If I ran the zoo, I would stipulate that doctors had to spend the same amount of time with the patient as about the patient.
What I learned was that ultimately it comes down to the doctor. During my first hospitalization at Hutchings, I had a very bright, highly competent doctor, James Megna. He had a Ph.D. as well as an M.D. He used the hospitalization creatively and hand-tailored it to suit my needs (my needs being diagnosed at that time as Personality Disorder, No Specific Origin).
One of the most important things he did for me was keep me free. In fact, at one point he had me “hospitalized” to the tune of about two hours a day. I would check into the hospital in the morning for group, lunch and my therapy session with the doctor then I would go home. The hospital, instead of being a prison, was an anchor that kept me from drifting too far off center.
A word or two about the therapy. First, Dr. Megna ran the group and it included about eight of us on the second floor (the fully locked ward was on the third floor; first and second floors were less severe). Given the reality of a state hospital and its chronic, low-functioning population it was a very good group. It worked.
The second thing that worked was a daily forty-five minute psychotherapy session with Dr. Megna. Daily sessions are unheard of in state hospitals but my doctor offered it and I accepted. Do I feel guilty about it? Somewhat. The time I got was the time that other sick souls lost; I wish there had been enough to go around. As it was, Hutchings was like being on a sinking ship. The cry went out “women and children first” and I realized that I was both woman and child.
I have discovered that there is a direct correlation between the intelligence of the therapist and how well I do in therapy. Given half a chance, I work well. Dr. Megna, for whatever reasons of his own, decided to give me a chance. He thought he could help me and decided to try. I did hear later that daily psychotherapy for me was not a popular decision with the staff and that he had to defend his actions. What defense can you offer for treating a patient well?
Where did this paragon of virtue come from? He came from the federal educational program wherein the feds pay the bill for the doctor’s education if, in return, the doctor agrees to work in an area that is designated as deprived. Hutchings was deprived; the doctor owed for his training, and sometimes the system actually works.
The problem is that state hospitals have the worst patients–patients with multiple diagnoses who have run through all their insurance money and ended up on Medicaid–and the least experienced doctors are staffing them.
The second time I was hospitalized I drew a different doctor. Actually, I was passed back and forth between Larry, Curly and Moe. (To be continued)