Early June. Cape Ann, Massachusetts.

A thick fog was hovering in almost perfect stillness over the water. I could see nothing through the grey, yet I could hear waves crashing onto the unseen rocks. The air was cold and I shivered in my sweatshirt clutching my “regular” Dunkin Donuts coffee in one hand while carrying a net and a bucket in the other. In between odd jobs painting houses and picking up shifts at the local ER as a medical assistant, I had scraped together enough tuition money to enroll in a Summer Marine Institute program at my college. I was working on a pre-med degree and had chosen a field course since I had always learned better outside of a traditional classroom.  It was taught by Dr. A, a tiny slip of a woman with wild curly grey hair and the balance of a mountain goat. I’m not exactly sure how old she was since she had the tan, weathered skin of someone who has spent their entire life outdoors and in my 19 year old foolishness, I of course thought that anyone over 30 was ancient.  I think she was in her late 70s, yet none of us could keep up with her as she leapt with ease up huge rocks and around slippery tide pools, never falling or slipping in masses of seaweed and unflagging in her enthusiasm for finding the perfect specimen.  She was an expert on all types of North Atlantic sea life, both animal and vegetable, and she was hell bent on sharing her passion with her students.  It was our second day out collecting specimens and breathing that particular loamy, salty fishy smell that is unique to the North Shore.  Later that morning I sat sketching periwinkles and fucus vesiculosis (aka bladderwrack) in my somewhat damp notebook, looking at rocks covered in layers of barnacles, admiring how the waves had cut smooth channels as it had flowed off in foamy rivers, wave after wave, year after year.  She noticed me looking at them and said quietly, almost to both of us, “water is the strongest force on earth and it’s the universal solvent. All it needs is time.”

When she said that,  I was thinking in terms of literality, thinking how that couldn’t be true- that it could never dissolve oil simply because of the properties of covalent and non-covalent bonds. And it’s only now, twenty five years later that I think I understand what she meant about time and solvents. I knew she had been widowed at a young age, and was always out on the water, or in the water.  In that phase of life in my own self-centered way I didn’t really understand anything yet.  She would often wax poetic about the therapeutic properties of sea water and tears; words I remember now.  She was talking about coping with pain and the unexpected. She was living her passion and healing herself at the same time, but I was blind to that.

She spoke about how water moves through the air, the ground, even inside our own cells and bodies and takes along chemicals, minerals and nutrients. It is part of us, around us, in us, flows through us.  It’s a wondrous and mysterious force. Like time.

The summer I spent lugging buckets of fish and urchins and learning the scientific names of snails, fish, plants and birds was one where I was deeply lost.  I was incredibly lonely, yet the desolate beaches of Cape Ann and Plum Island appealed to my desire to be invisible, to be lost in a landscape that was bigger than the girl I had become. The hefty athlete’s appetite that had been no problem in high school was suddenly a bad fit for my new sedentary life as I started college and worked and focused on studying.   I ballooned.  By that summer, I felt like I took up too much space. I had an anorexic roommate who was shrinking and dying while I exercised and ate compulsively. I was alarmed at her decline, but unable to stop my own descent into an eating disorder.  The voices that told me I wasn’t good enough, too soft, too weak, ugly, unworthy were too loud. I would tell myself I was a failure because I lacked the discipline to starve myself like she could.  I wasn’t the tiny fragile ethereal blonds that were the style of the times. I was a chubby girl with a round face and unflattering hair cut hiding in baggy clothes, hating myself so much. I longed for attention from the boys around me, but none of them noticed me.  I thought it was crazy that I could be so big and unseen at the same time.

I would starve myself, then crack and binge eat and then throw up and exercise compulsively for hours and hours, always in the dark, where no one could see me restlessly circling my campus for mile after mile driven by a desire to transform and to return to my old athletic self but unable to curb the insatiable hunger that had grown unmanageable .  Food numbed me and the rush and the exhaustion of the binge and the purge left me outside of myself for just a few moments. It was an act of violence against myself and when it was over, when I felt empty and light and spent, I would swear  that it would be the last time. I would be normal. I would get it together and stop.  I was stuck in an endless cycle that seemed to have no exit. I was spinning and going nowhere. But sitting on those beaches, with my feet in ice cold tidal pools, looking for elusive specimens to catch or draw in my notebook, I felt almost ok. The ocean made me feel safe as I gazed out at its vast wild. There was a big change coming.

Never in my fantasies was I ever me. I was always another person. Someone totally different. My outsides never matched how I felt on the inside. So I reinvented.  I became chameleon-like to see if I could be acceptable. I took on whatever form I thought would make me feel less “other”. I didn’t change for myself. I had no idea who that was. I just knew I was weak and fat and too sensitive. I  knew that my dreams were never going to come true unless I changed into someone else completely.  And with that first burning sip of alcohol, I found the key.  I finally lost the weight because now I had a new self destructive cycle.  I got edgier, harder, stronger, leaner, faster.  And with each drink, I imagined that I was finally the self I wanted to be. I had the courage to behave the way I felt on the inside. Brave, brash, not caring what others thought. Fearless, sexy, like I could have all the things I had watched everyone else getting for years while I stood on the sidelines waiting like a good girl.  I still had some struggles with food and  body image but I had my new thing. The thing that made me feel ok. It was all ok once I had those first sips and felt it rush through my blood like a warmth that made me forget.  And it went that way for years. Until the absolute pain of not having the insides match the outside returned in a different way.  Until my life was consumed by shame and the cognitive dissonance that can only result when you live in a way that is actually daily flirting with death.

When I was first struggling to get sober or stay sober for more than a few patched-together hours or days in a row, I had one central idea:  if I could just get sober, it would solve everything. Just stop drinking. It would be like water… dissolve all the messiness and the problems I drank over like some kind of magic. The ultimate cleanse.

Only it wasn’t. It was more like a magnifying lens on my life. Too bright, too loud, too messy, too much was the theme during those initial raw months.  I simply couldn’t imagine being at peace in my own head, inside a body that felt like it’s skin was on inside out. Nerve endings screaming, brain scattered to the winds. I could not sit still. It was nothing like I had imagined.

I read somewhere that growing up means putting aside consoling fantasies.  For me, that meant setting aside the notion that I could ever drink normally. And for a while, at the start of sobriety the unknown “solution” of getting sober was another sort fantasy. I thought if I could just get that one thing right then everything that was wrong, or broken or unrecognizable about myself after so many years of cumulative damage would be all better. The universal solvent. Like Dr A’s water. A force that would sweep away and wear down and smooth out the rough edges. That has been both true and not true.

These last eighteen months of sobriety  I’ve been doing the work of sifting through all the history and the wreckage. I unearthed about twenty old journals from a musty box in my basement.  I sat down and read my own voice writing about the paths I chose. I read the pain and the aimless reach for meaning.  I read the words of the girl I was, see how my voice changed once alcohol became part of me. How that voice changed even more when I deviated from the path everyone expected and instead became a soldier and then an ER nurse.  It’s all there in green ink in my tiny neat hand writing… like a road map to self-destruction. I can read how I pushed harder and went farther and faster, yet underneath there was still that same desperation of the chubby girl just wanting to fit in, except now I “knew” that weakness was unacceptable and hid all of my fear behind mirrored aviators with a BDU cap pulled low or under my calm exterior as I handled another horrific injury at work where only I knew that my hands were shaking.  I wrote about it all: how I learned to carefully separate my own ambitions from the attention of men as I used them the way I had felt used. Underneath my layers of armor I hid how I never felt good enough or like I deserved any kindness. I set out to be tougher than anyone, would work harder, go faster and faster trying to outrun those old voices. With each trauma, I told myself not to be weak and added to my layers of armor. The scars thickened and alcohol came along for the ride, clouding my judgement and telling me the lie that I wasn’t terrified and small on the inside.   Its not a great story.  I see so many places where I could have gone a different way.  I could have leaned into kindness or taken a softer, easier path than I did. But I’m making peace with it.

I realize that once again I am reinventing myself, because there is no going back to who I was “before.”  Because in looking at my story, I don’t think I had any idea who that was to begin with. I’m just now finding out who I am.  Without labels or mood altering substances. Just myself.  Seems a little late to be getting to know her, particularly when I’ve been so unkind to her all these years. But that’s what I’m doing, every day, slowly. It feels like a gift. And I’m no longer afraid.

I’m learning to replace self-destruction with self care. Accepting soft. Allowing vulnerability and being small.  I’m not just giving kindness to others until the well is dry in some desperate bid for worth, or doing senseless things just to feel “ok”.   I don’t have to prove anything.  I practice letting my emotions and thoughts ebb and flow and swirl like water, cleaning out things and bringing in new ones like tides.

I am deliberately writing a new life. And I bring all the cumulative lessons and scars and false starts and healing that is happening slowly in layers and circles. I don’t know the ending yet.

But I know that I like this story.

Scars and mirrors

Her twisted face is mere inches from mine and my ears are ringing from how loud she is screaming inside this small room. Her shrieks are echoing out into the rest of the Emergency Department which has gone eerily silent.  Black eye makeup streaks down her cheeks to mingle with tears and sweat. She is screaming obscenities and commanding me to let her go. The smell of alcohol, dirt and sweat stings my eyes. In the next breath she is screaming, begging ,”please just kill me. Just kill me”. I am speaking quietly, calmly down near her ears where I hope she can hear me. ” I hear you. You need to try to calm down. We don’t want to hurt you. We are trying to help you.”  But she is beyond hearing.  She is spitting, kicking and trying to bite my hand that is holding her hand down onto the bed as our staff struggle to put on the locked wrist and ankle restraints without being kicked.  I look down at her slender wrist, see the thin blue veins which are lumpy and scarred from shooting up and then my eyes travel further up to a network of silvery and red horizontal lines, scars from cutting. There are hundreds of them. A small, homemade broken heart tattoo hides on her inner arm. Her eyes are pleading, enraged, defiant and sad all at the same time.

Later, when the medications I have given her have taken effect and she is lying quietly in the darkened room with a warm blanket she whispers to me, “You just don’t know.  I have to get out of here. I got kids.”  She is barely out of childhood herself, though she looks much older. I imagine if that was one of my children, with a scarred body and shattered mind, strapped to a gurney in four point restraints, strung out and off their meds and so drug addled and drunk they want to die. And I know that I’ve seen the look in her eyes in my own mirror after I’ve been drinking.

The gurney rolls up the back ER ramp, surrounded by EMS workers in blue uniforms. On the stretcher is a man a greyish white color that any nurse recognizes immediately as a bad omen.  He looks frail, his skin translucent and clammy. His eyes meet mine with an animal desperation as he vomits cascades of bright red blood into a cheap plastic bucket. I can read what he is asking me without words: “Am I going to die?” I speak to him calmly, recognize the smell of vodka mixed with blood which is a smell that stays in your nostrils long after you’ve gone home and showered in scalding water. He vomits again, a seemingly endless gush; a startling crimson sea. I start his IV, type and cross for blood transfusion, start hanging IV boluses as I watch his pressure dropping precipitously. I send a tech on the run down to the blood bank.  As the monitors start alarming with a startling cacophony, he grips my wrist with his grey cold fingers and he says “is this it?” And I say, “I don’t know. We are going to do everything we can.” He is whisked off to the OR to fix his ruptured varices.. veins in his throat that are torturously dilated after years of chronic alcohol use. I survey the wreckage in the room he has vacated.. the trash on the floor, the suction equipment, the empty bags of transfused blood, the air still heavy with fear and vodka and the unmistakable metallic smell of blood. He is a year older than me.

The car screeches up onto the ramp in front of the ER, the doors fling open and a body is tossed out onto the sidewalk which is more like a river since it is pouring rain. I run down with my radio, immediately notice the blue color of the boy lying on the ground, call for help and start CPR. My team arrives, we load and go with me sitting on top of the gurney still doing compressions as we roll through the waiting room, full of wide -eyed back pain sufferers, toddlers needing stitches and miserable flu patients, back through the pneumatic doors to one of resuscitation bays. Everyone does their jobs, we administer narcan and suddenly the dead boy is back. His eyes open, he takes a gasping breath and immediately starts yelling and cussing at me, calling me the cunt who ruined his high. I remind him that he was dead five minutes ago and that we just saved his life. The doc and I calmly explain the need to monitor him for a while in the ER since the heroin he took could cause respiratory depression and death when the meds we gave him wear off.  He tells us to go fuck ourselves, rips the heart monitor off, flings it at me, cusses a few more people out and storms out of the ER, out onto the street as thunder rumbles.

Forty five minutes later we get a call on the EMS radio that they have a priority one overdose en route to us with a 5 minute ETA. They roll through with an intubated patient,  CPR in progress. I see curly wet hair, then peer at his face and recognize the boy who had just left an hour ago. EMS said unknown down time. We work the code for a long time, check with ultrasound for cardiac activity, and finally he’s pronounced dead, exactly 2 hours and 24 minutes after I first took his pulse out on a sidewalk in bucketing rain.

I hear a familiar voice from behind the curtain of room 3. I know who it is, even before I go in the room to go assess my latest patient.  He smiles at me as I enter and I check him out. Double amputee, Vietnam vet in the bed, wild grey hair he has covered with an old bandana. He has a raspy cigarette voice and a deep laugh that makes the fluid wave in his distended belly ripple. He is dayglow yellow and smiles with perfect white teeth in his wasted face. His spindly arms are cradling his massively distended belly and he jokes “We’ve gotta stop meeting like this, Wen.”  He goes on to brag to me that last week, when I was off work he came in and they tapped him for 4 liters of fluid. His personal record. His stories are great, his attitude is amazing. Yet his body is failing, his liver is shot and most likely I won’t be seeing him much longer. But there is something about him. He talks about the joy he found in sobriety. A joy that sustains him, even when he is obviously dying. I look at him and I think how can he be joking and laughing when he’s in so much pain. How can he be telling others about his peace and serenity now that’s he’s finally sober?

In my gut, deep down, under my neat blue scrubs and name badge that says “RN” on it, under my professionalism there was a voice that I tried to ignore. A voice that was warning me. A quiet voice drowned out by the raging need I felt after shifts like those when I would pull into my driveway in the wee hours. I’d come up the steps with throbbing feet and reach for that glass, hear the glug glug glug of wine that I was gulping before I even had my coat off.  When I was still a young, unjaded nurse, I used to come home and pray and go to bed…. then years later I would tiptoe into my sleeping babies’ rooms and kiss their sweet innocent cheeks and breathe a prayer of thanks over them, then lie awake until the call of the alcohol drew me downstairs for a glass or two. But in that last year, I couldn’t face their innocence knowing that I was bringing a monster inside me into their rooms. I didn’t want to breathe my poison on them.  I felt tainted by what I had seen.. and utterly convinced of what I knew was coming for me. I would sit in my dark kitchen and drink until the faces faded. But they still haunted me the next day when I would wake with a splitting head, queasy stomach and a soul that felt shredded and hollowed out.

My last shift before my last drink.

EMS rolls in with another intubated patient. Eyes fixed and dilated, she’s posturing on the gurney, a sure sign of neurological damage. I’m the primary nurse. Rest of the team shows up to help. EMS tells me that she was found unresponsive by her family. Suspected alcohol overdose. Respiratory arrives and we put her on the ventilator and we start multiple IVs. She starts seizing and I yell for meds. Someone brings them and I am hanging them as her family enters the room. 16 year old son acts as spokesman and her two younger daughters, age 10 and 5 hang back with fear in their huge eyes. One of the nurses goes over and speaks to them quietly, assuring them. I speak to her son who tells me that she had been in recovery for alcohol for a year, started dating a new guy who he said was bad news. She decided last night to have “just one more” which turned into him finding her slumped on the floor of the kitchen when he woke up in the morning at 10 am. He wasn’t sure when she stopped drinking or how long she had been lying there.
I start focusing on titrating drips as her blood pressure is dropping and she’s continuing to have intermittent seizures. I listening to the rhythmic hiss and whoosh of the ventilator breathing for her. Her jaw is slack, her eyes rolling. Her two little girls are crying quietly at her bedside and kiss her arm and hand.  The son takes them out to the waiting room to meet their aunt who has come to take them. I stop focusing on numbers and the medicine for a minute and really look at her. Notice that her necklace is digging into her neck around the ties that are holding her breathing tube in place. I can’t loosen it so cut it off and place it in a bag with the clothes we cut off. I wonder what the story is behind it… an angel with a single wing.

Boyfriend arrives, staggering and slurring, yelling at her to wake up and pulling on her tubes and lines. I call security and we all try to calm him down. His eyes are blood red, his hair is wild and nothing we are saying is registering. He keeps grabbing her and crying he’s sorry. He turns his eyes to me and towers over me saying ” the paramedics told me she was fine. Why did you do to her? Why aren’t you helping her.” His voice gets louder and he comes closer, grabbing both my arms. I grab his hands and twist away as security steps in and end up dragging him out of the ER.  Her son appears a few minutes later and tells me he called the cops to have the boyfriend arrested because he tried to assault him in the waiting room. I ask him if he’s ok and he says in a shaky, shuddery voice, “yeah. We’ve been through this a lot. I thought she was finally better. I can’t believe this is happening. She just kept saying she just wanted one more and then she’d be done for good.”

A few hours later, I’ve taken her to CT and xray and we’ve discovered that she had aspirated (vomited while unconscious and breathed it into her lungs), had a massive hemorrhagic stroke and most likely an anoxic brain injury. She will probably never wake up. I’m reading the CT results on the computer I’ve rolled up next to her bed and I look at her. Freckles across her nose, red hair, slender. A few years older than me. She looks like me.  I have a premonition and the hair is standing up on the back of my neck. I shake it off.  I give report to the nurse taking my assignment. I turn in my radio, grab my bag, walk out of the ER and drive home feeling that need. The need.

At home, it’s 0300 when I get in the door. I’m shaking. I can’t stop thinking. I drink. And I drink some more. As if I can just wipe that memory out of my mind, deny the premonition I felt.  The irony that I was making it come true was lost on me as I just slammed shot after shot.

I stumbled to bed, woke with my alarm, had a rough morning getting the kids to the bus. Fight with my son who was melting down about the seams in his sock, sending him off to school in tears instead of with a hug and less annoying socks.. still seeing her face when I shut my eyes. More drinking. A whole bottle of whiskey. Then darkness. Blearily waking to realize I forgot to get my preschooler off the bus. Squinting with one eye to see to drive when the road looked like four roads. Entering the school office, realizing I was slurring terribly. Bursting into tears and telling some unintelligible story about having the flu and oversleeping my alarm. Alarmed faces of the office ladies. Maybe the real truth was too hard to believe. I was almost falling down drunk at noon and about to drive my five year old home. I have no idea why they let me take her. Another squinty eyed drive up the road. Home. Making a peanut butter and jelly sandwich, pretending to be the competent mom who gives her kid lunch after a busy day learning her ABCS. Except I dumped a jar of olives instead of jelly onto her bread. Started over. Opened a second bottle of whiskey. A few more shots since the shame was trying to creep in past my “don’t care, nothing can touch me” alcohol fueled bravado.  I remember giving my girl a sandwich and some fruit and then stumbling upstairs to my room and that was it for the next 12 hours.

I remember horrible blips and snapshots of that night. I somehow called my husband in my blackout and told him to come home. I remember him trying to pull me out of the shower and my voice that sounded like someone else’s’ just crying over and over that I wanted to die. Telling him I’m an alcoholic. I want to die. All those fearsome truths that I’d been skirting around for years. The truth was out. The curtain was whipped back like in Oz and this was the new reality. Around midnight, I sat up in bed, finally able to steady my spinning mind to ask about my kids who I was assured were safe. Looked down at my legs and saw that my kneecap was completely dislocated. I felt nothing. Not a thing. Absolute numbness. Stood up and it popped back in, hobbled to the bathroom, squinting in the light to see the entire right side of my face covered in bruises, my lip split and swollen, my tooth missing, my entire body covered in bruises and aching from falling. I have no idea how I busted my face. Limped back to bed, pulled my covers over my shaking shoulders, feeling ice in the pit of my stomach. And I sat there in the dark and realized that I had two choices: I could ignore it. Chalk it up to a bad shift, a rough week, just a one time mistake. Yes, I’d had blackouts and hurt myself before but never that bad. I could cut back or try moderating again. Or, I could absolutely face the fact that I was going to die if I continued this way. I could choose to surrender to the idea that I simply can never, ever drink again. I could have killed my daughter or myself or someone else. The school could (and should) have called the cops. I could have fractured my skull falling with that much force, could have aspirated and been just like my patient, leaving my three kids crying and never understanding why I left them.

I chose the second. And every day I wake up and choose the second.

And I see these patients with different eyes now. I don’t fear them anymore, being terrified to see myself in them, wanting to deny the similarities.  Now I see the commonalities. I feel compassion.  I am able to quietly share, ask questions now that I never would have before. Because I KNOW them. I am them. And they can make that second choice too.

So, I’m like my dayglow yellow man now. I have hope and joy. I am utterly grateful that I was given the chance to walk away, though limping and looking like a hillbilly with one front tooth for a few days. I still have a lot of challenges, a lot of scars. But I have gratitude too. Oceans of gratitude instead of oceans of shame and despair.

Now when I look in the mirror, I can see the lines on my face, the remnants of pain. But I also see a twinkle in my eye.

And there but for the grace of God go I.