Vision Quest

It is a truly fine Sunday afternoon. A bit chilly (in the 40’s), but with picturesque blue skies and sun. It’s a welcome sight after the long winter’s dreariness.

As for me, well, there’s much to tell.

I get a lot of mentions on this site, Fraülein.

I like making you do things, fräulein. It makes me feel more powerful and Godlike.

As requested, I re-did my fourth step work for the second and final time. I presented the aforementioned essay, typed neatly, single spaced, all fifteen pages of it, to the Square-Jawed NP who then complained it was too long. Its itemized list of personal faults began, literally, at my birth. He wisely chose to read it himself instead of hearing it read out loud for the sake of brevity.

“I accuse myself…” he began reading back to me, “… of being born?” Really Margaret?

“Tough beans, bucko. You wanted it complete and thorough, this is what you get. Not only thorough, but ruthlessly thorough,” I said as I opened my Kindle to ‘casually’ peruse my email while he read my confessional essay.

“Yeah, but you’re blaming yourself for being born?” he queried.

“Yes, because if you read on, it resulted in being a burden on my parents. Besides, I wasn’t going to hear you ask me — again — if I’d included everything, so I included everything.” Back to my Kindle.

“Come on Margaret. Being born was your fault? What were you supposed to do? Strangle yourself with the umbilical cord in utero?”


I’m ignoring you, Nazi. It makes ME feel more powerful and Godlike.

I chuckled, but never looked up from my Kindle, swiping and tapping away as if its business was something far more important. “The Big Book says for every item on the fourth step list, you’re supposed to show what your role in the situation was, even if it was just being there. Therefore, I was there when this born thing happened, and it had an effect on my family.” I gestured with my hand in a brushing motion, “Keep reading. It gets better.”

Silence was followed by NP’s mutterings and comments like, “you can’t actually think these things were your fault…” to which I dismissively replied, “that wasn’t the point of the exercise. Keep reading.”

More silence. More reading. Next thing I heard was, “Wow.” I raised my head.

“What was ‘Wow’ about?” I asked.

“I knew about your addiction,” NP said, “But I never realized the extent. And that ordering from other countries stuff… you’re pretty resourceful.”

I lowered my head back to my Kindle smiling, “Yes, I am.”

Another minute of reading later was punctuated by “you do have a way with words.” I chuckled knowing he was almost done and put my Kindle down. Finished, he set the essay in front of him on the desk and closed the folder quietly.

“Any questions?” I asked.


“None at all? I don’t have to do it again, do I?” I gave him a squinky side-eyed look.


“Okay,… so now what?”

He asked, “Do you want to take it home and dispose of it or do you want to shred it here?”


Shred the tears away!

I chose to shred it — it was what we had talked about previously. He and I stood up, went into an inner employee break room where the shredder was located. An intermediate-sized silver cross-cut shredder quickly dispensed of all 15 pages of my ill-earned confessions.

We went back to the office in silence. The door closed and we sat down. He asked me how I felt. Honestly, I felt perfectly okay. I felt nothing. He didn’t seem to accept that. I told him that to me, it was just a writing assignment. I really hadn’t processed any “feelings” for it except to be glad it was done and doesn’t need to be redone. He seemed confused.

I pressed the NP for his reactions to my fourth step work until he finally told me he couldn’t understand why I felt it necessary to begin each statement with “I accuse myself”. Where were all the accomplishments? The good deeds? The strengths of character that (he says) he knows I have?


The Big Book: Not the way I did it.

[Author’s note: Okay, here’s where I need to interject something. The way I approached my fourth-step work is NOT AA’s recommended way. In truth, I’m not a big fan of the AA big book (sorry guys), so I had no intentions of following their format. But I noted that the fourth step’s intention seemed to be taking the victimhood out of the equation by mentioning whatever your part was (even if it was just being there). Plus, being that the fourth step is based on the Catholic sacrament of Confession — something this good Catholic girl was schooled in — I took the theme of accusation/confession and ran with it, beginning each new topic with “I accuse myself,” as one would do in a Roman Catholic confession (at least the old-fashioned kind).]

A couple of months earlier, the NP and I had done a form-based fourth step from Hazelden wherein once listed negative and positive traits in certain categories. I filled out the form as thoroughly as possible, but it ended up being rejected as “not thorough enough.” So I went hardcore when I did this one.

I explained to NP that the previous edition HAD all the positive traits in it should he want to revisit that.

I further explained, “If the intent of the fourth step is to take the victimhood out of life’s bad turns, then what’s left? In my mind, if one is not a victim, and one is not a bystander, that makes one the perpetrator. So I ran with that as the theme and angle of the piece. I certainly took a lot of doing to find my role in a lot of those otherwise-termed victim-type situations.”

The Square-Jawed NP looked at me and sighed. He was at a loss for words.

Hah! I thought, I had him! I had him on a technicality! I won!

He leaned in across the desk and folded his hands. “So basically, you’re telling me you suck.”


“You suck. You just totally suck then. That’s it, isn’t it?”

“Yep, and thank God you said it,” I laughed, “At last someone finally had the courage to tell the truth!”

“Now wait a minute. I didn’t say you suck. You did.”

“Yeah, but it’s true, isn’t it?” I pronounced vividly.

NP sighed again and leaned back in his chair in silence. He took a few beats to study me before leaning forward again. He’s been studying me a lot lately. It’s quite obvious as he cocks his head back and forth when I talk. I sometimes wonder if he’s still trying to figure out if I’m playing him or if I’m being real. (Hint: real.)

He asked, “Why don’t you ever give yourself credit for your accomplishments?”

Curious. “Like what?” I asked.

“You tell me. You mentioned in your fourth step that you used to be a famous painter. Yet you stopped painting. Why would you do that?”

“It stopped being fun.”

“That’s it? That’s all? Or was there something else going on. What was it like when you were painting?”

Art gallery painting: 'The Sneeze'I told him how it all started. Long before Kim Kardashian was getting famous for being peed on in a dime store sex-tape, I was a talented designer and illustrator just minding my own business in relative obscurity. Then I started painting stuff for a niche market collector’s area (not porn!!) in which I saw an opportunity. I enjoyed myself and quickly became a very in-demand artist, making a big noise, and earning quite a bit of money. I attended a convention where I was treated like a rock star. Long, boring story really, but interesting from the fame end of things. By getting famous, I became a dual-person. By day, a mild-mannered normal person working a salaried Initech job, but by night… people worshipped me. I use that word very specifically. Its definition: “the feeling or expression of reverence and adoration for a deity.” I was no deity and I knew it. I was just some chick who could perform a cool trick. But the real me woke up every day with drool on my cheek and stinking of morning breath just like everyone else.

At my peak, I was receiving hundreds of emails a day from people wanting my work, admiring my work, or wanting to hire me to do work. Some wanted me to donate work to charity. Others begged on behalf of a dying loved-one that I please give them my work (I fell for that once and found the item up on ebay the very day after it was received.) In those days, there weren’t talent managers for someone like me, no stylists, no spin-doctors, no agents. I did all this myself and was pretty good at it too.

And it was a heady experience — people wrote me every day to tell me how great I was. I received fan mail. People even sent me gifts in the mail — pictures, trinkets, sometimes gift baskets — people just wanted to be near me or hear from me so that perhaps whatever was “special” about me might rub off on them.

This went on for a handful of years. With all that, a person’s gotta fight hard to not believe their own press. And after a while, fighting the good press, for me, turned into a chronic case of “I’m scum and those people just haven’t figured it out yet.”

Then the negative trolls started appearing as if in answer to my concern — turning out to be mostly fellow artists that were sick and tired and jealous. They attracted others. That’s when it got ugly. One particularly unstable individual began calling my house and threatening to kill me. He wasn’t alone. I had to call the police and even had to inform the security office at work and make a thing of it.

Not long after that, my interest in painting in that niche market waned considerably. I still worked, but not as often. Being famous was a lot of work and responsibility and frankly, I was getting sick of it. My last piece was created sometime in 2003. And though I briefly revived my former career in 2009 in an effort to make money, I had burned out from it and lost all interest. Besides, by 2009, I was high all the time, drowning myself in a virtual sea of Vicodin, and really didn’t care one way or the other about anything except more Vicodin.

I relayed all this to the Square-Jawed NP who patiently listened, but did so incredulously. He believes I really quit because I couldn’t handle the attention and accolades. Maybe he’s right.

“So why not start painting again now?” He asked.

“Are you kidding? Hell no.”

“Yeah, but it could be a source of money. Why not capitalize on it?”

“The market has changed. My style is not the thing.” I continued my protests, but NP really refused to accept it. To him, this is a way I can earn money to get a car. To me, it’s jumping back into a black pit of goo that I’m glad to have left behind.

But it got me thinking.

After I left NP’s office, I fell to pieces. “He’s right!” I cried, “I suck!! And now he knows it too!” Feeling misunderstood, alone, and miserable, I cried that night into the next day. I couldn’t get past the feeling that I’d been exposed for the truly lower-than-whale-scum sucky, horrible, pathetic excuse for a human being I really was — and did so in front of someone whose opinion I actually cared about. I thought the NP’d surely lost all respect for me. It was clear, wasn’t it? I suck, right? The list proved it.

I was in emotional overflow — functioning, working, talking, walking — otherwise functional but with tears streaming down my cheeks betraying my inner turmoil. This had happened before years ago during the lowest part of my life. Not again, I thought. I had to find a way to stop.

visionI looked up “Vision Boards” on the internet and decided to make myself one. NP was right, but not about the painting. I need money. I need to get off my ass and make money any way I can — draw upon my strengths — make use of whatever I can. I need to take my life back and shed this skin — much of it made from that fecal fourth step — and be ME again.

I made some decisions and put them up on my Vision Board.

Since that day, I have rematriculated into college. I got them to accept my previous general studies credits in English, Sociology, and Psychology. I’m now studying for the Math entry exam. If I can take prerequisites this summer and fall, I apply to official Nursing School in March next year. Then once I have the LPN, I enter the accelerated RN-NP program, then finally get to diagnose and treat illnesses for realsies like a grownup person. If all goes well, I’ll be about 50 when I graduate. Okay, maybe 51. I might have shaved a year off there by accident… that’s why I have to study for the math exam.

On that Vision Board are other things I want. I want a car. (On this, I got very specific — I want a red car with a standard transmission like a little sports car or even a hatchback.) I want to get thin and fit again. I want more nice pieces of jewelry (I had to sell off everything when I became broke). I want a better apartment in a nicer part of town with a place to park and a bathroom where I can do my hair and makeup. I want nice furniture. I want to keep singing. I’d like to perform on stage again. I want a better job. I want a man and a family.

As I’ve already begun the process of achieving things on my vision board, I can now tell the Square-Jawed NP that I have goals that I will recognize as I achieve them. That should satisfy that requirement.

I already feel like I’m getting back to being me. (The good part, not the suck part.)


“You are not here merely to make a living. You are here in order to enable the world to live more amply, with greater vision, with a finer spirit of hope and achievement. You are here to enrich the world, and you impoverish yourself if you forget the errand.” — Woodrow Wilson


Posted in AA, addiction, Celebrities, depression, education, Humor, Job hunting, loperamide abuse, memoir, Shrinks, square-jawed np | Tagged , , , , , , , , , , | 1 Comment

New Loperamide Articles! (16 Mar 2015)

Two new and important articles have been added to my ARTICLE CLEARINGHOUSE page regarding the deadly cardiac effects of high-dose loperamide. Both papers introduce new cases and call for further studies and more clinician awareness. They further underline the causal relationship between high dose loperamide and cardiac arrhythmias. It’s no joke folks. Legit.


loptab3Ventricular Tachycardia Associated with High-Dose Chronic Loperamide Use

Hannah L. Spinner, 1,* Nick W. Lonardo, 1 Roja Mulamalla, 2 and Josef Stehlik 2 — 1 Department of Pharmacy, University of Utah Health Care, Salt Lake City, Utah; 2 Division of Cardiovascular Medicine, University of Utah Health Care, Salt Lake City, Utah

PHARMACOTHERAPY:  Article first published online: 3 FEB 2015 DOI: 10.1002/phar.1540

Conclusion: Our report concurs with two previous observations that patients exposed to high doses of loperamide may be at an increased risk of ventricular dysrhythmias. Further studies are needed to confirm a causal relationship, but clinicians should be aware of possible cardiac adverse effects related to the overuse of loperamide.”


loptab3Torsade de Pointes Associated with High-dose Loperamide Ingestion

1 LUCAS N. MARZEC, MD, 1,2 DAVID F. KATZ, MD, 1,2 PAMELA N. PETERSON, MD, MSPH, 1  LAUREN E. THOMPSON, MD, 3 MARK C. HAIGNEY, MD and 1,2 MORI J. KRANTZ, MD — 1 Cardiology Division, University of Colorado Hospital, Aurora, CO; 2 Cardiology Division, Denver Health Medical Center, Denver, CO; 3 Cardiology Division, Uniformed Services University, Bethesda, MD

THE JOURNAL OF INNOVATIONS IN CARDIAC RHYTHM MANAGEMENT:  January 2015, vol 6 (2015), pp 1897–1899

Conclusion: We report a case of markedly prolonged QTc and recurrent TdP in a patient who ingested large doses of loperamide coincident with cimetidine in an attempt to simulate the euphoric effects associated with opioid abuse. This is a sentinel case, as ingestion of large doses of loperamide for self-treatment of opioid withdrawal and as a drug of abuse appears to be increasing through internet dissemination. This may represent a growing public health danger and warrants further investigation.”


Posted in sobrietyland | Tagged , , , , , , , , , , , , , , , , , , | 2 Comments

The Interrogation, Part Three

nazistaringThe Square-Jawed NP has been, virtually since the beginning, a surprisingly large part of this blog (and my life) despite my only seeing him, on average, once every three weeks for less than an hour each time. He’s an interesting study in contradictions. He maintains strict boundaries and ethics, but that complicates things when he wants to express his feelings about something. I have always successfully read his every expression in order to know what he’s thinking and where he’s going with something.

But after this day, he would be the one reading me, and I would become the unenlightened bug under glass.

A week after the previous Interrogation, I knew our third session would require me to confess my biggest secret. I knew it would happen as certainly as I know I am writing this line. There was no escape unless I was willing to lie about it, which I definitely did not want to do.

I felt trapped — and that’s a bad place for me to be.

barb3 The epic distress made the cutting worse. I started cutting my arm, not just my wrist. And, because the cutting wasn’t stopping, and I was afraid to tell NP, I decided to talk to Therapist Barbie instead. The drive to cut was becoming stronger, urging me to cut deeper, longer, and create more of them. I needed to ask for help.

On arrival with TB, I loosely explained that the stress of everyday life (and therapy) was getting to me. TB was appropriately concerned and handed me a big rubber band to put on my wrist and instructed to snap it instead of cutting. She tried to convince me that cutting could lead to infections and scarring, but it was clear that Therapist Barbie didn’t really grasp the fullness of the underlying disordered thinking that really lead me to cut in the first place. The psychic stress, the self-punishment, the fear, the guilt, the rage. But I happily took the rubber band and said I’d try it. I was also instructed to use a suicide hotline if the urge to cut became too strong. I scoffed and nodded, but knew I wouldn’t use it. How silly — suicide hotline for cutting? Pshaw!

She asked if I was planning to tell The Square-Jawed NP about my cutting, and I laughed, childishly squealing, “No way! He’ll be mad! But if you want to tell him, be my guest!”

I left feeling somewhat confident that NP would never know.

I was wrong.

thA week later, I returned to their office for the appointment with the NP, I sat down and he scowled at me. He asked how I was doing, so I began complaining about work and my Aunt and Uncle Crazypants, and he stopped me cold. He was clearly cross. “I don’t want to talk about any of that. It’s a waste of time. So are you going to tell me, or do I have to be the one to bring it up?”

For a moment, I wasn’t sure what he meant. Then I confessed that I’d been cutting. He asked to see it. (I showed him.) He asked why. He asked if I’d stopped. He asked if I planned to do it again. At that I hesitated. He asked me agree to a verbal no-self-mutilation contract. If I refused (or couldn’t), then we could not continue. I agreed reluctantly and suspiciously. What was up with that? What was the big deal? And what was I supposed to do if I wanted to cut? Oh! How I wanted to ask him if I could call him (like me! tell me I’m good!), but quickly decided I didn’t want to be one of those patients, calling all the time seeking comfort and reassurance when I should be learning to comfort myself.

After our agreement, the interrogation that had begun in the previous session resumed.

I let him lead, but it was quickly evident where he was going with it. He asked me to tell him about my first time having sex.

I stopped and gathered my courage. It was time. THE THING.

This was the deepest, darkest, most horrible THING I knew about myself, but here it was. THE THING I lied to literally everybody about in order to fit in. THE THING I’d prepared myself for two weeks to tell him. THE THING I sliced my wrists up over.

I had to accept it was time to tell someone THE THING.

I raised my head, stuck out my chin, looked him right in the eye, and told him about THE THING. I did not shiver or shake. I did not choke up. I did not cry. I had already done all that in private while cutting myself. The scourging hardened me to deliver the news with courage.

But the Square-Jawed NP just stared at me.

I waited for him to say something, but it seemed clear he wasn’t quite sure how to respond.

Not that what I revealed was grisly so much as tragic. I am not deformed, I did not kill (or try to kill) anyone or anything, nor did I molest anyone or anything. It was simply and awful situation gone off the rails. And it made me feel mortified to admit and unduly condemned to carry. A life sentence. That is why it remained a deep dark secret. I think NP was trying his best to figure out how to appropriately respond.

“That’s it.” I said, trying to give him a cue to say something. “Not bad in my delivery, huh?” I chuckled. “I steeled myself to be able to do it.”

“You steeled yourself?” he asked quizzically.

“Well, yes. How else was I going to tell you that? I knew it was going to come out, so I wanted to make sure I could when I had to.”

He asked a few questions, which led to other questions, all of which I answered with equal matter-of-factness. There were reasons for THE THING, and he clearly understood them. I was impressed that he handled it with sensitivity and, moreover, I was actually incredibly impressed at myself for remaining calm and able to present such tragic information so coolly.

We talked loosely about relationships that I’d had in my adult life. He insisted that surely there must have been many. I said he should define many. He wanted to know what my current status was, and I crabbed. I told him that at this point in my life, there’s no way I could be in a relationship no matter how much I might want one. “Oh, please! Look at me. Who would have me in my current state and condition? What worth do I have? I’m unattractive, have no money, no car, some crummy apartment. And I see a shrink! I’ve got nothing to offer. Nothing anybody wants anyway.”

NP tried arguing the point with me, but I was having none of it. To me, this isn’t so much a problem as an unfortunate state-of-being. If I lost weight, then maybe, but I’d have saggy skin, I’d still be older (not 21 anymore) and my body, even thin, was always imperfect. I’d still be an ex-addict. I’d (probably) still be poor and car-less, etc. To me, it’s just the way things are. Quite matter-of-fact. I was worthless. Period.

To him, my attitude of nonchalance was unacceptable.

“But Maggie,” NP began, “you’re not worthless.” He seemed pained by the degree that I have internalized every ounce of self-criticism. “Aside from your weight which you claim is unacceptable” as he gestured with his hand toward my body, “You have to know you’re very attractive.”

“Pfffft.” I puffed and rolled my eyes. Ah, the usual line of bullshit, I thought. They always lie about that first.

He went on to list several positive aspects of my personality (none of which I remember) which he did only after I refused to acknowledge anything other than my intelligence, and ended by saying, “…and you forgot that you’re kind.”

I scoffed and told him that I believed the only reason he was saying nice things is that he had to — ” it’s your job to be nice… and you’re getting paid — maybe not by me —  but somebody’s paying you to do that.”

NP once again became cross with me. “I was wondering when this would come up, so now’s as good a time as any to discuss it. I schedule you at the end of the day because that way I can spend more time with you. All they pay me is the first 15 minutes. Then I’m supposed to go home. But from there, it’s all on my time. This is free.”

I knew this, but it was embarrassing to hear him acknowledge it out loud. “I know.” I said apologetically and softly. “I’m sorry, and I do appreciate it.”

“Thank you. And technically I’m only here to do medication management. Do you know how many patients I’ve agreed to do therapy with?”

I said, honestly what I thought, “At least a few. Maybe three or four?” He didn’t answer. “Five?”

“One. (Pause.) You.”

I was surprised — and confused. That couldn’t be true. Could it? I desperately wanted to ask why (as in, ‘what are you, nuts???’) but he responded before my thought was uttered by saying, “See? You are special.”


I desperately wanted it to be true. I wanted to believe every word of his whole spiel. (Please love me! Care about me! Tell me I’m good!) But the past told me a different truth which was all I knew I could trust.

I also wanted to crack a joke about it, but I sat with my knotted “Whaaaa?” brow and instead, said, “Thank you”.

“Why do you look confused?” He asked.

“I’m trying to figure out what your angle is. It feels… disingenuous… somehow.” I replied.

“Do you think I’m being disingenuous?” he queried.

I looked at him. I examined his expression and body language. No signs of lying. And yet…. I couldn’t believe him. “Not really. That’s why I’m confused.” I was convinced more was going on than I was being shown.

NP said a few more kind words, but I don’t remember any of them. The bad stuff is always easier to recall.

I left that day suspicious and confused, but at least NP finally knew about THE THING, so the worst was over.

For the time being.

Proceeding from this point on has become a game of unknown consequences. I’ve never been in a relationship where the participant knew virtually everything about me. What would be the ramifications? And what would the Square Jawed NP do with the information that I had armed him with?

I would soon know.

Posted in + recovery, AA, addiction, bipolar, depression, Shrinks, sobrietyland, square-jawed np, therapy, weirdness | Tagged , , , , , , , , , , , ,

The Interrogation, Part Two


Having been through it once now, I arrived at our second “therapy” session knowing what was coming. I wasn’t taking any of this ‘interrogation’ personally — this is his job, after all — but it didn’t stop him from being mildly offended by my referencing it as such. To him this was just a type of therapy intended to get me to reveal my darkest secrets and increase intimacy. To me, it felt like surgery — an excruciating but somehow necessary violation.

I knew that the Square-Jawed NP was certainly going to talk about my relationships, and I would have to give him the story about He Who Shall Not Be Named. Yes. That guy. The creature. The one who doesn’t even deserve to have a name anymore.

I had something of a plan. I didn’t want NP to guess my Really BIG Secret before I was ready to reveal it, so this one (about The Creature) would have to suffice as a distraction. I needed more time to build my courage. I needed to steel myself to it. I had been hiding this part of my life behind steel-reinforced doors, frozen in time and now was the time it would have to be defrosted and unlocked.

I practiced over and over. I wanted to strike the right tone. Not appear too overly pathetic, but explain it as factually as I could while still expressing the gut-wrenching devastation the end of that relationship had on my life. I had to tell him, but how?

How do I tell this person, (not so much a therapist anymore), that I was once helplessly in love with a homosexual man? A narcissistic asshole who cleverly manipulated me, cheated me, and left my life and career for dead — even though I’d been warned that’s what he was up to? How does a supposedly intelligent person such as myself get to that point? Moreover, how could I get NP to reconcile my intelligent persona with someone who would willingly hand everything over, lie down, and virtually beg to be treated like a doormat?

And how could I tell the story without sounding like the weirdest, shittiest, weakest, most pathetic person on earth? Who knows?

Under the tension all this worry and preparation caused, I began cutting again.

One afternoon, as my gut twitched with anxiety, a fresh blade drifted across my wrist under the watchband producing several small beads of dark red blood and a rush of endorphin relief. Several minutes later, it happened again. And again. Just scratches, nothing deep. Just enough to draw blood.

And that’s how I “trained” myself to get through it.

When the appointment came, I walked into his office, and the session began. Initially, I began talking about another topic altogether (something that was bothering me at work, I think).

“Let me stop you right there.”

NP held his hand up in a ‘stop’ signal. “I don’t want to spend a lot of time talking about that. That’s not what’s really going on with you, is it?”

At the end of the previous session, I had mentioned something in passing about a relationship that had gone bad, and he turned to that (as expected).

NP asked me a question something along the lines of: “What was the last major relationship you were in?” I drifted off in thought trying to think of a way to get out of telling him about The Jerk. Wasn’t there something else I could tell him? Toss him another bone? Avoid it for another couple of weeks?

“Margaret. Where did you just go?”

“It’s nothing.”

“No, you immediately went somewhere. Tell me.”

I sighed. “Okay. Fine. But you’re not going to like it. It’s bad. It’s stupid. It makes me appear in the worst possible light possible. There’s no way I come out of this looking good or intelligent or wise or anything else. I just come out of it looking sad and pathetic.”

NP said nothing. He just waited.

So I told him. The brief but ugly tale of me and that creature. Warts. Hairs. Weird itchy things that smell funny. All the gore and ooze of it. And NP sat watching me, silently observing, his elbow set on the chair while his chin rested in his hand, thoughtfully.

I cried. HARD.

I was furious.

I was sad.

I was rage-filled.

I was indignant.

I was pathetic.

And yet I couldn’t claim any of those feelings out loud. I cried… sobs. Yes, I totally lost it.

On his desk was a box of cheap tissues in an oatmeal-colored box. The first time I ever met the NP, which was also the last time I’d cried in front of him, I remember starting to cry and he pushed a Kleenex box toward me. It was one of those ‘fun’ Kleenex boxes that had cartoons of dancing aliens on the side. In the midst of my tears, I remember mentally remarking how silly that box looked and started to laugh.

On this day, this particular tissue box was a thin, cheap contractor-issue box with no such color or humor. I awkwardly plucked one tissue from the long, narrow box and attempted to mop my eyes and stop my mascara from running with the thin, scratchy tissue.

NP interjected a few pertinent questions — the most outstanding of which required clarification. “Wait a minute,” he asked, “You had sex with a gay man?” No no no… no sex. Dammit! I wasn’t being clear. The problem with delivering bombshell-type information is that sometimes, in the rush to just get it over with, clarity is sacrificed.

I sat shuddering with rage. I wiped my eyes and tried pulling myself back together to gather what little dignity I was left with.

“So how do you feel?” NP asked quietly.

I was dumbfounded. Wasn’t it obvious? Jesus, was he dense or something? I wiped my eyes again and thought about it for a minute. The best I could come up with was “Uncomfortable.”

“How do you think you look?”

I shrugged and sniffled. “Well, I have mascara running down my face and I’m probably beet red so,…”

“Nevermind that. I don’t care about that.” He shook his hand in the air.

“Well, I don’t know! I don’t have a mirror… I guess I look upset… How do I look?”

Normally, NP wouldn’t answer that, but in an effort to cajole me into recognizing my own emotions, he paused, then offered up his opinion. “If you ask me, you look… vulnerable.”

“Vulnerable?” Fair enough. But vaguely insulting somehow. I glared at him. “Great.” I rolled my eyes and chuckled lightly, still sniffling and kneading the wet ball of cheap tissue in my hand. “Not quite what I was going for.”

I had given up a big secret with enough emotion to prove that I’m not, in fact, a steel-and-concrete bunker. Yes! I have feelings. And yes, I can cry!

“How do you feel now?” he asked.

“Humiliated. Sad.” I replied.

And as I sat there with my shaking hands crunching that stupid Kleenex, sniffling back the last of my tears, NP smiled and said:

“Welcome back.”

Posted in + recovery, depression, sobrietyland, therapy | Tagged , , , , , , | 2 Comments

The Interrogation, Part One

nazlookingdownSorry I’ve been away for so long. It’s been hard for me to write for a while. Too many jumbled thoughts with little focus. Typical for me.

lopejpgLet’s see… where did we leave off? Oh yes, there was that Loperamide article that yours truly helped a bit with. Hey, nothing like being an unpaid, uncredited research assistant. The important people know and that’s all that matters. And it’s saving lives. That counts for something too. I’m proud of my work on that. It’s a pure good thing — and certainly works off some of that negative karma I might have built up during my time using.

My blog post prior to that, interestingly enough, was the day the Square-Jawed NP decided I’d had enough hand-holding and it was time to start beating me with a giant redwood. I have something to say about that now.

Well… uh… yeah. Hmm.

Before I get to that, allow me to digress and announce a couple of positive things:

lightFirst, I have POWER back in my APARTMENT! Waaahooo! Power! Heat! Hot water! Refrigeration! Espresso! Stove and Oven! Television! Internet Connectivity every day all the time! How did I pull it off you might say? Especially considering I owed National Grid so much money? Well, turns out, all I had to do was ask nicely and tell them I was getting help with that (which I am working on). Within a week, the nice man with the key came, unlocked my power box and flipped the switch. I can once again enter my apartment without stumbling over the stairs on the way up (’cause I gots me sum lights in the hallway now!). I can sleep in relative comfort because it’s not 40 degrees anymore. And I can watch first run television — okay, well, when the antenna picks up the signal correctly, but it’s a start.

But the most blessed thing of the experience was having access to hot water again. MY OWN hot water to wash my hands in, to wash my hair in, to wash my fat butt in. Oh, it’s glorious!

I admit even though it’s been on for a bit over a month, I haven’t taken full advantage of it. I’m frankly still in old habits. I forget to turn the light on when I come in (I forget that I can), I get up in the morning and make my way to the bathroom without lights, and forget that I can cook things, so I still buy a lot of prepackaged foods when I’m at the grocery store. That’s slowly changing. The heat hasn’t been forgotten yet , though I admit, sometimes it gets too warm so I have to remember to turn it down. Good problem to have, I guess!

yr1Second, I have met my first year anniversary in the AA program! Got my coin and everything. I have been asked to be the Guest Speaker at the Speaker’s Meeting in either April or May. I have some idea what I’m going to say, but as plans begin to be shored up, I’ll tighten my share-able anecdotes.

singThird, voice lessons are going very well. I have much of my voice back — not 100% but much better than it was. Recital next month. I’m doing four pieces — one opera, one Italian Art song, one Gilbert and Sullivan (don’t gag, this song actually doesn’t suck), and one by Gershwin. I’m not terrified, but I’m not really happily excited either. I’m mostly worried about what to wear. I’m still fat and have NO nice performance wear. Not that my teacher wants me to really dress up like I normally would. But then what? Hell, if it were up to me, I’d show up with no makeup, my hair in a frizzy knot, and wearing my oversized American Eagle hoodie, sneakers, and torn old blue jeans — but I’ve been told that might be considered too casual. No fun.

Okay, so that out of the way, we’re on to the deeper and more interesting stuff. I’m not sure where to start.

By the following visit, the Square-Jawed NP began to put his plan of breaking down my defenses into action.

hansNP had a brand new little office on the North side of the building where the light was better (though the scenery had not much improved). He had finally chosen to take my advice and make his office look more homey by hanging some fresh-off-the-freeway hand-painted “art”.  He also upgraded to wearing a better-fitting suit jacket that fit him through the shoulders better, another thing I’d hinted at. I’m betting he got a raise.

NP started the appointment by asking me about my medications and whether or not things were going well with that. We joked and did the usual small talk, and then he sat back and we began the transition.

“Now Margaret, this isn’t going to be like coffee hour. We’re not going to chat like buddies. No coffee and donuts, or whatever. This is going to seem…. really different. And it might be pretty jarring for you. Are you sure you’re ready for that?”

“Yep,” I smiled like a dummy.

“Now, I’m going to ask a lot of questions, and I’m going to expect you to answer. Truthfully. That might be hard because you won’t be sure what to say sometimes. And it’s probably really gonna bug you when I stop you and ask how you’re feeling or what you think you look like when you say something. That bothers everybody, but it’s important.”

“Uh-huh.” I was grinning, cocksure that I could handle this. I had no idea what was coming. Daring him, I narrowed my eyes and grinned overconfidently. “This is gonna be fun.”

“Well, if it’s fun, then I’m not doing it right,” he smartly replied.

“Ready?” he asked. I nodded.

Then he sat back and moved his chair back away from his computer. He turned to face me full-on. His smile faded away as if a thick fog bank had seeped into the room and obscured the upturned corners. NP’s eyes darkened and narrowed slightly and seemed to refuse to blink. “So tell me why are you so defensive about that fourth step?” He leaned back, watching me.  Maybe he knew… and maybe he knows that I know he knows…

And thus began what felt like the delicate dance of two black widow spiders. I knew I was going to lose. I knew I was going to lose from the first day I saw him. The game was designed for me to lose — I had to, or, as the theory goes, I might never get better. At least I had a worthy adversary across the desk from me. I studied his every movement, every eyebrow twitch. He was trying to be a blank slate again, but I knew his tricks now.

This guy’s no brick wall. I know the NP’s no Nazi. He’s just like most of us — he’s just some goofy kid in braces who woke up one day dressed up in professional grown-up clothes drinking too much coffee and wandering through life wondering how to put money in the kids’ college fund while making car payments and paying off school loans and wishing he had more time to go outside and play with his friends.

How do you tell your deepest, darkest, most horrible and scary secrets to someone who’s an actual human being?

Turns out, the first thing I would do is toss him a bone. Distract him from the larger problems that lie beneath. I was buying time.

“Okay. Fine.” I announced indignantly. “I’ll give you something.” I told him about the year that I lost (sold) my house, the subsequent loss of all of my belongings, the depression, and of course all of it leading to working at the thrift store, the overdoses, and then him. I went into quite a bit of detail regarding how much the loss of my things meant — specifying items (like photo albums) that felt particularly tragic to me. My voice cracked a little, but I did not cry.

NP acknowledged these things that I said and observed me. True to his word, he asked me how I was feeling ad nauseum — most of the time I felt okay — but this time, he said he knew that wasn’t true.

He stopped for a moment and observed my squirming. “How do you think you look right now?” NP asked.

“Look?” I thought about it, and honestly, I thought I was holding together alright all things considered. And truth was, I felt sad about the loss of things, but not really now. I was okay, right? So I looked at him and shrugged. “I guess I look fine.”

“Cause I’d say you look…. sad.”

Sad? Really? I was smiling. I felt okay. Huh. “Yes,” I acknowledged. “I suppose I should be sad. I am sad about the loss of it. The sheer scope of it.” Then I stopped and thought. My eyes darted to the floor as I suddenly pondered the idea. Though I thought I should feel sad, I did not, in that moment, actually feel sad. I felt nothing.

Watching me, NP queried, “What’s going on? What are you thinking about?”

“It’s just…. weird. I just realized. I should feel sad, shouldn’t I?”

“Should you?”

I paused. Quietly, I added, “Yeah. I think so. But I just don’t feel anything.”

“I believe you.” NP said.

It was quiet for a moment, so I decided to break the tension by adding, “Oh, and by the way — something else I haven’t told you or anyone else — I have no power in my apartment. I haven’t had it for about 2 1/2 years. No heat. No electricity. Nothing.”

NP was visibly taken aback. Not wanting him to interject anything, I went on to explain the circumstances surrounding how it happened and why it continued. He asked how I heated the place in winter and how I went about daily business (like washing and cooking), and I just explained the workarounds as unemotionally as I could.

Was I humiliated by all of these revelations? Yes. But I did it.

We had crossed the Rubicon. I had provided him two major humiliating admissions with almost no resistance.

We ended the session there. The game was on, and I was already losing (as was meant to happen).

I drove home knowing worse things were to come.

[End Part 1]

Posted in AA, depression, loperamide abuse, Shrinks, sobrietyland, square-jawed np | Tagged , , , , , | 3 Comments

New Loperamide Article!

Yes, kiddies, the latest-up-to-datest Loperamide Abuse article was just published and added to this site!

Good stuff in here — further indicative of a causal relationship between loperamide abuse and disturbances of the electrical system within the heart. Article is brought to you by the top toxicology experts from Upstate Medical University in Syracuse, Emory University in Atlanta, and Strong Memorial Hospital and University of Rochester Medical Center in Rochester. I’ve read the whole paper (not just the abstract), so I can tell you it’s the most comprehensive paper yet written on the subject.


loptab3Cardiac conduction disturbance after loperamide abuse

J. M. Marraffa, M. G. Holland, R. W. Sullivan, B. W. Morgan, J. A. Oakes, T. J. Wiegand, and M. J. Hodgman. 1 Department of Emergency Medicine, Upstate Medical University, Syracuse NY, USA. 2 Department of Emergency Medicine, School of Medicine, Emory University, Atlanta, GA, USA. 3 Department of Emergency Medicine, URMC and Strong Memorial Hospital, Rochester NY, USA. 4 URMC and Strong Memorial Hospital, Ruth A. Lawrence Poison and Drug Information Center, Rochester, NY, USA

CLINICAL TOXICOLOGY: November 2014, Vol. 52, No. 9 , Pages 952-957

Conclusion: This case series describes several patients with cardiac conduction abnormalities and life-threatening ventricular arrhythmias temporally related to loperamide abuse. With the recent efforts to restrict the diversion of prescription opioids, increasing abuse of loperamide as an opioid substitute may be seen. Toxicologists should be aware of these risks and we urge all clinicians to report such cases to FDA Medwatch®


More articles at the Loperamide Medical Clearinghouse

Posted in + recovery, addiction, education, loperamide abuse, sobrietyland | Tagged , , , , , , , , , , , , , | 16 Comments