The Valedictorian of Being Dead Page 2
I wouldn’t find out until several months later that after my mother hung up the phone she fell limp into my stepfather’s arms and wept. She sobbed because she’d heard the hope in my voice. To her it sounded like the angels she was calling upon every night in her prayers. And she’d continue to call upon them until treatment began four long weeks later.
* * *
“And this . . . you see this vial?” It was my first treatment, and the anesthesiologist was trying to explain exactly what would happen and why. Today it was Dr. Tadler—there would be five different anesthesiologists in total—and I appreciated that he was being so thorough. I nodded, because my anxiety in that moment had stripped me of my ability to speak. In subsequent treatments he would touch my arm. I needed that warmth of reassurance, because I was terrified. On the paperwork I had signed, one of the possible side effects listed was death:
RISKS:
Very Rare (less than 1/10,000): Complications including life-threatening cardiac arrhythmias (irregular heartbeats), respiratory arrest (inability to breathe), myocardial infarction (heart attack), stroke, and even death are possible.
Even though I wanted to be dead, I needed to get my kids to piano practice the following night. If I died, they would be late.
“This is fentanyl—it’s an opiate—and we give you this just in case you get a headache when you come out of the propofol, which is in this one.” He then held up a much larger vial filled with a milky-white substance. A nurse and Dr. Mickey’s research assistant both affixed a single wire to my forehead with Velcro squares. I felt the small pinch of each hook of fabric attaching itself to my skin. I would often wonder in the drunken state that followed each treatment how a piece of Velcro could stick to my forehead if my forehead was not made out of the other fabric that makes Velcro Velcro.
The nurse checked one more time to make sure that the tube connected to each drug was firmly inside the 22-gauge needle they’d placed in my vein thirty minutes before and taped taut against the skin of my arm. God, that needle. The whole process of that needle. I’ve never had a hard time seeing blood or having my blood drawn, and have bragged about this skill to each and every phlebotomist in my medical history. “Don’t even look; just jab that spike right in there. Seriously, I won’t even flinch.” But then, I’d never met a needle like this needle. When I saw it for the first time, I remembered the scene in Jaws when Roy Scheider’s character catches his first close-up glimpse of the shark.
“You’re gonna need a bigger boat.”
I had my right arm laid out on a thin table separating me from Molly, the phlebotomist for my first treatment, who was filling out my drug history on a computer screen. We’d chatted quite a bit as she gathered all the materials she’d need to insert the needle, and there were many.
I bragged about being the valedictorian of having my blood drawn and explained that after giving birth to Marlo without any pain medication, I didn’t really have a hard time with running headfirst into a brick wall. She nodded and shared her birth stories with me, one in which she barely made it to the hospital in time for someone to catch her son as he shot out of the birth canal like a cannon. I tend to find my tribe very quickly: I can immediately sense whether my brand of humor is going to make someone feel at ease or run away in horror. Molly was the former, so of course I told her that the doctor who delivered my second daughter had never before presided over an unmedicated birth and was so mystified by the experience that she jabbered endless, fascinated nonsense as she was stitching up my vagina. My doula had to stop her and say, “Let’s save this conversation for later.”
We were shaking our heads over each other’s stories when she said that she needed to go over my list of medications and ask when I had last taken each one.
“We’re going to be here all day,” I warned her.
She pulled up my history on the computer and scrolled from the top all the way to the bottom. After what felt like hours of scrolling, pursing her lips, and nodding, she said, “This is not the absolute worst I have seen.” My tribe.
Before each treatment—before they inserted the needle, even—each phlebotomist had to go through this list.
“This one?” they’d ask.
“Last night,” I’d answer.
“This one?”
“Last night.”
“This one?”
“Last night.”
Back and forth until . . . oh, wait, it’s still going on. We haven’t made it to the end of the list yet.
The only medication I take that isn’t for depression and anxiety is a drug called Macrobid, because I inherited a urinary tract whose shape makes it prone to infection after sexual intercourse.
I received no sexual education in my Mormon upbringing. Not a word of advice or warning, no tips. Tips, ha! Even those will give me a urinary tract infection. It is that bad. I got a UTI the first time I ever had sex, because no one ever told me, “You must go pee after intercourse, so make sure you head onto the court with a full bladder and a toilet nearby.”
The full-bladder strategy worked for me for a few years, until it didn’t and I had to start showering immediately after sex. Then I had a baby, and now screw all your strategies and pointers. Peeing doesn’t work, showering doesn’t work, and I don’t want to hear any cranberry juice nonsense. Through no effort on my own part, I have become the valedictorian of being resistant to every DIY approach of curing a UTI. I brag about this on my résumé. Now I must take an antibiotic after I have sex, every single time. Just one—thankfully, not a full course—that is specifically engineered to attack bacteria located in the urinary tract.
When Molly got to the Macrobid on the list, she had to say it a few times to get the pronunciation right.
“Macro-bid,” I said, to help her along.
“Oh, okay. Macrobid,” she said, and continued, “When was the last time you took this one?”
“Hahahaha!” I just laughed and laughed, and because she made me feel so at ease, I thought she deserved an explanation. “I only take that drug after I have sex. It prevents me from getting a UTI.”
“So . . .”
“A really, really, really long time ago. It’s not in my system anymore. Maybe I should take it for all the bats flying around in my vagina.”
Molly was my phlebotomist four more times, and every time that she’d get to the Macrobid, I’d interrupt her and say, “Still housing bats, Molly. Still.”
I’m glad she was the first one to attempt the needle—the whole process of the needle. Apparently the gauge of this needle was far bigger than the other needle they use for ECT procedures. Because I was only the third patient to enter this study, she and everyone else were having to get used to the difference. Every maneuver leading up to inserting the needle was exactly the same as what happens when I get my blood drawn, right down to the part where I point my head toward several bulging veins on the inside of my elbow and say, “I have been told by several practicing doctors that I’d be very good at taking heroin.”
Molly nodded, thanked me for making her job easier, and then tapped on a blue vein that had become as round as my pinky finger because of the tourniquet she’d fastened near my shoulder. And then she plunged the needle into my arm. I probably should have warned you about that sentence in case you are uneasy with the idea or talk of needles and blood. But, you see, it was just as sudden and unsettling for me. I was forbidden to eat food in the sixteen to eighteen hours leading up to a treatment and had to stop drinking water several hours before. I would show up each time famished and dehydrated—so dehydrated, in fact, that I was a phlebotomist’s worst nightmare. This could potentially ruin my résumé, especially since I am usually the valedictorian of remaining hydrated.
I go everywhere with a water bottle. If I were to go outside and peer into my car right now, I bet there would be at least five water bottles scattered across the front seat, occupying every cup holder in the center console and in the doors—water bottles I have put there just in
case I make a trip to the grocery store and they’ve run out of water.
Molly would have to try at least five times to get that thing in my arm. It did not want to enter a vein, not even the one that had grown at that point to the circumference of a grape. It was uncomfortable and awkward. It felt like someone jammed a tree trunk up into my shoulder via my elbow, hooked up my humerus to an electrical socket, and was flipping it on and off. When she finally did get it in—not just the tip, the whole thing—she was panting and sweating, and I was woozy.
* * *
My mother said that she always knew the instant the propofol would take effect. I have vague memories of clenching my hands near each other at the top of my chest as everyone was assembling the equipment—the vials, tubes, wires—and this clenching of my hands has always been a barometer of my anxiety. When I suffered postpartum depression with my first daughter, I would find myself sitting on the floor in the corner of my room when she was napping, my hands clinched into fists that I’d tuck up under my chin. Many times I would be unable to unclench them, and I’d use my mouth and teeth to pry each finger open so that I could flatten out my hands and use them to push my body up off of the floor. Afterward I’d have red indentations from my incisors on each finger.
Since I was lying flat on my back on a gurney with a needle and a series of tubes hooked into my arm, I couldn’t get my hands all the way up underneath my chin, where I would have preferred them. At home, I usually ran to the couch or my bed and curled into the fetal position, my clenched hands taking their place under my chin. If I was not at my house, I’d run to my car and crawl into the back seat, shove Marlo’s booster chair onto the floor, and tuck myself into a ball with my back facing outward in case anyone walked by to find a woman in her car having a panic attack. If they could see my face, they would see the terror; so I reasoned that if they saw the back of my head, they would assume I was taking a nap. In my car. In the parking lot of the grocery store.
I had to tuck my hands on my chest because of all the apparatus, and my mother said that my fists were so taut, she thought my knuckles might break through my skin. I was anxious, scared, and frightened—but not of dying. I was not afraid that they would be unable to bring me out of the anesthesia. I was terrified that I would never stop feeling this way—that I would always want to be dead. I could remember a time when I didn’t feel this way, but I couldn’t remember what that felt like.
When the propofol hit, my mother would watch my fists come undone, a cascade of skinny fingers, and my hands would fall to the gurney with a soft thud. It was an immediate physical manifestation of the drug doing what it was supposed to. My mother knew this; she’d seen other people undergo anesthesia before. But not like this—not for the purpose of making someone almost brain-dead. Not for the purpose of making her daughter almost brain-dead.
The first time, not even a minute after they had shown me the vials of fentanyl and propofol, something went terribly wrong. The nurse had just finished affixing the Velcro shapes to my forehead and I remember someone saying that I should soon feel the fentanyl taking effect. Dr. Tadler had just touched my arm, and the warmth of his hand still lingered there. But suddenly every form and line and figure in the room started melting. The walls dripped like wax and coagulated on the floor. Heads and arms and torsos turned into jagged crayon cartoons. Noses and hair grew into triangular knives. Someone’s mouth stretched across the room and laughed, and teeth big as tree trunks grazed my face.
“Something is wrong! Something is wrong!” I screamed, but the fentanyl was taking effect and my scream came out only as a whisper. My mother said she could tell something wasn’t right before I coughed out those words. The look of fear already on my face had turned into horror. I closed my eyes so that I wouldn’t have to witness the bodies dissolving around me. And then . . . nothing. There was a brief blink of nothing, a blip of total darkness, and then I realized I was taking too long to come out of anesthesia. I only had thirty-six hours to get my girls to their piano lesson, and this was taking too long. Someone needed to tell the doctor to hurry or we were going to be late. Please, someone tell him. The piano teacher’s face appeared, disembodied and transparent. I could see the wall of the hospital room through her forehead and cheeks. I thought of the scene from The Wizard of Oz when Dorothy’s house is caught inside the tornado, and people and animals float by outside her window—one by one—and you can see the tornado behind them. The piano teacher was as concerned as Auntie Em, wondering where I was. Why wasn’t I on my way? I’d never been late before, and I couldn’t get the words out of my mouth to tell her I was trying. I was trying.
I thought that if I blinked a few times that her face might become less transparent, that she’d be able to see me better, so that’s what I tried. I blinked and blinked. But her face disappeared and the wall behind her forehead turned into the shapes of people. Two in front of me. I blinked again. One to the right, two to the left. Where was the piano teacher? I couldn’t find her. I blinked until finally my tongue could articulate a consonant.
“The girls will miss their piano lesson!”
They immediately wheeled the gurney into a room directly adjacent to the one I’d been in for what they called a recovery period. They would hand me a cup of apple juice and ask me a list of questions. I remember being so thirsty that I guzzled the apple juice like I was chugging a beer and then drunkenly demanded, “Another!”
“Can you tell me your name?” someone asked me—someone I had not seen or met before. He had not been in the room during my treatment.
“Who are you?” I shot back, but not because I was mad. I was startled and drunk and didn’t know why a strange person had appeared like magic.
“I’m Chris. I work here in the recovery room,” he answered. “Can you tell me who you are? Your full name?”
“I’m Heather B. Armstrong,” I answered.
“Excellent. Now can you tell me what year it is?” he asked.
“Nineteen seventy-nine,” I answered.
“Nineteen-what?”
“Seventy-nine,” I said slowly and condescendingly.
“Could it possibly be another year? Can you think a little more about it?”
Everyone looked at everyone else. I really, really hate it when people do this. I get angry because it makes me paranoid, like I’m not in on the joke. Or maybe everyone knows the building is about to blow up and they don’t want to alarm me.
“It’s not 1979, is it?” I asked, since my mother was not backing me up. She had looked at my stepfather, who looked back at her. The two of them would be with me at every treatment. They would sacrifice a minimum of eight hours a day, three times a week, for three weeks so that I could participate in this study. One of the rules for participation, in addition to fasting for a minimum of twelve to eighteen hours beforehand, was having someone drive me home. This is normal for any sort of surgical or anesthetic procedure: drunk people aren’t supposed to operate heavy machinery. But I had to undergo ten treatments. I would need someone ten times: two times the first week, three times each during weeks two and three, and two times the final week. That’s a lot of times. That’s like handing someone your baby and saying, “Here, hold this for one second while I tie my shoe,” and then disappearing forever.
What makes this even more complicated is that I never knew what time I’d go in for a treatment until the afternoon before. It varied depending on how many patients they had coming in for ECT. Since mine was an experimental study—and since we never knew if it would take twenty minutes or an hour for me to wake up—I had to be either the first or the last patient of the day. Only once did I have to go in at 7:20 a.m. as the first patient, and that was for my first treatment. My mother and stepfather were supposed to pick me up at 7:00 a.m. Instead, they showed up at 5:45 a.m., before my alarm had gone off. They are habitually early to everything.
My siblings and I always joke about this.
“Mom says we’re meeting at your place at five p.
m.?”
“Yeah, between five and five thirty p.m. is good.”
“Which means Mom will be there—”
“At noon. She will be here at noon.”
She’s a good sport when we joke about it in front of her. You have to be a good sport in my family, because we show love by making fun of each other. That sounds terrible, but it means that we are comfortable enough with each other to show that we’ve been paying enough attention to learn our quirks and to celebrate how wonderfully funny those quirks are. If we’re annoyed by a quirk, we don’t make fun of it. No, we just stew in judgmental resentment until it festers into an ulcer and we end up at the ER. One time my brother had to spend three days in the hospital because my dad refused to tip a server more than five percent at a Chili’s.