The certainty of uncertainty


In my ongoing quest to get to the bottom of my annoyingly reduced sleep, I received the results of a recent MRI of my brain when I visited my family doctor yesterday and the report was clearly not written for me to comprehend.  Even my doctor was at a loss with some of the language but he concluded, “At least you don’t have a brain tumour,” which was more than I could deduce from this:

MR brain

Clinical history: New onset central sleep apnea.

Multiple sequences were performed through the brain.

The splenium of the corpus callosum is absent and colpocephaly is present.  There is a 1.2 cm gray matter heterotopia along the lateral wall of the trigone of the left lateral ventricle.  There is thinning of the optic nerves, optic chiasm and optic tracts.  The fornices are also quite thin.  The mammillary bodies are small.  The pineal is quite small.  The entire ventricular system is larger than normal.  There are mild microangiopathic changes in the hemispheric white matter.  There is a prominent cisterna magna.  There is mandibular hypoplasia.  There is reversal of the cervical lordosis.

Conclusion:

There are numerous developmental abnormalities of the brain as discussed.  The predominant abnormality is colpocephaly with absence of the splenium of the corpus callosum.  Of note is the presence of a gray matter heterotopia.

*****END OF REPORT*****

Some of the ‘abnormalities’ may stem from my prenatal and first couple of years of life.  ” Hydrocephalus Arrested” is how my mother recalls the episode being summed up by doctors at Montreal Children’s Hospital.  (Hydrocephalus is accumulation of too much cerebrospinal fluid in the brain.)  Outwardly my head was disproportionately larger than my infant body, leading me to sitting up and tipping over, occasionally knocking my head.  That it was “arrested” was of great relief to my parents because two children of two different cousins of my mother had been born with the same condition.  One died, the other spent his shortened life in a wheelchair so one can understand how worried Mom and Dad would have been for me in my early months and years..

I’m guessing the brain’s way of retaining all its history may be partly responsible for the gobbledygook in the MRI report but I’d like to hear it from a neurologist’s mouth, rather than via the cryptic language quoted above.

I’m Thinking, “This is Going to Hurt!”: On ‘How Not to Deal with Grief’


From my friend Betty Ann on her Facebook page:

“This article deeply moved me…as I suspect it will for any of you who have been impacted by the kind of grief associated with multiple loss, deaths due to overdose and or HIV/AIDS. Rather than just clicking on “like”, can you write a few sentences in a comment? Maybe just something about how this article landed with you? Guess I’m lookin for a little peer support here…”

I know there are many stories related to this piece which could be written. Don’t be afraid to jog my memory or ask a question.

I URGE you to click on the following link and read:

Guest Post – How Not to Deal with Grief

Remember those days when we couldn’t decide how to go to a funeral and make sure a dying friend was okay?  Open casket versus closed? Cremation versus traditional burial?  Would it be okay to go a little over the top in church?  Someone else is sick?  I thought he’d killed himself.

“…those days…come screaming back out of nowhere. I don’t live with it; it lives in me. It is a part of me and makes me what I am. That does not mean I want it. I am not alone in this. And I am not alone in finding that loss accumulates and is sticky and hangs together like lumps of tar and sticks and sand on the beach after a storm.”

“…these thoughts, the ones of dead friends and loved ones, are in the heap in the back corner. They lurk behind the door with a skull and crossbones saying; “Fuck Off, Asshole,” in 72 pica. Then in smaller type: “You know who and what’s in here, so why don’t you just walk the fuck away?” And every so often I walk through that door for whatever reason and it takes days to recover.”

“People died around you. Repeatedly. Let me emphasize: Repeatedly. There were no protease inhibitors. No Truveda. Just blind hope, determination, anger, solidarity, organizing, guesswork and gambling on whether to take a drug or wait for the big one that will work — and die waiting. This was not a time of long-term sustainability.”

“I am not perfect. But I have found some happiness in my life, not by achieving resolution, but by acquiring wounds, then healing some and developing scar tissue that will always be there, and by just keeping going.”

My laptop feels too small for what I want to write. I need a full-sized keyboard to spread out my fingers as on the keyboard of a grand pipe organ. I know the feeling of not wanting to go through personal items and photographs of friends lost. But I also know it’s an irresistible tug sometimes. I more often than not know what it means just to still be here when I could have, should have been dead, with only analogies of Vegas or God’s perverse selection process as explanation. I reject both.

I know that “just keeping going” has taken a lot of courage for many people, so why not me, too? I accept that there have been times when it seemed much simpler to die than to just keep going. I’ve even wished I would have died long before now. But there are new things to work on, new struggles to wage, even while bearing all the scars of having nearly shit myself to death.

Sleep, no longer taken for granted, will soon be improving – hopefully


Early this month I had electrodes taped to my head, neck, chest and legs, then I was wished a good night for a sleep study to see why suddenly, to me at least, I couldn’t get a decent night of shut-eye.

The results, which I received on Monday, showed that over the course of the six to seven hours that I slept, however intermittently, my breathing stopped briefly “like you were swimming underwater” hundreds of times.

This is apnea but not the most common type of respiratory apnea; mine is linked to the brain, which “forgets” to signal to breathe, and is known as central apnea.

The news flooded over me faster than I could think of questions but here’s what I know.  I’ll be forming a very close relationship with oxygen each night, I am having a brain MRI this coming Monday at Women’s College Hospital, I go back to see the sleep doctor on August 29, then I meet with a neurologist on the third of September and with my family doctor the following day  It’s the most intensive medical care schedule I have had for quite some time..

I’m a little nervous.

Early morning, April 25, 2007


A prompt this week to write about something in a health-care context brought out this story which, despite having been told over and over in my head, had heretofore not made it down in writing.

It wasn’t quite 5:30 am and Janice was already waiting for me on the main floor of Union Station. Her husband Randy, who drove her in from Ancaster, needed to get to work but first back to his parents who had been drafted to baby-sit the two kids.

Janice and I hugged, exchanging exasperated greetings, then continued the conversation from late the previous night.

Our brother Craig had been walking to his home in Montréal’s Le Plateau neighbourhood, arms weighed down with food and other birthday party necessities for Claude, his partner of sixteen years who turned 54 that 24th of April 2007.

As Craig approached their three-storey stone walk-up, he tripped and fell, almost instantly smashing his head on the sidewalk. The owner of a small store directly across the narrow street saw Craig go down and rushed to his assistance. He was clearly unconscious, his head bleeding profusely. She called 9-1-1 and eventually Craig was taken to the city’s well-known Neurological Institute (think “I smell toast, Dr. Penfield!”)

Claude was contacted at St. Luc Hospital, where he worked, and he rushed to the Neuro calling my sister Lynn in New Brunswick on the way. Janice phoned me after hearing the grim news from Lynn. They decided that Janice and I should go and stay with Mom at this critical time; that having seen Craig and Claude just a couple of weeks earlier over Easter she would be upset enough without rushing to Montréal. So Janice and I took the train to Kingston and then a taxi the eighty kilometres or so to Perth. Janice phoned Mom from Kingston, gently breaking the news and giving Mom a bit of time to absorb some of the shock before we got there.

I couldn’t believe it. Craig and I had both survived HIV/AIDS since the early 1980s, watching many loved ones die. But not like this!

Over the next few days Lynn kept us up-to-date on Craig’s condition which was critical at best. When our uncle told us he had to be in Montréal over the weekend, and offered to take any of us along, Janice and I decided to go.

The drive up the steep hill of University Street from the Ville-Marie Expressway seemed to take an eternity, not that traffic was especially bad but because of the pits of anticipation in our stomachs.

George dropped us off at the front door and Janice and I found our way to the Reception area of the Critical Care Unit. The hospital screamed, “Demolish me!” with its cracked interior walls and historic odours. Lynn stepped out of Craig’s room.

“I just want to prepare you as best I can for how you’re going to see Craig,” she said. “Whatever descriptions I’ve been able to give you over the phone this week really don’t count for much in person.”

She was right and, one at a time, Janice and I found out.

I went in first, Claude walking over in tears with a big hug and kisses on both cheeks. He made small talk in his broken English until I asked a few questions.

One of the first things I noticed about Craig was how the swelling of his brain had inflated his face to a preposterous size. His eyes were wide open and couldn’t shut even if he wanted them to. There was a large flap of gauze on one side of his skull, taped at the top but left unattached at the bottom to let the emergency surgery to relieve swelling of the brain do its work.

The most telling piece of equipment in the room, which was expanding his chest and belly the way his brain swelled his face, was the respirator and its associated oxygen pump, which rhythmically forced air in and out of Craig’s chest because he could, and ultimately would, not breathe on his own.

The artificial breathing made up in noise what the strained but quiet breathing of Claude and I did not.

Claude stood closer to Craig and shouted the news that Janice and I had arrived, at which point he gave the “thumbs up” sign. I eventually saw that to be his only method of communicating, and I now wonder if it wasn’t just some involuntary impulse of the brain.

Claude and Lynn reviewed what doctors had told them. Craig was in no pain, and no pain relief was necessary. They could tell this by the fact that he wasn’t restless at all. It almost went without saying that pain sensors in his brain were damaged, if not destroyed. Even in their earliest assessments, the doctors had told Claude and Lynn that if Craig survived he would not be the same person.

Janice and I stayed for an hour or so and then we all walked back to Claude’s (and Craig’s) place on de Grand-Pré. It was a cathartic walk, one which we would repeat, through the edge of the McGill campus, around Molson Stadium, and up Park Avenue, cutting across Fletcher’s Field to avenue Mont-Royal and Boulevard St-Joseph.

When Janice and I again visited Craig the next day before our ride back to Perth, I had a very tearful intuition, if not realization, that this would be the last time I saw Craig.

One attempt to see if he could breathe on his own had already failed. Staff hoped to try, or at least Lynn and Claude were certainly going to encourage another try, in the next few days. We were all in agreement, as much as feelings can be, to accept the results.

Ultimately the attempt failed and, while Lynn and Claude were out of the room having lunch, Craig died on May 9, 2007 – six days shy of his fifty-second birthday which that year also happened to fall on Mother’s Day.

That unimaginable Sunday was spent travelling to Montreal with Mom for the funeral service the following day. Then on Tuesday it was back in to two cars for the drive to Perth where a sunset burial was held at Scotch Line Cemetery next to the plot owned by Mom and Dad.

Later that spring, Claude bought a headstone with Craig’s birth and death dates as well as Claude’s birth date. The inscription described Claude as Craig’s “compagnon de vie”, the first openly gay – and surely among the first bilingual – grave-markers in the town’s three or four cemeteries.

Chaplin Craig et Claude

Tapestry, coping and shame


Last Sunday afternoon, Thanksgiving weekend, I was out for a walk in Perth taking some of the photographs I collected over my five days there.  I was also slipping away from the family in order to listen to a radio program which included brief comments I had made by phone as invited by the producers.

CBC Radio’s Tapestry was airing the second part of a series called Coping and at about 15:49 into the program I am heard introducing myself, then speaking of how my bipolar II diagnosis was an “A ha!” moment for me in the context of living as a survivor of childhood trauma, addiction recovery, and living with HIV/AIDS since 1989.

I also said that the bipolar II diagnosis has allowed me “to have a little more compassion for myself” and, in turn, with others with mental health issues with whom I can more easily and comfortably empathize and suppress my self-criticism.

“I live on,” I said, “and live on in curiosity”.

The reason I felt I had to head off to my favourite café, rather than invite my family to listen to the program with me, is that they are not all up-to-speed on my bipolar II diagnosis nor, in some cases, the sexual abuse.  In the case of my mother, I have withheld these because I have judged that she has had more than enough to deal with.  Whether it is worth the secrecy may be another matter entirely.

Fast forward to my weekly group therapy yesterday, which I had missed due to travel last week and being ill the week before.  It followed on the heels of my check-in with my psychiatrist in the same hospital during which I confessed that, due to financial problems over the past little while, I had been unable to pay my quarterly prescription co-pay of about $100 and had, therefore tapered myself off my medications – re-starting at the end of September after more than a month when my finances were back in limited order.

He urged me to be in touch with him should I ever run into trouble again (I had even bluffed my way through an appointment with him during the crisis) and to keep in mind that relapses could be very serious.

Off to group therapy I went where I broke down crying as I reviewed the past couple of months and spoke of the shame I felt in being short of money.  It was of my own doing, I judge, because I had sought sexual release time and time again with the click of my TV remote at $9.99 plus tax per viewing.  (More shame.)  The financing – no worries until the bill arrives – was as seductive as any of the pay-per-view characters.  There were equal amounts of shame in having dug myself into a financial hole, putting my health at serious risk, and the mental condition which I dared not speak of with my loved ones – despite all of their support for me in every other area of my life which many other families might not be able to tolerate.

I did manage to tell my family, as we packed down a splendid turkey dinner, that I had lost ten pounds in the past little while.  What went left unsaid was how much less I had been eating and why.

What could I have done differently?

Certainly I could have flagged the financial problem with not only my psychiatrist but also my doctor and pharmacist.  Heaven and earth might have been moved to make sure I had my meds.  Instead I chose, in shame, to deal with it myself – the same faulty self-reliance that got me through the rough years as a kid.

I could have told friends what was going on.  It would not have been too tough to borrow a hundred bucks for my meds.

No doubt I could spend time, honestly, openly and,  more constructively, out of isolation with friends.

Whispering “Help!” from the windmills (or silos) of my mind


Those of you who have followed me, be it through my writing, my tweets, or home from the convenience store will have picked up on the fact that I have a fair amount on my plate.

I’m a very slow eater.

I recently joined a support group for long-term survivors of HIV/AIDS – in my case it’s been no less than 23 years. Even more recently I quit the group when I convinced myself that there was something to the quizzical looks I was getting from existing supportive friends, surprised that I might have anything I couldn’t discuss with them.

Particularly those who were also HIV-positive; also long-term survivors.

It felt good to formally end my relationship, short though it was, with the “support group” and to tell them why.

I don’t want to compartmentalize my life any more than I’m ever convinced I have to – if at all.

I want to safely, sanely integrate the many facets of my life – which too often feel like they’re in individual silos – into something that I can present to anyone I choose.

To recap what loyal readers already know:

I am a survivor of childhood trauma at the hands of an elementary school head teacher/principal.

I was bullied – by him and by peers both in early grades and in high school. I survived.

In my adolescence I was sexually abused by strangers, i.e. more than once, in a part of my home-town that I would only, as an adult, recognize as a “cruising area” for men seeking casual sex with other men (or, since I was there, with boys).

I buried that sexual trauma until I described the first incident in the third person at a HIV/AIDS-related workshop in 1990, some eighteen years after it started.

Then I buried it again, for the most part, but it kept reappearing particularly in the context of dealing with alcohol and other addiction.

I sought support for the addiction but only occasionally mentioned the trauma(s), believing that help was not available as one-stop shopping. (It was also too much to deal with in the context of my HIV progression to AIDS-related illness, the support and care of friends who have long since succumbed, and my inability to stay sober for more than five to seven years at a time maximum.)

When my brother Craig died tragically in 2007, and I was drinking at the time even if not in the presence – not even the same town – of my grieving family I came to a critical point of despair. Thoughts of suicide both tormented and comforted me.

Earlier that spring I had considered running for political office. Me! On long-term disability insurance! I had also wasted the bulk of an insurance settlement from a 2003 accident as if I wasn’t going to live long enough to enjoy it.

I was assessed and diagnosed with/as (I’m not sure which) bipolar II, one step on the spectrum from the more notorious bipolar disorder or manic-depressive illness, as it used to be called.

Believe it or not it was a relief to get a better understanding of what had begun, to me, simply as an absence of depression – for which I had been treated since around the time I tested HIV-positive – and to make sense of what had clearly become episodes of hypomania and depression.

The cautionary experiences of my peers, plus the general stigma still associated with mental illness, have made it difficult to articulate all that I have been discovering about myself as I review the years but one thing is for sure: I can no longer just be a gay, HIV-positive and (to some a recovering addict) friend or relative to some while hiding the largely successful, but ongoing, treatment of my psychiatric illness. The silos drive me crazy – and anyone with a passing acquaintance of farming will know that silos can spontaneously combust!

I do not know to whom any, or all, of this is news. Please let me know. Maybe this is just a rant I occasionally need to let rip. My emotions are not helped by a temporary physical malady today but, then again, I know that’s what it takes to move me sometimes!

The bottom line is that I want to be able to describe the whole picture, even if I mix oil with pastels, chalk with water. The silos aren’t all filled at the same time, usually, but that’s just the point. I don’t want silos any more. Could you at least help me with a better analogy?  I would be so grateful.