Welcome to another installment from Steve’s playlist of delusionary tales experienced in the hospital setting during a severe asthma exacerbation.
This is the last and possibly the strangest of the 3 posts I’ve written regarding this particular exacerbation and subsequent hospitalization, which occurred in mid-November of 2021.
Taken entirely from memory and as accurate as I can be, I wrote this post to give people a glimpse into what a severe asthma exacerbation, mechanical life support, hospital confinement and potent drugs can do, not only to one’s body, but to one’s brain.
Thought to be a form of what they call toxic encephalopathy, no one really knows what causes hospital delirium, but up to 80% of critically ill patients, especially those who are older, have urinary infections, have spent a lot of time on a ventilator or in the ICU, will develop it. In my case, it’s thought to be caused by a combination of steroids and one or more of the sedative drugs they use while on the ventilator. From a breathing standpoint this particular asthma flare was pretty bad, and as of this writing 6 weeks later, I still have not completely recovered.
The altered reality that one experiences during these bouts is usually short-lived, typically a day or two… maybe three. But it can have a long-lasting impact on one’s overall physical and mental health. Ive been seeing a counselor to deal with my ongoing illness related PTSD for over a year now. While I can’t say I’m 100% better, it definitely helps to talk to someone and to learn different tools to better manage it.
Here’s the lead up to this story.
My asthma had been relatively stable from early August until early November, when a slow-moving creeper flare snuck up on me and put me back in the hospital for 12 days. I spent 5 of those days gorked out on a ventilator and an additional 4 days in the Bizzaro world of post extubation delirium. I didn’t actually come to my complete or rational senses until the day before I was discharged from the hospital.
As with most of my stints on a ventilator, I don’t remember very much after they put the breathing tube in. But real or imagined, I recall EVERYTHING that happened after the tube came out. The details of these events are as fresh and vivid in my mind today as they were when they were happening nearly two months ago. That’s not to say that what I remember is based in reality. Of course not, they were delusions, hallucinations, dreams or whatever you want to call them. But here’s the thing, when you’re in a situation like this, no matter how crazy your thoughts and odd behaviors might seem to those around you, delirium is very real to the person experiencing it. Thankfully, most doctors and Nurses who work in ICUs are used to dealing with patients who are acting out because delirium. God love em, Im not sure I’d be so patient if I was in their shoes dealing with someone like me.
So with that, here are my recollections of what transpired during that hospitalization. Ive condensed it down to just a few sentences each per memory because to be honest, even just recalling these events, as silly as they might sound, is still quite traumatic for me. Spending too much time writing about it makes me re-live it more than I care too.
We’ll start with the Devil, as this was probably the most disturbing of my delusions.
Not sure how I met him, whether I was somehow coerced or kidnapped, but he was this 40 something year old, well groomed, dark-haired man that could charm the pants off anyone. Right off the bat I could tell just by looking into his eyes that his plan was to kill me. And it wasn’t just him, there was a whole group of his followers that were coming and going in the background, preparing for my sacrificial demise. I remember being kept as a prisoner in what appeared to be a Hollywood style satanic temple, complete with alter and murdering slab. I remember repeatedly asking the devil man, why are you doing this, why do you want to kill me? He always responds with “Because I care about you.” WTF,? That sure is a funny way to show someone you care about them. As I would seemingly get closer to my execution date, I would either wake up back in my hospital room relieved by the familiarity of my surroundings, or I would awaken into an entirely new delusion. Unfortunately, for the times that I would wake up in my hospital bed, I couldn’t seem to hold on to that reality for more than a few minutes before drifting back off into one of the other delusions. It was awful. It’s like waking up from a never-ending nightmare only to repeatedly fall back into it where you left off.
Next up was Dr Skinners asthma rehab clinic. Not quite as scary as hooking up with the devil, but still a prisoner-based theme. (Most of my delusions involve some kind of imprisonment). So, I go to see this wacko lung doctor at the request of one of my real doctors at the hospital. Actually, they made it mandatory for me to go to this guys clinic as a condition to continue coming to the hospital when I got sick from my asthma. It’s a long and sorted delusion, but the jist of it goes something like this…… The clinic building itself was located in the city’s skid row. I had to first be detoxed inside a locked padded cell to rid my body of all the bad stuff. They did this by making you drink liter-sized bottles of various herb-based concoctions. Once you drank it, they would pin the bottle to a clothesline type set up that ran the length of the room. When you finished all the drinks there would be 12 bottles hanging on the line. After detoxing for 3 days, they were supposed to let you precede to the next step in the process by unlocking the door that separated your detox cell from the clinic waiting area. Once in the waiting room area, they were supposed to assign to you one of Dr Skinners associates, so that they could examine in person and give instructions on how to manage your asthma in the future. They were also supposed to issue you a certificate of completion to prove that you completed the program. Well, I kept my part bargain by drinking all that muck, but they didn’t keep their end of the deal. After being locked up in the detox cell for 3 days, they refused to let me out. Apparently, they thought I would try to escape if they opened the door. (uh, they would be right). Again, just as I would reach the maximum threshold of my agitation and anxiety, I would mercifully awaken back in my Bonafide ICU hospital bed. And each time I would say to myself…phewww, thank God that was just a bad dream. Somehow though I couldn’t hold on to that reality and would find myself drifting back into one of my delusions.
Finally, we have the “paying it forward delusion”. This was actually an add- on delusion to Dr Skinners Lung rehab delusion. It involved a clerk who allows people who have completed their 3-day lung detox, to be admitted into the main area of the clinic to be examined by Dr Skinner. There’s no coincidence that the main entrance and exit to the building are also in this area of the building. Most people who made it to the waiting room ran for the doors to get the hell out there. But I digress. I struck up a conversation with this young lady who was in charge of letting people into the waiting area from the detox cells. I struck up a friendly conversation and befriended her, not only to increase my chances of escaping, but also because I truly wanted to help her have better her life. I had had a small savings acct, and because my health was pretty iffy, I figured why not give that money away and make someone happy? I would do this by offering her money. I proposed the following question “What would you do if I gave you $20K, no questions asked?
I How noble of me, but I absolutely meant it. Her response was that she would indeed accept the money and invest part of it in a small environmentally friendly business. I said, that sounds great. Here’s my banking info, take the money at your convenience. Again, I would flip back and forth, in and out of this delusion, to either my real hospital room, a visit with the Devil where it was getting closer to my execution day, to trying to escape from Dr Skinners rehab and now trying to give my money away to his clerk.
Each time I returned to the “pay it forward” delusion, I noticed that she was indeed spending money, but not on what she told me. Instead, every time she would pop into my head, I noticed there would be a party going on in the waiting room, and each time the parties would be more elaborate. There were DJs, food, a bar, dance floors and multiple ATM machines where the party goers were withdrawing cash. She was definitely spending my money, but how much????? Finally, 4 days later, after everyone at the party was drunk and passed out, I managed to break out of my cell and high tailed it to the exit. As Im running down the street trying to flag down a cop, I woke up. And this time it stuck. The delusions seemed to be gone. My 3-day long nightmare was finally over. I was still having the occasional hallucination, but I was well on my way back to reality.
Ah, but thats not the end of the story. While I was feeling quite relieved and grateful for this nightmare to be over, I couldn’t help but feel that my bank account had actually been wiped out by my delirium induced generosity. I know it was only a dream, but it seemed so real that I kept calling Douglas asking him to check and re-check my bank balance to see how much money had been withdrawn. Did she take the $20K I offered? If she did, I figured I could live with that decision. But what if she took more? What would I do? Maybe I could tell the bank I got defrauded and they would refund me some of the money? All kinds of things were going through my head.
The uncertainty of all this continued for least another day, when all of a sudden, I came to my senses and realized none of this had ever happened, I just imagined it! The Devil didn’t kill me, I managed to escape from Dr Skinners hellish medical clinic and my bank account was still intact. Just to reassure me, Doug checked all of my bank accounts, and sure enough nothing had been accessed.
Life was fairly good again, but my head was still messed up. The Devil thing scared me so much that I asked to speak with a hospital Chaplain. She offered some great advice, like coming up with a Mantra to ward off evil spirits. Something like “My body and spirit are covered by a thick golden shell that your evilness cannot penetrate, so go way and don’t bother me anymore”. I never had a chance to try it out, because fortunately I snapped out of it. But if I ever meet the devil again, I will definitely try it.
So that’s what happened during this hospital stay. I think it’s a potent example of how a bad asthma exacerbation can morph into a literal nightmare. If you can help it, don’t let your asthma get to the point where you need to be put on a ventilator. It might save your life, but there are a lot of potential complications.
Oh, I felt so good about not losing all that money in delusion #3, I bought a new car. That’s right, on my last day in the hospital, while still a little loopy, I custom ordered and purchased a brand-new car online. Don’t worry, buying the car wasn’t a delusion, it actually happened. It wasn’t an impulse buy either; I’d been seriously considering it for several months before I got sick. Because I live on a tight budget, Id been on the fence about forking out a lot of dough on a new car, when I could buy used one. But I needed reliable transportation to get me to and from my medical appts and I also needed something to cheer me up. Having survived yet another bad attack, and having a sense of newfound money if you will (delusion #2,), gave me the incentive to splurge a little and treat myself. Though I admit, the next time Im hospitalized, it might be better for me just to leave my phone and wallet home…. they seem to get me in trouble.
Lastly, the recovery from this exacerbation was painstakingly slow with lots of setbacks and even a re-flare, for which I had to start back prednisone and then taper back off a for a 2nd time. Now 2 months later I’m just now starting to feel my normal self again. I think this tune that I learned during that period, called “The reset“, by Gordon Woodwin’s Phatband, sums up musically, the crazy journey I had been through.
(BTW…..The new car was delivered to a local dealership on November 29th, 2021, just 10 days after I got out of the hospital. This is actually amazing considering the worldwide shortage of new cars. It’s a cool little car with quite story behind it.)