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| Originally written from October, 2004, to June, 2005. |
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International Conference on Psychophysiology of Panic Attacks
I certainly wanted to attend the 2nd International Conference on Psychophysiology of Panic Attacks in early October of 2004. However, being a presenter at the first conference had greatly tested my limits and left me exhausted for some time. Trying to be a presenter at the second conference felt like too much stress for me. Traveling to Europe and attending the conference was difficult enough, so I decided to simply be an attendee this time. At least, that was my 'initial' plan. My only further ambition was to visit my friend Philip. Last year, I had wanted to visit my well known panic disorder friends Philip Peters and Jon Guite during the first conference, but this proved too stressful for me and I had to cancel plans with them. Sadly, Jon died shortly after. The second conference provided a second chance to visit Philip and I didn't want to squander this opportunity. I had no way of knowing when I might have another chance to visit Philip. Between the conferences I exchanged much e-mail with Dr. Stones. Angie, as I would come to call her, was the primary conference organizer. Together, we worked out a design for the initial conference proceedings web site. I came to view my role in the conference as mainly an organizer of the proceedings. This seemed a "panic friendly" task as I could make use of my random slices of functional time from home and without the stress of a schedule or deadline. My apparently cozy role in the conference would eventually prove a bit naive. For many months, I took for granted all the effort that goes into preparing a conference like this. As the primary organizer, Angie bore much of the burden and this gradually began to show in our friendly e-mails. I probably overreacted by worrying that the conference might be in jeopardy. Personally, I was very concerned about the subject of panic disorder sinking into neglect. Considering all the clinical dead ends I had encountered over the years, I felt that my own fate was, to some degree, intertwined with the conference. I simply couldn't refuse when Angie asked if I could help in other ways. Supporting the call for abstracts by sending about 200 e-mails was a tedious, yet simple, task for me. I felt considerably more intimidated by the prospect of sending e-mails to embassies in support of visa requests, but, thankfully, I was spared this. The greatest request, however, was her asking me to give a keynote speech at the conference! Giving a keynote is a great opportunity and honor, yet public speaking was also one of the big stresses I had hoped to avoid this time. Worse still, I only had about two months to prepare, which translates into only one month of functional time considering my anxiety and panic attacks. I was very concerned that the keynote would create an unhealthy level of stress for me. Stress is known to aggravate anxiety disorders in a variety of ways, both psychologically and biologically. In my own experience, periods of stress had often been followed by periods of increased panic attacks. In the spirit of Cognitive Behavioral Therapy (CBT) I was often testing my limits and sometimes to a reckless degree. Over the years I had learned all too well that pushing myself too hard could make seizure-like episodes of absolute terror more likely. Managing my "stress budget" is, understandably, a very important aspect of my life. Nonetheless, there are occasions when risking the worst seems warranted. I felt there was much that needed to be said and I saw the conference as very important. After considering the matter for a day, I simply couldn't say 'No' and agreed to give a keynote speech. The two months before the conference proved even more stressful than anticipated. First, my computer monitor started to fail. I desperately needed my computer for both travel planning and preparing my talk. Generously, my friend JB donated a spare monitor and my friend Jay delivered and installed it for me. Second, my trusty microwave of 18-years, which I greatly rely on in the absence of cooking, finally died, but I managed to buy a replacement the next day. Third, my eyeglasses started coming apart, so I had to promptly replace them. Fourth, the backpack I use for shopping and travel started to tear apart, but I fortunately found a new pack on sale. Fifth, the Philadelphia area was experiencing heavy rains and my home's roof developed a leak, so I simply had to hire a contractor. With some lucky breaks, help from friends, some financial assistance from family and very careful budgeting, everything was working out, but just barely. The onslaught of unexpected problems while preparing for the conference was a big strain. I felt my nerves were stretched to their limits and I had a number of breakdowns. Less than a week before the trip, I developed a tooth ache and made an emergency appointment with my dentist. My dentist could find nothing wrong and I soon acknowledged that this was probably a case of stress induced psychosomatic pain. Another challenge occurred just two days before my flight. Counting my tablets of alprazolam, I suddenly realized that I would probably run out of medication during the trip. Refilling my prescription about a week early seemed a wise precaution. Unfortunately, my pharmacist saw things differently. He insisted that he couldn't give me a refill until a month had elapsed unless given direct approval by my doctor. Since my doctor was already aware of my conference plans, I encouraged the pharmacist to phone him. The hospital phone lines were very busy that day, so it was left to me to use the pharmacy's phone until I could get through. I was eventually able to leave a message for my doctor, yet my doctor is a very busy person and there was no guarantee when he might be able to call the pharmacy. Trying to respect the rules, I informed the pharmacist that I had managed to leave a message for my doctor and I spent the next hour quietly waiting by the pharmacy counter. I pondered my dilemma while waiting in the pharmacy. I had used this pharmacy for almost a decade. My alprazolam usage was on a PRN (as needed) basis, not a regular dosage. I never before had a problem refilling my prescription simply because a month had not elapsed. Why was I encountering difficulty now? After a while I approached my pharmacist again. I calmly explained my situation; the impending conference directly related to my health, my risk of "subepileptic seizure" and pointed out that my pharmacy records clearly showed a history of responsible use. He confirmed my pharmacy records on his computer, yet he remained adamant. I then asked what law or policy had changed since this situation had not been a problem before. He explained that the situation was not based on law or policy, he was simply withholding my refill based on his own "professional judgment call." Suddenly, I saw the situation in a different light. Despite being a patient who used medication responsibly, my efforts to participate in the conference were now in jeopardy because of a very misplaced opinion! Only when I seriously threatened to report him and his supervisor did he finally relent. The pharmacy staff didn't seem very happy about this episode, but I was greatly comforted by leaving the pharmacy with my refill. My keynote speech was still not ready! After much good input and feedback from both doctors and fellow patients, my 9th draft still felt inadequate. All I could do at this point was print out a crude outline that was centered on a collection of good quotes. I would simply have to scribble down any further inspiration onto the pages of my outline as I traveled. I spent the day before my flight carefully preparing my packing. I prefer traveling light, with only the fundamental necessities that would fit into my carry-on backpack. Having made a thorough checklist, I neatly laid out all the items I would need to bring. However, I didn't actually pack that day. I knew that I would have obsessive and compulsive worries about forgetting something critical, so I resisted actually putting everything into my pack until shortly before leaving. This allowed me to check and re-check everything at will without having to pack and re-pack numerous times for reassurance.
I was extremely anxious on departure day. Despite a great deal of thorough preparation, both rational and irrational concerns would haunt me that morning. Would my home be Okay while I was gone? Would I somehow forget to bring something critical? Would any of my travel connections experience complications? Would a crippling panic attack strike on route? I took some alprazolam to help keep me functional.
My stomach was so upset that I didn't dare eat anything. The suspense was unbearable, so I felt I should get going several hours early and before I lost my nerve. I finally packed. I showered and dressed. As I checked the house one last time, an anxious sweat had soon completely saturated my clothes. I quickly changed into some fresh clothes. Loading my pockets, donning my pack and grabbing my blazer, I took a deep breath and tried to reassure myself. I then pushed aside that lingering feeling that something was terribly wrong and forced myself out the door.
Walking down the street in the cool morning air offered some relief. Still, my mind was in a cognitive fog. Half way to the train station, I couldn't remember if I had locked my home's front door. I dismissed this concern as more obsessing. Of course, each obsession I pushed aside would be relentlessly replaced by another. No amount of self-assurance could dispel all the uncertainties I felt at this critical time. Now that I was on the move I simply had to stay recklessly focused on moving forward.
My emotions became so suppressed that I felt like a robot executing a program. I boarded my first train into downtown Philadelphia. I then connected with a second train bound for the airport. Arriving at the airport, I found my way to the British Airways ticket counter. The counter wasn't scheduled to open for several hours, so I found a seat, sat down and waited like a mindless drone.
An older couple eventually asked me about the ticket counter. I told them that I was waiting for it to open within the next few hours. They sat down next to me and we started exchanging travel talk. They were returning home to Brittain after touring America for several weeks. I mentioned that I was on my way to London and The Netherlands. Complaints about airport comforts and security issues were also discussed. The friendly social interaction helped to revive my emotions. Further obsessing was somewhat balanced by my accomplishments so far. Feeling exhausted from my earlier worries also helped me to stay reasonably calm.
The ticket counter opened about half an hour earlier than expected. I was relieved that there were no ticket complications. My heart skipped a beat when they asked to check that my pack was within the weight limit for carry-on baggage. I had considered the size of my pack, but never thought about the weight! Thankfully, my pack was well within the limit. Moving on, I exchanged several hundred US Dollars for British Pounds and Euros.
Passing the security check was my next challenge. These days, security personnel look for anything suspicious, including signs that a person is "unusually anxious." There was no denying that I was unusually anxious, but would I be visibly anxious enough to raise concern among the security staff? Anticipating that this situation might lead to a prolonged security examination, my original plans had factored in some extra hours before my scheduled flight. Fortunately, the security check went smoothly.
I was now within the departure terminals. Having accomplished more and feeling a little more exhausted, my anxiety crept down another notch. I passed the time by alternately sitting in lounge areas and taking leisurely strolls up and down the terminal concourse. Hours passed. Through the terminal windows, I watched the sun eventually set and the horizon become aglow with color. Soon after, my flight started boarding.
My plane was a nice big Boeing 747. I had last flown in a 747 as a young child and had very romantic memories of flying in the giant double decked airplane. Back then, the plane seemed almost like a gigantic space ship. Of course, I was much bigger now and the plane seemed much smaller than I remembered. Even the seats seemed more narrow than my 777 flights just last year. The flight appeared fully booked, making the elbow to elbow conditions in coach class seem rather claustrophobic. Nonetheless, I was surprisingly relaxed as I watched the navigation graphics on my seat's display screen. The plane soon lifted off and the flight attendants promptly began serving dinner. Unlike last year, I had no serious anxiety during the flight, even after eating for the first time that day. However, I did have trouble sleeping this time. I try to sleep on such night flights to minimize jetlag, but only managed to get an hour or two of light sleep before landing.
I exited the plane and entered London's Heathrow airport. Following the crowds, I walked through the long and winding arrival corridors. Reaching a very crowded customs' area, I stood in a long and slow moving queue for almost an hour. Eventually, I reached the front and was called by the next available customs' official. After a few quick questions, my passport was stamped and I was free to pass.
Suddenly, a very official looking man stopped me. He asked if I would mind answering a few questions for a 'survey', but the tone of his request didn't suggest it was optional. I got the distinct impression that he was a customs or security person doing random cursory checks as this was in easy view of the customs staff. Sensing little choice, I answered questions about where I was from, where I was going, the reason for my visit, etc. He carefully noted each of my replies on his clipboard. With a very formal voice, he thanked me and I continued on my way.
Finding the train station for London's Underground (The Tube) was the last thing I expected to have problems with. After all, I found the station without any problem last year. Yet, somehow, the way to go was more confusing this time. I asked for directions, but soon got lost again. Eventually I found my way down an escalator, through a pedestrian tunnel and onto a train platform. Initially, I was impressed with all the apparent renovations to the station and it's new modern style. However, I didn't see any ticket windows and had trouble figuring out the electronic ticket kiosk. Asking someone for help, I was told that this was not the "Underground" station. I was in the wrong train station! Apparently I had wandered into some business class express line to downtown London. I felt very fortunate to discover my error before getting onto the unfamiliar and potentially expensive train line.
I retraced my steps back through the tunnel and back up the escalator. Once again in the airport, I asked another person for directions. They kindly pointed me towards another escalator with the familiar "Underground" target sign. Descending into another subterranean world, I followed another pedestrian tunnel and things started to look familiar again. The ticket windows were just as I remembered them, so I finally knew I was in the right place. I happily bought my ticket to Wembley Park, passed through the station barriers and waited on the platform for the next train. Surely, I had surpassed all the travel obstacles now, right?
My journey on the Underground was mostly how I remembered it from last year. With my handy Tube map in hand, I knew exactly which stations to step off at and change train lines. Also, I quickly got used to the signs and markings that told me which platforms and trains to use. Everything was going smoothly until the station just before my final stop. Suddenly, a strange announcement came from the train speakers. It was announced that the train would 'not' stop at Wembley Park (my destination) due to construction! There followed some confusing instructions about changing trains. With only moments before the train doors closed, I quickly stepped off the train with my pack and blazer. The doors closed and I watched the train move on without me.
I found myself standing on a station platform with a few other confused people. We started asking each other what we should do? None of us were certain, but after some discussion we decided to take the next train to the station past Wembley Park and then take a train back which, hopefully, would stop at Wembley Park from the opposite direction. As we waited, our practical discussion slowly became purely social. I often find it interesting how total strangers can quickly start talking like friends in the midst of a common problem. Having mentioned I was coming from Heathrow airport, I was asked where I am from? I explained that I was traveling from Philadelphia to attend a conference. A woman with her baby commented that my voice didn't sound American; perhaps expecting a pronounced New England or Southern accent. I jokingly suggested that maybe I've spent too many years watching BBC television programes.
The next train soon arrived and we boarded. The train passed Wembley Park and stopped at the next station where we stepped off. Changing platforms for the train back meant going up and down a number of stairs, so I helped the woman carry her baby stroller. Carrying one end of the stroller while walking backwards down a flight of stairs, I almost lost my balance. The sudden fear of hurting her baby while trying to be helpful pierced me like a javelin. Fortunately, my one misstep was not a disaster. The next train did stop at the Wembley Park station from the other direction. Very carefully, I helped the woman carry her stroller up one more flight of stairs. Pausing to check my bearings amongst a busy crowd of people, the woman and I lost sight of each other before saying good-bye.
A light London rain was falling as I walked to the Quality Hotel Wembley. I wasn't terribly wet when I checked in. My reservations were in proper order and my room was comfortably similar to last year. Despite a lack of sleep, my activity and anxiety kept me alert and awake. Wanting to feel more comfortable and prepared, I promptly braved the rain once again to visit the local ASDA store to buy an umbrella, a supply of bottled water and some crisps (potato chips). Feeling more reassured, I phoned Angie (Dr. Stones). Between the unfamiliar dialing conventions of the hotel and Britain, several attempts and some help was required to make the call. Angie and I eventually made contact and decided to meet later that evening.
Staying awake that afternoon slowly became difficult. The initial excitement of travel had started to wear down. More than a day had passed since I had managed to leave my home with great difficulty. I had overcome many challenges, confronted much stress and with only a couple hours of sleep at best. The two days seemed to blend together. Yet, I was very much looking forward to seeing Angie again and I knew I had to stay awake if I wanted to get in sync with local time. The exceptional importance I felt for this trip compelled me to embrace far more activity than I was used to. My ability to maintain such activity without aggravating my panic disorder was a concern, but I felt committed to testing my limits for the duration of the trip.
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| Angie and I rendezvoused at a book shop that evening. We greeted each other with a friendly hug. She had a membership at a nearby spa, so we went there to relax and talk in a quiet and comfortable lounge. We sipped cappuccino and tea as we talked about various topics. After a few hours, I gladly agreed to assist in the final preparations for the conference the next day. Briefly, we then visited a nearby Greek restaurant that would host the gala dinner for the conference. We then wished each other a good night. I returned to my hotel and soon collapsed into a restful and much needed sleep. |
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Part 4 - The Conference (Day 1) I don't think I got my wake-up call on Friday morning. Fortunately, I woke by a reasonable hour anyway. Angie soon phoned to let me know when Daryush, a fellow committee member I knew from last year, would pick me up to help with conference chores. I got myself together and went down to the hotel entrance to wait. Coincidentally, I crossed paths with Angela Brittain, a presenter at both this and last year's conference, in the lobby. She was just arriving from the airport and, like myself the day before, she was tired from traveling. We would see each other at the reception that evening, so we simply exchanged brief hellos. |
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Daryush soon drove up to the hotel entrance. Seeing yet another friendly and familiar face felt very reassuring to me. As he drove us through London's maze-like and thoroughly disorienting streets, we mixed small-talk with conference talk. Before long, we arrived at the University of Westminster's Harrow Campus. After parking in one of the car parks, he needed to briefly meet with the campus administrators to finalize details. The most comfortable place for me to wait was near the campus store. He only expected to be away for a short time, so I tried to relax and waited for him to return.
This year's conference was taking place during the Fall semester. Consequently, the campus was very busy with countless students passing between classes. This was a sharp contrast to the quiet, pre-semester campus I remembered from last year. As I stood near the campus store, the activity around me was a bit overstimulating and aggravated my social phobia to some degree. I discretely took a milligram of alprazolam to help me stay calm. After a short time, I felt bold enough to enter the campus store and buy a fizzy drink (carbonated beverage). Returning to my spot outside the store, I enjoyed a cool drink and a smoke. Gradually, my anxiety subsided and I started to relax. Daryush soon returned. He kindly asked me how I was feeling. Feeling somewhat near normal at that point I replied that I was doing Okay. |
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Putting up signs around campus was the next task. These signs were mainly to guide conference folks from the nearby train station or car parks to the conference hall. Campus security allowed signs in some places, but not others. Their logic wasn't clear to us, so we ended up politely asking permission for almost every sign we placed. Since classes were in session, there wasn't much else we could do around campus that day. We returned to the car and Daryush gave me a ride back to the hotel. Looking forward to the conference reception that evening, we wished each other a good afternoon as he dropped me off.
I walked to the nearby McDonalds and bought myself some lunch to take back to my hotel room. Like last year, I favored McDonalds to avoid phobias over unfamiliar food. Unlike last year, however, the staff of this British McDonalds didn't seem perplexed or suspicious when I asked for a large cup of ice. Perhaps someone remembered me, or perhaps they had since accepted that this was a strange, yet innocent, American quirk. I tried to put the afternoon to good use. Within my hotel room I worked a bit more on my still unfinished keynote speech. With less than 24 hours remaining, time was short and I was feeling the pressure. To some degree I was obsessing. After all, I pretty much knew what I was going to say at that point. I was mainly worrying about how to say things in a well organized and balanced manner. And, of course, my public speaking anxiety was rather high. Fortunately, I only had a few hours to dwell on my talk as the evening's conference reception grew near. I put away my notes and left the hotel. After a short ride on the Tube, I walked into campus and was soon at the reception. The reception had not officially begun yet. I deliberately arrived an hour early to help out with some further preparations. Daryush had kindly volunteered technical support for the conference and, with some trepidation, I had agreed to be the backup tech support person. We left the reception room to meet with a campus technical person. In the space scheduled for tomorrow's conference presentations, we received a quick lesson in how to operate the room's microphones and projection equipment. The sound system and computer controlled projection features involved a variety of buttons and menus that I found a bit daunting. My anxiety over possibly having to do technical trouble shooting during the conference added to my anxiety over public speaking the next morning. Nonetheless, I managed to embrace a kind of reckless optimism that somehow everything would work out fine. We soon locked up and returned to the reception. The reception went very well. Like last year, Angie and Daryush had prepared nice conference packages for presenters. These packages included the conference programme along with various goodies like nice pens, note pads and miscellaneous brochures. Name tags were also handed out. With some amusement, I noticed that my tag mistakenly read "Dr. Arthur Anderson" and I promptly used my nice new pen to cross out the 'Dr.' title. I met a number of this year's presenters that evening. In casual conversation we shared our perspectives regarding panic attacks. Personally, I respected some perspectives more than others, but we were all very polite and open-minded. Respecting diversity is a very important aspect of the conference. Even when views did not agree, we would at least gain a better understanding of each other's thoughts. My schedule became a bit more complicated before the reception ended. One of the older doctors requested that someone give him a ride to the conference the next morning. Since Angela and I were staying at a nearby hotel, we agreed to pick up the doctor with a cab. The reception then ended by a reasonable hour. Angela and I bought some McDonalds food on the way back. Returning to the hotel, we coordinated our plan for the next morning. I agreed to pay for the cab and she agreed to organize it. We wished each other a good night and retired to our rooms. I spent the rest of the evening watching Sky News, working a bit more on my talk and trying to relax. Fortunately, I managed to get to sleep by a decent hour.
I woke several hours early on Saturday morning. With the conference upon me, I simply was not sleeping well and used the extra time to review my notes and jot down some last minute changes. Receiving my wake-up call at 8:00, I then phoned Angela in accord with our mutual backup plan for failed wake-up calls. A short time later, Angela and I met in the hotel lobby. As agreed the night before, we took a cab to pick up the elderly doctor on our way to the conference. We arrived on campus with little time to spare.
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| Between a degree of sleepiness and more activity than usual, I felt a bit dazed as the conference began. This daze was probably helpful with my speaking anxiety because, before I knew it, Angie was introducing me. With thoroughly revised notes in hand, I stepped up to the podium. Fortunately, my keynote began with a brief introduction and the reading of several quotes. This beginning was simple and well defined; allowing me to build up some speaking momentum and adjust to the feeling of exposure. By the time I reached the less organized portion of my speech, I was feeling more confident and better able to think on my feet. Focusing on what I felt to be the most important topics, I spoke in a very free and open manner. Somehow, it all came together reasonably well. People would later compliment me on the talk. Personally, I think I could have done better given a couple more months to prepare, but I felt I did Okay and was very relieved to have done as well as I did. |
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Minus breaks and lunch, the following is a brief summary of the day's talks.
A number of people had agreed to meet in the hotel lobby and go to the gala dinner together. Leaving the hotel, we walked a short distance to the nearby Tube station. By now, many of us were talking like good friends. Various friendly discussions leapt from topic to topic and person to person. After a brief train ride, we walked a few blocks to join many others at the Greek restaurant hosting our dinner. Our conference group occupied half of the restaurant's largest room. We sat together at a very long table. As I guess is customary for a big Greek dinner, drinks and foods slowly came in a seemingly endless series of small courses. Talented musicians played Greek music that was very lively and somewhat loud. Our voices sometimes had to compete with the music, but our table's various discussions continued amidst brief breaks for enjoying the tasty foods. The dinner was a bit overwhelming to me. I was not used to such a stimulating environment. I'm sure that my clumsy efforts to converse often came across as somewhat social phobic, shy or a bit awkward. Yet, the nice thing about attending an anxiety conference is that everyone understands social anxiety. After a couple of hours, a few people had to leave and prepare for the next day's talks or the like. Feeling an impulse to escape, I almost left with them. However, Angie knew me all too well and, in a friendly and semiserious manner, she insisted that I sit down and stay. With a grin, I pretended to cover my eyes in shame and sat back down again. She knew this dinner was good behavioral therapy for me, and I knew it too. The dinner was one of the trip's lesser challenges. I was never quite relaxed in the restaurant, but I was not intolerably anxious either. At the moment, my major concern was managing my overall stress. I had already done much that day, as well as the days prior. My trip was less than half complete and I didn't want to exhaust myself prematurely. Stress was flowing into me faster than my mind or body could process it. I didn't want to be overcautious, but I also didn't want to press my luck and risk a serious breakdown either. Foods and drinks slowly continued through the evening. I continued awkward attempts at conversation as the lively Greek music boldly danced in the air. After a couple more hours, another group of people prepared to leave because they were uncertain how late the trains would keep running. When I chose to leave with this group, Angie did not protest, at least not strongly. As I started to leave, I noticed that Angie was trying to encourage the remaining people to join her in dancing and clapping with the music. A few of us stepped out of the restaurant and began our walk to the Tube. The cool night air was refreshing. Along the way, we paused for a group photo. |
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We rode the Tube a short way and then walked to our hotels. By the time I entered my hotel room, it was almost midnight. As usual, I watched a little Sky News on the telly before going to sleep. The day had been exhausting, but I felt very good about accomplishing so much. I had an interesting dream that night which would play an unexpected role the next day. In my dream, I was presenting a talk at a conference. As I spoke, I gradually became aware that the audience was not relating to the talk and they were quickly losing patience with me. Basically, it was a public speaking nightmare that summed up the fears I had about the talk I had given earlier that day. The actual events of the next day would compel me to share this dream in the midst of the real conference.
The hotel failed to give me my scheduled wake-up call on Sunday morning. Nonetheless, I happened to wake up on time. I washed up, dressed and attended the conference on schedule.
Minus breaks and lunch, the following is a brief summary of Sunday's talks.
Angie and I were ambivalent over which of us would play which role. After a few moments of indecision, I ended up being the one who would ramble on about my various anxieties. Angie listened as I randomly expressed one anxiety after another. Amongst my anxieties, I mentioned my public speaking nightmare of last night. After I said, "I worry about annoying the audience," she promptly stopped me.
The next step of the exercise was repeating the last anxious phrase over and over again to our partner. Consequently, I ended up repeating to Angie, "I worry about annoying the audience, I worry about annoying the audience, I worry about annoying the audience..." over and over and over for several minutes. Naturally, I felt a bit silly about repeating the phrase so much. Furthermore, I felt almost confrontational or abusive by repeating the phrase to the face of a good friend. We were supposed to maintain eye contact, but I ended up looking away a few times.
I wasn't sure of the general therapeutic value of the exercise at the end. Like most psychotherapeutic techniques, I felt it could be very useful in some cases, yet questioned its application generally. Nonetheless, the experience was certainly educational and offered valuable insight into one, of many, psychotherapeutic approaches.
As the conference continued, there were further intriguing talks:
Daryush and I began our cleaning up chores as people started wishing each other good-bye. As Daryush tended to the presentation equipment, I wandered about the university campus taking down our conference signs as daylight was fading. Returning to the conference hall, we soon had everything wrapped up as people were completing their good-byes. Daryush gave me a ride back to my hotel with Angie. We were all very tired, but also happy that the conference had gone well. As they dropped me off at the hotel, Angie and I planned to meet for lunch the next day.
The day still had a couple of surprises in store for me. The first surprise was not pleasant. After entering the hotel, taking the lift to my floor and walking to my room, I had trouble opening my room's door. I tried my hotel card key over and over again, but it wasn't unlocking my door. For several minutes I wondered if I was using the card wrong or if the card had demagnetized? Was I certain that I was on the correct floor and trying to access the correct room? Perhaps there had been a clerical error? Worse still, had I been deliberately shut out for some unforeseen reason?
I returned to the lobby to seek an explanation. I soon learned that there had recently been a power outage. The hotel computer system had to be reset, as well as all the card key codes for the rooms. Perhaps this explained the wake-up calls I didn't receive? I took my place in a queue of fellow guests waiting to get card keys reset. While waiting, I encountered my friend Angela, who was just returning from the conference. I told her about the card key problem. Before taking a place in the queue, she asked me if I wanted to join her in an evening trip to a famous London church. Being tired, I declined her nice offer, but we did agree to meet for brunch the next morning. This accidental encounter was a good surprise because we both wanted to talk a bit outside of the conference.
I eventually gained access to my room again. Shortly after entering my room, I decided I was hungry and left again to visit the local McDonalds. I returned with some fish sandwiches and, thankfully, my card key still worked. While eating in my room, I jotted down some notes on the day's events while watching Sky News. At some point, I grew tired of hearing the major news stories repeatedly. I started to channel surf while relaxing on the bed. This seemed a good way to calm down from the excitement of the last few days.
The final surprise of the day struck as I continued to channel surf. About 22:30 that evening, I stumbled across an extremely ironic report by the BBC news programme "Panorama." The subject was suicidal side effects of SSRI medications that had been concealed by both pharmaceutical companies and government regulators! Part of my keynote address, given just the day before, had featured remarkably similar issues and concerns! I practically flung myself from the bed to my note pad on the nearby table and began taking notes over the next hour. I was stunned by how the reported UK events were extremely similar to related events reported in the US. The coincidence seemed amazing to me.
I have since found an on-line transcript of this BBC Panorama programme entitled
"Taken on Trust"
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Angela and I met for brunch at 10:00 Monday morning. To our surprise, both the hotel's cafe and restaurant were closed. However, a kind hostess told us that she would be glad to bring us breakfast anyway and quickly disappeared into the kitchen. Angela and I stood there for a few moments wondering if we should sit at a table. Soon, someone told us that we could wait in the lobby and that a breakfast tray would soon be brought out to us. This wasn't bad since the lobby was fairly comfortable. We found a couch with a coffee table and sat down. The hostess soon brought us a nice breakfast tray with tea, coffee, muffins, croissants, fruit jellies and such.
Angela favored the tea and muffins while I favored the coffee and croissants. We shared friendly conversation and reflected on the conference. Soon we began talking about the proceedings and next year's conference. Angela raised the idea of starting a conference newsletter. Such a newsletter seemed like a great idea because it could keep people updated on future conference plans and opportunities while maintaining awareness. I told her I'd share the idea with Angie when I saw her later that day. After about an hour, we finished our breakfast and wished each other a good day. |
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I returned to my hotel room. Angie soon phoned to confirm lunch plans. We agreed to meet that afternoon at the same bookstore where we met last Thursday. Having some time to spare, I relaxed in my room by watching Sky News.
Suddenly, my anxiety began to rapidly escalate. I felt nausea, muscular weakness and my heart seemed to struggle. The feeling quickly grew into an intense sense that I was about to die. I had lapsed into a panic attack and frantically reached for my medication. Quickly, I placed a milligram of alprazolam under my tongue. The bitter pills began to dissolve. Waiting for the medication to take effect, I paced about the room like some kind of caged animal in distress. I desperately repeated to myself, "I'll be Okay... I'll be Okay..." My medication was not taking effect quickly enough. The first milligram had dissolved and the attack was still growing. Feeling close to one of my seizure-like episodes, I managed to place a second milligram under my tongue and desperately waited for it to dissolve. Panic clouded my mind as cognitive dysfunction grew worse. Dropping to my knees, I began clutching at the bed covers. I kept trying to reassure myself, but thinking straight was nearly impossible at this point. Despite having experienced about a thousand such attacks over the years, I was never able to get used to this magnitude of panic. The horror was so far beyond normal experience that my brain seemed unable to adapt to it. Eventually, the attack slowly started to decline as the medication took effect. I felt lucky that two milligrams had been been adequate to bring this moderate panic attack down to a manageable level. My severe and seizure-like attacks often required three or sometimes four milligrams. I considered the panic to be over when I felt at least some control over my mind and body again. I tried to reassess my condition as my mind began to clear. Leaving the hotel to meet Angie felt risky at this point. However, that feeling of risk was pretty much the norm for me. I guessed that this feeling was the usual residual or anticipatory anxiety in the wake of my attack. I decided to follow through with our plans despite my anxiety. To ensure my stability, using an extra half milligram of alprazolam seemed wise. I cleaned myself up and left the hotel about half an hour early, before I lost my nerve. Angie and I rendezvoused as planned. We visited a retro-style burger place for lunch. Neither of us seemed particularly hungry, so we shared a humble appetizer of chips (fries) with various dipping sauces. Friendly conversation was mixed with conference talk. I told her about Angela's idea for a newsletter and she liked it. We set some priorities for the next few months. My own top priority was updating the proceedings web site with this year's new material. After a while, it was time to say good-bye. Saying good-bye this year was easier than last year. Having completed two conferences and already planning the third, we felt more assured of seeing each other again. After a friendly hug, we parted. I soon returned to my hotel. Since my appetite had started to return, I bought some McDonalds fish sandwiches on the way back. I spent most of the evening preparing my packing. Tomorrow would be my next big challenge, traveling to The Netherlands to meet my friend Philip. I scheduled a wake-up call and got to sleep early.
All went smoothly on Tuesday morning. I woke as planned, shaved, showered, packed and checked out of the hotel without problem. The morning air was refreshing as I walked to The Tube station. The Tube trip was about an hour during the morning rush, but I made all the right transfers and arrived at Heathrow airport without incident. Following the signs, I retrieved my plane ticket and soon found the terminal's security check queue.
I happened to get randomly selected for the extra thorough security check. I was asked to adopt several amusing poses for the latest scanning equipment. Behind a partition were apparently various monitors and I have no idea how reveling these scans were. However, thanks to my passion for science documentaries, I knew that some security technology could literally see through clothes and reveal people in the nude. Fortunately, I'm not too self-conscious about such things. Years of medical exams have altered my sense of modesty to a degree. Besides, I simply had to cooperate with security procedures if I wanted to travel. No problems were found and I was politely allowed to pass.
Once again I was in Heathrow's pleasant international terminal. The place is very much like a comfortable shopping mall and was familiar to me from last year. Better still, I was well ahead of schedule, with several hours before my flight to Amsterdam's Schiphol airport. I bought a few postcards and stamps to write some friendly notes to family and friends. I sent one postcard to my dentist letting him know that my phantom toothache had not returned. After mailing the postcards, I wandered the shops and stopped in a bar for a ginger ale.
I boarded my flight around 13:00. My plane was a medium sized jetliner. With three seats at either side of a single aisle, the jet was a slightly smaller cousin to the larger planes I was used to. A friendly young woman sat in the window seat next to me. She had been working on cruise ships in the Caribbean and was now returning home. As the plane prepared for takeoff, the usual safety announcements were spoken in both Dutch and English. The plane soon lifted off and lunch service promptly followed. The woman next to me turned down lunch, but I was now happy to eat a nice sandwich. I offered her my dessert, but she declined the offer with a smile. Just as I finished my lunch, the flight attendants were cleaning up and preparing for landing. The flight was very brief.
The plane landed in Amsterdam and parked at a terminal. Leaving the plane, I found myself in the vast Schiphol airport. I remember hearing that Schiphol is one of the largest air travel hubs in Europe, yet it was also well designed and I found my way around very naturally. The custom's check was refreshingly quick and easy. After only a few minutes in a queue, my passport was stamped and I had formally arrived in The Netherlands.
My next challenge was finding the train to Den Haag (The Hague). Actually, finding the train was not very challenging. Every concourse in the airport seemed to lead to the airport's main atrium. This atrium was both the main entrance and a train station. I easily bought my train ticket and took a nearby escalator down to the appropriate train platform. Finding my way was made all the more easy by the fact that almost everyone spoke English.
Perhaps ten or fifteen minutes passed before my train arrived. The train was double decked (upper and lower levels) which is not terribly unusual, but somewhat novel to me. Entering the train and walking down some steps, I was also surprised by how comfortable the train's interior was. I found a single seat with a small table near a window. As the train started to move, I was surprised by the smoothness of the ride (almost like a plane in flight). This was outright luxury compared to the public transit trains I was used to at home. The train soon emerged from an underground tunnel and I found myself looking out across the Dutch landscape. The land was an almost flat expanse of communities and farmlands, neatly bordered by roads like some earthly mosaic beneath a vast sky.
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I arrived in Den Haag after only half an hour. Stepping off the train, I slowly wandered with the crowds towards the station's entrance. Philip and I soon recognized each other from the photos we shared. We greeted each other with a hug. He then introduced me to his wife, Christie, who greeted me with a hug and kiss on each cheek. It was a warm and exciting welcome. Being a bit social phobic, I felt some of the initial awkwardness that often comes with meeting people for the first time in-person. However, Christie and Philip didn't feel awkward at all and I quickly became comfortable with them as they led me out of the station and to their nearby home.
Den Haag is a very beautiful European city. The character of the place is most immediately defined by the many well preserved historic buildings. Yet, in European fashion, modern elements are tastefully intertwined amongst the traditional. |
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Christie and Philip's home was one of the more modern elements of the city. They lived in a building of spacious condominiums. Their place was much like a ranch house (single floor and L-shaped), only it was on the building's 4th floor. One side of their home featured a nice view of the city, while the other side had a nice view of a courtyard. Some of the house was divided into smaller rooms, such as Philip's office space where entire walls were hidden by impressive shelves of countless books. The heart of the house was a large space that served as an attractive living room with ample space for a large dinning table as well. Christie's beautiful paintings and ceramics decorated this portion of their home. Ironically, their home's interior bore many similarities to the home of my youth and the place quickly felt like a comforting sanctuary to me.
The wonderful aroma of dinner being cooked was obvious when I first entered their home. I was promptly introduced to the chef, who I initially assumed was a family member. The chef held out his arm, with hand down turned, and I shook his wrist. This wrist shake made me wonder if his hand was crippled, but I soon realized this was simply because he was handling food. Philip explained that the chef was actually an Israeli-Arab student from the Hague conservatory who they hired to cook dinner once a week. He wasn't studying to be chef, but his cooking skills seemed expert to me. A subtle and kind detail was that Christie and Philip had actually placed an ice tray in the freezer for me. Knowing of my ice frustrations in Britain last year, they wanted me to feel at home with the simple comfort of ice cubes. This may seem a small matter to most people, but I really appreciated and enjoyed the ice cubes during my visit. Christie and Philip spoke good English in my opinion. They would disagree with me on their language skills and they apologized when they occasionally paused to find the right word. Nonetheless, we conversed in English very well. My respect for their English skills was magnified by my difficulty to simply remember how to say "thank you" in Dutch. Between each other, they occasionally lapsed into Dutch and then worried if this made me uncomfortable. On the contrary, I explained that the sound of a north European language had a pleasant element of nostalgia for me. In my youth, I often heard my paternal grandparents speak in Norwegian. I personally found this language situation both comfortable and enjoyable. My first dinner with Christie and Philip was wonderful. Their student chef had prepared a meal comparable to a very good restaurant. Furthermore, this talented student also played some pleasant music for us using his 'ud' (a guitar-like instrument from the family of 'lutes'). With an excellent dinner, live music and enjoyable conversation, I practically felt like a guest of royalty. As someone who usually lives a house-bound and solitary existence, the moment felt absolutely opulent to me. At some point, I gave Philip a gift I brought from America; namely, one of the cool T-Shirts I had bought at the 3rd Panic Disorders Institute conference in 1999. After dinner and music, Christie, Philip and I stepped out for a nighttime stroll in the city. The Dutch Parliament was only a short walk away. Like much of Den Haag, the Parliament building was an example of extremely well preserved historic architecture. We passed through a handsome archway and entered a large and beautiful courtyard. The center piece of the courtyard was a wonderful fountain with a tall golden sculpture of traditional Dutch icons. A prominent symbol that I would often see was a stork. Returning home, Philip and I spent a few hours sipping a wonderful Tuscan red wine and freely talked about all sorts of things. We both tend to be night people, so our conversation easily lingered past midnight. By now, Philip and I felt like best friends despite meeting in-person only 12-hours ago. Our rapid comradery can be attributed to almost a decade of prior Internet correspondence. Various accidental commonalities probably played a role as well. However, I've often found that people who share the experience of panic disorder have an intangible connection that is hard to describe. All these various elements seemed to have conspired in a very positive way with Philip and I. At some late hour Philip and I wished each other good night. Plans for the next day were left very flexible, depending on the unpredictable anxiety or panic attacks that affected both of us. I retired to a comfortable guest room adjacent to Philip's office space and faded into a very restful sleep.
I tried to maintain my usual routine when I woke in the morning. Like most people, my daily routine begins with a visit to the water closet (WC or bathroom). Brushing my teeth was simple enough. Other hygienic matters involved unfamiliar plumbing features that proved a bit more complicated. It seems that every time I visit a country for the first time, simply flushing the toilet or operating the shower become a kind of devious puzzle or test of intelligence. Finding no flushing handle on the toilet, it took several minutes for me to realize that a small chrome bump on the top of tank could be pressed down to flush. Soon after, I awkwardly discovered that the shower was controlled by a strange metallic bar that could be twisted in various ways to control water flow and temperature. My shower was a bit cool that first morning, but I found this refreshing. Apparently, I had passed my plumbing IQ tests reasonably well, at least on this first day.
Christie, Philip and I soon gathered at the dinning table for breakfast. Breakfast was a light meal of bread with various sliced meats and cheese and, of course, some good coffee. The meats had a more smoky flavor than I was used to, so I tended to favor the cheese. I quickly became very fond of Dutch cheese. It's hard to describe the taste of this cheese, but it's flavor is like a delightful mix of cheddar and Swiss. One of the breads was a dark whole grain variety that Christie had baked herself and I very much enjoyed.
Philip wasn't up to much activity that morning due to anxiety. I completely understood his desire to relax and spend some time quietly at his computer. Personally, I had been taking slightly more alprazolam than usual since leaving America as this was the only way I could stay functional amongst all the stress and stimulation of travel and new environments.
As Philip relaxed, Christie and I ventured out for some morning shopping. Since I didn't try to carry shaving razors through airport security, I needed to buy some items before my face got too fuzzy. I also wanted to buy some postcards of Den Haag that I could mail to family and friends. Christie kindly guided me about the city to take care of my needs. We also indulged some brief detours to enjoy fine examples of local architecture. Lastly, we stopped at a wonderful open air grocery just outside the historic buildings of Parliament. Merchants sold many kinds of dairy products, meats, breads, vegetables, fruits, etc. Christie explained that all the food here was 'biologic' (in other words, "free range" or "organically grown"). Merchants were very friendly and offered generous samples of their foods.
Christie and I returned home with a nice load of groceries. I then spent some time addressing postcards and writing brief messages about my trip to family and friends. With some humorous inspiration, I addressed one of the postcards to Philip and Christie, writing them about the wonderful visit I was currently enjoying with them in Den Haag. However, mailing this postcard to Philip and Christie while staying with them and without ruining the surprise was not easy. The historic streets of the city were so confusing that I didn't dare attempt finding the local post office on my own. Philip or Christie would have to take me to the post office and would likely be at my side when I tried to 'secretly' mail a postcard to them. Certainly, one domestic card among several international cards would raise suspicion. How could I possibly accomplish this friendly stunt?
Philip was feeling much better by early afternoon. We decided to visit the nearby art museum Het Mauritshuis. I mentioned that I wanted to mail some postcards along the way, so Philip and I stopped at the local post office. Philip was constantly at my side wanting to be supportive and helpful. I desperately tried to think of some way to divert his attention so he wouldn't notice the humorous card I was trying to mail to him. I strategically asked if there was anything he needed to do while I was mailing the postcards, but he happily stood beside me the whole time. I feared that my secret plan was certain to be exposed. I managed to buy postal stamps without raising suspicion, but when I placed cards in both the international and domestic postal slots Philip promptly worried that I had made a mistake. I suggested that I was mailing a card to another friend in The Netherlands. The deception seemed to work because Philip knew I had other friends in the country.
We continued on to Het Mauritshuis (http://www.mauritshuis.nl). This art museum was of modest size, but was a beautiful building with many great paintings by Vermeer, Rembrandt and others. Philip's extensive knowledge of art dwarfs my own, so I enjoyed learning much from him as we wandered the galleries. He told me much about the contrast of life and death in the still life paintings. He pointed out how the use of light drew attention to subjects within the paintings. He showed me that vast skies tend to be a prominent theme in Dutch landscapes. One of the favorite features was a small painting of a gold finch by Carel Fabritius (a 17th century contemporary of Vermeer).
Returning home, the rest of the afternoon was quiet and relaxing. Since I travel light and with few clothes, I needed to do some laundry. Christie kindly helped me use their washer and drier.
We decided to have take out Thai food for dinner. Philip's daughter Eline (pronounced 'A-lee-nuh') joined us that evening. Eline is a young social worker and we ended up talking openly about anxiety disorders, therapies, medications and the like. She struck me as a very knowledgeable, insightful and understanding person. I'm sure Philip and Christie are very proud of her.
Christie was in the mood for a walk after dinner. Philip wanted to stay home and relax, so Christie and I took a night stroll through the city on our own. She guided me through Den Haag's maze-like streets to see the Queen's Palace which, like Parliament, was remarkably close to their home. Naturally, the Palace was beautiful. We walked past the palace horse stables which, well, smelled like horse stables. Walking a little further, we could glimpse part of the palace gardens. In a nearby public square, we visited sculptures commemorating King William II and Queen Wilhelmina. We paused and talked a bit about Dutch history in the cool night air before starting the walk home.
I was very struck by the beauty of Den Haag on the walk back. The narrow and historic streets had a special charm that night. The atmosphere of past centuries was so potent that I often felt as though I were traveling back and forth in time. Honestly, the place brought a few tears of appreciation to my eyes.
Philip, Christie and I were soon sitting at their dinning table again. Our casual conversation eventually turned to the topic of opera. Though I'm not a big enthusiast of opera, I do enjoy opera at times. Somewhat clumsily, I mentioned that the one opera I doubt I could endure sitting through was Wagner's Ring since it was six hours long. My comment happened to touch a nerve with Christie because she was very much looking forward to an upcoming and very artistic production of Wagner's Ring. With much passion, she began explaining to me the many virtues of the opera as a complex work of art. Since I had only listened to the opera's music and never actually seen it nor paid much attention to its story, I soon acknowledged that my perspective was probably shortsighted and premature. After listening to Christie and seeing some production photos, my perspective reversed and I found myself wishing I could stay to see the opera.
After a couple of hours Christie wished Philip and I a good night. Philip and I retreated to his office. Surrounded by walls of books, we sipped Tuscan wine and talked late into the night.
Thursday began like the day before. I visited the WC for my morning hygiene ritual. By now, the plumbing was less mysterious. Emboldened by yesterday's success, I experimented a bit more with the shower's control bar. A new found configuration of bar twists made the water pleasantly warm and increased the water pressure. Feeling somewhat proud of myself, I enjoyed a warm and relaxing shower.
Stepping out of the shower, I was suddenly horrified to find half of the room flooded! By increasing the water flow I had accidentally exceeded the capacity of the shower drain and floor slope. Wet and naked, I hesitated calling for help. Being exposed by airport scanners is one thing, but parading before a friend's wife while wearing only a towel seemed just a bit too awkward. Consequently, I tried to clean up the disaster as best I could. Using several towels, I frantically mopped up the water from the floor. I desperately hoped that none of the water trickled into the homes below.
Once partially dressed, I promptly told Christie of my shower mishap. I showed her where the water had flowed, described my mop-up efforts and expressed my apologies. She was very understanding and didn't see any serious problems. Soon after, however, she asked me about my shoes. Turns out that the tread on my shoes had picked up much sand during last night's stroll and, unwittingly, I had left a trail of sand throughout the house. She was about to vacuum up the sand, but I felt responsible and insisted on doing that chore myself.
As I methodically vacuumed up sand from various rooms and hallways, Philip observed my cleaning efforts and said, with a grin, "You're welcome to stay here forever."
I later poured myself a glass of milk with an ice cube and stepped out to the porch for cool air and a smoke. The day had barely begun and I had already been struck by Murphy's Law twice. In an obsessive-compulsive fashion, it was easy to wonder if the day was somehow cursed. Was this one of those days where everything I attempted would somehow go wrong in the most unexpected ways? Trying to be rational, I reminded myself that the shower and sand accidents were simply innocent and random mistakes with coincidental notice. Only raw anxiety suggested any further meaning. Still, the feeling was hard to shake off rationally; almost like my panic disorder had amplified the small mishaps into a tiny version of PTSD. I didn't want this feeling to ruin the rest of the day, so I took some alprazolam to help calm myself.
Christie, Philip and I enjoyed a late breakfast of coffee, bread, cheese and sausages baked in pastry. They also kindly gave me some gifts to take home; a nice bag of tulip bulbs and a generous wedge of delicious Dutch cheese.
Shortly after breakfast, Philip was feeling up to venturing out once again. We decided to embrace our boldest plan and bicycle about Den Haag to visit some very notable art sites.
Riding a bicycle was a daunting thrill for me. There is a saying that you never forget how to ride a bicycle. I spent much of my youth riding bicycles and was once very skilled in this respect. However, over the last two decades I had only ridden a bicycle once. As Philip and I mounted our bicycles, I honestly wasn't sure if my past instinct of 'balance' still existed in some hidden part of my brain. As we started to roll forward, I awkwardly turned the handlebars right and left like an amateur trying to avoid a fall. I was very clumsy and lacked confidence, but I kept my balance and cautiously peddled forward as I followed Philip.
Our ride through the city streets provided many obstacles. While maintaining balance and speed, I tried to avoid collisions with pedestrians, autos, other cyclists or simply static objects. This was a significant challenge as some streets in Den Haag seem extremely narrow and busy from atop a moving bicycle. Slowly, my ancient cycling skills began to revive. I almost felt like a competent cyclist when we reached our first destination.
The first stop was an art gallery with a special highlight. From outside, the gallery seemed very humble. After Philip and I entered the gallery, I wasn't sure why he was rushing me past all the paintings. Towards the back of the gallery, he led me into a very dark and narrow hallway that led to a small spiral stairway. Climbing the twisting steps upward, we emerged into what seemed to be an outside gazebo. However, we were still inside the building. We were inside the Panorama Mesdag (http://www.panorama-mesdag.nl).
Surrounding the gazebo was a huge 360-degree painting (panorama) of what Den Haag looked like a century ago from this very location! To the east, Den Haag appeared as a much smaller city than it currently was. To the west, there was a nearby shoreline with nostalgic ships visible upon distant waters. To complete the illusion, sand and grasses lead up to the painting's edge while a recording played sounds of breaking surf and shore birds. Even the lighting would subtly vary as if the painted clouds were slowly drifting overhead. The illusion was very convincing and felt much like traveling back in time a full 100-years. After a long pause to appreciate the work, Philip and I descended back down the spiral stairs and exited the gallery.
Once again, I was clumsily riding a bicycle and following Philip as we rode to a further destination. We soon arrived at Het Haags Gemeentemuseum (http://www.gemeentemuseum.nl); a prominent and beautifully designed museum of modern art.
We entered the Gemeentemuseum and began to stroll its galleries. Among the first galleries we visited was one devoted to musical instruments. Many traditional and odd musical instruments from all over the world were featured. There was also a live exhibit of a large and strange mechanistic orchestra that employed common objects to make sounds and music. Most of the other galleries that Philip and I visited were devoted to modern paintings. I must confess that I forget the artist names, but we enjoyed wandering among the art and sharing our impressions. Personally, I often find that walking about modern art exhibits is like wandering through other people's dreams.
Philip and I took a brief break at a museum cafe. The service was awfully slow, but I enjoyed a very refreshing ice cream sundae.
We then visited a few more galleries. Again, we rushed past a number of paintings because we wanted to experience a specific exhibit. I believe the exhibit of interest was called "Water Garden." The Water Garden was a large and dark room with black walls and black ceiling. Wooden walkways meandered throughout the room upon a floor of black and still water. The atmosphere was like wandering about some minimalist pond in the darkest night. Like a large sensory deprivation tank, the dark and quiet space invited my imagination to take flight. The experience was wonderfully intriguing. I think Philip mentioned that someone had fallen into the water on the exhibit's opening day. However, Philip and I chose not to attempt a swim.
We left the museum by late afternoon. I was feeling quite confident on a bicycle at this point and really enjoyed zooming about the city with Philip. We rode by the large justice building where international crimes are tried. A few streets further, we rolled past a number of foreign embassies. A nice bicycle path took us through a thick patch of bushes and trees. We then rolled through the narrow and twisting streets of the inner city again and soon arrived back at Philip's home.
After riding about Den Haag on a bicycle, I commented to Philip that I almost felt Dutch now. Philip seemed a bit confused by my comment. I didn't explain myself well at the time, but I was referring to an impression I had about bicycle use being notably common in The Netherlands. Perhaps my comment was somewhat dated or based on some kind of misplaced stereotype? Either way, I was trying to express my appreciation for a positive experience.
Christie had received the postcard I sent them. With some amusement, she showed it to Philip. We soon had to leave again for dinner. Christie had a class to teach that evening and our museum wanderings had taken longer than expected, so time was getting tight. Just around the corner of their home was a very nice Greek restaurant called Knossos. The servings were much larger than I expected, but the food was very good. Christie had to leave early on account of her class, but Philip and I were able to relax and eat our fill. I would have asked for the rest of my meal to be wrapped up to go, but I knew that I would be leaving early the next morning. As was often the case during my visit, Philip kindly insisted on paying.
Philip was tired when we returned home. He retired to the living room for a nap, asking me to wake him in an hour so that he could record a TV show for Christie. The timing worked well for me as I wanted to prepare my packing for tomorrow morning. My biggest anxiety at this point was making all my travel connections on schedule the next day, beginning with catching an early train back to Schiphol airport. But we still had several hours that evening to enjoy each other's company. I managed to wake Philip in time for Christie's show. We then sat around talking about all sorts of things while sipping some more Tuscan wine. Our one frustration was that we didn't live in the same neighborhood to share such times regularly. Due to tomorrow's early departure, we said good night by a reasonable hour.
We all overslept by about an hour on Friday morning. This wasn't a serious problem because, as always, I plan for such things. The only inconvenience was that I didn't have time for a shower, but perhaps this was for the best. The last thing I wanted to do was flood the WC once again in the midst of a critical time schedule. Having well prepared the previous night, I quickly packed my belongings along with the gifts of tulip bulbs and wedge of cheese. Christie gave me a friendly hug and kisses good-bye.
Philip and I were almost fully awake as we started off towards the train station. Strolling down the picturesque streets, we encountered one of Philip's longtime artist friends. Philip introduced us and we shook hands. As they lapsed into a conversation in Dutch, I began to worry about the time. After a few minutes, we continued on towards the station.
We soon learned of a complication when buying my train ticket. Sadly, someone had committed suicide by standing in the path of a train along the line. We were told this was the train I had planned to take and a delay of an hour or more was to be expected. Because I had planned for delays at the airport as well, there was still adequate time to catch my flight, though my schedule was becoming uncomfortably tight. Then, Philip suggested an alternate plan. Rather than wait for the train that went directly to the airport, he suggested I take the next train to Amsterdam and then connect with another train to the airport. The uncertainty of taking an unfamiliar and more complicated route to the airport worried me, but this seemed better than helplessly waiting for the direct train and potentially missing my flight.
The train to Amsterdam soon rolled into the station. I gave Philip a hug good-bye and thanked him for everything. I boarded the train and waved to Philip. The doors closed and I was soon rolling onward into the unknown. Many people had also taken this train, so it was absolutely packed with fellow passengers. The seats had long been filled and even the handholds for standing passengers were out of my reach. I simply stood in the middle of everyone and tried to keep my balance. Staying balanced wasn't terribly difficult because the train moved very smoothly. Still, there was an unexpected deceleration that caught me off guard. I stumbled left and stepped on someone's foot, then I overcompensated and fell against someone on my right. Feeling embarrassed, I apologized to the people around me. They were very understanding and polite about the matter. I then discovered that I could press the palm of my hand against the low ceiling and steadied myself that way for the rest of the ride.
The train eventually reached its first stop. I asked someone if I could catch a train to the airport from this station. To my complete surprise, they told me that this station was the airport! I thanked them and promptly stepped out of the train. An escalator from the train platform carried me up into the airport's familiar atrium. I couldn't believe my luck. Despite the morning's complications, I had accidentally ended up exactly where I was supposed to be and was suddenly back on schedule with plenty of time to spare.
My next challenge was finding the British Airways ticket counter. I didn't expect this task to be difficult because Schiphol is such a well designed and intuitive airport. Signs to the many airline ticket counters pointed the way. I walked down a long concourse, passing large rows of ticket counters for many different airlines. At some point, the counters ended and the arrows starting pointing in the opposite direction. Apparently, I had overlooked my airline's counter.
Turning about, I walked past the counters again, but the British Airways counter kept eluding me. With some confusion and anxiety, I wondered what I was doing wrong? I asked someone for help. Turns out that British Airways didn't have a ticket 'counter' but rather a ticket 'kiosk'. I had been so focused on the airline counters that I failed to realize I was standing right next to the place I was looking for! A few ticket kiosks were boldly labeled "British Airways" and were staffed by clearly uniformed employees, so I just had to laugh at myself for overlooking the obvious. Soon I had my boarding tickets in hand and moved on.
The security check was quick and easy. With an hour before my flight, I relaxed in a dinning area.
As before, my flight across The Channel was brief and uneventful. Most of my travel uncertainties seemed behind me as I arrived at London's Heathrow airport about noon.
I stepped off the plane and into Heathrow with a renewed sense of confidence. Since I was simply connecting with another flight, I wasn't exactly sure which branches of the labyrinthine arrival corridors I needed to take. I asked directions and soon found myself on a bus between terminals. The bus drove around some terminal buildings and then entered a long tunnel that seemed to pass beneath the vast airfield. Emerging from the tunnel, the bus parked to let everyone off. I wandered up some unfamiliar ramps and soon found myself in an unfamiliar security queue. I assumed the scene was unfamiliar simply because I was entering the building from a different entrance.
After passing security I wandered forth into the terminal building. Everything seemed strangely different. Instead of the dark hues and lofty ceilings I had come to expect, the terminal now had low ceilings and bright colors. I kept walking forward expecting the scene to change, but it didn't. In some Twilight Zone fashion, it seemed like the entire airport had been completely changed in only a few days! I began asking questions, but the answers were confusing. People seemed to be telling me I was in the right place, but how could this be? Something felt very wrong. I continued to ask people questions. Eventually, a British Airways employee asked to see my ticket. They promptly pointed out that I was in the 'domestic' terminal, not the 'international' terminal. I was directed back to the bus.
I returned to the terminal bus, almost expecting a kind of "Magical Mystery Tour" (grin). The bus passed through the long tunnel again and dropped me off at another terminal building entrance. I was greatly relieved to find myself in the familiar international terminal. Better yet, I still had a few hours to spare until my next and final flight. Once again I had fortunately managed to get to the right place at the right time despite much confusion.
One of my last remaining missions was to find a T-shirt for my friend Jay. He had asked me to buy him a T-shirt during the trip, preferably something unusual. After all his help with my preparations for the trip, I didn't want to disappoint him. I hadn't noticed anything that fit his request in Holland, so the shops at Heathrow were my last chance. I wandered up and down the concourse several times checking out all the options. Eventually, the best choice seemed to be an Underground T-shirt with a "Way Out" arrow across the chest. I then relaxed in the airport bar, sipping ginger ale while waiting for my flight.
I was happy to discover that my return flight was aboard a comfortable Boeing 777. We lifted off about 16:15 and began a long and uneventful trip across the Atlantic. Landing in Philadelphia at 19:10 (local time), I exited the plane and made my way to the customs check area.
My main anxiety at customs regarded my tulip bulbs. The little declarations form I filled out and signed seemed to have some very strict language about transporting "agricultural products." But even before addressing the tulip issue, the customs official I spoke with engaged me in a long and bizarre conversation. She asked me about the area of Philadelphia I lived in and my feelings about all sorts of local trivia. I honestly didn't know if this was some weird form of security interrogation or if she was just excessively friendly. Either way, I felt I had to cooperate, so I was trapped in a kind of purgatory of small-talk for a short eternity.
The custom's lady eventually released me from verbal bondage. She directed me to the agriculture counter to get my tulip bulbs checked. The agriculture officials seemed on the verge of confiscating my bulbs, but decided that the labeling on the tulip bag was sufficient and let me keep them.
The agriculture people allowed me to pass. Moments later, however, I was stopped by a stern security officer demanding to know where I was going! I humbly replied that I had just been passed by the agriculture counter. Without a word, the officer waved me on.
I changed my remaining currency back into US dollars before leaving the airport. A short time later, one train took me into the city and another local train dropped me off near my home. After a brief hike down a dark street, I finally arrived at my front door. Finding my home intact and undisturbed was a great relief. I did a little unpacking and sent a brief e-mail to family and friends announcing my safe return.
The whole trip felt like a dream now that it was over. For almost two weeks I had embraced far more activity, stimulation and stress than I was used to. I had seriously tested my limits, taken many chances and felt very lucky that so much had gone very well. I soon fell asleep.
Many people like to comment that such trips are good therapy for me. I tend to have mixed feelings about such comments. On one hand, such trips greatly elevate my mood, perpetuate hope and compel me to test my limits. On the other hand, such trips don't really diminish the severity of my panic disorder. Generally, regular CBT-style activity has helped to keep my chronic condition stable and not worsen. Like many aspects of panic disorder, the concept of good therapy is really a matter of degree and reasonable expectations.
I also have mixed feelings when writing accounts such as this. Such bursts of successful activity could easily create misleading impressions of chronic panic disorder. I worry that I didn't describe the difficulties and gambles strongly enough. I worry that short-term function might be mistaken for longterm ability. My use of medication to manage short-term stress is not necessarily appropriate to managing longterm function.
I know I am not alone in this sense as other patients have confided similar feelings to me. We can easily seem much less disabled than we actually are because we only dare to venture out into society during our better days or for exceptional reasons. Our worst periods of suffering often drive us into seclusion and leave few, if any, witnesses.
Simply writing this account has taken a number of months. Using my notes, I wrote a rough draft just after the trip while my memory was still fresh. Assembling the conference proceedings and helping to prepare for the next conference then led to periods of distraction. Time was also needed for the people involved to review the text for reasons of accuracy and privacy. And, as always, I can only get things done during my slices of functional time between attacks. I'm often surprised that I manage to get anything done, but persistence and patience eventually yield results.
The conference remains a great source of hope to me. Chronic patients, like myself, are constantly searching for fresh perspectives. We spend much time investigating new treatments or new combinations of old ones. Ongoing research doesn't always offer new treatment options, but often helps to better understand our conditions. And I continue to feel that promoting awareness will help encourage further progress.
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Special thanks to Jay Wesley, JB, Suzan and Marvin Lifschitz, Angie and Daryush Abbasi, The University of Westminster, Angela Brittain, Philip and Christie Peters, and many good family, friends and fellow patients. |