I am given a motor threshold test before I begin a course of Transcranial Magnetic Stimulation (or TMS). It’s to figure out the position and strength of the magnetic field that will be applied to my brain.The purpose of TMS is similar to Electro Convulsive Therapy – to stimulate specific areas of the brain but without the seizures associated with ECT and the need for repeated general anaesthesia. It doesn’t have the side effects of ECT either, which include unpredictable memory loss. There's a small chance that TMS can cause a seizure. I’m willing to take it. I recline in a large, cushioned vinyl armchair. My arms are outstretched so a nurse can monitor the movement in my hands. She stands beside me and tries to soothe my nerves. A doctor presses a large, plastic device that reminds me of a pair of Mickey Mouse ears to the top of my head. It generates the magnetic field to stimulate specific areas of my brain. He tells me he will adjust the strength and position until my fingers twitch. Nothing happens the first few times. Then my hands and legs 'jump' a few inches in the air. He lowers the strength. My fingers stretch and splay toward the ceiling. I am told that, usually, only the thumb twitches but they've found the right spot. The nurse marks it on my shaven skull with a black felt pen. The doctor then measures six centimetres from that point, to the area of the brain that is related to depression. He reads out measurements to the nurse, who notes them down.
He starts the procedure again on the other side of my head. This time, I feel the twitch inside my brain as well as in my fingers. It doesn’t hurt but it feels like an invisible finger prodding soft, sensitive tissue. I am suddenly afraid and my eyes well with salt water. I’m so tired of crying. The nurse strokes my arm and tells me to inhale deeply and focus on breathing. Again, she marks the spot on my head with a felt pen and the doctor reads out measurements. I tell them, "I just felt my brain twitch. I don’t want you to do that side, please.” The doctor assures me they'll administer only to the right side. My course of treatment will begin tomorrow and will be repeated every day after, including weekends, for three weeks. They hand me a small slip of paper with my name and the time of my next appointment on it. I return to my room. The next day, I sit in the same cushioned, reclinable chair. I insert disposable sponge plugs in my ears. The nurse asks me to turn my head slightly to the left. The device that generates the magnetic field is positioned against my skull. The nurse tells me she’s going to begin and asks if I’m ready. I say “OK.” She counts down from three, then flips the switch. I hear the sound at the same time as I feel it. It's louder than I had expected. I’m not prepared for the way it feels, which is like a tiny hammer tapping inside my skull, against my brain, every few seconds. She asks if it feels ok. I want to scream, "No!", but I’m crying too hard and I can’t get the words out. I fear I'll go mad from an hour of it. The nurse sits next to me and puts her hand on my arm. I spend the next hour sobbing and telling her everything that I feel sad or unhappy or upset about. I confess it all, talking rapidly, without pause. Later, she says tells me, "It’s part of the process." What's strange is that they’re not the things I thought were troubling me. They’re much simpler.I lose all sense of time. As soon as the tapping in my brain stops, so do my tears. Suddenly, I don’t feel upset anymore. I say to the nurse, “Well, that was weird.” She smiles and tells me my response isn't unusual. I walk back down the wide corridor to my room. My eyes are swollen from crying. But otherwise I feel fine.