Chemistry

 One of the many ways our healthcare system is broken is the difficulty of finding a psychiatrist who takes insurance.  The combination of low reimbursement rates and burdensome paperwork makes many of them opt out.  With such limited options, I wound up at a training clinic, where the doctors are residents.  Once they finish their two years of residency, they move on.  They finish up in June, and I don’t meet the new one until September, which would have been fine except that the leaving doctor only gave me two refills, not the three I needed to cover the gap.

 

I didn’t realize this until I ran out and my assistant called the pharmacy to request a delivery.  The training clinic, like so many hospital systems, is impossible to reach by phone, and since I have not yet met the new resident, I can’t message her on the portal.  My assistant and the pharmacy went back and forth trying to figure out this conundrum, but in the meantime days were going by.

 

 

I have missed a couple of days before, like when I was in the hospital, and even that made me cry like a human waterfall, like Alice standing in the pool of her own tears.  By day three, was not just the crying. My brain felt thick and sludgy and I was so exhausted that taking a nap on the hot filthy midtown sidewalk didn’t seem like that bad an idea.  Eating seemed like a strange idea. I forgot to eat lunch and ate the same dinner every day on autopilot - a single veggie burger with a slice of cheese. By day five, a well-meaning volunteer congratulated me on the weight loss he could see in my face, the assumption that all weight loss is a good thing being another problematic aspect of our society

 

Then the thoughts of suicide started rolling in like ominous storm clouds, heavy with the possibility of thunder and crackle of lightning.  They were not like the suicidal thoughts that show up in my life sometimes, difficult but familiar.  These kept expanding, taking up more and more real estate in my mind and rudely shoving other thoughts away.  At a certain point, I thought maybe I should email Sean and tell him this story, tell him that if I don’t survive this he can use it as an example of how broken our system is.   Somehow even with my broken brain, part of me was still thinking about advocacy.

 

 

Finally, on day six, a thought bubbled to the surface of my pea soup and I emailed my primary doctor. By that afternoon, the pills arrived. I thought it might be a while before they kicked in again, but by the time I got home from work I could feel my brain coming into focus like looking through a new pair of glasses. Then I started to feel energy flowing through me, like a circuit breaker had been flipped, resetting a blown fuse. Next the heavy clouds of suicidal thoughts started breaking up and dispersing, scurrying back to their spots on the periphery of my mind.

 

Despite everything I learned about the brain in grad school, it is still shocking to how influenced we are by chemicals, neurotransmitters and receptors.