309.81

I am a health care provider.
I am a human being.
These two things are not mutually exclusive, gratefully.

Medicine is often described as having 3 different facets; it is an art, a science and (disgustingly, but true) a business. As with all businesses, there is always the bottom line; profit. Tracking how to bill for pills, procedures, exams and evaluations is a complicated task. The billing of medicine is tracked through a somewhat organized system between illness/disease and procedures. The codes for the first are called ICD codes, the later CPT codes. I forget what that stands for, as I do try and remain as far from the business aspect of my profession as possible. I am especially irritated by the connection between healing and profit, but this is a rant for another day.

This morning as I was responsibly and routinely paying my bills, i came across a handwritten invoice from my therapist. My internal reaction upon seeing it was the antithesis of spying any other bill. The handwritten notice itself reminded me of how much I appreciate, adore and respect this woman. She has given me language for emotions I could barely name and showed me how I could navigate myself out of the most difficult times of my life, both past and present. When I flipped it over I noted the ICD9 code at the bottom of the letter; 309.81 because of course the insurance company would need it to pay it. With the curiousity of both a small child and a medical nerd, I wondered how I was being depicted via this numerical code, so I looked it up and found this:

309.81 Posttraumatic stress disorder
Chronic posttraumatic stress disorder
Concentration camp syndrome
Posttraumatic stress disorder NOS
Excludes:
acute stress disorder (308.3)
posttraumatic brain syndrome:
nonpsychotic (310.2)
psychotic (293.0-293.9)

The definitiveness, the concrete boundry in this code, let alone the pairing with 'concentration camp' pulled at a thread in my steady morning and unraveled me. Was the other end of this thread tied to some ghost of steel and dust laying in the landscape of my memory? Or did it go farther back to a place and time I still winced at? The origins hardly mattered, because I knew this was not a descriptor of convenience, it was not simply for the insurance company- it was part of me, it is part of me. I forget most days in the way we forget what our feet look like, though we can always look down and there they are.

I do this the same thing, every time I am faced with this. I compare, I diminish, I try and squash it into an impossibly small box. I am not being shot at in the gaza strip daily, I am not being raped in darfur, I am not drowned in a tsunami, I am not in a refugee camp or guantanimo bay for that matter. There are so many other trauma's worse than mine - and no matter how many times I think this, strangely, my shit is still there. I laugh a little at this exercise in futility. How many times do we fall in the same hole before something in our synapses fire and tell us as we approach the gap that it is there; WALK AROUND IT FER FUCKS SAKE!

But I'm describing rather than addressing my reaction to this metaphorical slap in the back of the head, and maybe it's because I still lack the language for it. Maybe that's a total cop out and I still turn away from it just because it's like wool underwear and I need to go underwear shopping.