The First Step To Recovery Is To Admit that You Have A Problem... Part I

So what the hell is the second step?

Maybe that isn't a fair question. I'm not even sure I've fully admitted that there is a problem. But I came one step closer this past Saturday.

I try and avoid the emergency room whenever possible. Now, I can hear you telling me that, yeah, so what? Most people try and avoid anything that might send the to the emergency room. But just hold on a minute, that is not exactly what I meant. Because as those of you who have read my blog before will undoubtedly know I sometimes engage in a specific behavior that could very easily land me at my local ER.

I cut.

And unfortunately I was careless enough this last time to cut just deeply enough in just the right spot that my normal method of care was not enough.

As I said I try and avoid the emergency room when at all possible. This is because it can sometimes be more trouble than it is worth (*trigger* at least, more trouble for a person with a penchant to take a razor blade to their skin). So I have become very adept at taping even the most gaping of wounds closed. This most recent one was no exception. Taping it closed was no problem. But keeping it that way proved more difficult than I had anticipated.

(This next section could trigger so please tread carefully)

It's on the side of my calf, about 4" long and 3/4" - 1" at it's widest point. It is not my longest cut, nor is it my deepest one; it is, however, the deepest one of any real significant length. I made the cut Monday night of that week. On Wednesday I tripped and only caught myself just before ending up on my knees. Unfortunately it bent my leg in such a way that it split the cut wide open. I wasn't thrilled about it but mostly I was just happy that I didn't bleed all over the carpet so after I got it taped back together it was no big deal. I contemplated going to the ER to get it stitched closed but because it was almost 48 hours since the original cut the odds that they would stitch it closed for me, as far as I knew, were slim to none. And since I didn't really relish the idea of owning up to the fact that I had intentionally inflicted such a sever cut upon myself (not that owning up to intentionally inflicting any sort of harm to ones self is ever pleasant) I abandoned the idea pretty quickly. On Saturday I showed up to work before the gal with the key did. It's been pretty hot here this summer (though not nearly so hot as you all in the East have been seeing) and that day was no exception so I found a spot of shade and sat down on the ground... and split the cut open again in the process. It was then I decided that, 'old' cut or not it was not going to stay closed without being stitched up. So I used what I could find at work to cover it until my shift was over (scotch tape and a tissue, not ideal but it kept any dirt out of it) and when it was I drove myself to the hospital.

Needless to say I was not looking forward to that visit.

(This is just a 'blanket trigger warning' as I can foresee several times that I may need to warn in the following section)

I think she phrased the question something like 'How did the cut happen?'. We'll go with that because she put it in such a way that, seeing as how I cut myself intentionally, I found it slightly amusing. In answer I chuckled and said 'How did the cut happen? Ah, well, I cut myself intentionally.' To her credit the nurse didn't really bat an eye; she simply asked me what I had used. When I told her that I had used a razor blade the nurse who was dealing with my blood pressure and pulse (no idea why they both had to be there, he showed up first but I got the idea that she was supposed to be doing it), without even looking at me, asked if it had been clean. I've seen him before when I have gone in for self inflicted injuries and I really appreciate his 'business as usual' attitude.

The gal led me back to a room and though I had come prepared with a book (thankfully I had one in the car) my wait for the doctor was very brief. I have to admit I often feel a bit of frustration at being asked by the nurse and later the doctor how I came to have these injuries. Why in the world do they ask at intake if the doctor is just going to ask again when he shows up? The answer is that, more often than not, the doctor has in fact already spoken to the nurse and knows exactly how I got the injury. It seems they most often just want to hear you say it for yourself. I haven't quite figured out why but that has been my experience with it. He didn't ask me why I had cut myself, just looked at it, listened to my explanation of exactly why I had used scotch tape and a tissue to cover the wound, and then told me, on his way out of the room, that I needed to be in a hospital gown. Great. I was less than thrilled with this as I've got scars pretty much every where (I actually started cutting on my legs as it was easiest to hide there; the since I always wore blue jeans no one would suspect anything) and I don't care who you are or what your profession is I do not want to show them to you unless I absolutely have to. Apparently the fact that did not want to wear one was something to be noted because after I tried to persuade the nurse that the leg of my pants would go up high enough (needless to say that didn't work) I heard her tell the doctor that I did not want to wear a gown. Big deal. I had not refused so why tell him? Because it was rather strange behavior, that's why. Anyway I kept my long sleeved shirt on under the gown so I was spared from showing off those scars at least.

If the doctor found it odd that I was still wearing my shirt underneath the gown he didn't say anything. He came back in and put the head of the bed down and told me to lay back. Wonderful. You never really think about how vulnerable you are in such a prone position until you find yourself in an already uncomfortable, mortifying situation. He took another look at the wound and asked me if I was depressed. I laughed a bit and told him that I was taking antidepressants. He started to ask me if I was depressed right at that time but then seemed to take my antidepressant answer to mean that I was not and did not finish the sentence. He didn't really look me in they eye throughout much of the process. I did not, however, get the impression that he was angry or frustrated with me. He was hard to read actually. He was almost as nonchalant as the male nurse (who when he came back in to irrigate the wound carried on an undemanding conversation about the small town that I work in, bless him) but there was something underlying that I could not clearly identify. This I know for sure, he was very kind. You hear horror stories of ER (or A&E for my friends outside the US) visits where doctors and nurses are rude and clearly upset that you would waste their time by intentionally hurting yourself to the point of needing medical attention. Thankfully I have never had such an experience.

He asked me, as he was numbing the area before the nurse came back in to clean the wound, who my counselor was. I told him I did not have one. He asked about my primary care doctor. Again, I told him I did not have one (I go to the free clinic in town). He mentioned mental health and said they would help me, if I wanted. I told him that they would talk to me and as I do not have health insurance and cannot get medical through DSHS they would then tell me there was nothing they could do for me. He deduced correctly that I had dealt with them before.

When he came back in to stitch up the wound he told me, almost apologetically, that he had had to call mental health. He told me that he told them he believed me when I said I was not suicidal (good man he didn't even question what I meant when I answered his 'are you suicidal' question with 'Not at the moment') and that I have a lot of scars, that this is just something I do (it was at this point he told me that it was probably not the best coping mechanism), and that he did not think they needed to go down to the hospital to see me. They did however, want to talk to me and so he had had to give them my phone number(they never did call, thank God). He told me all this so that I would not get a surprise call later. I told him that I would not have been surprised at all but thanked him for telling me none the less. It was some time around then that I told him that when I had dealt with them in the past I had come away with the impression that they do not really listen. They come in with a preconceived idea and in the case of someone who SIs that preconceived idea is Borderline Personality Disorder. 'They label you', he responded gently.

It took him the entire time but when he had finished stitching my wound closed he decided (after talking it out, with himself, I think) that I should probably have some antibiotics despite the fact that there was no infection present. I told him not to bother prescribing them as I did not get paid for another week and so could not afford them as it was (to be honest I couldn't have afforded them even then I barely make enough to afford my antidepressant and pay my electricity bill, forget anything extra). He said they would give me some. He left to write up my paperwork and in a few minutes the nurse came in with a glass of water and a couple antibiotic tablets. On his heels was the doctor with a small bottle of the same tablets and the instructions to take one every 8 hours until they were gone (I was given a larger dose to begin with). The nurse dressed the now closed wound and then brought back my discharge instructions. He told me, in a matter of fact way, to watch the wound and take my antibiotics and sent me on my way.

I went away much calmer than I had been when I got there; the experience had been much easier than I had anticipated, thank God.

Yet a couple days later I would realize that my worsening mood was correlated with my ER visit and I would try and figure out exactly why that was, seeing as how it was not nearly as stressful a visit as I thought it would be (and I hadn't had to talk to mental health, for which I was grateful).