lucid dream

tabula rasa

Aside from bringing him to the hospital, I tried not to protect MH from anything this week.  My hope was that he would finally suffer consequences for what he was doing.  They say that this is the only way to help an addict.

When he finally came out of the hospital, he seemed a new person.  I've been through this enough, though, that I'm staying numb to it.  On a medical note, he met with an addiction specialist at the hospital, who has proposed using naltrexone.  I encouraged him to go for it.  The typical route is a daily pill, but it also comes in a once-a-month injection which I think is better for obvious reasons--  Get it once and it'll be in your system for 30 days.

I had to keep moving with my own life; this week was busy with cardiac cases and being on call.  Furthermore I was faced with another tough decision to make.  I had thought I was okay accepting the fellowship offer at the university which pressured me into a decision by mid-June.  But then I got a phone call from a director of a program in NYC this week, offering me a position.  

I agonized about it for two days.  It would be tough to call the first program and tell them I changed my mind.  It would have to be worth it.  I would prefer living in NYC; aside from the obvious draw that the city holds for many people, I already have friends there.  I know nobody in the town I'm moving to.  Also, the program in NYC is more renowned in the field of cardiac surgery.  On the downside, could I really ignore the unhappiness and weariness behind the faces and words of everybody I met who has trained or is training there?  The hours are harsh, the environment toxic. I called him back on Friday and told him I had accepted a position elsewhere.  I was not sure I made the right decision but I have to live with it.  It doesn't help that a lot of people around me are now viewing me as a kind of crazy renegade, to turn down a solid program for a program that nobody has really heard of.    

To solidify the clean slate we all wanted, we went up north for the weekend.  It was the first time in almost a year that I went out of town for no other reason than to get away from it all and to start over.

I don't know what's going to happen a week, a month, or a year from now.  I'm trying to be in the moment, to appreciate the happiness I have right now.

rock bottom?

i came home yesterday morning after being on call.  he wasn't home, and he wasn't at work either.  his mom left me a message saying that she had heard from him at 6:45 in the morning; he was standing in front of the detox center and asking her if he should go in.  she of course said yes, and that was the last she heard from him.  i didn't hear from him all day, but i was oddly at peace.  i thought that detox would be a good starting point for him... and simply having him out of sight and mind brought back a sense of normalcy into my life.  i took a brief nap, went out for lunch at a vietnamese restaurant, took the dogs to the park, ran errands.

so when he came home around dinnertime, my heart sank.  he obviously never went to detox, was still drunk, and looked awful-- pieces of food on his face, smelly clothes.  i ignored him and continued to read my medical textbooks on the couch. but he had to continue stirring up drama.  drunken phone calls, watching the same reruns of "rescue me" over and over again on youtube, and intermittent trips to his car-- probably to drink, though he could barely walk.  after attempting to ignore him for two hours, i felt my patience and pent up frustration ready to explode.  finally i told him i couldn't stand the sight of him and would he please at least take a shower?  he refused at first but finally gave in.

when he came out of the shower, clean again, i couldn't help but stand up and give him a long, desperate kind of hug.  i don't know why i did this.  he was taken aback, and held me too for a long time.  at around 8 pm, i headed to bed, knowing that i'd have to get up at 4 am today for two heart surgeries.  he wanted to come to bed too, and i was glad he did because that meant he would stop drinking.

it was a long night in which neither of us got much sleep.  he was going into withdrawals:  panic attacks, wet, clammy skin, pulse of at least 120, and rapid breathing.  

when i left him this morning to go to work, he was drenched in sweat and shaking precipitously.  it wasn't just his hands shaking, but his entire body.  i also knew from medical experience that people don't die from cocaine or heroin withdrawals, but they can die from alcohol withdrawals-- when it gets to the point of seizures, severe high blood pressure and rapid heart rate, etc.  i thought i should probably stay at home, but i had a big day at work and i thought he wasn't that bad.  i also hoped he would learn a lesson from this.

at about 8:30 in the morning i got a call from him.  a colleague of his was going to take him to detox.  he already made an appointment for himself at 1:45.  but then he mentioned, that he went to the bathroom to vomit and he vomited copious amounts of blood-- enough to fill the toilet.

at this point i lost all hope of continuing my day at work with any semblance of normalcy.  i confided a little bit with my attending and he sent me home.  even with all my worry for MH I resisted this offer because i didn't want MH's problems to be ruining my career!  my attending was the director of cardiac anesthesia and i wanted to hard work for him.  

i came home and took MH to the emergency room of a local community hospital.  we spent ages at the registration desk as five people crowded around trying to learn a new system in the computer.  i was screaming inside.  HEMATEMESIS IS A MEDICAL EMERGENCY!  mh looked pale, clammy, and sweaty.  finally a nurse took him into a room to get his vital signs, and when mh stood in the hallway waiting for her, his eyes rolled into the back of his head and he started to swoon.  i yelled for help, and finally someone started to move a little faster and got him into a wheelchair.  then they whisked him away into the trauma bay where they started an IV, got some fluids into him, got some bloodwork and a type and screen (for blood transfusion if needed).

making a long story short, he seems okay now but is being admitted to the hospital.  i tried to go back to work but my attending, (the cardiac director), insisted that i stay at home.  this upset me as i wanted to get back to work, get my mind off things, and get back to normal.  i also felt bad that they had to pull one of the residents from his assignment to go work in my room.

history repeats itself

i broached the subject of moving on, and asked him to move out.  we didn't make progress on this however because he's still drunk, third day of drinking straight since friday, and i'll have to reapproach it when he's sober-- whenever that will be.  saturday, july 4th, was spent in alternating waves of anxiety, sadness, and anger.  he didn't come home until 8 pm.  i was only able to get a hold of him briefly on the phone-- he was continuining to drink himself into oblivion, at his office of all places.  he did his usual stunts on the phone where he wants to get back to drinking and evade my questions so he just hangs up on me randomly, leaving me in the dark.  i wanted to be strong, but i felt so lost that i called him a couple dozen times, of which he only answered once or twice, to see when he was coming home.  i brought the dogs to our favorite grassy knoll where i sat with them, the cool summer breeze wafting across our faces.  even that was hard because we saw families laying down their blankets, having picnics intermingled with the laughter of children and the yaps of their dogs, couples walking by with newborn babies in their strollers, and all the holiday merriment that made my sorrow reverbate within my soul.

as mentioned, he come home around 8, sobering up.  he looked awful, hadn't showered or shaved in at least two days, so he immediately went to take a shower.  things seemed to normalize as he cleaned up the kitchen a bit and took the dogs out for a walk to take the trash.  i went to bed shortly thereafter since i would be on call again today.  sometime past midnight i heard the cat crying outside so i went to the living room.  "MH," i said, preparing to tell him, get the cat, but this is what i saw-- MH sleeping in the chair in front of the computer, his head hanging down over his chest, shots of unfinished whiskey on the table.  i called his name again, but he didn't respond.  he was breathing though.  i shook him by the shoulders and called his name.  no response.  i had never seen him this obtunded before.  i shook him harder and he suddenly opened his eyes.

"jibwelrkjweoiru," he said in a slurred, unrecognizable voice.  "what?" i said with escalating desperation.  "sign the beast," he slurred.  "what?!!"  "sign the beast!" he said with more conviction.  "sign the beast.  sign the beast."  he was talking insanity without intention or control, only what his addled brain could offer spontaneously and sincerely.  at that moment, he appeared to me the saddest and most hopeless human being in the entire universe.  i had taken care of alcoholics and drug addicts in their final throes of life during my internship year, but i had never seen them in the prime of their pathos.  what i saw now disturbed me, i couldn't sleep; it will haunt me for the rest of my life.

i went to work today and tried to put him out of mind.  nevertheless, i hid his car keys away prior to leaving because i hoped he wouldn't buy more alcohol and sober up to go to work tomorrow.  (re SOJ's question, he hasn't missed work yet, limiting his drinking to weekends and holidays, but his drinking is escalating, getting progressively worse.  it won't be long before even his weekday routine will be unmanageable for him.)  he called me this afternoon, sounding as if he'd sobered up, which is when i brought up the subject of him moving out.  he was saddened by this, but wasn't remorseful about the drinking like he used to be during his first relapses earlier this year.  i hated myself for feeling better , more hopeful at the tone of his voice sobering up.  because only two hours later, i called him and he sounded worse... drunk again.  he must have had remaining supplies of alcohol in the house.

i haven't heard from him since, so i know he's continued to drink. 

i'm sad because of the man he used to be, the man he could have been, a husband and (someday)a father.  he was one of the most talented prosecutors in the state, and has achieved remarkable success in his short experience thus far as a defense attorney.  he had me.  together we had a bright future waiting for us.  and like all other lives destroyed by alcohol, he will lose everything... one by one.  i can only hope to have the strength to walk away.

another holiday lost

i need to be more proactive about requesting the holidays off.  i've been on-call for so many holidays in the last couple of months.  it comes as a relative disappointment therefore that i was on call yesterday, an official hospital holiday, came home this morning, and am on call again tomorrow for another round of 24 hours.

yesterday was not busy in the least and i got a lot of sleep.  i could have had a great 4th of july today with my husband.  but here is another holiday which he has ruined with his alcoholism.  he's been drinking since yesterday, is not at home now, and the house is a disaster.  the dogs are starving, there's dog poo on the carpets indicating that he hadn't been taking them out, the bed is wet because he, a grown man, peed on it in his sleep, he left the bedsheets in the laundry machine, and it's filthy here. 

i have all these plans in my head for what to do but i don't know if i can execute any of them right now. i'm under a tremendous amount of stress at work, and since it's cardiac month i've been too exhausted to do anything but go to work, go home, go to sleep.

sometimes i feel like i have nothing to live for.  and i've completely distanced myself from people who could help me, like family and friends, because i've hidden this part of my life away from them completely.  only you know.

Making progress

Today was an important day in the minds of many residents, including myself.  Everyone commemorated it as the beginning of their first, second, third, or in my case fourth year.  I did anesthesia for two heart surgeries today.  I felt happy, more comfortable than before, and confident.  I was curious to see how I felt during my first month of cardiac so I looked at my blog from October 2008.  

"saturday and sunday passed all too quickly.  i have palpitations when i think of returning tomorrow; it's as though the 3 days away have only set me back. i'm unhappy because i'm on cardiothoracic, where each day i feel like a failure.  failure is not an option, especially when i had felt so capable and competent after the last academic year finished in june.  everybody who's been through the motions said they felt the same way; "you feel like a first year resident all over again when you start cardiac," "you feel like you're underperforming," "you feel completely lost and uncomfortable," but i believe all of these people progressed nicely in the end.  i have very little hope in my own ability to progress.  and my new, omnipresent incompetence is a hard pill to swallow."  

It's nice to see that, actually, there has been some progress in my life.