Tag Archives: Hospitalisation

You wanna know how I got these scars?

Most people don’t notice the largest scar on my face. It hides in plain sight. It’s very pale, I’m very pale. But it’s quite long, starting about an inch above my left eye, running all the way up my forehead and ending about an inch and a half past the hairline.

The smaller facial scars are the ones that make their presence felt, because they’re the ones that interfere with the shape of my right eyebrow. It always looks a bit oddly plucked.  This annoys me far more than the deep, pale scar on my forehead.

Then there’s the scar on my left knee. It’s ugly and unmissable – or at least it would be if anyone ever saw my knees. That seldom happens. I don’t have much of a summer wardrobe, living in a place where warm weather is not abundant, but even the skimpiest of my dresses tend not to show off my legs. There’s not much about my body that makes me feel self-conscious, but the scar on my knee does. I hate it.

All of these scars are from the same incident, and they all turn ten years old today.

On the 8th of March 2005 I was involved in a five-car pile-up. I was still singing back then, and I was on my way home after a performance. The crash took place on Queensferry Road, just past the Quality Street junction heading away from town. Having grown up in the north-west of Edinburgh, it’s one of those places that has always been part of the landscape of my life.

At about 23.30, someone swerved out from his side of the road and onto mine. Despite the time of night, the road was busy. There was no evasive action I could take. All I could do was brake and hope.

The approaching car hit me. The car behind hit me. Apparently two other cars hit mine as well, though I don’t know how. My awareness ends with approaching headlights and the thought “I fucking refuse to die here” and resumes in the wreckage, watching blood dripping onto the airbag and realising it could only be mine. My passenger door was open and someone was telling me to stay calm and wait to be cut out of the car.

With impeccable shock-logic, I reasoned that if I didn’t have to be cut out there might be some chance that my car – my Mum’s car – might be saved. So I unbuckled my seatbelt and climbed out. Via the passenger door, because mine was staved in. As I hauled myself out I noticed that my left wrist was probably broken. Didn’t clock the multiple pelvic fractures, though. I staggered around for quite a while, trying to get someone to tell me what had happened and whether it was my fault (at this point I couldn’t remember the events prior to impact), before the paramedics arrived.

The twenty minutes or so that I spent in that ambulance were among the worst in my life. I was bleeding, frightened, in pain – and when the paramedic asked me if they should call someone, I had no answer. I desperately wanted my Mum and Dad, but Mum had been dead for over a year and Dad for eight months. Instead I lay there, trying not to freak out as they strapped me into the neck brace, and wondered what time it was and which of my friends would not mind being disturbed. I knew I was nobody’s first priority. It was an incredibly lonely certainty. I asked them to call the friend I had given a lift to that night, on the grounds that she would probably still be up, then I channeled my fear and loneliness into bickering with the paramedics about how long it would take us to get to the hospital. They said ten minutes. I said that from Queensferry Road to the ERI with a head trauma patient was never ten minutes. I had some vague memory of Mum telling me that ambulances don’t speed or put the siren on when the patient has head trauma, and I knew exactly how quickly you could get to the hospital, whether by staying within the speed limit or by breaking it, thanks to Dad’s tests and then his stroke. In those facts, in that knowledge, there was a little bit of them. It was the best I was going to get. Those poor paramedics…

What followed was a jumbled, nightmarish experience. In that overheated A&E ward I drifted in and out of consciousness. Sometimes I’d come to and someone would be doing something – plastering or stitching me up, wheeling me off for scans, taking blood. They took blood so many times. I was terrified that they’d found the same cancer in me that killed my parents. I had been warned that I might have it too and opted not to be tested. They kept taking my blood and not telling me why, and I was sure that they were making certain before telling me I was going to die. I didn’t have cancer, of course. I’m still here. It was just bad luck that my first couple of vials got contaminated.

By the end of the night, as the shock and morphine began to wear off, I knew that I had been in a crash with a combined speed of 100mph. I had five pelvic fractures, damage to my pubic bone and sacrum, my left wrist was broken and had been re-set, the laceration in my knee went all the way to the joint, glass had been removed from my right eyebrow area, and my forehead had been split open. Apparently my skull was visible, but no-one would give me a mirror. I can understand why, but honestly – how many chances am I going to get to see my own skull? Hopefully not many, but I would have been really interested to see it while it could be seen.

Scar 1

The doctors who treated me expected me to be in hospital for at least a month. I was having none of that. The hospital smelled of nightmares. The last time I had been there was when Dad had his stroke and I spent two days waiting for him to die (which sounds brutal, but we knew about the terminal cancer so swift death from a stroke seemed like a far kinder option). I wasn’t going to spend a minute longer in that place than I had to.

I forced myself back onto my feet and was home a week later. In retrospect, I shouldn’t have done that. I might have avoided some of the permanent damage if I’d stayed in. But… I couldn’t. Not that being at home was much better, in a hastily set-up bedroom in what was usually the dining room. That was where we had laid out Mum’s coffin. To me, it always smelled of formaldehyde. I managed two nights in there before I became convinced that if I stayed there I was going to die too and started dragging myself up the stairs to my own bed. I had specifically promised the doctors I wouldn’t do that, but needs must. I had thought that I’d have someone to take care of me while I got back on my feet, but… well, let’s just say that I learned a few excruciatingly hard lessons about trust after I came home from hospital. I was on my own, negotiating the house with a crutch in one hand, a cast on the other and a massive feeling of being kicked while I was down.

I healed, mostly. The facial scarring, as I’ve said, healed cleanly. The one on my knee stayed hideous, but easy enough to conceal. I never regained full strength in my left wrist, there was some permanent damage to my lower back and my neck, and I was left with involuntary eye movement and deteriorating vision after the head injury. I haven’t needed a walking stick for crash-related reasons since 2007. My confidence didn’t recover, though. I learned how alone I was. I learned a very particular kind of fear. It threw everything I had lost into sharp focus. And even now, ten years later, I can’t stand the sound of car crashes in films and TV shows. If I don’t see the crash coming and cover my ears in time, the trauma reaction kicks in and I start twitching like a fucking idiot and have to fight not to scream.

That’s quite a legacy for someone’s brief fuck-up. To this day, I do not know why it happened. I don’t know whether the other driver was high, suicidal or having a seizure at the wheel. I don’t know whether he was suspended or banned from driving. All I know is that he was male, speeding, alone in the car, and he escaped with just bruises. That’s what I got from the police and hospital staff. I don’t even know whether I should be angry for him or sorry for him. All I know is that something this person did, voluntarily or otherwise, left me with damage that will be with me for the rest of my life. Scars on my face, my leg and my psyche, and I still don’t know how I’m supposed to feel about it.

Scar 2

 

At least I could feel legitimately insulted by the compensation I was offered. Someone – his insurance company? – offered me £440 to compensate me for my medical expenses. I set the cheque on fire. £440 barely covered the amount I had to spend on getting to and from the hospital for cast removal, stitch removal, physio and god knows that else. It did nothing to cover the ongoing physio or my glasses or contact lenses. Those are costs I’ll always have to meet out of my own pocket, because someone drove his car into mine. I could have fought for more, but I was a traumatised 22 year old with no family and no-one who would support me through that process. I just couldn’t deal with the paperwork. I couldn’t handle reliving it and having the validity and severity of my injuries questioned. Dealing with the horrible, arbitrary nature of what had recently happened was enough, and if someone, somewhere was willing to price my well-being so low… fuck them.

Ten years on, I’m not entirely sure why I’m writing this. I feel the need to mark the day, almost to the minute. I need to remember what happened and how it felt, and how difficult it has been to set aside over the years. The reminder of the car crash is there every single time I look in the mirror. Facial scarring is strange. I’m incredibly lucky that it wasn’t disfiguring. It so easily could have been. But even so… it’s my face. Mine. My visual identity. And it’s got this big line down it because someone caused me to get hurt.

I choose to own it. Back in the ghost tour days I used to rub lipstick into it to make it look recent and livid, because it freaked people out. I knew it had the capacity to freak people out. When people do notice it, it’s ghoulish. I went to the release of the last Harry Potter book with my scar proudly displayed because sometimes you just have to make the joke before anyone else does (and believe me, when the scar was still easily visible I heard every fucking Harry Potter joke ever). I part my hair in line with the scar. I refuse to hide it. It’s barely visible, but I’d rather leave it available to be seen than brush my hair over it and look like I’m trying to hide it.

Bizarrely, I sometimes catch myself wishing that the scar had not faded quite so perfectly. Sometimes I wish it had stayed visible so that it didn’t look like I’d made an effort to conceal it. I haven’t, and I never did. The scar is a visual signifier for something I haven’t forgiven or forgotten, something I probably should forgive and forget but I don’t know how, because I don’t understand the event itself. If I could just be angry about it or just know that it wasn’t his fault, I could feel something fairly. Instead I feel nothing but confusion and pain, even now. I would probably have let go of the emotional pain years ago, were it not for the literal, physical pain that accompanies it. I feel the pain, it makes me angry, and all the feelings come flooding back.

I’m not sure I want to let go of the anger, anyway. Destructive and unhealthy it might be, but it’s mine. When I began to let go of the anger regarding the bereavements, what I found underneath was something much more complicated and harder to deal with. I don’t know if this would be the same. It might not be. But if it is… it’s easier to be angry. I know how to do that. I’ve mastered the art of a nice, passive rage that sits below the surface, kept at bay until I need it. Any time it starts to burn a little low, I can look in the mirror and the scar is right there to refuel it. Long, white, less visible than it was, but clear enough. A reminder of 2003 – 2005, and the last of the three events that hurt me badly and shaped the course of my life. The last of the Decade.

Scar 3

(This was taken earlier today. Ignore the facial expressions, this is what we call “resting brunch face”. It’s just that the scar was noticeable, and it prompted this post so I thought I should include it.)


A long and frustrated mental health post

Creative Scotland has taken over my blog for far too long. I’m still talking about the latest twists and turns in the saga over on Twitter, but the most recent piece of [headdesk]-worthy action took place while I was caught up with the double bill. Besides, Hannah McGill has been well and truly on the case and I don’t really have anything to say that she hasn’t already covered. I doubt I’ve written my last Creative Scotland post, but there are other things I need to write about just now.

So back to one of my other major topics: The Crazy and how to live with it. It’s that time of year. The dawn simulator has been back on my bedside table for a while. Mornings are just that wee bit harder than in summer (yes, even Scottish summer). And after my last self-sabotaging battle with myself, there’s an alarm set on my phone to remind me to take my antidepressants.

I wish it were as simple as just taking the bloody things, but instead it’s a minor skirmish every time that alarm goes off.

You  see, I hate taking antidepressants. I understand why I have to. My body is physically incapable of producing, transporting and absorbing sufficient serotonin by itself. So I get it. If my body won’t do this by itself and it’s a chemical I can’t do without, medication is necessary. But I hate it.  Logically, I understand that this mental illness is a manifestation of a physical problem and that I can’t overcome it through willpower alone. But to hell with logic – the point is that I hate that this is something I can’t control without relying on drugs.

Having established that, let me make it clear that any comments suggesting that I don’t really need antidepressants and could probably just take St John’s Wort or do more exercise or find god instead will not be met with grace and gratitude. I’ve spent the past 12 years learning the hard way that I have to take these drugs. Believe me, there’s only one possible outcome to my not taking them – my mental state deteriorates to the point where I stop eating or talking and start causing myself physical harm.

Earlier this year I had to increase my dosage. The dose I was on was no longer working for me. I could feel the symptoms of depression kicking in again, so I did the sensible thing and asked my GP for a higher dose. She put me on the next dose up. I’ve been round the block often enough to know that side-effects are to be expected and that the best thing to do is just hold tight for a while and see whether they subside. When the side-effects emerged, that’s what I did.

Within a few days of starting the new dose I noticed nausea, increased anxiety and problems with my short-term memory. I persevered for six weeks to see whether these side-effects were just teething problems, but nothing changed. I can deal with the nausea – it’s not pleasant, but as long as I eat little and often and/or suck sweets or sip water, I can manage it. The memory problems were much more of an issue. I’m used to having a rather good memory, but now I find that I reach for information and what I get is fog, or that tasks and appointments are completely forgotten unless I write them down (and I don’t always have time to write them down before they’re forgotten.) That scares me. It’s really unhelpful, especially as I’m self-employed, and it’s really worrying considering that I will probably have to increase my dosage again in future and don’t know whether that will make things worse.

Knowing that short-term memory is affected by concentration and that my concentration has always been affected by increased anxiety, I went to the GP to ask if there was anything I could do to control the physical manifestations of the anxiety. I was given beta blockers, which made me so dizzy I couldn’t stand and then made me fall asleep.

As you can probably imagine, that wasn’t ideal for getting through daily life. I stopped taking the beta blockers and asked to be referred to a psychiatrist to help me find antidepressants that will keep me from being depressed and suicidal but will still leave me in a fit state to live  and work. In the meantime, I was already struggling with self-destructive behaviour patterns. I got married at the beginning of the summer and found myself caught up in a massive internal battle between my newfound happiness with my husband and the depressive part of my brain that tells me I’m not allowed to be happy and that everyone I love dies. (Yes, that is what my brain is like even when I am taking antidepressants.) In my infinite depressed wisdom I decided the drugs weren’t working so I wouldn’t bother taking them.

Well, that worked out predictably badly. My mental state deteriorated, I found myself relying more and more on the façade and increasingly scared of being around lots of people. I did a bit of self-sabotage. Then finally the sensible bit of my brain remembered that I’ve done all this before and that it might be wise to take my tablets. Just for a few days. So I went back on them and voila, the greyness started to retreat… taking my short-term memory with it and leaving anxiety and nausea in its place.

After that I began trying to work out a viable pattern. Halving the dose doesn’t give me enough to keep the depression fully at bay, but more than half lets the side-effects run riot. Taking one tablet every two days is the same as halving the dose. My next move is to re-time the alarms on my phone and try one tablet every 36 hours rather than every 24.

I also went back to the GP for something unrelated, but while I was there I asked how my referral to the psychiatric department was coming along. The GP looked in my notes. Nope, nothing there about a referral to see a psychiatrist – just some stuff about my time with the community psych nurses. Why, did I want to go back for more CBT with them?

No, I damn well didn’t. If I want to do CBT worksheets (which I don’t, because the way I learned to do CBT was much more free-flowing and didn’t rely on worksheets as if I were still in primary school) I can do that by myself. I can certainly do it with a hell of a lot less judgment than I encountered from the two community psych nurses I saw before deciding that this really wasn’t for me – all they seemed to want to do was contradict my existing diagnoses and do those bloody worksheets. (Forgive me if I don’t give much credence to their contradictions, but I’m more likely to trust an actual psychiatrist who gives a diagnosis based on considerable observation and proper assessment techniques than a psych nurse who bases it on a five minute conversation and the infallible logic and clinical analysis that says “you couldn’t possibly have had a personality disorder at 18, that’s far too young”.)

So no, there will be no more psych nurse visits for me. Perhaps there are excellent psych nurses out there, but I got burned twice in quick succession. Also, CBT is not the answer here. CBT helps me with day to day management of my mental health, but it does precisely nothing to cause my body to produce, transport and correctly absorb serotonin. It’s the drugs that do that, and it’s the drugs that are causing me problems so I need to talk to someone who, you know, knows about drugs. GPs are barely trained in psychiatric medicine, hence my request for the referral in the first place.

I explained all this to the GP who told me that she was new to the area and didn’t know what was available, but she’d find out and let me know. To her credit, she did – but her letter was deeply disheartening. Apparently my options are 1) go back to the psych nurses for more CBT worksheets, because somehow that’s going to achieve something and not just waste resources that might actually benefit someone else or 2) go to a private clinic for which details were enclosed.

I checked out the private clinic. All it offers is psychotherapy. I have found psychotherapy useful on many occasions, but this time I do not need a therapist to talk to. I need someone who can advise me about medication. A psychotherapist cannot do that. A psychologist cannot do that. Who can do that? A psychiatrist. I’m not asking to see a psychiatrist because I think they’re higher status than psych nurses or psychotherapists or because I want preferential treatment, I’m asking because they are the people qualified to do the thing I need them to do.

So realistically, my options are 1) continue with the medication and see how long it takes for me to get myself into trouble for forgetting something important or simply being paralysed with anxiety and unable to do things, 2) find a private psychiatrist and hope against hope that I find a good one first time because at their hourly rates there’s not much room for trial and error, or 3) come off the meds and see how long it takes for me to deteriorate to the point where I am hospitalized, because at least there’ll be psychiatrists in the Royal Edinburgh. That last one really scares me. So far I’ve always managed to avoid being put in hospital. Even first time round, when I absolutely couldn’t take care of myself, my parents looked after me at home. Even last time round, when I was breaking my own bones, I only ended up in general medical. It’s unknown and I’m scared of it, and it would be the ultimate confirmation that my mental health is not under my control. And the path to get there is really horrible and involves the risk that I’ll succeed in doing myself permanent or terminal damage before I succeed in finding help.

I’m not particularly keen on any of these options, but most of all I’m frustrated – not just by the lack of care available, but more than anything else by the fact that the GP doesn’t appear to know the difference between psychotherapy and psychiatry. This is one of the biggest and most exhausting obstacles that you face in dealing with the Crazy. The GP is your first port of call, and even if you can get them to believe you (easier with depression than with just about anything else, but still tricky) it’s a real struggle to get access to any help. You might be lucky and win the antidepressant Russian Roulette where the GP prescribes you whatever’s cheapest and it either works for you or it doesn’t, but if you lose, my current situation is about the best you can hope for. I don’t know where this will end and all I can do is hope I don’t lose too much along the way.

The option I choose, unsurprisingly, is to start looking for a private psychiatrist and hope I can find one who isn’t charging £300/session. I have to keep reminding myself that while the illness is forever, psych sessions are not (because, guess what, I don’t like them either – not a fan of anything that suggests I can’t deal with this entirely on my own). All I need is long enough to get advice and a new prescription. I’m very good at monitoring on my own and following up with GPs. All of this is about making that very first step. I wish it didn’t have to be the most difficult and disheartening step of all.