Today's Reading
Her mental status exam, however, did reveal one thing of note, not mentioned in the emergency room doctor's evaluation. Jane told me that when she woke up in the park, in addition to her confusion, she had felt something else, too: a profound and perplexing sadness.
"As if something terrible had happened," she said. "Or was about to happen or was happening already."
She could identify no clear cause for this emotion.
"It was like that feeling you have after a bad dream," she said. "But without remembering the dream."
She said this dark emotion had faded.
But I have learned that depression sometimes sneaks up on a person. I began to consider the possibility that this sudden sadness, which Jane described as somewhat alien to her, might actually have predated her strange blackout—even, perhaps, played a role in its onset.
Postpartum depression came to mind, and I asked her some standard questions in that direction.
It was in this context that she mentioned how little sleep she'd been getting. "My son doesn't sleep well," she said. She reported that she had been sleeping less than five hours a night most nights since he was born. (She was quick to mention that she was her son's sole caregiver and that she'd had him through a sperm donor.) I could not rule out the possibility that this entire episode was prompted by sleep deprivation, which has been known, in rare cases, to cause unusual behavior.
"Have you experienced any trauma recently?" I asked. Certain events can set off a temporary disconnect from reality.
At this question, Jane hesitated. "Not really," she said.
Eventually, though, she mentioned, in the manner that one might relay an afterthought, that one of her neighbors had recently passed away.
"Were you close to this person?" I asked.
She shook her head; I sensed an immediate skepticism in her that this death had any relevance to her blackout.
"I actually didn't know her very well," said Jane, as she fiddled quietly with one sleeve of her hospital gown. "She was very old," Jane added. "And not in very good health."
It seemed to me that Jane wanted to distinguish this neighbor's death from the more straightforwardly tragic ones I might imagine.
Even as Jane downplayed the emotional impact that this loss had on her, I noticed that her breathing quickened as she shared the details of the story.
"The only reason I mention it at all," said Jane, "the only reason I'm bringing it up, is that I was the one who found her. Her body, I mean."
This, of course, struck me as a very important fact. "That must have been very upsetting for you," I said.
Jane went on to explain that a leak in her bathroom ceiling had alerted her to trouble in the apartment directly above hers. When she got upstairs, she found the door to her neighbor's apartment standing ajar and the woman's bathtub overflowing. The woman herself was lying, lifeless, on the kitchen floor.
"I could tell right away that she was gone," said Jane. "That she wasn't alive."
New York City is a place of strange intimacies, and this was not the first time I'd heard a story of one neighbor discovering the death of another. It is almost always unsettling to come across a deceased human being, no matter how natural the death might seem, or how distant the relationship.
"Must have been a heart attack or something," said Jane. "An ambulance came. I haven't heard anything more about it, but like I said, I really didn't know her."
This insistence—that the potentially meaningful is really not so meaningful after all—is a common response to traumatic experiences. But it is an impulse that carries obvious psychological risks. Wounds that go unaired can fester. What Freud called conversion disorder came to my mind: when some aspect of reality is so upsetting that the mind converts it to a physical ailment. The modern term is a functional neurological disorder, something that affects the function of the brain but does not originate in its physical structures.
I began to think of Jane's blackout this way: Perhaps it was her mind's attempt to unsee what it had seen on that kitchen floor. It didn't quite explain the timing, but I sensed a possible link, that perhaps Jane's amnesia was her brain's way of removing unpleasant memories, including, in this case, an entire twenty-five-hour period.
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