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2020
2020 Covid-19 Café  Photo by The Grey Monk, Tablecloth: Sand Hill by Anna Pitjara Somewhere in the Australian desert... there is a large network of underground caves, as in Coober Pedy. A secret society is gathering here for End Times. Covert operations have been underway for many years. The site is equipped with food and supplies and a pentobarbital lab. The number of bodies discovered later will greatly exceed the total number of deaths worldwide due to Covid-19. A note addressed to Australians and Citizens of the World will be found with the bodies: We are not a death cult or a religious cult. This is our statement about lack of humane end of life options. We have all suffered enough and will not be put off by false promises, nor will we be guilted into a convenient but false positivity. We feel you have forgotten us, put us indefinitely on hold, and that when a worldwide crisis occurs, we are hypocritically counted or measured as part of your 'success', your 'compassion' in not abandoning any of your citizens. Dr Velvet Thong: That looks suspiciously like a bottle of wine on the table. Velvet: Just as I was feeling like I needed to get out into the world somewhere, the Covid Crisis hit. I had managed 18 weeks without alcohol. When I cracked, rather than drink in my room I came up with some ideas to create a café here. Covid-19 restrictions haven't changed my 'lifestyle' much, except when it comes to the possibility of being able to go anywhere, once I'm 'ready'. In April, it was one of those rare times when I was 'ready', or close to it, and I couldn't go anywhere, and that was one of the contributing factors to me drinking again, and now I'm in the downward spiral. I empathize with what the world is going through. Dr Velvet Thong: So much has happened since last we spoke. You've been conspicuously silent. Velvet: I'll start by breaking the silence with a quote from my 2007 response to John Howard's Intervention: As long as John Howard refuses to acknowledge that Indigenous Australians have good reason to fear that they will be unfairly treated by those with more power and resources, and as long as no long-term commitment to health and social planning is made, he is not 'doing the right thing'. His motives are questionable, as is his version of 'help'. I am not saying it's fine to say something once a million years ago and that's it, you've done your part, you've proven you're one of the good guys. I'm saying that to repost this now is what it's possible for me to do, right now, rather than say nothing, before any more time goes by. The current government doesn't get it. It's my way of trying to show support, and of saying it's not all in your heads, you are not complaining too much. [If you want to see the full 2007 article, which contains various offshoots and angles, click land of grog and porn. I know it's flawed, and I'm hoping I will be forgiven for the flaws. It might be obvious, but the title is a comment regarding white culture.] Dr Velvet Thong: How's the ankle? Velvet: I like the idea of being a cyborg, but the contact I had with the Australian Medical System proved catastrophic. My ankle is fully functional. I have a plate and 12 screws in my ankle. X-rays are cool. I was in the hospital for just under a week in December 2019, I had one appointment to get stitches out just before xmas, and then I had a final outpatient appointment for x-rays and a physiotherapy consult in January 2020, just before Covid-19 became a matter of urgent concern. I was put in the queue for psych services, but due to Covid-19 restrictions they needed to either cross people off the waiting lists, or get them to do telephone or video therapy sessions. As there were no other options, I gave up in early April, although at that point I had felt I really wanted and needed to talk to someone. That's when I started drinking again. Dr Velvet Thong: How have you been getting through the time? Velvet: While I was recuperating and doing the rehab, I watched SBS On Demand (pretty much) all day, every day. And then I had my alcoholic relapse, and after that I tried watching to help focus on keeping myself sober. That hasn't been working out so well. Dr Velvet Thong: What about music? Velvet: Last year, I threw an iPod full of pirated material off the Story Bridge. I had to ask The Grey Monk to take me there, as I had as little energy as Frodo in Mordor at the foot of Mount Doom. I don't really know what music I want to listen to any more. I'm open to something new. Although I still feel I have accomplished something important through cumulative effort over the years, through many trips to Mount Doom and back, the feeling of peace I had and wrote of was short-lived. Dr Velvet Thong: You saved The Shire, but not for you? Velvet: I think I felt pressure to put a positive message out into the world, but there was also some risk that I'd make myself ridiculous, untrustworthy from then on, and so after 30 years, I didn't state a change of mind lightly. When I couldn't stop drinking even though it seemed to me there was lots to be happy for in my life, and when I had my accident as a result, it made me realize that in some ways I had understandably caved in to pressure to define my peace and positivity in ways that might help me to feel connected, and happy. I've always wanted to somehow help those who can't relate to institutionalized positivity. And I also wanted to feel connected, and happy. The positive thing was that I'd told my story, and I felt that I had done what I needed to do. I believe that Voluntary Dying can be a positive choice. I believe I am one of the people for whom it can be a positive choice. The reality is that there are painful and debilitating illnesses and conditions in the world, some of them psychological in nature, that we do not know how to adequately address, and that we do not currently have the resources to address. Aussie stoicism is not enough of an answer. I've been fighting for a long time to help people understand people like me, but despite all I've tried and expressed, when I faced the Australian Medical Establishment, it felt like all of that counted for nothing. The resources and know-how do not currently exist for people like me, and we are right to fear that facing the medical system will be a traumatizing experience. Many Australians had only recently recovered from, or are still trying to recover from, a horrific bushfire season, and now they are also dealing with Covid-19 and all of its implications. Australia has put off addressing many equality issues, refugee issues, quality of life, quality of aged care, disability care and euthanasia debates for too long (and Australia is not alone in this). In this crisis, we don't get to know what elderly sufferers or potential sufferers really feel, we don't have statistics regarding wishes, and it all becomes 'save any life at any cost', even when we don't know how those most affected feel. I want to stand up for those who do not want their lives prolonged no matter the cost, and who in fact have been trying to call attention to the fact that they want more humane end of life options available to all. But, this does not mean that I want to take away care, life or hope from any individual who wants to continue living, despite their suffering or prognosis, despite the expense of their treatment, or lack of support from friends, family or a community. I am not buying any of the slippery slope arguments. Life and death mistakes are made in all medical fields, and there's no reason to fear there would be a disproportionate amount in this area. It's more likely that those who are severely suffering would have that suffering alleviated. Yes, small strides for Voluntary Dying have been made in places like Victoria, but the criteria are still too strict, and don't include people who suffer horribly and are not going to die in 6 months, or there's no way to be sure, or they have some condition that doesn't meet the criteria for whatever reason, or they're too sick to inquire as to their options/rights. It seems to be common knowledge that Australia has a problem when it comes to aged care. Where was all this concern for the old folks before this virus? Ethics regarding allocation of ventilators and other resources, including staff effort when it becomes necessary to triage: Prognosis for recovery is what matters. For those with a poor prognosis, when it comes to Covid-19 or any other future problems with pandemics and lack of resources, how will those people be expected to die? Where's the humanity? Where are the provisions, where's the foresight? Dr Velvet Thong: Why are you calling him The Grey Monk now? Isn't that somewhat unkind? Velvet: I don't mean to be unkind, but I need to make a statement. I don't think he's hearing me. He is the most monklike man I've ever had contact with. He has no sense of entitlement at all to sex, love, pleasure. I want him to know that I think this is a tragedy. I've tried to express it and tackle it in different ways, I've tried to find out what it is he wants in life still, and I think it's that unless something outside of him breaks through his unconscious self-sabotage, he will never believe he deserves those things. He himself came up with the name years ago. It was an attempt to see the humour in his personal situation. Dr Velvet Thong: We've been through this before, and I feel it is my duty to ask you to get back to the topic in hand. Velvet: Fine. Attention Capitalists: when it comes to this Covid-19 situation, Epic Fail! Except companies like Dan Murphy's and Domino's, who have seemed organized and competent, and very good at preventing panic and 'un-Australian' behaviour. Dr Velvet Thong: Hey! Who's there? This is a private therapy session! Okti and Blinky emerge non-sheepishly from behind the drapery. Velvet: It's Okti and Blinky. I asked them to come. Dr Velvet Thong: Who's up for a vegan wine tasting party? At the time of writing, a Dan Murphy's site search turned up 23 pages of vegan wines. Although we know everyone already has a lot to worry about, we ask that members of the audience please check out Earthlings and/or Dominion, if you have not already done so. Rainbow of Cognitive Dissonance  Rainbow of Cognitive Dissonance 2018 Dr Velvet Thong: Yikes. Or should I say wtf? Velvet: I tried to paint using my collection of nail polish. Maybe the only way to make sense of it is to say I'm still trying to accept what I can't change, find the courage to change the things I can, and the wisdom to know the difference. The title pulls it all together, makes it work, makes me smile. It represents one of my biggest relationship patterns. I'm in a Bad Romance with the universe, and I'm trying to break up with it. I've had it with all the revenge. Dr Velvet Thong: For what it's worth, these images are not the whole truth of how you appear to me. Okti and Blinky are still in the room. They're playing The Quiet Game. Velvet: I'm struggling not to get weighed down by new baggage that was attracted by the old baggage. The Hermit and the Hospital I can now say I know what it's like to enter an Australian Public Hospital after living as a fugitive from the medical and mental health Establishment for approximately 3 decades. I am in a unique position to report/write an exposé. Also, I would like to put forth an analogy of my illness as a kind of 'climate change' issue: I've been warning people for a long time, and I see my accident as a sign that my condition is progressing, getting worse (perhaps as the planet gets sicker). The Grey Monk is a kind of traumatized, overwhelmed veteran volunteer firefighter, who thought he'd seen it all with me, but we managed to reach fire tornado level this time, such that he symbolizes an Australian Value that originally represented a decent character/heroic nature, but is something that now must be questioned, must evolve. The Grey Monk focused on the positives: that I made it through the experience without going feral (as I had feared in the preceding years I might if it ever came to hospitalization), that I was actually quite articulate, calm and respectful throughout, that we figured out many difficult practical problems together, that we got through the stress of it together, that I managed my PT almost completely on my own. I eventually brought it back to: 'Communities came together through the bushfire crisis, but climate change hasn't been resolved. More fires are coming.' If you would like to read this article separately from the whole Covid-19, Rainbow of Cognitive Dissoance entry, click here. Click the links below, or read all the way through from the bottom of the contents list: The Hermit and the Hospital 1. Foreshadowing 2. The Accident - The details 3. The Accident - Why? 4. Calling an ambulance 5. Ambulance ride 6. Admittance 7. When you can't act normal, even if you try 8. Asking for a psych consult 9. Personal history/previous hospitalization 10. Extremes: too little vs too much stimuli 11. Privacy issues 12. The importance of trust 13. What's in a name? 14. My non-Australian accent 15. Prejudice re: eating disorders and vegetarianism 16. Phone-free 17. Management of physical pain 18. Unusual stress above and beyond 19. Leaving hospital against medical advice 20. Arranging psych services after release 21. Rehab at home 22. The Grey Nurse 23. Possum Therapy 24. PTSD symptoms 25. Two followup appointments 26. How's the ankle now? 27. Last thoughts 1. Foreshadowing In 2018, I warned The Grey Monk that I felt things were not controllable, that at any time something might happen that I consciously did not want to happen, that my unconscious might overwhelm my consciousness. That very night, he had an accident and broke his little toe and we went to the hospital together and I tried to be supportive, but also tried to point out I didn't think it was a random incident - to me it seemed like his unconscious was also having a say, and my consciousness interpreted it as: he was scared, and didn't know what to do and was going to continue burying his head in the sand and reassuring himself and me that I was strong, I could probably drink forever and have no ill effects, and meanwhile a really big fire was coming. 2. The Accident - the details In late November, I was alone in the house on a major bender. I had been trying to stop drinking for months, and hadn't been successful. I was drinking large amounts of alcohol, usually 2.5-3 bottles of wine per session. The Grey Monk was away for work, and when I ran out of alcohol, I called him, in case he had hidden alcohol somewhere in the house. As it turned out he had - a lot more than I bargained on, and I felt sick and scared when I saw how much, because I knew I'd drink my way through it all. I was on the last bottle, I only had half a bottle to go, and he'd be home the next day, I'd drunk 2.5 bottles and was at maximum drunkenness, just trying to maintain for the rest of the night, when I fell. I don't remember exactly what happened, but I knew right away something wasn't right, and I suspected my ankle was broken. My glass was shattered and the pieces were everywhere. I had been going down the stairs to get a refill. My ankle was broken in 3 places, and it was dislocated. I didn't have any other physical injuries. 3. The Accident - Why? I don't expect that anyone who believes my only problem is drinking too much and not trying hard enough to quit has read this far, but just in case there are any stragglers here.. I know I have a problem, and I've been trying to quit since I was 13 years of age. It's not really working out for me. What motives could my unconscious possibly have for putting me through that horror? Was it because I had decided the way to have peace and be happy with what I have is to make sure I never had contact with people again, and accepted that I have drinking and non-drinking phases? The accident showed me that I wasn't unconditionally happy with that arrangement. It could have been a last ditch effort to try to get 'help' and contact with other human beings, and there were a lot to choose from, but it was more likely another horrible low designed to show me the future. The positive take I suppose is that it was a creative strategy to find me material to write about. It could be something like a self-regulating thing that wakes me up and forces me to get certain kinds of exercise before some abilities atrophy beyond repair. I don't think it was 'deserved' or that it was poetic justice or anything along those lines. I saw it coming and couldn't stop it. I think it's a sign that my illness is progressing, or, that it is a 'natural' part of the aging process, for me. 4. Calling an ambulance The best thing, once I had realized my predicament, would have been to find a way to kill myself without further ado. I had promised not to do it in The Grey Monk's house, but I thought in the circumstances he might have understood. He was due to arrive in 20 hours or so, and in a way, it might have been convenient. He would have just completed a work assignment, and while it would have been stressful dealing with all the arrangements, in some ways it might have been a relief that it had finally happened and was no longer hanging over both our heads. But only if I'd just done it, and not draggled him into it. I didn't have a good plan, and the discomfort from the ankle made it difficult to concentrate. The main issue was that I should have been ready for such a situation beforehand, and I wasn't. To leave the house would have been difficult. My assessment had been that it was better not to stand up, so I was basically dragging myself around the house, trying to protect the ankle, and the only time I put in effort to stand/put my weight on the other leg was when I went to urinate. If I was going to go somewhere, where? The driveway is very steep, and while I could get up that, I'd probably draw too much attention to myself, whether I tried to get in a taxi, or just crawl around the neighbourhood. I called The Grey Monk in distress, and it was a horror, something along the lines of 'I know I promised not to kill myself in your house, but I think this might be an exception', but I was not calm, I was crying and very upset and I know that makes the whole thing worse, and I never wanted to be like that. I'd had to make it up a flight of stairs and past all the obstacles in The Grey Monk's non-tidy bedroom to get to a landline phone. I ended up saying I'd take some time to think about it, then when I'd made my decision, I called him to say I was about to call the ambulance. He said he'd get the earliest flight he could, and meet me at the hospital. I was telling myself to try to hold it together for 12 hours or so. They'd slap a cast on me, the Grey Monk would come to collect me, and then when I had a chance to think back at home, I'd get ready to deal with the rest, whatever it was. As it turns out, I didn't know much about broken ankles, but we'll get to that. I remembered to/managed to blow out candles, turn off my entertainment centre and grab my backpack. When I made the call, I said 'Hello, I'm very drunk, I'm alone, and I think I've broken my ankle.' I suppose I could have said 'Hello, I'm very drunk, I'm a recluse and I think I've broken my ankle. What should I do?' I was not 'my best self', or the self you want to be when forced to have contact with the public after years of isolation. I had actually just done the laundry - it's something I often have done just before The Grey Monk is set to return from wherever - and I had showered that night. I was wearing makeup, a wig, and my usual black uniform of many layers. I was wearing clean underwear. My finger and toenails were painted black, but there were some chips on the fingernails, and I think a couple of toenails were chipped in the fall. But I was in a very bad psychological headspace, and I couldn't have called if I hadn't been drunk, and deluded about what I was about to go through. 5. Ambulance ride I had made the decision to try to appear 'normal' and non-fussy. I was told the paramedics couldn't get to me upstairs, so I had to make it down 2 flights of stairs to the front door. I asked one ambulance attendant to lock 2 doors for me. An old social mode kicked in and I think I was chatty and friendly throughout the ambulance ride, but it's possible I was annoying and I was being made fun of or looked down on. I made it to the hospital, although the ride seemed long, still determined to try to appear 'normal' until a cast was on and I could go home. Was I actually sort of charming and cute, drunk as I was? What I think of as perfect drunkenness is when I can sing along with Moulin Rouge and feel like I am hitting the notes. I think the likelihood of me being charming and cute is about as likely as me hitting any of the notes, at any time. 6. Admittance Australia doesn't prioritize mental health. There are no psychologists, psychiatrists or therapists on call. Medical injuries or health issues can occur at any time, and Emergency Departments are prepared for this, but not for psychological emergencies. The Emergency Department was brightly lit and to me it seemed like patients accepted they wouldn't have much privacy. They had an automatic obedience to hospital authorities. I sometimes found myself automatically doing things I don't like doing, including shaking hands with a couple of people. People would probably think there's a discrepancy if suddenly I start saying I don't want to be touched, but it's one of those odd things, an automatic ingrained polite response vs mounting sense of panic. I had originally decided to try to act 'normal' for 12 hours. I thought I could pull it off, partly because I was going to be feeling the effects of alcohol, plus whatever pain relief they gave me, for some time. I don't remember exactly when, but I received Fentanyl, and it seemed effective and long-lasting. The first x-rays are a blur, but I was able to deal with having my yoga pantleg rolled up to the knee. It was summer in a subtropical climate, and my skin wasn't in terrible condition. I had decided I would have to be brave about my weight/body issues, and in writing this up I am going to make an effort not to reinforce too many negative self-perceptions, while still getting across the facts of the situation. I was seeing many people, and perhaps because up until that point I had seemed friendly and chatty, they were surprised when I didn't want someone to lift my top (technically, 3 layers of 'tops', not counting the sport bra) in the crowded Emergency so they could put on those little things for resuscitation. That was the first major hurdle, and when I could no longer even pretend to be 'normal'. I wasn't able to think on the spot and say I refuse this option, and if I need 'help', I don't want it, let me go. I have an Advance Health Directive. I don't want my life prolonged by any mechanical or artificial means, and maybe that doesn't count in this case, but I might have had a right to refuse any 'care' I did not wish to receive. They had to put me under anaesthesia in order to get those things on (but they also needed me under so they could set the bones). I saw a lot of different people in the hospital, with different skin colours, gender and sexual identities/orientations, and I did worry about my reactions hurting others I really didn't want to hurt. I responded better in hospital to people who weren't impatient, or dismissive or who clearly wanted me to stop being silly, but in that moment, there was no person in the universe who could have got me to just comply. That's why I asked for a psych consult. My original plan to just 'play it normal' wasn't going to hold up and I needed help. I was basically so upset by the whole thing, even having been put under anaesthetic, that it felt like I had been raped, although I could understand that isn't what happened, it was just that my problems had been left unaddressed for years, like climate change, and suddenly I'm in an emergency I'm not prepared for, and from then on, there were more and more people, and it all seemed to escalate. I think someone said something, and then they began to treat me with an assault/trauma/rape protocol. I was taken to a special part of the Emergency Department, curtains were closed around me, and I think the lights were dimmer. One nurse in particular tried to find out what I needed to make me stay in the hospital. They sent me a drug and alcohol counsellor who I thought was nice. I did like him. What I needed immediate help with was my trauma response to being hospitalized, and while some people definitely tried, the timebomb finally exploded, and the entire stay was like an extended rape/torture. I know it's not rape if you give consent, but allowing people to touch me was required. It was a nightmare I had no escape from, for a week. I was constantly aware that if I did not consent scores of times per day, I might lose my leg, never walk again, whatever. Once I understood the seriousness of my injury, and the implications and specifics of treatment and rehab, I knew that what I wanted was pentobarbital. I didn't want to go through with the treatment, surgery and physical rehabilitation process. I didn't want people to invest time, energy, resources, the expense of CTs and surgery and all the rest. So for me, consent was not really consent, as I didn't have any good options, or any chance for dignity. I was planning to go home (once The Grey Monk arrived) and focus right away on killing myself (I did not express this out loud), but I was told if I left the hospital I would not be given any pain medication. And so if I could manage to plan and execute a suicide before the last pills wore off (at that point I was on Oxy, and it would only have been a couple of hours), there was still the serious problem of The Grey Monk. He was in distress himself, because he knew what the situation was. While I had waited for The Grey Monk in Emergency, the curtains were closed but I remember at times having glimpses of a man opposite me. For a very long time, his breathing was very labored and sounded excruciating, and this continued and escalated when The Grey Monk arrived, as he also remembers it, as well as the nurse's reactions. The nurse with me seemed almost casual about it when she told me he was dying and would be removed soon. I was thinking that nurses must be so used to certain things that this kind of death does seem natural to them since it happens so often, but I felt like a failure as a human being. I didn't even volunteer, I didn't ask for a wheelchair to go over and sit with him, but I also realized that maybe he wouldn't have wanted a stranger sitting with him, anyway. I wouldn't have. But this incident emphasized to me that many people die very painful and unpleasant deaths, and it doesn't seem like anything can be done to ease their suffering. I told the nurse that I could wait, and that it was more important to attend to this man. When The Grey Monk's mother was dying of cancer, I remember a woman in her ward moaning in pain, and we tried to alert someone, and were brushed off. I also remember patients being left in their diapers too long. I don't blame nurses for these, or other problems. I think they are overworked, and that the system is not set up to allow people more options, comfort and dignity, or better communication, such that the demands of a nurse's schedule are understood and respected, while a patient doesn't have to abandon all attempts to advocate for herself. After the initial x-rays were taken, a cast was placed on my ankle and I was told the surgeon would decide on a course of action once the swelling had gone down. (It was just after this that I was transferred to the quiet area in Emergency, opposite the dying man.) Later that day, I was transferred to the ward where I spent the remainder of my stay. Two days later, x-rays were taken again (maybe this was CT) and it was discovered that the ankle had redislocated. I was then taken for an ex-fix (an external fix) which is pictured in the photo below. Three days later I had surgery during which the ex-fix was removed and I was fitted with a plate and 12 screws. I checked out of the hospital the next day, against medical advice.  Ex-fix Ankle 2019 - photo by The Grey Monk 7. When you can't act normal, even if you try A person who was in a vulnerable state and wanted as little attention drawn to herself in that state as possible actually attracted more attention than those who kept their heads down and followed the hidden automatic response to rules/authority. As the Fentanyl was due to wear off, they switched me to Oxycodone and I was also offered Valium for both my withdrawal symptoms and my anxiety. After it was supposed to have kicked in a nurse asked me if I could feel the effects and I said I really couldn't tell. I was anxious enough that I didn't urinate for 17 hours, and for me, after having drunk 2.5 bottles of wine, that's extremely unusual. Not to mention that normally I'm well-hydrated, drinking up to 2 litres of water a day to help me feel hangovers less, and to attempt to keep my skin in better condition. When I was awake and did not have to talk to anyone, throughout my stay, I tried to close my eyes and keep doing breathing and relaxation exercises, almost constantly. While hospitalized, I never used a phone or computer, I didn't listen to music, I didn't read books or magazines, and I didn't watch tv. I had one stressful conversation with another patient on the ward. The Grey Monk visited once per day. The rest of the time I did what I have written in the paragraph above. I had managed to stay out of hospital for almost 30 years, and that streak was broken. I now could not trust myself to be safe in my own home, which was never really my home, anyway. 8. Asking for a psych consult During my hospitalization of 6.5 days, I asked at least 3 times for a psych consult. I never received a clear or comprehensive answer. I was told that psych staff were available only 9-5, Monday to Friday. I think once I was told it would take a week, but again I did not feel I understood the explanation. I think it represents that Australian hospitals do not prioritize mental health, or understand the mind-body connection as it pertains to hospitalization. My understanding was that when people are in hospital, they will know not to be 'silly'. I was told I had to put certain things on hold for now, and concentrate on my ankle. It could be that medical staff aren't completely familiar with psych protocol, and it could be that the hospital is split, the way universities are split - 'we're the smart ones, and the psych (humanities, arts) people are the mental defectives.' It is framed as a resource issue, but what's underneath that relates to a belief system that affects hospital structure and management. I saw the same drug and alcohol counsellor once more during my stay, and again, I liked him. I was not at that time having any trouble staying sober. I think he might have understood that it didn't seem realistic to me that I could stop drinking permanently. During my stay I saw so many different nurses, physiotherapists, surgeons, doctors and technicians that it was difficult to keep track of everyone, and people in the same discipline often said contradictory things. 9. Personal history I have problems with being touched and even being looked at, although I don't have trouble looking people in the eye when we are speaking. I don't have trouble in public when I am in the zone and have made a choice to go out into public, in search of adventure or enjoyment. I have been hospitalized 3 times in my life (in Canada, where I was born and lived until 2000) for psych-related issues. The last time occurred in 1990, and since then I have done my best to avoid hospitalization, not because I was functioning well, but as a fugitive from the mental health system and society. My diagnosis at that time was: Long-term Depression, Anxiety and Bulimia. I think what was missed was: PTSD and BDD, partly because in my 20s, I was still somewhat 'robust'. I realize many people might believe that I ended up in the hospital through making bad choices, and because when you're a drunk it inevitably catches up with you, but I see it as an unfortunate consequence of unresolved psychological issues, such that this was my 4th incarceration for psych-related issues. Addiction is currently defined, in part, as the inability to stop, despite mounting consequences (and an accurate appraisal or understanding of the consequences). Apparently to a signficant number of those who work in the Australian Medical Professions, this is poppycock. One young white male doctor wondered aloud as to whether now might not be the time to consider making some 'lifestyle changes'. I said nothing. Ah, that's another point. He was in a swarm of doctors when he said it, and that reminds me that often it felt like nurses or groups of medical professionals were ganging up on me, or like the odds weren't fair. The training to respect patients in various ways without showing prejudice is often obvious, but overall, there is a sense that patients aren't entitled to privacy or modesty - even if there are roomfuls of staff present. It's all either matter-of-fact, and expected that patients will comply with medical authority, or it devolves into 'don't be silly' impatience. Patients must accept that teams must regularly be relieved, and that there are many members of each team, as well as a seemingly constant influx of other specialty departments and excursions. We're all medical professionals, we all have your best interests in mind, we know what we're doing, we're on a tight schedule and time is money, you're not so special, do you think we haven't seen it all a million times before, accept that you're a piece of meat, or leave, you ungrateful cow. And you brought this on yourself, so don't complain. It's the subtext beneath all the political correctness. I've never been violent in any of my hospitalizations (or dealings with paramedics, or police.) I've never raised my voice or been snarky. I've never needed to be restrained physically or pharmaceutically. 10. Extremes: too little vs too much stimuli The only person I had had contact with in Australia for a very long time was The Grey Monk. At the time of the accident, he wasn't home, but even when he was home, there were/are times when we don't communicate, and because of my issues, he walks around averting his eyes. I have many unusual behaviours, including but not limited to showering in the dark, and locking my bedroom door and bathroom doors, even when I am in the house alone. I went from that situation to having contact with hundreds of people in a very short period of time. I was at my most vulnerable - dealing with a serious, incapacitating physical injury on top of the existing issues. We know that people who have been in solitary confinement, or who have experienced extreme isolation can have trouble adjusting to human contact and that chronic understimulation can lead to an overwhelming perception of overstimulation when there's a drastic change, as well as an increase in paranoid ideation. I was asked many times a day how I was that day, and if it was ok to touch me, take blood pressure, jab me with this or that, shift positions, and I had to ask for assistance to be taken to the toilet. My sense is that most patients were unconsciously affected by Australian Values, affecting such things as not wanting to be a bother, and stoically managing to hold it and not ask to go to the toilet very often. When the ex-fix was in place, my impression was that I was putting the nurses out more to ask to be taken to the toilet than to use a bedpan, so I reluctantly agreed to pee in a bedpan, and a couple of times I accidentally spilled a bit (possibly because I was so anxious), and the sheets had to be changed, and so it was more work, and from then on I just asked to be taken to the toilet. Once I had been moved from Emergency to a ward, I had no access to a walker or anything else for the duration of my stay, except on the final day when physiotherapists wanted to watch me walk with a walker and with crutches, and took these implements with them when they left. I spent a week on my back, with no escape. Not only was I physically incapacitated and helpless, I was undergoing alcohol and caffeine withdrawal, and although valium helped with the physical symptoms, it didn't shut off my perception, or help with psychological withdrawal/dependence, in a situation that was a lot more stressful than being at home. Some nurses seemed to think B1/thiamine was to help with symptoms of withdrawal, and that I probably had no idea what it actually was when I said I already took it regularly. I've been taking it for years on a daily basis. I had looked into the idea of harm minimization. It seemed to me that B1 was something I could take that would be unlikely to cause any harm or damage, and that it might help prevent the nutritional deficiency associated with the kind of brain damage that occurs with chronic alcohol use. Don Quixote explained to one physiotherapist that staying in the hospital for me was akin to having a fear of spiders and being told you can't have treatment unless you consent to lying in a pit with spiders crawling all over you for the duration - and I think she understood, because she said that she herself was afraid of spiders. Doctors and surgeons have to figure out which life-threatening problem is the most serious and needs to be prioritized, but in this case, no one had the ability to diagnose one of the relevant problems, and I believe this is because the training medical professionals receive perpetuates misinformation and stigma in relation to mental illness. As a result, they didn't know that staying in hospital and complying with their rules and requests was akin in a psychological sense to being asked to constantly walk on a trimalleolar fracture before it had been set and operated on and before I had done months of rehab. But what could they have done? I realize there wasn't much they could do, according to established protocols and available resources, and the reality is that my condition is so far advanced that there might not have been anything they could have done. In an ideal world, if someone was able to diagnose the severity of my condition and prognosis, they would have offered me the choice of Pento. Barring that, maybe they could have let me go home with a script for Oxycodone, such that I would have some time to make and carry out a good plan. What they did say was 'if you leave now, you will get no further meds'. They didn't give me a real choice when it came to refusing medical treatment. I knew if I left, I'd be in serious pain before long, and I needed all my wits about me to carry out a successful suicide. Nobody will get any thanks from me for 'keeping me alive', or tricking me into staying 'alive' longer, with new severe (psychological) damage. Medical professionals have to deal with life and death all the time. Don't be so fucking squeamish about voluntary dying. Maybe there could at least be an investigation, and discussion about the costs of Pento vs the costs I incurred during my stay. 11. Privacy issues When I was taken to a ward, the blue curtain was closed around me and a sign was put on it. I don't know what the sign said, but doctors passing by would comment on it 'There's a Patient History here', and they'd speak in quiet tones. The people on one shift might try to keep the curtains closed, but people on other shifts forgot, and food service people and floor moppers came and went at will and there's no way to knock on a curtain. At one point when the curtains were open, there was a guy with his phone pointed at me, and I wondered if he was sending my picture with all the gossip everywhere. Probably in every hospital there are people who do this sort of thing, it's part of human nature. The first day, there was a man opposite me who couldn't be left alone for more than a moment, and he tried striking up a conversation with me, through the closed curtain, despite the sign. He was sexist and prejudiced against mental illness, and luckily after our awkward conversation, there seemed to always be someone else for him to talk to, until the time he left the ward. I think some people understood my personal horror, at least to some extent, and were sympathetic and tried their best to adapt hospital protocol for me, but they had little power, and couldn't be on duty 24/7. I was allowed to wear my wig for my entire hospital stay, and in surgery, I was allowed to wear a white cap over top of the wig. I don't usually sleep in wigs, but I did for the entire hospital stay. Showering in the little room would have been a logistical nightmare, aside from the fact I wondered if there might be cams for my 'safety' in the room. When I got home, I kept sleeping in the same wig for a while. (And I slept fully clothed.) It was partly because I wasn't used to having The Grey Monk pop in and out of my private room (he doesn't usually enter the room at all), and I needed it as a security blanket. I had to keep my door unlocked because it was too difficult to get up quickly, and so I felt nervous. Even when I am alone in the house, I usually lock my bedroom door, and the bathroom door. My hair underneath was badly tangled, but less than I had expected. (It was in a braid, and pinned, and I remembered while in hospital to take out the metal clip.) I used my fingers first to detangle as best I could, then very slowly brushed it out. I lost less hair to this than I expected I would, but approximately 3 months after the date of the accident, my hair started falling out. The rate has slowed down considerably, but at the time of writing, it's still falling out a bit more than 'normal'. When I discovered I was allowed to do self-sponge baths in the hospital behind my curtains, I started doing this regularly. I had to direct The Grey Monk how to find my clothes and underwear at home, and how to launder the ones I took off, but he wrote it all down on his notepad. For surgery, I was required to wear a gown, with nothing underneath. I felt unsafe, my body unprotected with this arrangement. In the hours before surgery, I would have liked to have had the option to have a second gown, to wear it backward, like a robe. In 1990, I had been offered this option during the first week of my 2 month psych stay, when I was required to wear a red gown as I was deemed a flight or suicide risk. [The gown I was given had something like dried food or snot on it, and when I pointed it out, the nurse shrugged and acted like I was being overly picky. I guess whatever the substance was, it had at least been cleaned through the laundering process.] 12. The importance of trust Those blue curtains aren't soundproof, even if they remain shut. There were some questions I didn't want to answer on the spot, or before I knew someone was 'really listening'. I couldn't develop a sense of trust with anyone there because I had to talk to so many different people, constantly. There was no continuity, and there wasn't enough integration of all data. Some of the behind-the-scenes conversations I think led to well-meaning people being sent in to see if they could get me to open up, and the result was that while I was trying to heal, I found myself worrying about other people's feelings and trying to stay centred in my own belief system. In a large hospital, when you have contact with so many people, there will undoubtedly be a wide range of personalities, communication styles, beliefs, prejudices and personal preferences. If you have any stigmatized or poorly understood conditions, the odds are not in your favour, despite any sensitivity training staff receive. I would say that I have amassed more than an average share of stigmatized conditions over the course of my life. It's one thing to roll with all the psychological diversity in a setting when you're at the top of your game, and quite another when you're physically incapacitated and psychologically overwhelmed. And another again to begin to talk to anyone, for real, about things that have been left unaddressed for more than 30 years. I understand that maybe nothing could have been done, or not much, but people could have tried harder to get me a Psych referral, at all stages of my stay, or helped me to understand the process. How frustrating it is when people want to try to address symptoms, but don't seem to have a good grasp of the overall picture, and don't seem interested in the cause or how an unrecognized cause might continue to impact treatment of any or all symptoms. Another trust issue: you can't assume that there are no patients or visitors with criminal minds. Some people, upon hearing people's full names and dates of birth (repeating these details clearly is a requirement to receive medication and certain other treatment), might be motivated to use that info, which means people aren't technically 'safe' in hospital. The Grey Monk had a look around, and said that there wasn't much monitoring of who was coming or going, and if he (or others) had been so inclined, he (they) might have been able to pinch some supplies, or get up to who knows what. Everyone, from every walk of life, usually needs or visits a hospital at some point. 13. What's in a name? I had to repeat a name associated with trauma many times every day to access drugs and treatment, a name that is not my chosen name and that represents having no choice. This is the current hospital protocol, and it has probably been established for the hospital's safety and patients' safety, and I would hazard a guess that it might have something to do with how many staff members deal with any one particular patient. How could I feel 'empowered' in such an environment, with such rules? What would this do to my sense of personal identity? In addition, I didn't feel safe explaining about the name Xesce, because it wouldn't have been easy to repeat the explanation hundreds of times, and because I wasn't sure it would have been safe to have people there find all the easily searchable internet content, factoring in all the different personalities and belief systems I would encounter during my stay. I was worried I might face intense prejudice, even if surreptitious in various ways, because what I have expressed online is difficult to understand at a glance. I suppose that's on me, that my treatment didn't start with me secure in my identity? When I was in the hospital, I automatically told one person when asked what I do that I am a self-published author who writes about my struggle with mental illness. And then I realized it wasn't so smart, and that it might make my stay even worse if people were more prejudiced about me and so I stopped saying it. I was afraid of having no power and I was afraid of feeling like everyone was out to get me. I felt that way because of the experiences I had already had so far in that current hospital stay. And I still think that it probably would have been too much information, and it would likely have been taken the wrong way because it was too much to absorb. I was in too vulnerable a position. So after that, when asked by young nurses if I worked, I said no, and I said it without self-deprecation or self-consciousness, but I could hear the judgment, despite their sensitivity training. Being socially inconsistent stresses me, but trying to be universally considerate interferes with my ability to process in the moment. 14. My non-Australian accent I had to make small talk all the time. I'm not married, don't have kids or family or job, and so I suppose it was natural I'd get asked many times a day where my accent was from. Innocuous? It's all part of trying to figure out what right I had to be there. With Covid-19, I imagine people would instinctively distrust me if I opened my mouth to speak. How long have you been in the country, do you travel a lot... but the hidden subtext here is: what right do you have to be here and what right do you have to Australian resources? I've been a permanent resident since 2003, but I've made no secret of the fact that I scammed my way into the country, and that the way The Grey Monk sees it is that we made a political statement about fascist immigration policies. And no, I don't feel entitled to any Australian resources, and as far as that goes I've kept my nose pretty clean over the years (I haven't even used my medicare card all that much), before now, but on humanitarian grounds, I would like pentobarbital, and I'd be willing to pay for it. If you carefully read my report, you may conclude that I have contributed (free of charge) much that you might have to pay others a lot for, regarding how to improve the medical system. Speak Australian, Mate.. all of the issues and hidden agendas involved with asking me where my accent is from.. I mainly have a problem with those who want people to speak English and adopt Australian culture and values - while not realizing how bad their own English is, and that some Australians seem to find it humorous how dumb Americans and Canadians can sound, without realizing there are many pasty Australian equivalents. I know, Canadians are so non- threatening that even when they sound uneducated, they get a free pass. There is a very strong anti-American prejudice, and I do often get the feeling that in order to fit in, I have to denounce the US, whether I'm American or not. And that it's best not to say that Australia is still behind the US in a lot of ways, or follows its lead, as in legalizing same sex marriage. And they don't seem to realize that the Labor party might be spelled the way it is because Australia used to admire America. At one point, one nurse took a long look at me and called me a silly sausage. I don't like sausages, and I could have taken it as an insult. I understood that was her sense of humour, however, I didn't laugh, or play along. Australian Values. We've all got struggles and hardship, get over yourself. Be apologetic about drinking. You're supposed to bring up how silly and irresponsible you are before we do, and show contrition. 15. Eating disorders and vegetarianism I think eating disorders are still widely misunderstood. It's possible I faced prejudice for being vegetarian. I had mentioned my previous bulimia diagnosis. It has been a long struggle to sort out my eating, and in a hospital it feels really unfair to have people judging me for being fussy. It is still an issue that if I give up caffeine and alcohol, I have to be careful with food. Also, in a hospital, vegetarian and vegan options should be a given, and no one should be hassled, or given attitude over requesting them. Maybe it should be a job requirement for all hospital management and staff to Watch Dominion online. On the first night, a nurse had brought around a tray of sweets, and I think that was to help my detox, but I didn't take any. I was polite, but I'm not sure it was understood that in withdrawing from alcohol and caffeine I have to be careful about what I eat so as not to trigger binge behaviour, or other behaviour or an 'unsettled mind' that will ultimately lead back to caffeine and alcohol. When I detox at home, I've reached the stage in my drinking career where I experience alcohol withdrawal syndrome. At present, the main 'safe' sugar boost is apple and blackcurrant juice. I will usually avoid the orange juice offered on airplanes, and the same type was offered in hospital. I associate it with an unmanageable feeling of acidity later. I was asked every day more than once if I wanted coffee or tea, and maybe I was coming across as a puritan, but caffeine is a serious problem for me. I had to say no every day. I was put in the position of having to say no every day. For me, it's not the same, but it's similar to being asked a few times every day if I would like a glass of wine with my meal. It's a gateway drug. I didn't want to be awake any longer than necessary in the hospital, but more importantly, if I was going to do my rehab, I couldn't be on caffeine of any description - because for me, it's part of the slide back into alcohol, and just having it once can lead to a lack of focus in my mind that leaves things unfinished, such that as soon as I'm on my own, I go back to alcohol. I'm also somewhat surprised that in light of me mentioning my bulimia diagnosis I was prescribed laxatives and stool softeners in case I had constipation from taking oxy - without a doctor discussing it with me. Anyway, maybe it's not a big deal, because I've never taken laxatives, and I didn't need them here, but maybe medical professionals need to be more aware of what it means to have an eating disorder, or to have related addictions, like caffeine issues. I was a 53 year old woman healing from a serious fracture. The main sources of calcium available to me were full cream milk, full fat yogurt and full fat Tasty cheese, although I was once offered and accepted cottage cheese. It's not vegan, it's part soy and part cow, but I asked The Grey Monk to bring me High Protein Up & Go from home, and I continued to consume it upon my release. The soy milk I used to drink had been discontinued some time ago and it was getting harder to find anything suitable in supermarkets. At my age, it's a good idea to make sure calcium and protein intake are sufficient to shore up bones and muscles, regardless of any fractures. Full fat doesn't equal evil, but that doesn't mean it shouldn't be better integrated with lower fat options, for a better overall nutritional outcome. I liked the chickpea couscous. 16. Phone-free Most people can't wrap their heads around what this really means, and it's like they think there must be an app for that condition. I don't have a phone and the only person in Australia I see in person is The Grey Monk. I wanted to note down that when I had my accident, I had no one to tell. I could talk to GM, but he talked about the situation to me, his sister, people he worked with, and a neighbour, and even then, he probably would have benefitted from more support. I was too physically and psychologically uncomfortable to write, and I waited 4 months, until I was better, to even inform Boo. I felt some guilt, as if I were perpetuating unhealthy family communication patterns, but I thought the best I could do was to say I had something to say I'd try to say later. I felt that in a way I was carrying the weight of my fears as well as GM's. Yes, he did everything I asked him, but I had the responsibility of making all plans, and making sure he wasn't burdened more than necessary, while not disregarding what I felt was necessary for my own recovery. Throughout my recovery, I had to fully participate as Project Manager. I guess writing now is my way of substituting for talking to people. I used to at least check my email once per day, but while I still have brief periods of checking email regularly, in recent years, most of the time I only check once per month, and just try to get in and out as quickly as possible. While in the hospital, I did not search my condition on any device. I am not against technology, it's just that my behaviour online is now linked in destructive ways to my addictive patterns. My only chance of connecting with people and the world is now complicated by this extra level of difficulty. During my stay, I did not at any time feel focused or relaxed enough to conduct an online search, even if I'd had a device. When I say that I spent most of my conscious hours trying to breathe and do relaxation exercises, I'm not kidding. 17. Management of Physical Pain My physical pain was mostly managed well during my stay. I was admitted early on a Friday and at first they seemed to regularly ask me if I'd like to have meds (oxy and valium). Oxycodone is commonly called Endone in the hospital, and I did wonder if this is because Australians don't want to sound American. I just said yes to whatever, and also accepted the B1. I am not totally sure when they started giving me paracetamol and ibuprofen. They took blood tests and something about my liver readings was a little high, but they seemed unconcerned about it, and I was surprised it wasn't higher. Later on, when I had a chance to analyze the blood test results, I was surprised that most of them seemed so 'normal', considering the truckloads of alcohol I'd been drinking for the last 5 months. By Sunday I wasn't having much physical discomfort, and maybe I got complacent. Normally, I was given meds every 4 hours, and as the time passed, and no one showed up to ask if I wanted them, I started thinking that maybe I didn't really need them, but by the 5 hour mark I was in pain, and by 5.5 I basically had a breakdown. I described the pain as probably an 8 to the nurse, saying well I can imagine worse pain, and when she asked if I wanted her to bring the pain and frowny face chart I honestly didn't think I could concentrate to read it. I explained to the nurse that it might not be totally about pain, that a lot of it was about comprehending my situation, but that I would appreciate the pain relief I was 'allowed' to have. From then on, I buzzed them every 4 hours on the dot to make sure I had oxy and valium throughout my stay. I was allowed to have oxy every 3 hours, but found I only needed it every 4. In that first painful scenario, I found that it took 40 minutes for the oxy to kick in, and so I had a bit of a rough time, but not past that first time. I also tried to schedule my bathroom trips at the 4 hour mark as well, so as to pester them as little as possible. I got on a chair with a leg extender and was allowed to go unattended, but I had to be wheeled in and out. On Sunday night, it was discovered that my ankle was in a re-dislocated state inside the cast. An ex-fix was put in and was pretty freaky looking, in a fun way. I later found it was normal for nurses to ignore crying patients for a while. There was a woman next to me for a time, and at a certain point she began crying from pain, but didn't want to push the button and be a bother. This is another thing I felt guilty about. I should have tried to talk to her, or should have pushed my button to get the nurses to come, and I didn't. It might be some weird herd response in hospital where patients are unconsciously following rules. I had a lot of time to speculate on a lot of things, and I started to piece together a lot about the psychology of how things work in hospitals, and I will probably write it all down at some point. When I was at home with very little oxy and a lot of discomfort, what I found was that aside from the impossibility even when exhausted to sleep more than 1.5 hours, coping with the pain was easier because I was in my own room. The contrast between that and being in hospital made me more motivated to cope. I'm an addict, and so I know it's risky for medical professionals to prescribe painkillers, but I was able to ration the small amount of oxy I had when at home. I needed 8 of the 20 tabs in the first 24 hours as my pre-surgery nerve block was wearing off, but after that, I rationed the rest over almost 2 weeks. I don't want to get into the Polar Care yet, or that I wasn't ever given clear info about how they could tell when the swelling would subside enough for surgery to be possible, or that every physiotherapist seemed to say something different about how it worked, and how long to keep it on, or that I had to keep explaining to nurses how to refill it even though the instructions were printed on the container that held the water and ice - that sounds bitchy, but I didn't mind explaining, because the ones I had to explain to were actually very nice. If I try to get to the point, it seemed to me that almost no one agrees on the whole Polar Care thing. I was majorly relieved when I found a sign over my bed that said my operation was scheduled for Wednesday. I had had the impression that the earliest they were likely to get to me was Friday, but that it might not be until after the weekend, and I didn't know how I'd manage to make it through the weekend. I don't know if this was random luck, or if anyone shifted things around in an attempt to address my situation. 18. Unusual stress above and beyond When you're a patient in a large hospital, there's no way to shield oneself from all contact, and it's likely you're going to encounter many different personality types and communication styles, but I think some incidents that occurred while I was there could potentially throw anyone off guard. The first anecdote pertains to a me-specific unusual stress. I think a nurse with pattern alopecia was sent in to get me to open up about why I was wearing a wig (if she hadn't pointed it out to me, I wouldn't have noticed anything unusual about her hair/scalp). Maybe the intent was good, and maybe what they were trying to do was to 'problemshoot' the issue since I kept asking for a psych consult. They tried to find me people I could relate to, but it made me aware that I was probably being discussed a lot behind my back, and that no one thought they could ask me any direct questions, and that no one understood the extent of my trust issues, or that when trying to heal, it might add to my psychological load to find it necessary to prioritize someone else's feelings over my own. In the end, I came away with the feeling that the Australian stance is that it's ok to wear a wig if you have cancer, alopecia, or some other medical condition that causes hairloss, but in all other cases, only people who can't be trusted wear wigs, and that perception made me feel less safe in a hospital environment. [Note: the following occurred not during my initial hospitalization, but after my second and final followup appointment when I was outpatient.] It's possible the other nurse flagged me down as I was leaving the ortho clinic to make it possible for a last chance connection before I was gone forever, but the way it came across, it was almost like she and others hoped I would fail on my own. Again, this is the reason some kind of psych consult is necessary. When a person has major trust issues, even kindness can be perceived as judgment, attack or illwill. This particular woman told me that when she had the same injury, she thought she knew it all and so she left the hospital against medical advice, and ended up in a wheelchair for 3 years. And even now, she had ongoing issues, and she showed me how badly her ankle was swollen on that particular day. She also addressed me as 'you poor thing', saying I must be so uncomfortable with armpit rather than band crutches, and the thing is that I felt extremely comfortable and competent on the crutches that day. So it was like that 'kindly intent' actually backfired, and forced me into the position of having to shore up my own perception and self-esteem. And again, to both worry about another person's feelings and circumstances, as well as to try to avoid thinking about how much others had been discussing me, while not actually strategizing how they could get me a psych referral/appointment. I don't even know how to explain the other incident with the abusive mother, on the same day. I feel perhaps a responsibility to try to rewrite this without drawing attention to certain individuals, to have more compassion for them, to make my point without these specifics. I think it's a systemic and a herd issue, it's a belief issue and it is very much about where Australia stands on mental illness and health, whether they're consciously aware of it or not. They're trying to beat me down to their way of thinking, in ways meant to appeal to my humanity. However, I can't help that it remains clear to me that the system, and the beliefs that sustain it, are unhealthy. I had massive guilt in relation to not doing 'something' about the situation with the boy and screaming mother. True, no one else did (including hospital staff), and it was a hospital, but it was clearly an abusive situation, and I chose not to speak - maybe mostly useless, but if nothing else, the boy might have seen that in a public situation at least someone thought there was something off about his mother's treatment of him. I know what the horror of people screaming at you is, I know the stress of primal parental rage, and I went into stunned mullet mode. I had a lot on my mind, just trying to get through my last ever interaction with the hospital intact, but I suppose a situation like this or crisis shows what your real 'character' is, or how much you've progressed or not. In the moment, I didn't know what to do, and so I did nothing. Then I tried to recover and re-focus and get myself to my physio appointment. The hospital acoustics were odd. In the main, large foyer, no one seemed to hear the disturbance, even though it was visible and near. The Grey Monk did not hear. After the coincidental meeting with the nurse who scared me with her personal horror story, I tried to find a quiet place to sit and relax until my PT appointment. The Grey Monk became restless, so I said it was fine to get up and go for a walk. He left a large backpack, I had my backpack, and my crutches were leaned against a wall. My leg was elevated on some seats in front of me, so I was comfortable. A kid ran by, making kid noises, and I smiled, trying to be friendly. He ran out of view down a corridor. His mother then followed, and she bellowed extremely loudly at him, shockingly loud, and went after him, and it looked like she definitely had anger management issues on the high end of the scale. She turned to me and said 'IT'S SO FUCKING FUNNY, ISN'T IT, SMARTASS' in a very threatening way. Hospital staff behind a desk opposite me look worried, and one person picked up a phone as if to call security, but seemed unsure of the correct protocol. They huddled together nervously. I decided not to go after the woman and kid, on crutches, and later this became a source of stress to shake off. What I witnessed was child abuse, and I was worried for the safety of that kid, and I just sat there, trying to focus on my next appointment. It felt like a failure. Anyway.. on the way back, she had the kid in tow, and she came toward me and said 'LAUGH AGAIN SMARTASS AND SEE WHAT IT GETS YOU'. My instinct was that if I said anything or even moved, she was going to lunge at me. I was aware that if I had to stand up and defend myself, my physical pain/discomfort (unmedicated), and my current iffy balance would likely be a problem. My crutches weren't within easy reach, and it was like in a split second I was estimating how long it would take to grab them, and I wasn't sure I could manage. I felt that I was in a very vulnerable position. I said nothing, and kept my face as expressionless as possible, and at the same time I tried to stay alert, and I didn't avert my gaze. After she had left the vicinity, The Grey Monk returned and I relayed the incident. He hadn't heard the bellowing out in the main foyer. It was extremely loud, so it must be something about the acoustics there. Not long after that, a man who worked at the hospital came over to us briefly and said to me 'you're pretty'. I thanked him and he walked away. The Grey Monk didn't know what to make of it, and just chalked it up to one of those things. So that gave me something else to think about. I guessed he might be saying something like 'you're attractive, why are you so covered up', or you have a pretty face, if only you'd lose weight. (Or, the wig brings out your best features, and covers up the worst.) It was a puzzling incident, but I tried not to get overwhelmed, or offended regarding what he actually meant. And then, to add to the surrealism, down the same corridor, there was a guy pushing or dragging along a giant harp, of all things. He took it into the main foyer and started to play. A conscious strategy to soothe collective anxiety? Or was it a regularly scheduled thing? I found myself theorizing that maybe the woman, child and hospital worker were working some kind of scam. There were tons of people every few seconds walking by on crutches, or in wheelchairs, and I wondered if because I was obviously incapacitated and there were two backpacks, that if I'd gone down the corridor to check on the kid, they'd be out of my view and I wouldn't be able to take them with me, so someone could easily grab them and run. And then I started to think there might be security cams, and then that freaked me out and by the time I got to my physio appointment I wasn't so clear or coherent, but the physio himself seemed to pick up the slack and offered multiple options, such that it wasn't say no and it all ends here, and I finally (!) had a psych referral. 19. Leaving hospital against medical advice The day following my surgery, I was taken to a model physio room and asked to climb a set of stairs. I was also observed getting around using a walker and crutches. I don't think anyone was aware the extent to which my self-consciousness in being watched affected things. I was not considered mobile enough for crutches, but the reason for keeping me in hospital, according to the discharge papers, was the number of stairs at my place of residence (there are pretty much stairs everywhere), even though I said the place I'd be was like a self-contained apartment I did not have to leave. In an emergency, I could do what I did when I called the ambulance. I had to make it up the stairs to get to a phone, and down two flights to the front door because the ambulance people were not going to go up the stairs. I was able to go up and down the physio steps on my rear end. They thought I'd have trouble getting up two flights of stairs to my bedroom, and I had trouble explaining I felt I could do it. And once I was home, I did it very fast and was up on my bed in no time. While The Grey Monk held my moon boot going up or down stairs, he didn't ever have to lift me. I could see that while they sympathized with my mental health issues, they were not going to recommend discharge any time soon. I realize that people can make quick improvements on crutches, but I assessed what I thought their criteria were, including the ability to use crutches on stairs, and I was scared of getting trapped there 2-3 weeks. In fact I never actually used crutches on the stairs at home. I factored in my discomfort in being watched, and thought what was most likely was that I might shut down and refuse to do any further PT while there. That's another issue a lot of people don't realize: what am I going to wear for PT, how am I going to handle people watching me perform tasks, do I seem unhygienic, and many times I had already been close to shutting down. I also had other problems I feared might prevent my discharge. I have a recurring rotator cuff injury, and it did flare up during my rehab. And not only that, I sometimes also had trouble with the other shoulder. The left shoulder was the 'bad' one, and my right wrist is tricky and has been since I did all the work on the house in 2017-18. I think I had some kind of carpal tunnel, from all the scrubbing, cleaning, painting, etc, in a 5 month period, and at a certain point, I had to wrap my wrist snugly to give it support so I could continue. Obviously, if you move around needing to use arms and hands a lot to shift your weight, these issues might be triggered, and they could also be triggered using a walker - especially the wrist. I think I have arthritis in my hips, and especially the right hip. My left knee had problems in the past, but was mostly ok, and this time I had issues with the right knee, because of having to keep the leg straight, and having to support the weight of the leg in awkward ways. I did for a time wear a knee support, and this definitely helped. In addition to the numbness I had in the right foot, I also had actual pain and lack of flexibility in the ball of my foot. This is still an issue, and I notice that it's extremely difficult to try to do a lunge if the right foot is behind, but not in front. The ankle seems better able to bend properly than the ball of the foot. At the top of the stairs, it did often feel quite scary. It's like take your pick about what could give out on me. Now all of this sounds like I'm really decrepit, and maybe I am, but I still think I have a kind of flexibility and smoothness of motion that might not be common in someone of my age. I realize this wouldn't have been obvious to anyone who saw me in hospital, because I was constantly on my back, and when I used a walker I was self-conscious and in discomfort. Another thing is that it's like how possums can photograph as plump things from some angles, but when stretched out or walking on a flat surface can look slimmer. I have to be aware, and I have to keep making adjustments, and in the hospital I hadn't had time to make those adjustments. I was not issued the complementary crutches other patients received, or much in the way of advice or harm minimization. I guess they were leaving it up to me to rent crutches? But what it also looks like is that they were saying 'we know you'll be back.' I had been told PTs would be seeing me in the morning after my operation and I realized that this might have a lot to do with my release. After my operation, I was still wearing my gown, and for the operation I had not even been allowed to wear underwear. It was a good time to do another self-sponge behind the blue curtains, before morning, as I wasn't wearing much, and then it would be easy to get dressed and be ready. And doing it at night, in the dark, would have been a lot more peaceful for me. All the nurse had to do was wheel in the tray with two stainless steel bowls, a presoaped sponge thing in packet, and some white gauze cleaning strip things, and I could do the rest myself, and she could take it all away later, at her convenience. Maybe there was paperwork or red tape I didn't know about. I wanted to get this done before 7 am, because that's when tons of people started showing up, doctors making rounds, people bringing food and taking away trays after, floor cleaning, people poking heads in for various reasons, and I didn't want to be in the middle of cleaning myself. And if I didn't get it done before then, I probably wouldn't have another chance before the PTs arrived, and I already knew I'd be nervous and self-conscious, so it would have been a psychological step to at least improving my chances, to feel a bit cleaner. The soap in the sponges seems fairly strong. The nurse told me there were only 2 nurses on for the whole ward, and so I immediately felt guilty, but the problem seems to be that the nurses are overworked, not that my demands were unreasonable. Her anger should not have been directed at me, but at her employers. I thought at the end of the conversation that her preexisting ideas about me had been challenged somewhat, but I'm not sure what the final effect was. I didn't get the bowls as early as I wanted, and I did have discomfort and I was walked in on in the middle of washing myself. I tried to be a good sport about it, and to concentrate my efforts on getting the hell out of there, that day, and in that, I succeeded. The sensitivity training might have robbed me of valuable information. For example, no one told me how going back to alcohol might interfere with healing. I managed to go without, but many alcoholics would just drink as soon as they got home. While knowing the possible effects might still not have stopped me, I don't think there would have been anything offensive in giving me this information, such that I at least had an option to make an informed choice. It was more offensive to wonder out loud if maybe it was time to make some 'lifestyle changes'. It could relate to that whole 'empowering' thing, and so if a patient doesn't ask herself, it's bad form to push the info on her? But we have to see the overview, and also in particular it should have been noted down how many times I asked for a psych consult. That should have been in all notes, and training should include that for trauma cases, or unusual cases, such as mine, where a person has a wide range of issues and trauma responses, that it is good to try different approaches to making it possible for such a person to accept a psych appointment/consult, even if it's in the future, to not cut all threads, to realize a lot is going on in a hospital stay, the person is dealing with a traumatic injury, is detoxing from alcohol and caffeine, has been a shutin for most of her life and hasn't been hospitalized for 30 years, is not used to talking to people, and once the stress has reduced somewhat, she might be ready. There needs to be an understanding that overstimulation is as harmful as understimulation, especially when a person is forced into the opposite extreme after experiencing the other. 20. Arranging psych services after release I may have been too distraught to understand what was communicated to me, but part of the problem is that throughout the hospital stay, I had to make many decisions on the spot with no time to search, or go through options in a safe environment. While in hospital, it seemed impossible to arrange any kind of psych consult. After my final outpatient visit, I started the process with a referral I had obtained from the physiotherapist I saw that day. If expected to talk on the phone on the spot, it seems unlikely I would be able to convey enough relevant info to feel any potential therapy was starting off on the right foot. Yet after faxing in the referral, and waiting many weeks, that was exactly the situation I found myself in. I had to be ready at a moment's notice to start from scratch, with someone who knew nothing about my situation. Covid-19 limited treatment options. If the only therapy options include voice or video, it seems unlikely any therapy would be possible for me. My longstanding unresolved issues include but are not limited to talking on the phone and being photographed or filmed. I don't own a mobile phone. Rather than just assume the situation was hopeless, I thought I'd wait and see what was suggested. For example, is it possible to start out with plain chat/IM on a computer? I can type quickly and can organize my thoughts quickly while typing. On the Psychology Department's website, it was stated that one of the issues they deal with is Phobias Preventing Treatment. When I finally spoke to a psychologist on the phone, I first wanted him to read an email I had written, to introduce myself, and so I wouldn't blow my only chance. However, he did not want to read the email. The phonecall went badly, and in the end I gave up my spot to someone more deserving, in The Time of Covid-19. The one thing I want to point out that went well: when I had my PT consult in January, the physiotherapist seemed to grasp my situation, and offered me many options, such that it wasn't a black or white, all or nothing thing. I left with a referral, and the option to send it in or not, when/if I was ready. So I had time to think and then I asked for GM's help, and he faxed it in, and spoke to someone on the phone to make sure they received it. I couldn't have done this myself, as my anxiety was too unmanageable. So, you get a case where there's a person who has been without psychological treatment for 30 years and who lives in extreme isolation, who is clearly saying she wants a consult, and nobody can figure out how to make it easier for her (with one outpatient exception), or to help make it happen. To reiterate, I think the best I really hoped for with a psychologist was some kind of validation, acknowledgment or feedback, not that my lifelong issues would be resolved such that I become either a productive or valued member of Australian society, or even that I begin actively participating in the types of treatments currently available/prescribed. And if I'm honest, I know I wasn't going in with a totally open mind. I wanted to expose the prejudice and stigma I suspected were behind the way everything is run. I wanted confirmation that Australia's approach to mental health is fucked. However, I still genuinely wanted there to be some way I could talk to someone, and feel trust.  Panic Room 2006 21. Rehab at home From the night of my accident, I was sober for 18 weeks, and caffeine-free. During this time, I was able to do the physical rehabilitation exercises required for my ankle, as well as exercises for my overall fitness. The Grey Monk made my bed with my old quilt and quilt cover. Since I was going to be putting a moon boot on the bed, and I might spill things, I thought it was better to store the white set. The white one has held up pretty well for more than 8 years, even though I have spilled red wine on it a few times. The thing is, as soon as I'd spill, I'd jump up quickly and get the stains out. I couldn't see myself doing that in my current condition. The interesting thing was that my room ended up looking a lot like this image I created back in 2006, when I wanted to know what the room would look like with black walls. I no longer have a tv in my room - one wall is composed of cupboards, a computer desk, monitor. When I changed my room in 2011, the environmentally friendly lighting gave a more blueish cast to everything, but those original bulbs were taking longer and longer to boot up in 2019, and when I returned from hospital, The Grey Monk changed them over to new ones that turned on immediately, and made my curtains look a redder red. [The old air conditioner was replaced in 2011 by a highly efficient and environmentally friendlier one, in a different location.] In discharge papers, it was acknowledged that with my type of fracture I might need pain relief longer that the prescription they provided would allow for, but even though I had stated I had problems going to a GP, they just said see a GP. I was fully allowed to have my quota of paracetamol and ibuprofen daily, although they were unclear about for how long, and didn't seem concerned about any potential organ issues, even considering my alcohol abuse. When I had been discharged from the hospital, I spent one day searching rehabilitation options, but I had so much (physical) discomfort sitting at the computer, and I was so overwhelmed by it all that I decided to shut it all out and do it intuitively. Maybe at some point I will need to go back, and re-search, but at present, I can do everything I need to do for my daily functioning, and I feel that I know how to approach more serious training if I want to be fitter, as in the past. For the first two weeks, I stayed on my floor, and only left my room to go to the bathroom or get snacks from the converted pantry. I did some laps of the hallway with a walker. I only went downstairs once to see possums. After my stitches were out, and I was told I could take the moon boot off when not on my feet, my progress was fairly rapid. Once the stitches had been removed (12 days post-op), in hospital, I had a brief session (in the ortho clinic) with a PT who measured my range of motion (out of the moon boot for the first time there wasn't much), and suggested 3 exercises. He let me have a pair of crutches to take home. After that, I did ankle exercises three times a day, every day. Point-flex, side-to-side, circles (clockwise and counterclockwise) and alphabet with toe. I also started doing core exercises in bed and side leg lifts with point and flex. And a lot of stretching. From there, I added intuitively. When I was ready, I first started raising on my toes while in a seated position, feet on floor, and then I did it standing, and then I did one leg and then the other. I did a lot of stretches, including calf stretches. When I was not using the moon boot any more I started using the treadmill. It seemed that going up and down the stairs also helped and although I only managed once, when I walked in the neighbourhood outside, it seemed to me that I needed to walk on varied terrain in order to re-develop certain abilities. I had been scared to use crutches, partly because my bedroom is cramped, and partly because the carpet is an unstable surface, and even once out in the hallway, I'm never far from the opening at the top of the stairs where I fell and had the accident. But to do the rehab, I had to start doing back and forth trips the length of the hallway, first with the walker, and then on crutches. I worked up to doing 30 return trips at a stretch. For almost the first 6 weeks post-op, I had a very uncomfortable numbness, and was almost constantly trying to massage my foot, or apply pressure to it. It was very unpleasant. But just a couple of days before my 6 week appointment, it started to ease up a little, and in the next month or two, if it wasn't completely normal it was manageable. I had a gel ice pack and used it about 3 times a day until the 6 week mark. A few days before my final outpatient ortho appointment, I had the sense/intuition that my ankle was healing properly, and that if I did not go to the appointment, I would probably be able to figure out the rest of my rehab. I didn't know if this was a kind of desperate wishful thinking. Another issue was that for 6 weeks, I had been afraid I might have permanent nerve damage, and my doctors had been rather unconcerned about it. Yes, I received an explanation - that it was related to swelling that impacted the nerves, but the discharge papers were full of warnings and disclaimers and the discomfort I had was so severe as to prevent sleeping. In Canada, when you're out in the cold for hours and your feet go numb and just won't warm up, it's a very unpleasant feeling, and when your feet start to thaw there's a lot of pain. The unpleasant feeling was intense and constant, such that I was constantly feeling I needed to try to massage it or put pressure on it. A few days before that ortho appointment, it did seem that the unpleasant feeling was letting up somewhat. That progress continued over the next months, and eventually it felt fine. In early April, my continued training was put on hold, as I fell back into alcohol and caffeine, but in May I began to try adding in jumping jacks. The first week it felt a bit odd, but after taking one day off, it felt pretty normal to me. At present I'm in a chaotic state and my training is on hold, but I think I know what to do when I am able to focus. I went back to caffeine a few days before I went back to alcohol. 22. The Grey Nurse I don't want to leave out how much The Grey Monk had to do. It was significant, and many people wouldn't have been able to. While I was in hospital, he visited every day, and brought me what I asked for. I advocated for myself, but he also advocated for me, and let me know in various ways that I had his support. I want to try to at least note down some of what The Grey Monk had to do, aside from cooking dinner every night, doing the household laundry and washing dishes. After I had been in the hospital a few days, sleeping in my clothes and wig and hat, I realized that something would have to be done. I asked him to bring me a batch of new clothes and the sewing scissors. Because I had the ex-fix in place, I didn't think my yoga pants would come over it easily, and I didn't want to disrupt anything. Up until this point, all work had been done on my ankle through rolling up my yoga pantleg to the knee. I had to ask him to cut me out of my pants. I then wore drawstring pants, an old pair that I could easily get over the ex-fix, and that made going to the toilet easier, also. I also had an idea: maybe because he's so good at sewing, he could sew strips of velcro onto the pants he cut - and he did it. It didn't work out so well, but he had tried, and later, when I was better 'enough', I removed the velcro and sewed them back together because they are still comfortable pants. He prepared my room for me at home, including rigging a doorbell I could use to summon him. He rented a walker and a raised toilet chair, and the latter did make things easier. He later installed a bar beside the toilet, and this might have been sufficient originally, but without it, there wasn't much in the small room to grab on to. I had hand sanitizer in my room and in the toilet, and I used it often. In the first weeks, I had major discomfort any time my leg was not elevated. When I arrived home, The Grey Monk held the moon boot when I went upstairs. I'd use the walker and sit down with pants up on the toilet, he'd put a chair in front of me for the leg, pillow under it, and then he'd leave and come back when I was done. I had to use a lot of hand sanitizer, because making it to the sink was too difficult. I figured out, I was constantly figuring out, ways to make things easier for both of us. I copied the hospital version of self-sponge bath for my room (I was not able to use the shower for 2 months! The horror! The horror! and it was another couple of months before I went back to showering in the dark - although I can do that easily now). Eventually I would sit in a chair at the sink to wash, including my hair, but that was a nightmare. The first time I did my hair, it was so greasy it felt like it was wet, or like it had absorbed a bottle of olive oil. The Grey Monk's hair would never be that greasy in a year without washing. A massive build up of skin eventually occurred on my foot (actually both feet, but a lot more pronounced on the bad one), and I realized I needed to soak it in a basin and scrub. (Both) I needed to do that a few times to normalize. The Grey Monk would write down on his pad all the items I needed to do these types of things, and bring them in and remove them after. The Grey Monk made dinner every night. I kept snacks in a plastic box beside my bed, and I had a large refillable bottle of water. There is a converted mini-kitchen across the hall, and he kept that room stocked. I had a small cup for rinsing/spitting - I brushed and flossed my teeth in my room (I had started doing this in hospital, there hadn't seemed to be any other way without major disruption to already overburdened nurses.) The Grey Monk would (at first, until I became more mobile) have to empty the cup and refill my water. He would make 4 sandwiches at once, 2 cheese and 2 peanut butter, on wholewheat, and individually wrap them, and I'd use the walker to collect them. At first, I was trying to keep my leg immobilized as much as possible, but after the stitches were out, I started doing more and more for myself, like refilling my water bottle. He installed a support bar in the toilet, and replaced two towel racks in the main bathroom with support bars. Only one flight of stairs in the house already had a handrail, and he installed two more. There's a bar for the shower which has yet to be installed, but there were some issues in not knowing exactly where pipes and whatnot were. I actually like the look of the support bars better than the old towel rails. One thing that has changed is that when I use stairs now, I always use handrails, and while I used to often carry many items while going up or down stairs, now I reduce the load and take more trips. 23. Possum Therapy During the first 12 days I was back home, I only saw possums once, and I also didn't see them for the week I was in hospital. It was the longest I'd gone without possums for years. I was very nervous using the stairs. I didn't feel strong or confident, even when I went down on my rear end. The first night, I was very happy to see them, but it wasn't until after my stitches were out that I began to come down every night. I remember there was an unidentified ringtail that first night, and because Nikita hadn't been seen for some time we assumed it wasn't her, but it might have been her. The brushtails hadn't let her get close enough. I couldn't stand in such a way as to get a better look. After the stitches were out, the possums visited every night and came at a convenient time for me, such that I only had to come downstairs once per night. Miel and Sasha both sort of put hands on the walker, checking it out, and Miel climbed onto my canvas deck chair. Once I started seeing possums every night, I think it helped to have that structure. For the first few times, I sat in a canvas chair and they came onto the handrail so I could feed them, but before long I'd sit and wait for them to arrive, and then stand to reach something to them. The possums became my motivation for desensitizing myself to using the stairs. 24. PTSD 2020 I have never been officially diagnosed with PTSD. I started having nightmares not long after I got to the hospital, and they continued after my release. I don't at present want to write them out, and when they occurred I did my best to block them so that I wouldn't make associations that kept them in memory. I tried to analyze enough to get the gist: there was no place in the world I would ever be safe. Over the course of the years, it has seemed that occasionally unresolved PTSD from 1982 has been triggered such that it flares up or intensifies for a while, and then goes back to baseline. When I returned home from the hospital in December of 2019, I started easily, or overreacted to stimuli, and I experienced hyperviolent, mutated versions of flashbacks. I am still having the latter, especially just before I have to use the stairs or think about anything related to using the stairs. Upon my release, I had trouble even when exhausted sleeping more than 1.5 hours. I had a hellish time of it, and yet, there was contrast, and it still was better than being in the hospital. In the hospital, at first the combination of oxy and valium seemed to help me sleep, and not long after I'd take them, I'd be able to sleep sometimes for 3 hours. I was fairly sleep-deprived by the time I was taken from Emergency and placed in a ward, and in the early days, that might have helped me sleep. I think that started to change about halfway through my stay. I think the nightmares began to ease up after my final trip to the hospital in January 2020, but they did continue intermittently for a while and my dreams now are hardly pleasant. I think I have mostly returned to baseline. I still have an exaggerated response to hearing noises on the stairs. For example, if The Grey Monk drops something, and it makes a noise, and I'm not sure if he's fallen and hurt himself, I feel panic, and need to know that he is ok. Also, in the early part of my time back home, he slipped on the stairs twice in a very short period of time, and I had two different reactions: I was afraid for him and it stressed me out, but I also felt rage: I felt he was in denial about how dangerous the stairs were, especially when he brushed it off casually, and to me it felt like he was saying only a ridiculous person could hurt themselves on these safe stairs, especially since both of us had slipped or fallen on these stairs in the past, sober, and I'd broken my big toe once, when I was completely sober. Before the accident, I had trust issues, and I felt disconnected from life and people. After the accident, I would say that things felt they reached a new stage of seriousness/hopelessness. It didn't seem there was anywhere safe in the world to go, even my 'home', that I was right about the impossibility of fitting in with any Australians, and although I can argue that technically no one is safe at any time, that I know anything can happen, for me it's something different and while I might not want to admit it in words, I feel like I'm done with the world. I think what's difficult to get across is not just that my behaviour is weird, that I have weird issues with wigs and clothes and problems with people touching me or looking at me, that I shower in the dark, that I don't undress all the way for bed and my room is always dark, and that even the person I live with walks around averting his eyes, it's that there's a feeling that goes along with it, a feeling of instability and unresolved trauma. I'm not sure I exactly had flashbacks, but images of violent falls would come into my mind while I was healing, and this still occurs now, especially just before I have to use the stairs, and it also started recurring with increased frequency and intensity when The Grey Monk was due to come back from a recent work trip. Maybe think Suspiria as far as imagery. What also occurs to me is all the different ways a human body can slip or mangle itself in daily life, and what a miracle it is that it doesn't happen more often. I try to block these images and thoughts. At first I tried to replace them with images of myself safely performing tasks, but settled on blocking and just using the stairs. I use them many times each day, and while doing rehab, when practising with crutches, I had to use the hallway and go back and forth past the unguarded place where I fell, over and over. Sometimes when violent images of falls and manglings pop into my head, I have been able to imagine myself as a cyborg, that I'm like Nova Mnemonic, and if something bends into a weird position or breaks, it can smoothly and surely go back into position or fix itself, or I can fix it. The most difficult thing is going down, not up stairs, but I do it many times a day, and I think over time there will be less discomfort. When the ankle swells now, it is usually considerably less than a couple of months ago. I don't think I'm having trouble adapting to it, and I like the idea of being a cyborg or transhuman. I think for the future, I will be able to figure out how to do more strenuous or difficult exercise, and how to increase my endurance. Technically, perhaps I'm not a cyborg, but my xrays are cool, and I suppose I'm glad not to be totally Organic. To be transhuman is to avail oneself of science to improve upon the human body. If I had the choice to remove the metal, I wouldn't want to. 25. Two outpatient appointments Since my release from hospital in early December 2019, I have been back to the hospital once after (almost) two weeks post-op to have stitches removed, and once in January (approx. 6 weeks post-op) for x-rays and a consult with a physiotherapist. When I had my stitches out, I had no privacy, no blue curtains. I was on a stretcher in a busy room with a lot of other patients, and I had to make full trips back and forth the length of the room with a rollator, and then on crutches, in full view of EVERYONE, All the things I had communicated in my hospital stay counted for nothing. It's hard to know for sure when medical professionals are judging you and believe you brought something on yourself because you're an alcoholic or bad person, or whatever, and have no patience with your silliness, or whether they just don't know the backstory. Or, whether if they knew the backstory, they'd like or respect you even less. I was glad I made myself walk with the crutches, though, as the PT said I could take them home. (This was a different PT to the one I saw in January, and in fact every time in hospital, I had contact with a different physiotherapist - there might have been 5 in total in the hospital (or more), and 2 outpatient. And when I was inpatient, most of the time contact with physios related to farting around with the Polar Care, as I was supposed to keep the leg immobilized as much as possible.) At the 6 week post-op appointment, my ortho surgeon examined the x-rays and my ankle in person and said that I had done better than he had expected me to (and better than most people). At this time I didn't care if anyone had underestimated me, for any reason, it was basically just such a relief to hear that all was healing well. In my original (very brief) discharge papers, the plan had been for me to do a step-touch thing when on crutches until my 6 week post-op appointment, but a few days before the appointment I started doing a heel-toe rolling motion in the moon boot as it felt natural, and it seemed to me to continue the other would put too much pressure on knees and hips. I almost didn't go to that appointment. For about a week before there was major stress, including an increase in PTSD symptoms. It had been hard enough to face the 2 week post-op appointment to get my stitches removed. I didn't know if I'd make it to the January appointment, right up until the last minute. A few days earlier, I'd had the sense/intuition that everything was healing correctly and that I would be able to figure out the remaining rehab myself, and so I could skip the appointment if necessary, but it did feel extremely good to hear this confirmation (about how well everything was healing) from someone with more training, experience and knowledge than me. 6 weeks is a long time to try to focus on the hope that you can figure it out, on your own, and I didn't know if my 'intuition' was wishful thinking, inspired by anxiety at the thought of going back to the hospital. I obtained a psych referral from the physiotherapist. I explained some of my issues to him, and he gave me various options, including that I could take the referral with me, and think about mailing or faxing it in. First though, I had asked him to walk me through what to expect and to outline a course of treatment over the months. I said I understood the difficulty, but I accepted that it would be my best chance to absorb as much as I could, and I knew it wasn't the ideal situation. I knew I wasn't going to go back to the hospital, considering how difficult it had been just to get there on this day. On the visit to discuss my x-rays, I did have privacy (I was taken into a consult room), and I also had privacy at the PT clinic. (I was taken right to the back of a long row and had blue curtains.) I think it's possible that what I was wearing was so un-Australian and inappropriate for the weather that it was like a secular version of wearing a niquab and modest clothing that covers everything. On the day of my final appointments, two women wearing headscarves and modest dress smiled at me, perhaps seeing the similarities. (I smiled back.) Technically, my head and hair were covered, because I was wearing a wig and hat. Because of my 'inappropriate' attire, my body covered in layers of black clothing from head to toe, maybe I ended up attracting more attention to myself than those who adhered to the unspoken rules of what it is acceptable to wear in Australia in summer, and I became as much of a target as those wearing headscarves, or perhaps a more politically correct target. How can a traumatized person feel cared for when in a stay of less than a week they literally have contact with hundreds of people? I remember things better when they're written down, I absorb more, so it's possible my stressed state combined with that failing made it difficult for me to understand what people were telling me, but different people said different things, and even the Grey Monk said some people made mistakes or said untrue things, and he said that I was clear and coherent and articulate throughout. 26. How's the ankle now? I did a good job on my rehabilitation. I was regularly walking without a moon boot, and trying for most of the day to go without crutches by the 2 month mark. I found that using the treadmill (on a slow setting, then playing with the settings) helped to train my gait, make it even, and helped me to gain endurance. I put my moon boot and crutches in storage approximately 2.5 months post-op. I have good range of motion/flexibility in my ankle, possibly greater range of motion than some people ever have, even if they've never smashed their ankle. I have good strength, endurance, and balance. If I spend a day on my feet, there is still swelling, but it is fine the next day. I am a bit wussy about going down stairs quickly, but I can otherwise walk and move around 'like me'. I think this ease of motion will be more noticeable in less confined places than this house. I can balance on the 'bad' leg, and I can do calf raises. I can do jumping jacks. I feel that if at some point I am ready to train in a more strenuous way, I will be able to figure out how to do it safely and effectively. 27. Last thoughts It would be good to make provisions for Psych staff at Emergency hours, who are trained to recognize and offer support regarding many issues, and who can be sensitive to various kinds of trauma, anxiety, and 'Phobias Preventing Treatment'. In addition, many people undergoing physical trauma or illness may benefit from having greater access to psych services while in hospital. It could even be considered that psych support is a necessary aspect of medical care, and that ideally, Australia would transition to a more holistic model of care. I'd like staff to be aware that if someone has sensitive material to express, they might feel unsure of what to tell, and how much should wait until someone is really listening. In conclusion: In the long run, it might be a good idea for a person who has lived in an isolated or traumatized state for an extended period to have many different interactions with different people, who might have had similar experiences or who can help the person become accustomed to contact with people again, but first, trust must be established, and without it, it's just overload, further traumatization, and good intentions gone awry/amok. If it seems that someone's needs are too complex or unreasonable considering available resources, and that person is clearly suffering and their prognosis is poor, please consider that voluntary dying might be the most positive outcome. Rainbow of Cognitive Dissonance (continued) Dr Velvet Thong: How is it for you writing about all of this? Velvet: I felt like I needed to write, and it might have helped or felt like a relief or release initially, but the editing process started to feel overwhelming, and now it's becoming a torture to keep reliving it all. I don't think I can keep at it. Dr Velvet Thong: I'm a bit reluctant to say this, but although you describe events as catastrophic, you still seem like 'yourself', and I'm not sure I see how you're any worse for the wear. Velvet: This is pretty much what I was afraid of. A long, slow, agonizing decline. I don't know if I'm being false. Maybe I'm not really any worse off, and maybe it is for the best that I did get the ankle fixed. The hospital staff tried, and I tried, and between us, we managed to get the best possible result. Despite flaws on both sides, it worked? And if I'm not really negative, if I still have some secret hopefulness somewhere, then isn't it better not to belabour all the negatives with the hospital experience, and focus from now on on having a new lease on life? But if I don't share my experiences, such that I feel like I'm doing something to contribute toward increased awareness or understanding of the need for psychological care in combination with physical care, won't I feel more negative? There are good things in the system, but I want the system to change. Others might have less motivation for wanting the system to change or evolve. And if I don't even try, what about progress regarding more humane end of life options? Shouldn't medical professionals take a stand on this? Dying is something we will all do some day, so isn't it relevant that we all think about how we want to die, and make our wishes known? I am thankful to surgeons and medical staff that I am able to walk, and I feel some anxiety about not expressing this or making it clear to them. However, I also feel anxiety and shame about how much time, effort and resources were invested, and it seems a waste when the reality is that I don't really want to live, even though a good result was achieved. Dr Velvet Thong: How is The Grey Monk? Velvet: I'm not completely sure. When I've had some PTSD meltdowns, he manages to stay calm, supportive, and understanding. I know that even if I can say 'I think this is what is happening right now, it's a PTSD symptom', it's still difficult to stay calm yourself if someone is using a non-calm tone of voice, and seems highly agitated. He's been able to complete his work assignments and deal with the tasks of everyday life as usual, and his personality hasn't undergone any noticeable changes. He seems like himself. He might snap one day, and it would be understandable. I'm always trying to get myself together, to leave before it happens, to make the decision for both of us, before we're caught in a fire tornado. Since my trip in 2015, I haven't left the house much. In 2018 I went out a few times, and there was that period when I was technically outside because I was working on the house, and in 2019, for Xesce's 21st anniversary/birthday, I went to the beach with her and The Grey Monk. But since then, there's only been the hospital. The Grey Monk's help was invaluable, and I know a lot of people would have abandoned me, or would not have been able to cope, and might have called professionals to deal with the situation, or take me away, or lock me up. I am grateful that he did not. However, I do not think it was particularly efficient of me to have an accident so that The Grey Monk could feel like he had something he could help with, such that he could feel less useless and closer to me. That's a fucked up relationship. It's like Boxing Helena. OK, I understand that maybe part of why he felt closer to me was that we went through something difficult together, and in a sense we took on the system together. Maybe in some ways he was proud of me, understanding what I was going through, and that despite what I was going through, I was articulate, and considerate of others, and so he was impressed with my personal qualities. That does not negate or disqualify the other problem. Dr Velvet Thong: But do you acknowledge it's understandable that people who don't know you can't just assume you've given anyone or anything a fair go? Velvet: Yes. It's one of the reasons I find it unrealistic to socialize or connect with people. I know what I'm in for as far as 'justifying' or explaining myself, and I'm not sure I have the energy or endurance for it. It's already difficult enough that no matter what I say, on any topic, everyone's default position will be to assume that I haven't thought about all the positive ways to view any situation, such that we have to go through 20 or more questions and answers before they might even get close to conceding that my overview or position regarding dealbreakers might be valid. The way it all ended in the hospital, I felt that even those who had been kind to me or had gone out of their way in the hospital probably thought I was an ungrateful, crabby bitch. I started losing the sense that I had indeed been articulate and respectful. I also felt worried that the many people who seemed genuinely compassionate might feel I had dismissed their efforts, or them. Dr Velvet Thong: I'm not so sure. They might just have seen you as a lost cause, and it might have caused them discomfort for various reasons, including but not limited to feeling bad that they didn't know what to do. Velvet: One thing I worried about or wanted to ease people's minds about relates to blame and legal issues. I can understand that people are afraid of being sued, but I know I was already broken before I got there, and I understand that they do things in certain ways because they don't run hospitals for unusual cases - they have to think about the greatest good for the greatest number, and they are dealing with a limited number of resources. Anyway.. in a practical sense, there's no way I would have been able to deal with going to court, or any of what would have been necessary. In writing all of this up, what I hope for is increased understanding. It's not about seeking compensation, or revenge. Dr Velvet Thong: How do you think society views people like you, people who did not get help 'early enough'? Velvet: I think they blame us for our own problems, or we're amongst the invisibles. Parents get counselled that kids need a certain amount of structure and that if you move them around too much it can mess with their sense of stability and their futures, and also, if you fight violently amongst yourselves, you can also scar them. Rape, physical and psychological abuse are considered bad, as is neglect. Pedophiles get beaten up, harassed, killed. Poverty and prejudice affect life outcomes. Natural disasters, like bushfires, can take their toll, pandemics might call into question the futures of those at critical times in their schooling or development. But if when kids grow up they're supposed to be able to shake all of these things off, and be proper Robust Australians, what's the big deal? Australian hospitals and Australian conversations where non-un-Australian Australians are suppposed to be tough enough to Front Up don't make it easy to talk about yourself without people becoming suspicious of what a wuss you are, suspecting that you might be someone who likes to play the victim and milk it... If it's not really a big deal for anyone to go through these things, then we need to stop being so fucking mean to pedophiles and rapists. The kids are young, they'll just get over it. We need to say what's the big deal about natural disasters and pandemics, and let the chips fall where they may. We might as well encourage people to breed, breed, breed, regardless of whether they feel ready to be parents or not. Ok, I'm going off the rails a bit.. We throw around clichés like 'it's best to treat mental illness early', 'it's better to talk to someone than keep it in and let it fester', 'it takes courage to seek help, it's not about weakness'. In my experience, the way the system is set up, it's extremely difficult to get help if you're someone who did not get help 'early enough'. Dr Velvet Thong: We can be efficient here, it doesn't have to drag on for years, let's wrap this up in 5-10 sessions max! Maybe it is something that needs pointing out. There are people who for whatever reasons didn't get help early, and sometimes it was because the system itself was flawed or prejudiced. We now look with horror at the idea that homosexuality was once treated as a mental disorder or that we performed lobotomies on troublesome/'hysterical' women. Dare I say it? You would have probably been one of the glaring candidates. For the record, I would again like to state that the ways in which rapists, abusers and pedophiles are seen, discussed and treated aren't ultimately helpful, although it is important for their victims to have acknowledgement and that steps are taken so that they and others can feel safe. More effort needs to be put into understanding the whys of behaviour, and trying to address them. This does not mean that those affected by their behaviour are supposed to shake it off, and it doesn't mean that I can't see that it is safer for society to have somewhere to put people who behave in these ways. Velvet: We're now getting into some things I didn't know how to fit into the existing structure, and that I don't think I have the energy to organize even if theoretically it could be done if I could handle hanging in there longer. When in the hospital, I was asked at a certain point if I had any other medical conditions, and I was asked at such a time (I don't remember exactly what the circumstances were), that I couldn't understand the question and my mind went completely blank. I think I was trying to sort out what might be relevant to surgery, or any medications they might give me. I would like a prescription for Valcyclovir, but the stigma in relation to that would have made me feel even more unsafe in the hospital. It crossed my mind that I have ichthyosis vulgaris, but I thought maybe since it was summer that might be irrelevant if they can't see anything on my leg, and I didn't want to confuse things. It crossed my mind to say something about possible undiagnosed IBS, but I had so little strength at the time I was asked that I thought it would only sound nebulous, and/or that it would only confuse the issue when I was supposed to be putting everything else to one side while I concentrated on my ankle. Besides, the way they come to a diagnosis of IBS, after first crossing some other things off the list, with very unpleasant and invasive testing, didn't seem like something I could ever cope with, let alone in an already highly stressed state. The other issue is that just because the blue curtain is up does not mean that other patients can't hear your stigma-affected conditions. After I was discharged with a script for 20 tabs of Oxy, just as my pre-surgery nerve block was wearing off, I was told to get any further Oxy or pain relief from a GP, even though they were aware (because I told them) I'd have trouble going to see my GP, and that I hadn't seen her in more than 4 years. Some GPs offer home visits, but no one should ever assume that I'd be able to cope with having a doctor in the place I live, in my room, even though my room is 'nice', tidy, whatever. That actually would have been worse than going back to the hospital, and would have intensified my nightmares beyond imagining, no matter who the doctor was. As it was, I had to make the major adjustment of allowing The Grey Monk into my room, for a time. Dr Velvet Thong: Cyborg's Trial By Fire?  candlemaking 2020 Dr Velvet Thong: Have you muddled things now beyond all repair such that no one will ever trust what you say? After 30 years, you say you've had a good period, you've pulled yourself out of it, and now you're back on team Voluntary Dying to stay? Velvet: Even in that 'good' period, I would have been happy to have Pento, any time. I've always been on team Voluntary Dying. I'm left with the feeling that I really don't belong in Australia, but there's nowhere else to go. I think there are many compassionate people in Australia. I think there are psychologists who manage to get the qualifications and who are able to fit into the structure, and then once there, they are able to 'do their own thing', and help those with complex issues. However, I do not trust my ability to communicate with them or connect with them - it's kind of like it seems to me it will go the way it always seems to go when I have to talk on the phone. It is overwhelming to think about the history of suffering, the history of medical advancement, all the centuries and more of humans breaking bones and all the trial and error, all the pain and screaming, all the horrible complications, all other physical and mental health conditions... the painful deaths, the slow deaths, all the millions of shades and horrific creativity of awful death. Border control: when I think back upon the process of applyling for a permanent resident visa here in Australia, I do see that they wanted to make sure not only that I was white and spoke English, they wanted to make sure I was robust enough to survive physically, mentally, financially, and socially in this country, before allowing me in, and I got past the border. When I was in the hospital, the immigration laws, which are connected to Australian values and belief in robustness, were unconsciously affecting those who treated me, such that while on the surface it seems like I was shielded by curtains and dimmer lights, it was like I stood out to everyone, and many couldn't resist having a go at me. I was the dangerous outsider that triggered suspicion. I was using Australian resources I had no right to. I am not a benefit to this country, Does it make sense when you travel to try to live like a local if you don't live like a local in your own home environment? My Apocalypse Outfit  Rainbow of Cognitive Dissonance 2020 More painting with nail polish. Dr Velvet Thong, Velvet, Okti and Blinky get up, face the audience, and take a bow. ->exile on meme st: a diary ->xesce.net  |
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