Saturday, October 26, 2013

Stories From the Inside

I'm working on the next blog post in the more science bases series that I started but in the meantime I'd like to start a series of stories about people I met while staying on psychiatric wards. Part of the purpose of this blog is to educate others about the world of mental illness and this is part of that education. 

Weird Scenes Inside the Goldmine 

- Jim Morrison, 1970


Z was about twenty-one or twenty-two years of age in March of 2011. She had the beautiful high, hooked nose that many people of her native Afghanistan have, along with high cheekbones and eyes of a pretty hue of brown that were so deep you swear you could swim in them. She was small and frail. If her five foot frame weighed ninety pounds I'd be surprised. If I'm not mistaken, she was the youngest or one of the youngest in her family. She may have had a younger brother, I can't remember now. She did have, I know from her family's visits and through Z's stories, lots of older siblings, about evenly divided between brothers and sisters.

Z and her family were from one of the more southern areas of Afghanistan. I can't recall the name of the area. I think, though, that it was a suburb of Kabul. Nor can I recall Z's family's exact religious affiliation. I didn't get the impression that it was important to her. It didn't seem to be to any of her siblings when they came to visit either. Z and all of her family dressed and acted very progressively and with modern sophistication and style. Her father had been a gold merchant (not bulk gold but of the jewelry variety, something very important in Afghani culture). Her family was not rich but of upper middle class well off means. Z and her family lived well. Their family was well known and respected in their neighbourhood. Z told of her father being a generous man, one who didn't mind rubbing shoulders and sharing tea with anyone. The life of Z's family was good. They had everything they needed and were all ambitious as far as education goes, they were expected to gain a higher education and become doctors or other such gentrified positions.

Then one day the Taliban came.

One day Z's family was “in”, the next day it was “out”. The Taliban, as Z told it, had targeted her kind of family as “out”. I don't know what your knowledge of the Taliban is but at that period in Afghanistan's history, you did not want to be “out” with the Taliban. So, as with tens of thousands of other similar people at that time, they were left with little choice but to flee. Z would have been about eight at this time. Her life went from one of sheltered upper middle class with everything she and her family needed to one on the road with whatever possessions they could carry.

For weeks they traveled over dirty and barren roads through scorching hot valleys and harrowing mountain passes. All this while her family and those that they were traveling with had to keep an eye out for the Taliban and their sympathizers and to look out for bands of thieves. Much of the gold they'd brought along had to be bartered away for their safe passage. Several months later, they had crossed the Pakistan border and had found a refugee camp. As refugee camps go, it was no different than any such camp around the world. Relief organizations had done their best to erect tent cities and provide as much as they could. It was dirty, water was rare and precious, there was little food and there wasn't a speck of shade outside of the tents to give any relief to the daily 40C temperatures that seared down on them in summer. Nor was there much protection from the harsh mountain winds that sent temperatures plunging in winter. From playing with beautiful dolls in air-conditioned rooms, Z went to playing with sticks and rocks and balls of rags in ad-hoc games played with other children in small, barren, stone strewn patches of hard, sun baked soil. From being taken care of by a nanny, she went to having daily chores of scrounging for food and water. She went from having the finest clothes to wearing nothing more than whatever rags were left from what they could bring and what they could now find. Everywhere you looked, there were tents and other large families like hers. No one had much of anything.

This was to be Z's home for the next eleven years.

Z's family were cut from sturdy cloth, however. Somehow through all of this, they not only survived, but somehow managed to relatively thrive. And through relatives who'd long ago emigrated to other countries, connections were made, money saved, refugee relief procedures navigated. And Z, her mother and father, and most of her siblings found themselves in Vancouver, BC. Z didn't really know how all of this happened. She was young and unconcerned with such things. She just knew her father, mother and family had made it happen. As she was expected to, Z was entered immediately in school, in a school in an strange English speaking world where she barely knew a single word of English.

But, as immigrants have done for centuries in sink or swim situations in new lands, in new cultures and among strange people and a new language, she learned and she learned fast. Within a year she had a part time job at McDonald's. Within six months, she had mastered everything there was to know about working in that McDonald's and all of the English needed to boot. She was promoted to an assistant manager position. At the same time, she'd graduated high school and had been enrolled in college.

Throughout those eleven years in the refugee camp and the ensuing several years adjusting to Canada, Z's family's expectations for their children had never faltered. They were still expected to get the highest education possible and the best careers possible. Not jobs, but careers. Z's expectations were no different.

All of her siblings had done well and Z loved and admired them all but she had special love and admiration for an older sister, “M”. M had not, for reasons I can't recall, fled with the rest of the family when the Taliban arrived. I believe she may had already left for university and been well into her education and that that part of Afghanistan perhaps had remained in more liberal hands. At any rate, she stayed there, had become a doctor and in the now more liberated post-Taliban Afghanistan was practicing medicine specializing in women's needs (which was in very, very sore need among Afghanistan women). M was Z's hero and when Z spoke of M, her voice and beautiful deep brown eyes made this abundantly clear. Z said that they spoke often on the phone or through Skype. Z wanted very much to be like M.

She therefore put on herself, aside from the pressure her family put on her, a enormous amount of pressure to live up to the standard set by M. But she struggled with school. College was not like the simple courses of high school. The vocabulary and demands were much higher. In college she wasn't sheltered in an ESL program like she had been in high school. The stakes were higher. The workload to keep up with normal homework and to continue learning English at ever higher levels and to hold down her part time job at McDonald's was knee buckling. Delicate and frail Z was having a very hard time keeping up with it all. She began to suffer anxiety and couldn't sleep. She saw a doctor and was put on medications to ease her anxiety and help her sleep.

Then one day, while suffering from exhaustion, Z had failed a critical test at college. Utterly distraught and humiliated, she returned home and wept in despair. And then, and she couldn't clearly remember why or explain it at all, she took her freshly renewed prescription bottles and downed their entire contents, about a hundred pills in all. It was not long before she collapsed. One hundred pills in a body as slight and tiny as Z's will go to work fast and when her mother and sister found her, the toxins were already well within her system and were shutting organs down. She was already incoherent and lapsing into a coma. Her right hand had already frozen into a death grip around the bottle of pills she'd emptied. 911 was called, she was rushed to hospital and put on life support. Through some sort of miracle she survived. She spent several weeks in ICU.

And this is what brought Z to the chair next to mine to where our very disparate paths met in the TV room of the psyche ward of Royal Columbian Hospital where she had been telling me all of this in snatches of time in the long, boring, pointless days that we had to pass. She told her story with such humility, with such lack of self-pity and with such utter charm and humour, that at times my eyes stung with tears. The only times her voice showed much emotion was when she told of how fast she'd risen in McDonald's and had learned English. She was very proud of that and rightfully so. I've taught English to many, many people in the last twenty years and the level of English with which she was speaking to me was astonishing for the short amount of time that she'd been using it. She scarcely even betrayed a trace of an accent. For all I knew, she'd grown up here. The other time was when she spoke of M. It's not that her voice was flat otherwise, it wasn't, it was very animated (and of course it would be ... she comes from country with a thousands of years old tradition of oral story telling). It's just that there were those times that her voice told of a special emotion.

It was in the TV room that we'd met and we had become bosom buddies over the Vancouver Canucks of whom she was an avid and passionate fan (the Canucks are Vancouver's professional hockey team). The Canucks were on what would be a special run that season and the city was really fired up and the psyche ward of RCH was no different. Z and several of us gathered each night of a Canucks broadcast in the TV room and raucously cheered on our boys.

Z was therefore in the psychiatric wing of Royal Columbian Hospital because of a suicide attempt. She hadn't been depressed. There wasn't a trace of depression or of feeling sorry for herself when I talked with her. She had told me a lot of detail of what had been a very difficult life and had never shown a speck of sorrow or of self-pity. Talking to her, she was as vibrant, humorous and joyful a human being as you could want to meet. Positive life force verily radiated from her. She had been under a lot of recent pressure and stress however. I have no idea what her “diagnosis” might have been. She had been, however, obviously under a great deal of stress. 

The story of Z is one of several I'd like to tell of people I met "on the inside". I'd like to tell these stories for a number of reasons but chiefly to give an idea of the kind of people one will find on a typical psychiatric ward. I met dozens of people in my four stays in psychiatric wards no two of them alike. Readers of this blog also will know that I have a particular interest in suicide and the reasons behind it so I also think of Z as an interesting case study. We'll come back to this story, and others, later.