How much danger will these scars bring to my care?
I’ve regretted it.
Sometimes. That day (several to be honest), I disfigured my arm.
At the time, in my beleaguered mind, it was the only thing I could do to cauterise that crack in my traumatised psyche - the gap where all the flashbacks and pain streamed out. Desperate to get rid of invisible, hurtful hands on my skin, I burnt them off.
It made sense, at the time.
But, decades later, sometimes I’ve wished I could go back and cool that bit of hot metal, before it reaches my skin.
The burns themselves don’t cause me physical pain anymore, all the damaged little nerves back doing their normal painless thing after years of searing itching.
And, used to the scars, I almost forget they’re there.
What plagues me is the fear. Not fear that I will self-harm again, I don’t think I will. It’s a tingling fear of accidents. Not of someone else inadvertently harming me, but of me inadvertently harming me.
I stress about accidently burning my hand as I slam the iron down, distracted by some noise; ripping my arm on a jagged piece of metal; breaking a leg as I trip on the 12th stair of the dimly lit staircase; or worse, absentmindedly overdosing on the many, many pills I take every day.
Thankfully, the overdose risk is now minimal, courtesy of a webster pack doled out to me weekly by the chemist.
Yet, that fear of accidents, particularly overdoses, is powerful, lingering, spurred along by nightmarish memories of A & E trips where, cringing in fear, my brain flipped between the potential damage to my liver/stomach/brain/whatever, my billion PTSD hospital triggers, and the staff’s reaction to my scars. How much danger will these marks on my skin bring to my care? I would wonder. Will this be a quickish in and out hospital trip, or will those scars tip it toward an enforced extended stay?
Slumped on a plastic-coated crackly bed as harried staff shoved a pulse reader on a finger, a blood pressure cuff round an arm as they stabilised me, my drug-fuzzy mind would wait for the pause which inevitably followed.
All eyes now stuck to my arm.
They really are quite visible, my scars, particularly when seen through new eyes.
Pale, they patch my tanned skin like globs of mismatched paint, their appearance resistant to sunbaking and bio-oil products.
Once those scars are spied by doctors, nurses, specialists, allied health workers and anyone who takes blood, reading my electronic medical file with its list of psychiatric diagnoses, episodes of self-harm and suicide attempts, becomes superfluous, as all eyes interpret the hieroglyphics of my skin as it lays out their version of my story, past and present.
Even trainee medical people see through my whispered excuses, swatting aside my vague description of “a kitchen mishap many years ago” (emphasis on the “many years”) and “it’s just an old burn” as I pray that they don’t push for details (lying by omission is not really lying but fibbing is lying). I would rather not lie. In fact, in this particular environment, I would rather not have the conversation at all, not even to correct their inaccurate details, lest I somehow stumble into a trap.
Their minds tick over.
Is this attempted suicide? Self-harm? Surely it can’t be accidental.
She does (now skimming the file), have a history of self-harm.
My own eyes avoiding their seemingly hostile and accusing faces, ears full of their unfriendly sounding voices firing off questions in too loud tones, I squirm, aware that the reason behind this hospital visit has become suspicious.
Once a self-harmer, always a self-harmer?
Have I overdosed deliberately? Or not?
My claims that I innocently got pill A (little white one) mixed up with B (big purple one), therefore taking four white rather than four purple ones, merely raises eyebrows. They cannot believe that a seemingly intelligent adult can be so stupid. I assure them I can, providing vague examples of my own vague headedness, until I realise that I’m only digging myself into the sort of situation where a suspect should ask for a lawyer (or at least an advocate). Already, I feel guilty for my accidental overdose.
I’ve ended up in A & E because of the way PTSD affects how my brain works, rather than any desire to harm myself. However, bringing up the muddle-headedness of PTSD as the reason for my ‘stupidity’ is dicey here; mental illness + history of self-harm supports their argument more than mine.
Admittedly, my desperate looking face and defensive, clipped answers to their questions, don’t help me out.
Did you do this on purpose? they ask.
Are you sure?
To my suspicious mind, their questions are designed to trap me like quicksand. I won’t be sucked in. So, stubbornly I shut up.
I know it was an accident. I know I am telling the truth. And I know that their thoroughness is designed to save my possibly suicidal/self-harming life. If I wasn’t so terrified, there’s a chance I’d even see it as caring rather than menacing. I understand why they ask these questions. And, snug in the office of a well-trusted GP, those questions would be unthreatening. But in a hospital, the degree the staff believes my answers, combined with their views on self-harm, partially determines how psychologically hazardous my treatment will be.
I gird myself for the “she-has-a-history-of-self-harm” changes in attitude; the subtle switches: bodies suddenly angled away, blood pressure checks sped up as if I’m dirty as well as scarred, my arm flung down after taking my pulse, nurses/doctors’ smiles sliding, their eyes avoiding my face, speech dwindling into ominous silences, muttered comments linking self-harmers and wasted resources. I’m used to all these reactions. Still, I feel vulnerable, threatened, frightened and rejected, every time.
Soothing assurances at regular intervals from staff that they ARE on my side and won’t force me to do anything I don’t want to do, would help here, however, in the absence of that or an advocate, it’s me against every person in this hospital.
Getting upset doesn’t help my case, but inevitably I do. Heart speeding up, dozy headed, feebly I shove and cry as I cringe away from my potential jailors, craning my neck to see past too many uniformed bodies, wires, tubes, beds, trays and mysterious metallic obstacles, frantically assessing escape routes. Will they lock me up in here, sectioned under a mental health act? Pumped full of drugs which make me submissive and unable to protect myself? Will I be strapped to a bed and watched on a bedpan by a burly male nurse, for my own safety? A psych case who is assumed to have over-dosed deliberately?
Will I be forced to stay???
Like a prisoner falsely charged?
Feeling trapped is my worst PTSD trigger and, to me, hospitals are one big cage. Try and keep me in this building and they may end up treating injuries sustained in a desperate escape attempt.
Shivering, wild-eyed, as they deliberate my fate, I half listen to the man in the next bed explain that, fiddling on his phone, he tripped on the stairs, colliding with a banister. Holding my breath, I wait for what should be the doctor’s next question: “did you trip or throw yourself down”? but it never comes. He, I’m guessing, has no suspicious looking scars.
And that means he gets two stitches in his newly battered head as he jokes with the nurse, while I get danger and a drip.
And as I watch that drip, drip, I mouth silently: I know I used to self-harm. But people can change.
That is what I want to say, but never say, aloud.
Instead, my arm ‘speaks’ for me, splotched with ‘words’ I can never erase, with an underlying message few recognise.
I no longer self-harm, but my scars remain an everlasting braille of searing pain and courage.