I Can't Get To Sleep
by Bassey Ikpi
"I can't get to sleep
I think about the implications
Of diving in too deep
And possibly the complications
Day after day it reappears
Night after night my heartbeat shows the fear
Ghosts appear and fade away
Come back another day"
– "Overkill," Colin Hay
The Emergency Room: The First Night
It smells like what I imagine death would. Stale. Thin. Like the air has forgotten how to move. This is the kind of place that will steal your spark. That scares me more than what brought me here. I wish I could stop crying. There must be something here that makes everyone who has passed through give up a part of themselves. It would be easy to succumb to the mind numbing white walls and obstinately shiny linoleum floors. Yes, this place smelled like death and hopelessness and ammonia. And I have been here for four hours.
I wish I could just stop crying. The security guard reads from a textbook and seems to hear neither my sobs nor my, “Excuse me, sir?” When he finally thinks paying attention is worth it, he turns around. I wish he would have remained with his back to me because everything I ask for is denied and dismissed, with, "Sorry. I ain't make the rules." I hope he fails his exam.
Diane is in the waiting room. I feel guilty for making her wait. I feel guilty that she had to bring me here in the first place. Always feel it when people are concerned. I've been told that guilt is normal. It probably is. I just know that I am not. The waiting room is just on the other side of the door. I don't know what Diane is doing but every once in a while I can hear her voice echo from the hall. "Can I just see her?" I’m hoping she will get through, but the security guard rejects her requests as well.
I sit at the edge of a thin mattress waiting for someone, anyone to come in. I'm in this room alone. I can hear a soft moaning from somewhere down the hall. This scares me even more and I want to block it out. But I was instructed to leave the door open; outside is a steady parade of nurses and doctors. None of them know my name. They huddle outside the door and talk to each other like I don’t exist. I’m not sure if I’m supposed to be hearing this.
“So why is that one here?"
"And in the room next to it?"
"“Severe abdominal pain …“
"And that room?”
“Severe depression and potential suicidality.”
I'm digesting the word, “suicidality,” adding it to the list of words in my head right before “adumbration” and right after “euthymic.” I’m playing with these words, saying them over and over, allowing them to roll around on my tongue. I do this whenever I hear a new word. It’s the only normal thing I’ve done since I got here. My game is interrupted when I hear “Room 1” and “28 years old” and “underweight.”
I’m not sure if they are talking about me. Underweight? They can’t be talking about me. I haven’t gotten that small… Have I? When a few of them glance in my direction, I am suddenly ashamed and fold my arms across my chest. They all remain huddled around the door.
I shouldn’t be here.
It will be another 2 hours before someone actually enters. She is the attending nurse. She tells me she has only come to take my vitals. I don’t know what that means and am not sure if I want them taken. I have nothing but these paper scrubs. When they are wet, they stick to your skin like shame. I discovered that the first hour I was here. At least there is no more crying. I don’t really feel anything now, just a slight swimming in my head.
I wonder what people will say. Diane said later that I was in shock. All I know is that I am so tired. I don’t realize that the woman has already taken my temperature and blood pressure. She grabs my wrists and notices how thin they are. I pull my shirt up before she sees the way my collar bones struggle from my skin. The shirt tag reads XXL so it quickly falls off my shoulder again. The nurse asks if she can take my blood.
"Only if you buy it dinner first,” I say quietly. It is my first joke in 3 days. I want to keep what little spark I have left. The nurse ignores my stab at humor; I fall silent again. She struggles to slide a needle into my skin. I can tell she is new by the way she turns and taps the inside of my elbow searching for a “good vein.” I don’t know what the difference is. Maybe I could have helped. She finds one that looks like it behaves and slides the needle in again. No blood comes. She removes the needle again and attempts to find another vein and another and another. They are all empty. I wonder if I'm already dead. I bite my lip but can do nothing to stop the tears. The nurse ignores all of this; she is still stabbing and searching. I am only trying to keep breathing. She finally finds an open vein, and the blood seems to pour out of my body like it has been waiting for its freedom. She gives a self-satisfied smile. I watch the red race through the tube and fill the vial. I’m not sure I will have anything left. I start to ask her something, but she is done with me, instructs me to hold a square of gauze, and then tapes it to my elbow. This will stop the bleeding. I close my eyes and wipe my face with the back of my hand. So much for not crying. I swallow and ask, “What should I do now?” but she was gone before I looked up. I press the gauze and tape hard. Something about the pain makes me feel alive.
I’m alone again.
And still no one has asked me my name.
Day One: The First Night / Early Morning
It is maybe three in the morning. I have finally been admitted. I have nothing but the shameful blue scrubs and my fear. I’m in a wheelchair on a floor that will be my home for the next few days. Next few days… No one will tell me when I get to leave. The nurse who wheeled me up said, “You haven’t even been here yet. How would we know when you get to go?” I couldn’t answer that. I just stared at the hospital bracelet around my apparently-too-thin wrist. “Ikpi, Bassey admitted for ______.” I have been reduced to a condition. I don’t want to be here. I’ve never been a patient in a hospital. As a matter of fact, I’ve only been to the hospital to welcome newborn babies and see my mother at work. She is a nurse that would smile.
I am alone again. The bed is small and lumpy. I am grateful for my own room, but the quiet is unbearable. There is no television. No radio. There is only the sound of my heart pumping much too fast. I start to panic. I am afraid that I will be trapped here, will be lost here, just a part of the system. I wonder if Diane has reached my family. I need someone. I’m afraid to cry. I don’t want them to wonder about me.
I lay flat on my back with a thin, scratchy blanket over me. It is so cold here, but I refuse to change into the regulation white cloth scrubs. I don't want to feel like I belong here. I close my eyes and try not to think of the number of bodies that have been in this bed, the number of people who have pulled this same blanket around them. I can't think of these things or I will never rest.
Sleep is as impossible as privacy.
I've been here for two hours. The door to my room is a constant metronome of opening and closing. I've already learned how to time it. Can figure out who and why before they step in the room. The ones checking beds fiddle with the knob before they enter. There is one Jedi sweep of their flashlights, and then they are gone again. The nurses arrive quieter and quicker. They are in the room and by your side before you notice that you are no longer alone. These nurses are a bit better; they take your temperature and blood pressure. Some ask how I am and look like they would listen. Others ask and turn their heads before the words come. I've decided not to say anything to any of them. I don't want them to know. Besides, I know that it is all in the charts they carry. I have been here for 4 hours. Everyone who enters the room reminds me that it is a weekend. "Our usual doctors are out. You will soon meet the weekend team.” They are all saying that no one can help me yet. So I just nod; I am afraid to speak. I’m waiting for my family to arrive. I am waiting for my friends. I am waiting for someone who will speak for me. My voice has betrayed me too often. I need someone here with a spark of empathy. I need someone who will care. These people do not; they can’t. To them, I'm just another patient. Just another faceless body on a conveyor belt of afflictions.
Day One: Morning
I’ve watched morning arrive. I can’t sleep here. This silence is anything but peaceful. It sounds like the walls hold muffled screams, like there is something waiting just under the surface. I lay awake waiting for the explosion. I can hear the other patients outside of my door. They seem to enjoy this place. They can't seem to hear the quiet. It is not soothing or peaceful. It creaks and groans and smells like the end of you. I refuse to sleep here.
I am not like them.
Day One: Afternoon
I have not moved from my bed. Nurses have come and ask that I eat or talk but I shake my head. I want only to lay here until I’m told I can leave or die, whichever comes first. The nurses deliver messages from my doctors. They say simply, “Bassey, you have to try.” In my head, I answer, at least I’m not dead. I'm not sure if this is better.
I daydream. Stare off into space and think of places I'd rather be. I sometimes hold conversations with myself. I’ve done this for as long as I can remember. It helps me organize the rapid tumble of words in my head, and provides an internal monologue that keeps me from losing my mind here. In the middle of a sigh and nod of agreement, a doctor enters. I am once again shy. I don't know if he's seen this. I hope he doesn't think that that is the problem. I can’t stay here too much longer. He wants to take my blood pressure again. The nurses have commented on how high it’s been. They wonder out loud if something is wrong.
There is: I'm scared.
He studies my chart and asks me if I have a history of heart problems in my family. I nod and say, "Yes, but only the broken kind."
He doesn't look up but throws a low, tired laugh in my direction. The nurses don't smile. But I imagine that he is 16 hours on an 18-hour shift, that he has been yelled at and threatened in the last hour alone. "At least this one makes jokes," he will think. He will tell the others how I'm different. He will tell them that I have a spark. He will say that there is nothing wrong and let me go. I'm so lost in my fantasy that I am startled when he turns quickly to face me.
"Tell me what brought you in today."
I want to say, "a cab.” Something else to encourage a laugh or a smile. He looks up waiting for an answer. I don't know what to say. I've been here for hours, and no one has asked me anything that wasn't clinical, that is, if they ask me anything at all. I swallow, hold my breath and exhale, "I don't feel good." My voice betrays me and breaks into sobs. It had been 45 minutes since I last cried. I was going for a record: one full hour. I didn't want them to see this. I didn't want them to know that this is what happens. The doctor sits patiently waiting for the sobs to shorten. I’m sure he has been here before. I don’t know how, but I can see him resisting the urge to hold and comfort. This only makes me cry harder. I am shaking and weeping and tired and ashamed and scared and alone. I’m angry with myself, I cracked for this one the others think I will crack for them too. He pats my knee and offers me a Kleenex. It is all that he can do. His job calls for distance. I will only be a medical chart after he reaches for the door. He and I are the same. I take the Kleenex; refuse to get attached.
He asks me again, what brings me here. I swallow and shrug my shoulders. "I don't know."
It is all that I can do.
Day One: Evening
My family and friends have come and gone. I thought I needed to see them to feel better, but it only made the fear and loneliness even bigger. The look of fear on their faces terrified me. Their forced platitudes and words of encouragement frightened me even more. My father wanted to know what happened so he can fix it. My mother wanted to speak to everyone on staff. I wanted to tell them that it is all a big mistake, that they will release me as soon as they realize. My sister doesn't understand, and it is her that I want to understand me more than anyone else. I want her to be able to explain it to my parents. I want her not to feel shame. My real voice is locked somewhere, but she can't figure it out herself. I don't like to worry people. I didn’t want to trouble them with concern so I smiled as often as I could, laughed when it was called for. I avoided questions that I couldn't answer, deflected questions to answers that I didn't want to know.
"I'm going home on Tuesday, no matter what," I tell them.
My mother begs me to stay until they can help me, until they can figure out what to do. So I will never have to come back here, I nod. I don't tell them how frightened I am. I don't tell them how long it's been.
But I nod, say, “Yes, Mum," until she is satisfied. It's worth it when I lean into her and put my head on her shoulder. She kissed my forehead and held my hand. I'd almost forgotten how much I need that. I want to tell her that the nurses don't smile, but I'm not sure she'll understand. She is a nurse that smiles.
They stayed until visiting hours were over. I needed them longer than that. They told me they’d be back; I wasn’t sure if I believed them. This place leaves me terrified. I don’t tell them that. The nurses tell them that I don’t eat. They tell them that I don’t talk. My father wants to know why. My mother demands that I do. "They won't let you leave unless you follow the rules." My friends understand, and one comes with pens and a pad; the others, food and magazines. I can write again. I wonder what I have to say about all of this. I wonder how much I'll share. I leave the pen alone for a few hours. I read the magazines like I'm in them. As always, the food is more difficult.
Things that create pictures and record sound are not allowed. My cellphone does both, so they took it when I checked in. Maro smuggled my Sidekick and charger in for me. She knew I needed it. It is my only link to the things that make sense to me. I’m careful with it. When the nurses come, I hide it under my blanket or pillow. I’m not sure if the Sidekick itself is allowed, but it is all I have and will not risk them taking it away. The charger is trickier. I keep it stuffed into the toe of my shoe. Sometimes, I put a dirty sock on top so that even when it's picked up, you still can't see what's inside. The sock is filthy. The nurses cut their eyes at me and wrinkle their noses. I don't care if they think I'm dirty. At least I have the only thing that I need. This is the only rule I will break.
I want out of here too badly.
Day Two: Morning
Still no regular doctors. It's the weekend, you know? I mouth the words with everyone that says them. I hope they don't notice. It will be another reason to keep me here. I make a mental note: from now onwards, I will only get sick during the week.
Today will be the first day there are huge spaces between crying. Today is the first day I ask a question. The nurse is shocked but doesn't have the answer. She tells me that she will "ask the weekend doctor." We finish the sentence together. I tell her not to bother. She doesn't want to let go of the fact that I'm speaking. She asks me if I want to come into the lounge or get something to eat. Maybe I'd like to meet some of the other patients. I shake my head. I'm fine.
"You're going to get bored. You can't stay cooped up in your room forever."
I remind her that I can. "It's one of the reasons I'm here."
She nods and exits the room quietly. I hope I wasn't rude. I'm just not ready.
I'm writing again.
Day Two: Morning/Afternoon/Evening
The regular doctors don't care either. They talk to each other, not me. I'm angry at them for taking so long and for forgetting that I am not a case study and much more than the medical charts they cling to like needy children. I am tired now. The sleep is still slow and often interrupted. I have little use for these well rested, well-groomed doctors and their questions. They've already been told about me, have spoken to my regular doctors. I have little to say to them. They still offer treatments that I know damage my body. “I know my body,” I tell them. I know what makes me feel worse. They nod and make notes. The youngest looking one begins his sentence, "We were thinking of putting you on Geodon..." I've told him already that I can't take that, it makes me feel too numb. And the other one brings headaches. And that one makes me tremble so much that I can't sit or sleep. And the other one upsets my stomach so much that what little enters erupts out of my mouth like punishment. They stare at the bones poking from my shoulder blades. They scribble furiously into their pads. I tell them that I want to talk to my regular doctors. The woman who vaguely resembles Belinda Carlisle reminds me that my doctors are not here. I tell her that neither was she the last few days. I want to be seen by people I trust. You lot can continue taking my temperature and blood pressure. I will not take anything they give me. They insist. I tell them that I'm sensitive to medication. The one with the Payless shoes and homemade haircut seems to be a resident. He does most of the writing. He is too young to look so haggard and weather worn. He sighs and tells me that this treatment has worked for countless others like me. I tell him that I am not countless others and he doesn't know what I'm like. I want my regular doctors. I want my mother. I want someone who understands my body and my reactions. I want someone who will listen to me. I need someone who cares.
They write furiously in the books. I know they are labeling me as difficult. I don't care. I hate them all. All the anger I feel is betrayed by the tears streaming down my face. I am terrified and shaking. Why won't anyone notice this? They all stand and watch me weep. I hate them even more. One of the silent ones says, "We'll leave you alone now and try to get your doctors on the phone." I manage a thank you as they file out of the room. The door snaps behind them. Aside from the bed checks, I am left alone for the rest of the night. I'm not sure if this is a punishment or a reward. I try to be grateful for this pocket of quiet, but it creates a loneliness that recalls the curl and crying of the first day. It reminds me of what brought me here.
I'm starting to no longer feel like myself. I don't want to be here.
At least I'm not dead.
Will not continue . . .