I am returning to my journal with something resembling sanity after one hellish manic period that, from what I can piece together, must have started around Friday evening and did not end until early Tuesday morning. I collected the ghastly reminders of this period from the Icarus board and saved them above. I cut the fuck out of my left arm and put two deep gouges into my right arm. I decided to remove the bandages from my right arm at around 9:00 or 10:00 PM Monday night and clean away the dried blood and so forth. I was unable to get the lower wound to stop bleeding. I began to feel dizzy and worried. After ranting my brains out on Icarus I finally concluded I had to go to the Emergency Room.

As usual, I'm missing chunks of my memory. But I remember the emergency room.

It is staffed by young gay men. I fall immediately in love with them all, of course. They are so gentle and soft-spoken. I sit in a chair and reel off all of my medications to a young nurse who dutifully enters them into the computer. “Any current disorders, sir?” I love that word: Disorder. You mean besides the screw-up in Iraq, starving people in the third world, psychotics on the street, and a third bad marriage? I politely respond, “Hepatitis C and BP1.” The nurse doesn't recognize the latter and asks me if I was taking any medication for my “Blood Pressure Problem.” At first I think there is something in the computer about it – I vaguely remember my doctor spending six months convincing himself that I did not have a blood pressure problem. Finally I tell him I am referring to “Bipolar Disorder.” I guess this is the first time I publicly admit to having a mental disorder.

He asks the purpose of my visit. I tell him I have a cut on my arm that won't stop bleeding. He asks how it happened Now, I don't lie. I will sit and stare dumbly ahead, mute, before I lie. At least that's what I like to believe. Anyway, that's my story and I'm sticking to it. I say, “a knife.” The nurse leads me into a room where he removes the bandages and cleans the wounds. I have to take off my shirt, of course. He sees the left arm, of course. I ask him to please use a topical anesthetic – I'm sensitive to pain. The monumental irony of this is too intimidating even for a blabber-mouth like me to tackle. He says that after twenty-four hours it isn't possible to stitch a wound. I think, What? He says the doctor will be with me in a moment and leaves. I wait.

In comes the doctor. He looks at the wound and applies pressure in some mysteriously effective way that eluded me during three hours of trying to get it to stop bleeding. He is gentle and concerned and completely non-threatening. He asks about the cuts on my left arm. I look up into his eyes and realize I must trust this man. I fall like a stone from my manic high. But I am still hallucinating.

I tell him everything. I was diagnosed with Bipolar One about a week, maybe two, ago. I've been manic for days. I've not eaten or slept during that time. At one point I cut my left arm. Then I cut my right arm. I am seeing a psychotherapist. I was prescribed Depakote which I stopped when I learned it could seriously damage my liver. I will be seeing my psychotherapist later today. I have an appointment with my psychiatrist tomorrow. I have no medication but I'm working on getting some. I called the Emergency Psychiatric Hot line to find out if I could come in to this emergency room for treatment.

He asks if I think about suicide. Yes. Often. But I still want to live. My people (the Icarus community – I don't tell him that, however) told me to come here and get help. Is it OK if I go home?

He says that Depakote is indeed very dangerous, even for a person with a completely healthy liver. He says it is important for me to follow up with my therapist, my psychiatrist, and my general practitioner about this incident. He asks when I last had a tetanus shot. I have no idea. He says he wants me to get one. OK.

He says I can go home.

A different nurse comes in and gives me the tetanus shot so smoothly that it is over before I realize he began. He must be about my age and as cute as a bug. I tell him, “Damn, you're good.” He appreciates the flirt and says with a gentle smile, “Hold that thought. It will start hurting tomorrow.” (He was right about that, by the way.) I go out and it's clear from the look on everyone's face that I was no ordinary visitor. Well, clear to a person falling rapidly from a manic high struggling with paranoia. No one says anything. The receptionist checks to make sure I received my follow-up instructions from the doctor. Yes. I pay the $50 fee and leave.