“I want you to remember I have nowhere to be but with you. If you need to talk out all this horror, as you put it, I’m here for it. I have nowhere else to be.” I know she’s lying, but I accept it anyway and keep talking about how terrified I am that the baby might die.
“So, what might happen if the thoughts come back when you’re at home?” she asks. “What are some of the ways you can get yourself out of this train of thought?” Her questions are kind, leading me to believe there are no wrong answers. Even if there really are.
“I know I can call my brother, or my neighbours, to come over and help me,” I say unconvincingly. Can she tell I’m performing?
“Okay, but what if those people aren’t around to help you out? What if the baby is screaming and you can’t take it? Then what will you do?” We unpack every scenario. If she’s judging me, I can’t spot it.
“I don’t know what I’d do. I guess I’d just put the baby down.”
“That’s right, Amanda. It’s as simple as that. If you feel like things are out of control, take back control and don’t give in to the baby at that moment. She is fed and taken care of, so prioritize your own needs.” I’ve not considered that I could just put down a crying baby. Doesn’t she need me at all times? Isn’t that what attachment theory says?
“There is another option, too,” she continues. “You could come back to the hospital. You could call 9-1-1.”
I don’t love any of the options in front of me, but I like everything better than being back in the psych ward. “I’ll think about this,” I say in as optimistic a tone as I can pull together. I talk with her for well over two hours. She presents the term “sleep sensitive” as a diagnosis and I continue to reject the idea. “Sleep cannot cause this level of undoing, can it? There must be something more severe wrong with me?” I want this woman to tell me this isn’t something I had any control over, that it wasn’t in my power to prevent it. Otherwise it means this really is all my fault.
“Sleep deprivation is real, Amanda, and it can have very serious effects, like we’re seeing with you right now.” I hate that answer. The room feels colder than it did before. “Have you considered an SSRI medication?”
I immediately refuse. “I’ve never been on medication for anxiety and depression before. Not through my tumultuous teenage years, not through surgery and career changes and home renovations. Why now, when taking meds could hurt the baby?”
She looks at me sternly before replying. I can tell she’s had this anti-meds conversation before. “You can speak to an expert who can walk you and your family through the dangers to the baby of potential exposure through breastmilk. I assure you they are minimal, and the benefits to your well-being are great.” It’s clear to me that I won’t get out of this hospital unless I at least consider medication. An appointment is set up with Motherisk for the next day. I’m told they’re an organization dedicated to discussing the impact of drugs on pregnant and nursing mothers.
“If the people at Motherisk tell me I’m not harming the baby, then I’ll take the meds.” I head back to my room feeling defeated.
A little while later a nurse I’m quite fond of arrives for my regular room check. “Have you decided to take the medication?” she asks in a loving tone.
“I’m waiting to speak to the Motherisk people about whether or not I might be harming the baby,” I say defiantly.
“You know, if you ask me …” She pauses. “I know you didn’t ask me, but for what it’s worth, you’re harming the baby if you’re not well. I don’t think the doctors would prescribe anti-depressants for you that would hurt the baby. Who would do that?” I notice that the nurse isn’t making eye contact. Her logic is sound, but I wonder if this pep talk is all part of a conspiracy to convince me to take the mind-altering medication. Is it mind-altering? Who will I be after this?
“I’d like to speak to the drug experts, please,” I say to the nurse as she heads out the door, hoping she won’t mark me resistant in her daily check-in notes.
“There’s a resident pharmacist who comes into the ward often. Why don’t I see if he can stop by your room, that way you can ask all your questions in person. Okay?” The nurse leaves the room before I say anything else. I really want to speak to the Motherisk people, but I get the sense that the hospital staff would rather I take the medication without pushing any further. I lie back and close my eyes. Maybe if they see me sleeping they won’t push this meds conversation any further today. I’m tired of making decisions.
Some time passes and I’m awoken to Gordon rubbing my shoulder.
“Babe, wake up,” he says lovingly. “There’s a doctor here to talk to us about anti-depressant medication.”
“I thought I was going to get to have a conversation with Motherisk?” I say with a tired voice.
“Yeah, I thought so, too,” says Gordon. “But this option seems great. I have a bunch of questions for the doctor also.” He seems ready for a fight.
A young-looking doctor is standing at the edge of my bed. It takes me a few minutes to wake up fully. I must have been sleeping longer than I thought. The doctor explains that he is a resident pharmacologist here to answer any questions about side effects of the anti-depressant medication prescribed by my new medical team.
“I don’t care about side effects to my body. The single issue for me is how much of the drug will be transferred through my breastmilk, and what is the harm to the baby?” Gordon jumps in before the doctor can answer. “How often do you work with nursing mothers? My wife asked to speak to an expert about this, and then you arrived. Do you know why Amanda wants this information? We are both very concerned about what might happen to the baby.”
I rub my eyes and look over to Alice and Fiona, both asleep in the bed beside me. Hearing Gordon talk about what may or may not happen to our child makes me panic and want to run out of here. Then I remember I can’t leave. I’ve never had to be on anti-depressants before, but although I’ve only been in this ward for a day and a half, it feels like the only way I’m getting out of here is if I agree to take the meds. How is this what I’m doing today? Why aren’t we out taking the baby for a walk around the block? Why aren’t I at home, on my couch, with TV and tea? Will I ever get back to that life? Maybe the medication will stop the feeling that Fiona and I are going to die. I’m done worrying about the meds. I just want to feel like myself again. The doctor’s answers blur together in a jumble of noise. I don’t hear his answers to Gordon’s questions. Talking to Motherisk seems redundant now, given how adamant everyone here is that I take the meds. It doesn’t matter what answers I’m given. I’m going on anti-depressants.
“Okay. I’ll take them. Just tell my doctor I’ll take them.” I’m speaking to the pharma resident, but staring only at Gordon. I give up. I don’t want to be in here anymore. I’ll do whatever it takes to get me out of here.
June 29–30, 2014
IT’S 5:45 A.M. I wake up in my hospital bed freezing and soaked with sweat. Wrapped in a thin white sheet, I shiver and rock bath and forth, curled up in a ball. I am so cold. I check my phone and see that forty minutes has passed. Then sixty minutes. Then ninety. Why hasn’t a nurse come in to do a bed check? I must have a fever. I know that something is wrong. I h-aven’t been on medication long enough for it to be causing side effects. It hasn’t even been twenty-four hours.
I feel a desperate desire for those invasive medical professionals to come into my space. I wonder if I should I get up and go ask for someone? I’m shivering in bed. Please, someone come in and confirm I’m still alive, while I’m still alive.
What will they say if they find me unconscious? The shift change will come and someone will question why they didn’t check on me sooner.
“It was a failure of the short-staffed holiday weekend,” they’ll say. “An oversight that could have been prevented. A young tragedy.”
I hear the door creak open. Someone peeking in on me, finally.
“Help, please,” I whisper before the
nurse can leave.
“What was that?” She rushes aggressively to my bed.
I sit up slightly and say, “Please. Please I think I need some Advil. I’m not feeling very good.”
“Did you feel like this before tonight?” she asks, with a strong tone of skepticism.
Right. I’m in the psychiatric ward — everything I say is presumed to be fiction.
“No, this just started. I feel very dizzy and I’m very cold. Please, can you get a doctor?”
She walks over to me but doesn’t touch me. She leans in close, looks me over and says, “I’ll go and get a thermometer. I don’t know where it is but hold on for a moment, I’ll be back. We must have one somewhere.”
A hospital ward with nurses unprepared to diagnose a fever is painfully ironic. She hurries out of the room and I hear her call out for a medical kit. She returns with a cup of water, two small pills, and an in-ear thermometer.
“Oh, yep … 41°C. You have a very high fever. Take this, it should help.” She doesn’t tell me what “it” is, so I decide to have faith it’s ibuprofen.
“Pull on more blankets and drink this water. I’ll be back to check on you shortly. And I’ll call the on-call doctor but I’m not sure who is going to be able to see you for a while.” She leaves me alone in the dark with my damp bedsheets.
I send a text to Gordon:
I’m so sorry. Call me. I have a very high fever. I am sick but I don’t know what is going on. Do not bring the baby here. Stay home until I have more information.
My body is rejecting this hospital, this life, this body. My phone beeps. It’s a text from Gordon.
Oh my God. What is happening over there?
He must be scared. I pick up the phone to call him.
“I woke up with a fever,” I say immediately after he answers. “I’m so cold and I have cramps. I’m not sure what caused this, or what they’re going to do to help me.”
“Okay, we’ll stay home until you tell me we can come and visit you. I’ll bring your sister. But we don’t want you to be alone. I’m calling the front desk now to find out what’s going on. This is ridiculous.”
An hour later my mother arrives, and at the same time a team of five doctors and residents walk into my room holding clipboards and pulling along a heart monitor.
“It’s definitely mastitis,” a doctor says before asking about any symptoms. “I remember this happened with my wife. It’s an issue with breastfeeding. We’re going to send a lactation consultant down here to talk with you. Maybe there is a blockage. You don’t look like you have the flu. Do you feel like you have the flu? Your baby is less than two weeks old, after all. It’s the most likely cause of infection. How’s your bleeding?” He asks this last question abruptly. This postnatal body is no longer mine. We patients must get used to revealing our inner and outer selves in whichever way suits those who wear the suits. (They don’t have white coats on in the psych ward. They don’t need to look clean.) Descriptions of cramps, bleeding quantity, and breast soreness are all details these psychiatrists shouldn’t require but need for my medical diagnosis. Or maybe they’re just curious? Hard to tell, I think.
My mother has many questions about my fever’s origin. She has an air of authority, more than the previous week at my house. She’s in full-blown caregiver mode and is fighting power with protective power.
“I feel gross.” That’s all I can give this morning’s inquisition team. The doctors are now convinced the fever is caused by some after-effect of childbirth itself, not mastitis, but they’re not sure what, exactly. Or why it’s happening now.
“We’re going to start you on an IV drip with antibiotics in case it’s an infection. And get some bloodwork done. A nurse will come in to take your blood soon.” A doctor scribbles on his clipboard. The team of doctors seem interested in the curiousness of my case, the complexity of a sudden-onset mental breakdown accompanied by a sudden-onset fever. No one can come up with an obvious connection between the two. The fever’s source is obvious enough to me: I’m rejecting this place.
Once we know the fever is connected to childbirth and not a viral infection, my mom gives the at-home family members the okay to return to the hospital. Gordon arrives in the afternoon with the baby and my sister and we settle into as close a family bonding time as is possible within the prison quarters. Despite the fever I’ve continued to pump milk, though the amount seems to be dwindling. I’m happy that I’ve been able to sustain Fiona through pumped milk, and as far as I know they haven’t moved to formula yet. I’m thankful to at least be accomplishing this one goal.
After a while, my mother mentions that she hasn’t eaten today and suggests that she and Gordon head over to a local coffee shop, leaving my sister and me alone with the baby. I figure that my sister is intentionally not invited on the snack run because I do not have permission to be alone with my child. Will I ever have permission to be alone again?
More time passes and the fever worsens. There is talk of moving me downstairs to “a medical wing” where the nurses can properly monitor what is now being called a noteworthy condition by some who’ve stopped in for bed checks. Two new nurses I haven’t seen before come in to change my IV and take more blood. They start the procedure by informing me that this is a teaching hospital. They miss the vein and have to try again. The repeated needle pricks sting, but are manageable.
“Crap,” one of them says. “It looks like I’ve made too many attempts on your right arm and inner elbow. Do you mind if I run the IV from the outside of your wrist?” The placement will make nursing difficult.
We don’t have an official answer to what’s wrong with me, fever-wise. To be safe, I’m advised to wear a face mask while breastfeeding the baby so I don’t pass along whatever could be causing the fever.
“It could still turn out to be the flu,” says one of my night nurses. The first round of antibiotics isn’t helping, so two new ones are added intravenously.
My psychiatric doctor returns on his way out for the day. “It could be a uterine infection. We’ll run a couple more tests to see.”
I continue to feed the baby into the evening, and at one point while looking down at her over my face mask, I begin to cry. There are literal barriers blocking me from loving her the way I ache to. It hurts my heart to hold this tiny baby against my chest, with an IV tube in my wrist and my arm bruised from all the failed needle-stick attempts. No one can tell me what’s wrong with me. I try to send everyone home for the night and curl up to sleep, but my sister insists on spending the night with me. The next morning, when I hear another knock on my door, I consider whether saying no is an option.
“I’m an OB resident,” explains the woman at the door. “I’m here to look into this fever.” She wants to do a full medical history and see if there is something they’re missing. If I thought describing my inner thoughts in the presence of my mother was difficult, detailing my sexual history in front of my younger sister might just beat it. I am both uncomfortable and immune to embarrassment. There is very little part of myself that exists any longer just for me. It’s funny, but not that funny, how quickly after you give birth medical experts quit asking questions about you and focus all their energy on the baby. But in this scenario, all the attention has turned to me, with constant assurances that the baby is more than okay. The life story questions begin: “How many sexual partners have you had? How many pregnancies? When did you first become sexually active? What forms of birth control have you been on? How heavy are your periods? How often do you experience cramping? Please describe all the major medical procedures you have had in your life. What age were you? What year did they happen? How long did you try to get pregnant? What was the pregnancy like for you? Did you want to be pregnant? What drugs have you taken? How often do you drink?”
I recite my answers while the doctor writes and my sister paces.
It makes sense to ask any and all the questions when you don’t know what you’re looking for. Alice stares down at her
phone, and I’m not sure if she’s intentionally not listening or just pretending not to listen. The patients on the other side of the wall definitely hear this conversation, the way I hear their thoughts and worries all night long. I know all about their anger and their fears, and now they know all about my menstrual cycle.
“We’re going to send you for some more medical tests. An internal ultrasound seems warranted, and also x-rays to rule out pneumonia. A porter will come by to pick you up.” I get to leave the psychiatric ward. I’ll be supervised, but I get to leave this world for a while. I feel too ill to celebrate.
When Gordon, my mother, and the baby arrive, I don’t have the energy to update them on the unveiling of my medical history to yet another doctor, so I simply say, “More people came by to ask more questions.” I look to my sister in hopes she won’t feel any need to include more detail. She thankfully doesn’t. We don’t have new answers anyhow. The porter arrives at my door with a wheelchair, he walks in and hands me a medical binder. “We have to lug this thing down to the ultrasound. Will you hold it for me?”
“More tests?” Gordon says aggressively. No one responds. He’s mad. It could be that my pumped breastmilk is running low, and he knows we’re going to have to turn to formula sooner or later. I send the porter a kind smile. “The wheelchair seems overkill don’t you think? I would really rather walk. I was up and walking not four hours after having the baby. Is this a flexible hospital policy?” I use a little bashful wink.
The porter switches from kind to annoyed. “You have to go down in the wheelchair. No bargaining with me.”
The blue binder he’s given me to carry is heavy — a full three-ring binder with easily four hundred pages, maybe more. How can the hospital have created this much paperwork on me in less than a week? This could be all my life records! It looks like they’re about to let me out of the psych wing, even temporarily, so I decide I should be on my best behaviour and not anger the authorities, lest they tie me up when I return. I want to open the binder and look through what’s written about me, but I’m not sure it’s allowed.
Day Nine Page 13