The Valedictorian of Being Dead Page 5

  I was nobody.

  12. Thoughts of Death or Suicide

  I checked the box next to 1: “I feel that life is empty or wonder if it’s worth living.” The other options did not apply to how I felt about being alive. I didn’t have plans to kill myself nor had I ever tried. I didn’t think of suicide. I did not daydream of ways I would end my life. I just didn’t want to be alive. Daydreams consisted of eternal blackness and silence, an end to the hamster wheel of my day-to-day existence. I daydreamed about the annihilation of my senses—an end to the feeling of dread. Death would extinguish the fire inside my chest and brain. Yet, I did not ever consider specific ways I would try to make that happen.

  But make no mistake: I wanted to be dead. I yearned to be dead. Please, let me be dead.

  13. General Interest

  Was I interested in people or activities? I easily checked the box next to 3: “I have virtually no interest in formerly pursued activities.” And then I scribbled “Or people” in the margin.

  The woman who filled Leta’s Mylar balloons was the first stranger I had willingly interacted with in months. When going about my life in public places, I avoided eye contact and either nodded or shook my head in response to questions, even if those questions warranted more than a yes or a no. I didn’t want to risk getting into a conversation with someone, didn’t want to exchange words because of the pain of existence. That sounds so dramatic, and I’m guilty of having such tendencies. But this was just the opposite. Words held drama and theatrics and meaning, and I wanted no part of it, especially with a stranger.

  And as for activities? Was this a joke? My day started and ended with no break in between. I imagined what it would be like to flip through a home decor magazine and pause to admire a set of striped pillow shams. Or sign up for a cooking class. Or grab lunch with a friend.

  The final three items asked me to consider the physical manifestations of my depression: “Energy Level,” “Feeling Slowed Down,” and “Feeling Restless.” I hadn’t ever thought about my energy level. It hadn’t ever occurred to me to consider it.

  My God, I certainly didn’t feel slowed down. Feeling restless? Of course I felt restless. Of course I could barely stay seated and needed to pace around, and 20,000 steps a day were not going to walk themselves. The dishes were not going to wash themselves. My sick kid was not going to drive herself home from school and bring herself a bowl in which to puke.

  As I filled out the questionnaire, my mother found a nurse and asked if she could relay a message to Dr. Mickey. Just as I was signing my name to the bottom of the paper, he walked into the waiting room and took a seat across from the three of us. His boyish blond hair bounced with every movement.

  “Seems you had a reaction to something last time?” he asked, leaning forward, his arms perched on his knees. I nodded and told him about the horrifying hallucination I’d had before going under—how I’d battled a headache that entire afternoon and evening—and mentioned that I’d had adverse reactions to opioids in the past.

  “A hallucination . . . Have you ever had a hallucination with an opioid?”

  “No,” I answered. “But they nauseate me, and I have never understood why someone would want to abuse a substance that makes you feel like you’re in your first trimester of pregnancy.”

  He grinned. “I’m not quite sure what that feels like, but we can certainly leave out the fentanyl this time and see if it makes a difference. It’s not critical to the study. We’re just trying to prevent a potential headache, and it looks like we failed miserably.”

  Dr. Mickey wore thick black glasses and dressed in neatly pressed pants and a tie. He stood a few inches shorter than I did and always spoke softly but deliberately. During the initial intake interview he had run through a list of questions about my history with depression and the current episode I was suffering. The question I remember most was the last one: “Do you feel like you have a reason to live?”

  I couldn’t look at him and instead stared at my entwined fingers resting in my lap. The tears involuntarily started pouring down my face and onto the scarf I’d worn that day to hide the dirty shirt underneath it. I didn’t say a word and barely shook my head. He set down the pen he’d been using to comment on my answers. Then he paused before saying, “You have so much to live for, and you deserve to feel that way. It must feel horrible that you don’t.”

  FIVE

  NO MEMORIES, NO DREAMS, NO LIGHT AT THE OTHER END

  MOLLY WAS NOT MY phlebotomist for my second treatment, and I had no rapport with the woman who was desperately trying to get that needle into my arm. We’d gone over my list of drugs and the last time I’d taken each one and she’d collected all the gear she would need to insert the needle. After four unsuccessful attempts on my left arm, she started to ask if she could try a vein in my right, even though that was the arm where the needle had been inserted for the previous treatment. Their plan was to switch arms each time to give each one a break, but I interrupted her question to scream, “YES!” I startled myself, even, with the desperation in my response, but she had just spent over five minutes torturing me with a 22-gauge needle.

  The needle went smoothly and directly into the same vein from the previous treatment, and she taped the end of it down so that it lay flat on my forearm. I walked back into the waiting room and took the seat next to my mother.

  A nurse I had not seen before then walked in and motioned for me to follow him. They were ready for me, and the three of us followed him directly across the hall into the room where my gurney sat in the middle of the floor dressed in off-white linens. The anesthesiologist—someone other than Dr. Tadler—was gathering materials, and Dr. Mickey and his assistant were looking over some paperwork. I passed by the nurse, who asked me to confirm my name and date of birth and to take my place lying down on my back. The nurse asked if I’d like a warm blanket and this would become one of my favorite parts of dying, of going down to zero, slipping away into nothingness: the warm hospital blanket. He pulled one out of what looked like a refrigerator, except its shelves were lined with blankets like the one he very sweetly spread from my feet up to my neck and helped tuck between my arms and torso. It was as if he was telling me with that gesture that he knew this was scary—they all did—but he cared enough to offer me something as intimate as warmth.

  Another nurse I hadn’t seen when I walked in worked with Dr. Mickey’s assistant to prepare the Velcro attachments that they then affixed to my non-Velcro forehead. I will never understand the science of that.

  Everyone worked quickly and seamlessly, a choreography of human hands in rhythm. Without getting up from his stool, the anesthesiologist wheeled himself over to introduce himself. The comfort in that elegant dance calmed me and my parents. My stepfather was seated next to the doorway, my mother was walking back and forth in front of him. She wasn’t pacing, she was getting her steps in for the day: 20,000 at a minimum so that she would not only keep up with me on our Fitbit trackers but also beat me. I don’t get from just anyone my drive to be the valedictorian of everything.

  “I’m Dr. Larson and I’ll be the one working with you today. It’s really nice to meet you,” he said, and offered his hand. Both of my hands had already assumed their clenched positions on my chest, but I managed to release my right hand and take his in a brief exchange.

  “You’re in charge of the propofol today,” I said back flatly. “The drug that killed Michael Jackson.”

  “HAY-THER!” my mother called from the end of the gurney.

  Dr. Larson laughed and said, “Well, you could put it that way.

  “Dr. Mickey said that you possibly had a reaction to the fentanyl last time. We’re going to look into that, and thank you for telling us so that we can modify this for you and possibly for future participants. Again, we’re going to give you Zofran for possible nausea, propofol, and a different, less powerful drug. When the anesthesia enters your arm, it can sting, and the fentanyl was supposed to help with that, too. We’re
going to give you just a bit of lidocaine. Have you ever had that drug? Maybe at the dentist’s?”

  Why, yes, I had been given lidocaine many times at the dentist’s. And it was glorious. I had no idea that I’d enjoy that numb feeling in my lips and gums as much as I did, and I’m not even sure why I did other than to guess that, God, isn’t it great when you don’t have to feel anything?

  “I know what lidocaine is, yes,” I said to Dr. Larson. “And if you have any extra, could you also numb my mouth?” My mother just glared at me. “Don’t look at me like that, Mom,” I said as they connected the vials to the needle in my arm. “If I die, that will be the last memory that I have of you.”

  But there were no memories. No dreams. No tunnels leading to a light at the other end. No visions. When Dr. Larson told me that he was starting the propofol, I looked up to find Dr. Mickey’s face, his gentle eyes, and wondered if I was powerful enough to resist the anesthesia. How long could I stay awake? Could I fight it for seconds? Minutes? What if I could fight it for—

  And then nothing.

  Since I’d been under anesthesia only once, I didn’t know if what I experienced was like what other people experience when they go under. Maybe people who meditate have taught themselves to envision nothing when they close their eyes, but my mind usually darts in and out of images of All the Things Needing to Get Done. But the black nothingness of a really deep coma—like, all the way to zero—was like having all my senses shut off with a switch. A black curtain descended and smothered me, swallowed me whole. No color, no smell, no texture.

  I never remembered closing my eyes, never remembered the moment the anesthesia would devour me. But my mother would tell me two weeks later in a fit of tears—it would take her two weeks to be able to talk about what she had witnessed—that I would go under so fast and so hard that they would race to get the giant spatula-shaped breathing tube into my mouth and down my throat.

  “You were a rag doll. They handled you like a rag doll, sometimes more than one of them. They were racing against time, and sometimes it took more than one person to maneuver you. Your body had no life; your arms and head hung like limp wet rags as they struggled to get the tube in fast enough. I was certain you were dead.”

  Technically, I was. At least, my brain was. And Dr. Mickey would keep my brain in that state for over fifteen minutes, until he was satisfied with the length and movement of the lines on the monitor connected to the wire on my forehead. One line measured my brain activity; the other measured how much anesthesia they were administering. One line started at the top of the screen; the other sat directly opposite it at the very bottom. They would immediately beeline across each other to occupy the other side—a straight line at the bottom tracing the abyss—until it was time to bring me up and out of the nothingness, the lines sulking back to their original positions and creating a lopsided U with their paths. These lines, however, weren’t nearly as important as the burst suppression ratio that they were measuring with the line at the bottom. Under certain kinds of anesthesia and when the anesthetic state is deep enough, the brain can experience a very unique bistable state: it’s either flat and very suppressed or there’s bursting activity. It alternates between these two states—between several seconds or even a minute of being very flat and quiet, there is a sudden burst, only for it to become quiet again—and the ratio between these two states was their ultimate goal. They were shooting for an 80 percent suppression rate for fifteen minutes. My mother said she’d often hold my hand when the lines sat at opposite ends, but I don’t remember. I don’t remember Dr. Larson removing the breathing tube from my throat and mouth. I don’t remember taking the first breath by myself or the nurse wheeling my gurney into the recovery room.

  I heard someone say something—I don’t know who and I don’t know what they said—and then I blinked my eyes open. They had propped up the top end of the gurney so that I was no longer lying flat on my back. I glanced around to figure out where the hell I was. I saw my mother and stepfather sitting to the left of the gurney. Chris, the recovery nurse from my first treatment, stood to my right.

  “Nobody melted!” I suddenly realized, out loud. I turned my head to look Chris straight in the face and opened my eyes as wide as I could stretch them to emphasize this very important truth. “The people stayed people,” I continued, except I was slurring my words and it sounded more like “The pee-poo stay pee-poo.”

  “That’s really good to hear,” he said generously, given that he almost certainly had no idea what I was referring to. “Can you tell me your name?”

  I held up my arm and pointed to the bracelet Greg had affixed to my wrist when I checked in. “Heather B. Armstrong. With the B. Always with the B.” He started to ask me the next question but I interrupted him with “Don’t you know who I am?”—thinking I was being terribly funny when instead I was being terribly drunk.

  “Yes, we all know who you are.” These nurses are so used to hanging out with drunk people. “Can you tell me what year it is?”

  “It’s 1979,” I answered. Again. My stepfather started to laugh, and I saw my mother reach over to put her hand on his arm, an indication to him that drunk people sometimes get really sensitive when they think you’re laughing at them, although she was on the verge of giggling herself.

  Chris cleared his throat and asked again, “Can you think a little harder about that? What year is it?”

  I didn’t want to think harder about what I knew to be true, so I blurted, “It’s 1979.” And as that number tumbled out of my mouth, a wall calendar appeared in my head, its pages flipping as if caught in a gust of wind—1985, 1993, 1997, 2001, 2004, 2009—until the whole daydream stopped at 2017.

  “Oh yeah. It’s 2017. Now I remember.”

  “Good,” he said. “Would you like something to dri—”

  “APPLE JUICE!”

  I gulped two cups and listened to my mother describe the shape of the lines on the monitor. She gestured wildly with her arms and hands, although I was having a hard time concentrating in my drowsy, drunken state. Couldn’t we talk about this later, maybe after a nap? I mean, I knew I’d just woken up, but being brain-dead for fifteen minutes is hard work, and I was the best at it. I had a reputation to uphold and wanted nothing more than to go back to sleep—a very different state from my usual panicking and pacing and screaming into the phone about laundry.

  After a few more minutes, Chris asked if I thought I was able to stand up. I was so distracted by the unfamiliar state of fatigue that I wouldn’t even realize until hours later—after attacking two chocolate protein bars; after the drive down 900 South in the back of the minivan; after a ninety-minute nap made possible because my parents had stayed after driving me home to watch my kids—that I didn’t have a headache. In fact, nothing hurt save for the gaping puncture wound in my right arm.

  I’d been right about the fentanyl.

  The following week Dr. Mickey and Dr. Larson would tell us that they had to do an unforeseen amount of research into the matter, but turns out I can count myself among maybe four percent of the population of the entire world whose reaction to an opioid in the structural class of fentanyl could include the kind of delusions or hallucinations I’d experienced. The headache afterward was a bonus, a slightly more common side effect.

  Not only was I the valedictorian of being dead, I was also the valedictorian of teaching these doctors new things.

  SIX

  MARATHON TRAINING FOR BEGINNERS

  NINE MONTHS BEFORE STARTING this treatment, I made an appointment to see my talk therapist. I had not seen her in over a year. I hadn’t needed to sit across from her and comb through my neuroses like I had every week for almost a decade when married to my ex. But my primary care physician didn’t have an opening for a physical for another four weeks, and something was wrong. My body and mind didn’t feel normal; they did not feel like my own. I needed to get some blood work done, maybe have my thyroid checked. I needed an official diagnosis—something t
o hold on to.

  Melissa—or Mel, as she likes to be called—had moved her office to the fifth floor of a building close to downtown and had changed all the furniture. I felt a little disoriented when I sat down across from her on a sprawling leather sofa and picked at the tassels of an orange wool blanket draped over its arm. I began to speak and she interrupted me to say, “That is the stupidest thing I have ever heard.”

  “But I got to run the Boston Marathon! I mean, who—”

  “Heather, are you a runner?”

  “Well, sort of. I ran the New York City Marathon in 2011—terribly. I mean, I broke my foot—”

  “HEATHER.”

  We’d always had this rapport, this dynamic where I was the china shop and she was the bull running wild. This was why I trusted her so much. She wasn’t afraid to call bullshit, and she always set meaningful goals for our time and work together. Which was why I hadn’t seen her in over a year. I’d met a goal we’d set together: I ended a three-year relationship that had gone on three years too long. He and I started seeing each other a few months after I separated from my ex, and I loved that man, I really did. But his jealousy was so all-consuming that he once accused me of having rough sex with another man because of the indentations left on my butt from sitting on a metal picnic bench. I can laugh about it now, but at the time he was stalking all of my social media feeds, cross-referencing them with my friends’ social media feeds, and making an inventory of all the inconsistencies to prove: one, that I was lying about everything; two, that I didn’t want to be in a relationship with him; and three, that I wanted to have rough metal picnic bench sex with someone else.