A Bipolar Diagnosis: Suicide Watch
by Gabe Howard
The first thing I remember when I opened my eyes was a pair of ugly green curtains against a white concrete wall. I took stock of my situation. I was lying in a bed. On the other side of me from the wall was a curtain, probably white, drawn partially around the bed, closing me in. The room was unmistakably of hospital décor.
Dim light came in through the door, which was propped wide open. I found this odd, since I was wearing only a hospital gown. The bed’s side rails were up. I felt equally trapped, safe, and confused.
As I lay there, trying to figure out what to do, a figure appeared in the doorway, staring directly at me. After what felt like an hour (but was probably only a couple seconds), I heard a scribbling noise and noticed that the figure was holding a clipboard. As the person backed out of the room, I heard the clunk of the clipboard being dropped into a holder.
The thing is, I wasn’t entirely certain this had happened at all. In my confusion and half-sleep state, I had to consider that I could be dreaming or even delusional.
Next to the bed was a brown nightstand. On top of the nightstand, whirring away, was my CPAP machine, which I use to treat my sleep apnea. Only then did I realize that the CPAP mask was attached to my face and doing its job of blowing air into my nose to keep my airways open. The familiarity of the mask, the machine, and the blowing air was the only thing, at that moment, that felt normal. The CPAP was from my bedroom and as near as I could tell, it was the only thing in this place that belonged to me
There wasn’t a clock and I wasn’t wearing my watch, so I had no idea what time it was. I did remember arriving at the emergency room after eight p.m., and that it was past midnight before I was finally admitted to a room.
I drifted in and out of sleep for what felt like hours. Every time I woke, I saw my frequent visitor in the doorway, heard the scribble, and then the “clunk” of the clipboard as he or she disappeared. Although this happened many times, there was still no clear indication whether this was really happening or was something just in my mind.
While I knew exactly how I came to be in this room, I was confused about why I was here.
The previous afternoon, I called the woman I was dating to say goodbye. I was going to kill myself. I was depressed and desperate, but apparently still gentleman enough to not leave a woman wondering why she didn’t hear from me again. The conversation about my impending suicide had not gone according to plan. Instead, she came over, picked me up, and drove me to the hospital. We walked up to the nurse on duty and she said, “My friend wants to kill himself. He needs help.”
At some point during the night, the curtain was whisked back and the lights thrown on. My first full view of the room did little to raise my assessment of it. It was a standard hospital room, except much less furnished: no TV, no extras of any kind. The hideous green curtains didn’t even have pull strings.
Someone grabbed my wrist. This startled me. There were at least three people standing above me. One of them said, “Mr. Howard, we need to draw blood.” I’d had blood drawn before, so I went limp, extended my arm, and looked away.
At this point in my life, I weighed over five hundred pounds. At six-feet, three inches tall, I weighed at least double the healthy weight for a person of my height. I was a giant of a man in all ways – height, weight, broad shoulders, giant hands and feet. To call me “large” would be to greatly underestimate my size. According to all medical documentation, I was “super morbidly obese.”
Drawing blood from me was a challenge under the best of circumstances. My veins were hidden under layers of fat. Between the phlebotomist’s inexperience with people of my size and my inability to assist, I was stuck with the needle three times before I curled into a ball, crying, begging them to stop. It was too much. I finally hit the breaking point. It all finally caught up. All at once, I put everything together.
There are many moments from my journey with mental illness that occupy my mind. I turn them over in my brain and I look for answers. I think about them at night when I can’t sleep. I search for closure, understanding, and perspective. This moment, however, there in the hospital with a phlebotomist trying vainly to draw my blood, is the earliest of them.
This was the moment I didn’t see coming, and the one I had the least amount of experience to deal with. Nothing that had happened to me before even came close. I was blindsided and sucker punched at the same time.
At that moment — in that room, in that bed, in front of people I never met and wouldn’t recognize if they were standing in front me today — whoever I used to be died. I would never be the same person ever again. That was the moment I realized just how sick I really was. It was a moment of clarity in which I accepted that everything I thought I knew was wrong. To this day, that moment is the most significant of my entire life.
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I was furious. I was devastated. I was terrified. The physical manifestation of this combination of emotions was howling cries, rocking back and forth in the fetal position, and for the first time in my entire life, my mind just shut off. I had absolutely no idea how to process the overwhelming emotions that gripped my body and completely defeated my psyche. I had been in the psychiatric hospital for less than six hours and I had already completely given up.
To this day, I don’t know if the medical staff went away and came back, if they stayed and watched as the reality of the situation washed over me, or if they tried to intervene in any way. I didn’t even know how long the entire episode lasted. The next thing I do remember was a nurse holding my hand. She was a middle-aged woman with dyed blonde hair who reminded me of my mom. I wasn’t crying any longer, but my cheeks and eyes were still wet. She said, matter-of-factly, “I heard you were a hard stick.”
I nodded and wondered why on earth she was focused only on my difficult blood draw and didn’t seem to notice anything different about me. She handed me a stress squeeze ball and told me that she was the best blood drawer in the entire hospital and she promised that it would take her no more than two sticks to “get me” and probably just one.
I looked away as she kept up this constant banter of nonsense to distract me while she carried out the procedure. As is often the way with people who just meet me, she talked about my red hair. She then exclaimed, victoriously, that she was done and on the first try. I do believe she was genuinely pleased with herself and her skills in this area. She deserved every bit of praise. I thanked her and she replied, “No problem. I had to come and check on you anyway.” I then heard scribbling and a familiar clunk. I immediately reached over and felt the bandage on the crease of my elbow, confirming she had really been there.
Whoever that nurse was, she was the first person I spoke to after my entire life had changed. In that moment, she was the most important person in the world. If I ever knew her name, I have long since forgotten it. She was kind to me and I’m certain this short interaction in the middle of the night meant very little to her. She was doing her job, and she did it well. The defining moment of my life was shared with a person completely unaware of its significance to me.
As I calmed down and attempted to fall back asleep, I replayed the questions the doctor had asked me the evening before. He was a young man, mid-twenties, and a psychiatric resident. He asked me why I wanted to die. I replied that there was nothing here for me. I’d had enough and was ready to move on. I would later learn that he asked me the same questions in multiple ways, over and over, and I would always answer with some variant of that answer. My answer was always firm and confident, like I was telling a waiter what I wanted to order for dinner.
As I was lying there, I thought my diagnosis was “crazy” and my limited knowledge of any sort of mental illness led me to one conclusion: My life as an equal member of society was over.
I was broken.
I was damaged.
I was mentally ill.
I fell back asleep for some time. When I woke up, I heard noise: people talking, feet shuffling, and general commotion outside my door. It occurred to me then that I had no idea what was out there. The hideous green curtains now had some light escaping around the edges. Not a lot. The room was still fairly dark and I was happy about that. The ugly curtains were effective, at least.
I was scared to get out of bed, scared to venture out of the safest spot I knew in this place. I had heard horror stories about psychiatric hospitals. I wasn’t completely sure I wouldn’t be placed in a straitjacket, restrained, or drugged. I may not have ventured out of the room if it hadn’t been for two very important things. I was hungry and, more pressing, I had to pee.
I climbed out of bed and walked slowly over to the bathroom. I’d survived the first night. I felt alone and scared and I desperately wanted to see my friend, Lisa, who brought me the night before. She had answers that I needed and I trusted her. But I didn’t know if she could visit or if I could even call her. The night before when I asked the hospital staff if she could stay in my room with me, they said no. At the time, I thought this an odd response. I had stayed overnight in hospital rooms of friends and family many times. I recall her reassuring me that it was okay and I had believed her.
Before I got to the bathroom door, the nurse approached me. “I’m glad you’re up,” she said, “I was just coming to check on you.” She reached over and pulled the clipboard and pen out of the holder on the wall.
I told her she didn’t have to come and check on me so much. I said I was okay and would come get her if I needed anything. She looked at me, put her hand on my arm, and said, “Honey, I will be checking on you every fifteen minutes.”
I stared at her, puzzled, until she leveled me with a four-word gut punch: “You’re on suicide watch.”