Eighty per cent of people who think about or attempt suicide have sent out a warning sign to those around them , however, few will make a direct request for help to deal with their suicidal thoughts.
Story 203
Hospital Cashier Coat Story
I have waited one year to get into this clinic; it is my first visit. I am shy and pretty, with long dark hair and a slight figure. I try to dress well and usually turn heads. This is my reality, it is my way of knowing what I present to an otherwise shaky, uncertain world. I am not well.
“Hello, I’m Judy, I will be your psychiatric nurse and this is Dr. Carluke, your psychiatrist.”
When Dr. Carluke comes walking into the interview room I notice he has a sprightly step, and he speaks with concern and a little levity.
We shake hands. Joan has a dark page boy haircut and remnants of deep red lipstick, she dresses business casual. Dr. Carluke is graying with a beard dressed in an expensive suit, he looks like a psychiatrist.
“There is a team approach to treatment here. There is a team of doctors behind the mirrored glass, they will observe our session today.” He says.
I describe my experience of my illness. It is a difficult thing to do. “I was under-diagnosed at sixteen; my world fell apart, but I was too young to medicate.”
Dr. Carluke asks many questions, he makes his diagnosis backed up by the team of doctors:
”A bipolar illness; a chronic recurring illness.”
“I’ve waited a long time to hear these words. I have been misdiagnosed and ill for fourteen years. I’m thirty years old, I have three children and I’ve been married for eight years. To say my life is a challenge is pretty basic.”
My husband has accompanied me to the appointment, we visit the cafeteria on our way out to buy a muffin and a soda. The cashier bears a strong resemblance to a friend I once knew.
She punches in my purchase, “that will be $3.25 please.”
I hand her the cash; I am quiet and contemplative and I observe her with equanimity. She is there when I return to the clinic the following week.
Judy has my chart, a binder of notes clutched in her arm. “Hello Gloria, come right this way.” She takes me to an interview room. I notice the pattern on the curtains framing the mirrored glass, swirls of deep red and purple. ”How was your sleep this week?”
“I haven’t slept well, I’d say I average six hours a night. I’m not tired though.”
“And your mood? Would you say it is elevated?”
“Yes, I’d say I’m a little hypo manic.”
I never read what she writes. I find it easy to talk to her, to tell her my deepest darkest thoughts; I talk for a long time. She leaves when the interview is done and consults with Dr. Carluke, who watches the interview from behind the mirrored glass.
He comes in to interview me after conferring with Judy. “Remember, you are one of the team.”
This goes on every week. In addition to monitoring my medication and dealing with my bi-polar symptoms, we are doing therapy.
We quickly get to the bottom of things such as my birth origin family history. “Events in your life were not normal; most people don’t experience what you did, was your family trying to convince you this was common?” Judy looks at me deeply.
“I’ve never had anyone ask me this, I didn’t know it wasn’t normal.”
Dr. Carluke asks me one week, “Did you ever consider suicide?”
“I am ashamed to admit that I did try once.”
“Tell me about it,” says Dr. Carluke.
“It was two weeks before my thirtieth birthday. I was not feeling well at all. I thought my life was not worth living. I was in extreme emotional pain. My husband was working late, and I was at home with my three children. They were two, five and eight. It was around four o’clock in the afternoon. I went out the garage and closed all the doors, got into my car and turned on the ignition. I sat there waiting to die. I was feeling a little sleepy. Then a thought flashed through my head, “Your children are going to find you in here, is that what you want?” I quickly turned off the ignition and got out of the garage as fast as I could. I went inside and collapsed on my bed, and cried for a very long time. A few months later I received a phone call that I had been admitted to the bipolar clinic at the hospital.”
The following week I notice a jacket hanging on a coat rack in the waiting room of the clinic, it is blue and quilted, with a fuzzy gray lining. It has been left behind by someone in a thoughtless rush. I notice every week, the jacket is still hanging there.
One day I learn there is a staircase behind the elevators which is the quickest way of getting to the second floor bipolar unit. Everyone in uniform, some with stethoscopes, take this route. This becomes my special route to my place of healing.
Initially I bring my three year old with me to the appointments, having no babysitting options. He plays, and stays with me in the interview room, when he gets restless I let him wander around the clinic. Sharon, the middle aged secretary with golden hair swirled up in a chignon, gives him things to do. He colours on paper and uses chalk on a chalk board. In the fall Darren goes to preschool. I resume my appointments after the summer hiatus.
Dr. Carluke has put me on a regime of medication which keeps me functioning, but not at a premium. He tries me on different medications that only partly change my symptoms.
“You are a partial responder to Lithium; it does not work alone. In addition to this you are a rapid cycler, your bi-polar phases have a short cycle of approximately three weeks, as opposed to the six month cycle most other bi-polar patients experience.”
It is a mixed relief to hear these words; my illness has a sense of dignity. But I am still incapacitated, unable to work outside of the home, unable to take care of my children without outside help, and the ultimate insult is that I suffer from schizo-affective disorder, a form of psychotic thinking.
Years pass as I am maintained on a schedule of drugs that keep me functioning but at a subpar level. I have no friends. I have no social life. I am reluctant to get involved with functions at my children’s school for fear someone will discover I have a mental illness and ridicule or exercise stigma on my life. I fear for my children, of someone accusing me of being an unfit parent, although I put my children first always.
It becomes apparent that my “psychosis” is interfering with my day to day existence. My husband is requested to be at my next consultation. I am convinced that someone is coming into my home to read my diary. It is very real to me.
Dr. Carluke strokes his gray beard and asks,” Are these people real?”
My husband fumes in frustration and disgust. “For God’s sake Gloria, no one is coming into the house, your thoughts aren’t real, can’t you see that?”
Dr. Carluke suggests, “Would a locking filing cabinet work, to lock these diaries up and confound these thieves…”
My husband snorts at this: “Face reality, is there really anything wrong with her other than a fanciful imagination?”
I am isolated, I am psychotic, I have three high spirited little boys to look after, and Dr. Carluke has exercised all options as far as medications are concerned.
But this week Dr. Carluke’s excitement is visible.” There is one medication that is in research stages at our hospital, it is used for schizophrenics, there is a possibility that you will respond to it. Will you try it?”
The pills are an orange colour, they look as if they should taste like a sweetart candy, but they don’t. I take them for a few weeks… nothing happens.
“You need to be patient.” Dr. Carluke advises me.
The third week approaches. One morning is very different, I have woken up from my delusions to clear headed rationale. It is an innate sense of being, I am alarmed by what I previously believed to be true. Four years is a long time to wait for wellness, eighteen years is even longer. My husband calls me “Sleeping Beauty.”
I continue my weekly appointments, to monitor my bi-polar illness controlled by drugs on an ongoing basis.
As the years go by, my appointments became less frequent as my symptoms improve. Eventually the appointments are once every six months. I continue on with a career, and my children grow up to become gifted university students.
I lose track of the appointments I have kept over the years, but year by year, Dr. Carluke and Judy, my constant psychiatric companions, have made my life possible.
For a very long time, every time I check in, the blue jacket is there. I see it from across the waiting room floor, hanging on its wire hanger. It never occurs to me to touch it; a forgotten but present item, a visible reminder of something avoided and unwanted. One day I show up for my appointment, and it is gone.
I am silver haired now, thick in the middle despite my best efforts at the gym. I see the cashier at her post in the hospital cafeteria occasionally, she looks a little bored, I wonder if she feels the tedium day after day. I see myself mirrored in her almost. She rings in my purchase; her face is lined, her jowls sag a bit, her uniform and jaunty cap match though. I’ve been coming to this cafeteria for a very long time. She takes my money for the usual muffin and soda; she still looks like my old friend, I don’t know why we never talk.