Gina has her blood taken most weeks. This time, she has a new nurse. The nurse asked about her scars (nicely) and Gina replied, “self-harm.” The nurse exhaled sympathetically and said, “it certainly left its mark.” Ain’t that the truth!
There are the obvious scars all over her skin, there’s the toll on her body that you can read about in her medical records, and then there are the indelible marks on her mind. The more she thought about it, the clearer it became that self-harm has permeated throughout her life. Gina has so many habits, rules and thoughts that all loop back to a time when she was routinely hurting herself. The depth of it is both a revelation and strikingly obvious.
There are seemingly trivial things that, at first glance, appear to be casual preferences. Gina only buys dark bedsheets. All her beddings are black or red or purple. Sure, she likes these colours, but she switched to exclusively dark tones because you can’t get blood stains out of the lighter ones. You also can’t see the stains between washing. I realise how gross that sounds, but when you always have open wounds, your sheets are continuously bloody. You get used to it. Ditto all of the above for dark-coloured jammies.
Along similar lines is her constant manicure. Gina liked to paint her nails. However, she didn’t need to keep her nails painted at all times until cutting came along. It’s really hard to clean the blood from under your fingernails. You can scrub for hours and still see red. Covering the telltale crimson tinge became routine. Her love of shiny black polish on her toes has the same origins. Gina's toes don’t see a lot of blood these days, but necessity has grown into a habit. Her cardigan collection also has secret origins. She has a million cardigans, shrugs etc. Whenever she buys any outfit she immediately runs through what cover-up she could match with it. She doesn’t even keep her scars covered anymore, but she finds herself buying items to hide beneath. Again, precaution has become ingrained.
The tentacles extend further. Years of self-harm has skewed her perspective on several things. For instance, if you accidentally injure yourself Gina is the best and worst person to ask for help. she’ll tch wound care advice. She knows what dressing you need and how to clean every gash. She'll also almost always think you’re making a fuss of nothing. She’ll probably think you can manage without medical assistance unless your leg is hanging off. When you cry or complain about the pain, she will be outwardly kind, but inside, she thinks you should cowboy up. Your ‘call an ambulance’ is her ‘stick a plaster’ on it.
Gina knows she's wrong, but that’s how her mind works. Furthermore, any accidental injury that anyone ever tells her about will arouse her suspicion. Same deal for most scars. She spent years lying about cuts and breaks and burns. She has concocted excuses of every kind. No matter how plausible your story is, she will have a moment’s doubt. It’s no reflection on you. She knows you didn’t do it to yourself. It’s just that she knows that people lie.
Gina lied. To everyone. Repeatedly. Habitually. For a very long time. It warped her thought process. Oh, and if she has an accident, Gina spends a lot of time carefully crafting how she will explain it. Her head’s first assumption is that everyone shares her doubts. She's always scared that someone will think she has fallen off the recovery wagon. Logic kicks in and throws the crazy out, but there’s always a delay.
Gina never answers the door in short sleeves. Everyone knows they can’t just drop by her house. In the past, she didn’t know if she or her home would be fit for visitors. The anxiety of unexpected guests live on even if the pools of blood do not. Her first aid tin is always extensively stocked. She still can’t go anywhere without a cover-up. Her days of hiding every scar are gone, but her brain needs to know that she has the option.
Watching cinematic portrayals of gore annoys the hell out of Gina. She know that slash wouldn’t produce so much blood. Blood doesn’t stay wet that long. Cutting your wrists is nowhere near as easy as films would have you believe. Cold water and salt are how you remove a blood stain. Rotting blood smells a bit fishy. A troponin test will determine if you’re having an actual heart attack. Stitches in the stomach don’t really hurt, don’t bother with a local anaesthetic. The body takes 4-6 weeks to replace the red cells when blood is lost. Doctors will usually insist on a transfusion when haemoglobin drops below 7 g/dl. Learning the topology of Langer’s lines allows for cuts to be made in the correct direction to reduce scarring. Inadine patches will prevent infection. Anti-bacterial gel stops scars from itching. Scalpel blades can be bought in innocuous places. Ice can burn. Arterial blood pulses.
Gina's brain clings to all of this and more. Information, dictums & routines that no longer serve a purpose, but retain a hold. That nurse was more right than she could ever imagine. Yes, Self-harm leaves one hell of a mark.
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MENTAL HEALTH