Saturday, 31 August 2013

A Walk in the Garden with PTSD

Revelation most often comes in my life like an errant snowball right to the junk. This particular snowball was actually a series of photographs that were put together for my fortieth birthday. I didn’t see it then. I did see it eight years later when I played it for a new friend. There in the images of me, as if a magical mirror, I saw it. Rather I saw the absence of it. I saw the absence of joy. I don’t know if my defence system was down, or if I was “just ready” to see it. But like many of the things seen that got me here I knew I would not be able to ignore it. Just as I knew I’d try.

What exactly am I talking about? Fair question and one I don’t think I could have answered three weeks ago. I am talking about Post Traumatic Stress Disorder. The really weird thing is three weeks ago I would have punched you in the head for even suggesting I had it. I actually never really thought; “Hey my dick isn’t showing up for the game without some serious coaching. Something must be wrong!” Drinking a sixty of vodka a week for the past seven years, you would think, might draw my attention.

Nope! I didn’t have a damn clue. Now before you start doing the judgement thing and trying to convince yourself, in that really loud voice we save for situations just like this. Let me stop you. I have a B.A. from a great University with a minor in Psychology. I also have job specific training to an advanced level in Critical Incident Stress Management, or CISM for short. I’ve worked as a Federal Correctional Officer for twenty five years and get paid to be aware, observe, and react to behavioural issues. But I missed it completely until I saw this old picture and was struck by the absence I saw there.

Even then I really didn’t let myself believe it was Post Traumatic Stress Disorder, or PTSD, for short. For short, don’t you just love that? Because somehow when we abbreviate, it doesn’t sound quite so overwhelming, or embarrassing. No, I went for the simple question. Why don’t I look happy? I mulled that one over for quite a bit. I have great friends, a good job. I fly to Vegas three times a year to have fun. I get laid on a regular basis, and enjoy a very good life. Yet the evidence was staring at me like the mirror above the toilet you just puked in.

I came back to this absent stare, adorned with a plastic smile. The answer came when I rephrased the question. Not why but what. What is making me unhappy? I’ve never been a great supporter of A.A. but in this case they’re right. Acceptance is the first step. That answer isn’t the easiest thing to put into words even for a professional author. But what I can do is define what PTSD does and in that provide a better definition. PTSD creates shadows in your soul and steals the light from your eyes. Ok, sure it is a little florid as a definition from a Prison Guard. But, even if it is I think it is the most accurate. Let me explain.

If you got mauled by a dog and after, when a dog barked, your hands shook and you dribbled pee, it wouldn’t take a psychologist to figure out what your malfunction was. Sure you could develop PTSD from a serious dog mauling, but that’s not my point. My point is that this break down is insidious. For me it was slow and spanned several years. In this lies the real bitch of the bunch for diagnosis. Because we live in cycles, sometimes up sometimes down, how do you know it is a psychological issue and not just a mood? Because past all the overt signs of emotional dysfunction and inappropriate self medicating coping skills, it does something else. It causes brain damage. Images of the brain actually show physical changes inside the sticky parts of your bean. This damage seems to install a worthless filter. You look at things without the “light” of positivity. It also installs “shadows” that echo and cast doubt at the very core of your personality. So while fancy I think this is for me the best place to start.

I say start because from here the choice is to deal with it or say fuck it and carry on. I’ve been functional for a long time with this problem. I am lucky to have genes that allow me to drink, and a job where is a little antisocial behaviour is acceptable. So do I accept that this is just what happens to us? Do I accept that these traumas are going to influence me for the rest of my life?

I went to school for sixteen years and hated ninety five percent of it. But I did it so I could get a job I liked and have a good life. I didn’t hit that goal and knock it out of the park either, but it’s been ok. I’d like to have a retirement that kind of makes up for it. I can’t do that suffering from PTSD. So this is something I can choose to do or continue thinking things like: “Well if I were to get killed today at work I’d be ok with it as I’ve done enough of my bucket list!”

So this is a story; A walk in the Garden of Post Traumatic Stress Disorder. It is most certainly not a self help book. I hate those and to be honest generally loath the people that read them. It’s just a story of one guy trying to fix all the shit that fucked him up. My hope is that by telling it you get hit by a snowball, right in the junk!

I guess the best place to begin is at the end. For me it was sitting with a drink in hand, staring into a box of things that used to mean something, and grasping at the vapours of why. Now in my case it really was a box. But it doesn’t have to be. It can be a journal, an old car you use to like to restore, or your golf game. The”it” of the box really doesn’t matter. The lack of interest is the important bit, along with the trying to discover what happened. If you’re depressed you might not want to go pull wrenches on the 69 Cutlass. However, if you are asking yourself why it is sitting in the garage, and why you ever tossed cash at it? You might want to look a little closer. If you’re Tiger Woods and your game is off do you blame the grass, or your emotional state?

I could go into a few comparisons here, actually I did, and all of them would have got me sued by Wood’s legal team. So I am left and you by default, with my examples. The melodramatic Scott might say a drink in one hand, gun in the other. In fact I believe I did write that exactly to my x-wife. But in reality the survivor mentality was so entrenched at this point suicide was never a solution. Life was going to come along and do it for me at any time. Normal people, when faced with the likely probability of death, react rather poorly. Sure, we hear the stories about the ones that championed above and overcame the odds. We hear about those for the same reason we read about heroes in books and not the stable boy that died under the horse. In reality people don’t do well with the impending doom scenario. I was cool with it, so long as I lived up to the challenge and went out swinging; part of me welcomed it.

The strange part of this for me is that I believe suicide is weak. A coward’s way out. I’ve had three friends do this over the years and I view each one of them as pathetic for doing so. By friends I don’t mean I knew them on Facebook. I am talking friendship like you could show up at their door, drunk, with a hooker in tow at three in the morning. They’d open the door and even though their wife’s mother was over and they were both in their cycle, he’d let you in. After calling a cab for the prostitute, let’s not be unrealistic.

A caveat, I think suicide is an ok option if you have a horrible debilitating disease that can’t be treated, is only going to get worse, and will take you anyway. Then it is like a “fuck-you” to death itself. I get to kill me before you do! PTSD is all of these things with one difference. If you’re aware of it you can fix it. Awareness!

I know I am going on about this being the hook in the Virus that changes it from benign flu, to the Shepherd's crook that spells Ebola. I want to err on the side of caution and say if you’ve been in a first responder or Emergency services position for longer than six months you should find and do one of the many PTSD checklists available. BE HONEST! We can lie to ourselves about everything but in this one case attempt to be honest. Your life and happiness depends on it.

So we have the first and second A’s in our program; Awareness and Acceptance. The final start to this road to recovery is Adaptation. We learn as Emergency personal to adapt everything we know to overcome the issue we find ourselves faced with. I remember in Staff College being told how this or that is policy or procedures based on best practices, but wait ‘till you get to the Joint. Then the real learning begins. Those instructors understood that they couldn’t teach us how to overcome each challenge we’d face, because the nature of our businesses is people and people are unpredictable. This normal unpredictability gets all the more interesting when coupled with substance and mental health issues. This described many of the offenders I worked with over the course of twenty five years!

I remember one afternoon working in the unit of a maximum security jail when a convict came down to the office just after my partner had finished a tier walk. He came to the door and said that we’d better do another round. My partner asked why and the convict, wanting to remain solid (not a tattletale or rat) replied, “Just do another fucking round”.

We both got up and did another round finding an inmate had cut the tip of his penis off with a homemade knife fashioned out of a tin can. There was a great deal of blood and the Inmate was very pale and sweaty. Seems the inmate had converted to Judaism and been denied the surgery to remove his foreskin. Taking matters into his own hands had proved, on application, to be a little more difficult that it first seemed. My partner, being much more senior to me, reacted and told the inmate just how stupid this was and that he’d better squeeze as hard as he could or he’d bleed out.

The inmate was walked to the jail’s infirmary and a doctor was called. I, being the rookie, was tasked with staying with the whimpering convict while the doctor made the thirty minute drive to the jail. The doctor was an elderly man, having done many years as a military doctor before contracting with the Correctional Service.

He attended the isolation cell inside the hospital wing and asked the inmate; “What in Christ’s name would make you do that to yourself?” The inmate mumbled something about wanting to be Jewish and the old doctor just laughed. The nurse prepared the inmate for surgery as the old doctor went and washed his hands, and I just watched the blood ooze from his decapitated dick. I was not accustomed to looking at other men’s penises, yet couldn’t look away. The soon to be coined car wreak syndrome.

The doctor returned and before slipping on gloves to my amazement pulled out a pouch of Black Cat tobacco and rolled himself a cigarette. The nurse helped him slip on his gloves and then paused to light his smoke. With smoke curling past his head he set to stitching this inmate’s penis together. The inmate cried out and I held him down as he yelled. “Aren’t you gonna freeze it first Doc!”

I remember very clearly what the doctor said and the look he gave the inmate, as I struggled to secure the violent convict. “Did you freeze it before you did this?” He said pulling the hand rolled smoke from his ruddy face, blue grey eyes fixed on the convict’s.

“No.” Whimpered the convict, shrinking under the old surgeon’s steely gaze. As if the man was more Medusa than doctor. Putting the cigarette back into his mouth he mumbled. “Didn’t think so.”

Then with adamant protest from the convict he continued the delicate task. The inmate picked up the tempo of his complaints and the nickname Half Cap for his trouble.

I didn’t know it at the time but I passed my first line screw test. I had stayed and did my job. I had adapted and overcame the rather disturbing incident, and had done so without complaint. My reward was to be invited to the Legion after work for drinks. I was the first of my group of new fish to be extended this privilege, and I blew it.

The Legion was the only place you could drink in Uniform and not run afoul of the Code of Conduct. It was close to the jail and basically on the way home for almost everyone. As such it collected an assortment of Officers, or as they called themselves back then. Line Screws, Guards, and Digger Pigs. I was proud to be asked to attend and listened as the tale of the headless hammer was told. My mistake was commenting on the incident in an emotional manner. I really don’t remember how I put my words, but suffice that they all landed in my mouth sideways.

I was immediately told that this incident was hardly of note and if it weren’t for the fact the guy sliced his “Johnson” it hardly would have been brought up. Then I was regaled with three stories, each worse than the next further entrenching the idea that today was a pretty easy day. So began my career and the first stroll in the garden with PTSD. Staff College had offered little if any training in dealing with stress. My peer group had been through far worse and admonished my feelings as trivial and weak. I adapted, and pushed them deep down next to the childhood terrors instilled by McCammon and Lovecraft, and nurtured by yours truly.

While my peer’s condemnation at the time had been harsh I came to understand how very true it was. But before those of you first responders reading this drop into that comfortable old rusty armour of “You don’t know what bad is” let me assure you, I’ve seen bad. I’ve seen a guy hit with a bat so hard his head popped and one of his eyes came out. I’ve seen men open their forearms like gutted salmon and bleed out. I’ve got between men bent on killing one another, tackling one to prevent him from stomping an already ruined head into mush. I’ve witnessed the despondent slash his throat, and bleed into a flushing toilet in order to hide his act. His whimper chasing tears “ratting” him out and drawing my attention. I lived through riots, hostage takings, and the proverbial catch all, “isolated incidents”. I survived them all. I never went to counselling. I didn’t need it. Everything just rolled off my back with no impact.

Or so I believed right up to my revelation. Then even after that memorable snowball I tried to ignore it as I really didn’t know how to fix it and I was well adapted to ignoring things. Divorce, death, destructive practices and hobbies, I had ignored the lot! I most certainly wasn’t prepared to bring them to the surface with a professional. Besides, what help could an arm chair observer provide? How was navel gazing and discussing my feelings going to make this new reality ice-cream and rainbows? I understand, believe, and support getting professional help. I also know Officers and know it has to be almost insurmountable before we do. I believe this is because at a core level we need to believe we can adapt to overcome any challenge. We after all have lived and corrected the worst offenders in Canada. Eaten lunch and drank our coffee in societies worst neighbourhoods. We do it every day, come home and tell our partners nothing happened. We’d adapted to our environment. Became a product of that adaptation and were comfortable in it.

So we know my revelations are painful. My epiphanies are even worse! I figured I should do the test and stop drinking for a couple of months. Follow some general advice and talk to someone, to try and get this life back on track. I had arrived at the awareness level and had basically come to terms with the acceptance side of the equation. Professional navel gazing sessions helped to take the “basically” out of the last statement.

So what was left was adaptation. Having proved that despite drinking copious amounts of Vodka for a very long time I was not an alcoholic I filled a flask, dug out a cigar and figured it was time to do some hard thinking. I like doing this type of therapy alone and preferably by the sea. I like the rhythmic crashing of waves and the small feeling I get staring out at the vastness of our coast. Cigar alight, and flask open I basically set my mind to drift on things. Attention deficit hyper active disorder is a large obstacle to overcome and I was quickly entranced by a bird. The wind was scything onto the shore tossing huge waves into the grey rocks. The dark water chased the white surf toward me, while this bird pitched and rolled in the air above. It was caught by a hard gust and driven harder still into the rocks about eight meters to my left disappearing for a second in the debris that littered the area just above the surf line. I heard it make a sound. It was a sound in-between a chirp and a squeak and not very pleasant. I jumped to my feet thinking one thing and forgetting one crucial item.

I thought that this was a very traumatic event for the bird and it may be hurt. I forgot I hadn’t had a cigar or a drink in several weeks. The rocks pitched under my feet, and I followed them forward. I landed chin first on a large and thankfully barnacle free rock, my teeth grinding together threatening to break. Instinctively I had saved the vodka and cigar, tossing my arms out in a cross fashion and failing to get my elbows down prior to my chin. The bird jumped up onto a rock of its own, looked over at me, chirped, and opened its wings to the gale. It had adapted, and I had my epiphany along with the burnt chalk taste of chipped teeth.

It seems to me, like the bird, first responders’ have to work in what is at times a hostile environment. But it isn’t like that all the time. In fact most days are pretty much just average days. Other days are really good, and a few are really bad. If we allow ourselves to focus on just the bad days then they start to feel like forever. But if we adapt and allow the situation to just be as it is and choose to instead focus on the good days it doesn’t seem so hard. The malevolent storm that slams you into the ground in an attempt to kill you is just a wind that picks you up when you’re down. Nothing has any real type of meaning until we assign it one. If we allow ourselves to continually assign a negative meaning to the events we are forced to deal with then that bleeds into our regular life and spoils it. Fortunately for the bird this is hardwired into its brain. As humans we need to be aware of the issue, be able to put aside our pride and bravado to accept it. Then with a firm understanding, or a resounding kick in the teeth, adapt and work out coping skills that allow us to put it all into a better perspective.

1 comment:

  1. You're familiar, of course, with the painting "Wreck of the Medusa." It's based on a true event. I think it's symbolic. The ship went down and those who were supposed to help were the first to bail. All of the safety nets failed. One by one, people on the life raft waved for help at the passing ships and were not spotted. When the ship went down, the managers made it; the others didn't. Great parable.