Magnetic Resonance

This is my brain. You’ll have to take my word for that though – it looks so ordinary, doesn’t it? Just an ordinary brain – a vast and beautiful ecosystem of interconnectivity. The extraordinary complexity of it is somehow diminished by the flatness of the image, the deceptive simplicity of the gently undulating sulci and gyri.

A nurse leads me from the psychiatric unit down through the guts of the hospital to the MRI room. Scrub-clad staff shuffle softly past us, diligent and busy, unnoticed aboveground but vital to the round-the-clock function of this teeming facility. We pass the steamy laundry room, the fragrant kitchen, several silent storage vaults. The hallways are cast in pale fluorescent light with an occasional dull orange flash from the elevator displays. A stripe of faded blue tape splits the corridor in half, faint dusty footprints crisscrossing back and forth across the dividing line. We have entered an entirely different world down here – a dim basement fairy-tale world of medical equipment and quiet footsteps.

MRI stands for magnetic resonance imaging, a technique developed in the 1970s that uses magnetic fields and radio-frequency waves to create cross-sectional images of organs and tissues. I am getting an MRI of my brain as part of the work-up for chronic depression, to rule out possible organic causes such as inflammatory disorders, cerebrovascular anomalies, or brain tumors. All of these are very unlikely, but because my depression has been unusually severe, prolonged, and resistant to conventional treatments, my in-patient psychiatrist wants to explore the possibility of rare underlying causes.

So the nurse rolls my body into the machine and I lay as still as death – movement artifact can interfere with image quality – wth my head in a plastic cage, cranium cushioned by foam pads on either side. The loud mechanical clunking from the machine becomes a visceral thudding din that seems to penetrate right down to my bone marrow. I can force my body into stillness, but I cannot quell the restless activity in my mind as it dredges up fragments of conversations from what feels like a thousand lifetimes: who I was and who I am, things I’ve lost and things I’ve locked away, wise voices echoing in a chamber of despair.

“She is probably the best student I have worked with over the past 15 years I have been in academia.”

“People with great abilities naturally have great successes and great failures.”

“You expect people to behave in logical and predictable ways. But they don’t. Not everything is logical. And that expectation creates a lot of frustration and disappointment for you.”

“You wear your emotions on your sleeve, McMurray. You can’t hide your anger and frustration, even when it’s directed at yourself. That much emotional intensity is intimidating.”

“You are a solution that’s just waiting for a problem.”

“Remember we once talked about finding your way out of the darkness of a great forest?”

“That’s not how it works here, princess…”

Today my psychiatrist tells me that the MRI showed no abnormalities. I ask to see the images – not because I don’t believe him, but because I want to see this brain of mine. On the screen it looks so… grey and calm and normal. I had expected, at least, that the machine would have somehow captured the racing chaos of my thoughts, like headlight streaks in a long-exposure photo of a busy city during rush hour. Or I thought perhaps the image might show a rim of necrotic blackness devouring the grey matter, some kind of visible sign of the darkness in my mind. Or I even half-expected to see a nest of snarling demons ensconced in their cerebral lair, ghoulish grins like candid mugshots of the pain that grips my brain.

Staring at my brain on the screen, this restless mind once more starts sifting through the debris of recent conversations. The technician who said, “What’s a nice girl like you doing in a psychiatric unit?” The nurse who asked me about my suicidal intentions and then, after I described my list of lethal methods and the pros and cons ascribed to each, said, “You look really good right now. You seem calm and coherent.” The friends who have expressed their confusion and disbelief when I describe the severity of this depression, “But you sound so normal! You seem like your usual self!” Even my out-psychiatrist who admitted that I seem so composed and articulate during appointments that he initially questioned why we were considering readmission to hospital. My outward composure – sometimes the hard-won result of energy I can barely muster, sometimes simply the only way I know how to be – seems to mask the intensity of my internal pain. And this MRI image feels the same way: it looks perfectly ordinary, composed and coherent, while the agony remains entirely invisible.

“Forgetting pain is convenient, remembering it: agonizing. But recovering the truth is worth the suffering…”
– The Cheshire Cat (Alice: Madness Returns, 2011)

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