The New Business Model in Psychiatry

I checked myself yet again at the hospital. It became my full time job really.

Shame on me, I ain’t strong enough to survive outside more than a few weeks. But is it really my fault?

Not more than 24 hours later, yes you know it, I checked myself out. I wasn’t scared of the environment this time. I liked the room. I even met a couple of people with whom I could have a decent conversation – shout out to K, L, N and N!

My problem was the medical body. My sessions with them were more of open ended questions like in qualitative research. I felt time had no essence to them. Like progress cannot be measured daily.

When I went to London, and I am not being payed to say this – if you only knew how expensive it actually is to get treated there out of pocket – every single word I said was taken seriously. Every little side effect was looked at. I was seen as a person; a real person and not a spoiled brat complaining for no reason.

Secondly, the doctors would not dwell endlessly on what to do. They took calculated risks. Because if they agreed to the status quo then nothing would happen.

I was always reassured and never ever did anyone tell me this drug or this method works for 20% of the patients. I was given hope – in abundance and also had the opportunity to chat with other patients who are now truly healed.

While I was completely fitting the box of patients in the clinic, my individual voice and needs were immediately heard.

That is why I felt I was wasting time at the hospital and that is why I left 24 hours later instead of staying for a whole 10 days.

My business teachers at university always said a good product or service starts by answering a customer pain.

Very well, mental illness is filled with customer pain; be it the patient herself or her family members.

I have been treated and admitted to hospitals both in Paris and Cairo. Although the settings could be strikingly different; there are major similarities.

Patients have little control over the course of their treatment; unless they happen to well read – and still that could be interpreted as a personality disorder.

Here, business people, here is a business model for you to follow. Instead of keeping the one patient coming back for 10 years, you can have thousands of them and most likely very happy ones too. Am no mathematician but get your excel sheets out and do the works. It doesn’t need a genius to tell you where the money is; and coincidentally health too…

TBC

Capitalism and bipolar disorder

My illness relates to many many factors. It is my upbringing and my biology. It is society, it might even be fate.

My illness maybe relates the most to a lifestyle, no; to a mode of being that I am not the only one to have created but surely had to abide to. My illness is so common you would be surprised. My illness is “in” these days. My illness is a mutation, a mistake if you would like. My illness is a blessing as much as it is a curse.

I get to the downs of the deep blue and sometimes I stay afloat. Sometimes I even catch a boat, a sailboat- nothing too fast. I wonder and I ponder about my existence and yours. I shed a few tears and even pop a few pills.

I always end up where I started with mixed feelings about everything. Nothing is my favorite as how should I know? My illness changes my mind as I grow.

Something is constant amidst this storm. I know there is a malfunction, that much is true. Why does it relate to inequality go ahead and ask me. All is a competition, life has become a race. We run around all day seeking a bigger dream. I don’t get there and you don’t either, but why does she? Born in here, studied in there, oh that is her family? Where is my choice in all of this? Where is this leading me? Achieve and fail and fail to achieve. I ask myself why I stopped dreaming. Those images were not mine but yours, so why keep them in the first place? Illusion, delusion, materialistic being. This is not whom I should be. Why wake up and swirl like a mouse? That’s when I decided not to leave the house. I felt immense fear from life; how on earth can I win this race? Exclusion, demotion, gender roles or nationality?

TBC

When the dream catcher fails to catch all your dreams

So I went all the way to London. I am from Egypt you see, I had to pay good money for a visa, and lots more for accommodation and living expenses. One hefty sterling pound costs 23 Egyptian pounds. You get the picture.

Any-who. We travelled, out of pocket. We did everything by the book. We stayed in the nicer areas. By we I mean my husband and I, and later my sweet father. We ate out, he took me shopping. He transferred money to me weekly even though he was already paying for most of the stuff.

He isn’t a millionaire. He isn’t a business man. He is just a loving father.

Twenty five days we stayed in London. Day in day out. My husband visited every single second he had. He took me out even to the west end.

I cried in their arms and laughed some more.

I was not prepared however for what the doctor told me one fine morning.

He told me Nour you have to go home. I didn’t comprehend. What home? Like the place we are renting out here in London? No? Home as in Cairo? As in the Middle East, pyramids and all? Why!! I am following your words by the book. Doctor Zamar your words are my command like literally.

Why summon me and tell me this?

It figures the bloody Prozac is giving me horrible withdrawal symptoms. He can’t treat me with them taking place. It is nothing personal he said but rTMS won’t be efficient. Nothing would work.

His plan was to fly me home and give me back Prozac and instead of weaning me off cold turkey; to tapper it off gradually.

Trivia: do you know that they don’t sell Prozac in smaller doses than 20 mg in many countries?

Guys, people of the pharmaceutical world stop lobbying against recreational drugs and kindly start putting your **it together with psychotropics.

An Arabic word comes to mind to describe the situation “Haram”; it roughly translates to “god forbidden”.

God forbids this bullshit companies are selling to us the millions of us this shit as pain relief…

God forbids you to prescribe us shit that will literally make us want to end our lives

God forbids you from making zillions hurting us and also making us dependent on you with every cell of our body.

We don’t need strong will to quit the poison you are selling us, we need a miracle.

I was willing to undergo Electric Chock Therapy ECT- which would basically erase what is left of my poor memory- just to get rid of the effect of the antidepressant in my body. That my friend is like asking me to deep fry my hand to get rid of a mole. It is that illogical. But I was willing to; cross my heart. Doctor bless him said it would be useless.

So now after quitting dear Prozac – the sweet antidepressant that is almost given over the counter – and I swear to god given to “normal” people who just want to lose weight; I am back to square one. I am taking it again. And will reduce the dose every 10 days.

I can’t give you more feedback about my new treatment as it came to a halt.

But for the love of god, for the love of Jesus, of Moses, Mohamed, and Buddha; NEVER take antidepressants if you might be suffering from a mood spectrum disorder.

TBC

I just checked myself in a few hours ago and now I want to run through the iron gates and never come back.

I cannot deal with my thinking, my needs, my wants, my moods.

Is this a magic spell?

Get me in here

Get me out of here

My patience is nonexistent and my insight is blurred with my tears.

End this torment for I am at the end of my rope

This song is on a loop and it won’t stop

TBC

Worry of hope – rapid cycling

It’s 5 am and I cannot sleep.

I am angry of myself. I am angry of the world. I am angry of hope.

I am supposed to try a new treatment soon. My mood changes more than I can handle. I am up and down at the same time.

I put on my trainers and went down for a walk.

Am writing and waking while listening to music. That is how restless I am.

I am worried it will fail

I am worried I will fail

I am worried I will fail them

I am worried they will fail me

End up my post with the usual

God grant me the serenity to accept the things I cannot change

The courage to change the things I can

And the wisdom to know the difference

TBC

You must know

Know that I love you since before I was born

Know that I loved you since before you were born

Know that you are my every reason for being

Know that I want to leave to set you free

I try and I fail and I try again and I fail and fall harder

Maybe this time it will work

If I were

If I were at the hospital

I would wear my pyjamas all day

I would say good morning to everyone

I would wake up on time

I would have breakfast at the communal table

I would go for a smoke when the nurses say so

I would wear a nicotine patch To get me through the day, and I would be allergic to it

I would use the communal shower and dry up with a bed sheet; I would find hair everywhere and stay with my slippers on

I would wait for the doctor to pass by and say the daily bla-bla-bla;

I would play Sudoku- pen and paper sir not online

I would stare at my family’s portrait hung on the window and imagine them touching my face

I would move my chair around to be in the sun, seeking emotions and failing to find none

I would be disconnected; off the grid and not feel guilty about it

I would pretend it is doing me good to be here

I would take my blood pressure and temperature every day

I would talk to others about side effects of this or that

I would fancy getting better

I would know it is good for me, it has to be; it better be

I would feel guilty about the kids, my husband, my father; my kids, my husband, my husband, my husband, my father, my father, my father, my father….but my kids…

I would wait for 2pm when visits start, no no tears this time

I would wait for 7pm when I can call the kids and ask them to sing me a song, sometimes they would

I would give them imaginary baths and diners

I would blow imaginary kisses and I would make belief that I am tucking them to bed

I would kiss my husband good night and say a silent prayer, god let tomorrow be normal – one more day

I would beg for the drugs to black me out at 8pm

Dinner would be sprouts and more sprouts. Some borrowed olive oil here and some salt

The other day I took the kids bowling and felt so self accomplished just as if I landed on the freakin moon

I am sitting by the louvre sipping my Bloody Mary with tears

People are standing up here and there trying to get a perfect picture

They bend and jump into strange angles to look like the pyramid is on the palm of their hand

It is all make belief, looking for the perfect moment

A tour guide has an umbrella up for everyone to follow her

Where else would they go I wonder? Isn’t this the perfect moment? To follow someone without thinking? Tick this box and that one. Been there, done that…

We talk and talk and talk and talk

We shut up and up and up and up

We should know better

I am writing compulsively, but you don’t have to read me

It is building up

I know myself, I wish I didn’t

Solve it; for you god brought me here in the first place

No shame; maybe some

No regrets; just a few

Oblivion where are you?

TBC

The tunnel at the end of the light

I wake up and find out that the life I thought I had is slipping through my fingers.

I look at myself in the mirror and I don’t see me. My son tells me what is wrong with your eyes? He is three.

Where is my silent mantra? Where is my magical oxygen?

Like a broken record, or a bad movie that always has a sequel…

I am just a

Racing heartbeat

Cold limb

Thought with echo

Foggy brain

Shallow breath

Flushed face

Spent energy

Headache

Backache

Fear

Silent scream…

I ask myself. Are you coming back? Are you already here?

I can’t be. You left me, remember? You almost promised not to show up again…

Why is it always payback time? Didn’t you take enough through out the years?

I have nothing more to give or to give up. I surrendered everything. You took it all away.

I am hesitant again…

I am dizzy again…

I am in bed again…

One of us has to leave and it cannot be me. I told you this before. I cannot go, it has to be you.

These cycles are endless. They tell you there is light at the end of the tunnel. Sure thing. Can’t argue with that. But they fail to mention that there is another bloody tunnel right after the light.

TBC

On shame

Raw

That is how you feel after one of them attacks

Raw

Like the flesh of your wounds that you cannot hide from yourself

Raw

As shame invades your soul trying to find even seeds of regret

Raw

Emotion and thought entangled in a web like a knot I cannot undo

Raw

I wish I can curl up and wait till the storm is over

Raw

I know that this is a dream for I am the storm

Failed experiment – on being human


I want to take a pair of scissors and chop my hair off

I want to break both legs

I want to cut my face with a knife

I want to slice my wrists and watch blood oozing out of my veins

I want to live on the street

I want to never speak again

I want to never feel again

I want to never see again or hear again


I took the drugs today. Don’t know why or how many… probably lithium 250*3, Prozac 20*3 and a couple Temesta 1.

I had gotten so angry before it. Not mad angry but scary angry; where nothing matters anymore. I have been there and it is not pretty. I am getting numb now. Getting slower. My nerve endings are not painful anymore. My upper back has stopped wanting to detach itself from the rest of my body. I am mellow. I am high and low and I will hit the ground faster than I know it.

I couldn’t succumb to what I wanted to do. Is this safer? No. Is this what I want? No. Did I lose yet another month or two trying to be a good girl responsible for her body and mind? Yes. Do I gain points in this game or does my score go back to zero each time? What now? A life of broken promises and misery all around to which am the catalyst always. If I could just be on an island free to live or not as I please. Would it change anything?

The worst feelings I have are about those around me. The destruction I create in their eyes. I don’t want to talk to them or look at them. I don’t want them to see me. I should be locked up alone like a crazy relative in the attic. In a bare room with a small window. I wouldn’t be let out because I lost my confidence and words remain words. What is a promise? Why is it so important?

I want to see my children grow from far away. No need to get them messed up with me. I will tarnish their childhood with worry, fear, and dread. Their small hands come to me to cuddle and my skin burns. Their kisses burn my face. I know I shouldn’t have been their mother. It burns and I feel I am contagious. What did they do to get me? How could I have predicted my state now 10 years ago? I love them too much to hurt them. I hurt them just by being a mass in a bed that moves right to left all day. I hurt them when they cannot play because Mama is in pain. They cannot go out band cause Mama is having a bad day. They cannot have friends over because Mama needs silence. They know I am sick and they ask me what hurts. They bring me dolipran and ask me if I want coffee. They tuck me in. The small one tucks me in ans shuts the door behind him… How long will I be able to lie?

I want to get my father only on the phone. I don’t think I can even handle this. I don’t want him to see me a bag of bones. I am his life and that is the problem. What kind of life is that? Tormenting my old man is what I do.

My husband…

My husband, I don’t know what I want for him. I want him to go on and not stop because of his handicapped wife who should be locked in the attic. I want him to forget me and that is the toughest of all. I want him to forget 19 years of mostly joy and a year of mostly hell. I want to erase his memory of me and maybe remove all love and pity from his heart. If he forgets whom I was before maybe he will let go easier…

I want him to stop believing it will pass. I want him to stop hoping it will not be like this tomorrow. There is no more older me, a me of those were the days: she is gone. He says: She is getting used to new drugs, she reached the therapeutic level of the drug to work, she is having side effects from the drugs, she is in withdrawal, she is …. she is…she is done habibi that is what she is. The one you loved dearly is not me and I am not her. All what we had has been taken away with my illness. We got robbed 20 years and only you have at least a couple more 20 years to live. Don’t live in hell.

I want it to stop being about me.

Is this too much to ask? I want him to go to work. I want him to travel for work. I want him to do his job as he should. I want him to have friends and hobbies. I want him to have fun. He cannot with me around. How can I disappear? I want him to plan his life like anyone should be. I want him to stop walking on eggshells all the time. I want him to stop detonating my bombs right and left… I want him to live and embody life for our children. He can do it.


The nausea is kicking in now. My body is very heavy. I have a few hundred steps to take back home. It is sunny. I had coffee. People are in summer dresses. The street is buzzing. Kids in strollers and people on bikes. Motos ans buses make the most noise and it is annoying. The world is not stopping…

TBC

Changing psychiatrists like changing socks

Waiting again this time for my 5th psychiatrist in less than one year.

I am going because of family pressure and not for any other reason.

Waiting on the red chair for her to come out and tell me in.

Recounting endless details- oh, session is over. Why am I here?

I don’t want to hurt myself

I don’t want to hurt myself. I do not want to end up in an emergency room.

My only weapon is my writing.

I have to fight myself as much as I have to fight the system. What on earth am I supposed to do not to end up in an emergency room? How can I control my impulses?

Could my pain make my heart explode? Is this physically possible? Will I let my children see me this way? What does the system offer to those in my position? Waiting and some more…

I wish I could feel numb like the last 48 hours. Today it hurts like an open wound. Will I keep on bleeding endlessly? will I hold this scream till the end of time? Will my tears ever dry? What can I do to protect my children from me? Leave? Go where? Die? They will be motherless just like me.

I have given all my strength in this fight. There is nothing left in me, not even pride. All what I ask is for is that it be quick. This separation that is tearing me apart, could it happen in the blink of an eye?

I am rambling, scared like a lost child in a forest. How can I be a mother when I am like that? God, if you exist help me… and if you don’t, then let me be…