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Crazy Like Me
By Rachel Bravmann
I had just finished watching One Flew over the Cuckoo’s Nest for the first time. The black and white photograph of Jack Nicholson’s face on the front of the slip-jacket looks truly disturbed and has always made me not want to watch it. That and the fact that so many people have told me it will be too upsetting for me. Chris, my ex-husband hated when people protected me like that. It reminded him of his father and how his dad always sheltered his mom from anything that wasn’t “safe,” robbing her of valuable experiences. I ultimately decided to watch the movie, despite people’s admonitions and what I had read was going to be an explicit electroconvulsive shock (ECT) scene. In fact, I watched it precisely because of that.
Despite its history of misuse, movies like One Flew over the Cuckoos Nest and A Beautiful Mind, and warnings of potentially severe memory loss, I elected to have ECT myself. I had tried all the medications and therapies, and it looked like nothing else could possibly help me. I felt like I couldn’t safely stand near our kitchen knife block. In a small, comfortable room, the doctor objectively suggested ECT to me, Chris, and my mother and father. No one pressured or forced me. I chose it with a mixture of anxiety, fear, and blind faith. I signed my name as a consenting adult, fully aware of the risks.
When I was twenty-five, my newly comfortable life ended. I caused a near-fatal car accident while reaching for a James Taylor CD. My friends survived with virtually no physical injuries but the emotional damage was palpable. I broke my neck and hit my head exceedingly hard on the steering wheel which resulted in a mild traumatic brain injury, triggering the loss of some cognitive and executive functioning and memory loss. I am told regularly-as recently as this morning-that I am very, very lucky to be alive and a fully functioning person on a physical level. And I am incredibly grateful. But on any given day I still can exhibit a laundry list of symptoms such as sleep problems, fatigue, nausea, loss of sex drive, distractibility, poor judgment, depression, agitation, apathy, fearfulness, impatience, thoughtlessness, irritability, confrontational attitude, explosive temper, fear of going crazy, guilt, shame, and helplessness. But the most bothersome impact of the brain injury was the effect upon my memory.
Who I am now, how my mind and memory function, is a combination of many factors. I live a life that is rich in the present, coupled with yesterdays that are a mish-mash of flimsy mental Polaroids packed with details filled in by others. Sometimes I’ll have a crystal clear memory and other times I remember things only to be told they never happened.
Other times someone will tell me something I have no memory of, describing it so vividly it makes me cry. I am frustrated by having to rely on other people’s memories; it’s like having my food chewed, I feel like a fledgling.
I can get a little crazy. I’m not being self-deprecating; I’m getting a head start on anyone else who wants to voice that opinion. My troubled mind preceded the accident. I was walking a mental tight rope from early on, but clinically speaking I was a fairly run-of-the-mill manic depressive. But then in a moment of carelessness with my parent’s gold Honda Accord, my life took a new path. In addition to breaking my neck, there were emotions and energies, new and more intense, surging through me like highly-resistant viral strains. Although I managed to move myself to Colorado, hold down a great job, fall in love, and get into graduate school, this disease and feeling of dis-ease went on fairly routinely for several years. Then everything hit the fan.
The first time I was in a psych hospital was four years after the accident. After a week of full-spectrum hallucinations precipitated by a minor fender-bender in Longmont, Colorado. It was a small rear end hit; our car was sandwiched in traffic. Chris had gotten out of the car quickly. I shook as I struggled to slide out of the car. I walked over to him as he stood between our bumper and the crumpled front end of an emerald green Jetta. I glanced at the teenaged girl getting out from behind the wheel. I told Chris that he was going to have to do the talking. I was certain I was going to hit her. My neck was throbbing. I panicked and sat on the curb. I looked over and the girl was squatting next to Chris in the street with her lace thong underwear sticking out of the back of her pants. It was the metaphor of a lifetime for me. My life hadn’t been a pair of thong panties in a long time. My life was no longer filled with casual, sexy, liberating thoughts, but with practical white-granny panty days. The course of my life changed again. I proceeded to quietly lose my mind.
The first facility was in Ft. Collins. It was surreal from the moment the intake doctor told me I was making it all up; to when they wouldn’t let Chris leave because they were sure he was a patient. My roommate was having ECT and for the first week I was there she just lay in the dark never saying a word. I took some satisfaction knowing I was better off.
Not that I was doing well. They did take my shoelaces away, but gave them back the minute I requested them, no questions asked. I was schooled in social work and even in the state I was in, this discernible slackness astounded me. After being told I had lied to get into the facility, I wasn’t too receptive to their wisdom. I concocted a much less tragic persona and got out of there as quickly as possible.
Chris and I moved back to Seattle where I grew up and had doctors who knew me well. I quickly was back in the hospital, making origami swans and generally being good. I was released after two weeks and maintained for a while. Then I entered another deep depression and ended up back in again. This time I checked myself out after the attending physician suggested that all of my problems were “family-of-origin” issues. Regardless of the possible truth of his suggestion, I told him to stick it. With sheer teeth-gritting will, I managed to hold it together for a year.
My last time in-patient was five and a half years ago. This time I was in a different hospital, a much better one that was Catholic run. Being Jewish, and not knowing many things Catholic except stereotypes and my lapsed ex-husband’s experiences, I expected it to be severe and chilly, but it was the opposite. It was two days after the September 11th terrorist attack. In retrospect I see that people’s guessing the connection makes sense as I have a very thin emotional membrane for filtering sociopolitical events. But my meltdown had far preceded that fateful event.
I found myself soothed on the surface by the hospital itself, the tall-windowed rooms full of light, the helpful staff, and the late night packets of hot cocoa mix. All of these things made me feel just a little bit safer, a little less like I was shattering. There was group therapy, which moved as slow as paste. There was more “art therapy” with more origami. Other than eating better, and smoking a little less, nothing was changing. I wasn’t changing. I was more depressed than ever. My days were routine - medications, therapies, journaling. Shampoo, rinse, repeat.
After three weeks of no improvement, my doctor finally approached us about a possible solution - ECT. I remembered my roommate in Ft. Collins and was petrified by the sheer magnitude of what that implied. In my mind it meant that I had truly crossed over into the realm of being crazy. I was beyond cure. Just the day before, some asshole eating lunch across from me in the community room had bragged that they didn’t put him under all the way before his treatment and that he had felt it. I knew he was lying, but still it heightened my fear.
My doctor warned me about the memory loss, but assured me it was transient. Subsequent doctors concurred. When I considered the existing memory loss and the cloudiness from my meds, it didn’t seem so grave. I felt my only other choice was to try and wait out the cycle of illness, but this depression was by far the most stubborn I had experienced.
I was at the end of my rope. I figured now was the time to hang myself or pull myself out of the hole.
I remember a psych ward attendant getting me from my room and taking me to the ECT waiting room. It was a good room. Magazines like People kept me distracted by the vaunting the Worst Dressed at the Oscars. There was a big Jacob Lawrence print on the brown wall. It did a lousy job covering a floor to ceiling crack rendered by the big February earthquake. There was a sign on the bathroom door telling us to “empty your bladder” before treatment. I found out why. The hard way. ECT’s electrical currents stimulate all sorts of things, including the muscles that make you pee. As if the experience of walking through the door marked ECT weren’t embarrassing enough, walking out into the community room with a big wet spot on your crotch and ass sort of rounded it out. That day was a nice, clear testament to my incompetence and my incontinence.
The waiting room was a mixture of inpatients and outpatients. I noticed in later days that there were always a lot of older adults, seventies and eighties, being escorted by their children. I always wondered, “Was this destined to be my life?”
After about ten minutes, a nurse named Molly with short curly brown hair called my name. She was wonderful. Molly sat me on a stretcher and explained everything. I remember, this with crystal clarity that she told me I was going to have a controlled seizure caused by electric currents induced in my brain. I didn’t know what that meant. When I'm nervous I don’t think clearly, but I didn’t ask. Later it was explained to me that I would be given a muscle relaxant so I wouldn’t have convulsions, except maybe in my toes.
Then it was time. Molly started sticking these electrodes to my chest and head, the machines started beeping and I had a panic attack. Molly was sympathetic and gentle; agreed to wait until I was under the anesthesia to position the electrodes. She must have noted my fear in my chart because she made sure everyone respected my need to be “out” from then on. Because of her, I didn’t feel like a whiner.
The doctor came in, said “hi” and smiled reassuringly. The machines were beeping, and my pulse and vitals scattered across the screen, just like on ER. The anesthesiologist arrived and I found I was looking forward to seeing him and to the idea of drifting off, to the overwhelming world melting away. But even with the most talented professional, finding my veins was always a ridiculous endeavor. It took up to eight dry pulls before the doctor found an active vein.
It was as I had imagined, the anguish left my entire being, and my mind was blessedly quiet for the first time in months. It was so much better.
I woke up in an ECT post-op. I was helped off my stretcher and then I sat up in a light blue vinyl Lazy boy-type chair. I was little confused, just like I’ve felt after surgery; dazed and a little drugged. There were a few of us sitting silently in the room.
After about 20 minutes I felt more grounded and went into another larger room with tall windows, and several folding conference tables pushed together. There’s a white board that says where we were and the date. Underneath is a big smiley face in red ink. I had my choice of little cereals in one-serving boxes, as well as coffee. Here I was under the watch of Mandy. She’s also terrific, and she helped me orient cognitively by asking me simple questions. “Who’s the president?” Even in my drugged state, all I could say was “Yuck.” After I had eaten and relaxed for about an hour, I went back to my room. I was really sore the next day; the seizure, even though controlled, tightens up your body. The depression started to lift as early as the day after the first treatment.
I don’t remember ever talking about it with other people on the floor except those people telling tall tales surrounded by avid listeners. I wish I had heard more about other people’s experiences, but I never found a support group. With a lot of searching I’ve found some mixed online resources. For every site expounding on the safety of ECT and its benefits, there are two more broadcasting how evil ECT is and how ignorant we all were. I don’t feel safe posting messages on a board where I might be emotionally ransacked. This is a constant reminder of the isolation that I feel.
I’ve had another twelve to fifteen treatments since I’ve been an out of the hospital. The treatments seem to do their job of short term relief. But in the long-term the cycles continue. I’m learning to deal with that. And I’m coming to grips with the fact that in the absence of new medications, the ECT may be a repeated commitment. After 17 years I struggle to try and live with chronic mental illness graciously; to live in a way that doesn’t inconvenience my friends and family, or require me to hide myself in a culture that fears, stigmatizes, and ignores mental illness. I fight the urge to smother my personality for other people’s comfort.
This may be my Everest: I can fall at anytime, by a misplaced foot or a gust of nature’s breath.
All day long, every day, my speech is still peppered with, “can I ask you something?” “Can you explain to me again…?” “I can’t really remember doing/saying/thinking that, can you tell me about it?” It’s frustrating and embarrassing, but friends and family are kind and patient. I think it’s obvious how anxious it makes me to have people repeat things time and again. The routine has gotten more matter of fact over time and I feel less guilty, although I am still a bit uncomfortable and feel overdramatic trying to explain about the head injury and the ECT and my having a memory like a colander. And although I understand people’s good intentions when they say ‘oh I know what you’re talking about, I have a shitty memory too,’ I find it frustrating. Being a touchy-feely person by nature, I suspect that trying to show empathy may be a way of diffusing the discomfort of the consoler. I feel the support of these people, but I am often left feeling more alone and insecure, assuming that they think I’m being grandiose.
I used to think I couldn’t remember things before the accident. But I do remember some things. The book Harold and the Purple Crayon. The night of the eclipse in Bellevue when someone took my temperature in my bottom while I was lying face down on my parents brown velour bed cover chewing on the nap. The grassy knees of my Hee Haw overalls. Bilbo’s, the Mexican restaurant on Orcas Island back when Eastsound wasn’t paved. The smell of the kidney-shaped pool that lingers in my grandparent’s elevator in San Diego. Dressing up as a Cheerios Box for Halloween. Playing “Come Here Little Muffletuff” with my mom. It’s not a total void.
But the only first kiss I can remember is from my Chris, when I was 27.