Sunday, July 24, 2011

The Broken King

When we are born into this world, we are unable to do anything for ourselves. All we have is our voice. When we are in need, we call out and our needs are met, we are fed, we are cleaned, and we are comforted. As we grow we learn to interact with our world. First, we crawl, then we walk, and then we'll run. We see a big new world full of things to discover. We learn to throw a baseball, to swim in the deep end, and to sled down the big hills. The spirit of adventure is born within us. As we grow older we refine our skills. We are no longer the children whose weeks were filled with after school activities. We become garage band musicians, budding athletes, and enthusiastic video gamers, and then we learn how to drive. We move off to college, every day building our education in the ways of this world, and our independence.

Waking up in the rehab unit, all of my needs are met. A tube that runs through my nose and down into my stomach provides a path for a nutrient rich paste. When I make a mess, my diaper is changed. If I need anything, I need only raise my voice. But as the time passes, there is no realization of what I can do, only of what I can't. I cannot crawl, I cannot walk, I cannot run. The transition is so sudden that it is impossible to understand the implications all at once. Each day brings a new discovery that something else is missing. So much is out of sight and out of mind, but what is in front of you cannot be ignored. When it is time for something new, everyone says that it must feel great. When a sling and a lift pull me out of bed and put me in a chair, they say that it must feel great to be up. I smile, but if they could only look deeply enough into my eyes, they might see the truth. A piece of me is dying, 25 years of walking, 25 years of running, 25 years of independence. The story repeats again and again, when dressed for the first time, when it's time to eat. Any conversation, or phrase, or word, can show me something new that I'm no longer capable of. It is the time of learning, it is a time of discovery, and when everyone else sees me slowly coming back to life, I feel like I'm slowly dying. In one moment, I cannot help but laugh at the grim irony. The nurse brings in a device aptly named a shower/commode chair and calls it the throne. When we have our freedom, we each rule our bodies. So there I was, sitting upon my throne, the broken king.

After a traumatic event like my accident, detachment is the name of the game. It is all too much to handle at once, and so we have to take it one day at a time. If I can just focus on today, I will make it to tomorrow. Everyone wants to be encouraging, but that doesn't mean they understand. If I had a broken leg, it would be great to get out of bed again; it would be great to get out of a hospital gown and into normal clothes; and it would be great to get outside. All of these things signal a return to normality. The difference is in the permanence of the injury. For me there is no normal to return to, only future that I do not yet have the strength to contemplate. I can stand being confined to a bed in a hospital gown. In a way, it helps me to deal with things on just this day. It helps confine things to just one day at a time.

Everyone takes this process differently. A nurse told me, during my second week, that I was not like other patients. I did not know then what she meant, but I think I do now. The guy in the room next door to me swears loud enough for the sound to drift into my room. He wants something, or he needs something, or things are just not going quickly enough. We all deal with the pain in different ways. I take much the opposite route. I say very little, other than thank you, and I wait. I want very little. I just want to lay silently in my bed, and let the emotions roll over me until peace presents itself. If I wait long enough, the water pooling in my eyes will evaporate, and I will learn what it means to live life as the broken king.

Sunday, July 10, 2011

Dark Thoughts In Dark Places

After a day or two in the ICU, the pain might be called under control. The pain is not really gone, but through long acting meds or IV drips, a new baseline is established. At this time different types of pain become distinguishable. Instead of a singular feeling, there are now sensations of burning, freezing, shocking, sharp, cramping, and aching pains. These come from nerve pain, physical damage, and muscular contraction. Each requiring a different type of medication. Each of these having an allowable dose and a different number of hours between doses. As a result, the pain is under control only until a particular medication begins to wear off, and one of these types of pain rears its head. At first I ignore it. Next I work to deal with it. Controlled breathing helps calm the mind and smooth out the instinctual reactions to pain. After that comes an attitude shift. We grow up avoiding pain, trying to get rid of it any time that happens. We learn to be miserable when we are in pain. Do we really have to be miserable? Only if we feel that pain is a miserable experience. If we take away all the connotations that we pile on to pain, it becomes more bearable. In effect, the belief that pain is a negative experience helps to make it one.

I have a limit. Some level of pain at which I ask the nurse for more meds. Inevitably it's too soon. Enough time has not passed to give them to me. She tells me they don't want to put me too far under. The voice in my head screams Do it! Do it! Anything but this, but the look of regret in her eyes is plain to see. I nod my head and go back to trying to accept the pain. I get much better at it over a few days, but for now it's just not enough. When the time does come, the transition is mercifully fast. Drugs administered by IV act quickly, releasing me from the pain.

Narcotic pain meds come with a price. The reality is, you are not all there. The higher the dose, the higher the loss. In most cases this is not a big deal. The drugs wear off and everything returns to normal. This was not one of those cases. Immediately after a dose, I was too far gone to contemplate my injury. Inevitably, the drugs slowly recede. The curtain draws open and the show starts. I find myself a head cemented to a lead anchor in the shape of my body. I stand naked before the reality. My defenses are gone, stripped away by the same medications that protect me from the physical pain. Had my mind been clear it would have been different. As it was, I had no future. We all think about our futures every day. It is only natural, but never in my wildest dreams had I imagined myself to be in this condition. How could I have? So there I was. The man with no future. If I could even be called a man. If I could even be called Craig. A thing with scant identity, stumbling forward deaf, dumb, and blind.

As the meds peeled back further, it only got worse. I began to remember my past, but the future was still in the dark. The thoughts that tumbled through my mind had a certain rhythm, a dark cadence kept by the bass drum, each blow driving the breath of life from me. What is left?... we are not meant to live like this... why did they save me?... I wish they had let me slip away... how cruel, to save someone so that they could live like I am, not even able to kill myself, not yet anyway...

Ironically, knowing that you can kill yourself later, brings about a certain peace. Having a solution, you can put it out of your mind to a certain degree. A common tactic used by suicide hotline operators is to extract a promise. The caller promises not to kill themselves until a specific amount of time has past. Having made a decision the individual has less anxiety, and has time in which they can be talked out of it.

The cycle repeated itself as the pain meds were administered and then wore off. In the beginning they were mostly a repeat of the initial revelation. I just would not remember having gone through it only a few hours prior. It is a common thing for people waking up in the ICU to not remember someone telling them what happened. In those initial cycles, the return of the physical pain as the meds wore off was almost a mercy. Eventually I started to recognize and remember the people around me. Friends and family became the life preserver keeping my head above water. Even if I could not see myself in the future yet, I knew that those people would be there. I recall thinking that if anything could save me, if anything could make life worth living, it would be people. Nothing more specific. Just "people."

The dark thoughts, and the emotions that come with them, never really go away, but they become less frequent. As the physical pain reduced, and the medications were in turn reduced, the fog in my brain went on its way. I started to see not just what I had lost, but also what still remained. My family was still there. My friends were still there. I still had my mind. As I thought more about these things, I thought less about being broken. It was as if the darkness was just filling in the empty space.

We play an active role in how long we feel a particular emotion, but we have little control over their arrival. It is as if we constantly have strange visitors in our house. If we are mindful we notice them right away and know them for what they are. If we feed them they will grow and become more a part of our home. And so I name them and make a choice. Hello anger. Hello fear. Out you go. Hello love. Hello compassion. Make yourselves comfortable. Stay a while.

I must not fear.
Fear is the mind-killer.
Fear is the little-death that brings total obliteration.
I will face my fear.
And when it has gone past I will turn the inner eye to see its path.
Where the fear has gone there will be nothing.
Only I will remain.

the litany against fear from Frank Herbert's Dune