On Tuesday, April 14th, after a very good session at the Trauma Center, followed by a muy bueno plate of rice, beans and tomatoes at an excellent restaurant in Brookline, I went back home feeling the best I had felt in a very long time. It was a great day. Until…

That evening, quite suddenly, I felt very “spaced out” and was somewhat hallucinating. My skin was “crawling” and my senses were hyperaroused — I could hear the slightest noises from other rooms — lightbulbs were loud.

When I stood my ears would begin to hiss annoyingly. I was sweating profusely. I could not relax let alone sleep.

Then, my legs started convusling; they would squeeze together at my feet and tense upward to my abdomen, the intensity was increasing as was my fear that something bad was happening to me beyond my control.

I went to the ER and could barely speak coherently as I tried to explain, in layman’s terms, how my legs keep tensing and untensing uncontrolably.

During triage, I tried desperately to explain. I mentioned the MAOI I was on and guessed it was interacting somehow (I knew of the food restrictions related to an MAOI, but I thought I ate correctly). The triage nurse kept questioning what I was saying; she had an odd skepticism of me, and at one point said, “Why do you think it’s the MAO?” That she left off the letter “I” told me she had no knowledge of MAOI’s and their side effects. Just fucking great! I was completely frustrated at this point. I did list for her all my medications, dosages and frequency of taking. (She was pleased that I had all that data ready.)

By the time I got to a bed — after being unable to leave a urine sample as I was still severely tensed up. I REALLY wanted to give them a sample as I assumed they would be looking for drugs.

And so, the Doctor comes in (with some witness, head nurse or something). “So, what makes you think you are having a medication reaction?” he asked in a very skeptical, arrogant even, way. I’ll call him “Dr. Rotten.”

I tried to explain my symptoms but was having cognitive troubles as well as difficulty speaking. The Doctor’s attitude was very rude, arrogant and skeptical. “Are you sure?” “Looks okay to me.” “Your vitals are fine.”

They took vitals — blood pressure and heart rate were okay, but I did have a temperature of 102.1 (and was sweating profusely).

The Doctor felt my stomach and declared that it “feels soft.” And it was when he checked; the tensing in my legs and abdomen — as I told him — comes and goes. (It is called clonus.)

Finally, his rude face turned to a smile and he reassured me that my “vitals look good,” and that “you’ll be fine and we can release you.” I will never forget that fucking condescending smile/smirk on his face as he said that.

“Now let me go take a look at your meds,” he said and took off.

When Dr. Rotten came back his entire demeanor had changed (I see he has finally read the list of medications I was on).

“Who is your psychiatrist?” he demanded.

“Dr. Rickle,”¹ I said.

“Vinkle?” he demanded.²

Perplexed, as I answered clearly and he was right over me, I said, “No, Rickle. With [such 'n such office].”

He stormed off.

I am thinking, holy shit, there must be something wrong with the medication combination I am on and the good Dr. Rotten was perhaps going to “talk” to the psychiatrist about it. Um, no. I got that wrong.

I overheard the two on the phone:

Dr. Rotten: I am calling about Greg [lastname]. Do you know this guy?
Dr. Rotten: He’s here with a temperature but looks better now than when he came in.
Dr. Rotten: I don’t think it’s hypertension from the Nardil.
Dr. Rotten: He did?
Dr. Rotten: Yeah. PCP.

That is about all I can recall. Yeah, that last part threw me too.

He came back a few minutes later all smiles.³

“Okay. Your vitals still look good and you’re to see your psychiatrist tomorrow at one o’clock, okay? Now we’ll see about letting you go.”

As the nurse was preparing me to be able to go he reminded me, “You are not to take your morning Nardil, okay? Do not take the Nardil.” I liked this guy; he was very professional and polite and seemed quite concerned about my leaving.

I got up and got dressed — and proceeded to cramp up so severely I cried out in pain behind the closed curtain to my bed. I could just sit there for a minute for the pain to subside.

I walked out in a daze, no escort, completely ignored. I stumbled around until I saw the exit sign hanging from the ceiling. I made it back to where I had come in. Cramping severely again, I had to sit down in the waiting room for a few more minutes.

Completely ignored, I staggered out into the night.

So, I was sent home by Dr. Rotten. Clearly, although I did not realize it at the time, I was in the beginning stages of a moderate case of serotonin syndrome — and Dr. Rotten, clearly, thought I was just someone strung out and looking for a fix.

Read about serotonin syndrome at Wikipedia.

Anyway. It’s fucking late. I can’t sleep. I can’t relax. My legs are convulsing. I’m sweating. I can’t think straight. I am halucinating. I am in pain. I cramp up if I try to stand. It hurts bad. I am at times so dizzy and disoriented that I would fall down if not careful.

In the morning I get so bad I have to be driven back to the the ER. They admit me. Give me some benzos, and I proceed to go unconscience. I was unconscience for two days and ended up staying there for a week.

Dr. Rotten could have fucking caused me to croak if I hadn’t someone to drive me back to the ER.

Be careful with an MAOI.

1 Not his real name.
2 Was this some kind of trick? Did he expect me to say, ‘Yeah, Dr. Vinkle.’
3 As if he was so glad to be free of me.