Heartbeat

My heart pounds, pounds, pounds, not that of a man who has been defeated, not one whose pulse is fading in such a way that you cannot tell if the man has lost the battle, or the ghost has won. It's not like that. Things cannot always be wrapped in peppermint bows and almond kisses. I wish that it were so, but it isn't.

Another day at the VA. For those who don't know, the VA hospital is off 42nd Avenue by the ocean, up a hill. The cold cement structure has a pulse of its own, and I can feel it as my stomach turns inside out as I walk up to my appointment. This was supposed to be meet and greet with the physician I would be working with and for, but as I approached the office, I was also informed that I had agreed to participate in a starle study after meeting with the man. So, first I go to meet the doctor. He tells me what I want to hear -- the course of treatment will be at the patient's pace, and there would and will be no pressure to deal with anyting in a certain way. If the treatment does not work for "the patient," then we would explore other options. His office is immaculae and looks over the ocean, and I am reminded that I do not want to associate the therapy with the beautiful water each week when I come and visit. He talkes about "nuts" and "bolts," and we talk about placebos, contriol groups, D-cycloserine, PTSD, cognitive behavior therapy, and the benefits of just being in a "supportive" environment with the doctor regardless if I receive the placebo or the medication. I look out at the water, feel myself start to drown a bit as he, the doc, stops talking, and sits quietly staring at me. I know this approach. The patient will invariably break the tension by talking about their anxiety. It worked, even though I knew the strategy, but his explaining things in widgets and then going silent leeaves me cold, even though he has had experience he says in treating PTSD since the seventies. We shake hands, politely. He gives me his card with an appointment date for next week.

I am then ushered into an office for the "startle" survey, and electrodes are applied to measure how much I perspire and how much my heart pounds, as I listen to a series of sharp noises while staring at a screen with a black "X" and keeping my arms and legs still. The experiment begins. The sounds are jolting, like the needle of a turntable when you forget to put the record on -- a nasty scratching noise. I jump, yes, startled, and think, why am I doing tis when this only triggers symptoms, like each intake caused symptoms since I had to reveal trauma to three different doctors up until this point, as a fourth, who can help me, waits in the wings? I make it through. Then the clinician says that the next part of the experiment will involve noises again at different intervals and some will have an electric shock. That's it. I am out of therre. I tell the researcher that the "experiment" is over, and I am told that many people refuse to go through this, not just me. My only problem with this news is the lack of disclosure of this information prior to my involvement. A project manager comes in, very empathic and allows me the time I need before leaving.

I had therapy with my therapist, my regular one, later that afternoon. Somehow, setting boundaries help me relax and I think how relieved I did not allow this to go further. Yes, I plan on returning to the VA, and I plan to give this a shot, but with a healthy dose of feedback for the research team. They are all excellent practitoners. I just feel sometimes it is easier to focus on the actual research and forget the individual, just slighly, more that there was a lack of anticipation, much like putting a bandaid on a wound after you get burned. It isn't over, not by a long shot. I am here, and anxiety or not, I plan to make it work, study or ot, one way or another. Progress was made. And my heart is still beating.