Medical Trauma

Nightingale has been stranded in hospital for 8 days. We called an ambulance when her pain, which has been worsening daily for 6 months, finally reached 10/10.

Right now my world is divided into two groups. Those who believe hospitals are safe places, and those who know otherwise. 

So today when we were in a stand off with the doctors who had no handover, had read no notes, and were adamant than none of the carefully planned and negotiated trauma informed arrangements would be implemented, I held her hand very tight. I made them give her time to speak.  I backed her when she withdrew consent. 

When a doctor chased her withdrawing hand across her body, grabbing at her to put a line in for anaesthesia I removed his hand from her body. And when I requested trauma informed care protocols for her after they would make me leave – that if she withdrew consent by voice or by raising her hand they would stop, and I was sneered at impatiently and told – “of course that’s always how it’s done”, I felt in my body a rushing tide, waves of every time that’s ever failed. Every touch we ever tried to escape roared through me without sound, without a ripple on my skin, in the blackest night within me.

When they wheeled her away from me sedated, and closed the door between us, I found myself stranded there in the corridor.  I felt like a dog at a train station who’s beloved person had been conscripted away to war, far from protection and likely to be harmed. I stood with my back to the wall,  involuntarily listening for the sound of her voice, the sound of her cry. I stood there knowing they had said they would care for her, and knowing they lie. I stood there knowing what power looks like when it stands at the bedside of a woman naked and trembling. I could do nothing but commend her body into their hands. 

The nurse, the other person I had to tell to stop touching her without consent, walked past and looked at me with impatience and something like disgust. “There’s no point waiting here, you know they’re not going to let you into recovery.” I very quietly and carefully agreed that I knew that, my bones screaming down in the deeps.

There’s a terrifying defensiveness when trauma is mentioned,  it’s taken as a kind of slur, an insult to their trustworthiness.  Without any comprehension of what it is or what is needed they puff themselves up and demand “you can’t possibly need protecting from us,  how dare you! we are the good ones.” They are all the good ones, even the ones our nightmares are made out of.

I went back to her room to wait. The lights were unbearable. The TV running a children’s show that shrieked in my brain.  I went and quietly asked a nurse if there was a chapel or quiet room I could sit in.  She led me out of our ward,  into the ward adjacent,  down a long corridor and around to the “sacred space” that I went and sobbed in when I first confirmed that Hummingbird was dying and no one had been brave enough to tell her,  instead pretending she was recovering and going home, stealing her hopes for hospice, for a last drive home to her garden, for any of the palliative care resources, for the letters she had hoped to write and the goodbyes she had planned to say. 

Ah, I say.  Perhaps you could show me where the patient or family kitchen is? She walks me back to a room with a lock on the door.  We both look at the lock. “You’re not allowed in”. she tells me. Only the staff are. Ah I say.  Well in that case I guess I don’t really need to know where it is. She goes back to her station.

I go back to the room. I darn a sock for Little Bear. I keep my back to the wall and stay as far as I can from anyone who might touch me. I am a fox in a cage, seething and terrified. Exhausted and wired. Desperate and alone. Finally they return her. Maybe it will work, maybe it won’t. Maybe she’ll be home this week, maybe not. Maybe they’ll do another one in a different spot on her spine. It’s stopped raining out the window, but it takes hours for the sense of threat to ease. I am held together with love and pain and memory, wired shut.

Nurses and doctors flick in and out of the room like the little birds feeding at the shore line, retreating before the waves. I imagine the notes from today which will say something like “procedure successful,  unremarkable”. We walk entirely different worlds here in mirror of each other. They are confident we are safe and we know we are not. They do not understand it, their bones do not scream. 

She’s back in the empty, lonely room to wait out the night without us. The sheets show no tear stains. There’s no bruises on her skin. No trace, no evidence, except that flinch everytime the door handle turns. It doesn’t matter. It’s unspeakable. Tomorrow it may well happen all over again. The carousel spins on and the carnival continues and no one is counting the screams. I take her hand and behind my teeth is more rage than I can bear, more heartbreak than I can breathe through. They do not see what they take away.  I hold her hand. They do not see. I hold on. We breathe together in the dark. 

The Gift of Neurodivergent Diagnosis

Like many late diagnosed neurodivergent people, I’ve had a hellish run with episodes of severe exhaustion and burnout. Not understanding how I function, what supports me and where my limits are, seeing and being seen only for my capacity with my difficulties all unnamed and invisible created a horrifying cycle of productivity and crash. Diagnosed as gifted in my teens but not with ASD and ADHD until my 30’s created a horrible environment of insanely high expectations and invisible vulnerabilities. Every few years I’ve been diagnosed with exhaustion as my mind and body run out. I’ve endured brutal unexplainable immune system crashes where I’ve simultaneously contracted infections in multiple areas. My other conditions such as fibromyalgia and PMDD flare to unmanageable levels. I fall off the edge of my world and I never see it coming. Trying to stay alive takes all my energy and every resource I have. I lose everything I’ve built and have to start from scratch, and I never have a good reason why.

This is the not the future people envision for their children when they say they don’t want to burden them with a label. Diagnosis has been complicated for me, painful, isolating, relieving, hopeful. Since I’ve been diagnosed with Autism and ADHD 5 years ago, I’ve never experienced that level of exhaustion again.

I’ve learned that I’m risk blind and need to pay attention to the anxiety of those around me when I’m flying too close to the sun. I have explanations for what used to be confusing and humiliating limitations like not being able to listen to voice mail or reply to emails. I hate myself less. I pace myself better. I let go of a lot of things. I’m beginning to understand what I need to be able to show up and do the things that are important to me.

The labels come with a price of course. The diagnoses subject me to misunderstandings and low expectations. But the alternative was devastating. I’ve pursued diagnoses for my loved ones, hoping to spare them what I’ve suffered, and aware that I have no idea what it’s like to have been diagnosed young, and that they may have both benefits and costs I can’t relate to.

Here is a journal extract I wrote in an episode of exhaustion a number of years ago:

“Finding words for experiences that have no language for them, finding ways to string life back into stories, into a narrative that starts and proceeds and finishes, when my world has unstrung like a broken necklace. Discovering that in this place where things do not make sense that there is no inclination to share, no longer a drive to connect that makes me tolerate the whispered accusation of narcissism when I bare myself in public. I can be silent. I don’t need you, I don’t need this space, I don’t need to be heard.

I wait. I wait for the world to have meaning again. The days pass. Some days I find contentment. Some days I live with a stoic acceptance. Some days I cry until I vomit.

People miss me. While I’m in deep space, protecting the world from an atomic anguish. I tow my boat way out to the deeps where the blast won’t burn anyone else’s house down. I swim far from the old comfort of my online world. In sudden panics I run to familiar harbours. I bite my teeth over the blackness and crouch at the edge of other people’s lives and bask a little in their normality. Some days I fail my own principles and howl while a loved one talks soothingly, holds my hand, listens sympathetically, tells me I mean something to them. Sometimes I make them cry. I watch tears in their eyes, desperate to feel anything but the void.

Someone sends me an email like a crow sent winging from a black well to say thank you for writing from your own hell, it helps. I want to save us all. I’m saturated by death. Sometimes I become terrified I’m going to kill myself, and I calculate the loss, the holes punched through everyone I know and have loved and my reach, my influence, my connections so hard won now seem like the worst possible thing I could have done. Alone my death is just a sad story. Have I built a tribe so you can watch me self destruct? Will pain be my legacy here? Why write when I have no answers, only fears?

After a night of terrors I calm over and over, that reignite the moment I fall asleep and wake me in panic, I crawl to my psychologist’s office and wrestle with hysteria in front of her. She books me an emergency appointment with my GP for anti-anxiety meds and diagnoses me with severe exhaustion. None of the fast acting meds are pregnancy safe so I come home holding a script and a sense of being broken that I’m going to have to live with. How sweet it was to feel above this, once.

I start culling the big dreams, the vast sense of responsibility, the career plans. Tangled with my grief is peace. I have tried very hard and maybe now I can stop pushing this boulder up the hill. Enough…. I look into short courses and small jobs – orderly, care worker, and when I’m not being garrotted by my own high expectations and elitism I’m relieved at the prospect of just living a small life, earning a little money, letting my business be a hobby. Painting when it moves me, writing because I love to. Selling a few prints. Letting it be what it is. Not having to turn those skills into a factory, or myself into all those things – entrepreneur, leader, business person, change agent. I’ve watched the successful ones and tried to do what they’ve done, follow their paths. My own parents ran a very successful business for many years. I’ve risked many things and nailed my colours to the mast. Some of them have worked out and as my world burns around me I want to let go and go back to loving the things I have, the risks that paid off, the life that’s waiting here for me.

Exhaustion is storms and sunbursts that run according to their own tides. I have no more control over my feelings than I do over the weather. Night falls at 2 in the afternoon and I creep to bed to hold my wrists and tell myself I’m okay over and over. The moon sings to me and I find I’m still alive – not numb, not ruined after all. I haunt my house naked with starlight on my skin and breathe galaxies with a rueful smile and the night smells of roses. The strain of feeling deeply alive and very dead each day leaves me trembling with shock, a violin with strings wound too tight. But I can feel it seeping back into my cracked heart.

More human than I want to be.”

I tripped over my invisible disabilities and fell hard, and fell often. I am better off where I am now, knowing what I know now. Life still hurts badly at times. It’s more complicated and tangled with more people whose stories I’m careful not to share. I miss writing this blog and having my online community, and being able to use my words to provide context to so much about me that is different and doesn’t make sense. This blog was the way I leapfrogged over so many barriers between me and other people. I felt like I had a whole world of people once, who knew me and cared about me and felt cared about by me. I lived in public in a way that was a mutual gift. I am more private now, I have children, clients, employees who all need discretion and all fear exposure. I find myself more decontextualised than I was to my people. I make less sense, become more isolated. There must be a pathway between disconnection and exposure, but I’m not yet able to see it well. If I can’t be sure, I hold my tongue.

But I spend less time in meltdown, sobbing on the floor. I keep house. I am raising four children at home. My capacity has increased, my understanding of self care and my knowledge about my limits has been a gift. The first time someone gave me noise cancelling headphones to try, I was walking with them through a busy airport. I put them on and pushed the button and the peace came over me like a flood of warm water. It was so intense I couldn’t walk. I sank to the ground where I was and just wept. I had never experienced such peace outside of water. I used to calm myself by lying in a warm bath with my ears underwater. The same muffled quiet wrapped me up and it was so beautiful and so painful to realise I had lived my entire life in a harsh bright world that always hurt and never made sense.

It’s a strange story to tell, given my deep ambivalence about diagnosis in mental health. Diagnosis of poorly constructed syndromes, laden with assumptions and stigma, can function as social curses, doing catastrophic harm. The world of neurodivergence with it’s profound observations and confused wrangling of slippery categories and terms is not so different. The low expectations that come with a diagnosis like autism, and the stigma and misunderstandings that shadow the poorly named ADHD have costs. But on the other hand, I spent literally years trying to understand and find words for concepts as basic as body doubling. I have been on the intersection of so many invisible diversities, contorting myself to try and fit paradigms I was never built for. I am now finally beginning to understand my long history of failures and losses, and start to claim my skills and build my capacity. It’s sad, and hard, and beautiful, and deeply liberating.