Thursday, March 16, 2006

Background radiation

They call these the small hours of the morning, but they loom large when you are in the midst of them. Between two and three in the morning as I write. There are occasional whispers of rain outside: a few seconds' sussuration, a smell of cold air, and then a silence. The first real rains of Autumn are still some weeks away.

I can't sleep. Outside I think there is a half-moon.

If I go outside now, and stare up between the clouds, I can see that blackness between the stars. I suppose I would say I am looking at space, or looking into space. But 'space' is an elision, something omitted rather than stated, a common, short, handleable word for something that is really too strange, too alien, to really fit into our heads.

Think of it this way. You look think you're looking up and out, you gaze out maybe with vague thoughts of the future... but you aren't. You are looking back and behind you, looking into the past. You're seeing things how they were, tens, hundreds, thousands of centuries ago.

The way your mind works - and it's perfectly adequate for most times, most places, seems to get us by - the way the mind works is you see a point of light in the sky, and you think, because that's how it always is, that that burning point of light means something. That there is something there, some glowing thing, some star, that there is out there some fire in the dark.

But that's not true. What you see is not there. It's really a trick - a trick within a trick, a trick of the continuum and another trick of the mind. All you really see, all you ever really see, is afterimages. You look up in the sky and see things, stars and galaxies, but some of the stars you see now will have died - flickered out or flared into unwatchable light - died before you were born.

All we ever get is afterimages. You can go out there now and gaze into the workings of a time machine, face up into the dark, while the cold, old light, ten thousand years aged, sinters down on you, light from things that were dead before you were born.

Back in the sixties, from what my currently seemingly quite drug-fucked brain can remember, they (you know 'them', the ones who find out stuff, prove things, the whole amorphous gaggle of of them, white lab coats pressing against each other, thick glasses glinting) - they discovered something about the night sky.

They found that the sky is not utterly black and cold. They found the sky glows, too faint and cool for us to see, seems dark and yet it glows. It glows with microwave radiation almost three degrees above absolute zero. Something only detectable by sensitive instruments, a cold, dim murmuring drowned out by sun and star, but always there.

This thought is leading me somewhere, I'm not sure where. I will try and be patient and tease it out. But outside to the west there is the sound of thunder, soft and low. Something moving in.

This three degree, microwave radiation, this faint afterglow you see wherever you look when you look at the night sky, this is the cosmic background radiation. Mathematics that I cannot understand assures me that this is of significance when determining the age of the universe and other imponderables.

Right - all spaced out for a moment. A brief diversion.

What's going on in my life? Besides the low, the not-going-into-work, not-sleeping, not-seeing-or-writing-to-people low, the humiliate-myself-in-front-of-my-workmates-because-I-can't-remember-shit low?

I'm dragging myself out today to see my psychiatrist, which should be a hoot. He is meeting me at Clearwater, the state's sole secure psychiatric hospital. It is a pleasant, Edwardian building set amongst manicured lawns, and surrounded by a sixty centimetre (yes, that's right) tall decorative brick wall. The locked wards are hidden deep within - all security guards and electronic locks. Whenever I drive in there I imagine seeing uniformed guards pursuing a shaven-headed man in a straightjacket across the lawn, in the sunlight, beneath the oaks.

I was there in fourth year for a day as part of my psych rotation. I'm sure it'll feel good to be back.

And I'm taking the tablets. My psych will probably suggest the good old triple whammy - anti-depressant, mood stabiliser, anti-psychotic. I suspect that may mean no work for a while. Looking back, I reckon starting the valproate was the right move, good clinical decision. I reckon wimping out on the antidepressant was less so. If I'd done that before no-one would be talking about quetiapine now - a drug I have only ever prescribed to psychopaths and criminals.

And I'm checking the thoughts, not letting the bad ones build up any of that horrible emotional momentum that they can.

And I'm doing all the things I know I should, (the things involving tablets and exercise and a non-negotiable "getting out of bed and fulfilling basic responsibilities" plan) and I'm doing none of the things I want to. Because a lot of those things are stupid ideas.

I think the thing about the background radiation - the reason the phrase came into my head about four am the other night, the reason I am trying without success to get these words down, explain some thing before it is lost - the reason all of this came up is the thoughts of death. My thoughts, specifically. My death.

Now, my experience is that phrase generates more alarm than perhaps it should. I stress there is a difference between this and much more worrying suicidal ideation.

I think thoughts of death are common thoughts. I feel that thoughts of death, of dying, thoughts of just not being here any more, of stepping into oblivion - I have believed for many years that these are under-reported, that they may be extremely widespread, almost ubiquitous, maybe experienced by almost everybody at some, possibly fleeting, times in thier lives. They are the rule, not the exception, and thus it is difficult to really consider them a symptom of a disease.

To put it another way, thoughts of death, thoughts of your own death, even fantasies about your own death and dying, may not necessarily be pathological. Or if they are, then we are all very sick indeed.

Specifics: I think that everyone - child to adult, father or son, mother or daughter - I feel that everyone at some stage imagines these things:

what would it be like if I died?
would it hurt? even if it did hurt, it wouldn't hurt for long, would it?
how would anyone get on? would they get over me? would they mourn forever... or would I be forgotten?
what's it like - if there's a like? is there a like?

See, there is a seduction, a guilty childish pleasure in these thoughts. I suspect there is some deep ego-stroking in it. I suspect, in fact, that if a benevolent extraterrestrial starship descended upon us tomorrow, and gave each and every human being a necklace with a fragile bauble on it, and said "this is our gift to each of you: whenever you want, reach up and crush that bauble and you will fall dead, instant, soft and painless"... then a fair percentage of the population would be gone within the month. Impulsive, unplanned events. Stepping out into oblivion.

Those thoughts of death are common. They are, if the analogy makes any sense, they are the background radiation. We don't notice these thoughts when brighter stars are in the sky, but in the still small hours they are there. Murmuring away, beneath the threshold of our hearing, but audible to the heart when it is alone.

But those thoughts of death are not suicidal intentions. Again, if we locked up everyone who had ever thought of killing themselves, it'd be pretty damn lonely out here. There'd only be those people from breakfast cereal ads and the occasional cheerleader.

Having said that, at the moment the other thoughts are there too. It wouldn't be depression without them - I think they're the ninth out of the nine criteria - and I've got a fair few of the other eight. But I don't know that they're that uncommon either. It's all fairly low-grade stuff.

Who has not driven along a lonely road and thought - that tree. That salmon gum, that she-oak, that tingle tree. Or seen a rafter and thought - that looks strong enough. These pills. Or the gas oven - easy enough.

My understanding, by the by, is that modern technological advances - in this area, as they have in many other areas - have made achieving this kind of peace a much more difficult process. It's something about the gas.

And with the new catalytic converters - not sure of the details here, might be the petrol, told you I know nothing about cars - it's fairly difficult to asphyxiate yourself. People who have 'success' in this area tend to own the older cars. Otherwise it tends to require a fair amount of fuel. Every year we see a few people in the ED who have been brought in by police, who attempted to end it all but instead ran out of petrol and have had to call the RAA.

And don't talk to me about the pills. Overdose is bloody difficult. If you can't get hold of some decent cardiac or oncological drugs, you'd better hope that your GP is incompetent enough to put you on the old-school tricyclic antidepressants. Otherwise, these things have a depressingly high failure rate, or an embarrassing wait after the event while the damage done kills you - paracetamol is the classic example here - one dramatic orgy of pill-swallowing, then a week or so of mild abdo pain, the seven to ten increasingly unpleasant days on the transplant ward at the Royal. Fucked if that's where I'm spending my last days.

I have morphine, diazepam, a few vials of atropine (not enough), a very little insulin - even I've brought people back from more than that. The atropine might need a bit of work, but there's nothing there that's really useful.

And the chances of fucking up some major organ that you really don't want to do without - liver, brain, whatever - and still having to live, always sick, never as good as you could have been, only now with every bugger watching you like you're crazy... those chances are relatively high.

Nope, as things stand, couldn't recommend the pills. To be honest, suicide, except in my patients, is not something that I look into that much. I have kids.

So, that's what's going on now. I don't think it's the background radiation, it's something else. It's pathology. Maybe it's because everything else has gone quiet, the way you notice silence sometimes, so loud it rings your ears. But that's pretty much the tenor of my thoughts this last few days.

There - spoken.

See, there's only so much you can cover up with speculations about the seven dwarves and woodworking.

This is what, lately, I think about a lot. My death, the arranging of it. That tree. That lamp-post, a good site for a noose. That eighteen-wheeler barrelling along the highway - that'd crush a skull, surely. I could sling a rope over that rafter.

I stress this is not a plan for suicide. Even if I could do these things - and I can barely tie a knot at the best of times, and I am a terrible physical coward, more scared of injury and disability and weakness than of anything else - I would not be able to.

I have a beautiful and long-suffering wife (at least until she wises up) and two glorious sons, and a niece who looks up to me. From what I have seen of survivors of suicide (and by that I mean the people who are left behind, the ones who have to deal with what the others fled), suicide cripples those whom the suicide least wishes to harm, those who were closest to that unimaginable ground zero. The fathers, mothers, sons... a wound that does not heal for years. Nobody should be able to harm their children so much, plant that cancer in their souls.

And I know, too, that people with depression are much less likely to see how things really are than they are to see things as they are not, to show the symptoms of their disease - inappropriate guilt, poor concentration, disturbed sleep, loss of pleasure in things that normally give pleasure.

And I know that this is a good life, that I do useful work when I am well, and that I have friends who love me and people who depend on me.

I just can't feel it at the moment.

This is the bitch about the moods. The ups have to have a down.

So dawn goes down to day / Nothing gold can stay.

And that's another thing I have to do. Read something good. Doctors should prescribe poets as well as potions. This time, straight for the top-shelf stuff, the schedule eight literature - Much Ado About Nothing. Taming of the Shrew, the Tempest, that kind of thing. And some of those cheery little ditties from Ted Hughes. Maybe not.

Seriously, if you hammer beautiful thoughts into your skull you feel better. I have experienced this to be true.

Any day now the valproate will kick in, that soft purple blanket effect. And then the others will. And I won't have to be on them for ever - the valproate for nine or so months, the reboxetine for less, the (still experienced as deeply humiliating) quetiapine maybe only a few days. Then this will pass, and I will get better, and I will be judged worthy to go back to work.

Anyway. Enough of this staring into the dark. I wonder if it helps - after you've looked at the night sky long enough, even the half moon seems bright. After writing about this kind of stuff, I feel better.

However this goes, if you're reading this and you feel low, it gets better. You just have to wait it out.

And however this all ends out - and I know it will end well - everyone here has been wonderful.

And while I will pre-emptively appreciate everyone's concern, this is not so much a plea for reassurance or help or company or anything. I won't be fun to be with for a few days yet. But should be compos mentis soon.

Thanks, and look after yourselves. Will join you later.



Anonymous Camilla said...

I've had those thoughts. The wondering about death thoughts, that is. Mostly I'm afraid to die because I'm not done living yet, but I'm also a little bit curious about what comes next, if anything (I believe there's something. I certainly hope there is.).

I think the analogy you drew with space and background radiation was a good one. It certainly resonated with me, the idea that we all have this low-volume question humming away in the very backest of the background.

And those questions you listed, I've asked all of those too. I think a lot of people do.

As for the death-bauble...well. Death: The Final Frontier? I wouldn't be at all surprised either.

8:38 PM  
Blogger Benedict 16th said...

1) It isn't suicidal thoughts, its the hiatus, the nothing between. I think its the idea, not of actively dying, but of nihility, of not existing, of not experiencing this pain of existing. Not dying but the lack of hurting, for the religious "a soul ache".
2) Insulin and a handful of sleepers, quick, peaceful and very very hard to reverse...*

* this might be considered sedition or aiding and abetting suicide under our current government's legislation!

PS verification is inerzyf, perhaps that is the athiestic answer to "soul ache", or maybe the name of the latest antipsychotic fat pills.

PPS Quetiapine IMLTHO is probably the singly least worst antipsychotic on the market

9:46 PM  
Blogger Prom said...

I agree that the thought of our own death is something that most of us have considered.

There is something seductive about the thought and really it is only a worry if the pull starts to feel like intention rather than speculation.

I know for me that everytime I stand on a high edge, the thought of stepping off enters my mind. The seduction of the thought adds a little thrill to that moment in time. That has nothing to do with dying for me but of feeling free. One of the things I think about when some life anxiety begins to feel too much is that I can always make the final escape if things get to bad but I'm not at that point yet. It is calming to think that there is an escape. I don't know how people who see hell as the result of suicide cope with daily life anxieties. No wonder they have to believe in God and give over their worries to Him. They don't have any other way out.

The one true thing I know about suicide is that it is something that is always worth procrastinating about.

Here's to feeling one's true self and knowing when it happens.

11:57 PM  
Blogger Prom said...

Oh and read this (not related but I think everyone should read this article).

If you don't have an account with the NYTs, you can get one free just by signing up and then you can read the article.

12:02 AM  
Blogger Foilwoman said...

A book that has helped me through this last few weeks (psychotic not-soon-enough-to-be-ex-husband stalling sale of house -- our only remaining asset -- and forcing foreclosure) is the The Island of Lost Maps: A True Story of Cartographic Crime by Miles Harvey. Not great literature, but a good read.

2:16 AM  
Blogger Chade said...

Take heart in this doc,
The thought of Death is an eternal meme of any organism on it's path to entropic death.
I actually take great comfort in the concept of dying, the methods, the processes, the ramifications, the possibilities. I embrace the idea that this long and treacherous, quite exhilerating journey through something that I'm sure can't always be called life because of it's lack of experiential days, will one day come to pass. Knowing that my time is finite allows me to go beyond what society deems normal and grants me experiences I probably wouldn't have persued without that knowledge.
Personally, I can think of no worse thing than existing indefinetly through this world. True, I'd love to know where it's all going and what would come next, but in the end the further forward you go the more you will lose and eventually those people and experiences upon which you have grown and based your life will become too dim, too distant, irrelevant and leave a gaping hollow that will never be filled.
Life without end. Life in the wake of the death of love, lovers, friends, family, enemies... True you could make more over time, but don't we cherish our first experiences more than any other? Like when your FIRST born mumbles their FIRST word, or walk for the FIRST time into your arms, the FIRST time they fall over and need you to hold them and make it all okay, The FIRST love of your life that you will hold all others in regard to, the FIRST time you met your wife. If life were to continue without end these things would become meaningless.
I could go on, but I'm sure that I've already imparted enough of my skewed life view.

By the by, if you want to read something beautiful and incredibly relevant and insightful, read Three Dollars by Elliot Perlman. I read it twice in a row because it just made sense and made me very jealous. I don't like it when writers are able to capture these human things so precisely. Although, I have been told not to see the movie.

9:51 AM  

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