GETTING RELEIF

We have friends and neighbors whose children died from overdoses at home, turning the home into a crime scene. Another friend’s son shot himself, so the parents were unable to view the body. The three examples in the paper that I listed yesterday encapsulated some of my worst fears for Andrew and me while he was alive.

That he might end up in prison, that he might accidentally injure another person. Once, the police arrested Andrew for driving the wrong way down a busy highway after medicating himself for sleeplessness.

           I was so thankful that he was not injured and that no one else had been hurt, but very anxious that this might happen again. Talking to Andrew after this incident,  I knew that he would not intentionally take such a risk. I was also aware that with the severity of Andrew’s symptoms, sometimes getting relief was the only priority.  

LIFE BY MISADVENTURE

      I did not think it would be possible to feel lucky in relationship to Andrew’s death. After reading about the horrors of other people’s stories, I feel grateful and relieved that Andrew was never violent except in the end to himself.

      Andrew’s method of suicide seemed more thoughtful of himself and of us. His death was not even ruled a suicide because at the time of initial investigation no note had been found.

      The police report read death by misadventure. On the other hand, was it life by misadventure?

WHY DO PEOPLE COMMIT SUICIDE?

IN THE NEWSPAPER

     On the front page of the Philadelphia Inquirer of July 28, 2011 there was an article about three schizophrenic men. A 46 year old was in prison for responding violently to taunting, actions that he does not remember the next day. His 75-year-old father is the first to admit that his son did wrong but says he needs to be in a hospital and not a prison.  A 23-year-old man fatally stabbed his parents and twin brother. The third, a 17 year old, attacked his policeman father with a hunting knife and after a struggle, the father shot him with his service revolver.

     I was so sad for these families and so grateful that Andrew’s disease did not take these paths.

HEARING IS HEALING.

I guess it is not really doing less. It is more about being available to others, to notice things, to speak with them and to myself.

 It is a stretch to search for resonance with others’ feelings and to have patience, and to appreciate how they are different from me. Because this is not my default setting, it often requires great discipline of me.

I am encouraged to keep practicing by my increasing awareness of how wonderful it feels to have more options for myself. My normal reaction is to listen long enough to offer a response that has more to do with me than them. It is often about what I know and what I can tell others.

My dream personality is to be comfortable enough with my own frailty to allow others theirs without having to fix it. Not to have to say everything that comes into my head, not having to move quickly, to be able to be still and really hear my complete self and others. Hearing is healing

THE VALUE OF PRODUCTIVITY

       I am tracking my accomplishments mentally and judging my productivity automatically much as I have my entire life. 

      The difference is now I am wondering if a better choice might be is to see if I can be still and without a production schedule. Will I still have value to people if I am not doing or producing?   

        I suspect the answer is that my value to others and myself may actually decline in response to my need to be doing and conversely rise as I am able to find peace just being, without looking to how productive I am.

A GOOD USE OF MY TIME

I know that for much of the last two and a half years I have not felt much of anything except a growing desire to leave my job. I had no interest in pursuing clients, no interest in dealing with the daily rejection of a sales job. Really, no energy or enthusiasm for discovering the next client or the next job and feeling terrorized by having to go in to work every day with people I loved being with and not being able to do my job well.

         The only real peace I felt was when I was away from work and with my grandchildren who are completely distracting. Even physically overwhelming at times.  Now that I am out of work and home with time to think, read, and write all this down, it turns my contemplation to the question,  what is a valuable or good use of my time?

AT HOME IN MY BODY

     How does the body heal? While I sometimes feel anguish in my body as aches or pains, usually it is more allusive. Like right now, I have a pain in my left arm and an off and on tightness in my chest. Just how is the body/mind complex working in me?      
     How much of what I am experiencing is the result of habits learned and refined over a lifetime of living and defending myself against real and perceived threats? How much of it is aging –a body that is less able to withstand the chronic stress and punishment that my coping mechanisms require?

      How much is directly the result of Andrew’s life, his suffering, his death. The knowledge that I will never see him again and all that will never be; these things that I am often not conscious of but of course my body is always unconsciously dealing with and trying to keep me well. 

     Is my main physical thrust healing, growing,surviving or being overwhelmed or transcending ? I cannot even tell you that. 

A STEP TOWARD HEALING

I told John about seeing Andrew jump from the train trestle in my dream. His face grimaced and he said, “That’s horrible. “  We sat together for a while not talking and then he said he could not get the image out of his mind.

          I asked him if he remembered Jan telling us about not being able to get the image of her husband out of her mind until she owned each detail. He did not remember but it seemed to give him some relief.  

         He said, “Maybe this is a step toward healing”.  

ANOTHER DREAM

I had another short dream that I was watching Andrew jump off the train trestle, landing with full impact, feet first, and crumpling. His great height compacted by the impact of his fall but otherwise he was not disfigured.

In the dream, I wanted to turn away but I did not. I recalled when I went to my first Survivors of Suicide meeting, our leader, Jan, described finding her husband who had hung himself in their home. She said that when she closed her eyes she always saw him hanging in front of her, forcing her to open her eyes. 

   

     After her husband  had been dead for a while, she decided to continue looking at his image until she could own every detail of it and then it seemed to lose its terror for her. I felt this way in my dream today.

            I felt that I could look at Andrew’s fall and see it in a detail I was never able to conjure up before. I hoped that he did not feel anything, that the force of the ground caused him to sever his spinal cord and leave him instantly pain free. I hope that is what happened. 

ASKING FOR A DREAM

 I had requested a dream the last time I spoke with Andrew at his tree.  I asked to know where he was and how he was doing. Not long after I made this request I dreamed that Andrew and I were at a juncture on a beach path. Andrew was walking away from the beach and I was about to turn toward the beach. He looked at me and seemed to be saying with his body, “what are you doing here? I can’t hang out with you”.

I just stood there staring at him. A day or so later I was reviewing this dream and realized that  Andrew is going in a different direction than me, he away from the water, or feeling and me toward it. 

MORE OPTIONS

Andrew’s dying has made me question anew all my assumptions about life and death. I believe it has made me question what I do not have control over and what I do.

 In some ways, it seems I have more options when it comes to reacting  to my physical aches and pains and to my feelings and less understanding of why I feel the way I do in the first place.

Since Andrew died,  I have become much more aware of the tension that I hold in my body. I have learned that some deep breathing will center me and ease some of the tension I feel. I am also aware of greater toleration for what others are saying or doing. I have not learned how to give my body a much needed break by limiting the amount of anxiety that I somatize in many different ways

 I seem to have less of a need to react verbally. I am sometimes more able to just be with others and have as much compassion as I can muster for them and myself.

     Any increase in self-awareness and anxiety management is great. I hate to think that it came at the cost of Andrew’s death. 

NO TIGER AT THE WATERING HOLE

At one point, I thought that everything is a choice. Now I wonder if much of what feels like a conscious choice is really a rationalization that occurs a nanosecond after our unconscious physiology reacts to the incredibly complex information coming at us at unfathomable speed, intricacy, and diversity.

 The unconscious allows me to take it all in, processing at lightning speed, and often leaves me with the feeling that I am in control, in charge.

     When I feel angry or annoyed over a problem, am I already angry and the problem situation  gives me a place to go with my anger, my defensive energy. 

     
     This life force challenges me constantly. I cannot live without it but I often do not know what to do with it now that there is no a tiger at the watering hole. 

DO WE HAVE CHOICES

We know for sure that we may never know for sure. Maybe that is good. It leaves us with an unknown to be curious about and the freedom to learn and change, as we grow old with this loss.

     I used to believe that we are what we believe. I still believe that is true, but what we believe may not be so simply the result of our rational conscious neural interactions but may be determined largely by our inborn neurochemistry. What neurotransmitter dominates in our unique physiology and why does it dominate.         

      Do we have a choice or are we more at the mercy of our neurochemical heritage. It feels like we have choices. 

THE HORSE WHISPERER

John and I saw a movie last night called Buck. This was the life story of the original horse whisperer who describes his brutally abusive young life with his alcoholic father. He talks about using his knowledge of how he felt living in terror to understand how horses feel when humans try to break them. He felt that he had a true sense of the horse’s feelings and reactions because of his own suffering.

In one particularly moving scene a women brings a young colt to one of Bucks clinics because he bites and kicks anyone who comes near him. This colt was orphaned during a difficult birth during which he was deprived of oxygen. He was eventually revived and hand raised by his owner. In the end, Buck recommends that the young horse be put down because he is so volatile and unpredictable.

In the movie, he scolds his audience with his view that the problem horse always has problem human handler (s).  I thought, “maybe the horse was not able to tolerate contact due to altered brain chemistry caused by his birth hypoxia”.

I found myself thinking defensively and with compassion about the owners in this movie, much as I do about my parents and myself.  Did we pass along bad genes and make bad decisions unconsciously that allowed us to replicate our family of origin or did Andrew’s suffering come from a prenatal injury related to maternal rejection syndrome or both or neither. For that matter, what causes the Maternal Fetal Rejection Syndrome and who thought up that name? 

OUTSIDE HELP

     I certainly can see the possibility that, in some ways, I may have been  duplicating unconsciously, my parent’s tragic loss of a son who spent years suffering with drug and alcohol abuse and in the end died alone in a hospital at 32. 

   When I was younger I sometimes blamed my parents for not getting Mike help, seeing him as delinquent rather than sick. 

     Now I am unsure if there is always help or a treatment that works. Or if there is something someone else can do for us, outside our readiness to be helped.



    

WHAT MAKES US DIFFERENT?

     These days I am definitely coming down on the side of abilities/disabilities and these two cases may illustrate my question. Said another way, “How much credit can we take for both the good and bad that we experience. 

     There is so much we do not know about the mind and how it works. What is driving our behavior, our choices, and the outcome of these? 

     How much of who we are and who we are to become is a result of our careful decision making? How much of it is driven by our unconscious selves and our inherited genes, resources,biases, innate health, wellness, disabilities and capabilities? 

ANOTHER SUICIDE

The second story is of the Madoff family. According to Diane Henrique’s, The Wizard of Lies, for much of his sons lives Bernie Madoff ran a Ponzi scheme that allowed them to live and work in a prestigious environment. When Bernie was forced to tell his sons that his business was failing and that it had all been a fraud, the two sons reacted quite differently in the immediate aftermath and in the years that followed.

Andrew Madoff, the youngest son sat on the floor and cried when he first heard from his father that their entire business was a fraud; Mark the eldest raged at his father. While both sons consulted an attorney about how they should proceed with the knowledge of their father’s crime, Andrew was able to hug his father after his tears. Mark just continued with his anger. While neither son was ever indicted or even the official target of an investigation, they lived different lives after the arrest and imprisonment of their dad.

Both men complied with their attorney’s advice to sever all ties with their parents. Andrew continued to use the name Madoff and he his fiancé formed an organization to help others respond to crisis. Mark, on the other hand, changed his name, as did his wife and children. He continually struggled with the guilt by association and felt that no one believed that he had no previous knowledge of his father’s crimes and took no part in them. He eventually committed suicide.

 Here are two brothers who had similar upbringings, and worked in the same family business, had access to the same family resources and yet one is able to move on with his life and the other ended his. Is this because we each have different innate abilities/disabilities, or different experiences, relationships?  

WHO WE BECOME CON'T.

 Just recently a couple of stories have caught my eye because of the different paths peoples lives have taken despite having a lot in common. The first is the story of two baseball players, both left handed pitchers, who played on the same team, who were roommates and fraternity brothers.  Frank Fitzpatrick writing for the Philadelphia Inquirer tells their story. Here is my condensed version.

Steve Gardner was offered $50,000 to play for the Chicago White Sox while still in high school. He was the starting pitcher on USC varsity team and the 1960 college player of the year. After graduation, he went directly to triple A ball for the Dodgers. Pat Gillick was also a good player but always played second string to Steve. Pat’s forte was his mind trap for anything baseball—a whiz at studying and knowing competitive statistics. Pat was good enough to get a major league contract playing for the Baltimore Orioles.

Both men were injured and could not continue playing. Steve’s injury occurred while he was in the army and Pat’s while playing in triple A ball.  After the injuries, these men’s lives took dramatically different paths.

          Pat was quickly promoted to the front office, first as a scout and then as General Manager, leading three different teams to the World Series and finally inducted into the Baseball Hall of Fame. Garner struggled after his injury and was never able to perform at a star level and eventually the Dodgers dropped him from the team. 

         Not playing baseball he grew more and more miserable and finally took his life in the USC stadium. He shot himself surrounded by his diploma and his All American Award. 

WHO WE BECOME

I was listening to a book on tape called the Social Animal and I had a strong reaction to the way the author, David Brooks, described the formation of a new human being, particularly the mind.

His impression, after surveying the existing research and literature was more of a Tableau Rosa.

He gives voice to the fact that we are largely our unconscious selves made manifest. His belief seems to stem from the fact that life is simply too complex and coming at us too fast to rely solely on our conscious minds. 

Is there more to who we become. How much say do we have in who we become. It seems to me a mysterious combination of  genes, choice, chance, cultural memes, the historical period into which we are born and the people and events of our lives. 

What role does mental illness play?

SO UNLIKE ANDREW

     I mentioned before the essay that Andrew wrote for his college application. It was candid and heartfelt. 

     He once wrote a short story for school about how ants became ants. It was such a clever creation myth that the teacher had accused him of plagiarizing it. John and I had watched him write it so we knew it was his work. 

     I actually understood the teacher’s reaction a bit because I was so impressed with his originality. When he came home from school with the teachers note, I assured him he had nothing to worry about—we would go to bat for him. 

     We said, “Look at it this way-your teacher must have been really impressed to have come to her conclusions.” Andrew was able to shrug it off. 

     His temperament was so easy going and understanding. That is why his delusions were so hard. His voices were primarily belittling and degrading as well as relentless. 
So unlike Andrew. 

A VERY GOOD WRITER

     I have been reading a memoir about the death of someone’s young wife. The author has been spending the last two years going through her papers and discovering her anew. 
     It made me jealous that I do not have more of Andrew in a computer or a box somewhere that I can go to and try to know him better as Andrew was a very good writer.

WE ARE ALL IN ADEQUATE IN THE FACE OF SERIOUS MENTAL ILLNESS

When people close to Andrew including Marnie and Eileen found out Andrew’s diagnosis, they were furious with me for not telling them. 

I guess I thought they knew what I meant when I used the word delusional to describe Andrew’s illness. 

They had been around him enough to know that he was not his old self, at least some of the time. 

My neighbor Lynn was also upset with me and said how inadequate she felt. “Me too, I said, when it comes right down to it we are all inadequate in the face of serious mental illness.” 

ANDREW FELT LIKE HE WAS HEARD.

After Andrew received that new diagnosis, he did not want us to talk about it. We respected that and never told anyone. 

I assumed he told Marnie and Eileen but it turns out he never did. In the last six months of his life, when he was living with Eileen and Rich, he was telling them what was happening at work and they thought that what Andrew was describing were his real experiences. They had no idea that he was describing his delusions.

Rich and Eileen were trying to coach him on how to handle tough bosses. Of course, to Andrew it was what was happening to him, it was real. 

He often told me he learned a lot from Rich and Eileen. They took him at his word because they had no other frame of reference. 

Andrew felt like he was heard by Rich and Eileen

NOT GETTING IT

Andrew had no ability to moderate his delusions. Perhaps he was never able to see them as "not real", as something generated by the disease within his own mind.  He did not feel he had any control over the voices.

Both John and I tried to discuss with him  some skills he may be able to learn to modify the voices.  Andrew immediately dismissed the idea that he had any control over the voices and again accused of us of not “getting it”.

I am sure now how little we really understood about what he was withstanding day in and day out. We offered Andrew only what we knew and it was not a good fit for him regarding how he dealt with the delusions. 

TRUE SCHIZOPHRENIA

The specialist said that although Andrew was misdiagnosed as bi-polar with schizoid affect, he had been given the correct treatment. 

It was then that we learned that the differential diagnosis is determined by the chronicity of the delusions. Bi-polar disease is episodic, true schizophrenia is constant and unrelenting without medication. 

Some sufferers do not get complete relief even with treatment. Andrew was one of these.

THE VOICES

Again, Andrew told me, “Mom, you just do not get it. These voices are real”. 

He still had not been given the diagnosis of schizophrenia. This would come less than a year before he died. A specialist in the medicinal treatment of delusions at HUP saw him and said Andrew was most definitely schizophrenic. 

This specialist said Andrew had been misdiagnosed as bi-polar when he had his first psychotic break after entering the Citadel in 1999.

I NEVER PROMISED YOU A ROSE GARDEN

Instead of trying to understand, resonate, and maybe somehow relieve Andrew’s pain, I was pushing him to conquer the voices. 

I had read I Never Promised You a Rose Garden and felt that it was possible to give up the voices. This is what the patient/heroine had done in this case history of the successful psychoanalytical treatment of a young female schizophrenic in the time before antipsychotic medication. 

Reading this book had given me much hope.

ANDREW'S NOTE

Well, lets take little time to rest on Sunday. Everybody needs some rest even John Andrew Gillis. Amen. I am relaxing for the rest of the day. Okay. Just keep on trucking. I drive a Hyundai Sonata. 

May 28, 2009. My heart, my fear, my love, my mind will be free forever.

          Okay, I will be wiser and stronger each day of my journey, Is it crazy to follow your dreams, maybe, food and drink is awesome.  Passion, I don’t get it. But that is how it is. Freedom. Who? USA, that bad, that good. We will whe the Back th straight up. Eas does it okay. He is the best. Believe he would not be where he is unless he earned.  JAG. Mr. President. 

     The best obviously he is older and wiser. Those are the facts. I do it all for  love and peace and oh yeah honor!

Well deserved break. Thank you and good night. I love you all. Peace. 

TERRIBLE VOICES

During this time, Andrew had terrible “voices”. Some days the voices would be worse than others and in the end, they would become unrelenting. 

What would I have done to get him some relief ? He needed a rest, as he would tell us in his final note.

SIX MONTHS BEFORE HE DIED

I had spoken with John about Andrew moving back in with us. 

We both felt that it would be better for all if he did not. Before I spoke to Andrew, I asked Eileen what she thought of Andrew living with her and Rich. 

They had bought a home that had a big finished recreation room with its own bath—no outside entrance. She thought it would be fine. They could charge him rent and that would help them pay for some improvements they were trying to make to the house. 

So Andrew moved in with them about six months before he died. 

REHAB

Looking back it seems that some of the time after Andrew began rehab was very good. Some was okay and some time was not good at all.

In the beginning when he was taking only his prescribed medications, he was definitely feeling better. He was able to organize himself to get the kind of job he felt good about. He joined the firm where Eileen worked, although they worked in different locations.

I wanted him to go back to school but he was already aware that he could not be successful at that.  During this time he and Melissa became engaged and bought a house and became unengaged and sold their house and Andrew moved in with Rich and Eileen.

TERMINAL ILLNESS

After we learned that Andrew was taking OxyContin, he and I were discussing how long he had been using it. 

Somehow it came into the conversation that he had been taking it the night of his father’s birthday party. It came to me then that he was pain free when he was taking OxyContin. 

I came to the conclusion,  judging by the difference in his countenance the night of John’s birthday, that  he must be in a lot of pain most other times. 

Certainly, we know now that he had an illness that was terminal for him. He would only live three more years after starting in the drug and rehab program. 

JOHN'S 60TH BIRTHDAY

I was always vigilant about Andrew’s reaction whenever we were having a party even if it was just a few people. In the end, even Marnie and Corbin coming for the weekend could send him back to Eileen and Rich's basement. 

Our house was under construction for Marnie’s wedding that was in our yard in june 2006. John’s 60^th Birthday was approaching. We had been to several 60^th birthday celebrations and I had asked John if he would like a party when he turned 6o and he immediately said yes.

So I decided give John a surprise party and to do it at a local golf club. We had about 60 guests. Normally Andrew would have been withdrawn and maybe even a no show. This night Andrew was fully engaged and seemed to be truly enjoying himself. I was in heaven seeing him in such a good place. I noted that he seemed in a good place after the party and he just agreed with me with no additional details. 

MY GOD!

“My God! Maybe that is it. Why not? How is this different from the chronic pain of other debilitating and life threatening diseases? No, no Marge this is an opiate, a highly addictive product that would just lead to ever-growing needs for higher and higher doses. Don’t be ridiculous, he needs to get off this drug immediately”.

 This was the essence of the conversation that I had with myself. I think if I had it to do over again, knowing what I know now I would have definitely tried to get him a prescription for the OxyContin.

SOME OF THE BEST DAYS OF MY LIFE

I was impressed by Andrew’s immediate and committed response to our demand that he take charge of the Oxycontin problem. 

Several weeks after he started the program at Penn,  I asked him how he had managed to go cold turkey.

I assumed  that after we discovered and stopped the cash withdrawals from our account, until he was established on the Suboxone.that he had been without oxycontin. 

Andrew said, “Mom, you cannot really go cold turkey. I had some (OxyContin) left and I dosed it out slowly over the days until I started treatment”.

I asked him if he missed taking the OxyContin. He said, “Of course. It produces a wonderful feeling, some of the best days of my life”.  

WHAT A CONUNDRUM.

I include myself in those who think we understand or know about mental illness but are really only slightly aware of the enormity of the problem and the suffering it entails. Much of the “crime” associated with drug and alcohol abuse is efforts at self-treatment—that is, stopping the pain.

If I had understood the level of Andrew’s suffering, would I have lobbied for him to be given a prescription for OxyContin to help him manage the pain of schizophrenia? I was so concerned about him becoming addicted that I did not really even begin to contemplate the other side of his conundrum.

SELF-MEDICATING

It is just occurring to me as I write this, that Andrew, in his use of OxyContin, was managing his incredible chronic pain.  If he had arthritis or cancer, the OxyContin would have been prescribed for him.

Mental illness is still poorly understood, under treated, under diagnosed, maybe incurable, and often seriously debilitating. People with serious mental illness are frequently perceived as antisocial. They can be misunderstood, punished and / or exploited because we do not understand that their behavior is caused by a physical malady and / or an effort to self-medicate their pain with drugs that can worsen their ability to cope.

DETERMINED To DO THE RIGHT THING

Suboxone works by tying up the opiate receptors in the body with little if any of the euphoria associated with narcotics. If you take a narcotic like OxyContin while you are also taking Suboxone you will not experience the typical “high”. In order to experience the euphoria you would have to stop taking Suboxone first in order to free up the narcotic receptors.

University of Pennsylvania Program participants have to submit to weekly blood and urine analysis in order to ensure that they are taking the Suboxone and not taking any narcotic analgesics. Evidently, there is a high noncompliance rate.

 Andrew was in this program for 3 years and never had an incidence of noncompliance and eventually was able to give up the Suboxone. Dr. W, the head of the program, saw Andrew for weekly psychotherapy talk sessions Dr. W said Andrew was remarkable for his determination to do the right thing and to get better.

SUBOXONE con't

Suboxone is a narcotic medication indicated for the treatment of opioid dependence, available only by prescription. It must be taken while under a doctor's care. Suboxone contains buprenorphine, an opioid medication. 

Buprenorphine is similar to other opioids such as morphine, codeine, and heroin however, it produces little or no euphoric ("high") effects and therefore may be easier to stop taking. It also contains Naloxone, which blocks the effects of opioids such as morphine, codeine, and heroin. 

When Suboxone is injected, naloxone will block the effects of buprenorphine and lead to withdrawal symptoms in a person with an opioid addiction. When administered under the tongue as directed, naloxone will not affect the actions of buprenorphine. 

SUBOXONE

John and I went with him to the first meeting at Penn several days later. Initially, Andrew spoke privately with the head of the program, a very kind and patient psychiatrist. Then the four of us met together. 

Dr. W explained the program to us thoroughly. Andrew would immediately have baseline blood work done. Then he would begin taking a drug called Suboxone.

UNIVERSITY OF PENNSYLVANIA

     When Andrew arrived home a few minutes later, John and I told him what we had found in the bank records. It was probably me doing most of the talking—it usually was. 
    Andrew said immediately—no beating around the bush, “It was me”. Fear, anxiety and anger crazed me. I demanded to know, “What the hell was going on?” 

     Andrew was very chagrinned but also very honest. He told us that he was sorry, but that he had to get the drug. We asked what drug and he told us about the OxyContin. He said it had made him feel so much better. 
     
     We asked him if he knew the dangers of addiction and he said, “Yes”. We told him that this was out of our control but that if he wanted to stay living with us he would have to figure this out immediately. 

     The amazing thing is that he did. Within 24 hours he had found, applied for and been accepted in the drug treatment program at University of Pennsylvania. 

THINGS ARE OUT OF CONTROL

     All of my children have always had access to my ATM card that I kept in my purse. They also knew my pin number. I would give them the card to run errands for me or to use it to get cash for me or for them. 

     John and I were down at his office computer that is set up in the basement. Andrew was not home. The girls were not living at home then. I believe this was spring of 2006.  I called Andrew and got him on his cell phone.. I told him we needed to talk to him immediately and he said he would come right home.

     I believe he knew why we wanted to talk to him. I thought he was sending us a red flag that said, “Help, things are out of control”.

We found out about Andrew self medicating with OxyContin when John noticed that I was making daily $500 withdrawals using my ATM card. He asked me about it and I told him that I had not made the withdrawals.

We called the bank to report it and were told that the only way those withdrawals could be made were with my ATM using my pin number. As I was talking on the phone with the bank, it occurred to me that it might be Andrew.

      I said as much to John. He said that the thought had also occurred to him.
 I was frightened and upset that it might be Andrew.

OXYCODONE

OxyContin (oxycodone) is a narcotic pain reliever similar to morphine. OxyContin helps to treat moderate to severe chronic pain, that is, pain expected to last for an extended period. 

OxyContin is for around-the-clock treatment of pain. It is highly addictive and abrupt discontinuation after a period of use can cause strong withdrawal symptoms.

 I do not know when Andrew started taking this drug. 

GREATEST RELIEF

     I am beginning to appreciate how important it was for Andrew to take control and try to manage his illness. When Andrew would go off his meds for a few days, it would take a while for the meds to clear his system. 
     During that time, where he still had some benefit from the meds but few of the side effects was when he felt the best. However, it was a very short window. 
     This may have also been true of his use of marijuana and prescription drugs. When he was taking them, he felt better; the after effects of marijuana were an intensification of irritability and delusions. 
     The prescription drug that he used to his greatest relief was OxyContin. 

TAKING CARE OF HIMSELF

       Andrew struggled to the end with the value of taking his meds versus other ways of taking care of himself, like eating healthy, working out, and self-medicating with the ever so much more socially acceptable marijuana or other street drugs. 

       The prescribed medicines he took had side effects--weight gain, depression, and sexual dysfunction to name a few

WHOSE JOB IS IT?

     Boy, oh, boy, in writing this I realize just how little I understood of what Andrew was dealing with day to day. Despite all that he was going through he rarely complained. 

     Andrew mostly wanted to try to deal with things as he saw fit. I think we tried to let him do that much of the time. I would go along with him. The anxiety always building in the background and then I would see from the weekly medicine case that he had not taken his meds for a day or two or three and I would lose it.

He hated taking those meds. He hated being “sick” and often said that he was not sick. I think this was the part that I didn’t understand. I didn’t understand how hard it was (read that impossible on some level) for Andrew to think of himself as sick or as needing medication. It was really unacceptable to him.

IS SUICIDE PREVENTABLE

Is suicide preventable? You recall my earlier mention of suicide as a preventable cause of death. Right after Andrew died, John and I started going to the local suicide survivor meetings. One thing that had a strong impact on me was the two widows who were at our first meeting.

Our leader had lost her husband ten years ago to death by hanging. She had come home to find him hanging in the doorway of their home.

 She said she had been unaware that anything was wrong. She said that she always knew her husband was a little quirky but had no idea that he was suicidal.

The other widow who had lost her husband two weeks before we met said that she had been caring for him as he suffered from bipolar disease. She said she did everything to make sure he was getting the treatment and medications as prescribed. Her husband called her at work to tell her he had stabbed himself. He was still alive when she got home to him. She had called 911 and got to her house as they were taking him away by ambulance.

She followed him to the hospital and was with him as he went into surgery. She begged him to be strong. He did not survive the surgery.

In listening to these two survivors talk about their different experiences of the time before their husbands’ suicide, it struck me that despite the ultra-interventionist vs. the unaware approach to their spouses’ illnesses the outcome was the same. For me this begs the question, “Just how preventable is suicide?”. 10/17/14 

SELF PROTECTION

Maybe we all do go through losses like his death alone on some level.  

For me the supportive presence of my neighbors,, my family and my friends allowed me to begin to stitch together a new framework for being that was different because Andrew had died. 

I did not really understand that he was dead and physically gone forever. I do not think I understand that now. In some way he is just away. My sister Kathy died last August and I feel the same about her.

 I was explaining this way of being with death to Marnie and she told me it was the same with her. She added that she felt it was her way of protecting herself from losses that were just too big. It was as if she was describing me exactly. 

NOT ALONE

Friends and family were bringing me things, food, pictures and anecdotes. 

They were writing me notes about Andrew—wonderful notes. 

They were holding my hand and telling me by their presence that I was not alone and not the only one who had lost him. 

What all of those wonderful people did was keep me sane. Could I have gone through Andrew death alone?

MY SAFETY NET

For me, it seemed to me like the sheer presence of people held me in a safety net, prevented me from falling into a dark, empty place. 

They were holding me when I did not have anything to hold onto. They were adding their life to mine to lift me over a dangerous passage that had no bridge or guardrails. 

They were guiding, holding, running interference, and scouting ahead to anticipate rough and dangerous spots. 

BEING THERE FOR OTHERS

Of course there was also ambivalence. In some way, I wanted it all to be over and everyone to go home—but I was also aware that the line would end and it would be over. 

After thinking about folks being there for me I shifted to the thought, “Have I been there for others?”

     “Not enough” is the answer. I had not realized the importance of simply showing up. What was I thinking when I just decided not to go sometimes.
     
It seems shocking now to me that I did not realize that in some very important way each of us counts the absolute same. 
       
     

BEING THERE

Last week, June 10, 2011, I read an article in the New York Times called You Look Great’ and Other Lies, by Bruce Feiler that recants the experience of being with family and friends during his bout with bone cancer. 

The result is a distillation of do’s and don’ts for being with people in distress.

In the author’s list, things not to say included:” What can I do to help?”, My thoughts and prayers are with you”; “Everything will be okay”; “How are we today?”;  “You look great”.

 What to say included: “Don’t write me back;  “ I should be going now or I love you.” 

I wondered when I read it if I was missing something important. I was overwhelmingly grateful that so many people reached out to us when Andrew died. I was afraid no one would come. That his death and our loss would somehow go unnoticed or unmourned. 

As weary and terrified as I was of having Andrew’s wake at our house, I was more concerned that few would come. It felt right that people would not know what to say or how to be me with me. I did not know what to say or how to be with them.  My over whelming feeling was thank God you are here.