• Fight or Flight


    IV.

    Fight or flight they call it. Panic-attack. Adrenaline rush. What happens is a restriction of blood flow to certain areas of the body and increased blood flow to the muscles. Increased air flow and heart rate. I’m not actually thinking this, it sort of all coagulates into one messy thought. Biology and Anatomy courses seeping into my memory. After all, thoughts are merely chemical reactions and electrochemical signals from the neurons.

    This is all what your body does in a millisecond. And when that sudden wave of epinephrine takes over, those neurons process information twice as fast. We call this slow-motion. Again, I’m not thinking these exact words. Or any of them. What do I think?

    I think ‘********’.

    ...

    Go back to the night the three of us were accepted into med-school. Back to holding those letters of acceptance in one hand and a beer in another.

    Thomas is giving a toast to lifelong friendship. One of the many infamous stories he tells on occasions like this. See, Thomas, Christina and I, we grew up together. We built tree houses, rode bikes and trespassed into neighbors yards. Here, some twenty years later, nothing has really changed. Only now we share an apartment. Now we all have jobs we hate and school-loans to pay off. Now the world isn’t so mysterious. No, nothing has changed, we just got older.

    Thomas holds up his letter like it’s a trophy. This is an all your dreams may come true moment. Take a picture. Let this moment burn into your memory. It will come back to you someday.

    “Remember that time when we were all seven or eight or something?” Thomas says to me. “When those helicopters were flying over the neighborhood searching for that bank robber. There we are in the backyard, playing god knows what, having fun. And I remember your dad had asked you to get something from barn earlier.”

    Thomas can’t stop laughing in between each sentence. The way he tells it is like we’re in our seventies, looking back at our lives. The three of us here at our bar, our table.

    “Anyways, so he comes back out and he yells at you asking if you forgot about your chores then storms back into the house. And it’s dark out by now. Like, the helicopter cops have their search lights on and everything. So what do you do? You got out to the barn and the ********’ bank robber they’re searching for is just standing there. He points to his lips and goes ‘shhh.’ Creepy as ********. And what do you do? You ******** point to the broom stick, he hands it to you, and you just close the barn door. We’re all so shocked we don’t say anything. They never caught the b*****d either!”

    Christina spits up her beer she laughs so hard. Says she forgot all about that.

    “I never told anyone about that either.” Christina adds.

    “None of us did.” Says Thomas.

    Before any of us can take another drink we burst into a second wave of laughter. We’re here so often no one seems to notice us spend the night in hysteria, growing louder after each drink, each story more fabricated than the last. Thomas even jumps onto the table at one point for dramatic emphasis onto his stories.

    Back to that night when I shut the barn door and never said a word. Thomas had nightmares for months. Said every night he dreamt that the robber came to his room and he’d wake up with the robber hovering over him with a knife. Before he could even scream for help it would be too late. Christina and I were the only ones he ever told this too. Now it was all a joke.

    Back then, Thomas’ parents put him in therapy. Took him to a shrink cause he wasn’t sleeping well.

    III.

    Everything you feel, every emotion from anger to love, is a chemical reaction. Right now all I am is a response to environmental stimuli. The feeling encumbering me now? Its not too unlike the effects of dopamine and adenosine while sleeping. That hazy ecstasy of dreaming is how my mind perceives the world right now. Thank you general lessons in anesthesiology. Thank you neurology courses.

    This is what my mind goes through in the next millisecond. I hear a scream and reach out but it’s all just impulse. Part of that fight or flight instinct evolutionarily ingrained in us to survive. You see it at war and in mothers whose kids are in danger. When in a fight and when you get stage-fright. I’m not perceiving things how they actually are because my body won’t allow me to.

    Right now I am just a result of environmental stimuli. A by product of chemical reactions.

    ...


    Go back to receiving the results to our first major Pathology exam. To the hours spent studying with Thomas on identifying the different causes of cellular necrosis or distinguishing the varied types of viral pathogens. Things not too difficult generally. Back to Christina and I receiving perfect scores and Thomas failing.

    To Christina, the protégé of her mother and father and a long line of doctors in her family, these things come easy. Christina takes it for granted that not everyone knows that the term analgesic derives from two separate Greek words meaning “without” “pain”. Christina, she’s here because she is good at it and because she has to be. She doesn’t see that some people, like Thomas, have to give it their all to get a “C”. That some people, like Thomas, are passionate about life.

    And I’m only here because they are.

    Christina puts her hand on his shoulder, tells him he will do better next time. She omits the fact that if he fails another he’ll fail out of med-school. That only the top students ever graduate. This all happens as we are walking through the hallways from one class to the next. Thomas says he just hasn’t been feeling well lately. He doesn’t look well either. What he doesn’t tell us, at least yet, is that when Christina touched him, he didn’t physically feel anything.

    Losing or reducing sense in touch or sensation: that’s called hypoesthesia. Losing sense of balance, another symptom he told us he was experiencing only months later; that’s called ataxia.

    Flash forward a few hours to the bar and Thomas slurring his words. And notice now it wasn’t because he was drunk, its another symptom called dysarthria. Everything we do is a result of chemicals or neurons. There’s a name for everything wrong with someone and everything right. Thomas leans into us and says “I’m lucky to have you guys.” It’s so incoherent what I hear is “I ******** hate you guys.”

    Within the next few minutes Thomas is slacked back into the booth with his head lobbed to the side. Christina and I find him like this after going to get more drinks. With a spilt beer pouring into his lap and drool dripping down his mouth we find him. Christina dials 9-11. Med students calling for medical help. Thomas’ eyes are twitching. Pathologic nystagmus is defined as an involuntary eye movement with a smooth movement in one eye to one direction and a violent movement in the other. Thank you biochemistry and immunology. Thank you physiology and pharmacology for making this all part of my everyday thought process.

    And its only downhill from here.

    “I’m just under a lot of stress lately. I haven’t been sleeping I’ve been studying so much.” Thomas tells me later.

    “We’re here for you.” Christina reassures him.

    Flash forward to us once again at the bar only a few weeks later. Another perfect exam score on myself and Christina’s part. The only thing that happened in those weeks were more laborious hours of studying. Another failed exam on Thomas’ part. Thomas looks over at me, smiles, then laughs in the way you know he’s got something to say.

    “I got one. Remember a few years back when we’re still working as EMT’s and we got that call for this same exact bar? We were bickering like a married couple those days about god knows what. Anyways, we pull up and the place is just a mess. There’s a line of guys sitting at the curb just covered in blood. Broken noses, arms, black eyes; the whole nine yards. There’s even a guy laying on the floor with a knife sticking out of his chest.”

    Christiana leans in as if she’s never heard the story before. These days, everything he says to her is like a last wish.

    “Continue.” Christina urges.

    “And even though all this s**t is going on, here you and I are,” he says, nodding to me, “just screaming at each other. Never mind we’re on duty. Totally professional. And we go on for at least ten minutes just arguing. Then out of nowhere, the guy with the ********’ knife sticking out of him just gets up off the ground and turns to us. He smiles and he’s all, “morning guys, good to see you’. We shut up instantly and just stare at him, but don’t say or do anything. He waves, walks about ten feet with the blade still in his chest and falls face first. Knife pushes deeper into him and everything. Almost gave you a heart attack. The worst part is, the guy who stabbed him is on the curb whining about his black eye the entire time.”

    Here, after getting kicked out of med-school, Thomas is the one telling anecdotes. Thomas finishes off his drink and takes his leave to the bathroom. For a minute neither of us speak. Christina just glares at me.

    “Come on, you can’t seriously be considering dropping out. You’re really good at med-school.” She finally says. “You have aced everything up ‘till now. Are you just gunna’ waste all that time and money?”

    “Do we really have to do this now?” I ask her.

    “You’re kidding. When’s a better time for you huh? When is ever it a better time?”

    “Thomas failed out. You only have a few months to go before you graduate. What point do I have going there? I don’t want to be a doctor.” I say. She falls back to her seat and makes a sort of “hmph” sound. Christina spends the rest of the night looking anywhere but at me. Even Thomas notices something is up when he returns.
    Think back to telling my parents and their dealing with their disappointment. To my professors urging me to continue on with my education. Think back to Thomas yelling at me feeling responsible for my mistakes, lecturing me, like I’ve already ruined my life. Like I missed out on something great.

    “I don’t want to be the one to blame for you quitting. You can make a damn good doctor” he says.

    Go back to that night in the apartments. Thomas holding an unopened envelope from the hospital in one hand and a beer in another. Thomas is once again giving a toast to lifelong friendships. How we grew up together. How we built tree houses, rode bikes and trespassed into neighbors yards. And here how nothings really changed, we only got older. Thomas holds the envelope similar to his notice of failure from med-school. This is an all your nightmares come true kind of moment. Take a picture. Let this burn in your memory. It will come back to you someday.

    Watch the look of utter disappointment spread across Thomas’ face as he reads over the letter. Welcome to being diagnosed with multiple sclerosis.

    II.

    What I hear and see is all in slow motion. Screams and sirens sort of coagulate into one messy backdrop of white noise and scenario. I see Christina holding out her hand. I see Thomas not too far from me. It fades quickly. I still feel the effects of epinephrine rushing through me. Here, right now, that fight or flight response is really pointless. There’s nothing I can do. This is here and now and no chemical can do much except slow time. Processing information twice as fast at this moment is a torture.

    No, this isn’t what I’m thinking and what I see. I see Thomas, Christina and I growing up. I see us graduating high-school and junior college. I think everything I don’t ******** want to think about. I’m thinking this is pretty unfair. Not that anything is fair or unfair really. Everything is just a reaction to stimuli. I’m thinking if I could change things I would.

    And this too is all in a millisecond.

    ...

    Think back to moments prior to this.

    Here the three of us are standing at the top of the apartment complex. The ten story complex. Here Christina is crying uncontrollably. Here Thomas is standing at the ledge. And here I am not knowing what to do. Here’s the scene.

    Its close to three in the morning. Below us, at the bottom of all those stories, the police have just arrived. The sirens echo all the way up the building structure. Christina looks at me like I’m supposed to do something. Like I’m some sort of savior.

    Moments before this the Christina and I were just getting home from a late night out. We come home to find a note on the counter, a goodbye from Thomas. Thomas the storyteller. Only hours before that we urged him to come with us, which we knew we shouldn’t have. Months before that we watched Thomas’ condition decay away. First he lost all sense of balance and coordination. Ataxia. We watched him go into epileptic seizures and slowly lose control of his speech. Dysarthria. We watched all this and did nothing. Christina, the protégé of medical education and myself did nothing. Flash back to all those nights in the hospital watching your best friend go into surgery.

    Here time has already slowed. Only now nothing seems to process at all. The sirens flashing and Christina’s sobbing sound louder than what they really are. They sound like someone screaming in your ears. Think back to those moments of sitting by Thomas’ side in the hospital. Think of him pleading you to kill him.

    Everything, even this, is a reaction to environmental stimuli. To chemical reactions and neuron transmissions.

    Thomas’ legs start shaking. Anymore, he can only stand for about ten minutes before they give out; and it takes all of his strength to last those ten minutes. Thomas steps back untill he is on the tip of the edge. Christina is inching closer to him, reaching out and still sobbing. I’ve crept forward enough to where I am only a few feet from him. My hands are reached out as well but it’s to grab him the second I get a chance.

    Think back to some unimportant date when the three of us are sitting in the bar. Sometime probably back while we were still junior-college kids. To when we thought we could tackle the world. Thomas smiles at us and begins.

    “Oh god, remember that party, don’t give me that look. You know what I mean by that party.” he says to me. Christina’s heard so many of these, she actually is interested to hear Thomas’s anecdote. She can’t figure out which night this is about.

    “You’re never going to let this one go are you?” I ask.

    “Hell no.” Thomas responds as he hands us all new beers. “This was like, your first night drinking heavily. I mean heavily. You were hammered. What did you have that night?”

    “Brandy. At the time I didn’t realize that it was more of a dessert drink. I drank as much brandy as everyone else seemed to be drinking in beers.”

    “Oh, that night.” Christina says and sighs.

    “Half way through the night your body decides it can’t take it anymore. Alcohol poisoning is a b***h. So you’re in the bathroom puking everywhere. Christina’s holding you while your slouched into the toilet and a group of us are at the door watching.” Thomas stops as the smile widens. “And you look back at Christina, you look absolutely disgusting, and say to her ‘I think I s**t my pants”. Needless to say she jumps back and lets go of you.”

    Both Christina and I are shaking our heads as Thomas laughs.

    “But since she’s not holding you up anymore your head smacks into the toilet seat and you flop onto the floor. We all think you’re dead cause you don’t say anything for about five minutes. The only thing we can manage to say to each other though is ********, someone’s going to have to clean him up. You finally wake up with all of us surrounding you, all of the girls have been weeping, and mean weeping. They have tissues in their hands and Christina thought she killed you. I even felt terrible handing you drink after drink. You look up and your all ‘What the hell is going on’. After some smart a** says you s**t yourself you pat yourself down. ‘No I didn’t’ you tell us and then just go to sleep on the bathroom floor.”

    Think back to all those jokes and memories Thomas, Christina and I shared.

    Here Thomas takes his first step off the ledge. The epinephrine hasn’t done it’s magic just yet. Christina shrieks and I jump forward to grab him. I reach out, one step too far, as his body slips off the building roof. The motion is so great I can’t stop myself. Before I can process my surrounding I have slipped off with Thomas.

    Fight or flight they call it. Panic-attack. Adrenaline rush.

    I.

    The rate an object falls is approximately 9.8 meters per second. In one glimpse I see Christina leaning over the ledge, her hair falling down and her screaming. The next glimpse she’s a dot in the sky flying from me. Thank you lessons in physics. I see Thomas’ body spinning slowly near me. All of this is illuminated by flashes of sirens. The stars floating above us. City lights polluting the sky.

    But no, I don’t think any of this. As collected and coherent as these thoughts would normally seem, they all hit me at once. A blur of everything my mind can throw my way in hope to make sense of this. In hopes to find something to hold onto. Fight or flight.

    No, I don’t think any of this.