Wednesday, July 25, 2007

The Weirdness of Id

How much must this suck?

You're walking around fine and dandy one day when suddenly your brain bleeds. Intraventricular hemorrhage, subarachnoid hemorrhage, whatever: suddenly, you've lost your inhibitions, your ability to form coherent sentences, and your will to do anything. You are, in short, a perfect candidate for employment on our unit.

The one thing that's better than it was before is your brain's ability to get into a groove. That would be okay if your brain were focused on ponies and butterflies, but it's usually not. In fact, I've only met one person in five years who grooved on positive things. The rest of the brain-bleed population lives nightmares over and over and over.

One patient, born in America of Iranian parents, was stuck in Paris on September 11th, trying to get home. Over and over. Another was in the middle of divorcing her abusive husband and on the run, something that had happened forty years ago. A third was trying to get the ambulance for her horribly injured youngest child. Over and over.

Mostly, people who groove on nightmares are quiet. Anxious and confused, but quiet. They can't be reoriented (sometimes trying just makes it worse) but usually they can be calmed. And, eventually, the brain heals itself to the point that they can break out of that nightmare box. Until then, they talk constantly about the nightmare they're in.

Sometimes, though, Horrible is happening in somebody's brain and there's no telling what it is. We had a patient like that last week: perfectly fine one minute, he'd suddenly sit bolt upright in bed, eyes wide and face pale, and scream.

Something was coming after him, that's for damn sure. And whatever it was, neither he nor I wanted to see it again. I had a choice. He didn't.

I had no clue what he was seeing. He couldn't articulate it. I got the feeling from watching him, though, that it wasn't as simple as watching a buddy step on a land mine planted by the Viet Cong, or seeing his house destroyed by fire with his family inside. Whatever it was that came out of the walls at him came from his own mind. I don't scare easy, but seeing his face as Horrible came at him, just before he screamed, made it hard for me to sleep for a couple of nights.

1 comment:

Anonymous said...

I have PTSD from childhood sexual abuse, and I work with elders, including folks with dementia. They can get 'stuck' in the same "loops" over and over again, and can't give coherent words to what is happening in their brains....and these are folks who are all in the present moment...forever.....when i think of developing dementia, and having THOSE memories play repeatedly, the idea of suicide has a certain appeal.