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 this...here 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