Waking Up in the ICU
Big squares on the ceiling jumped back and forth in colors, green and yellow, back and forth. A fascinating play. Where was I? Through my throat went a big tube, which was hooked up to the heart and lung machines. This tube was connected down into my lungs so they would work, and another small tube inside that one sucked up the blood. There was oxygen streaming into my nose from another tube. I was surprised that so many lines and tubes were connected to my body. I counted them. Sixteen. One line was inserted into the femoral artery and one into the subclavian. I had an IV in each arm. The EKG lines were stuck all over my chest, lots of little sticky circles. My body was covered with blue bruises. Wow, I thought, That was a serious car accident or was I climbing high up in the mountains somewhere? But I studied my body and as far as I could see I could not find any real, I mean, open, injury. I had no stitches anywhere. Where did those bruises all over my body come from? I had no recollection of anything. In fact, I was in a good mood and interested in learning all about the technical apparatus surrounding my body — the heart monitor, the blood pressure numbers, all the beeps and tones, as though all the machines were talking to each other. A young man who seemed to be a stranger soon walked in. His big glasses were surrounded by lots of brown hair, and he wore a V- neck, stripy T-shirt under a blue hoodie. He wasn’t very tall but also not short; he was just a little more than skinny, and I did not know who he was, nor did I know who I was. I could not talk because of the tube down my throat and I was weak. He gave me a piece of paper and a pencil. All I could make was a shaky question mark.
“You?” I pointed to him as in, who are you?
“Wali, your friend,” he smiled. Then, I held the question mark next to me.
“Stanzi, you are Constanze Frei. You should know who you are,” he said.
I shook my head, though he was right. But who was I? I held out my hands and pleaded with my eyes.
“You worked here in this hospital. You are in the nursing school.” He looked worried. I looked at him, puzzled. What? I was in a nursing school? And he said, hesitating, “You tried to kill yourself, Stanzi.”
Was that about me? Was Constanze Frei, me? I could not remember any of these things, but it made me think seriously. If that were me, I was forever unworthy to work in a hospital. I was not worthy. I wanted to sleep. There was no energy I could draw from. When I woke up again, a nurse was with me. She replaced one bag of fluid with another and injected medicine into the IV. Then, the doctor came and explained to me that he was very surprised, not only that I was responsive, but alive at all. He also informed me that I had tried to kill myself.
“You took a concoction of deadly pills. Unfortunately, while we pumped your stomach and reanimated your heart, fluid ran down into your lungs and poisoned them. The lungs are damaged and heavily infected. Your heart needed to be restarted many times. Every now and then, it just stops working. We still need you on the heart machine until the heart functions are stabilized and the lungs start working independently.”
The doctor waited a moment, took a deep breath and continued, “We also do not know the extent of your brain damage. I hope the motor coordination from the brain to your arms and legs will increase. I hope you learn to control your fingers again and learn to walk. I’m not sure. But we never know. It is a miracle that you woke up. We hope that there is another miracle and you will walk. We need patience. For now, we are very happy that you woke up from the coma. That is a good sign.”
He seemed relieved and so were the nurses, who also knew me as a student. Ulrike and Felix knew me from before, we were friends, but I did not recognize them and did not know their names. One day, Felix showed me the reports from the time I was in the coma, showed me how they all tried to bring me back to life. Felix noted that even he reanimated my heart one of the many times it failed.
“It was really hard to watch you lying in a coma. I tell you, we fought and fought every day; it was an incredible team effort. We had a crisis every day. Every day, we thought you would die. We had to take risks that meant you would either survive or die in an instant. We took them. You know, when you look at this report, you supposed to be dead. Nobody survives this.” In tears, he held my hand.
“It was so hard, it was so hard, Stanzi. Seven days in coma is a long time. I’ve known you for nine months and I had to go through this. I tell you I couldn’t sleep, I was so worried. Then, just a few days ago,” he stopped for a moment. “We thought that if you ever would wake up, somebody would need to feed you every day. You would never be alert again, never speak a word to anyone and never smile. I’m relieved you woke up. I’m so glad.”
He wiped his tears with his white sleeves and smiled. “And now you can see me, you can think, be awake, be here.” He stood up, pushed the chair back to the window and smiled, “Now make sure your heart keeps working. I don’t want your heart to be shocked again.” He gave me a little kiss on my cheek and left for work. I was touched. I had tears in my eyes, too. But I could not recognize him, as hard as I tried. It did something to me, to see him. I knew that Ulrike and the others, including the doctors, cared, too. I felt bad that I made them work so hard. I watched fluffy snow falling off the tree. It is different to find yourself waking up in the hospital after an accident, like falling off a mountain or a car crash. But in my case, I am guilty and the shame is unbearable.
I crawled a little deeper under the covers so nobody could see my face. A pain, an ununderstandable pain crawled through my body. A pain to breathe, a pain just to be. I listened to the machine, the machine I borrowed life from. Guilty. Ashamed of being and I did not even know why. I was silenced by my body as my brain tried to reflect the hopelessness of words and meaning. I could not figure out who I was. My own name did not sound familiar. Thinking in an almost-dead body is not a good idea. The snow lay heavy on the branches.
One day I tried to sign to Wali to ask again who he was and what happened. I could not remember anything and forgot what he told me. Why was it so hard to remember? I had no sense of people and places. There was a big emptiness in my brain, like a blank white paper. In the meantime, I understood I was Stanzi, but I did not understand that life of Stanzi, what she did to get me into this situation. What life did she have? Life is complicated, given this feeling of innocence and guilt at the same time. Wali had to repeat things in order for me to keep it. But beside the names and places, what did I do exactly and why? I felt heavy. I was guilty of trying to kill myself. Why? Why did I do this?
Wali sat on the bed next to me, holding my hand. I still couldn’t remember him. I just let it go. Then, Wali picked up a letter on the nightstand and read aloud, “‘Constanze Frei, you are immediately expelled from our school. I have instructed all the students not to contact you now, or in the future. Our school will not be giving you a diploma. You tried to kill yourself and that makes you unworthy before God to ever work in a hospital.’ It was signed by Ms. Kobler, the head of the school.”
The whole school was not allowed to see me, Stanzi? Oh, I committed a sin, an unforgivable sin. Stanzi does not belong. She is invisible. But I still needed to know what happened, put the puzzle together.
Wali explained his painful experience of watching me falling deeper and deeper into the suicidal spiral. How less than a year ago he fought to keep our unborn child alive. How he offered to take care of it and me and that I had been so convinced that I would die soon and it was so important to me not to create more orphans. Still, he stood by me when I got the abortion. I could not remember that either. I looked respectfully at him and adjusted the tube on my itchy nose. From the tube in my lungs threaded up through my nose, clots of blood slurped into a clear plastic bag.
The next day, Wali told me about an upcoming ski trip we had planned for Christmas in about a week or two. “I think I have to cancel the trip,” he said.
“Why?” I needed to know the whole story.
He looked so sad. “Stanzi, I don’t think you can walk — at least not right now.”
I wanted to show him that maybe I could. But my legs did not work. I could not lift or move them. I could not stand at all. I thought maybe I’d be quick to recover, but no, I had to give in.
I had to sort things out in my head. So, my name was Stanzi, l was no longer a part of that school Wali mentioned, my lungs are damaged and I am not going to walk anytime soon. The doctor and nurses told me to be patient. But the whole suicide thing made me think the hardest. It was quiet in the room, only the machines made their noises. I again watched how the little clumps of blood made their way through the tube; I listened to the sound. It felt like a little vacuum cleaner sucking up stuff, making my breathing easier.
I felt empty. What is my life? I started to remember Wali’s face. It had begun to look familiar, less strange. He kept visiting me. He explained to me that he lived about two hours away, in Lausanne, where he studied to be an engineer. He also told me where I was right now — in Solothurn — and where the school was. It was like a geography lesson. God, Wali was patient.
The squares in the white ceiling had lost their colors. A nurse checked the machine and my temperature and left again. Days passed. Wali came back, but I still could not remember him, not even that lost child. I had no feelings about it. He told me stories about his family and our adventures, the hikes in the mountains or along the river close to his house with his sister Annerös. He told me about my younger brother, Matthias, who I almost never saw. He told me that I grew up in an orphanage — and told me stories I told him. Over time, I started to remember the past, far away, and then the past, a little closer. The closer past, the harder to remember.
Then, one gray day, after two weeks in the ICU, Wali said, “Do you remember? You were not talking to people anymore, nor did you speak to me. I started to be worried, really worried. I knew you walked around with your little sharp knife. You told me it comforts you. Then, about two months ago you were brought from work to the psychiatric clinic in Solothurn. The nurse who worked with you in the hospital thought you were too suicidal.”
I still could not remember, but I was fascinated to hear more.
“I picked you up two weeks later from the clinic. I was relieved, you seemed happy, at peace. You did not seem to struggle anymore. You talked about being free. Stanzi you had an angel-like glow, do you remember? You were so beautiful.”
Free, I thought, free? Free, I remembered something. Free … I could not tell him. I could not talk. I moved around in my bed. I wanted to tell him — I did remember something. I remembered being rolled into a room at the clinic. I overheard a nurse telling another one that the room was full, but they could put the bed by the entrance for the time being. I stared at her. The room is full. That is it. The room is full! There is no space for me, the room is full. I held a plastic peach in my hand. Shampoo was inside and it smelled like peaches. I held my peach. Harry gave it to me. He was in the ICU at the hospital now and about to die. I held my yellow-orange-red peach with a little green stem. That is what I had. No purse, no suitcase — only a peach. I held it in my hand. There is no room for me, but I have a peach.
Then somebody came in. “Please give me your peach,” she said.
I stared at her, held my peach.
“You will get it back later.”
I kept staring at her. I gave her my peach. It was my peach and there is no space in the room. The peach disappeared. I had nothing. People talked. All I could think was there was no room for me. People talked. There were a few other people in beds in the room. I heard talking around me, the voices disappearing more and more. Everybody disappeared. I started to see everybody farther and farther away. There is no room here. It did not matter. The peach disappeared. It did not matter, not anymore. Wali was far, far away, too. It did not matter. I saw people from a distance. They ran around. I saw them as if I was flying in the sky. They worked, had sorrows, did errands, needed to eat, needed to drink in cafes, had to read newspapers and needed to swim in blue swimming pools. They worked in fields. I was free. I no longer needed. The light was a beautiful white. I did not need anything. I was free from needs. I will never need food. I would never need things again. I was finally free. Death, it must be death, it arrived with light, I thought. I did not know death was freedom — an absolute freedom. Now I knew what absolute freedom was. I was scared of death in the past but not anymore. I was in heaven with angels. I was free. I had never experienced this kind of a profound freedom, profound relief. I felt light, very light, and the happiness was indescribable. Peace is the right word, yes — an ecstatic absolute inner peace. I was in a place I never was before. Not even my thoughts did justice to what really happened in that moment. I could not think that intensely again, let alone express it with words, even if I could talk. I felt bad for the people on Earth. I felt really bad for them not knowing how free and peaceful they could be. They were running, needing food, needing things, struggling with each other or themselves. They were even unnecessarily worried about getting old. I was in an absolute state of happiness, and not even education was important anymore.
I looked at Wali, took his hand for the first time. I could not tell him what I just remembered. That was in the psychiatric clinic. I knew it. But wait, why did I remember this, but not other things? Were not all memories attached to the soul when feelings were involved? Why did I not remember, then, other things?
And what happened then? Why was I here? How did I get here? What happened to my death? I am supposed to be dead. I experienced it, I really did! I turned to Wali, grabbed a paper, drew a question mark again and some crooked letters beside, “Here? Why?”
Wali, shook his head. “I don’t know everything.” He pulled his chair a little closer to my bed. “You ran to Harry who was lying in the ICU. He saw you last.”
Harry, Harry? Who was Harry. I couldn’t ask, I was exhausted. My eyes went back to Wali.
“You only said goodbye to him, that things would be OK, and then you ran away. You still had your keys in your hand when moments later they found you unconscious on the floor, a little open container beside you, probably where you kept those pills. You are lucky that you lived in the hospital dorms so close to the ICU. It still took you seven days to wake up. I was so afraid, Stanzi. By the sixth day we all thought you finally might leave us for good. I told them that you have a father somewhere. They called him, told him you were dying, that he better hurry to come to say goodbye. But he didn’t. He said, ‘Killing yourself is a sin. I don’t need to see her.’”
Wali wiped away tears. “I did not tell anybody that you actually have a mother. I knew you would not want her to be here. I’m so glad you woke up. I’m so glad you are here, Stanzi.”
It made me feel good to have him there. But in another way, I still had that feeling he was a stranger. It was good that he cared. I was tired, very tired. I started to see things like through a veil. Wali left.
I felt puzzled about that pregnancy story he told me. I did not feel that he was my boyfriend. I did not want to have a boyfriend, anyway. I did not see myself in a long-term regular life. It was an accident that I was here. But it looks like my unborn child is in heaven. My poor little baby … Do you miss me? Do you have feelings?
Anyway, I was too tired for all this.
As I was waking up the next day, I remembered that intriguing light, that peace. How wonderful to be weightless. I had a hard time thinking of anything else. Instead, I was heavy in this bed almost locked in like in prison, attached to machines and tubes, a body hardly functioning. I was still on the heart/lung machine in the ICU. I looked down at my body under the blanket as well as I could with all the tubes coming out of my mouth and nose. The artery on my leg was still open to a locked catheter. If I just took off that cap … hmm, the blood would burst out so fast. I would die very quickly. I could then get to rest. It would be a relief. It will never be as easy as now. It’s an inviting situation, that. Then, I felt the cap with my fingers, played a little, checked if it really would be so easy to unscrew. The nurse had just left. It was a good moment. OK, one, two, three — I unscrewed it. The blood gushed out the plastic tube through my fingers. I felt the blood, lively, dedicated, almost angry. I felt alive. Life was bursting through my fingers. Wow, amazing. It seemed in just seconds I lay in a trench of blood.
Dripping sound, where does it come from — blood on the floor? So fast? The machine screamed: PEEP PEEP PEEP! Alarm! The nurse came running. She looked at the machine, puzzled. “What is happening?” she yelled.
I felt peaceful, lightheaded, very peaceful, waiting for the light, waiting to fly as I had last time.
“Blood is running on the floor!” She opened my bed covers. Everything was soaked in blood.
“Take that thing out of her leg,” somebody said. “She is suicidal, take that thing out of her leg! We have to manage without.”
The sound of voices disappeared as I lost consciousness.
The next few days I slept a lot. I was still alive, though with death gripping my hand. I wasn’t so sure anymore if he really was my friend. He had a grip on my body even more on my soul. I held on to him almost as though we were grimly intertwined. I had a real problem now. Things did not look good. I am still alive in an almost-dead body. Nobody could help me and I did not want to see anybody. I knew I disappointed everybody. I wasn’t even sure — was it that I still lived or that I was embarrassed? My God, I was embarrassed. The faces from the doctor and nurses were serious. I did not want to see them, but I couldn’t even really hide.
One day, the doctor told me that I was now able to be out of the ICU and would be moved to a regular hospital unit. I no longer needed the heart/lung machine to breathe. They took the pipe out, which left my throat wounded. Still, I could breathe by myself again. I could hardly talk with my raspy voice, but at least I could talk. My lungs still were heavily infected. I missed that vacuum cleaner tube. Now I had to cough things out without help. In the weeks ahead, I learned to move around with the wheelchair, but my arms were still weak.
Inside me, I had a fight going on. I could not live and I could not die. My thoughts went in circles. I did not know how to deal with all this. How could I kill myself again? I tried to so many times. Life could not go on like this. I did not see any future. I was not depressed or anything, I just did not know how to live. That was more of a practical problem than a depression. I did not know how to not think of killing myself.
The doctor said to me, “We know you are highly suicidal, but you are medically still so ill we still have to keep you here in the hospital. When you are better, we will bring you to the psychiatric unit. Maybe in a week or two you will be transferred.”
It did not mean anything to me. I only lived today.
Wali still visited me, now in the regular hospital unit. With the help of his stories I could remember more and more. I remembered the school and some people. I remembered Aurelia again. I was thankful that I remembered situations, and Wali helped me to find names and places. Only the last few weeks after that amazing experience with the light and freedom — I could not remember. As hard as I thought about it, I did not remember a thing. I could now piece together, from what Wali said and Felix who worked in the ICU, just what happened.
I again thought of some way I could end my life. I wheeled myself out of my room. This time I picked a subclavia set from the nursing station in a moment nobody was around. I knew where things were; I had worked here. I would poke my artery right below my clavicle. I would pump some air into it. That should do it. In the meanwhile, I was already about two weeks in this unit. I felt alone with my suicide thoughts. All I could see was the light on the other side. It was not even worth talking about. I already wore everybody out about it and even one more word about it was too embarrassing. I had to deal with it alone. It seemed I had nothing else, just a big emptiness. Daily life did not interest me. I still felt my spine was an open wound, spilling blood to all sides. The spine was broken; I was deep-inside broken. But still it seemed it was difficult again to actually do it. That hesitation was not understandable.
For days, I went back and forth in my head. But then I thought of a plan. I gave myself until 6 a.m., right before everybody from the day shift came to work. If I did not actually kill myself by 6 a.m., I would not be allowed to think about it ever again. I would only be allowed to think about the current day. I would not be allowed to plan another suicide — ever. If I don’t succeed, I actually will be forced to think about the day, what happened in the moment, about daily life.
But now I had everything I needed under my bed covers and held it tight to me. I swabbed where I planned to poke. I waited. I thought. I thought some more and started to poke with the needle into the skin. I did not know what to do.
Dying is so lonely.
My little travel clock read 4 a.m. How free I felt last time. I would never need anything, ever. I did not cry anymore. The situation demanded a decision, but it was exhausting. It was so much work to deal with it all the time — to make a decision about living or not living. Exhausting work, that’s what it was. I don’t think anybody out there could ever imagine how hard it is to live like that. Behind my smile, that so many people loved, behind my enthusiastic curiosity — the great student — that deep unworthiness, that brokenness, and being ashamed of being. I even knew that people loved me in spite of that, people like Wali or Markus’ family or Harry. They did so much for me; they were here when I needed them. What was wrong with me? Why was I so ungrateful? How could I hurt them like that?
It was a long night. I sat in the bed holding the grip above me. Now I still had two hours, I thought. I fondled the needle, the tube. I thought, I have to make a decision. I wanted to kill myself, put all to an end forever, but I could not. It was lonely. It was so lonely to die.
You have an hour left to do it. If you don’t, you no longer get an opportunity in the future. Don’t hesitate. Do it now, get it over with. You have been fighting for so long. You are not worth living. You are nobody, a zero! Remember? You are an orphan child! You will never have an education, you are too dumb, accept your limits! You pretend that you were a good student! Only you know the truth! You can’t contemplate all the time. Just do it. You will never have to feel your bleeding, cracked-open spine. You will be forever silence!
I swabbed my skin again, wiped away the little blood from before and poked a little into the same place. Then, the night nurse came in to check my pulse. I was covered so I pushed the catheter set down a little and held out my arm to her.
“Ah, you are awake. Are you doing OK?” she asked.
“Yes, everything’s fine.”
She took my temperature and my pulse.
“Everything is fine,” she said. I smiled, could almost not hold my tears back. It was 6 a.m. I missed my chance. As I planned, I threw away the set. Most of the day, I cried. I was a coward. I lived and I did not even know why or how. I did not know how to live. My other voice immediately said, Don’t whine, you had your chance. Now only think what is today. There is no tomorrow, just today and no more suicide for you. You are facing the day as it is.
I tried. I tried to not think of suicide. I did not know what to think if not of that. I noticed how the woman struggled beside me to get up. How it made her happy that she could wash her face and put lipstick over her wrinkled lips. She organized her few strands of hair into a bun.
“I don’t look bad, do I?” She looked at me for confirmation. I smiled. She did look beautiful. In a weird way, I was relieved. I did stick to my plan. I lived just one day at the time — for a long time. No, it was not easy, no, not at all. But I tried every day again. My inner police voice was strong and unforgiving: No, look around to do something with your day. No, don’t go there! The inner struggle remained. Was it enough? No, but it was a start. But I learned to see again the little gifts from the day, a smile of a nurse or a bird sitting on the tree outside the big hospital window, and sometimes, when it was dark, I could see the moon. My life was about little steps, sometimes literally, when I learned to walk or when my fingers tried to write words again. I tried.
Constanze Frei was born in Switzerland where she pursued socialpädagogic studies in Bern and psychotherapy at the Fritz Perls Institute for Gestalt in Düsseldorf, Germany. She came to the U.S. with her two young children and earned her MFA in Creative Writing at Antioch University, where she completed “Girls of the Moon,” a memoir of her early life as an abandoned child growing up in and out of orphanages. She is currently working on a children’s picture book and chapter book, also based on those experiences. Her second adult nonfiction project, “Stone Seeker: Three Months in the Sahara,” is a narrative of her journey through the northern Sahara Desert, culminating in her arrest and escape from an Algerian detention post. Constanze Frei lives and writes in Los Angeles and Switzerland.