The light above is a bright halogen light, like a vampire, I am afraid to let it touch my skin, petrified by what it will reveal.

I stare down at my feet trying not to make eye contact with the woman across from me.

I want to say hi and ask her about her day, but I am embarrassed to let her see my face.

Counting the numbers, 1, 2, 3, 23 seems like such a long way away.

Finally, the elevator ends and I exit.

The anxiety is gone, at least for now, until I have to go back down the shaft.

The 3 wall panel mirrors, the reflective metal, the overhead light. It is like a BDD box, the worst of them… Oh how I wish I could just take the stairs.

Sometimes things happen in life that make no sense whatsoever. 

Or they are so ironic that they are unexplainable by natural phenomena. 

8 days ago, while traveling through Hoi An Vietnam my wife was hit unexpectedly by a moped. 

She was knocked unconscious and later airlifted out of Vietnam to Bangkok Bumrungrad Hospital where I write this post. 

The events leading up to her eventual transfer were nightmarish and something I would never wish upon anyone. 

She sustained 8 facial fractures that required special repair by two plastic surgeons and several titanium plates. 

The reason we left for this around the world trip was because of my state of mind prior to the trip. 

My state of mind was the result of an injury and a facial laceration that left a 1.5 inch atrophic scar on my left cheek. 

My BDD drove me into a deep depression and eventually I found myself going mad, this trip was an escape, and besides that it has provided the soulful nourishment to lift me out of my depression and open my eyes once again to the beauty of the world. We were growing stronger and more resilient as a family. 

Now, the fears of facial scars and public ridicule that started this trip are coming full circle. As my wife lay in her hospital bed awaiting surgery I can’t help but wonder if there is a reason for this. How could our trip be created and ended by similar yet very different circumstances?

Is there a lesson here? 

My wife has been stoic, she is 2 days post-op, swollen and in a bit of pain. Yet she is recovering quite well. We are grateful she is a alive and well. When I see her I will always see perfection, there is nothing that can steal her beauty inside and out. Yet, my BDD is still here, having retracted but only a little. 

We are going to continue, a week more in Bangkok and we will pick up where we left off. How will this experience change the way I see myself?  This remains to be seen, but I have a feeling there is something percolating inside, a lesson to steal away from all this madness. 

I look at my last post and only have a slight remembrance of all that pain, I can feel the place inside my chest and the holes inside my face where it resides. But today, I feel strong, and confident… well at least a little bit.

Tomorrow? who the hell knows.

The problem is, I still haven’t fixed the problem.  All the depression and self-hate that conjures up feelings of hopelessness and helplessness live in a place not so deep inside me.

They come and go, along a continuum of life:

Some days good, some days bad, some days, somewhere in the middle.

Today is a good day, in fact the last month or so has been full of good days. We have been traveling through Thailand.

Part of the reason is that I have been keeping myself very busy. Thai kickboxing, rock climbing, my wife and I got our PADI advanced diving certifications in Koh Tao. I have also been burying myself in work, often late into the night when the family is in bed and the kids are sleeping.

I like it when I can walk out the door in the morning with a positive attitude and an optomistic outlook on life.

I still feel the crater scar on my nose, but the scar on my cheek, although omnipresent, is becoming less of a concern. Only when I look into my computer screen and see the deep crevice that it is do I feel anger and resentment. Otherwise I avoid it, I study the world around me, taking in the culture and the people, noticing the exterior beauty of all there is.

The road that has brought me here, to Thailand, 6 months removed from my life back home has been such an interesting one.

I was running away, but at least I was running “too” something.

If today is the result of fear, self hate and loathing then tomorrow could be anything. Last night, it was a beautiful sunset with my wife and kids on the rooftop veranda.

But, until I get the help I need, today and tomorrow will continue to have unpredictable outcomes, based on factors that are still largely out of my control.

Resting on an unattainable continuum, which draws me away from the things that matter most.

You can die alive, I have been proving it over the last few months.

At first I thought my only way out was to hang myself from something or make a 2-inch slit through one of the great arteries on the side of my neck. But I devised a better plan, one in which I could commit a similar act and look like less of a coward.

First I withdrew, it was slow and steady, I stopped attending social functions, I stopped calling friends, going to the gym, anything that involved my face in a public arena. Anything that included being vulnerable. .

The depression, which hit hard and sudden, I hid very well. Because somehow I have been able to maintain a false persona of a stable, possibly even self-confident person, but if you were paying attention you would see the changes.

The short temper, the self-loathing, self-hate that I pass onto others in the form of subtle comments. This further drives away the ones I love. It hurts, but even in this lies hope, hope of my further decomposition into non-existence.

Then I withdrew from my job, my patients, eventually I quit.

We left our home, our car, sold our stuff… This was all disguised in the “we are a brave family traveling the world”, and because I am weak our family has suffered to some degree. I figured that if I kept running I would feel better, it didn’t work.

The only persona that grew was my online persona that I could fake, for a while at least.  But now I am realizing that this can no longer sustain itself. Even though in the digital world I can exist in pixels, shaped to my liking, the reality of who I am, my selfishness and shame empty out into everything that I do (or don’t do) as a result.

The only things I have left are my 2 small children and my wife and 1 very good friend who is busy with his own life. I can tell even my wife has had enough she doesn’t touch me our even hug me anymore, her looks are cold and standoffish, I created this, because I think it is what I have given her. And it has nothing to do with her, it is simply a byproduct of my deep-seated shame.

No job, no friends, a family life that is falling apart, I am all alone, and I created every single bit of it.

The final step is to jump feet first into a wooden box 6 feet underground. This would be my final disappearing act.

But, I don’t want to die, so where can I go? What else can I do, but to commit a living suicide, one that leaves me with all the fears I conjure when I look in the mirror:

All alone, unlovable, disconnected and afraid…. So no, maybe this isn’t death, it is the definition of what it is to live with BDD. Death would probably be a whole lot easier.

No, this is not a living suicide, this is the definition of a living hell.