle aged man, thinning straight dark hair, pasty white complexion, antique white, like the walls of his office. Hello, I'm Dr.M, please have a seat.


Nice to meet you, as I had imagined me sticking out my hand to shake his, but instead, grabbed my purse and held it close to my chest. Protective pleather armor to shield me from his adroit diagnosis. 


I knew it was coming. His matter of fact textbook look, shuffling of papers - the preamble to a "well, this is what it is and that is all we can do..."


After reviewing your file, I have to say that perhaps anti-depressants are not for you. In several case studies, we have found that these can actually trigger mania in patients that are bipolar, so i think we should start you on a course of Lamictal with some Abilify."


pause


I'm sure you've seen the commercials


yea - the ones with the litany of side effects that rival the ingredients of a david lynch film


well, most patients tolerate this drug relatively well, and in a small case, only 7% complain about weight gain...


my big thing was feeling flat and weight gain. Two situations that would push me deeper into a dark hole of despair if they were thrust on me knowingly.


but that's 93% of people who don't experience weight gain...


yea, sunny side of the street, glass half full instead of half empty. Hate to tell you this dude, but i am the side effects queen. After having worked in photo labs for years, soaking my fingers in stop bath and other delighful acid washes, my immune system had now morphed into it's own bipolar monster. Like mother, like daughter. My inner was a reflection of my outer self.


and then we'll put you up to 150mg of lamictal, perhaps even higher to a 'therapeutic dose", up to 800mg.


I began to sputter. My mind working faster than my mouth could open and shut: "but that is the medication that is making me feel flat! At 150mg, i felt like a zombie!"


Well, perhaps that was something else making you feel that way. I would like to see you only on lamicatal with some abilify. No more anti-depressants. Primarily mood stabilizers/anti psychotics.


Clutching my pleather shield, i flashed back to the days on lithium. Bloated, 30 pounds overweight and experiencing a deep brain freeze that left me barely able to speak. Sure, i was stable, but at what cost?


and then it hit me: Had I been born 50 years ago, i might have been on the operating table, prime candidate for a lobotomy. 
Terrifying.


50 years ago, hospitalized, hopeless and helpless, I imagined myself diving into the abyss of a certain metaphysical death. Circumstances beyond my control; the desperate ranting of other lost souls echoing over mine. I would have no choice in the matter. My fate would be decided for me.


The now famous photo of "The falling man", gracefully plunging head first to his demise while the twin towers behind him burned.


Damned if you do, damned if you don't. What is the lesser of the two evils?




Mood stabilizers are the modern day lobotomy without the mess. For all I know, the chemical composition of my ransacked neural connections thanks to these drugs might soon resemble a plate of watery scrambled eggs. Either way, it wasn't going to be pretty.




And we will push to have you seen at the mood disorders clinic, that way, we can follow you closely was we make the switch. Your case history is too complicated to be seen as a regular out patient. We will try to fast track you back into the system.




Swallow a pill, make it all go away. Now you're quiet. Good. Stay like that...




I feigned relief and thankfulness.




In and out in less than 10 minutes. 




I threw a look over to the new intern, a non verbal: "you gotta help me here! I know there are options! Didn't anybody hear my concerns about the side effects? Did anybody hear what I said about "feeling flat was the same as feeling dead inside?!" 


She looked at me, with hands figurative tied, shook mine and whispered: "good luck".




And so it begins again.
Back to where I started 20+ years ago.
What I thought I had left behind has come back to haunt. 






Those ghosts of my inner demons always so present, now resurrected and revisited.





Clair Obscure - a visual autobiography from Kathy Slamen on Vimeo.