Monday, 9 October 2017

The Narrative

I wrote this a few days ago.

Last night I cried for an hour and a half. It was intermittently cathartic. I would cry and then feel better for having cried. Then I would feel awful and disintegrate. As I cried, I analysed. I judged my technique. My expressiveness. The sincerity of the underlying emotion. I wondered why I needed to cry.
It’s no wonder I need medication.
There’s a suggestion in Terry Pratchett’s Witch novels that people all have second thoughts which analyse what they have done. Witches have third thoughts which take a step away and analyse as you are doing. I’m not saying burn me at a stake, but I don’t think I’d have fared well in medieval times.
Unsurprisingly, I find it unpleasant to think about the world as posited by stories like The Egg, where we are all part of something bigger and we are all one mass, interconnected. Because, among my other thoughts, are those horrible dark ones that I fight and the idea that there is a version of me that didn’t fight those, or that there is a world where other people know I have those thoughts and assume that means I feel they are good thoughts to have is… well, I don’t like to think about it.
So, I don’t. I touch it on the surface and skim away from it.
But I see, in the world around, constant signs that the narrative is real. All the stories we tell and hear are reflections of the world. Maybe they are accurate. Maybe not. But they are connected to something. Something deep within us.
I am a storyteller. I know very little about politics. People peacocking around to further their own agenda in the guise of working for the people is so intrinsically false it feels unpleasant and I avoid it. I keep informed, but I rarely seek out a deep knowledge. I don’t know names, or parties. I won’t vote without confirming I agree with the manifesto (and I feel incredibly uncomfortable that people are OK with Jeremy Corbyn leading a party whose manifesto he isn’t 100% behind. Apparently it’s ok to be “principled” and not adhere to your manifesto, but there’s no test to distinguish “principled” from “bat crap crazy, power hungry mania” so forgive my discomfort).
My boyfriend is a politics guy. He knows all the fact and figures. He knows what he agrees with, where he stands and what “should” happen. I tell stories.
We had an argument (we’re very good at them) about politics and whether Donald Trump would get in, and if he did whether or not he’d be any good and whether or not the media needed to portray him less like an amusing piece of entertainment and more as the danger he was.
I went by the narrative. He went by facts and logic. Look how that turned out.
As a point of fun, I did the same with our most recent election. He asked for my predictions before the poll came out and I was initially going to scoff but I thought – nah, I’ll give it a shot. I thought about the narrative, what I’d seen and how I felt. I thought about the way the media had influenced me and if I listened to every part of my soul how the breakdown would fall. What had my internal swingometer done?
I said Labour would gain x number of seats. He scoffed. I said Lib Dem would get this, and Green would get that. He went with facts and logic. The Tories, he said, would get loads. Was I saying the Tories would drop? Yes, I said. The Tories would drop. I had nothing to go on. Nothing but the narrative. Nothing but the feeling that the zeitgeist is real and we are constantly fed stories that we absorb and remember. We are played by the system, over and over again.
I was exactly right.
I don’t know how. I don’t know what the odds are against it. I don’t know anything about politics and I’m no psychic.
I have my third thoughts. I listen to how people are pushed and how they respond.
When I was a child, my Dad had an interview. He was not especially himself in the week that followed and my Mum wasn’t sure why. I pointed out it was probably because he didn’t get the job. Her response was “He didn’t want it.” I couldn’t articulate the feeling at the time, but I knew not wanting is not the same as being ok with being rejected.
When I was crying last night I had a flashback to another time I couldn’t articulate the – to me – exceedingly visible link between motivations and behaviour. A singer was very obese, and I wondered aloud that she would risk damaging her performance by the way the weight affects her voice. Mum was adamant that she should be more worried about dying, but… death is such an abstract concept, and small short term rewards are so much easier to value than large remote ones. If you told someone that by exercising every day for 100 days you would give them £100,000, they probably wouldn’t exercise more than a few days before they hit their barrier. But give someone £50 each consecutive day they work out over 100 days and they’ll find a way to earn that £5,000.
It’s what I learned from fiction.
It’s what I rely on when I write.
It’s a bugger when I have to deal with anything in the real world.
And it’s completely unreliable.
I can see the narrative and its impact on people. I can feel the shifts in the world. But the narrative is a living thing too, with quirks and motives of its own. We try to shape it, to fit in with it, to make it work for us, but the narrative cannot be caged. It will always be impossible to pin down and it can choose to take any path it wishes.
We know what it was and we know what it is; but the future could be anything.
When we write, we have the most compulsive story when we adhere to the narrative. And the funky thing is, that people who don’t know the narrative can still feel it. If you write historical fiction you can find the narrative of today doesn’t work for the time you write about and there’s a reason for that.
The narrative of earth may not work for space, and there’s a reason for that. But looking at the narrative through a gravity well will give you enough distortion to make things work.
The world we experience is not made of facts and logic. It’s made of an amorphous mass of continuity and physical laws. It’s the chaos theory applied to jelly and plasma, shocked into the eighth dimension and studied at a quantum scale.

It’s the most awesome, improbable child of science I can imagine.

Sunday, 17 September 2017

Diagnostician

I remember my mother’s response when I first told her I’d been accepted to medical school. I hadn’t even hinted that I’d wanted it until then and her expression of astonished delight was my short lived reward. What was I going to be? A surgeon? A therapist?

“A diagnostician.”

She fought hard to hide it, but I saw her pain and despair in the way the light went out of her eyes, and I heard it in the quiet praise which contained equal measures of pride and sorrow. It’s certainly a lucrative profession, but the overwhelming majority of people would refuse to do it; especially on a day like today.

This morning I have an NHS referral. We aren’t part of the basic cover – a full diagnostician is far too expensive so we mostly see private patients. An NHS referral only comes when multiple specialists are convinced the sufferer has a real complaint and none of them have been able to isolate a cause. It takes years and a great deal of suffering to get to me via them, and they always come with the same desperate hope.

She walks into the room and immediately fixes her gaze onto me – and I see exactly what I expect. That unblinking, unwavering guilty expression that wonders if they’re a fraud and I’m about to tell them all their pain is imaginary. The fear that if I confirm their suffering, it still won’t be fixable. The hope that it is; that this is finally the end.

I wave her into the seat opposite and introduce myself. I explain the process as simply as I can. She isn’t listening, none of them ever do. Our function is well known to our patients and they don’t really care about the how. Once I’ve covered that, I move on to establishing a base line.

“Before we begin, can you tell me how you are feeling today?”

She is surprised, but quickly succumbs to my air of quiet expectation.

“I’m OK, actually. It’s been a pretty good week.”

“No pain? No nausea, stiffness or other symptoms?” The way she sits tells me she isn’t feeling well, despite her statement.

“Only mild discomfort, really.” Her thumb nail scores her finger absentmindedly as she speaks. It’s pain management and I suspect it’s unconscious.

“OK. And on a normal day? What would you expect to feel?”

“Pain, generally. It gets difficult to walk, my stomach hurts and I stiffen up a lot.”

“It must be tiring.”

“I guess. I’m not a great sleeper, so I’m tired most of the time anyway.”

“OK.” I make a mental note. “And on a bad day?”

She shudders involuntarily – a slight tremor only, but her thumbnail works rapidly back and forwards, drawing a sharp distress line to distract her from the discomfort she feels elsewhere.

“It’s… it’s not good. I can’t eat or drink. On bad days I can only just about get out of bed and into the bathroom. I have to roll out and land on my hands and knees before working my way upright. The pain is all over on those days.”

“And is it a stabbing pain, or a burning pain?”

“I don’t know – just, a lot and constant.”

“OK, so we’ll get set up now and begin. Are you ready?”

She nods and the nurse who has been hovering in the background begins to fix bits onto her as I settle into my chair. With familiar ease I nestle into its depths and trigger the link.

Before the nurse steps away from her I can already feel the shape of her thoughts; mostly revolving around me and the uncertainty. I can feel her pain – a constant tearing feeling that is bearable if she remains stationary. She is uncomfortable, wanting to shift, not wanting to hurt, and she is mostly appallingly conscious of me.

“To synchronise us, I will need you to sing something.” It’s a lie, but a useful one. I hate having patients who are thinking about me. “What’s your favourite song?”

She’s immediately paralysed by choice and frantically tries to remember any words. Into the silence I prompt: “Do you know Bohemian Rhapsody?”

“Yes!” The link isn’t required to feel her relief.

“OK, then. Whenever you’re ready.” I choose this one for its duration more than anything; I’ve now heard it sung in every possible way, by the worst and best the world has to offer.

“Is this the real life….”

Her thoughts and emotions coalesce around the memory of the song as her conscious mind is trapped by the singing process. It leaves me clear to access her older experiences.

The mind is a funny thing – experiential data is stored in perfect format. Our memories are made from that data, but we can only access them through several layers of self protection filters. I can’t afford to be misled by how she remembers her illness; I need to burrow through to the truth and experience it for myself.

I dive through her mind to her earliest experiences and slip forwards looking for anything at least one standard deviation outside the norm. A broken bone doesn’t count, and nor do growing pains. This ability to judge events as they happen is what makes diagnostic links so complicated. People are used to the idea of simple links, although most have only encountered them in the workplace for brainstorming - instantaneous sharing of ideas. Professional and recreational links are deeper, but even they are relatively uncontrollable. A justice link will simply replay the experience of the crime and its impact; it’s completely immersive. An X-link will give you mutual access to the here and now of the person or people you are linked with, adding all of their sensory feedback to your own. Even a standard medical link only looks at the current trauma, and has a basic array of medical logs to compare it to – diagnosis then relies on the accuracy of the practitioner’s memories of the experience.

The diagnostic link not only looks through the whole history, it also allows me to keep my self-conscious active, while living the patients’ life and maintaining my whole array of medical knowledge. I can simultaneously experience her life at at any speed I wish, diagnose her symptoms and relay notes to my nurse.

Everything about her experience is within the realms of normality until she reaches adolescence. Her first period is absolute agony. No-one is impressed by it – she is assured this is normal and she should stop being dramatic.

Over the years it fluctuates; always bad, sometimes worse, and she persists in the belief it is normal. This then becomes her standard measure for a reasonable amount of pain. My hand writes “Endometriosis?”

I’m oddly conscious that although her experiences pass in real time and my handwriting feels as though I’m moving at normal speed I’ve blasted through six years of her life before the word is written. It seems like a long song won’t be necessary.

The nurse moves behind me and glances down at the notebook. She prefers when I dictate to her, but it isn’t always wise or kind to the patient to say things out loud.

“Caught in a landslide…”

Something new registers; a stomach pain. A strange tightness that builds gradually over a few months. Along with it is a funny sensation of not-quite-pins-and-needles down the right hand side of the body. I can feel her not really caring about it. It’s painful, but much less than her periods, so she ignores it.

It becomes worse. I interrogate it. What is the specific kind of pain? What made it worse or better? Heat? Cold? Stretching? Compressing?

As I feel her pain, I feel deep compassion. It’s a hazard of the profession. If this were a basic medical link I’d only have a snapshot and would not have the separation of personality – I’d believe I was her for the duration. But I can be me and her simultaneously, so although I’m going through it there is a tiny part of me that knows it isn’t real and uncomfortable as it is I can make it stop any time I want.

My mother still hasn’t realised what a difference that makes.

As I dig deeper I become more convinced this poor woman has both endometriosis and Multiple Sclerosis. She hasn’t been able to accurately report her symptoms to anyone thanks to the misguidance she received in her adolescence and now she’s perpetually exhausted, depressed (I check off a note as I recognise a familiar pattern of long term despair and hopelessness becoming a severe mental illness) and losing motor function.

“No escape from reality…”

I’m caught up with her symptoms and I drift away from her. I reach up and detach the head piece.

She stops singing and stares at me in confusion.

“Is it broken?” she asks.

“No, not at all.” It’s difficult to form words – although I didn’t physically suffer, I have endured almost two decades of mental suffering in a few seconds and my brain can’t easily adjust. I gesture to the nurse and she takes over.

“The Dr has been able to study your symptoms – the process is very quick when you have this level of skill. I have some information here for you and the Dr will be able to give you a fuller explanation once the analysis is complete – but right now I need to take you away to ensure there are no remnants of the link.”

It’s another useful lie. The link goes as soon as the headpiece is removed, but I need an hour of privacy to overcome the trauma I’ve just experienced. The nurse will keep her busy, make her feel like something substantial has happened. We learned early on that patients just don’t believe the process is accurate unless there is some heavy duty “uhmm”ing and “ahh”ing, or at least some indication that it’s been challenging. On the other hand, when they were exposed to the reality of the diagnostic process, many of them – like mother – couldn’t handle the guilt, so we have to make it seem as though the impact on us is minimal.

As soon as I’m alone I begin to shake and have an overwhelming urge to vomit. I learned long ago it’s best to get it over with, so I grab the bucket stashed under my chair and empty out my guts. Hot and cold sweats rush over me and every time I blink I’m trapped in a world where time has no meaning and pain is intense. I fixate on the loud ticking of the clock to track the true passage of time.

As my brain realises the shape of my body is different to the shape of pain it has so recently experienced, it stops trying to purge. No matter how many years you do this job, it’s always the same. All the systems and process that are out of our conscious control kick in to try and “cure” whatever we experience; first the physical symptoms and then the mental.

Ironically, it’s the one thing that protects our justice system from psychopaths. Although most people find the idea of having to experience being a victim of the crime they committed a terrible penalty, there were once those who committed crimes and let themselves be caught so that they might have the satisfaction of feeling the suffering of their victims. The satisfaction – and the few who were willing to work with us honestly remarked that it was intense – is fleeting, and this readjustment to normality may take years, depending on the depth of the trauma suffered. With the X link people consider it a fair trade off; although many couples prefer to adapt to the link on a permanent basis rather than suffer through frequent separations.

This separation is particularly brutal. Despite the brevity of the session, my immersion was deep and physical recovery is slow. I can’t stand yet – I’ll fall over. I shudder at the memory of the pain and my muscles tense in preparation for the onset of another wave of distress. It doesn’t come and I feel involuntary relief. Despite my best efforts I have not been able to rationalise away the fear that one day my brain will forget that I don’t have these illnesses and keep producing pain in an effort to protect me.

I am getting old. My body has lived through 37 years but my mind has lived over 600 and the vast majority of my experiences are torturous. I am tired and afraid of breaking.

Maybe it’s time to stop.

Friday, 28 July 2017

What am I doing?

Hello everyone, how are you doing? I hope you're all well - and it's difficult to hold a conversation in this medium, so on to me.

I've been working very hard on taking care of myself and it's beginning to pay off.

The last few years have held more than a handful of major life events. I'm now 33 and although I can't remember the dates, I know that in the last decade I have:

  • Moved from the North to the South, leaving all friends and family behind (except my fiance)
  • Got married
  • Got divorced
  • Started a new job twice
  • Been hospitalised twice with stress related illness (abscesses. They suck) and been on heavy duty courses of meds three additional times for abscesses that didn't require surgery.
  • Lost my Dad
  • Seen both my sisters through extreme depression
  • a few other things that are less impactful individually but really add up when piled on top of all that.
I'm now on anti-depressants myself (for anxiety) and I'm going to start CBT so that I can manage myself better when I come off them. I am determined to come off them - not because I'm ashamed or scared they're harming me, but because I *need* to know I can live my life without support. I *need* to teach myself the control mechanisms. I can't afford to be dependent on drugs (in case of the apocalypse), people (in case they discover how horrible I really am and leave me) or any other external force. I have to learn to be me; individually, simply, independently me. And I have to learn how to be me and be healthy.

Please note - I don't equate "healthy" with "free from problems". My anxiety isn't going to go anywhere. What is healthy for me is to be aware, respond appropriately and manage its impact (a realisation I picked up from a dear friend who I'm convinced is completely oblivious to the impact he has on my life!)

Other than the medication, I have started to regulate my behaviour based on my anxiety responses. It's funny - the things I thought stressed me out *don't*. It's hidden factors that are slowly revealing themselves. On the bright side, it's about three million times easier to socialise and get to know people nowadays. 

I worry about people. I worry about events. And you know the stupidest thing? It turns out I can handle the worst life has thrown at me *ONCE IT HAS HAPPENED*. I just can't deal with the prospect of it happening. I worry. I stress. 

If people hate me and walk away - I can deal with that. I can live my life. I can cope. But in prelude to every single event, circumstance or whatever, I worry that I will say or do something that will make people hate me or walk away or whatever. Every single time. I worry so extremely it makes me physically and mentally ill. For years I could not walk into a room of friends or strangers without mentally running through every single worst case scenario. Every conversation I had up until this year was fuelled by adrenalin. And I'm a flight animal so with the adrenalin always comes a heavy surge of nausea and shakes (according to my therapist it's normal to want to be as light as possible in a flight situation - you do the math) which gave me another thing to worry about.

Did you know that every time I went to purchase something I had to battle with the prospect that this one unnecessary item would be the thing that made me unable to pay my rent or eat for a month? Did you know that if I got close to payday and didn't have a minimum of £200 in my bank account I would check it on a twice daily basis *minimum* to make sure no unexpected bills had gone out? I know my bill schedule - I know logically how much I need in my account at any time of the month, and track by those numbers for the majority of the time. But closes to payday? Hoo boy. Logic went straight out the window.

Funny impact - when I started anti-depressants, I had no impulse control at all. Because my actions weren't shadowed by constant dread, I did whatever I wanted. I came very close to being in financial trouble, but a well timed panic attack finally overrode the drugs and I've been aware of this need to look for healthy ways of managing my behaviour since.

I had another bad day more recently and it coincided with a couple of my Tweeps also suffering. I worried about them, so I wanted to help and help, but I couldn't - it exacerbated all my own problems and drove me deeper into the black hole. I couldn't understand it at the time, but with hindsight it makes sense. I left Twitter and I didn't miss it. I could - I can - control my own behaviour, even in this. I'm *not* an addict, I'm *not* compelled. I just need a reason and in this instance, wanting to be happier and calmer was enough of a reason.

I'm back on Twitter, back with my #fp friends, back with my awesome social circle of lovelies. Nearer home I'm beginning to branch out and meet more of my friends, ex-colleagues and acquaintances and building up a more regular physical social network. Got to be honest through - what with NaNo, my hobbies and my intense interest in the Regency, being my friend on a schedule isn't easy. I get super excited about little things and go charging off for a weekend at the drop of a hat. I used to have a "never cancel" rule, but to be honest that too was driven by anxiety. Now I have a "be a decent human being" rule. If I'd be ok with someone doing it to me, I'm ok to do it to them. So, no giving up on a once in a lifetime opportunity because I have a monthly game night to go to. 

Life is not easy. It's a struggle - it's a huge struggle some days, but that's ok. I paint pictures in my spare time, sometimes with words, sometimes with acrylics. I have begun to widen my habit of gifting people decorative items I've made and whether or not they like them, they claim they do and that makes me happy. At work, I have driven myself into exhaustion and that is beginning to tell, but the flip side is that my role is once again changing and growing and the college is aware of how I am moving forwards.

Next steps - an L5 apprenticeship in management, a Masters in digital education, an HEA fellowship and consolidating all of the digital learning systems in the college. Outside work I'm finishing my latest novel (I've been reading a lot of thrillers and it triggered something), reading more, and planning to exercise more frequently (again) but the big thing is that I am not wielding this as a stick over myself. It isn't a Must do - it's a want to do. And that is very important.

Now, I'm going to go eat something. And since my wisdom tooth is finally useable, it might even be something crunchy,

Love you

Friday, 19 May 2017

Statues in faith

They gather throughout the day to observe. These worshippers look to the light, not in adoration but with the fervency of true faith. They know their time will come; they see it nearing as they stand, frozen and heedless of the life flowing around them. Here a pair of children play tag around the enraptured statues. There a man eats a sandwich, a sliver of tomato escaping as he walks. A small hand slips into an unguarded pocket and liberates a purse. Busy women navigate the clusters, slipping through the gaps and weaving around obstacles without hesitation. Still they stand, gazes turned upwards, waiting to hear their call.

There are two main factions - one facing east, the other to the west, a stark division that they select and adhere to through personal preference alone, yet no mere preference could motivate such loyalty. They all await their moment, somemore patiently than others, with certainty. There is a delay. Some lose faith in the light and walk away. Most express their frustration and remain in place until finally their time comes.

The light travels faster than sound and many watchers have already turned to follow the guidance they have been given down their new path before the audio re-inforces the longed for message:

"Passengers for Cheltenham Spa please make your way to Platform 3 where the delayed 18:47 Great Western Railway service is now boarding."

Wednesday, 3 May 2017

I'm sick

So yeah. The wall I hit was apparently a physical one. I'm sick, again. These bloody abscesses.

Thankfully, although relying on the drugs is doing not-pleasant things to me, the antibiotics may have caught it just early enough. It's been getting bigger for the last 48 hours and I was very worried, but suddenly realised that I'm comfortable even though I'm due to take a painkiller in an hour. That usually means the infection is no longer chowing at my flesh.

It should still hurt under pressure and will not deflate fast (and I'll probably feel like crap until the antibiotics are done) but it should not get any bigger now and I should be able to sleep tonight without the aid of medication.

We'll see.

Friday, 28 April 2017

Ok then

Life is ticking along. I've been very productive and putting in lots of effort at work all week. Today I hit a wall. I think it's just the limit of what I can reasonably achieve under the current conditions.

I haven't been exercising. I have been restricting calories but not necessarily eating healthily, so I'm still losing weight but I have to be more careful long term - nutrition is important!

I haven't been writing or creating but that's ok. I have been doing cryptic crosswords.

This weekend I will be relaxing and enjoying myself, going out with Gavin and being non-self-judgmental. Next weekend I will see how I feel and if it's feasible I will start a new painting.

The most important thing about this medication - I think - is that I no longer feel like I have to outperform myself every second of the day, and the release from that stress is phenomenal. I mentioned to my GP I still get surges of dread, but even those are fading.

I might be a normal person soon.

A

Tuesday, 25 April 2017

Hey there

I had two weeks off work and I've been taking happy pills now for a month.

I feel better.

Not great. I'm not in a position where I can claim I'm 100%. I'm still grieving for Dad. I'm still super stressed at work. I haven't written or painted anything for ages. I don't feel great.

But...

  • I've spent the last few days working on a long term strategy for my department
  • I've been hiking by myself and walked through fields of cows
  • I've cried - properly cried, not uncontrollable hysteria - for my loss
  • I've spent time with family
  • I've been sleeping well
  • I've rested.
That last one? That's the important one.

I saw a GP not long after my last but one post and I told him how I never felt like I could rest. When I wake up I'm exactly where I was when I went to sleep. I slept well, but it wasn't working. He gave me happy pills with a tiny side order of diazepam.

I took a diazepam that night and I remember waking the next day and knowing everything that had happened. As I thought through the things, I felt the burden of taking each of them back on. I had put them down overnight.

It wasn't much, but it was enough. It made the next few days (week) easier. Then I had a panic attack and took another diazepam. It got even better. The happy pills apparently haven't even kicked in yet, according to my latest GP visit, but the temporary aid from the diazepam is such a relief.

I've taken three in total and I'm functioning like a normal human being. 

I'm looking forward to the day when I am functioning at my peak. And then I'll hopefully be able to quit them and be awesome without the aid of drugs. Right now I'm happy to be this.

-A-