A Hard Year: Emergency Room

I left the ATM with a bit of cash which I figured I could afford to spend at my favorite coffee shop for dinner. This was a bit of a treat in February 2016--I wasn't eating enough, a problem I will examine in another post. I walked two miles to the Hard Times Cafe as the temperature fell.

Writing in my Moleskine has been a good way to organize my thoughts since I started directing. So while I was waiting for my food I just wrote what I had on my mind. I don't write free associations, but this entry has that feel about it.

The page wanders from instances of anxiety producing triggers in my life; some interpersonal difficulties I was facing in my living situation; a small meditation on film. One of the things that can happen in the real throes of anxiety seems to be valuable insight into a topic. There is a high degree of mental activity which can seem like an excess of clarity--like an over exposed photograph.

For a moment on this page I considered how music might inherently detract from film. The reasoning here is still very clear to me, something to return to. Basically the thinking goes that cinema is an art all its own, the addition of music or even dialogue, while perhaps powerful, also dilutes the medium. It hybridizes it, something perhaps problematic. This is something that's connected to many other thoughts I have on film as a medium and I think belies my interest in minimalism e.g. sound and music should only be deployed as little as needed in film.

I would like to come back to the idea, no doubt. In some way I'm sure I will. But my handwritten paragraph, rather than drawing a conclusion ended with the words "so fuck him." It's not even tangential like this reflection is. It's jumbled. The paragraph, the entire page, points to all sorts of things that were on my mind. It draws no conclusions.

One aside catches my attention though.

"I want to yell and scream and mug like a monster. Like a rabbid [sic] dog. I'm sublingual. I constantly struggle with speech. And no one sees." February 12, 2016

"I want to yell and scream and mug like a monster. Like a rabbid [sic] dog. I'm sublingual. I constantly struggle with speech. And no one sees." February 12, 2016

Only recently have I looked at the idea that "no one sees" and it's a deep yearning I feel. It was not something I merely wanted at the time, it underscores existence. The next morning I would live out the preceding description in this paragraph. I'd be alone.

February 13, 2016 I woke up at a friend's house, I slept on the couch because home wasn't where I wanted to be. That morning I had a meeting scheduled and I didn't make it. The temperature in Minneapolis that morning was -8 Fahrenheit and this was a problem. Unprotected and over used, my phone battery died again and again in the cold as I tried to reserve a Car2Go. I was running late, it was a Saturday, nothing was open and nothing worked. The batteries in a Smart Car struggle to start the engine in Minneapolis on a day like this.

Being in that kind of situation, constant failures and mental rerouting has a distinct feel to it. Wikipedia describes a diagnosis of a panic attack which includes the word "un-reality" and that is a true description. The thought in my head was "how is this possible?" It didn't seem like what was happening was remotely possible. Everything that I took for granted failed. My phone, the car, the stoplights didn't work, the streets seemed unnavigable. It's not bad luck and it's not first world problems at some point. And more than being self critical, there seemed to be no explanation of the situation I was in despite very real experience of it.

Eventually I was driving on I-94 toward St. Paul doing 80 and as the words in my head to describe whatever I was feeling at the moment failed me too. So I screamed and mugged. Trying to dead recon my way to where I was going, I pulled off the highway, got lost, and stopped near a BP.

I went in and asked to charge my phone. The answer was "no," and the guy at the gas station had probably seen a million crazier things than me at that moment. That's a problem too, I was holding myself to a standard of normality that required tremendous concentration. Shaking, I broke what might have been my last dollar into quarters and used a payphone outside in Minnesota's version of February to call my Dad, an analyst and LCSW. He cut through the noise and oncoming tears and told me to get to a hospital.

On this call a guy, Dave, asked me if I was okay. This was an unbelievably fortunate meeting. Looking back it is absolutely the kind of strange collision that killed the dinosaurs or welcomed the grief stricken mourners at the empty tomb of Christ. Dave asked me directly if I needed a ride someplace. I told my Dad I was going to get to a hospital and I hung up.

I pulled myself together as much as I could--any resolve must have been transparent--and said "uh, can you take me to a hospital." Dave took me to Regions Hospital and maybe I owe him my life.

Regions took good care of me. I've heard that the best way to get seen at the ER is to say you're bleeding and you move to the front of triage right away, but maybe saying you think you're having a panic attack works well too. They took my vitals, verifying the hypertension from the night before and pretty quick observation must've made diagnosis pretty easy. The doctors tell you who they are, there's two of them, then they ask you these questions:

"What brings you in today?"

And I said "I think I had a panic attack."

"Do you have any thoughts of harming yourself or others?"

And because if you're in that seat, being asked these questions, you do want to die you say "yes."

Then they ask if you've ingested any alcohol or drugs recently, and when your repression about the last days makes you clam up they tell you "we just need to know what we're dealing with." And you tell them the God's honest truth for what feels like the first time in your life even if ten seconds earlier was the first time you'd verbalized suicidal thoughts, and twenty minutes earlier you couldn't speak. The doctor said "I tried weed and didn't like it at all."

This was all good. It happened fast. And then things get a little less great and a lot more harsh reality. The hospital has some ward for emergency psychiatric issues, but it's not great. They take all your stuff and put it in a locked room while you change into scrubs. Then you get a room and a little later the worst cafeteria food ever, and they get your order wrong. But I hadn't eaten really at all. So I ate the chicken and peas.

This ward was actually in disrepair. They were building a new one, so maintenance wasn't a priority. But I had my own room with no windows and very beige walls and some stock photo of a palm tree bolted to the wall. There absolutely is a camera in there. And they check on you.

I know I was not the worst case in the hospital. At one point I heard a nurse remind the guy in the room next to me that he'd pulled a knife on a guy outside a bar last night. He denied it. But I think I was very high on their priority list because they had identified me as a suicide risk. Although by this point I felt like I'd seen too much to even try it.

So a doctor met with me pretty quick.

"We can give you a 'chill pill' that'll knock you out for a while," he offered. We talked about a bunch of things, but I didn't want medication like that. It seemed like it'd just be another blow. Then they tell you what they want to do. They wanted to move me "upstairs" as soon as they could, but this meant waiting in the room overnight. They didn't have the space or the doctors to make that happen.

The doctor also outlined other options for observation. In that situation the options really sound like the end of your ability to have any control in your life. I really didn't want to give up what little control I had over my life at that point. It's seemed like a misconception that being in even a pretty laissez-faire institution would be desirable. I could have my thoughts, but maybe not have control over my food. In other situations maybe that seems like a huge boon, like you wouldn't have to worry about living, but some pretty basic functions were the limits of my control and I didn't want to give them up. I thought about it though.

At some point I made a few phone calls. I called my work, told them I was in the emergency room and that they'd have to find some way of making coffee without me. I don't know if they could've guessed what'd happened. I feel like they had some idea. I called my parents and told them I made it to the hospital.

Then I waited for hours to be seen by a social worker. Apparently she described my looks as "he looks like he wants to crawl out of his skin." Basically I just lay in the bed. My cousin came by, she would help me immensely over the coming weeks.

In the end though they can't keep you in the ER when you ask to leave. But they will write a prescription for lorazepam to keep you from coming back in. I'll talk more about lorazapam in another soon, but it stops a panic attack like a freight train. This is the only time they'll just hand you this pill and basically tell you to stay doped up on it for as long as the prescription runs.

The hospital pays for a taxi. And this taxi driver was exactly the kind of over masculine, I work out, hot girlfriend, meathead I could barely deal with. I sat there next to the patriarchy for a little while.

I got home and made a few more calls. At this point there was also an early warning sign of things to come between me and one of my roommates. We got pizza and, couched in concern for me, he said "you've gotta go home, dude." And that's really hard to hear when your life is in this city and except for the last 12 hours you feel self sufficient. When I could think about it more rationally, my entire system of support was in Minneapolis--family, a therapist, hospitals, my job--and I wasn't about to abandon it to be home. And I hated Minneapolis. So it was a dubious claim. In hindsight this conversation began to make me unsure of myself in how I handled day to day situations and planted seeds of personal attacks that eventually did push me out of the house.

Ultimately I did the best I could. Eventually I did what I had to. Somewhere in there were some fuck-ups too.

On February 14, 2016 I was pretty doped up--lorazepam. But looking at the scribbles from two nights earlier, the beginnings of the effect the lorazepam has are clear. My writing was straight, pragmatic, to the point, and fiercely linear albeit a little more open than I like.

I've excerpted the entire page.