Tuesday, January 21, 2014

No. 135 – Passive

Performer: A Perfect Circle
Songwriters: Danny Lohner, Maynard James Keenan, Trent Reznor, Billy Howerdel
Original Release: Emotive
Year: 2004
Definitive Version: None.

When Laurie scribbled an illegible signature on the consent form for ECT at Evanston Northwestern Hospital, it was only the midpoint of what turned out to be the most emotionally draining period of my life. Now we actually had to undergo the procedure itself. It was scary, but the only thing more scary was Laurie never getting better.

The plan was Laurie would go in for the procedure two days later at 6 a.m., and I’d be there as support for her—and to make sure she didn’t back out. You know what they say about the best laid plans, right?

To try and recount everything that happened that morning would be overwhelming, although I bet I could do it. Fortunately, I don’t have to. I have an in-depth account thanks to the daily emails I sent to everyone letting them know of the situation. The following report was sent June 12, 2008. It hasn’t been edited except to clean up typos and punctuation. It’s very long, and I think it captures the tone much better than I could recreate with the distance of 5+ years behind me. Don’t say I didn’t warn you:

***

Got to the hospital at 5 for the ECT, and—this will come as a shock—it was a total SNAFU, FUBAR and Mongolian clusterf--- to use all my proper military terminology. No one thought to leave a note saying I was coming, so guess what? They wouldn't let me upstairs.

I was about to kill somebody, but the nurse called Dr. Anderson—at home, at 5 a.m.—and I was cleared. Laurie was not yet downstairs, so I wasn’t too late. They'd send someone down to get me at 5:50. (Because it was so early, the regular main entrance wasn't open yet; I had to go through ER.)

Well, it's going on 6 and the security guard, clearly seeing my agitation build, called upstairs to see what was what. He got a call back about 10 minutes later: Someone was coming. We went up to where the ECT would take place and they said Laurie wasn't down yet. Whew, a reprieve.

We go upstairs to the psych ward. Nope, Laurie's already left, said the none-too-apologetic nurse (whom I have not had the previous displeasure of meeting yet), but they’d have it all straightened out for Friday. "Best I can do."

Needless to say, since this was the first treatment and thus crucial to establishing trust and that my presence would go a long to way to establishing that, if this was the best they could do, it pretty much sums up my opinion on the human-relations management aspect of Evanston Northwestern: It sucks, big time.

So, back down to the waiting area by surgery after firing off a phone message to Dr. Anderson dripping in righteous indignation and anger (but, believe it or not, profanity-free). I waited there about an hour or so, when finally one of the assistants from the fifth floor came to get me and say they were going to bring Laurie up shortly but that it might take time, because she wasn't ready to be transported via wheelchair.

When they brought her up, Laurie was fast asleep, and the questions came fast and furious. The assistant, who obviously didn't get the memo that everyone's supposed to be treated with contempt, answered them all. Laurie did fine. The whole thing took about 3 minutes but that the procedure itself including the prep was about an hour. She was out of it when they took her down and didn't say anything. (Thankfully, she didn't say, "No.”)

He said Laurie had about 11 seconds of convulsion (foot tremor), which wasn't much. Typically they like to see 28 to 40 seconds. Great. So a potentially ineffective treatment—$250 plus anesthesiologist fees and God knows what else—down the drain.

Dr. Anderson came in at about that time and after profusely apologizing for the morning screwup said the depakote could've affected the length of seizure because of its sedative qualities. She also said they're stopping the haldol, in addition to the depakote. Anyway, both she and the assistant, whose name I unfortunately have forgotten but will get, so I mention how good he was when the time comes, said that while I'm welcome to come back Friday morning early, they recommend that the prep takes a while, and it would be more beneficial to be up on the unit at 8, when Laurie gets back there. I'll have to discuss with work about this; I don't think they're going to go for me routinely coming in at lunch.

They said they'd let Laurie sleep a bit on the gurney and then get her up for breakfast. I said I'd stick around, but given the news and the details, I sure wasn't expecting anything.

Well.

Let me just say that I've been told that effects would probably not be dramatic and likely won't be sustainable until Laurie has enough treatments. That said, after she was rousted from the gurney, got to her chair and was brought breakfast, Laurie said the following to me in less than an hour (and remember, this is compared to maybe 40 words total in the previous four days):

"Whoopie-cushion chair"
"Yes" (something she has said maybe twice in a week and a half)
"No"
"More juice." (A favorite. She might have said this five more times as she put down three things of cranberry juice.)
"Why am I here?"
"What about my job?"
"What about YOUR job?"
"I'm cold."

Then the following conversation took place, verbatim:

L: "Some cream of wheat."
W: "Of course, of course. It's a little stiff. Do you want some milk in it?"
L: "No. I'll try it as is."
W: "How about some sugar?"
L: "Artificial sweetener?"
W: We got some Equal."
L: "Perfect."

Then after a couple bites.

L: "I want some milk by itself."
W: "You want a straw or out of the container?"
L: "A straw."

After a few sips:

L: "Put some on the cream of wheat."

(Editor's Note: Compared with how she's been the past 10 days, this was Shakespearean-level dialog happening here.)

"What are these for?" (in response to the nurse bringing her her pills—can't say I recall her asking this question in my presence previously.)

"I need to push it back." (explaining why she wasn't able to swallow one pill)

And then came the capper:

"Why does my neck hurt?" (This is literally a question she has not asked the entire time her head has been hanging down, which it still was, I should point out.)

Finally, she said, "I'm ready to lie down now."

When I got her into bed, she moved stiffly but so much better than the past two days and again complained about her head and neck. I told her it's just going to hurt, because it's sore from being stiff, but she should think to work on it as much as she could. Then I explained that I had to go to work and that I'd be back tonight, and she said OK. I told her I loved her, and she responded in kind, and then I said, "nochy noches," our Spanglish code for nighty night and she repeated the phrase.

She was groggy, tired, but in all honestly, it was perhaps the most lucid I've seen her the entire time she's been at the hospital. I say that, because in addition to the lucidity, which we've seen, there wasn't a single instance of confusion or paranoia in what she said. All of it might have been brief, but it was all logical and clear.

So, yeah, I am an absolute convert on ECT. It's definitely the way to go. I know that there's still along way to go, and I fully expect Laurie to be out of it tonight again when I visit, but if yesterday was the first time in a month that I've seen a light at the end of the tunnel to this ordeal, this morning I saw that maybe—to steal from Metallica—it's not just a freight train coming my way. If yesterday was the first time in a month I let myself fantasize about what bringing Laurie home again from the hospital will be like, this morning I saw that it might actually happen sooner rather than later.

***

Obviously, I was encouraged, but I tried to temper my optimism as much as possible. I was afraid that the clear improvement I saw that morning—even in my ignorance—was illusory. However, although I didn’t know it at the time, a corner had been turned. Laurie was on her way back.

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