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melicorn · 1 year

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Content warning for discussion about depression, suicidality, mental illness, disability, therapy, treatment, hospitals, and the American healthcare system.

I don’t know a lot about John Fetterman; he seems like a decent guy though and I hope his treatment goes well. When I first saw the headline that he was checking himself into the hospital for depression, I thought, “well, good, I hope this starts many conversations about hospitalization for mental health treatment.”

I have already been thinking about hospitalization a lot lately. I turn 40 soon, which means it’s also the 10 year anniversary of my most recent mental hospitalization, following what had been my fourth or fifth suicide attempt. That stay got me on medication I still rely on today, and the follow-up outpatient care eventually led to the ADHD diagnosis which explained why my depression had been so resistant to treatment for such a long time. (Like I said, before age 30, I had four or five suicide attempts, over fifteen years in and out of therapy with at least half a dozen practitioners by that point, including a previous hospitalization, and tried more SSRIs and supplemental medications than I can remember.) Turns out all the serotonin in the world can’t make a difference if you don’t have dopamine.

One of the things my therapists would often ‘congratulate’ me on was my very clear and precise self-awareness regarding my mental illness. But that level of introspection meant over the years I grew increasingly frustrated and isolated by others’ inability to understand or empathize with my struggles. Even when I had complete lucidity over my mental state and could communicate it in a descriptive and accurate manner, there was no way the other person could actually *know* what it really *felt* like. Excepting, of course, some of the other patients who were in my unit at the hospital. In the year or two following my second hospitalization, I came to realize that the major barrier to neurotypical people understanding people with mental illness disorders and other neurodivergent diagnoses is that, unlike physical ailments, there really is no temporary mental illness. Of course some people experience trauma, grief, or deep sadness that require a short period of medical intervention, but the type of conditions that lead to multiple crises and hospitalizations are always lifelong. I do not pretend that passing physical maladies are truly comparable to permanent physical disabilities, but the fact that almost all people will have an injury or illness at some point that will at least partially debilitate them before recovery gives them at least a starting point to imagine what a permanent disability would be like. I do think this is part of the reason why society has been much better about creating standards for accessibility and accommodation regarding physical status as compared to mental status (although of course they are still woefully lacking in both areas).

After this realization, I had an idea for a comic I wanted to do about my experience with mental illness, and more specifically treatment for mental illness, especially in regards to how it works in the United States. I think I even talked about the general outline of it with one of my therapists, but of course, it never came to any kind of fruition because of ADHD and extreme executive dysfunction. (I mean, that’s why I gave up comics and any kind of art as a career all together, after all.) So here is the script I have carried around in my head for some nine or ten years, a bit of solace for whenever someone (including myself) asks me why I can’t just do a certain thing, or why I take so long to do something, or just in general why I am how I am.

Imagine you are walking along one day, and suddenly both of your legs break. Now, this isn’t the first time you’ve broken a leg, in fact, it seems to happen with some frequency, but rarely simultaneously, and this time they are really bad; all kinds of messed up angles that shouldn’t be there.

“Hey! Help!” You cry out, “I really need someone to help me!”

A few people pass by not noticing or pretending to not notice, but eventually someone stops and says, “oh wow, that looks really bad!”

“Yeah, I know” you reply, “can you help?”

“Oh sure, there’s a hospital just a block that way. If you get up and walk over there I’m sure they can fix you right up!”

“Uhh, what. Are you joking?”

“No, it’s just right there, see? It’s a really short walk!”

“Both my legs are extremely broken. I’m quite sure I cannot walk at all.”

“Have you even tried though? Look, I walk all the time, it’s quite easy, just put one foot in front of the other. Watch how I do it and I’m sure you can too!” And you watch them easily walk away as you are lying on the ground.

You start dragging yourself in the direction of the hospital using your hands and arms, continuing to ask for help from those walking past you. One person suggests that if your leg doesn’t work, you could just hop on the other leg. You explain, no, both of your legs are broken, you don’t have another leg to use. They look at you with a puzzled expression and say, “well that just doesn’t make any sense” while shaking their head and then going on about their business.

The last person you ask for help says, “oh, of course, let me carry you the rest of the way” and you let out a huge sigh of relief.

They continue, “just stand up so I can pick you up and piggyback you over there.”

“Umm, is it not clear that is entirely impossible for me?”

“Ugh, just standing?” They scoff, “how can I be expected to help you when you aren’t willing to help yourself even a little bit?”

“I mean, I already dragged myself over fifty yards of pavement, I think that’s pretty good.”

“That’s ridiculous, everyone can stand, even toddlers can stand for a little bit. All I’m asking you to do is stand for a few seconds so it’s easier for me to pick you up.”

You look down at your legs, each curved in a different spiraling shape, now fairly bloody from being dragged down the street. “And I am telling you I definitely cannot do that” you respond as they walk away.

Eventually you do manage to drag yourself through the hospital doors, your arms bruised and scraped, looking almost as bad as your legs. Fortunately the medical staff gets to you and takes you in for surgery right away. Well, not quite right away, as you’re hard to see on the floor, and perhaps one or two of the orderlies accidentally trampled you or ran a gurney over you, but none of that matters because now you’re in the hands of professionals and they are going to fix you!

The first thing they do, of course, is take you in for x-rays after asking you a few questions. They wheel you in to meet the doctor, and you think, “ah great, we’ll have the surgery to set the bones and then in a few weeks or months I’ll be good as new!” The doctor then explains that no, that is not going to be what’s happening, as you can clearly see in your x-rays, you don’t actually have any bones in your legs, just a bunch of toothpicks held together with scotch tape.

On your floor of the hospital, you meet other patients with toothpicks and scotch tape in their legs, some with twigs held together with twine, some that have plastic forks and hot glue, and even a few that were somehow getting by with crazy straws and silly string. Most of them are like you and never had bones in their legs to begin with, but there are a few that had their bones stolen by someone, or lost them in a horrible accident. You also see a few patients that do have real bones in their legs, but they also grew spring-loaded hammers attached to their toes that whack them in the shins every time they try to take a step.

Well, the toothpicks and scotch tape definitely explain why your legs seem to break so easily and frequently, but is there any way you can get real bones for your legs?

“Oh no,” the doctor explains, “your body can’t grow bones in your legs, and it would reject any bones we transplant into your legs, plus you would have no idea how to walk with them.”

“Well, I would argue I can barely walk as it is,” you respond, “but I guess I see your point.”

So you and the doctor discuss options and plans for treatment. Perhaps you can start by upgrading to bamboo skewers and duct tape, there’s a lot of new and exciting research coming out about the use of wooden dowels, and maybe once you’ve been in outpatient treatment for a while you can find a carpenter who can carve you custom support with hinges that are actually screwed in.

(And since this all happened before the Affordable Care Act was passed into law, and since even after it was passed it didn’t provide anywhere near the help that is needed.) “This all sounds good, but I just don’t know how I’ll be able to afford it. I’ve had a hard time staying employed, since my legs break every few months and jobs almost always require some amount of standing and walking.”

The hospital staff reassures you, “don’t worry, there’s a program for people without leg bones to help pay for their treatments, just go to this building when you check out.”

And so after about a week you do check out of the hospital, legs in full casts up to your hips to protect your new, but fragile, sticks inside. You’re able to hobble around surprisingly well using crutches, so you make your way to the address you were given.

When you get there, you find a building surrounded by a 10-foot tall stone wall and a 5-foot wide moat. You circle the whole building, but there are definitely no doors, bridges, or even windows within reach. You do find someone who seems to look official and in charge though.

“Excuse me,” you ask, “is this the place for people without bones in their legs? How am I supposed to enter?”

“Yes, this is it. You’ll just need to pole-vault over the moat and wall.”

“Umm, I think there’s been some mistake. I’m just recovering from both my legs breaking, as are most of the other people seeking your services, I believe. Are you able to provide any kind of assistance for me?”

“Oh, there’s no mistake. You grab onto the pole with your hands, so it’s totally fine for your to do. And we can loan you a pole if you need, you’ll just need to do 10 jumping jacks and a short hopscotch run.”

You roll your eyes thinking, how on earth does anyone ever get through this? As you look around, you see more people with fresh casts on their legs, or old bandages, or some with a leg still broken. You see a lot of them run a few steps with the pole only to have a leg give out from under them and they fall again. Many of them do just give up and crawl away at that point. Some people look like they have family members that are trying to push them over, or do the pole-vaulting themselves while carrying the injured person. A few have even hired a catapult to fling them over, but that seems to cost more than any financial assistance you could get. Eventually you decide to tunnel your way under. It’s slow and laborious, but it seems the least risky, and you really don’t want to break a leg again.

When you finally get through, you do start getting regular checks on how your legs are doing. You learn how to spot splinters so you can plus some glue on them before they turn into full fractures. And importantly you start working with a trainer to build up the strength of your leg muscles, and learn how to walk more delicately so that the sticks in your legs don’t get so much damage from impact. It’s a slow walk, but you’re staying upright, and it feels like something you can maintain for while.

As you start getting back out in the world more, you do notice that everyone walks much faster than you. Most of the time it doesn’t bother you that much, but sometimes you’re walking somewhere with family, friends, or coworkers, and they’re just getting really impatient with how slow you are. Some times you take the time to explain about how you don’t have bones in your legs, and if you walk any faster you risk one or both of your legs breaking again. And they will make a sad face and say that they will wait for you to catch up, but no one ever slows down to match your pace for more than a few strides. So more often you just say you’re tired, and the other person responds, “oh, that’s too bad. I would wait for you, but I have to go run this 10K to support #NoLegBonesAwareness - you really should join next time, bye!”

The worst thing that happens, though, is when someone asks you, “have you thought about what would help you walk better?” And you want to scream at them, “Bitch, of course I have! I think about it all the fucking time! Having actual fucking bones in my goddamn legs would help!” But of course you can’t do that because at least they’re trying to understand that you have a problem that they don’t know how to fix, whereas everyone else is suggesting calcium and vitamin D supplements to help your non-existent bones grow. Or when they find out walking is difficult for you, they suggest jogging might be easier instead. Or perhaps flying? Have you tried flying?

And so you just keep walking along, mostly slowly, sometimes a little quicker, and sometimes really, really slow. And meanwhile your peers are getting married, buying houses, starting families, all the regular things society likes to celebrate. And one day you realize you’ve been walking for a really long time, years maybe, without breaking a leg, and it’s the first time in your life you’ve gone that long without a broken leg. And you know that’s a much harder and more difficult achievement than any degree anyone’s earned or promotion they got, and took so much more work. But there’s only about a half dozen people in the entire world that actually understand that, and you’re not close with any of them.

And while you’re thinking about that, you hear a sickening, yet familiar crunch.

That’s what it’s like to live with mental illness.

#depression #tw sucidal ideation #mental illness #mental health #adhd #disability #hospitalization #adhd problems #tw depressing thoughts #healthcare #john fetterman #no bones day #cw depression #cw mental health #cw mental illness #tw injury

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