The alarm is ringing. It is 6:00 a.m. and my headache – my migraine – is still there from last night. Thought the headache rarely disappears overnight, I fall asleep hoping that I will be so lucky as to have an unburdened start of the day. I drag my throbbing head to the hospital, holding an ice pack to my head as I am driving. I play a game with myself sometimes – how long can I stand this pain until I give in to the medication Enough, I will now take one Imitrex pill – just one – and hope it relieves this pain. I will now suffer just a little less and endure this day.
Another day of my Psychiatry roation. I figure that I can probably survive an eight-hour day. I have an Imitrex injection kit in my bag in case this throbbing becomes disabling. I have a pocketful of pills as well. The chances are that I will just continue to suffer. I always reflect on why I do this. Is it because I have spent a lot of time around addicts and don’t want that label myself? Is it because I grew up watching my mother suffer through migraines, boasting that she can live through these nightmares without medication? Or is it a means to test my self-control?
As I walk down the hallway, it seems that my steps are in rhythm with the throbbing of my headache. I arrive at the room of one of the patients that I am following. The door is closed. I put my ear against the door. The coldness of the door is actually providing some relief. I hear several voices. One voice is the paitent “JJ.” She has a single room so those voices do not belong to roommates. Ah, maybe the resident and attending are in talking to her. Should I go in, I wonder. Maybe not. I turn to walk back down the hallway and see the resident and attending at a distance. I turn back and place my ear once again against the door. The throbbing has eased slightly but now I feel my heart beating. I hear two, maybe three, male voices – very distinctive voices. Hmm, maybe visitors. I look at my watch. It is not the time for visitors. I am now just leaning with my head against the door, stifling the throbbing as well as contemplating knocking.
I feel the throbbing intensify. I knock, mostly as a distraction from the pain. I hear JJ say come in. I walk inside and see JJ sitting alone on her bed amongst hundreds of receipts and dozens of magazines. She looks at me and smiles. She thanks me for giving her some more magazines and again asks for Fiorinal for her headaches. I lose myself gazing at her magazines and think about her persistent requests for pain medication for her headaches. Every two hours on teh dot, she goes up to the nurse’s station and asks for whatever analgesic she is allowed to have. I know that her nurses and doctors think she is faking it – or at least exaggerating it – in order to get more powerful drugs, like Fiorinal. Oh, no, the throbbing returns and I suddenly remember those voices again. She is a schizophrenic who has admitted to hearing voices in the past, but…But, she told me that she has not heard them since starting the medications again. Is she lying to me? No, I will not believe that.
Oh, the throbbing. I need to know that she is not lying, so I need to confront her. I tell her that I heard male voices while I was approaching her door. I ask her who they are. The pain is becoming so bad that I do not want to know if there are voices. I want to know who they are, now.
She looks up and puts her right hand over her forehead. “Those are relatives who have taken over my head. I starve because the food I eat goes to them. Their voices are in me,” she tells me. She looks like she’s in agony.
My head is throbbing so intensely now. My vision is clouded with small flashes of lights. I see her face emerge through the constellation that is obscuring my vision. Her voices are silent, but I wonder what her head’s invaders are doing inside her – those invaders that are eating her food, imposing their thoughts, and causing her pain. Is her pain as real as mine?
I feel my throbbing ease slightly and then return full force. I look at her again and see her grabbing her head with both hands. I ask her if her pain is getting worse. She mumbles that it is. She actually continues to mumble and now I believe that the invaders are not letting her go. I distract her by telling her that I will bring her more magazines tomorrow. I leave her room and go take my medication.