Words Matter, Until They Don't

(This is based on an actual patient story. Names have been modified to protect privacy of those involved).

Jenny awoke with a start, leaning up on her elbows, alert and still, slowly scanning her room and her bed.  There was her TinkerBelle, there her Woody, Buzz, and Jessie, there her Knuffle Bunny, and there was Dora, and there an array of Beannie Babies.  All looked in order.  But so silent, so very silent was the house.  An unfamiliar silence, the kind of silence that suggests something is off, something wrong, something perhaps not safe.  The way birds grow silent just before a tornado hits, or dogs before an earthquake.  She sat motionless, trying to discern sounds in perfect silence, the way one tries to “see” imaginary shapes with eyes closed in the black of night.  The unease grew and she ventured out, tiptoeing down the hall, and the smell of burnt matches and something slightly sweet permeated the air.  Opening her brother’s door slowly, bathed in half light from the NY Jets night light on his dresser, strange shapes slowly came to focus.  It must have been a minute or longer from when she saw it to when she allowed herself to see it, and what was frozen in anticipation now was frozen in fear, and trauma.  He lay on his side half off the bed, left hand dangling down touching the floor, just off to his side the handgun, still smoking.  She stared at those details for some minutes, frozen in place, and then scanning up saw the blood and the bits of something on the wall, and then slow and deep like rumbling thunder came the shrieking, “Mommy, Mommy . . .”

The next moments came as a blur, a line of staccato images one after another, devoid of feeling in a strange way monotonous.  Those of us not touched by severe trauma have glorified Hollywood conceptions, but in fact in these moments the psyche enters shut down mode rather quickly, deflecting all of our energy (physical and mental) to more important fight or flight instincts.  So what seems like a hyperarousing event often quickly becomes a monotonous serious of single small events one after another . . . disjointed . . . disconnected.  And the moments passed over her – mother yelling at her for waking her up – mother realizing – mother pushing her aside and crowding over the body – mother screaming – frantically looking, wide-eyed,  for the phone – yelling at dispatch “Stop telling me to calm down!” – holding his pillow behind his head to stop the bleeding – crying her mantra . . .

“No, no, no . . . not this, no . . . this is ok, this is ok . . . he’s ok . . . he’s gonna be ok”

And as mother began to realize the gravity of the situation, the trembling in her voice worsened until she couldn’t speak.  Jenny snapped out of her daze, picked up the phone and told dispatch where they lived.  Followed was a continuous blur of strange images- blue flashing lights, paramedics running, words like “STAT” and “IV” and “compression” and “hang on God Dammit!”, the officer holding mother back from the ambulance, the paramedics neutral blank-faced look as he lifted the sheet over her brother’s head, the numb look of neighbors standing on the sidewalk.

Jenny already knew he was dead, she knew it when she entered the room, she knew it before when she awoke with a jolt.  She knew.  At such moments the knowing comes in small gradations, not absolutes, and the knowing grows towards confirmation, but the knowing was there long before.  Children are perceptive of such nuance, they must be to navigate a world run by adults who control that world in so many ways yet make so little effort to truly understand them.  Children are master readers.  They haven’t honed the ability to self-delude so easily yet.

Three weeks later, mother has fallen depressed, on the bottle again, can’t go on.  Jenny finds her one night, drunk, holding the same handgun, sitting on the couch.  Again, she calls the police, and both are brought in on emergency custody.  It’s a quick evaluation, a “slam dunk” as we say in the callous tone used by emergency personal- perpetuated as a defense mechanism allowing us to maintain our intellectual and expert focus, by trampling the immobilizing humanity of these moments. Mother knows she needs help, Jenny says almost nothing.  Mother is involuntarily committed, and as I walk Jenny away she casually says to me, numb . . . monotone . . .

“It’s my fault, you know?”

“You’re fault” I ask, “Why do you say that?”

“Mommy only got a gun because she kicked Daddy out after he tried to touch me, and he wouldn’t leave, so after he beat her up and then left, she got the gun from Uncle Jimmy, she got it for our protection.  If I never told on Daddy, she wouldn’t have the gun.  That night I was yelling at my brother for messing up my room, and taking my iPod, and I called him a jerk, and a dork, and said that’s why none of the girls at school like him, and they all think he’s a loser.”

We walked on in silence for a few minutes . . .

And then she turned to me, and finally some subtle emotion broke, and she asked with full sincerity “How do you say sorry to your dead brother?”

Fade to Black.
______________________

And the short answer is, “You don’t kid, you don’t”

What you can do is say sorry to yourself, and to those you affected, and in a righteous world maybe they’ll say sorry back.  Sorry for putting you in a situation where you had to tell on your Daddy for touching you, and setting in motion a chain of events where he beats your Mommy, then leaves, then Mommy feels she needs a gun for protection, in a house with two young kids and a mom with two jobs.  Sorry that our society doesn’t have checks in place to prevent this shit from happening.  Sorry that you need a license to drive a car, do someone’s taxes, or even catch a fish, but no such regulation on bringing children into the world, and more importantly parenting them. 

There are a long line of sorry’s, some we owe, many owed to us.  That is a real tough lesson for an 8 year old.   I hope no one, at age 8 or age 38, has to learn that lesson in that way.  But we learn those same lessons somehow, the lesson that we’re all on limited time and we’re all vulnerable to the tragedies of life, although admittedly some have the cards stacked against them.

I recall a great TED talk by the conductor Benjamin Zander.  A great talk, funny, witty, informative, and so very hopeful.  At the end he shares a story about a woman he met who was an Auschwitz survivor.  She was 15 and her brother was 8, they were on the train on the way to the camp, their parents were already gone.  She looked down to notice the brother lost his shoes.  It was bitterly cold, and snowy, and she reprimanded him for losing his shoes, “You idiot, you’re always losing things, how could you lose your shoes now.  You’re so stupid.”  And they arrived at the camp, and were separated and she never saw him again.  He didn’t survive.  She told Zander that once liberated she made a decision . . .

“I’ll never say anything that couldn’t stand as the last thing I ever say.”

Powerful words to live by.  We have to live with our actions and their consequences, and our words ARE actions and they have consequences.  I don’t blame my patient Jenny for the death of her brother, that is a complex issue with many factors.  But she blamed herself, and likely still does.  And in the end analysis, we have to live with our actions, and our words, and decide when and how much to forgive ourselves.

But Zander also says something quite hopeful as well, reflecting on Nelson Mandela’s time in prison, and comparing it to the composing of Frederic Chopin, he says that both have to focus on the “Long Line” in the trajectory of their work and what they are doing.  Much like looking at the big picture, and that’s hard to do amidst trauma and youth, and so many other painful moments in life.  But Zander’s line speaks for itself  . . .

“This is about the long line.  Like the bird who flys over the field and doesn’t care about the fences underneath.”

As pain and tough decisions and joys and sorrows and triumph and vulnerability all come your way, and they all will, remember the Long Line, and try when you can to muster the courage and the strength to be like the bird taking flight and transcending all the feeble fences that life may throw your way.