tips to keep your sick little mind from crashing out all the time, per a trauma psychiatrist

On learning to protect yourself, whenever, wherever.

This is Bite Back, a newsletter from Tess Koman. A heads up: As of this week, I’m starting to paywall issues that feature interviews with A+ physicians, like this one. Questions, comments, concerns? Lmk!

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Run me through the things people most commonly believe changes a person. Time, I guess? Money, I’m sure. Parenthood? That tracks. Adversity, too, probably. At different times and stages, each of those things has made me feel things I hadn’t felt previously. Has made me think differently than I had prior. Has taunted me with more immature versions of my younger self, blah blah.

But changed me? Nah. The only thing in my entire life to date that has molded my brain and psyche into a previously unrecognizable, fully cemented different person was—you’ll never GUESS, dear reader, you’ll never guess!—almost dying from sepsis that one time. Have I told you about it? The time I lived in the hospital for months and stopped eating for even more months? The continued recovery that is more disgusting and fraught than any other recovery I’ve ever, well, recovered?

OK, yeah, we have talked about it. But this time, I got a doctor to confirm I aaaam a whole new person for having dredged and sliced my way through the past 10 months. That it’s not bizarre that I, a person who really thought she knew herself pre-intestinal explosion, find myself just now constantly asking the people around me “who the fuck am I and what the fuck am I doing?” I didn’t go around doing that shit when the baby I spent years of my life chasing was born; when I first experienced the freedom of my own disposable income. I never even did that any of the last 24 times my body had been opened and shut again!

Just now. Just this thing. It finally broke (sorry, changed* lol) me.

a recent example of the aforementioned brain-cracking, but this one was toddler-inflicted

How we got here

I’ve known for months that I have been a blurry, unidentifiable mess to those around me and to myself; this is not terribly surprising. But I don’t think I could articulate “something has changed within me and that’s why I’m so consistently and surprisingly snappy all the time now” until the world’s stupidest ER visit three weeks ago.

…I slammed my finger in my car door trying to get my golden retriever’s lazy ass up into the backseat and saw bone! I got myself to the nearest hospital very calmly and quickly, and was so pleasantly surprised to be able to quietly bop about the triage and waiting processes without having any breakdowns. In fact, I breezed through everything, telling myself this was a nice and chill and clean ER experience, not a traumatizing one about to halt my entire life in its tracks…untiLLL post-X-ray, when they brought me into the proper, pre-admission ER space and I locked eyes with NG tubing and its accompanying canister hanging on the wall.

……I don’t really want to run you through my three-day ER admission that saw 3,000 milliliters of unmoving fluid sucked up and out of my body in a matter of hours (...ask a doctor in your life. They’ll confirm for you that’s too much fluid in too little time). I don’t really want to get into the hazy memory of my favorite doctor coming to visit me, green-lighting more Ativan and Dilaudid and stomping on a cockroach that was beelining toward my hallway bed. I don’t really want to get into the churning devastation of attempting to FaceTime my two-year-old daughter on her birthday and only show her half my face, knowing the tube that’d been in there for months at that point would horrify her. I don’t really want to tell you how I gargled through “happy birthday” and proceeded to have the biggest breakdown of my life while my hospital roommate shat herself joyfully and unendingly about four feet away.

……………But the nausea and paralyzing aftermath of that NG sighting that day really clarified shit for me.

What we’re (maybe) trying to do about it

Dr. Katrina Hacker is a clinical psychologist at Dartmouth Hitchcock Medical Center and assistant professor of psychiatry at Geisel School of Medicine, and she’s