I’m fairly militant on the subject of mental illness. I make no bones about the fact that I have a mental disorder and am, like a good gravesite, in perpetual care. But the memory of my last hospitalization at Hutchings Psychiatric Center causes me great pain and a goodly amount of fear. What do you, as a citizen, have the responsibility to know? What do you, as a taxpayer, have the right to know? What do you, as a friend, want to know?
Hutchings is a state psychiatric center in Upstate New York. I was admitted there with a preexisting broken leg in February 1992. My first hospitalization at Hutchings some time earlier had turned out to be quite wonderful. Everything had gone like clockwork. What I remember most vividly was everybody seeing me (absolutely everybody, my dear) in the first day and a half of hospitalization. The psychologist saw me, as did the social worker, the physician’s assistant, the physician, the lawyer, the chaplain, the lab tech and, grandly bringing up the rear, the psychiatrist. Comprehensive care. I was an unknown entity, so I got the A-class treatment. I had attempted suicide, and had worked out most of the kinks in the Intensive Care Unit before I was committed; all that I really needed was a good night’s sleep.
My second hospitalization, I was crazy off the wall. I was behaving very impulsively. I had locked myself out on my balcony accidentally, then “jumped” down and fractured my leg. Just as I jumped off my balcony, so I feared I might jump right out of my own life. It had been so easy to jump. All I did was let go and fall, and I now felt, very dramatically, that if I let go then I’d be sucked into the maelstrom. Why couldn’t I see myself as a buoyant being, rising if I let go?
I was admitted. I don’t remember much in the beginning except that I yelled at one nurse that I’d kill her if–if something. Who remembers the conditions? I just remember the panic. I was looking for a safe haven from the emotional battering that I was experiencing.
Leslie was one of the nurses. She was an LPN. She had been hired to pass medications, but then came the cutbacks; as cuts were made, the Civil Service workers were forced into their fallback positions and Leslie ended up as an aide. When you worked with Leslie, you got a great sense of how the system could have worked. She was fair, rational, and reasonable; she was consistent and clear. And she was not without compassion. What she was without was patience.
The standard drill was that if a patient wanted to see a psychiatrist then she would ask the aide and the aide would relay the message to the doctor’s office. According to theory, the doctor would then come to see the patient. In reality, the doctors never came. It got so bad that virtually all the patients were requesting their doctors every day, but, as I said, they never came.
So Leslie quit asking. She planted her heels and said it wasn’t working, the doctors never came, and she wouldn’t take any more requests. Can you imagine the level of frustration that she was experiencing? She was doing her best work and her institution wasn’t backing her up; it was putting her on the front lines and then abandoning her.
And what of the helpless, hopeless, powerlessness that the patients felt? The psychiatrists held our rights of freedom and the psychiatrists wouldn’t speak to us. We couldn’t walk out the door because the psychiatrist had it locked; we were told to call our doctors to request freedom, but then we were handed a phone that didn’t work. One of my enduring images of Hutchings is standing on the unit with a phone with no dial tone, talking when no one was listening.
I regressed. It was something I had experienced years before and it recurred. Internally, I was functioning at the level of a three-year-old; externally, I pretended adult behavior. I was despairingly alone and frightened. I tried to find a staff person in whom I dared confide. What I got was a nurse who said, “I don’t know what regression is, but I think I’m opposed to it.” So much for the official position.
It became increasingly apparent to me that Hutchings was primarily functioning as a triage center. The question was not, “What can we do for the patient?” It was “Where can we refer the patient?” They referred with no sense that it was an appropriate referral based on the program; it was simply some place else to send the patient; another way to get rid of the patient.
The Chili-bowl Referral
Hutchings does two meals well. One is chili and the other is spaghetti. I had just sat down to a chili lunch when Dr. Jane Kou and the social worker showed up. It was immediately evident that they expected me to abandon my meal and go elsewhere to meet with them but I was not about to blow one of the two decent meals I would get out of the sixty or so that I would be served and, besides, if the roles had been reversed and Dr. Kou was doing the eating and I wanted to do the talking, would she interrupt her meal for me? In a pig’s eye.
So I sat my ground and they decided to sit down at my table, which blew the program for the rest of the diners. There were not enough seats for the patients but that didn’t seem to bother Kou and the social worker.
They sat, and told me that I was to ship out on Friday for the first of a two-day trial at St. Joseph’s Hospital Continuing Day Treatment Unit. I wanted to ask why and what for, but in my chastened state, all I could do was mumble agreement. They gave me no reason or rationale for the referral. Just do it, they said; okay, I said. (To be continued)