Friday, February 29, 2008

No Change; Despair in Ascendancy

Today is leap day, and if I calculate my treatment correctly it corresponds to my tenth ECT treatment. I went in in tears and I was in tears before they put me out and put the electrodes to my head. I told my doctor that I wasn't getting better, that I was getting worse. He seemed to hear me because afterwards he loaded me down with some new prescriptions and increased some of the old. You want to see my menu? I won't go into all the dosages, I'll just name the medicines: Prozac, Wellbutrin, Trazodone, lithium, Klonopin, Invega, plus aspirin and my blood pressure pill. Some of the dosages are really high; Wellbutrin, for instance, is now 600 mg. day, which puts me at risk for having seizures from it. (Since I am paying to have seizures induced I expect that's not a bad bargain.) My Prozac is at 80 mg./day, four times the usual dose. Invega is new, an antipsychotic that differs from Abilify, the one to which I briefly responded. The addition of lithium, 1200 mg./day and Trazodone 150 mg. for sleep are both new. The doctor would prefer I take Trazodone if I can't sleep rather than Klonopin, as Klonopin is a mild anticonvulsant and we are trying to elicit seizures. I know, I know, that's a lot of medication and a lot of electricity. It is only evidence of how desperate I am after nearly two years. Come April 1 I'll have my two-year anniversary of the onset of this depression, and during that time I may have had three months remission, total--spread out over different times-each time thinking I might have made it through the eye of the proverbial needle only to have the meds quit working after a brief time. This length of depression sets a new record for my 53 years; I have never been depressed so long. I want to weep as I write this but by force of will I won't allow myself to do so or I wouldn't be able to type.
People tend to wonder what this depth of depression feels like. All I can say is that what makes me saddest is the notion that someone loves me, because I feel so utterly unworthy to be loved, and the certain intellectual knowledge that my dear wife, Kathleen, loves me, consistently brings tears to my eyes. "Why is she wasting her time with me?" I think to myself. "How could she possibly love me if she knew what an awful person I am? Why doesn't she cut her losses and find a life partner not afflicted with manic-depression, someone more emotionally reliable?" But her love and loyalty are beyond question; to me they are absolutely supernatural. Underneath the darkness in which I travel, I know I am in love with her as well. For all time. Forever. And it is true that I have nursed her through some serious depressions for my part, and she came through and found the light. But she's never had a depression this long and this bad in our nearly nine years together, and I don't know how she holds up under the strain of my continued illness.
Little things can break me. "Can you make some coffee?" Yes, but in beginning such a simple task I feel overwhelmed and I suffer severe doubts as to whether I will, indeed, be able to make coffee, and the spectre of failure is always on my shoulder, whispering, telling me I can't do an effin' thing. I am so sad that I think if my sadness were parcelled out to every man, woman and child in this country the entire nation would be clinically depressed. And what am I sad about? I don't know. My daughter's death occurs to me, but that happened July 29 and I felt that my grief for her, though painful, was healthy and healing, I welcomed it as a relief from depression--not that I welcomed losing my daughter, naturally, but that the experience of having an appropriate emotion for a change felt good and right and human. Whether that was just a phase and the grief subsequently piggy-backed on top of the depression, I don't know. Because when I cry now, I cry for crying. I cry for the emptiness, the hopelessness, the devastation I feel inside the hollow of my chest. I feel as if I'm made of wicker or papier mache'--there is just this hollow inside containing nothing but an infinite sponge of grief, just squeeze my arm and it will leak. And fear? Fear attends everything. I'm afraid to rise up and afraid to sit down; I wish with all my heart that I were confronted by a real danger, a man wielding a knife, for instance, so I could lay it on the line and do my damndest, but life doesn't work like that.
I was reading a clinical treatise on ECT last night and although it was twenty years old, it was clear that they didn't know how or why it worked, and nothing I've heard since elucidates the mystery. I conceptualize it as a re-set button on a computer, a wiping of the disk that has become frozen in one repeating affect. But who knows? And there are side effects. My memory for this period is very poor, I have trouble with directions; the internal architecture of my geographic perception is much reduced, I feel as if I have entered Flatland, because normally when I think of directions I see the actual places and turns, for the most part, and I can trace the pattern with my finger in the air. Now directions seem more like words without the maps attached.
Whatever I am, I am not me. I'm a shell of myself with all the filling sucked out. Craig has sprung out of the box of his body and we don't know how to get him back in again. What you meet, what you see, is a construct of Craig, a golem that looks like Craig but really ought not to cast a shadow. My essential Craigness is gone, my way of looking at the universe, my take on literature, humor, my daffy take on so much, it is not there. I cannot laugh except out of politeness. I shudder to give any advice, fearful it may lead to trouble. I crave the simplest tasks, tasks I can do like sweeping or washing the dishes. In short, I don't know who I am. I've lost myself. I don't recognize myself in the mirror; what looks back at me resembles me (with extremely puffy eyes), but it does not feel like me. To touch myself is to touch a golem, a doppelganger, a very weak approximation of who I am as a human being. That I have lost such normal sensations of the self argues that perhaps my sense of self was always very tenuous, but I can assure you that in my manic phases I was more self than anyone wanted to put up with. I was simply too much, knew too much, did too much, slept too little.
For those joining this story late, the onset of symptoms of my depression coincided exactly with when Kathleen and I moved into our quite little house in the redwoods, and all the trouble and sturm and drang and torture of Mexico was behind us. I couldn't believe how quiet everything had become; where was the pressure, where was my next struggle, my next date in a Mexican court or jail, how would I keep up the spirits of my dear wife, there was always purpose and work, both of a nature I didn't want, but I was busy. Busy combatting evil. It was like I held my breath all the way from Mexico until I had us and our dog in a safe dwelling in the beauty of Northern California before I could collapse altogether. And then I did collapse altogether. Sure, I've tended a garden, written much, played music, cooked, hiked, fished, and all the other activities I might have usually done, but the savor is gone from those activities. I walk through them like a ghost. I don't feel present. Like I said to the anesthesiologist this morning, "I hope I don't wake up." I don't. I hope a boulder would fall on me to put me out of my misery. But I won't consider suicide because I know how awful that is for your loved ones, as my father burdened our family with that event when he was 62. I keep telling myself I'll get better someday, but all I have is the terrible now, the feeling of devastation, as if Napoleon and all his armies had marched through my chest and where a heart was is now a vista of burnt and blackened fields. It's a sadness that won't abate, won't relent, can't be forgotten for one iota of a second. The pain my my solar plexus focuses everything inward, like a black hole bending light to its center. If I touch you I'm afraid I'll steal something from you, some life force or animation that inhabits normal people, good or bad. I can't own who I am in this condition because I am not who I am. It's more alien than being another gender or a different animal. If I were a horse and could experience horsness I would count myself blessed. But as a depressed horse, I couldn't experience horseness for that matter; there is just this acre of sadness and tears inside the field of my soul, a graveyard if you will with no redeeming virtues, where no one is mourned because there's nothing to mourn although it feels like an absence of something.
They say 10 to 15 courses of ECT are the usual limit, and already I wonder what's to become of me after I've had 15, which shall be in less than two weeks. Then what therapy is available? Is there a halfway house for the superdepressed, a place where manual labor can be enforced to make our bodies feel as if they were our bodies? I think of some wilderness journey, some extreme physical trial as a possible antidote, something so physically dangerous that I have to pay attention to my body until I begin to inhabit it once again else die trying. You'd think with all the advances in biological psychiatry that someone somewhere would have an answer for me. I'm open to anything. I would try religion but religion just makes me feel more damned, I feel so unworthy of God's love and forgiveness. And it does not escape me that my inability to receive love and laughter could be a form of the Devil's pride, a "You can't help me!" game. But it's not like that. If only God could reach his healing hand inside my empty chest and light a spark, a small flame of Craigness, a hint of self, I think I could make it back. But that isn't happening, and if I start frequenting Pentecostal churches or healing services I'll just end up feeling worse, like my lack of ability to be healed is an insult to God and man and faith.
Too bad we are symbolic creatures, too bad we can think about our inner states in words. If I were a cow and depressed, I'd just stop eating and socializing and eventually die. Because I am a man I can by sheer will make myself get up, get dressed, eat something, try to do something, even though all of it seems like play-acting self-deception of the lowest variety. You see, I don't believe in me. I lack faith in my own existence. If I knew someone else in this condition my fervent wish would be for their death and release from this vale of tears. I don't know how to feel any lower. Feeling low is all I know. Or better, feeling alienated from my former self. After oodles of medications and ten shock treatments I'm just as bad as before if not worse, because I'm having my last hope taken from me. I can't imagine living another 20 years like this; I wouldn't wish it on my worst enemy. I would do anything to get well that doesn't involve hurting another person or creature. The greatest kinship I feel is with plants, if I feel any kinship at all.
So this is my condition. This is what I'm being treated for. This is what I'm indebting myself for financially to have treated, piling up debts for the future should I ever get well enough to pay them. I don't want to be a human anymore; I would be insentient as a stone, I can't stand the pain anymore, I understand why adolescents cut themsleves for relief, but in my case a good cut wouldn't help because it would have to be sewn up. Am I making sense? I'm no better than a sock monkey; no, worse, because sock monkeys don't have feelings. I don't know how not to feel, you'd think this array of drugs would turn me into a walking zombie, but even they are not powerful enough to make me feel any different. I offer myself to you, the reader, and ask for your good will and wishes, even prayers if you can utter them. It would mean a lot to my friends and family if I could get better; I ask you for their sake, not mine. I'm told I was once a good man who did much good in this world, but now I don't even feel a man, more like an oyster for the walrus to weep over.
Please bear with me as I endure this. I'm not going anywhere. I promise not to intentionally hurt myself until I blog again, though I don't promise to continue blogging, for what's the point? For folks to read this? Who wants to read this? I certainly don't and I feel ashamed to broadcast it in a blog like this to the unsuspecting. Yet if you have any loved ones who suffer from biological depression, perhaps reading these remarks will give you more compassion. We don't want to be depressed. We'd do anything to get out of it--take any pill, have any current applied to our brains, you see what lengths I am willing to go to? And I so want to get well for my beloved wife, I know her seeing me like this is a torture that is hard to match, because I know, to a lesser extent, what it is to endure one of her depressions. And with that I leave you.

Sunday, February 24, 2008

Down for the Count

It's been over two weeks and seven shock treatments and I am no better. It would be precipitous of me to give up hope, particularly for treatment of a disease most in need of hope, but I can't help but prepare myself, in my imagination, for a life of sadness. It wouldn't be so bad if it were confined to me, but alas, no man is an island and I have the great good fortune to be loved by a number of people, Kathleen chief among them. I know the shibboleths: I must accept myself as depressed, as hopeless, as I am in order some day to have a chance to be well. But I greatly fear I let this depression--(that's not strictly true, I knew I needed ECT long ago, but had no way to afford it)--stew to the point to where even the ultimate treatment no longer works. So what do I have to look forward to? A life of dissimulation, where I strive to appear no more miserable than the next fellow.

I was tearful most of the day. I was tearful before and after ECT. It's a feeling so familiar that it comes as no surprise. I can still laugh, on occasion, so I am not completely lost. But I seem to have hit a default position, pure sadness. I am not angry or fearful. Just inexplicably, irremediably sad, and with that goes a feeling of being apologetic--I want to apologize to everyone for not being better company.

Most of you don't even know me except through my writings. I can be quite the humorist when I'm well. I've been told, even by people who didn't necessarily like me, that I'm "a funny guy." But this is not a time for humor. This is dead serious. This is my life. I'm losing my life to this disease. I cry even as I write this. I have no desire to go on but my personal code of ethics will not allow me to snuff out this brief light. So I must trudge on, lacking any feeling of hope, even after my seventh treatment by ECT today. Dr. Svensson also prescribed a new antispsychotic, Invega, but I have not been able to connect with him in order for him to connect with my insurance to have the medication authorized. If it's anything like Abilify it will run about $14/tablet. After all the hard work Kathleen has done to obtain insurance for us, I'm not going to pay out-of-pocket for an expensive drug my doctor has deemed medically necessary.

If I could get well for anyone, I would get well for Kathleen, the love of my life, the light of my eyes, the heart of my heart. Apparently this illness is even stronger than love, though I hate to admit it. If love could cure me, Kathleen's love would have cured me. I don't want her to suffer because of me, but what can I do? Is it my fault she loves me? I believe I'm doing all I can, all I know how to do, I don't know what else to do. It's not as if a positive thinking book or seminar is going to reverse this longstanding condition. I can't bear the thought of being like this forever, but I can't think about it in those terms. "One day at at time," truly. "Sufficient unto the day is the evil thereof." I would say, "more than sufficient." This is my life, damn it, and it is not a life, it is a living horror. I don't know how I go on. I won't commit suicide because I wouldn't do that to those who love me, and besides, my father committed suicide, so that would be a bit of a defeat. I don't want to lose the Oedipal thing. (That was, I think, an attempt at a joke.)

I'm ashamed to write this, I don't even know if I should let people read it, I don't know what purpose it serves. There's enough sorrow in the world without nibbling on mine.

Whoever you are, whatever you are doing, be grateful you are not in my condition. This illness is a soul-destroyer. All I can do is weep. I managed to eat an apple today. I'm sorry if this blog is degenerating into pathos and bathos, but it is what it is. All I can say is that I'm very, very sick, and no amount of thinking or prayer or medications or electricity or exercise appears able to reverse my illness. Of course I'd rather be dead, that goes without saying, but I will not usurp that right from my creator. I'm just stubborn enough to go on living. I'm just stubborn enough to remember that I haven't always been like this, even though that's how it seems. I'm stubborn enough to keep blogging, however much you may be driven away by the boredom of my suffering. Be grateful for whatever light and love you have. More cannot be said.

Friday, February 22, 2008

How I Am Currently Responding to Current

Two weeks into ECT and I'm not doing very well. I feel in danger of complete relapse. What precipitated it was my sister's generous suggestion to have a driver take me home for the weekend to Mendocino. My sister's too good of a soul to say, "It's been almost three weeks and you're a space eater and I'd like my house and nuclear family back," but that has to be part of it, too, and I understand. Even though I try to make myself scarce, hiding in the basement with a book, going for walks, I am nevertheless an interloper, a species not native to this house, like a northern pike in a trout lake.

The thought of seeing my one true love, Kathleen, while still depressed, was too much to bear. I so want to get well for her; I want her suffering to end, and because of the love she bears me her suffering can only end when I am stable and my depression is in remission. As my illness began on April 1, 2006, it will soon be of two year's duration, with only two partial and brief remissions. I'm a sick puppy. I can't imagine being in Kathleen's position; I have been with her during her depressions but she's never had one this protracted and treatment-resistantant since I've known her. Nothing makes me sadder than the thought that my presence will sadden Kathleen. We had such hopes for this treatment! Obviously I need more, but how much will be enough? And I'm wondering if I shouldn't be on stronger medications as well to try to help stabilize my mood during treatment.

In any case I broke down in tears in front of my sister after treatment today, not a good thing. I also forgot a lunch date I'd made with a poet from San Francisco; the overwhelming emotion of my situation caused me to forget. I did call him and told him I had a good excuse for forgetfulness: "Sorry, I had electroconvulsive therapy this morning." He likely didn't need to hear that and was probably relieved not to have lunch with me afterwards, though he said he still wanted to meet. Oh well. I wouldn't have been very good company in any case.

I just finished Margaret Atwood's The Blind Assassin, which my sister recommended. Atwood's work always humbles me and I did find this book alluring.

I got a note from Sam Rasnake today that soon a new issue of Blue Fifth Review will be out and had forgotten that I had a poem in it, "Home Surgery." I'll have another poem in Barnwood (a paying venue) and three in Umbrella. Niederngasse has also accepted a poem, as has Barefoot Muse. These are all pretty good venues and I'll post the links again when my work comes out. (Meanwhile you don't need me as an excuse to visit these fine e-zines!)

See that? Talking about something besides myself, like literature, helped the tears dry up. (I try to explain to Craig that he's not worth crying over but he doesn't get it.)

So, having mentioned a number of poems you can't see yet, here's one I wrote the other day in San Francisco:


Something Christian

Rheumy eyes, mahogany head;
tan polyester coat, white shirt;
no tie; septuagenarian
tiny Chinese-American
stood on a folding two-step
stepladder of aluminum
in Union Square and preached:

"Homo sick! Queer go to hell!
“AIDS wrath of God”

I must say I've never understood
why Jesus hates queers
more than other men.
Besides, if God has time
to invent new scourges
to punish the innocent--
babies guilty of birth,
patients guilty of transfusion,
doctors guilty of defective gloves--
maybe I'm on the wrong side?

"The city is filled with sin!”

How must it feel behind those rheumy eyes
to hate and think God's work is being done?

"You look unhappy,” I offered,
"Your eyes are filled with hate.”

“I hate the devil and I hate sin,” he said,
his thin lips set in a Maginot line.

"No, no, you hate yourself,” I said.

His look of incomprehension
was almost beyond redemption.
I should have passed and said nothing
like the other pedestrians
but something Christian wanted out.


Pray for me in whatever way approximates prayer for you; if you are an atheist you can wish for new treatments for depression, for instance.

In need of a miracle,

CE

Tuesday, February 19, 2008

From Lobotomies to Creeley. New Pics!

Here's a recent picture my friend Kelton unexpectedly sent me, from inside the Headlands Cafe in Fort Bragg:




Today I have my fifth treatment at 4PM, due to surgery scheduling. Lobotomies take longer than ECT and we have to make room for all the ECT failures.

Pray for us, though I always forget the saint of lobotomies. Did I say that already? Oh well, being vacuous doesn't come easy, I'm sure he or she must have suffered a feeling of emptiness at the least.

Yesterday I flew my $10 Costco Space Shuttle kite at Coyote Point on the Bay, and the wind shifted during the afternoon so that it flew it in both directions, as one would expect of a manic-depressive's kite.

I'm not through crying over my daughter and the fact that I can't see my grandson, I expect to take those tears to the grave--but they are not hopeless tears. I can be a part of Jacob's life once I get well. I intend to make it a priority. Wouldn't you? Just look at the tyke!



What a relief, the tears of grief. Cleansing, wholesome, life- and love-affirming. How different from the bitter tears of depressions, where one is overwhelmed by one's unworthiness to such a degree that the most painful thought is the idea of someone wasting their love on you.

If I had a lobotomy I could finally write like Robert Creeley, reams of anti-poetry bereft of music and metaphor. But we wouldn't want that, would we? Let me give it a try:

When they strap the electrodes to my head
and the anesthesia burns
I know I will wake up foggy,
hope I don't pee myself.

Creeley is the greatest fraud ever perpetrated by the Academy of American Poets; he was truly an emperor with no clothes. Anti-poetry. What will they think of next? Oh, right, John Cage already did anti-music and Pollock did anti-art. The difference between them and Creeley is that they truly had talent and chose to go in a certain direction; Creeley's lack of talent left him no choice.

Norm Ball and I have been trading e-mails about this lately. If there are any fans or defenders of Creeley out there, please stand up and we will give you a fair hearing. I think my next critical essay (and I mean critical) will be, "Robert Creeley, Minimalist Fraud?" Were it not for his theorizing with Charles Olson we would have forgotten him, as history surely will. As has been well said, Robert Duncan was the best Black Mountain poet and you don't hear about him much. Better to be weird than good.

Speaking of which, I thought: What about a return to rhythmic poetry, not necessarily rhymed, ala Swinburne and Vachel Lindsay? I see so much "chopped prose," even where I am assured it is a "better board." What happened to the kind of poetry that makes you speak it in a certain cadence? Isn't that what poetry's about? It's certainly the origin of poetry, the chant and the drum. Let's see if I can change my Creeley poem into a different sort of example:

Strap the electrodes to my head
with a twist and tweak and a hey hidey ho
I"ll take the current and play I'm dead
with a drool and a stool and a hey hidey ho
Though the anesthesia burns like crap
with an ouch and a grouch and a lickety-split
I won't be deprived of my battery nap
let my brain be the plain in a lightning fit!

OK, so this comes perilously close to rap, but look, in a more subtle way, how good poetry makes you conform to its rhythm when read out loud, rhymed or not:

"I like its heft, I like to stretch
my knuckles against its links and feel
the ache of constant use relax."

(from my poem, "About the Bracelet," published in niederngasse, whose archives I can't find or I'd post a link).

These lines are regular blank tetrameter. I flatter myself to think that the language sounds like the stretching of a bracelet. In all my work I try to define my rhythms, though they are not alway so obvious as this.

So I digressed from lobotomies to Creeley. That's a sign of health. Endless digressions and indiscretions, the bloviator's club. You like me, you really like me!


Thine in Truth and Kilowatts,

Craig Erick

Sunday, February 17, 2008

Music and Valentines

I've got Hendrix on the earphones, always a bad idea when trying to write. I can't help it if my comfort music includes Jimi as well as Frank. My tastes are eclectic. Still, I generally require of a performer two qualities: expertise and soul. I've always had problems with U2 and Neil Young for that reason, as they have soul but their musicianship is at best, average. Dylan, for that matter, knows how to pick a good backing band, and in his recordings there is enough soul to overcome occasional musical missteps and turn them into a rustic charm. I've been trying to make peace with U2 and Neil Young for years, as they are outstanding stylists despite ham-handed guitar work and the fact that “The Edge” (a title which irks me) couldn't even play his way out of a twelve bar blues break. I guess it's one of those “sum of the parts exceeds the whole” thing.

My ultimate comfort music is the Beatles, whom I listen to each Sunday morning with “Breakfast with the Beatles,” a longstanding California tradition and radio show. Once a week for a couple of hours the Beatles are plain therapeutic. Their genius becomes more firmly established with each new year of Grammys for songs with no melody to speak of. Fun that Aretha got a special award this year, though I blame here for introducing white and black America into endlessly toying with each note, sometimes over three octaves, as if to impress the American Idol judges. Whitney Houston and Beyonce' just took it too far, IMHO.

A good song doesn't need a bunch of embellishments to make it good; just straightforward, soulful singing will work. You know of what excesses I speak-- the runs and riffs that singers, especially female singers, wring out of notes today. “Won't you be-ee-ee-ee-ee-ee-ee-ee mi-hi-hi-hi-hi--i-i-i-ii-iii-ne for-ee-ee-ee-ee-ever.” I think our national anthem one tune extremely ill-served by such pyrotechnics. And I sometimes think all the playing around with the least syllable is a way of disguising the fact that many singers can't hold a true, honest note for more than a second or two. Some of my favorite singers? Fred Neil, the guy from Crash Test Dummies, Cat Stevens, Frank Sinatra (even Tony Bennet dolls up his tunes too much for me), David Byrne, John Lee Hooker, B. B. King, Eric Clapton (I think he sings better than he plays), Gordon Lightfoot, Joni Mitchell, Joan Baez, Judy Collins, Streisand, Phoebe Snow, big, rich voices—although I'm also quite partial to Dylan and Lennon and their nasal tones and twang for some odd reason.

Yesterday's treatment went smoothly. Afterwards I hitched a ride into the city with my sister and wandered around, finding a pair of shorts and a new backpack at a four-story Ross Dress-for-Less downtown. It felt good to buy something for myself. As for food, I had a jumbo San Francisco dog with everything from a vendor near Union Square, a tuna sandwich from an Internet cafe', and some sushi from Safeway later, with a Sierra Nevada Pale Ale and a Lagunitas Seasonal Ale thrown in there somewhere.

I most enjoyed visiting hippie hill and the drum circle in GG park, where I danced, or moved rhythmically (depending on one's point of view) and let all my joints loosen up. The drum circle at GG is one of the best I have ever heard. Really good players come there. One guy specialized in three types of cowbells and several tambourines all mounted on a custom rack. Others had the usual congas. The whole effect was of a living, breathing organism, and it felt so human! No other animal can accomplish such diverse patterns of rhythm in a communal exercise. The complexity, the changes, the movement, the spaces, all very therapeutic. If music is the universal language, then rhythm is the universal touch. To let your joints dangle freely in response to multiple beats is good therapy. I truly felt a part of, not apart.

So the day went well, and I even had a chance to chat with my sweetheart for about an hour from an Internet cafe. Because of our new digs, Kathleen's captioned phone is not yet working. But the chatting brought back old memories, as in the winter of '99 after we had first met and we used to chat a great deal from LA to NY. I still have records of some of those conversations, just like I have hundreds of our early e-mails tucked away somewhere. I'd love to tell our love story sometime, as amazing as any love story I've heard. It seemed as if heaven and earth moved to bring us together and afterwards we could never be sundered.

There is true love, true Eros that can last a lifetime, but it is an anomaly, an anomaly I wish for all, pofor nothing is so good as to be deeply in love and have love reciprocated, or better, multiplied exponentially.

Here's the Valentine I wrote for Kathleen:


Valentine 2008

You are a granite waterfall, my love.
Your stone is slippery and sensuous.

I fall into a pool beneath your feet
And lie upon a thousand polished stones.

I look up at the alders overhead
And marvel at how you give yourself to them

Without diminishment, without attrition,
A steady miracle of sacrifice.

Downstream trout fingerlings mouth bits of algae
Because your pounding fed them oxygen.

The vines that weave the cliffs live off your spray.
Bright orange salamanders make their bed there.

The hummingbird hovers to sip your mist;
Droplets adorn his iridescent green.

A pale succulent grows in your cleft,
Its purple stalk a wand of yellow stars.

Inside the moss-lipped haven of your granite
I hide behind your thundering skirt of water.

Your clarity dissolves all self-deception.
I would not recognize myself without you.

The shelter of trees is never so generous
As your pouring and thinning of yourself

Into the forest air. I kneel and drink
And like the alder rise up satisfied.


If I can keep from any conflicts with my loved ones I may yet heal. I cannot bear to hurt or be hurt. I need comfort, not rigor, mercy, not judgment.


Thine in Truth and Art,

CE

Thursday, February 14, 2008

Day 10: ECT Treatment #3: Poem from a Bus

This morning I had my third treatment, and man it was strong! I felt pretty damn fuzzy afterwards. "You had a good seizure," said the nurse.

I didn't know I was being graded. Now, as a depressive, I wonder if my seizures will ever be good enough. Don't they know how we twist such statements? I'm already blaming the patient for having inadequate seizures.

I did notice that after the last treatmen my muscles ached, especially in my abdomen. The doctors reassured me this was not from the seizure but from the muscle inhibitor, succinyl choline, which first causes muscles to contract before they relax. I expect I'll ache even more tomorrow.

One possible sign of improvement is that I wrote two poems yesterday, a love poem for Valentine's Day and the one below (I won't post the love poem until Kathleen receives it in the mail.) The poem below came after reading a good bit of Charles Simic. I wanted a regular rhythm (iambic trimeter) because I was in motion on a bus and Simic's rhythms are at best eccentric. But I love his honesty.


Lines Composed on a San Francisco Bus

Your ear buds counteract
the threat of close contact
here in the cell phone desert.
The world between your ears
that we're not privy to
expands and won't contract--
the genie fled the lamp.
Your lips are not sewn shut,
they're working very hard.
You rattle in Portuguese
about the price of beets
but cannot hear the beggar
and need not meet his eyes
nor try to avert your gaze.
Your world is tailor-made.

Charles Simic talks
to mirrors and trees and clocks
and gets away with it
like Strand shaving his beard
grown by somebody else.
But I've heard better verse
while captive on a bus.
A man was lecturing us
that America was born
with Castor and Pollux rising
which meant we'd always be
competing for attention.
(A nation of teenage clowns
in charge of nuclear silos
made perfect sense to me.)

That man got a free ride--
no justice on a bus
where public peace must trump
Puritan righteousness.
No driver wants to risk
his life and liberty
to shut a madman up--
no need to envy, either,
he paid in other ways:
no one gets a free ride.
I think we have to trust
karmic economy
or sanity's a bust.

All the years I spent
concentrating language,
were they, you think, well spent?
Most poetry is forgettable
as a four-legged dog,
Pulitzer Prize or not.
My personal albatross
is that this art should be
something that won't wash off
with salt and terrycloth
when all one really needs
for entry is a pen.
Since Gemini is rising
let P. T. Barnum sing
with Charles H. Bukowski
for literary bling.
“There is no competition?”
Not in the Yank tradition.


The only unfortunate occurrence today was that not long after I returned home from ECT, my middle daughter called, quickly became incensed and hung up on me. She likely will blame me for her behavior. Sometimes manners seem to degenerate in proportion to the degree of kinship one shares with the target.


With that Edisonian glow,

CE

Tuesday, February 12, 2008

Day 8, ECT #2; Roaches

Today I had my second ECT treatment. Although my alarm was set for 6:25 AM, I woke up several times beforehand and never needed it, due to anticipatory anxiety. Although my instructions, so I thought, were to show up at 7 AM at the outpatient surgery center, when I arrived I was mildly castigated for lateness and hurried to the treatment room in short order, except for my feet, which hung far over the bed.

The psychiatrist seemed more relaxed this morning and spoke with me longer, peering down with his half-glasses over the stainless steel railing. I think there are few positions more avuncular than a doctor at your bedside, especially given the vulnerability of a hospital gown. But was he more personable or was I less desperate? He told me the brief improvement from the first dose was typical, and that three or four doses into the treatment would be more indicative of the outcome.

The young anesthesiologist tried to tell me, somewhat awkwardly, that the procedure was “not without risks,” after I had already signed my life away and indemnified the hospital and doctors in triplicate. I informed him the mortality was in fact 1/20,000. He said, “Really?” and thanked me for the information. Amazing what they don't teach doctors anymore.

This time the short-acting anesthetic, whose name I could not parse, burned considerably upon entering my vein despite the local. As I felt woozier upon waking half an hour later, I assume the doctor increased the current discharge. The only hitch in the procedure today was emotional. The nurse who disconnected all my lines and wires after the doctors had left attempted light conversation, asking me about my children—where the recent death of my beloved Rachel instantly reduced me to sobs. But it was grief, not depression, as I was crying over her loss anew. It's something I'll never get over, something I can only get through. But its occurrence has complicated my case to a degree, because when I start weeping for good reason, I fear I shall soon be weeping for no good reason and plunged back into the Black Hole of Mybuttah.

Afterwards I had a delicious omelet at a local cafe, the “Omelette Monterey.” It was a thin, three-egg omelet containing artichoke hearts, chicken apple sausage, green onions, mushrooms, Monterey Jack cheese, and smothered in Hollandaise sauce. I ate half of it for breakfast and half later for lunch. Re-heated it was not as good, naturally, and the toast turned to rubber. Do not nuke old toast, especially if you wear dentures.

So much useful information I have to impart!

I napped for two hours then went for a walk after the late lunch (whose deficits made me wonder whether the famous “rubber chicken” so prized at conferences could be improved to “super rubber chicken”). I was interested in buying a pair of shorts, but in this tony suburb of San Francisco the cheapest pair I could find was $50.00 and the only pair I liked was $70.00. And you thought it was just the housing that was expensive in California, when indeed it is a locale where a man cannot afford to lose his shorts. Nevertheless I bought myself a new Lakers hat and a slim volume of poems by Charles Simic, Sixty Poems—a new collection of favorites in homage to his being poet laureate. (He was born in Yugoslavia and emigrated at age 16, which may explain his relative lack of lyricism. What, aren't there enough native-born poets to choose from? I think I'll start a jingoist movement against him. Has England ever had a laureate who was not a native? Hmmph.) As further evidence of my kindness to myself I also had one scoop of lime daiquiri ice at Baskin Robbins, a chain now perhaps better known for its crusading vegetarian heir than its ice cream.

Another good sign? I didn't really feel like blogging tonight because of my interest in other matters. I didn't need the therapy. And I almost forgot my medications today, a sure sign of improvement. Yet however superficially improved I appear, I know that the demon of depression is still burrowed deep within my soul and lives on. It will take more current to render me emotionally current than I have received as yet, as this disease is sneaky and if not properly extinguished can quickly and exponentially multiply again like roaches in my brain--which reminds me of two unpublished poems, one about depression using a roach as a metaphor and one purely about roaches.


Kitchen Talk

The world's expert on melancholy
cringes in the corner.
“It's just my mood,” he says
then scurries under the refrigerator,
safe in the compressor's hum.

Herky-jerky he scales the wall.

“Where are you going?” I ask.

“While that sweet motor still sings in my head
like the blessed cicadas, I must seize
this absence of self-absorption to scavenge.”

“When will you return to human form?”

“When my shell chafes and I crave light
and faces don't look alien anymore.”

“What about my face?”

“Don't make me look.”



Roaches

Silent and sticky, yet awkward and almost blind
their glistening shells scatter at light,
their frenzied, diagonal courses unwind
in the kitchen, foraging at night.

They come in all sizes; the larger, the more repulsive:
Oblong brown jewels with pearly yellow highlights,
motile, feelers twitching, bodies convulsive
at any sounds, at any human sights.

When you smash them with a shoe or a book,
white squish exudes from their armored hulk--
and then you wish you hadn't perhaps looked
so closely at their wriggling bulk,

Bulk on an insect scale, I mean, their size
only sickens because insects should be small--­
O God! I hate their tiny primitive eyes,
the way they zigzag on a bedroom wall!

(written in Galveston, TX)


Unrateable,

CE

Thursday, February 07, 2008

Day #3: My First ECT Treatment

I was just rudely awakened at 5 AM from a pleasant dream where I was laughing in a bar with my brother. The dream also involved, without carnal coupling, a lovely young woman who I knew was to replace my first wife. The nightmares of my first marriage recur from time to time, though my nightmares of being a doctor and medical student are more frequent when depressed—if I dream at all. I can't remember when I laughed in a dream.

The nurse took my pulse and her face registered displeasure because my pulse was only 48. She asked me if this was normal for me and I told her yes, that bradycardia was normal. It's funny that when I use medical terms with staff they are never curious about how I know them. I assume my slow pulse may be in part from my aerobic exercise, though I have fallen off of late. Still, swimming a mile within the last two weeks might have some lingering benefits. Else I am unlike the grandfather clock, and instead of keeping good time and coming to an abrupt end, I am slowly winding down. If only life were that gradual! Mine has always been composed of starts and stops; I've been either ahead or behind. What would it be like to have a life of gradual transitions, say get married at 30 instead of 19 and not already be a doctor and father times two at 25? I've always felt pushed by some invisible hand, propelled to excel, whether from anxiety and inferiority (most likely) or some innate property of my disease—I've always been in a hurry to get to the next step, even if the next step is undesirable. I have been the proverbial hare to the tortoise, and let me tell you, the tortoise, though slower, does a much better job at life, though not as well at E-Harmony.

After my vitals the nurse gave me a shot of Rubinol in my left upper ass. It didn't burn much but began to itch afterwards, slightly. She explained the drug was to dry my secretions and prevent nausea for the procedure. I'm sure that's what they told Soviet dissidents.

Afterwards came the hospital gown, a puzzle I'd never solved before. But in remembering how my wife puts on her bra, I tied it in front then took it off and reversed it. I was proud of myself for such a neat solution. Too bad the gown is designed for someone much smaller. If I don't get another one, more than my crack will be out in the breeze; the moon will likely be half full.

I didn't wake up crying today. One change, even before the procedure, is that glimmer of hope. I know I'm getting what I need and I hope never to find myself in a position again where I need ECT but cannot obtain it. Depression is a a severe brownout and full power needs to be restored.

Last night I watched a video for patients on ECT. Patients kept repeating how their memory was fine. I thought they'd never stop.

Actually the memory loss of ECT is consistent with the “post-ictal” phase of naturally occurring seizures. Memory of the procedure itself remains fuzzy not just because of the seizure but but because of the anesthesia. Long-term memory is not affected, but please don't ask me my date of birth.

My roommate, who had ECT in September of 2006 and is here for it again, is a pleasant fellow who resembles Jon Stewart. He was admitted after turning the gas on in his apartment at night. The only problem was that he had roommates, but no one was hurt. He now regrets that oversight. The ghost of Sylvia Plath must have been watching over him. Unlike her, he didn't stick his head in the oven but just let the gas run. That's certainly a sign of depression--the laziness in carrying out a procedure. When depressed, no matter how well you do, it is never right, so you often end up doing a shitty job out of despair. But that tendency can apply in general to a life like mine, always taking things too far in overcorrection. In second grade, for instance, I pushed the crayons so hard against the paper that they broke and the picture smeared. I marveled at he girls who colored so lightly and neatly. Maximum intensity of color was what I sought, maximum effect. The result was sloppy, I admit in retrospect, but it reflected my nature, just as my love of purple and red reflect my romance with the far limits of the spectrum, just as I was born manic-depressive.

Oh, and my MRI was “normal” except that I have sinusitis. Since I don't have any symptoms, I assume that is the effect of weeping too much and too frequently. Maybe the Rubinol will dry my sinuses out. It's certainly drying my tongue out as I write.

Dressed in one hospital gown but with the advantage of a pair of underwear to civilize the view of my posterior—(that's periphrasis, btw—“to cover my ass” would be better English), my escort arrived with the obligatory wheelchair to take me down to the dungeons, as most surgical theaters are located in the basement of hospitals. Why, I don't know. In case of war? Because you can't get any lower? For ease of a sterile environment? To best protect all the expensive equipment? One thing I do know. As we descended on the elevator to lowest floor the air became at least ten degrees cooler. The only thing colder is the morgue, and that's convenient since one can easily lead to the other.

The ECT staff was quite solicitous. They wrapped me in heated blankets. (I asked for a facial but there wasn't time.) They hooked me up to the monitors and I got to follow my pulse, oxygen saturation and blood pressure at my leisure. It wasn't Katie Couric in the morning but I don't much go for cuteness anyway. They also stuck oxygen prongs in my nose, which I found slightly uncomfortable, like snot freezing inside your nostrils on a very cold day.

The anesthesiologist and treating psychiatrist came by my bedside briefly to explain the procedure. The shrink was surprised, like all have been here, at the answer to “How long has it been since you had ECT?” “24 years.” The general consensus is that I had a good run, but the truth is that there were three times I could have used it since the initial treatment instead of fooling around with expensive pills. An ounce of electricity is worth a pound of medicine.

After my roommate emerged from the treatment room I was wheeled in on the bed. The ECT nurse put an oxygen mask to my face over the prongs, the usual hospital redundancy, just as I have been asked at least ten times since admission if I am diabetic. The anesthesiologist started an IV in my left arm while the psychiatrist fastened the rubber strap with large, steel electrodes around my head. Afterwards he took over holding the oxygen mask to my face, which he did so tightly I couldn't breathe (likely why he became a psychiatrist). I asked him to loosen it and he moved it so far away I don't know if it was doing any good. The idea is, I'm sure, that extra oxygen might prevent the death of brain cells. I know of no study to prove this but it seems like a nice precaution.

“Breathe deep four times,” the anesthesiologist said. I was hoping he'd say, “I'm going to inject you now and you will go to sleep in one... two... three... four seconds.” I like to know when my drugs are having their effects so I don't lose out on a new experience, but it was not to be.
ov
The next thing I knew I was recumbent and awake inside the recovery room, and the nurse said to me “It's over.” There are better words to utter to a depressive but I knew her intent. I couldn't count the times I've wished it were really “over!”

It seemed as if little or no time had passed when I awoke, though the return to consciousness was not as alacritous as from Diprivan, or “milk of amnesia,” which I recommend to all depressed persons as an excellent treatment (yet to be approved). After staying in recovery for a brief time I was wheeled back in the bed up to the ward on the third floor, I left the bed under my own power while a nurse hurriedly added a second gown to hide my posterior, despite the underwear. Then I was positioned in a large, blue vinyl chair facing the nursing station, along with my roommate, and served breakfast, though not the one I ordered, naturally. I turned in my choices yesterday but the hamburger of efficiency is sometimes slowly ground at a hospital. The nurses then observed us, presumably to make sure that we didn't choke on our food. I was in more danger of choking from the psychiatrist's heavy hand with the oxygen mask.

I felt tired and groggy but not mentally impaired--I remembered my new landlord's phone number to call him and my sister's as well. The retrieval of my sister's number, which I know so well, did take a little longer in my internal Googling, but I snagged it.

Supposedly I'll be discharged tomorrow and ECT will be continued next Tuesday, February 12. How I will stay amused between now and then will be my biggest challenge. The writing helps. Oh, and there's basketball to watch!

Unrated,

CE

Wednesday, February 06, 2008

From the Hospital

I am sitting in a hospital bed with a plum bedspread of rough cotton beneath me, my knees slightly elevated and the back of the bed up--the perfect couch potato lounger you see advertised on late night TV. They have wifi here in the hospital and I brought my laptop to communicate some of my adventure.

Tomorrow I will have my first treatment of unilateral (right-sided only) electroconvulsive therapy. Of course I'll be knocked out with with anesthesia when they plug in the toaster, but what they aim for is evidence of a generalized seizure ignited by the single burst of current. They'll start me at “50%.” I asked the doctor how many Joules that was (a measure of amperage, as in a car battery), but all he could do was draw pictures and talk about percentages, so obviously he didn't know. (It used to be 200 Joules.) He was the kind of authority who tries to give an authoritative answer even when he doesn't know it. Maybe he should run for office. (I'm voting for Senator Eagleton, who, if you are too young to know, was dropped from the McGovern ticket when it was discovered that he had had ECT. Don't supersize me, supercharge me!)

The psychiatrist responsible for a second opinion spent more time with me than my admitting psychiatrist, who asked me nothing about my history except as it related to ECT. I thought that odd, but I had typed up a history for the doctors to make sure they got the facts right and to make their dictations easier.

Why should they work for their money when I can do it for free?

Today I also had the unique experience of a brain MRI. Before my head and upper body were slowly eased into the white cylinder, the attendant put ear plugs in my ears. He didn't say, “Turn your head and cough,” just “Turn your head,” but a cavity was poked in any case. Why a patient can't be trusted with his own ear plugs is beyond me.

I think I went through two five-minute and two three-minute scans. What was most surprising was the noise, at one time a loud buzzing of eight bursts to my left followed by eight knocks overhead--over and over. It was as if someone were shooting a ray-gun at my head, followed by a troglodyte rapping me with a stick. The tech said this was due to the fact that they had to mechanically move the magnets around to get the scan. As you may know, the magnets align the positive hydrogen ions in your brain in one direction for the sensors to map out soft tissue. A CAT scan is still better for bone, but apparently they thought there was more to my skull than an empty shell. I look forward to proof of a brain.

I did feel something in my head as it happened, but it is too subtle to describe—like a little wave of energy slightly heating my brain. Luckily I had no psychic powers to lose, so that was not a problem, but the buckshot I'd stuffed up my nose as a kid tore a hole through my forehead.

When I was asked before the procedure if I had any metal or wires in my body, I almost felt embarrassed to say I had none, as if Borg status should have already been achieved by most humans. That's just my depression, however, making me feel inferior. In depression I am never concerned with what I have but always what I have in comparison to everyone else, which is never enough. How silly is depression? I can feel inferior for a lack of internal hardware.

After my first treatment tomorrow I will attempt to blog in that groggy, disoriented state in which I found others at group today. I will try to put the feeling down on paper but it may come out as just some retarded guy typing.

I especially want to thank and praise my wife, Kathleen, whose hard work to obtain insurance for us through employment made this treatment possible. She is the best (and you can't have her!)



I should also mention my sister and brother-in-law, who have graciously agreed to let me stay at their house and will transport me back and forth when I am converted to outpatient ECT.

With a glimmer of hope,

CE

Friday, February 01, 2008

At Rope's End

It's hard for me to blog and I don't know how often I'll be able to do it in the near future.

Presently I am pursuing electroconvulsive therapy (ECT) at hospitals in the Bay Area, as there is no such treatment available where I live.

It saved my life in 1983. I hope it can do so again.

Since Kathleen left on a trip to NY for her mother's birthday, all semblance of emotional maintenance on my part has departed. There's no one I have the strength of will to appear well for. I hope to have the good news of my impending hospital admission when she returns. As she says, “I just want my husband back. I want Craig back.”

The uninitiated cannot know how bleak depression can be, how physical an illness it is. It's as if there is an eternal well of sadness in my chest and it takes very little for me to wet my face with it. I have no confidence in anything. Little tasks are daunting. Everything makes me sad. What makes me saddest is the idea that anyone could love me because I feel so unworthy. I'm such a downer I wish that those who care about me might never have met me. Like Job, I wish I had never been born. It's a terrible thing to admit but it's true. To be born only to suffer like this seems a waste of protoplasm. A weeping willow is much more useful than a crying Craig. One provides shade and aesthetic pleasure, the other only takes up space and continues to eat food and consume other resources for no good purpose.

I don't know what to do with myself. I'm very sick and very stuck. The record keeps skipping, the tape keeps looping back on itself, there is no up or down or forward or backward, just this hole I have fallen into.

I believe the body and mind ultimately know what they need in order to get well and that they lead us to that. Strange that in my case all the wisdom my body has tells me I need ECT. Too bad I live in a state with the most impediments to having the treatment. In California we'd rather let the mentally ill be shot by the police on the street than force them into treatment. Protecting the victim's right to be crazy is much more important than intervening for their welfare.

I have an appointment to see a doctor who does ECT on February 6, for which I am grateful. I can be grateful, strangely; in fact the least kindness shown me makes me want to burst into tears because I feel so undeserving of it. It has been hard work on the phone talking to so many hospitals and doctor's offices and insurance people in trying to get a doctor to see me who does ECT. It's not always easy to obtain. Stanford, for instance, has a two-month waiting list for the procedure.

I don't want to think about what happens if ECT doesn't work. It is the single most effective treatment for depression. Cross your fingers for me. But if you notice I have no reflection in the mirror, hold a cross up to me and please, drive a stake through my heart until it stops spasming.


8 Kilorats,

CE

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