I did not belong there. At least that’s what I thought as I was sitting at the long table for breakfast, my first meal at what I, perhaps rudely, call the crazy house. I know it’s terribly politically incorrect, but it’s the label that makes the most sense to me. “Inpatient treatment” is probably more accurate but it subtly masks the truth, the truth about how awful it is to really be in one of those places. And being there is awful. “Inpatient treatment” sounds like something you get after major surgery, not somewhere you go when you get majorly crazy– which is what it really is. So I call it the “crazy house.” Mental institution works too but I prefer crazy house, political correctness be damned.
Unfortunately, I did belong there. Looking down the table, I tried to assess the damage. Scanning the faces of the others who actually got up for breakfast at the ungodly hour of 7 a.m.– an ungodly hour for a student anyway, especially one who hadn’t been to class before 10 a.m. in a year– I tried to evaluate their level of craziness. Some of them were in blue hospital scrubs. Not necessarily a full set: some wore only the top; others, only the bottom. There was one old man in a hospital dressing gown, the kind that ties in the back but not tightly enough hide what should be hidden. I made a point not to find out whether he was wearing anything underneath the gown. There were others, like me, wearing sweats or normal clothes. Upon closer inspection, some of them looked quite ordinary, though sad.
I found out that the old man in the gown — who looked 70 but was probably somwhere is in his early sixties– was an alcoholic who’d tried to kill himself. It was not his first time in treatment. It seemed, based on the snippets he revealed in “group”, that he had been scraped off the cold floor of his rock bottom and brought into treatment, maybe as an alternative to jail. The circumstances were unclear. But, of the group of us, he seemed to be in the worst shape, at least phsyically. He joined our ward–the depression ward– after first being admitted to the substance abuse ward and was still going through the alcohol withdrawal symptoms and was usually ill. Despite this, he had a simple but surprisingly cooperative and somewhat positive attitude. It seemed like he’d gone through all this before and he might have known that this was going to be one of his last chances to get it right and get himself together.
There were a few other patients that appeared to be about the same vintage of the old man, and from there the ages were scattered from middle age to, what appeared to be, sixteen. I later found out that the girl I thought was sixteen was, in fact, twenty nine and married with two kids. Other than a twenty year old boy, I was the youngest on the ward.
The twenty year old boy was from Mexico and had only been in the States for a few years. His English wasn’t great but he was very chatty and always smiling. He was always at the coloring table with me and was not content to color in silence, which is what I preferred. He told me he’d tried to kill himself by overdosing on his cousin’s Valium. He arrived about the same time that I did. After they let him out of the hospital he was immediately transferred to our ward in the crazy house. Aside from that bump in the road he was very positive about his future– and his odds of getting out once the weekend was over.
I was determined to leave as soon I saw the psychiatrist I was assigned to, Dr. X. Breakfast had been enough to scare me straight and I was certain I was ready to leave, the sooner the better.
After we’d all picked at our breakfasts and returned our bland trays to the bland beige carts they’d arrived in, I was informed that it was time for “group.” I didn’t know exactly what that meant but I suspected that it would be lame and useless. It was not useless, as I later found out. The nurses, always watching our behavior and taking notes to report back to our psychiatrists, took group seriously and our responses and behavior during group were a factor in the formula that determined our release.
“Group” happened after breakfast and then once more after the last “snack time” of the night, around 9 p.m. (Yes, snack time. Complete with graham crackers, pudding cups, and applesauce.) During group we filled out a worksheet, the same worksheet, morning and night.
In the morning, we used the front of the worksheet which predictably asked us to desribe “how we were feeling”. The front page also required us to list our “goal” for the day. After that, we had to list three specific actions we would take to help ourselves accomplish that goal. There was a place at the bottom of the front page of the worksheet where we were supposed to list any “issues” we had in the previous 24 hours, describe any discharge plans we had, and write down any concerns we’d like our doctor/nurses to be aware of.
At night we filled in the other side of the worksheet, stating whether we had met our goal and how we felt about achieving/not achieving it. And then we went around the table and “shared”, the nurses watching, ever vigilant.
After we’d completed the morning portion of worksheet, we went around the table and shared. Meaning we went around the table and, one by one, read off what we had written. There was a tad too much oversharing in the realm of GI troubles for my taste. We read our goals and issues for all to hear while the nurses watched closely and took notes. My goal was to leave as soon as I’d met with my doctor. I didn’t make it through my sheet without crying. Not a good move with the eyes of nurse-hawks on me, pens in hand and scribbling notes in my chart. Strike One.
After we’d all “shared” we were free to go. Free to go back to sleep, to lay in bed, to wait to be seen by the doctor (although I would soon find out that the doctors didn’t deign to visit with their patients on the weekends, leaving the unpleasant task to their nurse practioners), or to engage in one of the few “recreational activities” that were available to us. (Click here for details of how few activities there really were).
I anxiously asked the nurse 20 questions. When would I been seen by my doctor? How long until the doctors arrived? What if I wanted to take a nap, would they wake me up when it was my turn? Should I just wait in one the armchairs in case they forgot to wake me up? When could I go home?!? I was not a happy camper and I was nearly bursting with anxiety and nervous energy while I sat quietly and waited for my name to be called.
I didn’t like the doctor they’d assigned me to, Dr. X. He was the university’s psychiatrist– the only one. He thought I was a drug addict and at the beginning of my third year of law school he, and my counselor at the school’s counseling center, had decided I needed “more help” than the university’s counseling center could provide. And so they farmed me out to a community provider. Luckily for me: 1) I was on my Dad’s insurance and could afford to see someone outside of the univeristy and, 2) the therapist I was referred to was by far the best therapist I’ve ever had. (Unfortunately, when I graduated and moved back down South I couldn’t take her with me…still searching for someone to replace her, which will be very difficult.)
I was apprehensive about seeing Dr. X. When I checked in, he had me put on a low dose of Norco because he thought I’d be in opiate withdrawal. Once I found out that this was why I was being given those pills I started refusing them. I was not, in fact, going through opiate withdrawals because I was not, much to Dr. X’s surprise, a heroin user. This man had been my psychiatrist for a year, had been told about all the drugs I’d done or been doing– and heroin was never on the list– but he nevertheless pegged me for a heroin junkie. (Nothing against heroin junkies, I just know I would never last on that stuff. Because I would die. I like opiates too much, have very little self control, and so I suspect that I wouldn’t last long.) To cut him some slack, which I am loathe to do, the man is the sole psychiatrist for a university of ~12,000 students, including grad students like me, AND he was in charge of the facility that I had checked into– which was not affiliated with the university. Again, this speaks volumes about the inadequacy of the university’s counseling center. (For more on that delight, click here)
I sat in one of the almost-comfortable arm chairs in the common area and jangled my legs until my name was finally called. But I was not greeted by the familiar, smug face of Dr. X. I didn’t recognize the man who guided me into the little room with no windows. Apparantely patient-doctor conferences happened in this little room, just big enough to fit the round table and four chairs surrounding it. The man explained to me that he was a nurse practitioner and that Dr. X didn’t come in on the weekends.
I didn’t know whether this was good or bad news for me. I didn’t like Dr. X and I suspected he didn’t particularly like me either. So I thought I might have a better shot with the nurse practitioner.
I was wrong. I instantly told him that I was ready to check out and go home. He did not agree. He informed me that they usually don’t do “releases” on the weekends. And even if they did, he said he didn’t think I would get cleared to leave because of “substance abuse” concerns.
I started to panic. I absolutely, positively, had to get myself out of that place. I’d been there for a little over 12 hours and that was all I needed. I had been scared straight. I would stop doing drugs forever if they would just let me out. I had to get out of there.
I started to beg. Not a good move. He didn’t budge and took my desperation as a sign of weakness, indicating that I was not fit for release. When I saw that my efforts were unavailing, I lost it. Strike Two.
I started crying and told him that if they didn’t let me out that day then they had better pump me full of Xanax if they wanted me to make it through the weekend. Another bad move. He dug in and told me to calm myself down. I was informed that if I threw a full tantrum I would have to get “a shot”, i.e. being forcibly sedated, and then my chances of getting out by Monday would be nil.
I couldn’t handle this information so I got up and left without saying anything else, but sobbing hysterically as I went. I ran straight to my room to cry my eyes out. On my way there I walked right through the middle of lunch, crying hysterically in front of everyone in the ward, trying to get back to my room so I could throw my tantrum in the semi-privacy afforded to me by a room with a door that shut but would not lock. One of the nurses called out to me as I went streaking by, “don’t you want your lunch?”
No. I did not want my lunch.
It was going to be a long weekend.