December 01, 2006


...of one of your doctors, the one with the electricity
in her hands, the seizure control, your brain,
the one with her parchment, her calligraphy pens
and fondness for what you would never call
even in the most polite company the F word
but say it out all four letters naked under the sun,
a dream of someone you trusted with the frailty
of your life and the brain that has served
you adequately, though not as well as it could,
a dream that she not plays but is Medea, hands
sticky with her boys’ rich, warm, lifeless redblood,
a dream— but is it only that or does it say something
more than the mind’s fanciful confusion
of its female characters? You can’t will yourself
to forget this collision of identities any more
than the expert silver burglar can forget the success
of his life of crime and go chalk-line straight.
There is only one question in the back of your mind:
will she handle you with care or play out the script,
taking your life not just in her hands but with them?

Thhis poem is about Dr S at St R's hospital, where I had my second set of ECT sessions (electroshock therapy). The first 8 were voluntary, as I believe I have written elsewhere before. But I grew terrified of the anesthesia, which I experienced as falling off a cliff into an abyss like a black hole, being sucked into it really, then seconds later being hurled back to consciousness, only to immediately vomit, sometimes all over myself if the recovery nurses weren't prepared. The vomiting wasn't so bad though. It was the experience of being sucked off the cliff into darkness then propelled violently back to the world that scared me to death. So one day, instead of agreeing to follow the others like sheep to the slaughter (we had to walk a long way from the ward to the ECT suite on the other side of the hospital) I snuck to the kitchen and stuffed a pear in my mouth and ate it as quickly as I could. That effectively ruined my ability to have ECT that day as you were not allowed to eat or drink anything after midnight.

After that episode I simply refused to go, and since it was voluntary and I had asked for this treatment in order to rid myself of the delusional need to set myself on fire, which ECT had effectively cleared one other time, no one could make me. So I thought. But one day Dr S came into my room and started talking about the need for me to continue ECT, how I was not doing well, had been in the hospital a month and had not improved and that ECT was the treatment I needed as pharmocological interventions were clearly not enough. THEN she said, softly but clearly, you are going to have ECT whether you like it or not and I have the authority to make that happen. You have to understand that. Whether you go willingly or kickiing and screaming is up to you. But eventually, you will go. Do you understand what I'm saying?

I didn't believe her, frankly. I didn't believe there was any way she could force me against my will to undergo such a barbaric treatment. But as you all know, there was. She took me to probate court, got Lynnie assigned as my conservator and also got her to agree to sign papers allowing Dr S to give me ECT involuntarily...Needless to say, I was pissed. But I also sorta knew it was for the best as I suspected nothing else would work to rid me of these terrible thoughts, frightened as I was of the anesthesia. Amazingly enough, the second series of 8 sessions was not as bad as the first, and I got used to the anesthesia after all. But as for outpatient maintenance sessions, once a week to begin with, diminishing to once a month eventually -- those I would not tolerate and despite the court order, I decided to risk it and refuse, figuring no one would force the matter after I was discharged, nor would the police actually come 35 miles just to pick me up and forcibly bring me to St R's for the treatments! I was right. I wrote a note to Dr S telling her why I wasn't coming and mailed it, and no one made any fuss. I simply dropped out of treatment and never went back.

A few months later I set my leg on fire, but I think that was due to the general failure of the treatments not to my refusal of maintenance.

Anyhow, as to the poem, in my dream Dr S is Medea, an ancient mythic Greek woman of whom all you need to know is that she murdered her two children, sons, in order to get back at her husband, Jason of Golden Fleece fame. To dream of the doctor this way is very suggestive as she literally had my life in her hands, as the poem says, and that is what it is all about.


Joe's bipap alarm has been going off every night several times, and we thought the machine was broken, that there was an air leak somewhere that was triggering the alarm, which simply wouldn't stop. But even with a new machine, last night the alarm woke him and he realized, being more alert than usual, that he had not been breathing, and that is why it had gone off. That is what I fear the most, that this sort of apnea -- stopping breathing briefly or longer during sleep -- which ought to wake him to take a breath, won't do so because of his sedation. But he feels so good and alert during the day that I can see why he just doesn't want to spoil that by taking any Zyprexa then, and I appreciate that immensely. When I was on Zyprexa, the visiting nurses and Dr O made me take all 35 mg during the day so they could make sure I took it. But it made me sleepy, so much so that my day/night cycle was reversed and I'd stay up all night simply because it was then that I felt most alert. Damn, this is a problem! I don't want him to have an iota less of quality time during the day...Yet I fear for him at night, sleeping as deeply as he does with a tendency to accidentally take off the machine mask and not put it back on...

I had an aha! moment with Dr O on Wednesday when I finally understood part of step two that I hadn't before. When I have a feeling -- the reason for her mantra "the feeling is primary" -- like rejection or feelings of being hated or of fear, it is so intolerable to me that I IMMEDIATELY resort, or my brain does, to making up a story to render the abhorrent feeling null and void, irrelevant or unimportant. If the story is so much worse, the feeling fades into the background and goes underground, and I focus then on the story, the delusion my mind has constructed in its effort to avoid feeling the feeling! I understood this viscerally, in a way I hadn't before...Or had perhaps understood several times before, but it felt like something new. It must seem like I have the same revelation over and over to her, to you. But I keep losing the insight, losing insight altogether, and have to regain it all over again, especially after a hospitalization. I imagine it must be frustrating to Dr O, though she doesn't show it...

I think part of the problem is that I don't pay attention very well. So I keep missing her explanation and don't know how to ask her to repeat herself, so ashamed am I of NOT paying attention. I fake it most of the time, since I have not heard a lot of what is said. I try to act like I understand much more than I do. Oh, sometimes I am there, and do pay attention. But only when the sentences are short and the answer or question is short. When faced with a long unbroken question or soliloquy that I can't interrupt with a question or anything to chop it into hearable quanta, I lose attention within a minute and have to keep pulling myself back to whatever is being said, which gets harder as I lose the train of thought, missing more and more. This is my problem with reading as well. I can't keep my attention on the subject at hand very long, but start daydreaming or thinking about other matters very quickly, sometimes before I've read a full page. Occasionally I get into the reading and can read several pages before becoming distracted. But usually it is only a few at best...Partly I get sleepy, but mostly I simply zone out and start thinking of other things and lose track of what is being said on the page. Ditto conversation. I have to try very hard to pay attention and NOT lose track. If I do even once, I am sunk as everything hinges on staying in touch. With Joe I can ask him to go back and repeat himself, though he never realizes quite how far back he must go. But not with most people.

Posted by pamwagg at December 1, 2006 10:37 AM


Margaret Manning, a psychologist who received ECT for devastating depression and later wrote the book "Undercurrents," described her first ECT session this way: "I am covered with hands. They take hold of different parts of me, staking out their territory. Voices tell me that this is a dance done hundreds of times before, so I need not be afraid. But their casual confidence, their ease with my body, gives me no comfort. Just as I have lost so much of myself in the past year, now I lose more. I offer myself up to these strangers in exchange for the possibility of deliverance. Someone holds my hand and sleeps needles under my skin. Another slides down my gown and plants red Valentine hearts on my chest . . . They cover my mouth and nose with plastic and instruct me to breathe. For several horrible seconds I am paralyzed before I lose consciousness. This is the nightmare that has haunted me since I was a child. I am on a beach, caught between a tidal wave and a towering seawall. In my terror, I am frozen. I cannot run, or move, or scream. The waves slam me down and take me with them. I am drowning." To sooth herself over the course of her half-dozen treatments she recalls with each one a fragment of a poem: "I let go of all holds then, and sank / like a hopeless swimmer into the earth." Upon her arrival home after the sixth treatment the remainder of the stanza, previously forgotten, returns to her: "I let go of all holds then, and sank / like a hopeless swimmer into the earth, / and at last came into the ease / and the joy of that place, / all my lost ones returning."

Manning, blessedly, did experience the remission of her depression and continued to think well of her doctor. Still, Pam, read this passage from her book and note the interesting parallels (which I will not attempt to analyze) between her visualizations and your dream: "Dr. Samuel summons me by loudspeaker. I am struck by two intense feelings each time I see him--surpise and nausea. In between treatments, his features are one of the few things that sharpen in my memory. His eyes get darker and meaner and his teeth grow pointier. His voice lowers to a growl. And I always remember him as very hairy. In the flesh, however, he is a soft-spoken man with a gentle face, normal teeth, and an average amount of hair . . ."

Well, enough, for sure. As usual, I have addressed your many points in the most skimpy and haphazard fashion, but I mean well!


Posted by: Cynthia at December 2, 2006 08:24 PM

Dear Pam,

I only spent time in a hospital once overnight early on in my illness so I've never encountered electric shock therapy. The idea of it frightens me but I can see using it as a last resort. There just aren't so many options open to schizophrenics. But to be FORCED to do it is beyond my imagination. No wonder you envisioned your doctor as Medea, cold blooded and powerful.

Paula mentioned Sylvia Plath. Here's a quote from the book GRACEFULLY INSANE by Alex Beam: "Plath's story was approaching its climax. Barnhouse decided to gamble and proposed electroshock therapy to the young girl. The idea of shock therapy was plenty scary, but it was especially scary to Plath, who had suffered through several painful and impersonal shock sessions at the hands of Dr. Peter Thornton and then Kenneth Tillotson at Valley Head Hospital that summer. She had received no anesthesia for the treatments, and after being semi-electrocuted, she had been wheeled into an empty recovery room to cope with her trauma." (p.154) Plath then went on to consider suicide but soon after this she resumed the shock treatments briefly and improved a great deal. Plath writes: "Why, after the 'amazingly short' three or so shock treatments did I rocket uphill? Why did I feel I needed to be punished, to punish myself." (p. 155) It's interesting to note that at that time she felt that the treatments were a good way to punish herself and so she responded well to it, at least temporarily.

It seems to me that ECT is only a temporary palliative in some cases and in other cases a mis-treatment with negative consequences. Not particularly trustworthy though it's been used for decades. Just goes to show that the experts don't really know what they're doing when it comes to treating mental illness. The anti-psychotics meds are also partially effective for most people and for others not at all. All in all an incomplete treatment at best. Still, I'm hoping this may change and have respect for those who do research into creating more effective drugs.

P.S. Roberta, I'd be very happy to read more of your poems. Please do post some more.

Posted by: Kate K. at December 2, 2006 02:15 PM

Dearest Pam,
Your poem is certainly of the "confessional" genre, and as such, it chills me to the bone. You know my strong feelings concerning having treatment forced upon anyone, and your poem is so consistent with the works of others who have had EST. Sylvia Plath felt just as you did, and my heart almost stopped when Big Nurse had her day in the sun, when the fictional Randall Patrick MacMurphy was lobotomized. The worse part is that you suffered such physical and psychic agony only to discover that the improvement was only temporary. I am paralysed by my indignation.
It is amazing to me that you reveal such psychiatrically significant reactions to your therapy in your blog, but it appears that neither Lynnnie nor Dr. O. ever READ it. If they did, it would be worth a dozen therapy sessions. How can Dr. O. help you in any substantive way if she doesn't realize that you aren't even listening? If she knew about how your concentration disappears when she launches into long speeches, perhaps she would modify her advice by presenting it in short, quality sentences that you can follow and remember. Even better would be if she adopted a sort of "question and answer" method in which she would periodically ask a question that would key her in to whether or not she has lost you. If you can't tell her yourself for fear of offending her, why don't you copy this and bring it along to your next session WITH the preceding blog that inspired my comment. I feel strongly that you both would benefit immensely.
As for Joe, I quess I was wrong in suggesting that he is as 'thick' as I am, but in the long run, what I think is not important here. It is you who must decide(which you apparently have) that just as Dr. O's words of wisdom are essentially wasted on you when you are not listening,so is all your caring, worrying, and advising wasted on Joe since he will not heed your advice. All you can do in this case is to give him all the love and support that you can, but you must stop feeling responsible for his physical and mental wellbeing. You have filled your plate with far too much for you to handle once again. Please let it go, Pam. You have tried earnestly to help him, but now you must realize that what will be, will be. You cannot save the world,Pammy. Your first responsibility is to yourself. I will end here, wondering how you can possibly read my long and laborious comments. I really must try to be briefer.
So caringly, Paula

Posted by: Paula Kirkpatrick at December 2, 2006 08:08 AM

WOW!!!!!!!!!!!!!! and thank you!!!!!!!!!! You made my day!!!!!!!!!!! As far as publishing I am not sure what to think of that. To me my poems are basically written just for me, kind of like journaling. I feel that if others read them they will not get the same kind of feelings that I do. Weird, I know!!!!!
And thank you to Paula too!!!
I will post more if anyone is interested???!!!
Again thank you to Pam for allowing me this space and I will continue to read your blog as often as possible.

Thanks again,

Posted by: Roberta at December 1, 2006 05:42 PM

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