Friday 13th, full harvest moon....

Had busy shift. Not as Cray Cray as I expected...

I did have a patient that I have seen before. He was an inmate. In for OD on unknown substance. Standard workup:::call poison control, take recommendations, review medications listed yada yada yada...only difference is that in addition this dude is a "cutter". His cutting is a part of his psychiatric illness...that apparently is not under control with his current medications. He has used a razor blade fairly creatively on his chest, upper abdomen, both thighs and up and down his left calf. None of the injuries are life threatening, none require any real I intervention except cleansing. He is apparently a long time cutter judging from the various stages of healing cuts from his feet, to his neck.

Now, I do have some psychiatric nurse training having worked at a psychiatric facility I do have some personal experience with a friend who was also a "cutter". My friend "K" had experienced horrific sexual child abuse at the hands of her father, since the age of 5. When I was close to her, many years ago, she had been going to therapy and getting her past behind her. She had been hospitalized at one point, and discharged and all was better., or so everyone thought. One day, I don't remember the exact details, but I noticed some cuts on her. We spent a lot of time together, going to the pool and to karate lessons and such. I had noticed her limping. She admitted to me that she had been "cutting" again. Well, I was quite the dumb-ass, and did not even realize that was a "thing". So she explained to me that when "things" got too hard to handle, her memories, the trauma, something could bring it back, and she would take a razor blade and literally slice off the soles o f her feet. Additionally, she would start cutting on her thighs or upper arms, where it could not be seen under her uniform. I was at a loss as to why or how anyone could torture themselves this way. I was not in the medical field, and to say the least I was a dumb ass...but I did care. I asked her to explain how this helped her. She told me that by focusing on the pain of the cuts she could close out everything and everybody that was causing her pain in her life. That focusing on the current pain , negated all the other pain she had in her heart. Well, I thought that was pretty fked up, and I suggested that maybe she needed to call her counselor because I was pretty sure cutting the soles off your feet was not in her recovery plan,.,.Fast Forward a few weeks later...and I get a bizarre call from her telling me she was going to kill herself by slicing her wrists with a knife. She sounds very strange. I made her promise me she would not harm herself. She kept telling me she was seeing her counselor the next day. I made her promise me to put all the knives away …. right now...and told her I would call her counselor to confirm her appointment. (at the time I had children in school and lived 15 miles from her). She said "ok" in a very child-like voice. I called her clinic (Lord even knows how I knew who to call, and they told me everything was confidential and they could not tell me if she had an appointment.) I demanded that I talk to a counselor and I told them that if someone did not call my friend RIGHT NOW... that she was going to commit suicide. I gave them her number and hung up. I then called my friends husband. This SCARED  the shit out of me...how was he going to react. He was a VERY HIGH UP in the chain of COMMAND where I worked. I COULD EVEN LOSE MY JOB! I told him he needed to go home RIGHT NOW! IMMEDIATELY!!!!!!!!! That if he did not lock up his knives he would not have a wife to go home to tomorrow.

Well, he did go home. The counselors did call. My friend went to what she called "The Farm" for about 6 weeks. While she was gone, she made me a ceramic egg, with a crack and gave it to me when she returned. After her visit to "The Farm" she did not have much to do with me. Never called. Did not meet me at the pool. I became an unwanted friend. I literally lost the best friend I ever in my life had, because I tried to save her. That was over 30 years ago. I still have dreams about my friend. I still have dreams where we are holding hands and walking and talking together. The last time I spoke to her, around 8 years ago, I asked her if she remembered calling me, and she said she remembered nothing at all about the events surrounding her going to "The Farm", but that it changed her life.

Now, back to my patient. After he was awake, alert and going back to his unit. I told him "Ok, this is none of my business, but I know If I am pissed off about something, the last thing in the world I would do is cut myself, cause that crap freaking hurts!". He actually made eye contact (a biggie) and said "well, you just ask God to take away the pain, and it don't hurt no more".  So I say "You believe in God?". He says "Yeah". I said "So, I am stepping on my soap box right now, and I want you to hear me out. (he nodded his head yes, so I continued) I ain't no expert or anything, but in my opinion we all have a job that God wants us to do...do you have kids (he says yes).  Do you have family (yes), where are there (he says Gainsville). " I said "well that is a far piece from here, so it's probably pretty hard for them to come visit very often, but that is not to say that they don't love you", he hung his hed down, "I believe that every person born on this earth has at least one job that they are destined to do,,,it may not be much, it may just be a kind act or telling somebody about God, or a kind word, that changes someone else's life...I have always felt that we have a job in God's plan....and if we choose to commit suicide, that we leave this earth with our job unfinished, we have not completed God's plan for us. " "I think that God has a plan for you, and I don't think that you have fulfilled that plan yet, do you?" He looked at me and said "no, I think you may be onto something there." At that point I mimicked stepping off a platform and said "I am stepping off my soap box right now. Please, just think about what I said.". He said "I respect that, I like how you said that. I will think on it".

So, weather I have made a difference in his life or not, time will tell, but I came home thinking that , for a moment in time, I have touched someone in a way that is meaningful.