Monday, June 14, 2010

Hospital Experience #10: Panic Throws Light on Rage

This is the tenth in a series of posts on a recent experience at Ochsner Hospital - having a cardiac catheter ablation procedure to correct a heart arrhythmia. These posts describe and reflect on various aspects of the hospital experience.

This tenth post is a follow-up to "Hospital Experience #3: Panic." Here I will reflect further on lessons to be learned from the panic I experienced in the procedure room, just before undergoing the cardiac catheter ablation. I especially want to consider the similarities between panic and rage and to see how my having experienced a state of panic may increase my understanding of what it's like to be in a state of rage. To make full sense of this present post, it will help to have read "Hospital Experience #3: Panic." It also wouldn't hurt to have read my post of March 21, 2010, titled "Philosophy Cafe: Detachment," especially the final section of the post, subtitled "My Father."

In "Hospital Experience #3: Panic," I described how I panicked in the procedure room. Before being sedated, I was hyperventilating, trembling, jerking about, struggling, and crying out. I was out of control. My behaviors seem to have an instinctual component - near-automatic responses to what was being done to me, responses that were largely beyond my control.

I remember a similar incident from when I was five years old, an incident when I panicked. In the five-year-old incident, I was more deeply gripped by panic, even though the catalyst was minor when compared to a cardiac catheter ablation. I panicked over a simple booster shot at the doctor's office.

Here's what happened. My mother picked me up after kindergarten and took me to the doctor for a booster shot. The doctor's office was not in a typical office building but in a small one-story house converted into a medical office. (This is why I was able to do what I did.) When the nurse called my name to come in for my shot, I panicked. The door of the waiting room was ajar, opening onto the porch. I saw my chance and ran for it. Out the door, across the porch, down the steps, over the path, through the gate, and up the street I ran. The grown-ups gave chase and caught me. I fought - kicking, punching, flailing. I remember knocking one nurse's glasses off her face. The grown-ups, of course, were over-powering, and soon I found myself being held face-down on a table. The shot was administered, but my adrenalin was pumping so strongly that I didn't feel a thing.

The point of this is that I was in the grip of panic. I was out of control. I did not decide to run for it or to fight. I just instinctually did. Panic had taken over at a deeper level than was the case with the cardiac catheter ablation, where I was actually thinking about my behavior and even considering if I might try to calm down and breathe deeply, but not seeing how to get there while overwhelmed with all that was happening to me in the procedure room.

At age sixty, in the procedure room, I was panicked and out of control, but I was still able to think about my behavior though not able to change it. I also had enough presence of mind not to hit anyone. At age five, in the doctor's office, I was more deeply panicked and out of control. I had no thoughts about what I was doing - I was pure action, first flight and then fight. I hit people.

I also find that I have compassion for myself at age sixty and at age five. I don't judge myself for being out of control, for panicking, for being unable to calm down in the procedure room, for running away from the shot, for hitting the shot-wielding grown-ups. I also find that I have compassion for the cardiac doctor and medical team and for my pediatrician and nurses. It is not difficult for me to have compassion for myself and for the medical professionals - and for my mother!

NOW - here is where I want to go with this. It IS hard - at least it has been - for me to have compassion for people who go into a rage and hurt or kill others. But being in the grip of rage is like being in the grip of panic. One is out of control. The rage takes over. I think that a person in the grip of rage may not have decided to bash or kill the object of the rage - the rage takes over and the rageful person just does it - the rageful person acts without having made a decision to act. It is as though the rage is acting rather than the person whose body is doing the actions. The rage possesses the person and acts through the person.

I do not mean to suggest that this is okay - that it's okay or excusable to hurt or kill others when one is in a rage. It is not. At the very least, one is responsible for recognizing when one is moving toward rage and walking away from the situation. Unfortunately, some people have not learned how to do this. They do not know how to recognize when they are moving toward rage, and they do not know how to activate the strategy of walking away. They may even see that strategy as cowardly.

All I want to say here is that having been in a state of panic gives me some understanding of what it may be like to be in a state of rage. I can begin to stand in the rageful person's shoes. I can begin to imagine pulling the trigger without having decided to do so. I can begin - but barely - to imagine what it must be like, after the rage has evaporated, to realize that one has taken the life of a fellow human being. (I do recognize that different people who kill in a rage will have different post-rage reactions, probably ranging from horror at what they've done to callous indifference.)

I would say that one important lesson for me to learn from panic is a tiny infant step toward compassion for those who hurt or kill others in rage. This is not to excuse or justify the hurting or the killing but simply to gain some understanding of the perpetrator and to move a tiny tenth of an inch toward compassion for that person.

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