Tuesday, January 18, 2011

Life with ‘The Situation’

“Well, we’re back in our situation again,” my aunt said.

It was Christmas Day — her 72nd birthday — and she had spent it eating alone at an IHOP in Central Texas. Her husband of 42 years was in a psychiatric hospital, and sadly, this was not the first time.

I can count on my hands the number of times I have spoken to my aunt — my father’s older sister — since my grandmother died in the late 1980s. It was around that time that my uncle and I nearly came to blows over the handling of my grandmother’s illness, and at that point I pointedly walked away from two people who had a long-term influence on my childhood.

A bit of background is necessary: My father became ill when I was 8, and for major portions of my childhood, I spent summers and school breaks in Longview, the East Texas town where my parents were raised. My aunt and uncle lived 10 to 15 miles from my dad’s parents, and I spent much of my time going back and forth between the two houses.

Reflecting on that time, memories flash by like 15-second commercials from childhood, with yellowed and sepia tones. I remember sitting in a boat belonging to my aunt and uncle, hands on the steering wheel and making sputtering sounds with my lips as I imagined being in a high speed chase. I remember fending off the dirt dobbers, the flying bugs that nested in the homes they built in the ceiling corners of their carport. I can see my grandfather working in the huge garden he set up in their backyard, his skin leathered and tan in the years before he became tethered to oxygen. I remember the Dallas Cowboys games and my grandparents’ 50th wedding anniversary celebration at their house, my grandfather dying then.

And I remember the confrontation.

••••••

As I write this, my uncle is in a different hospital. His physical “situation” — my aunt’s word to describe his state at any given time — is not good. He has blood clots in his leg and in his lungs that are life threatening. And then there is the mental illness, about which my aunt is reasonably matter of fact.

“He gets on these kicks,” she said on Christmas Day. “He gets revved up and he starts having fears and hallucinations. He gets paranoid. He can’t slow down. He can’t sleep. He’s all agitated and revved up, and then he starts being belligerent. I had to take him over there because I couldn’t have handled him when he is like this.

“So,” she said with the voice of someone who has been through this countless times, “we’ll get his meds straightened out and then everything will be OK for a while, or at least until he has another one of his episodes.”

My uncle was formally diagnosed with bipolar disorder in 2000, but he had shown signs of erratic behavior for at least two decades prior. Anxiety could make him extremely demanding and overbearing. At one point, he took a two to three week leave of absence from his job “due to nerves.” He retired in the mid 1980s, even though he was only in his 40s. No one knew, or spoke of, the exact reason why.

“We were so dumb. I didn’t even have a clue what they were talking about,” my aunt said. “As he got older, it got worse, and when he turned 60 it completely got a hold on him.”

••••••

I abhor violence. I don’t like TV shows or movies that glorify or wallow in it. However, I do understand primal instinct. The two fights I got into at school growing up were with people who said cruel (and not well thought out) things about my parents.

And no one, absolutely no one, could say anything about my grandmother or cast a vote to prolong her suffering. End-of-life decisions are extremely personal, and when my uncle — during an extremely stressful point in time just days before her death — tried to take control and made a number of statements about what my grandmother “had to do” and what we “had to do” for her, I started to snap.

And just as quickly, I walked away. Self preservation demanded that I not stay involved with someone who put me in a primal state.

I kept in touch with my aunt and uncle through my parents, who served as intermediaries. We exchanged Christmas cards. Occasionally, and usually at my parents’ behest, I would call to check on them.

This year, after my mom told me about my uncle’s latest meltdown and that my aunt had to eat alone on her birthday because he refused to see her, I decided to reach out and call her at home. After all, it was Christmas, and I had a confession to make.

••••••

The conversation lasted 90 minutes. I asked questions and took notes, writing down parallels between some of my uncle’s episodes and those of my daughter, who also is bipolar. Their situations are different, in part because of age and gender, and in part due to the fact that no mental illness/disorder results in the same experiences.

“It’s the strangest mess,” my aunt said. “Everyone has so many different forms of this.”

She went on to describe how and what happened when my uncle’s “situation” became worse, how she has been on a decade long series of cycles that start with emerging paranoia and isolation, followed by anger and depression, then hospitalization and renewal.

“I don’t know what causes this, but I know that when he becomes anxious about everything, he can’t do anything about it,” she said. “For a while, he just knows that he can do something better than everyone else, and he will drive that point into the ground if he has to, just to get his way.”

What I appreciated most was my aunt’s candor — a trait I had not realized she shares with my grandmother. And what emerged in the conversation was her great strength in the face of mental illness. Why didn’t she leave him?

“He’s a very kind man when he’s not all caught up in this, and it’s not something he can help,” she said, referring to his “crazy episodes” as blackouts. “When you get to know him, you know he’s not like the person he is when he’s in one of those states. I’ve just learned that the meds only hold him for so long, which means when they don’t work that he’s going to have to go to the hospital and stay for a while.”

I told her about my conscious withdrawal from them, explained my reasons for staying away, and said how guilty I felt. “I do understand,” she said. “This is not an easy thing to deal with — for anybody.”

Our relationship felt renewed by the end of our talk. She expressed her concern for Kate and — here’s that word again — our “situation.”

“Fortunately, things are different now,” she said. “It used to be that people who went to a psychiatrist had a bad reputation, but now we know that they’re getting treatment for something they can’t help. It’s not something we expect to have in a child, or in a spouse, but they can’t help it. They just can’t.

“You can help them, though, and others, too, by being open about all this,” she said, not knowing how much she had helped me — on her birthday.

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