Ward 13 & Clozapine

It was a ward 13 Wednesday yesterday, for therapy and to get meds. Starting and titrating Clozapine, tapering off lamotrigine and sertraline and chlorpromazine. Weekly white cell counts for a bit, and ect next year. Therapy doesn’t generally happen well there, because it’s an understaffed department of a big state hospital, but we managed an hour with only one interruption today. Shrink one glowered somewhat and wrote a stern do not disturb note, muttering “let’s see how many idiots ignore this”.  A very small doctor tapped on the door and stuck her very small head in, to speak to shrink one about a patient. When she saw me, she said, “excuse me sir,” and shrink one looked at me and said, “she called you sir,” and of course the little doctor was mortified, despite my reassurances. I get called sir a lot, I like it. I do not give a fuck which gender I’m read as. Shrink one eventually said “don’t worry, it’s a private joke,” to soothe the small doctor. It all felt a bit surreal; the rest of the session consisted of me weeping more than I’ve ever wept in a therapy session. It was at least a ten tissue level of tears. I wasn’t expecting it. After that, I went to the pharmacy – usual procedure – sit on the wooden benches in the front rows and inch along until it’s my turn to hand in my increasingly battered yellow patient card, then go and sit at the back of the room till my name is called. The shouty gnome with her microphone wasn’t there this time, instead there was a quietly spoken young woman who projected kindness. It was startling. Usually I’m at the back people-watching while I wait. Today I shifted forwards to make sure I could hear my name, leaving the two friends who were on moral support duty at the back. It also allowed me to hide my face a bit, I just kept leaking tears, it was horrible. I’m not shy about crying; I have wept in public more times than I care to remember. I don’t perform, I just end up like a rainy windscreen or something. Whatever. I cried. It hurt. I guess I was on edge to start with, I felt as though shards of my mind had begun to fall around me, my ears felt dull but my voice felt knife-like. I don’t even know if I’m making any sense now. Fuckit. I’m so over bi-fucking-polar and its meds and its talons.

Patient folders (it’s Africa, the entire continent is patient) waiting to be filed/defiled in an overflow waiting area. Patient confidentiality isn’t top priority in an understaffed ward in a country where 80% of psych patients receive no treatment at all.

Meds collection window.

Corridors, always corridors.

(photo by J) Patient patients.

(photo by J) It’s the psych dept, we’re already disturbed thanks.

Waiting for meds.

Does what it says on the tin.

Shrink’s office wall.

The small doctor and I passed each other in a corridor as I was leaving and she apologised again. I lit a smoke, walked to the car and my face leaked quietly all the way back to good food and coffee. It’s bloody exhausting isn’t it – having a waterfall on your face, not to mention the raw eyes. I’m tired of despair as heavy as mercury and hell in my head. I’m tired of the way I babble when I’m trying to hold it together. I’m just very fucking tired.

Tell you what though, even removing money from the equation, I’d rather go to that particular public sector hospital than any Life Clinic franchise, they’re kinder. It matters. Oh look, I’ve just written a nice tidy conclusion. It’s true, but not accurate.

*reboot*

Here’s the crux of it all. The weeping came from talking about stuff that I have no idea about. Have I been taking things too personally, do I have the right to feel this sore etc. And then –

Shrink one: what is your purpose – and this time I’m not letting you get away with saying “my dog.”
Me: does there have to be one? I don’t have one. No dreams, no goals, I’m just going through the motions.
Shrink one: you’ll find your purpose.
Me: or not, I don’t want platitudes, I want logic.
Shrink one: yes, fair enough. Do you want a purpose?
Me: no.

– and so on. I like her a lot. She suggested I stand up for myself more, she asked me to think some more about the questions I answered with, “I don’t know.” CBT homework these days is constant: write, write about the feelings and the flawed logic behind my self loathing. Think and write about why I do not want to be alive.

None of this feels even vaguely coherent right now, just sore. Pain can be an extremely tedious beast.

Ag fokkit, this isn’t living.