Nightmares

My heart was pounding and sweat burned my eyes. There were 5 minutes left, and I had five questions left. This was not your typical multiple-choice exam, Each question required at least two paragraphs of analysis. I couldn’t possibly complete five analyses in five minutes. My chance of getting an ’A’ in the course was fading fast. I would never be accepted to Medical or Law school. Not that I cared about Law school but at least it was an alternative.

I squirmed in my seat and wrote as fast as I could. Each time another student rose and handed in their paper, my heart rate increased, and I felt waves of nausea. Worst of all, I’d developed momentary writer’s block. Even though I knew the answers to all the questions, I’d draw a blank. Eventually, my memory would return, and I’d be able to resume writing. These blocks were making things worse.

The bell rang and the exam monitor instructed us to ‘put our pencils down and stop writing’. I had two more questions left and ignored the instructions. My life depended on finishing.

“You, in the second row put your pencil down. Continuing to write will invalidate your exam.”

I looked up briefly but continued to write. Just one more answer and I’d be home free. A shadow loomed over me. The monitor was standing next to my desk, glaring at me. I had only one more paragraph to go. A feeling of terror gripped me.

“You’re whimpering.”

I opened my eyes. It was my wife, Sandy. She was nudging me as we lay in bed.

“Oh, thank God, I was having a nightmare. It seemed so real.” My sweat and palpitations certainly were.

“Let me guess. You were having another exam dream.”

“Yup, they keep coming.”

“After forty years, you would hope they would stop. I think you need therapy. Maybe a psychedelic drug such as Psylocibin would help. You definitely have a form of PTSD.”

“Anxiety is certainly my demon or dragon, and I still haven’t found a way to slay it.

“it’s almost as if you’re living in episode of the movie Nightmare on Elm Street. I wouldn’t be surprised if Freddie Kruger was one of your teachers or exam monitors. You wake up from each nightmare so shaken and gripped by terror.”

I laughed but had to agree. “They seem so real. I have trouble separating them from reality. It takes me a few minutes of awake time to get a grip on myself.”

“Do you always dream about exams and school? Don’t you have some pleasant dreams like the rest of us. I’d be happy to hear you were having erotic dreams even if they did not involve me. At least it would be a change.”

“Of course I do. There are fewer erotic dreams these days, but I do dream of living in an apartment near the ocean. It’s sort of a refuge but even then, sometimes I can’t find my room.”

“See, anxiety.”

“Yeah, then there is the car out of control dream. Pretty transparent, eh? I used to dream of having the ability to fly. That was before I finished school and all of my training.”

“That’s pretty telling.”

“Yeah, I haven’t felt that free in years. I don’t think people realize the toll that years of exams and caregiving can take on one’s mental health. First, the pressure to succeed is enormous. Then the responsibility of caring for people’s health and life can be overwhelming. You’re always on call or on edge. I felt tested every second of every day.”

“You can’t be the only doctor or professional who went through this experience. I’d bet very few of them have recurrent exam dreams.”

“I wouldn’t bet on it, but I’ll admit that I’ve been anxious person from an early age.”

“Okay, I hate to see you like this. Let’s see if we can find someone or something that can help you slay your dragon”

***

Two years passed after months of psychotherapy and several Ketamine sessions. The nightmares came less frequently and there was even a sighting of a flying boy. Then one night…

It was my second year of training. As the doctor ‘on call’, I was the designated leader of the code team. It had been a quiet night, so I was sleeping in my underwear in the on-call room. There was no such thing as sleeping soundly when you were on call. You had to be ready to jump up and be fully awake at a moment’s notice. This night was no different. The loud code blue announcement jarred me from my sleep. I was probably having another exam nightmare. I jumped up and was momentarily disoriented. My first impulse was to grab my stethoscope and run down the hallway to the ICU. By the time I reached the coding patient’s bedside, the code team had assembled and were looking to me for directions. One nurse was compressing the patient’s chest while a respiratory therapist was bagging the patient’s airway. The cardiac monitor indicated that the patient was in ventricular tachycardia. I had to decide the next step. Was it medication or defibrillation? There could be no hesitation. This person’s life depended on my decision. Before I could make my decision. The intern on call entered the room and whispered in my ear.

“You’re in your underwear.”

I panicked. There was no time to change. I had to give the orders. The patient’s life depended on it. This was another exam I couldn’t fail. I ordered defibrillation. Just as I was putting the pads on the patient’s chest, I looked at his face. It was my father!

I awoke to a burning feeling on my chest. I was surrounded by strangers in uniforms. Sandy was standing in the background. I was in my own bed and naked. Who were these strange people and why was my chest burning and feeling bruised? I looked to the side of the bed and saw a heart monitor. The beeping and tracing were irregular. Was this a dream inside a dream? Was I the patient? The tracings on the monitor were becoming more and more irregular. The last thing I heard was “charge” as I felt an electric shock.

I was failing.