The Final Manic, Part 1

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Upset young man against dual colored backgroundMy wife was dying. It was November l5th–our first wedding anniversary. It was at the ICU at Mercy Gilbert Hospital. Earlier that day she had tried to have me barred from the room.

During the past six months her COPD (emphysema) had worsened. That past June she had been forced to give up the career she loved and apply for disability. Every few months there would be a severe worsening of the condition called an exacerbation. Exacerbation meant paramedics, a visit to the ER, hospitalization and mass doses of the steroid prednisone.

For about ten percent of the population prednisone causes extreme paranoia and hostility. My wife was one of the “lucky” few. That Sunday in November she snapped. Early that morning I slipped out of her hospitalroom to go home and get some rest (could they make the couches in the ICU any more uncomfortable?). I got three hours of shut eye and a hot shower.

As I checked my cell phone before heading back to the hospital there were twenty-seven messages from my wife: Where are you? When are you headed back? Then a change in tone … where the hell are you!? Who the hell are you with!? You son-of-a-bitch don’t bother calling! I’ve given orders for you to be barred from my room!

There had been some “prednisone moments” before that day, but nothing like this. (She once did demand at a summer cookout that there would be rice at EVERY meal from that day forward—apparently twenty five years in Hawaii will predispose you to having room temperature rice at most gatherings.) But that chilly November day the paranoia and hostility was raging more than any time in the past.

By the time I rushed to the hospital the nurses are doctors were huddled outside her door discussing next steps. Apparently she had barred them from her room as well. A psychiatrist was called, sedatives were administered, a kind and compassionate nurse rustled up a small wedding cake so we could celebrate our first anniversary.

The prognosis was grim. Drugs could be used to manage the COPD to some extent, but we were told to expect more exacerbations on a more frequent basis-one of them might prove to be fatal. There was talk of a lung transplant–had it really come to this?

A few months earlier I had made the conscious decision to stop taking my bipolar medication. Me and God got this covered. Stress triggers mania. Being told the love of your life is dying just might be categorized as stressful.

Within a few days my wife was released from the hospital and doing as well as could be expected. She was breathing without assistance. She was sane. My decent into madness had just begun.

Our health insurance situation was complicated. When we married she was uninsured. Given her pre- existing condition no company seemed to be inclined to offer coverage. I was self-employed as a consultant. She was self-employed as a hairdresser. We had to get creative.

The State of Arizona offered a policy for companies with a least two employees. We applied together–an information technology consultancy that also did hair. At first the state balked. But we persisted. They relented. It was crappy insurance–it only paid eighty percent–but at least we were insured.

Only one problem, my wife had gone on disability since getting that insurance. The two employee company only had one employee. We were out of compliance, filing lots of claims, and liable to be audited any day.

My wife was dying. My health insurance situation was deteriorating. And I was slipping into mania.

In a normal state of mind I would have just taken a regular job, gotten group coverage and bypassed the pre-existing condition nonsense. But I was far from a normal state of mind.

Instead I got grandiose. I would save her like no one else could. Two employees to qualify for insurance? Ha. That’s nothing. I would have dozens of employees and plenty of cash to satisfy the steady stream of medical bills we were accumulating.

Already making hundreds of thousands of dollars consulting I took on another engagement. Big plans demand big cash flow. Sure it was more work than I could handle, but who needs sleep?

Well, as it turns out, if you want to keep hypomania from escalating into full blow mania with psychosis sleep is kind of important. But then how would I have known what it’s like to be picked up by the police for an involuntary mental health evaluation… ?

To be continued Sunday.

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