Monday, May 24, 2010

The seizure

Damn she’s pretty. We were in the basement of a coffee shop off campus. She sat with her back to me, typing in a laptop surrounded with a scattering of papers, occasionally pausing to take a sip from her paper cup while keeping her eyes trained on the computer. She got up and asked if I’d watch her stuff so she could leave to have a smoke.

She was young, tall, and skinny. Probably too skinny for her own good. And I thought she looked too innocent to be smoking and—because of hay-colored mane of hair, pallid complexion and noble carriage—too regal to be hanging out with a bunch of yuppies. She looked like she should have been leading a gaggle of sycophantic courtiers down the halls of some Scandinavian castle or admired as a marble-dipped statue surrounded by arching fountains and trim hedgerows.

Soon after she got back and sat down, I saw a sudden movement out of the corner of my eye. With her head tilted toward the ceiling, she rose from her seat ever so slightly and gracefully fell to the brick floor where she began writhing helplessly. Her eyes bulged and her teeth clenched.

People looked around their laptops to see the cause of the commotion. A man nearest her got down on his knees and held her head. It was the first time I saw someone having a seizure and, stunned by her contorted face and the horrific jerking of her body, I couldn’t move at first. I forced myself up, stepped over her, and called 911. While waiting for the paramedics, the man caring for her announced that she’d stopped breathing and that there was no pulse.

Before the paramedics came, she started breathing again and slowly—very slowly—regained consciousness. She didn’t know where or even who she was. But she did know that she’d never had a seizure before.

“What does this all mean?” she said, with tears rolling down her face.

She was asked about diet, stress, and medication changes that may have caused it. She only said that she’s been really busy with schoolwork. That’s when I got upset. There could have been a hundred reasons behind her seizure, but I decided it was because of school.

Despite being in one of the most youthful, energetic, and imaginative periods of their lives, many students suffer from poor health and depression. Between work and school, I remember being so busy my junior year that I stopped exercising altogether. Throughout my college career—even as recently as this past semester—I’ve pulled several all nighters and consumed unhealthy dosages of caffeine to get my work done.

There are many types of college students. There are slackers who smoke and drink their parents’ money away. There are dedicated students who care about their education. And there are the hyper-focused students who live in libraries, never sleep, and whose idea of success is largely determined by grades and accolades. Rarely, I’ve found, does this third group work so hard because they're passionate about the subject they’re studying. Rather, they’re more like robots programmed to pursue their flimsy notion of success, fueled by Adderall and energy drinks. It’s this group that’s most likely to crash and burn.

College—they don’t realize—is a fantasy land. The deadlines and grades and expectations are only real as long as we believe that they’re real. When I begin to stress-out over deadlines, I remind myself that I’m in school of my own volition. I can neglect to turn papers in, I can skip class, hell, I can even drop out. I never do these things but I think it’s important to understand that the world will not end because of a bad grade, a failed class, or a rejected internship application. A volcano spewing lava over someone’s home is real. The world ending because of a B- is not.

Other students—who’ve spent their entire lives in schools—cannot make a distinction between what’s real and what’s not. A “B-” is not just a “B-”; it very well could be the end of their world. That’s because they feel some deeply rooted need—implanted in them by parents, teachers, and even themselves—to keep pace with fellow students, to get grades, and to get a good job. When expectations are set so high, it’s only natural that they burn out trying to attain these things and feel worthless and incompetent when they can’t.

They go to college not to grow into fully-functioning, self-sufficient, critically-minded men and women, but to become nurses, investors, and marine biologists. Today, college is considered less a place to develop and more an arena to compete.

It should come as no surprise that suicide is the third leading cause of death among 15-24 year olds. There are 1000 suicides a year on campuses and a 2000 survey by the American College Health Association reports that 9.5% of its student subjects had contemplated suicide (American Association of Suicidology).

Six students from Cornell killed themselves this past year. It got so bad that the campus has posted guards and built a wire fence on the bridge where several students jumped to end it all. My friend, an RA at Harvard, told me how two underclassmen killed themselves last year, likely because of the pressures of school.

Plus, when you have excessive student loans, it’s almost inconceivable to drop out without a degree to show what you've paid for. When you go into school not to attain knowledge but to attain a degree, college becomes less a beacon of truth and more a prison that’s too risky to escape.

But I’m being awfully presumptuous. It could have been a chemical imbalance, or a hundred other reasons. School may have had nothing to do with her seizure.

After that afternoon, I began seeing her everywhere: outside the gym, on the bus, walking across campus. When we’d cross paths I could tell she didn’t recognize me from the café.

I started to feel like I was stalking her. When I’d see her, I’d change my direction and follow her with the intent of stopping her and telling her that I was there. What would I say? That I watched her die and come back to life? That I saw her vibrating on the brick floor with spit all over her face? Thinking about her skinny frame, the caffeine, the cigarettes, and all the homework, I really just wanted to tell her to take it easy; that she could be killing herself with schoolwork; that it’s going to be okay if she gets a C and that it’s okay if she takes a semester off from college. I’d tell her that if college doesn’t rouse her passions, leave and find something that does. I’d tell her to go look at the stars and mountains to remind her of how small and insignificant we are, and that the troubles we bear are even smaller. Then come back when you’re ready.

Alas, I said nothing. Instead, I just trailed her from behind. It was as if I held some secret about her that I shouldn’t have had, like I’d seen her naked without her knowing it.

Months went by until I saw her again, this time in a different coffee shop. She walked past me to get her coffee and on her way back I smiled and kicked out a chair. I was probably blushing and my heart was racing. I asked her if she recognized me. She said no.

“Well, this might be somewhat uncomfortable for you, but I know you from the coffee shop.”

It still didn’t click, but I gave her a look, and it hit her. Her face reddened and her fingers fidgeted, but she was palpably curious. She said she had no recollection of the day and because she didn’t know anyone at the coffee shop, no one had been able to help her recount the episode. I told the story as best I could. With eyes welling with tears, she smiled and thanked me.

We’d see each other occasionally on campus, but every time she’d look away as if she didn’t know me, probably because she was embarrassed or because she didn’t want to be reminded of the episode.

I looked for her this past semester, but it appeared she’d left. I figured she took some time off from school to relax and reassess. Good for her, I thought. Then, towards the middle of the semester, I saw her again at another coffeehouse. Like our first encounter, she had her back turned to me. A lap top, a scattering of papers, and a smoking cup of coffee in front of her.

I was focused on my work, until the room went silent and someone yelped, “Does anyone know what to do!?”

I looked over and saw her that her arms had flopped to her sides and her head hung over the back of her chair. Her body was jerking madly. I didn’t “know what to do” but I got up slowly, walked over, and put one arm around her back and another beneath her long, dangling legs. I lifted her from her chair and looked at her face. Her teeth were clenched again and her eyes were zombielike: full of fervor but absent of life. I gently set her on the floor where I cupped her head with my palm so it wouldn’t hammer against the ground.

I've had Wilderness First Responder training, but because our class had spent exactly 30 seconds on backcountry seizures, all I knew was to keep her head secure, not to put anything in her mouth, and check her breathing and pulse regularly.

After the convulsions ceased, she started gulping for air and then stopped abruptly. I thought I’d have to begin CPR, but my hands trembled so much I couldn’t take her pulse. I turned her on her side and a syrupy mixture of saliva and blood oozed from her mouth.

By the time the paramedics arrived, she was breathing okay and a similar scene unfolded. More questions and more tears. Her friend came over and told them that she’s been working really hard.

“I really don’t like it here,” she said, her face pink and wincing. She also told them that this has happened only once before.

She saw me sitting in my chair, looking on sadly. She smiled again with a face full of tears.

I saw her a few more times on campus and felt just as reluctant to approach her as I did the first time. We bumped into each other outside the library, but kept walking as if we’d never met. Halfway to the van, I turned around and went to speak with her, hoping I’d tell her everything I wanted to say.

Except, I just asked how she was. She said the seizures had stopped once she started taking medication, and that she was doing a lot better. I wasn’t so sure.

I looked at the smoke billowing from her cigarette, and in the background was a statue of Benjamin Duke, presumably one of the founders of the college. I thought of the statues, the legacies, the great men and women, and how they will all be ashes and dust one day. Future generations will forget the names and the sacrifices of these men, just as we’ve forgotten the names of kings and emperors that once ruled great civilizations. The books in the library will crumble into worm food and the work of the many ambitious students around me will one day be swallowed by an apathetic earth and forgotten by an indifferent universe. So why spend our lives chasing elusory, foundationless goals, killing ourselves (sometimes literally) in the process?

I think it’s alright to pull the all-nighters, abuse the coffee, and neglect the gym if you’re passionate about your work; a daily dose of invigoration will compensate for other unmet needs. But to spend your time seeking something you don’t truly want or studying a subject that doesn’t interest you makes suicide—for those who can’t see the world beyond classroom walls—look like a reasonable alternative.

Ever since that conversation by the library, we’ve been saying hello to one another on campus. While I’d like to see her again to catch up, I’d be happier if I never saw her at Duke again.


-Heidi said...

Wow! Powerful!

I don't know what I'd have done if I'd gotten a "B" in college! I'd convinced myself that the very lives of my children depended on perfect grades... and a double course load. I was such an intense young person! lol

I was in my early twenties, just divorced from my husband who was then in prison, and had three young children all in diapers. There was no room for error! I was in a constant state of panic!

I graduated with a 4.0 - and I could have done much better! lol But seriously, I could have given my children less money and more mom.

I could sure relate to the young woman... I hope she'll be okay. :(

Awesome and moving post!

Anonymous said...

Great writing. Wow.

Anonymous said...

How does it feel when you meet your future wife? I mean, really, you keep saving her life. Seems natural to continue to do so.

Seth said...

please continue to write about this idea. more people need to be talking about it.

Ray Janes said...

excellent. Hope the young lady truely does have it under control

Kevin M said...

You have a gift for storytelling, not to mention wrapping up a very important message in that tale. There is a lot messed up about the current state of higher learning and you touched on just about all of it - the competition, pressure, the debt - not to mention the difficulty getting a job. At what point do kids realize college might not be the best optino?

Ken said...

Heidi--Goodness. A small part of me does care about grades. Ideally, I think our ambitiousness should come from passion, but I think it's okay for grades to give us a little push. While working the past few years, I had plenty of time to read, write and learn, but I found that without the structure of school I wasn't absorbing the material well. I needed the homework, the seminars, even the grades of school to progress at a rate I was happy with.

Anon-Thanks, I actually thought that it wasn't up to snuff; I can't quite give enough attention to the finer aspects of an essay with these really long posts.

Anon--you're more of a romantic than I am. I can tell she's a nice girl, but I don't think "Act II" will play out how you wish it will.

Seth--One of my passions is our education system, specifically higher ed. I think there's a lot wrong with the system, which I'm sure I'll touch on more here and there. John Taylor Gatto is a great read if you're interested.

Ray--thanks, me too.

Kevin--I agree that some people aren't meant for school. I think in most cases, though, it's less the person and more the quality (or lack thereof) of the school that may alienate some people. I believe very much in a liberal education--I think the critical thinking and creativity it fosters can hugely benefit a citizenry.

Fannie said...

It's pretty amazing that you happened to be there during her only two seizures. Sadly the medication she takes for them is likely pretty hard on her body, but the personal choice she's made with the cigarette may eventually become far worse than either seizures or medication. Good things can come from an education but I will say I regret with a smile my first 7 years, the last 2 were worth every minute!!! In the end life is just the next moment before us. I haven't been keeping up on your blog Mr. Ilgunas. Sorry. Have you returned to this neck of the woods?

Ken said...

Fannie-- I am not in your neck of the woods unfortunately. I've chosen a backwoods locale in N.C. to get some studious things done. I already miss the arctic but comfort myself knowing that I'll be back before long. Have you begun saving the world yet?

Chris said...

The first part of the article sounds strangely familiar. Did you by chance tell this half this story on a visit?

Ken said...

Chris--I'm sure I did! Good memory.

mOOm said...

I was happy when I passed some courses... When I've looked at grad student applications (including being a grad program director), I'm suspicious of students with too many A's. Rather I'd prefer to see A's in courses they were passionate about and OK grades in others. The only places undergrad grades count of course is in grad school applications. And they are just one component.

KClowlife said...

the stresses of a hardcore college are real but I wouldn't force that on something that is likely just a biological issue.

I know it's a scary thought, but many of us are physically flawed but can be treated with drugs. On the up side, it's better than when we'd either burn her for being a witch or she'd just die in the woods somewhere.

Ken said...

Moom- Indeed. I think students are better off taking part in clubs/extracurriculars than focusing solely on getting a 4.0. My college newspaper experience was life-changing.

KC--perhaps it was just a bio issue, but I figured it was a way for me to discuss issues that I've been itching to discuss. And yes, certainly better than witch-burning.

Slatton said...

Great entry. Perhaps the saddest part about your hyper-focused students is that they often don't realize they're crashing and burning. For so long they expend all their time and energy on pursuing their notion of success -- and one day they are unfortunate enough to attain it: the high-paying job for which they have no passion, the trophy husband/wife with whom they are not intimate, the money that they're too old or worn out to enjoy, etc. It's kinda funny -- if someone had told me a few years ago that my pursuits would lead me to utter emptiness rather than fulfillment I, like so many of my hyper-focused peers, would probably have laughed in his face. It was only through sacrificing relationships and the healthy (and somewhat stress-free) lifestyle I once had that I came to learn how important these things really are.

Your Thoreau-esque insights are a breath of fresh air for those of us who have fallen too easily and insensibly into a particular route. Keep up the good work.

Anonymous said...

A few years ago my roommate (may her soul rest) had several seizures and was diagnosed with brain cancer. I and my friends could not shake the feeling that it somehow had something to do with graduate school, this hellhole we were all in. But maybe what it was, was the look in her eyes afterwards, that she had been waiting to finish graduate school to start her life, and now she would never have the chance. Thanks for the post. Please write more on this.

Adam said...

Though this post is a few years old now, I hope someone else is still reading. Like the girl in your experience I too suffered my first (and thankfully, only) seizure in college, but as an undergrad.

It was during a final presentation in one of my English classes. I had had a successful presentation earlier that day in another class, and I was about 30 seconds from wrapping up this presentation when suddenly I felt that I could not finish what I was saying. It was a kind of stuttering, but I was stuck on one word, glue filling my mouth, sound escaping in one long drone, feeling terribly embarrassed that I was incapable of finishing the word. I vaguely remember falling to the floor after that, but that's all before I woke up in the hospital. My professor rode with me in the ambulance and later recounted that I had writhed on the floor, similar to the girl in the post, and I had finally woken up at one point with no memory of anything or anyone, acting very strangely when the paramedics arrived.

Several tests and neurologists later I was told that seizures are like "colds of the brain:" they could be indicative of any number of problems or indicative of nothing at all. There was no single likely cause that could be confirmed, it was just chalked up as a freak accident. Sure, I had an unusually large blood vessel in the speech part of my brain, and because it started with a stutter maybe this indicated the dysfunction started there before spreading like wildfire across the rest of my brain. But it could just as easily have been a coincidence; in their experience, they had never seen these abnormally large blood vessels play any role in seizures before.

I was told that I may have many more seizures or I may have none at all the rest of my life, or I may go forty years and then have another. I was told that while I was technically not epileptic (the definition of epilepsy is having two or more seizures in your lifetime) I should probably take medication for the rest of my life, just as a precautionary measure; medication with debilitating physical and emotional side effects that were immediately noticeable. Under family pressure, I took the medication for about six months before discarding it. In about a week, I will celebrate being seizure free for three years. Thankfully, the only reaction to ending the medication so far has been freedom from the side effects, ever-present side effects which give one less than a half life, and to me certainly outweigh the risk of a seizure which may happen tomorrow or may happen forty years from now, or may never happen at all. I am quite fortunate in that my likelihood of having more seizures is so uncertain; for many people there is near certainty of more seizures, making their use of the latest medication almost obligatory. Furthermore, with every successive seizure you have, the more likely you are to have another. In my limited understanding, this is not just because seizures are so poorly understood as a whole and have many causes, but also because a scarring of the brain tissue can develop which makes you more prone to them.

Adam said...

My seizure certainly shook up my world. It was one of the first moments in my life when I suddenly didn't feel so invincible anymore, when I suddenly realized I needed to do more living and less waiting. Did it make me take a break from school or take better care of myself? No; I was only a semester from graduation, and I vehemently denied that it was the stress or lack of food or sleep which might have caused the seizure. At the time the neurologists seemed to be on my side, and I felt that my family was using the incident not as a constructive wake up call, but as a way to exercise more control over me. I come from a very protective family; no, I wasn't breastfed until I was ten, but suffice it to say that I've never come across anyone who would not agree that I was highly sheltered for most of my life. After the incident, I was no longer a person to them, but a highly fragile egg shell.

When you have a seizure in my state, your driver's license is revoked for six months. It added to the sense of helplessness. I gave in to my family's coddling; living in the suburbs, I needed them to get anywhere and accomplish many of the things I had done in my previous, carefree driving days. They will never let me forget that I am "different," more likely perhaps than the average person to pass out at any second and endanger myself and possibly others, but it's a thought I have to repress. The only way to live is to live freely, not without a single thought or care for your own weaknesses, but without worrying about absolutely all of the what ifs. The Epilepsy Foundation estimates that nearly 10 percent of all people suffer at least one seizure at one point in their lives, and when I first read up on the subject I thought I saw even higher figures than that. Most seizures are more mild than the convulsing, mouth-foaming "grand mal" type that the girl in the article and I experienced. Fainting can be a seizure, as can a momentary eyes-glazing-over release of present consciousness.

I have become much more health conscious in the past couple years, putting much if not all of my faith in optimal nutrition and exercise as the panacea for the majority of first world health problems, so I now agree that misplaced priorities and undue stress at school could have been the cause of the seizures in both the girl's case and mine. However, aside from this conclusion, I think my story demonstrates the frustrating and even counterproductive effect the medical establishment often has, especially when they themselves do not fully understand a topic by their own admission. They could find nothing wrong with me, nor did any of the half a dozen doctors I talked with think that stress, lack of sleep or improper nutrition would be enough to cause the incident, even in combination.

Their primary contribution to the situation was not to console me and my loved ones, but to heighten our fears. It was a freak thing which could easily happen again, but may never, like getting struck by lightning or an asteroid. Like the weathermen, they wanted to hedge their bets. The chance that I would have one seizure in my lifetime was 10%, but now that I had had one, the chance that I would have another rose to 20%, let's say. Clearly, it was time to wrap me in bubble wrap and keep me out of direct sunlight. They had to recommend that we be afraid - very afraid, and that I begin a permanent, costly, daily regimen of the latest medication and undergo a lifetime of negative side effects, all as a precautionary measure. Partially as a result, I believe that the highest priority for most of the medical establishment is not health, but guarding against malpractice. If you made it to the end, thank you for reading my story and indulging my ramblings.