“Trauma destroys the fabric of time. In normal time, you move from one moment to the next, sunrise to sunset, birth to death. After trauma, you may move in circles, find yourself being sucked backwards into an eddy, or bouncing about like a rubber ball from now to then and back again.”— David Morris, The Evil Hour, p xxi
A medical debt collection notice convinced me that I was suffering from symptoms of post-traumatic stress disorder.
After the first attack in 2015, Jason had six and a half hours of plastic surgery to rebuild his face and skull. The day after, I went to pick up his pain killers from the pharmacy and was told that our health insurance was denied.
When I reached our insurance company, a call center operator told me there was no “start date” for our coverage. She explained it was probably just a technical glitch — but I was suspicious. They had paid out on the emergency room visit a few weeks earlier. If they had already settled a claim, how could they not have a start date for us?
I believe they were investigating us for fraud. It was a brand new policy. Jason and I aren’t married, so he was covered as my domestic partner. His initial treatment took place late at night. The ER prescribed pain killers for his injuries. All red flags for an insurance scam.
In the end, our coverage was re-instated. But for several weeks, Jason and I lived with the specter of $62,000 in medical debt, just a few thousand less than the cost of our house.
The moment the problem was resolved, I put the insurance drama out of my head and moved onto the next set of crises: producing an endless stream of soup and smoothies for Jason, whose jaw was wired shut; starting a new job that required a ton of travel; coordinating with Jason’s employer, doctors and therapists; and managing the extraordinary (but somewhat overwhelming) generosity of our community. Except for a brief mention in my last book — I write about algorithms that predict fraud, among other things — I tried never to think about the experience again.
Fast forward to 2020. It had been something like five years since I last had a physical — so long that my general practitioner retired and I had to find a new one. A billing error in the new office resulted in a medical debt notice. The notice went unresolved because, well…PTSD households sometimes have trouble keeping track of details and paperwork, especially during a global pandemic. Then, I received a collections notice. One of those terrifying pink envelopes. DEBT DEBT DEBT! LAWYERS LAWYERS LAWYERS!
It was like a wormhole opened in time. I was transported back into the worst moments of my terror after the attacks, trying to care for Jason and also fight with an enormous faceless company against complete financial devastation. Caregiving beyond my capacity. Failing to protect the person I love most in the world.
I paced until my knees gave out and I collapsed on the floor. Trying to calm my breathing, I hyperventilated. I cried so hard one of my eyelids turned inside out.
“Oh,” I thought to myself. “This is what triggered means.”
So I get it when Vonnegut writes,
Listen:— Slaughterhouse-Five, p 29
Billy Pilgrim has come unstuck in time.
Billy has gone to sleep a senile widower and awakened on his wedding day. He has walked through a door in 1955 and come out another one in 1941. He has gone back through that door to find himself in 1963. He has seen his birth and death many times, he says, and pays random visits to all the events in between.
Billy is spastic in time, has no control over where he is going next, and the trips aren’t necessarily fun. He is in a constant state of stage fright, he says, because he never knows what part of his life he is going to have to act in next.
PTSD messes with your sense of narrative continuity, with your memories, with your experience of time. Billy Pilgrim is captured by Axis forces in the Luxembourg woods and becomes temporally untethered. First, he travels back to childhood traumas: birth, his father throwing him, terrified, into the deep end of a YWCA pool. Then, he catapults forward to his 40s, a moment close to his mother’s death. “How,” she gasps, “did I get so old?”
Dr. Shaili Jain, in her fascinating book, The Unspeakable Mind, explains how PTSD affects memory, creating the “spastic in time” effect. On one hand, involuntary intrusive memories — flashbacks, nightmares — occur because the mind’s consolidation process goes into overdrive after trauma. Trauma etches sensory details deeply into our survival brains, bypassing the prefrontal cortex — the rational, cognitive part of the brain that attaches sense impressions to narrative. This produces embodied triggers that you can’t process intellectually. You smell the scent of diesel or see the color chartreuse, and for no reason you can discern, BAM. Flashback. Time travel.
On the other hand, the traumatic content we can voluntarily recall is disordered. This isn’t because people with PTSD are bad at remembering things. Rather, it is the very nature of traumatic memories to be disorganized. “In essence,” Jain writes, “there is an inability to put into words the most emotional part of a traumatic event” (Unspeakable Mind, p 42). You might not be able to remember the moment, but it feels like you might have to live inside it forever.
Jason’s PTSD — much more serious than mine — has severely impacted his memory. Billy Pilgrim came unstuck in a Luxembourg forest. Jason time travels in bed, waking up struggling to know what part of his life he is living in: Am I in my childhood home in Amsterdam? My dad’s house in Schenectady? My apartment in Peekskill? It’s not just a question of where his body is, but of when.
When you are healing from trauma, time won’t pass. Then it passes all at once: you wake up one morning five years later. You age a dozen years in six. This wouldn’t surprise a Tralfamadorian, but it shocked the hell out of me.
Time travel is more stressful than I expected. It leaves you feeling deeply out of control. Vonnegut captures this helpless feeling when he writes, “Among the things Billy Pilgrim could not change were the past, the present, and the future” (Slaughterhouse-Five, p 77).
Traveling in trauma time also leaves you unsure how much of your life you can expect to hold, to claim, to possess. PTSD doesn’t just re-orient your relationship to the past (the trauma) and the future (the new self you have to be after the trauma). It alters your perception of the current moment as well.
“And I asked myself about the present,” Vonnegut writes, “how wide it was, how deep it was, how much was mine to keep” (p 23).
* Note: The guy who coined the phrase “trauma time,” Onno van der Hart, lost his license in 2020 for (very serious) boundary violations with a female patient. I can’t find a source in English to independently verify this, but there is an interesting discussion of the implications on Reddit.