You are standing at the front desk of the hospital; a sign above you reads “Information.” The two women sitting behind the desk are very kind when you ask to use the phone; it’s a direct line to Yellow Cab for situations just like this. You’ve been discharged from a 72-hour psych hold, held there for your own safety. Safety’s a funny word. Picking up the receiver, you feel its weight; it’s heavy with the weight of all the other patients discharged before you. You are on hold. There is no hold music, just silence on the other end and an occasional voice recording thanking you for calling and informing you that your call will be answered in the order it was received. It’s going to be a long wait and you settle in, leaning against the counter, cradling the phone receiver to your ear with your shoulder.

When you include suicide on a list of possible solutions to life’s problems, people get concerned. When you focus in on it and consider all of its consequences and implications on a running, constant loop through your mind, and when you admit to developing a plan of action with a sense of accomplishment, people worry about your safety. That word again. Your hand begins to sweat from holding on so tightly to the bright magenta plastic bag that reads “Patient Belongings” in huge black letters. Every person who walks by looks first at the bag and then back up at you. It feels judgmental, but who’s to say; everything is still so indecipherable for you. Your ear is sweaty from the heat of the receiver and your neck is sore. The voice recording comes on again. You are still on hold.

“The physiological error called migraine is, in brief, central to the given of my life.”

—Joan Didion

Having just read Joan Didion’s essay “In Bed,” about her struggles with migraine disease, I am struck by the unseen quality of her suffering. I think of the “given of my life” and what is “central” to it. Depression. Anxiety. A conviction that everything is fine when, in my head, I know that it only lies dormant, never seen until it is too late. If I vomit all over the place, if my eyes are dull and red while my nose is running, and if I change color from a healthy hue to something vaguely gray and white-pale, then people want to help. They wish you a “get well soon” and send you home to rest with empathy and concern. If I have that quality of suffering that is tangible, relatable, if it can be seen, people are so caring, so understanding. However, if my suffering is introverted, if it affects the way I think and translate the world around me, if it plays detrimentally with the emotional center of my brain, then people are decidedly unsympathetic, a current of blame in their sideways looks, stifled whisperings and general attitude. I did not choose to be sick. I do not want this pain. I am doing the best that I can. I am not asking for a solution, only recognition that my suffering is legitimate, that I am just as sick as a person with the flu. It’s hard not to take things personally; it’s hard not to get frustrated from all of the advice that will surely cure me if only I tried harder.

“That in fact I spent one or two days a week almost unconscious with pain seemed a shameful secret, evidence not merely of some chemical inferiority but of all my bad attitudes, unpleasant tempers, wrongthink.”

—Joan Didion

You walk outside and the harsh sunlight makes you squint. The cab is not a car but a van: one of those family transport vehicles you’re sure most of your friends have now. The driver asks your name. You tell her. “That’s all you had to say, honey. Get in.” The van smells of families, stinks of the pungent, sickly odor of kids before puberty. You get in and realize that you never want kids; the odds are they would also be sick with this thing. You tell the driver your address and the family taxi van pulls away from the curb. It is still way too bright, and now there are too many cars, too many people on the sidewalks, too much air to choke on, too much… too many… too much…

“It was a long time before I began thinking mechanistically enough to accept migraine for what it was: something with which I’d be living, the way some people live with diabetes.”

—Joan Didion

The good days are good days because I can live with it (whatever form “it” takes). I can sit with it, have whole conversations with it. I can live with the looping, repetitive dark thoughts that creep in and even joke about them, about the depression, strange and funny. As a cynic, I have a dark sense of humor: It’s how I cope on the good days, the days when the illusion of well-being and being in control is most prominent. People sometimes ask me about it; I am happy to tell them. I can see, not long into the conversation that they’re getting uncomfortable, their faces showing a mixture of pity and fear for me. I may be too comfortable with it. But it’s still a good day.

The bad days leave me in tears. I can’t move without pain; I don’t want to anyway. I can’t enjoy myself. The things that brought me joy and the people I loved yesterday are now gray imitations of a former life and everyone thinks I’m full of shit. They probably don’t, but that’s how I’m translating the world right now. I am angry and I isolate myself. Alone, I can finally see how sick I am. I don’t want to need help. I don’t want to burden the people whom I have alienated; what would they care, anyway? Everything is different now. I don’t even know how things were. I cultivate a familiarity with the unrecognizable, the unknowable, barely existing in an indescribable terror.

"All of us who have migraine suffer not only from the attacks themselves but from this common conviction that we are perversely refusing to cure ourselves by taking a couple of aspirin, that we are making ourselves sick, that we ‘bring it on ourselves."

—Joan Didion

Walking up the steps to the house that your apartment is in is difficult. Your feet are heavy, too heavy to lift. Feeling for the edges of everything you make it through, somehow. Opening the door, you walk into your apartment for the first time in three days. Breathing in, you feel your heart pumping at a pace that seems way too fast. The air holds in it the foreign essence of a strange place. Everything is where you left it: bed (unmade), dusty desk and nightstand, the computer, silent and eager for you to start it up again. This is where you live; this is not where you live; this is where you will live. Everything should have melted; it’s easier to start new that way. What not long ago was your refuge is now cold, unmoved by your return and quiet. It’s the quiet that always gets you; it’s the quiet that taunts you the most. There is no new; you have to pick up where the former person who lived here left off. You must assume a life in progress with all of its expectations, all of its pressures and all of its faces convinced that they know you and what you need. If you’d only get out more, eat better, power through, exercise more, do something you enjoy, something that makes you happy, meditate, be mindful. If only you’d try to try harder.

“It comes instead when I am fighting not an open but a guerilla war with my own life…”

—Joan Didion

I don’t start pacing until the second day in. The common area to the discussion room for group therapy to the hallway with our rooms to the discussion room for group therapy to the common area. And back again, and back again. It’s not so much that we’re bored (though we are) but that we’re fighting from within ourselves. For some it’s a lost cause and some have already lost their hope, not realizing it, but we can no longer stay still. Full of potential energy with no outlet, we are caged animals at the zoo confined to too small a space. And back again, and back again. On occasion one of us stops and cries: the realization that, for some, this is just a storehouse where we are kept until they can figure out what to do with us.

I walk right up to the door at the end of my pacing route. There is a sign on it that reads in big, bold letters: “SECURE DOOR. FLIGHT RISK.” It’s at the halfway point; I turn around and go back. I think every time I pass the sign: Am I a “flight risk”? Do I pose a danger to the world outside? Should I remain locked away for the safety and security of others… and myself? I resent being put on a shelf away from the rest of the world. I don’t think I’m a threat. I would, however, run the first chance I got. I would run; I would run so far away and as fast as I could. I want to outrun that door, the one that closes so quickly, and so finally. Locked and secured, I now know that I am definitely a “flight risk,” and will always be.

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