In case I forget.

Bleeding Heart
May 27, 2007, 2:43 pm
Filed under: Dr. PCP, Fear, Mental Health, RX, Seizure

When we were talking he asked me, “Are you thinking about suicide?” I told him that of course I was. He asked, do I have a plan? I said “We’ve talked about this before. I’ve always had a plan.” He nodded his head in agreement. I told him that I wasn’t thinking about doing it, but it was always in my mind.

I told him that what was scary was that I had never thought before about hurting myself. That is when he asked, “Are you hurting yourself?” I nodded yes. The first thing he asked was “Does it cause bruising?” I shook my head no in shame. I don’t remember the second thing he asked but the third was “Are you cutting”? The shame this time was much deeper. I told him, “It hurts when I do it, but the blood is very satisfying.” He is the only person who knows. He asked where I do it. I told him it was somewhere that no one can see. He asked if I had told my counselor. I said no. He asked if I’ve told my husband. I said hell no, are you crazy? I told him it helped me focus the pain.

This was the first time I cut myself. The blood was in fact very satisfying. When I cut I waited for the blood. I did’t cut very deeply, and sometimes is took a few moments for the blood to start oozing. I pulled the skin on each side of the cut away and the blood flowed more quickly. I dabbed at it with a paper towel.

With every cut I used a different part of the paper towel, carefully marking it with blood so it was almost covered entirely with my redness. He asked what I used. He said, “A razor blade? Scissors? A knife?” I laughed in a morbid, quiet way. I told him the only really sharp knife I have is “this” long, stretching my hands apart to demonstrate a length of about ten inches. I told him it would have be very hard to control. He smiled at me. He looked at me as said, “It helps you focus”. I nodded my head yes.

When I knew I was going to cut myself I had wandered around the house trying to decide what to use. I first thought about a razor blade but I use a safety razor to shave and didn’t think it would work to tear it apart. I did consider a knife but mine are too big. I thought about an Xacto knife but didn’t think I had any new, sharp blades for mine. I was standing in the kitchen, trying to think, when I saw a utility knife on the kitchen table. I took a butter knife and used it as a screw driver to open the utility knife. There were three spare blades inside. I removed one and screwed the utility knife back in place. I knew the blade was thicker than a regular razor blade, and that it wouldn’t be as sharp, but it would do. I didn’t clean it. I didn’t care if I got infected.

He leaned back onto the counter behind him. He pulled one leg up and put his shoe up on his rolling stool next to his thigh. His right hand moved to his mouth and he looked off into space, thinking. Again I told him that I was scared because I’d never thought this way, much less done it. I made no move to show him the lines of clotted blood, the red rimmed wounds.

He rolled back over to the exam table where he had laid down my chart. I rarely if ever sit up there. I sit on the visitor’s chair. He rolled close to me and took my hand in his, grasping it tightly in both of his. His skin was warm and smooth. He has held my hand before. I told him that I was afraid. I told him that when I increased the anti-seizure medicine at the instruction of my epileptologist that my seizures had increased dramatically. I told him that it is almost as bad as it was before we started all of this so long ago. I told him that my epileptologist wanted me to have a blood test to check my Lamictal level. He nodded his head. He had been watching me and listening to my repeated hard burping since he had come into the room.

He told me he would continue praying for me. I told him thank you, that it meant a lot to me. When the tears started to roll down my face he reached behind him for a tissue. I remember that they were tan instead of white. I wondered if they were ordered that way on purpose or if it had been a mistake. When I couldn’t stop crying he brought the box to me and put it on the exam table next to my chart. He started writing. He told me that cutting is tied to self esteem.

He pulled out his prescription pad and told me he was going to increase the Effexor. He told me I have to talk with my counselor about what I was doing. I told him I would think about trying.

When he stood up to leave the room he stopped, turned around, and leaned over me. His hand went behind me and he bent at the waist. He hugged me tightly but didn’t use any platitudes, didn’t say “It will be alright” or “Be strong” or “You’ll feel better soon”. He just hugged me tightly. I hugged him back. As he walked toward the door he told me he would send a nurse in to take my blood. He closed the door behind him. I took another tissue and tried to look like I hadn’t been crying, because of the shame. The nurse came in and did her work. I asked her if I could see the doctor again for a moment. As she left the room she said she would ask him.

When he came back I was standing against the wall near the door. I told him I hadn’t wanted to freak him out, that I’m not gouging myself. He said he wans’t freaked out, that he had had people come in with ten staples in their arm after they had hurt themselves. I told him I wasn’t digging for my femoral artery. He smiled and said yeah, that would be bad. So much blood would be hard to clean up. He smiled and said it would make a big mess. He told me to come back to see him in about a month, or sooner if I needed to. I told him thank you.

As I walked down the hallway to check out at the front desk I started to think that I might change my plan. I started to wonder if I could dig deep enough to reach my femoral artery.

I am scared.


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