Day Nine

by Amanda Munday

  I can’t roll over onto my stomach to hide from the light because of the IV in my arm. She’s fumbling to change the saline solution, seeming quite flustered, and sending alarms through the entire ward. I scream the loudest, most desperate scream. I’ve had it.

  “Please, please stop. Please let me rest. I can’t take it anymore. Turn the light off, take the IV out, just leave me alone, please,” I plead and plead. Royal Blue’s attitude shifts from curious and caring to stern and authoritative. She doesn’t take well to being lectured. “You need this bag changed so that’s what I’m going to do.” I cry and cry and look over at my mom, who is sitting up in her bed, looking ready to pounce on this nurse any moment. We are all in pain here.

  You can be sure that my team of doctors hear about the evening incident the next morning when Gordon arrives. My mother tells him and my sister the story of “Amanda’s breakdown” and the horror of what happened after the nurse wouldn’t let me rest. It’s all my husband needs — an excuse to fly off the handle and centre his rage on an actionable cause. He demands that the nurse be removed from my case (not an option) and that I be moved to somewhere with staff who are familiar with IV machines.

  There are faint apologies, but I get the sense no one is really too disturbed by his complaints. This isn’t a four-star-hotel stay, and no one is interested in our return business. Through his anger Gordon demands an update about when I can get out of here. “She’s being kept here so she can sleep — and so far, she’s been woken up every hour and now she has a high fever. This is the opposite of healing and I’m fucking tired of it.”

  In other areas of the hospital, Gordon’s screaming fit would be an attention grabber — other patients’ family members would peek out from behind their doors to see what all the commotion was about. But on the ninth floor, yelling fits are standard, and obviously something this team of doctors is well-versed to handle.

  “You want your wife to get better, right? She needs to be here to get better. The more you yell and the louder you get, the more anxious of a situation you are creating for everyone here. Your wife is safest in this place.”

  In this outburst-meets-family-therapy session, I did overhear one of the doctors tell Gordon that if the fever doesn’t break and my white blood cells continue to be as high as they are, they are going to move me down to a “medical” floor, where I can be monitored 24/7 by nurses.

  Considering I already thought I was under constant surveillance, the suggestion of nurse observation makes me curious. I can’t believe I’m at a place in my life where being moved out of the psychiatric ward could be an indication I’m getting sicker.

  There are some small promises made — that Royal Blue will try to let me sleep, that the fifteen-minute checks will be paused overnight, that all attempts to let me rest will be made a priority. Short of me falling into a coma and dying, I allow myself to think. Will the meds be kicking in soon? I sense that sta-bilization is now the priority. What started out as a journey to find an outpatient therapist and treatment plan has become all-encompassing — in-patient psychiatry, fever and infection, and now SSRI medication. The person I was before I had a baby is fading further and further away from me.

  July 3, 2014

  MORE DAYS AND NIGHTS pass in the psychiatric ward. I haven’t attended any group sessions. I do recognize the cognitive behavioural therapy approach in my conversations with my psychiatrist. I wish someone would acknowledge the emotions behind my disagreement with CBT. So what if the likelihood of the baby dying is 0.5 percent? Isn’t 0.5 percent too high a risk? I will never get any rest as long as they’re giving me a rational answer to an irrational feeling. I long for a different strategy. Doctors show up twice a day to evaluate me, and the nurses switch at 7:00 a.m. and 7:00 p.m. I’ve learned to flow with their routine. With each new nurse introduction, I have to describe the best version of myself for that hour. They arrive in my room with the same questions every time: “How are you feeling this morning? Any dark thoughts? On a scale of one to ten, how is the pain?”

  I’m sure they’re reporting me, though I’m unsure to whom.

  In the last few days, it feels like I’ve seen 25 percent of the staff at the hospital. Nurses, residents, med students, lactation consult-ants, social workers. A revolving door of curious professionals who all want to collect their own version of my truth. There are similar themes in each conversation: “You are brave for coming forward. You did the right thing by seeking help. Your baby is only healthy if you are healthy. I can’t figure out what’s going on with this fever.”

  I brought this on myself, I tell myself each time. They didn’t say it, but I’m sure it’s what they’re thinking. They have yet to learn the reason I’m here: I’m an unfit mother. Just like casinos, there are no clocks on the walls outside the rooms — maybe it’s all a strategy to make me lose track of time as I roam the halls.… Oh, who am I kidding? I’m roaming no halls. I’m suspicious of the clock in my room, and I refer to it constantly to see if the time is moving faster or slower than I expect it to. I’m fixated on the idea that I always notice the time at 9:11, a.m. or p.m. It would be nice to fixate on something more productive, but I can’t come up with anything.

  Dr. Brenda called earlier, following up on our conversation from a week ago, after I didn’t reach back out. I forgot to mention sooner that I’d been locked up. She promises to come and visit me in the hospital, when I’m ready, and I wonder if there will be a face-off of therapists — new versus old. I doubt anything that entertaining would happen here though. I feel weird about Dr. Brenda coming to visit me in this state. Even though I pay her to help me with anxiety, having her see me in the hospital makes me feel like a failure, like all her work was for naught.

  There’s a knock on my door. It’s just Gordon and me alone in the room. Alice has taken the baby for a walk. It’s a young doctor. He explains he’s a resident working on this ward. We’re both residents of the ward. I’m surprised it’s not a running joke.

  “Your fever has subsided. It looks like the three rounds of IV antibiotics have done the trick. We still aren’t sure what caused it, but no matter. I’m here to ask if you’d like a day pass to walk outside for a few hours?” His tone is optimistic; I think he’s offering me a way out.

  “No, thank you. I’m fine right here.” I can’t do it. The thought of leaving the psychiatric ward is terrifying.

  “Amanda, what the hell? Do you really not want to step outside?” Gordon can’t believe I’ve just turned down an opportunity to go outdoors.

  The doctor nods his head and makes notes on his clipboard. “After all the change in the last few weeks, I can understand why you might be apprehensive. We don’t have to do this today.” He looks sympathetically at Gordon, who is visibly frustrated.

  This doctor is validating that my need for safety trumps a desire to appear to be getting better. What does it mean that I’m choosing to stay in this place instead of accepting an offer to escape? There is little to love about the psych ward — not the least of which is the bland premade meals served with unripe fruit and small plastic juice containers. I’m such a coward.

  It’s hard to say I’d rather not leave, but the truth is the only thing I trust is the safety of this box of a room. There are no threats here. I didn’t think I was worried about hoodie strings until they told me hoodie strings could harm me. Or that I could use them to harm myself. A nurse earlier took a pop can away from Gordon, citing the number of ways patients use the tin can to slice open their skin. The world outside the door is rich with danger; I’m staying right here.

  Gordon is upset that I refused the day pass. “I’m going to take your sister and go out to get some food. You’ll be okay here with the baby. They do bed checks every fifteen fucking minutes. If you want to stay here that’s okay, but I need to get out for a bit.” It makes sense; he still has the agency to make decisions.

  Alice returns with Fiona, and she and Gordon go back outside. While Gordon’s out, a tall and a
uthoritative senior nurse from labour and delivery, who tells me she’s a lactation specialist, stops by, holding my massive blue binder in her arms. Here comes another lecture about all the ways I’m not feeding the baby correctly. She starts by asking how I’m managing all the changes to my health and well-being after having a baby. Then she asks me a question that almost stops my breathing: “Do you really want to breastfeed?”

  I’ve never considered that not breastfeeding was an option at all. Since Fiona was born, Gordon has said more than once that he’s tortured by the idea that our baby is being exposed to the chemicals in formula. However wrong he is about the magic of powdered baby food, the guilt feels gut-wrenching. And my values are always aligned with my husband’s; we think the same. We’re not aligned on this. But breastfeeding the baby is one thing I can do to show him I’m committed to my job as a mother. The guilt he brings on with every sigh as he shakes the powdered formula into a tiny four-ounce bottle is stronger than the pain of bleeding nipples and the pressure of the industrial breast pump.

  I’m so stunned by this woman’s line of questioning and the permission she’s offering me that I can’t answer the actual questions. I stare at her in silence. This is the first doctor to talk to me like a human being. She seems to understand the complexity I’ve found myself in — the pressure to care for this baby and the failure to care for myself.

  She stands in front of me calmly and quietly holding the blue patient binder against her chest. “I hope you realize that your baby will be okay regardless of how she is fed. There is no way that you will fully recover until you begin to prioritize your needs.”

  I’m stunned by this whole conversation. I can’t speak.

  She continues, “You do not need to breastfeed her if it’s causing you pain.” She doesn’t define my pain. I don’t ask her to. The concept of prioritizing my own needs is as obvious as it is foreign. A lactation consultant is giving me permission to put myself first. Where was this lesson in prenatal class? I understand that what she’s saying is that surrendering to treatment in this psych ward is important for my immediate, short-term safety, but that I might need to consider some bigger changes to ensure my sustainable long-term health.

  The truth is that I don’t want to stop breastfeeding. But I do really want to remove the number of things I’m worried about. I want to be the good mother I’ve read about in baby books, the mother I thought I’d be, but it’s hard to think about swaddling and nursing and burping techniques when I’m engulfed by dark thoughts about hurting myself and the baby.

  I try to reply. I start slowly.

  “I want to believe that all this talk therapy will help heal me, but it also feels like I’m handing in my letter of resignation for the organic parent I planned to be. It’s like I’m relieved and disappointed at the same time. What do I do with that?”

  “You have to find the path that works best for you and the baby,” she says. This woman is kind and loving and we’ve only just met. She’s a departure from most of the others I’ve met on this floor. “It’s hard for women like you. I understand what is going on here. The beautiful new motherhood experience isn’t what movies portray it to be, and it will remain hard throughout this journey. You have to start saying out loud what you need. Whatever it is. Start naming it.” Great.

  This woman is confirming one of my new fears — that no decision is obvious and that I have to decide how to best take care of myself and my child through trial and error. I can’t follow the prescriptive plan that I defined before I gave birth. I decide not to share the chat with Gordon because I don’t want him to get angry that another doctor is telling me formula feeding is okay. He doesn’t need another reason to be disappointed in me. I already know that I’ve disappointed him because I can’t care for our daughter the way I thought I would. I made promises that I did not fulfill. I’m sitting in a psychiatric ward, topless, with an unidentifiable infection still unresolved, feeding my two-week-old baby and talking about detaching my body from hers. How could he not be angry with me? I understand the sadness I’m creating.

  Despite all of this disappointment and failure, the light in my room seems brighter today. The colours are warmer, less cool and foreign. This lactation consultant doesn’t seem sad, but she does seem concerned.

  She wraps up our conversation with an offer to send me what I need. “If that’s more breastfeeding and pumping supplies, so be it. If it’s formula and instructions for how to bottle feed correctly, I can make that happen, too. If it’s less IV medication and a better explanation of the effects of anti-depressant medication on breastmilk, I’m committed to sending in the right professionals as well. You can get better here.”

  She’s the first person to take a holistic approach to my hospital stay. She’s helping to lift the fog. It’s too bad she’s not my primary caregiver here.

  When she leaves, I wonder if I’ve dreamed the entire conversation. It’s the first time I’ve felt hope in weeks. The contrast between her patience and the other doctor inquiries is so stark it’s hard to believe these people all share a lunchroom. Although I’ve decided to keep this conversation to myself, I feel a glimmer of hope. I have a renewed feeling that there are people in this hospital who want me to get better. I hope I didn’t make her up.

  July 4, 2014

  I’VE LOST COUNT of the days. I feel tired and hopeless this morning. It’s likely because the medication is starting to work and the fever seems to have passed. I guess all the antibiotics worked. Either because I really did have a bacterial infection, or the meds were strong enough to blast the fever away, infection or not. Last night I woke up more than usual, tossing around in my bed in between the non-stop bed checks. But I did sleep. Actually, I’d like to continue sleeping. I long to go back to sleep. The inability to sleep has left me. Now I just want to stay under these thin hospital sheets. The drugs must be working. My thoughts were quiet last night and no anxiety stood in the way of my dreams. Instead it was the sound of the hallway piano that kept me awake. Someone else on this floor couldn’t sleep and decided that a 4:00 a.m. rendition of “She’ll Be Coming ’Round the Mountain” was the solution to insomnia. Or the cause of it?

  Since I had the baby, I’ve noticed the emotional pattern my brain is constructing: Feel anxiety. Solve immediate worry. Feel relief. Sink into deeper sadness. Repeat.

  I am now a card-carrying member of the medication-to-reduce-motherhood-anxiety-and-depression club. The all-natural, chemical-free lifestyle we imagined for our child is evaporating to make way for this new survival-only mentality. No one in this hospital seems to accept the idea of natural supplements as a legitimate treatment for anxiety. Then how did I survive all these years without anti-depressants? It seems that it’s not about what’s best for me or for the baby, it’s just about what we all need to do to get through the day. So if that means anti-depressants over vitamin D, then we wave hello to Prozac. In some ways, the pressure is off now and I feel some relief from the expectations of motherhood. I have the permission I needed to recover from my physical wounds, the internal parts of me that still ache from childbirth. I have permission to stop breastfeeding if that’s what will release me from the hospital and stress, and I want to believe the medication is helping to stabilize this mental cycle I’ve been in. No one expects me to be a mother anymore. I’m certain that the meds are reducing my overall feelings of anxiety and quieting the dark voices telling me I should let it all go and die. If there’s one thing I’ve learned from sitting in this hospital bed, it’s that there’s no one responsible for healing me but me.

  My sister changed her train ticket again this morning. I heard her on the phone with the train company, asking about her options for refunding a ticket home, one she’s exchanged multiple times over the last week.

  “So what’s the cancellation fee?” she quietly asked into her phone.

  I don’t know if she was being quiet so she didn’t wake me or the baby. I wanted to sit up and comfort my sister, and tell her
I’d reimburse her for the wasted ticket cost. But I couldn’t. I couldn’t seem to vocalize the kind thoughts that were floating through my head. I could only lie here, isolated in my hospital bed, exhausted and sad that on a sunny July morning we’re stuck in an emotionless hospital room waiting for an upgraded diagnosis or treatment plan that might suggest when we can leave this place. I have hope that I might be getting better, but I still don’t know when I might be able to go home. I haven’t attempted a day pass yet, which probably only convinces them I’m extra crazy. I can only continue to be curled up under these foreign blankets, wishing I could hear the sounds of early morning birds chirping in the summer breeze.

  It’s a little while later now, and I stand up and kiss my sister on the forehead, then head into my tiny bathroom. I peel off the clothes I was sleeping in. As is the case every day now, my shirt is wet from leaking breastmilk that I failed to express overnight. Gordon has started the last few mornings by asking how many bottles of milk I pumped overnight. I’m always ashamed to answer, knowing it’s never as much as he’s hoping for. I imagine him walking back and forth with Fiona at night, tripping over the unopened baby books, wishing his wife wasn’t crazy. He’s been dividing up the nights with Alice, Max, and my mother. We’ve also had friends stay overnight in our living room, pulling all-nighters so Gordon can catch up on sleep. Our friends Sydnie and Matt drove from London, Ontario, to stay and help. None of our friends are parents yet; we’re all learning how to keep Fiona alive together. In the mornings Gordon downplays the work he’s doing at home, and I can tell by how little detail he gives me that it’s probably been really hard for him. Otherwise I’d expect to hear about funny little stories from the night or cute things Fiona did. Usually though, he simply says last night was “okay” and I just have to hope that it’s true.