Saturday, December 27, 2008

Those Patients

Stripped down the first thing you see on the patient is the purple and back bruise on the left bicep. It is raised and angry, and you can tell with out asking that it hurts. But that it hurt much worse the moment it was created. It has a matching circular hematoma on the right, but it was the left side that took the most force. Every physician and police officer can recognize these bruises. They are thumbprints from being grabbed, and shaken. Behind the deltoid you can see the matching fingerprints that go with each thumb. Fingerprints always leave that distinct pattern of one large bruise and 3-4 smaller ones close by. Travel down the arm and you find the bruises around the left wrist, same pattern, same story, different day. No defensive bruises along the forearms, she either didn't fight back or couldn't. Sometimes defending themselves these patients will be covered with bruises from elbow to wrist. Hit hard enough they'll get a nightstick fracture, an isolated broken ulna usually seen when you get beaten by the cops. The back is free from any physical evidence, maybe an abrasion on the scapula from being thrown against the wall. Even though you can't see anything she complains that her back is twisted up inside, the muscles ache when she stands. Moving to the abdominal exam, there are three raised fresh scars from a recent surgery. The superficial stitches are intact though from the way she gets up, holding her stomach tightly, its fair to assume the internal ones may have stretched or snapped. Scattered bruises down the shins round out the significant findings. She assures you that her face is fine, it happened Christmas night, and he knew people would be taking family photos. It is important to him that she still looks beautiful to everyone else, regardless of how broken and battered she feels inside.
Everyone hates these patients. We pretend that we don't, we say the right things to their face, how its not their fault. Even though in the back of our minds we wonder what she must have done to deserve it. Why she can't just leave. She says she's afraid, afraid it will push him over the edge and he will come back and kill her. And I reassure her that he won't, though in the back of my mind I can picture all the dead women I have seen after they made a run for it. The ones who were beaten to death, or shot in front of their families. The ones who make it to the hospital still alive with their throats slashed, the ones covered in multiple stab wounds. I try to pretend she is wrong when my work shoes are stained with evidence to the contrary. I try to tell her that the police can protect her. That she will be safe. I try, but we both know the truth.

It's two days after Christmas. I just got out of the shower and I'm drying off with a towel. And that patient, and those injuries, are just my reflection in the mirror.

Thursday, December 25, 2008

Merry Christmas

It's Christmas morning and I am where every loving mother is on her daughter's third Christmas. I am at work. Where I've been for every major holiday and social event since the day she was born. I'm living in the Pediatric ER this month so now I get to bring all the coughs and colds home to share with her. Who says I never bring her anything nice. We have been rocked and rolled as usual for a holiday, but not as bad as the big room. They've been turning over the Trauma Bay all night long. 18 traumas, four GSW's, one pediatric full arrest and a partridge in a pear tree. Oh wait, that's not how your version goes.

It's never a holiday without at least one dead kid. Every holiday goes horribly wrong for at least one family. There was last Mother's Day when dad was drunk and turned in front of a car. Killed mom and the kid in the back, the other kids survived to be shipped off to grandmas and watch their Dad get taken away for vehicular manslaughter. I'm guessing no ones going to forget that little Kodak moment. And forget about the commercial. This Thanksgiving I intubated two kids, one lived, one died. Ahh, the stories I could tell. I probably will tell given enough time. That Pediatric resuscitation room has put more cracks in my soul then anywhere else in this hospital. It is the one place that reminds me of how much I still have to learn and of the fleeting nature of life. The holidays, they just shatter you.

I've learned to control a lot of how I feel and react. I've taught myself to toughen up. There are so few things that get my adrenaline to flow anymore but half dead, sick as shit kids rattle my cage,. There's so many different tube sizes and equipment, their vital signs are all over the place. Every drug you give is based on how much they weigh and as if that isn't bad enough their weight is calculated in kilograms. Are you kidding me, in the middle of this grand cluster fuck known as a Pediatric trauma, I have to deal with the metric system. These are the moments your high school algebra teachers never told you about.

So what to tell you . The kids seized, then stopped breathing then died. Just like one did in ER's all across this country tonight. It doesn't ever stop in my world, not even for the holidays. Merry Christmas. I'm going to go open presents with my daughter now.

Friday, December 12, 2008

Random Ramblings

I spent the day today like a normal person and it never ceases to amaze me how the most mundane moments can give me such pleasure. My daughter had her Christmas pageant and was chosen to be the Christmas angel. She was just a vision with golden curls and enormous blue eyes. It was such a pleasant hour, of just being able to sit in the audience, not have be a leader or have any level of responsibility. Not having to think about my job or my marriage, for the most part. To just blend in as part of the crowd. Every few moments the curtain would open and another group of kids would get ready to give it there all. Its always funny to see which ones will freeze up and then watch the other children try to adjust their dance for the three of four kids who become stunned little statues. Some kids just dissolve into tears while some get that special glint in their eyes, get an extra shimmy in their step and steal your hearts. I love to watch the teachers in the corner exaggerating the dance moves and then you can see which kids are even remotely in sync. Sometimes I like to watch the parents who are intensely wrapped up trying to get their kids to smile or wave. It's so beautiful how we want so much for our children, even though they won't remember any of this. There so young and yet we want to package the world for them and say "Here it is, take it all and make it yours". When they're young we encourage their greediness, to want it all to see it all, to be it all. I don't know when that changes but how different the world would be if we could hold onto that innocence and the blind faith in everyone. Of course, how different would the world actually be if there was a Santa Claus and every boo-boo was healed with a kiss.

I'm feeling better because I'm sleeping better the last few days, so you guys can cancel the suicide watch. What a difference a good night's sleep brings. I also have been getting a lot of support from some one I never thought would have become the friend he has. It's strange that you can meet some people who the instant you speak to them, you feel like they know who you are even when you don't know yourself. One of those people who you never feel the need to lie to because it would be like lying to yourself, and really, what's the point of that. I have one of those to thank for getting me writing again, and I'm glad I am, even if it is painful and is scarring the shit out of you, dear readers. But this other person, I never saw coming and that makes his presence all the sweeter because I never expected anything from him and yet I've gotten so much. We had worked together for awhile, he tolerated my cynicism in the alcove, and I tolerated and lets be realistic, encouraged, his blatant flirting. He also accidentally caused me to have my first flashback, one that I didn't handle well because I had never experienced it before. After I pulled it together as best I could, I explained things and we became fast friends. I was transferred to a different ER for month and would occasionally think of him. The first time I saw him again I was intubating a patient and I looked up to see him looking intently for me because he had heard I was back. It was one of those times when you watch someone and they don't know your looking at them, so there not trying to hide anything or be someone or something else. And sometimes when I have a bad day I think of the look on his face as he was trying to find me and it reminds me that even though I don't always realize it, I matter to someone. And now he and I text everyday, at least a line or two, just because. He was the only one who responded to my text the day my heart was breaking over my son. I haven't seen him since last month and I'm very conflicted because I worry so much about screwing things up somehow if we go out for dinner or hang out together. I'm a pretty damaged person, I freely admit it, and I have forgotten how to have normal friendships and normal relationships. I feel like everything I touch I ruin these days so I'm constantly pushing people away. And I don't now how to be a good friend to anyone because I have spent so much time this last year avoiding people so I wouldn't have to answer personal questions. I feel bad because I don't think he ever planned to meet someone he would need to worry about, worry about me getting hurt and worrying about how I'm doing emotionally. It must be an awful big weight to be responsible for redeeming one broken girls faith in men again. But so far..... he's doing a really great job.

Wednesday, December 10, 2008

Missing him...

I'm having a hard time tonight and I don't know where to turn so an anonymous blog it is. I miss my son. I miss him and everything that he represents. I think about what he would look like, and smell like. I wonder what he would be doing right now. I covet an ultrasound picture I took of him before I went to the clinic. I know, it was stupid, but I snuck an ultrasound picture of him before he died. I have a crystal clear picture of exactly what I did and exactly what he was. Not a piece of tissue, not something that didn't exist. He was my son and he is dead and I miss him. When I feel like this I have no where to go because except for you, dear readers, a very select group of friends ( only one of which have responded to my Hail Mary text tonight, fuck you very much to everyone else) and my soon to be ex-husband, no one knows he ever was. If a child dies in your womb and no one knows he exists, does he make a sound? I don't know but he is definitely missed. I know life would be infinitely worse with him here but what I wouldn't give to hold him just once. I had no say in his conception, its a story I refuse to tell, but I had NO say in it. But I alone made the decision to abort him, drove myself to the appointment, (after showing up early to work of course, no day off for me, before or after), and I'm pretty sure I'm the only person on earth who mourns his passing. And most days and nights I forget that he ever was. And then I have nights like tonight where it hurts to breathe. I cry and cry and cry and I don't know how to fill the emptiness inside. An emptiness I have felt from the moment I came off the Propofol drip and knew he was gone. A mother knows when her womb holds a life inside it, and conversely when it does not. Sometimes I just drink, until I pass out. Because I know tomorrow will be another day and I won't have time to think of him. That of course leaves me with tonight and I'm a wreck. My emotions are raw and I know I would make the same decision if two little pink lines popped up on that test instead of one, but it puts me in an awkward place doesn't it. How do you mourn the child you killed and would kill again without being a hypocrite? How are any of my emotions justified? And will writing this post again expose me to the hateful world of the pro-lifers, who will use this as a rational for outlawing abortion when the fact is my husband would have likely killed me had I stayed pregnant again. The last pregnancy pushed him over the edge of insanity and there's no telling where he would have gone with this one. I chose my life over my sons. This of course makes me a bad mother because in America, the definition of a good mom is one who chooses her child's life over her own. And I also chose my daughter's future over his. The living one over the unborn because I don't care what the religious right has to say: they are not the same, they are not equals. But I miss my son. His ten little toes, his tiny little fingernails. Whether he would have had brown eyes or blue. What gifts I would be picking out this Christmas for him. Maybe Thomas the Tank Engine. Who knows? That decision has already been made and it can not and should not be undone. But I miss my son tonight. And I know I will miss him a thousand other nights to come.

Tuesday, December 09, 2008

In sickness and in health

I have to return to work in a few days and I am of course dreading it. It's not that I dislike my job all that much, contrary to some opinions. I'd say I dislike 60% and all out loathe 30% which means the remaining 10% has a shot at getting a compassionate, caring doctor like on TV. Do you feel lucky today? Yeah, me neither. By the way these odds are pretty much in constant flux so some days my patients are fucked the moment they cross the double doors.
I've been out of work for over a week now because I finally got sick enough to get myself admitted to the hospital and get surgery. There's an old joke that says that residents don't call in sick, we call in admitted. Unfortunately, it's fairly accurate. I've had gallstones for three years now that intermittently bothered me, not enough to do anything about. I've been dreading surgery because I'm afraid of the anesthesia and what I'll say or feel when I wake up. The last time I was sedated they were scrapping my son out of me and I haven't really recovered from that ( See my post Then three weeks ago I spiked a temp, started vomiting and have had constant pain. we've been treating me as an outpatient because I have vacation in February and like all residents I am expected to save all family and medical crises for when I have spare time. How dare I expect time off, medical care, or compassion. This is a hospital dammit! Go somewhere else for that. We tried treating me with antibiotics, anti emetics and pain control in an attempt to keep me working. When I nearly fainted a work , we just hooked me up to an IV pole and I kept seeing patients. Some of you dear readers are laughing because you think this is in jest. NOPE, the jokes on you because I ran the ER strapped to an IV pole one night rather than getting sent home. In the last three weeks I have been shot up with Toradol and Zofran in every intramuscular spot imaginable. It reached the point where when I would drink a glass of water it would stream out my hips, buttocks and shoulders like a sieve. So I've been slowly getting sicker and sicker as everyone in the ER watched me get thinner, more pale and finally begin to make serious mistakes. The day before I was finally allowed to go home sick, I missed a pelvic fracture on an old man hit by a car. A nurse saved my ass when she insisted I walk over there to re-examine him as his blood pressure kept slowly dropping. This was her third time coming to me and I kept telling her to "just put up another liter" because I didn't want to walk all the way over to Bed 3. He was 80/60 despite three liters when I finally went over there and as soon as I touched his belly I knew he was in trouble. He got emergent embolization, transfused two units and sent to the ICU. All because I fucked up. Because I had no business being there in my condition. I knew it, all the nurses knew it, my bosses knew it. But such is the nature of medicine. We care for the tired, the sick, the huddled masses. We are here twenty four hours a day, seven days a week and all major holidays: Our doors never close. We don't turn anyone away regardless of ability to pay or country of citizenship. We are the place of last resort, the quintessential safety net. We will help you when no one else will....unless you happen to be wearing a white coat. Then you need to suck it up and get your ass back to work.
Our program in particular should have known better, had swore that we had gotten better after what happened last year. You see last year, one of residents had been getting more and more tired, had been getting slower about picking up new patients. Just not carrying her fair share, it had been agreed. Her co-workers of course did what we were expected to do. We rode her harder, picked on her, and threatened her with failing the program if she didn't get it together. She didn't. She ended up in another hospital's ICU on a ventilator, almost dead, with a diagnosis of leukemia. I still wonder what that meeting of attendings most have looked like when that tidbit of information came out. Did they feel like shit for even one minute or were they just worried about covering her shifts. I have my own personal thoughts on that one, but hey I'm a cynical bitch. She is doing okay now. If by okay you mean she will never have kids, she lost her house, and she has to finish her final year of residency or she has no source of income, no health insurance. She has trained her whole life to do one thing. And now everything she had been putting off and waiting for since medical school is gone, that the dream she had been reaching for disintegrated right when she could final touch it. She gave everything to medicine and like the selfish bastard it is, it just kept taking. Her heart is not into medicine anymore, not that I blame her. I know a little about what it's like to give yourself heart and soul to something and almost have it kill you, oh yes, I do. I imagine her story starts in a bright white room to the sound of a ventilator slowly pushing air in and out of her diseased body. But it is her story to tell, not mine.
After this we promised that we would be a more compassionate program. That we would have back up so that if someone got sick they could take time off to get better. That we could all attend funerals, births and weddings. Except we just failed our first test. For those of you who are confused about why this works this way let me explain. In our department there are only four true physicians who are working at one time There are two second year residents (R2's) and two third year residents (R3's) at any one shift and they are the work horses of the department. The R3's are one year ahead of the R2's and so can work pretty autonomously. I am an R3. I can intubate, run a Tier II trauma, run a code and stabilize critically ill patients by myself for the most part. I still fuck up a lot though, which is why I'm still in training. Compare this to an R2 who may or may not be able to put in a central line, may never have run a code by themselves, and have never seen a traumatic airway with blood and teeth and vomit obstructing your view. It's important to have at least two skilled docs on because multiple traumas pour in at the same time plus we get the sick medical runs. Now none of these people can wait, it is life or death right then and there. You need a doctor at the head of the bed for each of these and we barely make it with just four doctors on and only two seniors. If you take out an R3 then we have only one person on who has necessary skills to see sick patients and that's just not enough. Don't tell anyone, but We just can not do it. That's how we ended up with me running a trauma attached to an IV pole. There was no one else available at the time. Part of me understands it and part of me doesn't. There is no backup plan, no re-enforcements to call in when all hell breaks loose in the trauma bay, we just make do with what we have. And while that is happening fast track is being opened up and the charge nurse is having an aneurysm because the 20 year old with chest pain hasn't been seen yet, even though we all know they are not sick. Some shifts are a nightmare and some are no big deal and you never know what your going to get. That's why I'm dreading going back to work. I'm one week post-op and I' m not sure that I am physically up for the challenge.

And let's be honest, I'm angry. Angry that I was allowed to get that sick and no one gave a shit. My last shift I showed up to work febrile with a heart rate of 138. My white count was 19,000 and I was damn near septic. I was sicker than most of my patients and I still showed up for work because that was what was expected of me. Its hard to look at my attendings and not wonder why any of them did not put a stop to this sooner. Didn't put their foot down and insist that I go home. I feel like I've lost respect for people who I work for and that makes it hard to go back . Its hard to work for something that seems to care so much for everyone else but looks the other way when we need help. A system that works itself into a frenzy when a patient accidentally dies across the street but looks the other way when it's one of our own. Medicine is like a marriage, we take the good with the bad, faithful to it and nothing else. Putting it above our real families, our real spouses and our own children. But I'm pretty sure that last line, in sickness and in health, was never intended to be a suicide pact.

Sunday, December 07, 2008

Its late, I'm tired and I'm scared as shit to fall asleep. I have a fairly long history of nightmares, I would suspect most people in my situation would, but the intensity has been ratcheted up lately. Most of my bad dreams occur with such regularity that they no longer have the ability to frighten me. I wake up from them and shrug them off as a marker of my current state of mind, like something akin to a nocturnal mood ring. More adventurous women can relate to my dreams like their stable of lovers. "Hmm... last night I was with John, I must be having body issues today" or "Rob again, guess I wanted comfort sex'. Same concept, different circumstances.
Except, in the last few days my nightmares seem to have crossed over into my waking moments a la Freddy Kruger. I wake up in my bed, sweaty, my heart pounding, and I know I'm awake but I'm still surrounded by this malevolent force. I don't know how to shake it off. With each creaking of the house I anticipate someone coming for me, hunting me. It's waiting, bidding its time for the assault to begin. When I give it a form it becomes a vulture perched on the footstool, hungry to pick over my carcass. When it lingers behind me it's so tall, it casts this enormous shadow over and around me, blocking out the light. It's Benecio Del Toro's character in The Cell come to visit in my sleep. Horribly and intensely violent, graphic and disturbing. The worst is when it's the dogs. This snarling, rabid pack that descends on me in a feeding frenzy and rips out my throat. I am pinned beneath this heap of anonymous teeth and claws, my face seared with their body heat and spurts of hot blood and I can't breathe. And I wake up gasping, hungry for air, thinking that its all over it, its just a dream. But its still there. And I know I'm awake. It's not as if I'm confused about that, but it's like the nightmare is following me out my dream state, stalking me. I wake up and I'm terrified to even turn over because I'm convinced that it's there, sneering at me. I can feel its breath on my neck just as real as I can feel the heat from my lap top right now. So I just lay in bed. Frozen. Listening. Trying not to breathe hard so it can't find me. I can't close my eyes either because even though I don't always remember my nightmares, I still know whats happening in my slaap is infinitely worse then what happens when I'm awake. And this goes on for hours and hours at night.
The inner psychologist in me would say it's because I'm starting to feel emotions again rather than living in perpetual numbness. And I'm sure some good will come out of this but for right now it is sapping the last bit of strength and dignity I have left. I'm 30 years old and I'm afraid of the dark. I'm shaking right now because I know I have to sleep tonight and I know what's going to happen. Sometimes I try to stay up all night but then I'm just exhausted the next day. I'm struggling against the bogeyman and he is winning.
A friend of mine who knows some of what I'm going through, enough to know that he should be worried about me, offered to let me sleep at his house with him. Nothing sexual, just a chance for me to get some actual sleep. I initially said yes, and now have backed out of it. And I don't know if I should or not. The idea of falling asleep in the arms of a man I trust is like Heaven to me. But what if he makes a move or tries to kiss me. What if I have a nightmare and flip out on him. Not just cry, but full on PTSD flip out. I was out recently and someone playfully grabbed my neck like they were fake choking me and I thought I was going to die. I froze up, I almost vomited. Luckily I didn't scream, but I was with people who don't know my current situation and there was no hiding my reaction. And that was an ideal situation: I was in a good place emotionally, I was in public with multiple people, I felt like I was in control. Counter that with me being in a one-on-one situation with a man ( and I am terrified of men, fucking terrified of them) and its a recipe for disaster. So he's a little upset with me for backing out, and I'm still alone at night with these nightmares. Sometimes I run through my phone book texting friends hoping one is awake and can keep me occupied for a few hours. But that is going to get old fast, and soon they're going to start asking questions, and I am not read to go public yet. I just don't know what to do. It's late, I'm tired, and I'm scared as shit to fall asleep.

Thursday, December 04, 2008

Start where it starts...

So it's about time I buy a return ticket back to reality and writing seems to be the only vehicle that knows the way home. After all the fighting to stay true to who I am and not lose myself, I suppose I will admit that it was a forgone conclusion the entire time. I was never going to win. I was never going to be the same person I was before becomming a doctor. There is no way to learn the true nature of the human spirit, the miracles and horrors, and then walk around the supermarket like every one else. You are all walking trauma victims, heart attacks, and ICU players. I don't see you in front of me. I see your veins and gauge how easy it would be to start an IV. How quickly I can crack your chest. I look in your cart in line as we wait and try to guess whether its your diabetes or cholesterol that will initiate our first meeting. Your buying your grandparents 50th wedding anniversary cake and I am wondering which one of them will walk out of my ER alone. Lets face it, the chances of them dying together is fairly slim. One day Nana is going to lay down in her bed, and for the first time in her adult life there will be no one beside her. Although she can stretch out, she will curl up on her side of the bed, unable to break a habit that it took a lifetime of companionship to learn. His silver hair will still rest on the pillowcase, she will smell him in the sheets. And as her heart breaks and an empty house fills with anguished sobs, she will picture my white coat and hear those simple and inadequate words. "I'm sorry, he has died". When people think of the worst moments of their lives, they see my face. So lets stop pretending that you and I are the same.

So this particular free fall starts and ends with a popcorn ceiling and a pale pink room. I am starring up, and the light is streaming through the window in such a way I can see the dust dancing. It s early morning and I can't move. Like a trauma patient strapped to a backboard I can only look up and side to side. I hear my colleagues voice in my head, a very unexpected source of comfort. "Its okay, your going to be alright. Your safe now". For the last year I have heard this particular surgeon whisper these words to every terrified MVA and GSW in the trauma bay. And for the last year I've always wondered how no one, not even him, noticed that the most injured person there was the one at the head of the bed. I takes a second to piece together what has happened, a little anoxic brain injury I imagine. I have been lying unconscious on my daughter's nursery room floor because my husband just finished strangling me.

I was almost seven months pregnant when I got a call from another hospitals emergency room that he had been brought in to after having a psychotic break. In retrospect he has been unraveling for years, I was just too busy reaching for my dreams to realize he was uncoupling from reality. I blamed myself, my unwavering pursuit of the dream I thought being a doctor was. Our daughter was my last attempt to prove to him that I loved him more than medicine, more than myself. I thought it would give his life purpose again but it simply accelerated his demise. I just didn't see it then. I see it now.

I have spent the last year trying to reach him. Being the good wife and refusing to accept the diagnosis and all that it entails. Going to the doctor's appointments, the group therapy, counting out his pills. I've been chasing him down the rabbit hole that true mental illness is. This potion makes you bigger and this one makes you smaller, but I'm looking for the one that makes you my husband again. And it has taken until this moment and this morning to see that the man I fell in love with no longer is. He hasn't died, he didn't leave. He just no longer exists. Perhaps one day I will be able to explain it better then this, but not today. The loss is still too great and the wounds too fresh.

It starts with my daughter crying in her crib and me not getting there fast enough. I had just opened her door when he grabbed me by my hair, threw me down and began to strangle me. I trusted this man with my life and I have now learned the hard way, the hardest way there is, that I made a mistake. He easily overpowered me and the whole time I clawed at his hands, fighting for air, waiting to wake up from this nightmare, I looked at him. I looked deep into the eyes of the man who I have loved since I was seventeen, the man who I chose to walk to on my wedding day. I looked at him and realized that the man I was looking at was a complete stranger. He had no sorrow in his eyes, no regret, no remorse. He was and remains completely untethered from reality. He just gripped tighter and tighter. So tight I never had a chance to scream or get a tear out of my eyes. So brutal and quick I never got a breath in. I never got to reach him, to pull him back from the cliff and bring him back home. Back to a time when the world was ours and we were going to grow old together. To celebrate our 50th wedding aniversary. I looked into is soul and saw a madman there. One who didn't recognize me anymore. The last thing I remember as blackness began to envelope my head was thinking "Oh my God, he just fucking killed me"

Then I came to on the floor, staring at the popcorn ceiling in the pale pink room. The most violent moment of my life juxtaposed with the serenity of my child's room. A shattered life in a Mother Goose nursery rhyme. My life ended in that room that morning. I keep walking and breathing but I will never be the same. I am desperately trying to get out of my marriage right now. I walk through these hallways terrified most days, waiting for that madman to come out again. At work I see him in every 5150 that rolls through those doors, raving against unseen henchmen and pursuers. I am afraid to breathe wrong, to commit some unknown crime and suffer the punishment. I am struggling to be a good doctor and a good mother. I still hold true to my vows and be a good and faithful wife, but it is to a husband that no longer exists. I know I have to start over, to start somewhere. But I don't know how to get this train back on the tracks. I am lost, but I am trying. Everyday I put on my white coat and navigate through the sea of humanity that is the ER and wait for someone to give me comfort, to heal the healer. Someone to walk into the quiet room and tell me "I'm sorry, he has died". To let me be the griving widow and you be the bearer of bad news. I want to cross back over that invisible line that seperates us and be one of you. But we are not the same. And its about time I accept that.

So here's to starting over again, just as messy and painful as you remember. I had hoped to make myself something more, to make you all, my dear readers, proud. To tie everything up in a neat little bow. But if I keep waiting for that moment I will never get my feet under me again, never halt this year long decent into madness. So I will have to make my new begining here, from the floor of a pale pink room, instead. But as I heard someone once say: It starts where it starts...