The intake nurse asked me to remove my top and wrapped the cuff around my left arm. I stared at the wall.
“Would you believe . . . uh . . . anxiety?”
She gave me a look of sympathy. I was choking on the words. She told me she could see it in my face. The wringing hands and avoidant gaze were obvious tells. The train wreck eyes.
The machine whirrrrrrred. The cuff swelled, shrank briefly, swelled again. The nurse’s eyes went wide. She ran it again.
I saw her flinch. She turned the machine so I could see.
“Are you . . . are you experiencing any dizziness? Nausea?”
“Are you in pain right now?”
She took my right hand, put the cuff on my right arm, and instructed to hold it out in front of me at head level.
Whirrrrrrr. Squeeze. Fuck . . .
She shook her head. We were cheating the test, and I was still a hypertension hand grenade. My actual blood pressure was so high that a lesser man would have puked on his shoes in the last blackout moment before he passed out on the floor.
I stood and zipped up my top.
Going back to Behavioral Health felt like ringing the bell.
Fuck it. You win. I quit.
The first round with the counselor was rote. She reviewed the bullshit, watered down screening test and informed me that I had exceptionally high levels of anxiety, and tested high for Post Traumatic Stress.
I felt like I’d just been hit in the chest with a hammer.
The rest of the conversation went right through me. I rambled as long as she asked questions. When she asked to set up our next appointment, I requested to speak to a counselor who had been to combat. She looked hurt, but she made the referral.
The “pill doctor” was a separate thing. I filled out a second “disclosure” form. He started to ask if I had any questions and I laughed.
“Sir, there’s no such fucking thing as non-disclosure wearing this.”
I tugged at my uniform.
After a long discussion he gave me a dozen different medications to choose from. I opted for Hydroxyzine. It was good for another hour of sleep a night, if I poured ZzzQuil and booze on it.
. . . It didn’t work. I went back to psyche.
“How have you been?”
“Fuck. Awful. Pills don’t work for shit.”
We talked symptoms, concerns, and drugs. I was in much better shape than the last time. His eye contact avoidance and uh-uhms were exactly the same as the first visit. I’d already dialed in his idiolect and mannerisms.
I liked him.
He punched at the keyboard, pulled up every medical statistic the Army had compiled on me. Blood tests. EKGs. For all of my issues, I was a robot. Even in my worst shape. Mental. Emotional. I was thumping along. Spec perfect.
“They have me on a five day blood pressure thing. Today I was down to 124/77, until work fucked me. Now I can feel my fucking pulse in my neck.”
He scrolled through the stats as fast as he could. As we sorted details, I gradually unfolded my hand. The best way to deal with medical..
They get uncomfortable when some thick neck primitive speaks their language. He knew I was operating at a crippling level of stress. He probed into the background.
“Doc . . . so . . . Grossman wrote about it, how I know about it . . . After World War II the Air Force looked at their pilots. Found the best of ’em, just a handful, did most of the killing . . .
“The only common factor? They had all been in a lotta fights as kids.”
He hadn’t read “On Killing”. I’d figured it was mandatory for his lot.
“So . . . got this idea in my head . . . as opposed to my fucking foot, I guess, uh . . . Getting hit in the face as a kid, you get exposed to adrenaline earlier than most.
“I was bullied my whole fucking life. Fat, church-y kid. White trailer trash. I got it at school, I got it at church. Once I weighed enough, the old man bounced my fucking head off the wall . . .
“Until I hit puberty. My shoulders got ‘this’ wide. Haven’t lost a fight since. Not a real one.
“Early exposure to adrenaline causes the same kind of adaptation that hypervigilence does. The endocrine system innervates the adrenal response . . .
“Fight or flight.”
He leaned back in his chair. I hadn’t seen him do that before.
“Genetics cocks the gun,” he replied. “Nurture pulls the trigger.”
“That’s the best explanation of soft determinism I’ve ever heard . . . ” I said, brows raised.
“I went to Afghanistan already geared for it. A year of constant stress . . . I mean, this isn’t fucking Post Traumatic Stress . . . Hypervigilance rewires the endocrine system.
“I went in already primed. Now I’m fucking hard wired. Kinda broke-dick explanation . . . sound about right?”
He looked at me a moment, eyebrows raised.
I was more fucked up by whatever clinical definition he operated by than I was letting on. I knew it, and I refused to cross whatever metric would have taken control of the process out of my hands.
He looked at his computer. He looked at the ceiling. He hmm’d and aaaaahhhhhhh’d . . .
“Well, uh . . . yeah. Yeah. I’d say, given what you’ve told me before, and that . . . Yeah . . . I’d say that’s right.”
He scripted me the pill I asked for.