Ride the Lightning

I do not recall the exact date or month, or even a really coherent narrative of how I found myself an inpatient at a psychiatric hospital in the Borough of Queens, city of New York. However, I do know that it was not the first hospital I was admitted to. Nor were any of the events transpiring not of my choice. I have for some time been realizing that things, somethings, then everything, were somehow not quite right. Part of the recipe here was the fact that I was involved in a near fatal motor vehicle accident, upon my ejection from my vehicle a good Samaritan at the scene thought it proper to drape a blanket over me as she was convinced there was a dead body on the side of the road, and the decent thing to do would be to shield others from such a sight.

Suffice to say I survived, but when presented with the laundry list of damage done to my body, subsequently requiring over 20 operations and a full 18 months of being bedridden, one cannot be blamed for thinking survival is a relative term. A preponderance of my injuries was of the orthopedic nature and despite the general unpleasantness of having so many broken bones fuse, snap, and be replaced by metal, left unnoticed was traumatic brain injury. This is not to say it was insignificant, it very much was, but it had time to do its work while I was in a morass of seemingly endless corrective surgery followed by learning how to walk again. The TBI was given a nice head start and it did not waste anytime going to work

Have you ever heard of Dyscalculia? How it was explained to me is that it is the math version of dyslexia, only the brain's ability to understand numbers and calculation replaces the problems with reading. Prior to leaving my house the day of the accident I had neither heard that term, and while I was no Archimedes, I was not bereft of the ability to do simple calculations. I am now.

When you are told by a doctor after many diagnostic procedures, tests of cognitive function, etc., that you have a TBI and the associated symptoms particular to your condition, that is to say what region of your brain that is supposed to do what it does no longer performs that duty, it is a lot to process. Many, many unanswered questions are right away conjured. What is particularly insidious about a brain injury is unlike bone, which basically has a self-repair function ready to go upon it being broken, your brain most certainly does not. In fact, there are very few imaging procedures available to even give a hint of what is wrong if it is not self-evident on say an MRI or a CT scan.

Compounding this already overwhelming situation is the worst part of having a brain condition, that in order to properly navigate your way through it, inevitably you will require psychiatric care. Whereas not a person on this planet would fault a person for attacking a cancer diagnosis with chemotherapy, heart troubles with immediate surgery, things of that nature, the sad reality is psychiatric treatment is not so cut and dry and carries a heavy stigma to a lot of people.

Almost upon receiving a formal diagnosis of brain injury and what your proposed treatment plan is, it is gut check time. In addition to doing battle with your injury you will be almost feel forced to explain your situation apologetically to others. To sort of speak of your injury as an alibi, "I'm not crazy, it's just the head injury that requires me to see a psychiatrist".

It is at this time you ask yourself a very simple yes or no question. Am I to hide in shame because of this? Or am I going to be true to myself,show the real me,not hide anything from anybody and deal with whatever stigma I get regardless because I must get better?

I chose the latter. Having served in the Army and participated in the Iraq war, I know intimately the stigma of seeking help, and the unfortunate events that happen if you do not. Add into that the resiliency training and resources available to veterans my decision was incredibly easy for me. I have seen many acts of bravery in my life done by very brave people, but I feel personally the bravest thing one can do is raise your hand and say, "please, I need help". And that is exactly what I did. I was staying true to myself, letting light shine on me harsh or benevolent. I was going to beat this, and I am not too proud to say I need help doing it.

Consequently, there came a day were just nothing was making sense. Had I not known about my TBI I would have been convinced that I was losing my grip on sanity, and this is what it is like to lose your mind. I couldn't help the almost morbid curiosity of it all. The descriptions and depictions of people having a break with reality are legion. But to have a front row seat to it? I can only say it is interesting. I was transported by friends to a psychiatric emergency room. As I was not in any way suicidal or a danger to myself or others it was not considered an involuntary committal. That does not mean I did not find myself in a locked ward without the ability to leave. I did. But the question remained, what do we do with this guy? He has a brain injury but there is no way to address that via surgery, he is not in any kind of psychotic or dangerous state, he is not even on anti-depressants. What on Earth are we going to do with him. Observing this exchange happening right in front of me with a kind of amused sense, I off handedly remarked "you guys can always try shock therapy". The attending Psychiatrist eyes snapped to me almost audibly. 'Can you repeat that?'. "Sure, you can always try shock therapy".

It was at this this time that an education in "shock therapy", in today's parlance called Electroconvulsive therapy (ECT), was given to me. My medical team sat down with me and explained that yes ECT is still done but is hardly ever by request and cannot be given without consent in the absence of a judicial order, why are you inquiring about this? "Because I am obviously unwell, and I intend to get better." Considering that there really was nothing that could otherwise be done for me, and in any case my results good or bad from this can possibly help someone else in my position, I was game if they were. They were.

To be perfectly honest with you the facility I ended up in to receive my ECT reminded me of a modern college dorm or one of the updated barracks I resided in when in the service. Expecting to see some sort of combination of a Quiet Riot album cover and the place they tossed Hannibal Lector in I was shocked (no pun intended) how modern and nice the place was. The nurses and doctors were great people and my fellow patients and I had sort of an unsaid or unwritten bond. We were all being true to ourselves, just laying it all out, whatever people think.

My treatment plan called for three sessions a week, Monday, Wednesday and Friday with Tuesdays and Thursdays reserved for recovery and general follow up. Being that ECT is done under anesthesia the preparation for it is not unlike any other anesthesia protocol, don't eat or drink anything. Early in the morning an orderly would arrive to transport me via wheelchair to the appropriately named "ECT suite" for treatment. The room the procedure is carried out in resembles what you would find in a modern hospital emergency room. A plethora of machines that make incredibly annoying sounds, all kinds of tubing, buttons, lights etc. But not for the sort of ominous looking device that resembles a toaster from the sixties with electrodes protruding from it and analog dial gauges on its face that depict how much current it is sending into your brain you would think you were there to get a teeth cleaning.

The process thus begins. EKG, blood pressure, oxygen masks start being applied with the speed and choreography of a busy aircraft carrier deck. Sitting at an incline similar to a dentist chair as all the somewhat familiar paraphernalia is applied, the unfamiliar aspect makes itself known. Your forehead and temples are cleansed and made moist as the tray the ECT device is perched on starts getting wheeled closer to you. Observing it further one notices that it also prints out a strip of paper that would look like the kind an EKG machine produces. After assurances are made that you are feeling OK the sensation of the electrodes being applied to your temples is felt. Almost simultaneously an Anesthesiologist enters the room. After double checks of everything applied correctly and as the ECT device is powered up the Anesthesiologist applies an oxygen mask to you and in a way that has to be taught in medical school because they all do it, you are politely asked to count to ten. By three you are out, and by what would have been ten current is being sent directly into your brain.

Yes, it causes you a headache and lost time. Because I was unique patient considering the TBI aspect of this I was requested to do further sessions as sort of an exploratory nature, to see if ECT can help TBI as a first line treatment. I accepted without preamble. My attitude was if this can help anyone deal with this, I am already here so let's get on with it.

This is were staying true to yourself is very important. The mere act of being in therapy can be seen by others with stigma. Can you imagine what kind of reaction being candid about getting ETC elicits? I care not what anyone thinks of me, and I am not saying that to sound tough, I honestly do not care one bit. We have exactly one life to live and to a large degree it is your decisions, choices, and actions that will define your life. Ultimately it is to that reflection in the mirror you are directly responsible for and must do whatever it takes to ensure its well-being and survival. WHATEVER IT TAKES, EVEN ECT. You need to face all these things with nothing but complete self-assurance and in full faith that you are being candid, honest and open and it will serve you much better than hiding and shame. You can be assured what I just told you is the absolute truth.

It has been years since the ECT treatment, and I possess exactly zero regrets for doing it, and zero shame telling you about it. And while the finer details of date and time will remain fuzzy, I can tell you I was there straight through the holiday season, Thanksgiving, Christmas and into the new year. On New Year's Eve I was sitting with my fellow patients watching the television in anticipation of the new year ball drop, ironically only happening a few miles away. At the precise time the new year began we embraced and toasted each other. I looked lovingly at each and every one of them, knowing the path that took them here and the by no means guaranteed path back to the place we need to be. " To us!"