Friday, January 12, 2007

The trouble with triffles

Sarah tells me I have comments aplenty, all of them heart-warming, one or two a wee bit baffling, but as soon as I can read, I shall reply. She also says read Foilwoman's blog about some journalist in the UK clearing up any confusion as to how low a human being can actually go - go thou to her blog and see for yourself.

And how do things go at Clearwater? Oddly, unsurprisingly enough. The same woman or man as was here last time cries late at night, between two and three, a soft, high sobbing, just on the edge of hearing. A distressing, lonely sound, something "calling after someone that wouldn't come", as MR James said. I don't know who it was last time, or this time, and I don't know why they are still here. I do know that they were most clearly heard the first few nights I was here, the implications of which disturb me.

Still, it's not all misery and woe. There are the meals, which resemble aeroplane food, for the same reason (you don't like it? Go elsewhere), and there are the day courses. I have been attending these in a Caesar's wife kind of way - I must not only try to get better, I must be seen to be trying to get better.

There's a whole crack in the foundation there, something that needs to be explored, the whole "good patient is someone who tries to get better, bad patient is someone who choses to remain unwell" thing that if my mind were more nimble, I'd be onto. But the fact is I am trying, because nobody wants me out of here faster than I do.

With that in mind I attended today's talk on generalised anxiety disorder. These are relatively well attended - Diana, the woman running these, makes up in enthusiasm what she lacks in experience. I am going to sound like a curmudgeon however I say this, but I think there is a certain something you get being, say, forty, that very very few people have when they are, say, twenty. Diana would not be twenty five, and she is not one of the one or two.

Case in point. Today's session on Generalised Anxiety Disorder. GAD is actually a remarkably disabling condition, under-disagnosed and undertreated. Anxiety, panic and phobia (now don't they sound like a modern three fates, three grey-faced sisters in a cave, one spinning the thread, a second measuring, the third cutting*) have an impact on the quality of life that people who don't have them don't understand. But before we got onto GAD and its mysterious ways we had to go around the room and introduce ourselves and say how anxiety made us feel, or how we dealt with it.

"Afterwards, can we play some games?" said the young man in the Bob the Builder tee shirt. I guessed mania. He paused, then said in a rush "It's probably not appropriate, but when I get worried I usually masturbate. I worry a lot."

I uttered a prayer of thanks that he had not told us how it made him feel.

"Adam" said the other young man, the one who has worn sunglasses all day and all night for as long as I have been here. "I mainly get anxious that they're not going to treat my pain right, or that I'm going to get addicted to this morphine." Chronic pain, probably some iatrogenic component, morphine dependence.

"Henrietta" said the school-teacher, slim and businesslike. "Little things get to me, things I can't control. Like messy seventeen year old boys, and how they won't look after themselves. And you've used the subjunctive there when you mean the indicative."

The above is as close as I can come to a direct quote, may GAD strike me dead. And she wasn't even an English teacher.

"Thanks for all this stuff" said the strongly built woman, in a voice that was somehow childlike. She had a key with a label on it pinned to her jumper. I felt that fellow feeling I feel for those you suspect are being courteous because they are lost.

"I mostly worry"" said the new woman "about how I'll get through the day."

I looked at her. She was new, hadn't been here yesterday, I'd seen her being half-shown, half-lead around the place late yesterday afternoon. Something in her gait was odd, not Parkinsonism, not that dazed wandering you get with the benzodiazepines, not the phenothiazine shuffle - more the look you see on people who have been led out of the mouths of disasters - tsunamis, fallen buildings, bushfires.

"I worry about what I'm going to do with myself now" she said.

There was a pause, and Diana, cheery, enthused Diana, said "Okay. And how do you cope?"

"Mostly I cry. I lie on the floor and cry. I use tea-towels, one or two tea-towels, so it's a one or two tea-towel cry. Once in a while a three. I wash them separately, of course."

I had this image of this this tall, dignified looking woman lying on the kitchen floor, curled like a comma on the lino or the tiles, face buried in a teatowel to stop herself screaming.

"And how does that make you feel?" said Diana.

"When it's like that" she said "I want to go away. I don't - I don't want to be here anymore."

"You mean bored?" asked Diana.

As GAD my witness, if I had happened to be carrying an axe at the time it would have all been over. Thankfully one of the manic patients interrupted with something about sex or Africa or the history of the krugerrand or something and we were all able to move on.

I am reading, in my spare time, about osteoporosis, the disease of thinning of bone. As a matter of interest, the parts of the skeleton that osteoporosis affects most are those parts with the highest concentration of trabecular or spongey bone. These are the end bits of your forearms, the hips and the back - which is why little old ladies get dowager humps, break their wrists, and fall and break their hips (or break their hips and fall).

As a matter of interest a mirror image of this condition occurs called osteopetrosis, literally stone bones. This disease is so rare that authorities advise ruling out pyknodysostosis before leaping gaily to the diagnosis of osteopetrosis... and you don't see a lot of pyknodysostosis.

Anyway, people with osteopetrosis suffer from too much rather than too little bone - the bone grows into the marrow space, so the body can't make as many white or red blood cells, the bone grows tight around the nerves (some nerves pass through bone) and traps them, the bone is not able to be recycled and is thus weak and brittle.

Well, I thought it was interesting.

Anyway, off to busywork. Should be getting weekend leave on the ... weekend.

Thanks for listening,

* I have to share that one of the web pages I looked up on this sort of things years ago warned me not to triffle with the fates. And I am proud to say that I never have.


Blogger Foilwoman said...

Dr. John: Thanks so much for mentioning Nicholas Hellen and his actions toward Abby Lee. Now, if any of your readership (bigger than mine) would like to comment on Hellen's actions and correspondence, they could do so by emailing: or

I do hope you are feeling better, and wish my superpowers reached to the antipodes. Or that I actually had superpowers that would be of any assistance to you and TduCN.

2:28 PM  
Blogger Camilla said...

I've blogged the Nicholas Hellen thing too. Grrrrrrr.

Now I'm going to write my steaming emails.


7:21 PM  
Blogger Bronze John said...

I hope it does some good. I think there is a certain point up to which newspaper editors feel that any publicity is good publicity, and beyond which they feel someone (grudgingly) has to be sacked.

Hopefully we can get this guy gone.


11:29 AM  

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