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   He who fights with monsters should be careful lest he gaze long into the abyss... only to find his own reflection.

McLean Hospital inpatient, Belmont, Mass., 2010

Introduction

This is my journal when inpatient at McLean Hospital, Belmont, Mass.

I do not have the dates of this inpatient stay, but it's probably 2010. This is just the start. I have many pages to transcribe. Unlike the others, it starts the day before I was admitted.

"Gulping all night. Lying on the floor surrounded by various bottles of booze. By nightfall dissociation and uncontrollable actions occur. I don't remember the cutting -- on my forearms -- and I come out while witnessing myself gulp down a handful of my meds..."

Day Zero

Hanging out at the ER the next afternoon... My face became flush and red, my heart rate and pressure rose dramatically -- they took me right away. BPM 140. They quickly found me a bed.

Fluids. Valium (which did nothing!). Fluids, fluids, fluids. Vitamins. My stats when down but not the red face.

They found me a bed at McLean (Thank you W.! [my therapist]). Where I should have gone and expected to go.

Day One

McLean is fucking great and makes BMC/CSU look like shit and Arbour Fuller like crap.

McLean -- diagnostic and trauma unit -- has a quiet, "safe," home-like feel. Art on the walls, photos and paintings -- BMC and AF had none! Patient artworks are everywhere. (It turns out that the meals compared to here BMC food was barely edible and AF food plain, while here the food is, um, real home cooking.) BMC had nothing but an occasional apple or two and crackers. AF had a small variety of cereals and crackers. BMC had no coffee and juice. AF had terrible (vended) coffee and juice/milk. The differences are so stark.

The best things about McLean is, compared to the others: The staff always immediately respond to questions; the take your vitals every few hours and adjust the PRNs as necessary (BMC and AF took vitals once a day midday and in in the morning respectively).

They have been monitoring my vitals and [tried to adjust] them several times (BMC/AF are nuts compared).

There is a piano here (BMC had no arts at all and AF had childlike coloring books).

The redness of my face is lessening.

For the first day, 4:30am to the time I fell asleep about 9 or 10, I was in a panic attack. My meds went up and up -- 100mg Seroquel, 50mg Librium along with B vitamins.

Day Two

I get up and my PA [Panic Attack] symptoms are down to a simple general anxiety. But I feel slow, like I have to make a concerted effort to move.

I spend more time out of my room and actually spoke to P-L for a while. Turns out we both are PTSD sufferers and shared many traits associated with guilt.

There are not many books here, but one is "The Best of F&SF #4". The stories are all good and two are very similar to two of mine; "The Test," by Matheson and "Brave New Word," by J. Francis McComas.

Another book that caught my eye, "Know Your Nutrition". As I thumbed through it I came across the section on Vitamin-C and read this:

Vitamin-C is stored in your adrenal glands. Any kind of stress, shock and worry destroys all of the Vitamin-C in your adrenals in seconds.
[Klenner & Davis] suggest... 1000mg of Vitamin-C. This keeps you from becoming nervous. ("Let's Eat Right to Keep Fit", 1954.)

The book also mentions that germs thrive in an alkaline environment and V-C is an acid medium. And that calcium plays a role in the body better in a physiology on the acid side, and "Calcium and Vitamin-C is recommended together." (Davis) Again, this provides another example of how my fears and isolation prevented me from learning about physiology and how nutrition plays a role. How terrible! Imagine if I had learned such things and had made attempts to control my body and my mind?

This Unit has all women for patients. I, and a couple of the staff, are only men. It may seem like a "cool!" situation, but with social anxiety and other phobias, that ain't so. The women -- and this is not just a detox -- are mostly withdrawn and quiet. There is no shouting, no power plays, etc. Man, what a difference.

About 1:00pm 50mg Librium. At 9:00pm Amitriptyline, Seroquel and Librium. But I am not keeping track of my meds well.

Saw another doctor! Man, there are so many these last few weeks, and this was the second one here. One tells the "Benzo tale," that "it would be negligent to prescribe benzos to an addict."

I will try to talk to regular staff doctors -- the ones I have talked to are "weekend" temps -- about discussing my blood work (taken this morning) and my meds/vitals history.

I am not in panic mode, just in general anxiety mode.

Day Three

Seroquel 50mg, Librium 50mg, Thiamine & Folic acid. Should see case worker and doctor about 10:30am.

The despair has come along side the anxiety -- the panic is there under the surface. I know it. I know it. Shit.

I should be on a "Librium taper" and then I will be left with just the Seroquel. We shall, when the Librium is gone [know] whether Seroquel alone relieves the panic.

Most other patients are dull, dazed and/or off balance. Except one who is on methadone who talks, well, normal. But I do not much about women. Maybe I can learn.

I'll probably be here 7-10 days.

Despair comes from the stomach, Panic from the heart and Anxiety from all over. They are all always there inside, like little demons vying for power over their host who has to battle with them constantly -- and who usually fails.

Some meds help hold back the demons, but so far (for so long, so many years) the meds fail after awhile (or the demons figure out how to get around them).

More and more meds are tried and will be tried; combinations will be tried.

Previously the demons have all won. Now, with 50/50 Sero/Lib Panic is held back; Despair and Anxiety are happily (to them) dancing around in my insides.

In this place the staff are diligent and busy. The nurses, case worker and doctor are always talking to some patient. This place is active. Yet, if a patient wants some space or quiet time they are allowed it.

Fuck, I just hope that my first priority is to suppress my anxiety and especially my panic attacks!

Saw the psychiatrist -- yada, yada on the Lorazepam; she is one of those that thinks that withdrawal from alcohol causes panic attacks. No, I said (how many times over the last few months?). "I get sober for months and then I get panic attacks which cause me to drink to suppress the attacks." She, as so many do, seemed incredulous that my attacks last all day long -- it is (DSM) called Panic Disorder when people have severe and prolonged panic attacks.

New meds, still on the old meds: Amitriptyline 40mg, Seroquel 50mg, Librium 50mg, one I did not get the name of (looks like 100-300mg capsule) for nightmares and Neurontin 300mg.

I have not been dreaming the past three nights.

Day Four

I have been eating a lot of foods with whole wheat and A/B+/D vitamins as I have a few signs of some deficiencies of them (possibly).

Nothing like a "high" or any effect at all from the meds (it's now been about an hour). My heart still pounds in my chest but my BP has been slowly getting lower since yesterday. I am just generally feeling that gravity has increased and that I am off balance.

"Art Therapy" went well; I opened up and drew two pictures, one describing "a bridge" in which I drew of a journey to a mountain top, and the other "a circle" in which I showed myself in a circle representing this place with my heart pounding, my stomach full of butterflies, my brain thinking of what I want to do, with a window with the sun coming in and a door (closed) leading to a wilderness on the left; on the right was a cityscape showing where I came from. I was surprised how quickly the imagery came out.

There was a PTSD group -- very emotional for all -- many tears. This PTSD is so painful and so difficult to understand.

I can understand why we all walk around withdrawn and quiet -- full of fear and medication.

Notes
  1. Boston Medical Center.
  2. This is standard alcohol detox protocol.
  3. Patients are identified by P and their first initial.
  4. Which is typical. But I am an alcoholic. I am not an addict!
  5. This is a meme that repeats itself over and over... I will write about this in greater detail in the next month.
  6. Many medications take time to work, some weeks (anti-depressants for example), however, anxiety and panic "attacks" are named "attacks" for a reason and generally require relief from somatic symptoms.
  7. The drawings were not very good.

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Writing Down the Pain
I'd like just once to fall asleep feeling good about myself. Just once. Drunken stupors do not count.