I was admitted to 4B, Upstate Medical Center’s inpatient psychiatric unit. It was there that I began my education about Mental Hygiene Law through the auspices of Barbara.
My mind’s eye sees Barbara clearly, sitting in a black vinyl chair in the corner of the day room. She was middle-aged, medium height and overweight, with short blond hair. She had heavy jowls and the sucked-in mouth of a woman who wouldn’t wear her dentures. She looked like a bulldog, and she watched, listened, and defied the system. Therein lay her downfall.
Her story was that her husband was an alcoholic and a volunteer fireman. The two of them would get into drunken fights. After they sobered up, she would get depressed, which is anger turned inward, and he would go find the fire department doctor and get Barbara committed, which was anger turned outward.
Involuntary commitment to an inpatient psychiatric facility is usually done by a “2PC,” that is, a two-physician commitment. Two physicians are supposed to independently interview the patient and if they both decide that she’s a danger to herself or others, then they each sign off on the commitment papers and in she goes.
What actually happens is that one doctor signs the papers then calls a colleague who usually sees things his way and/or owes him a favor. The second doctor says, “She needs to go in? Okay, have somebody bring me the papers and I’ll sign them.”
There is no independent judgment; there is a second opinion based on a collegial agreement to go along with the first opinion. Here is the second doctor’s dilemma: “Shall I go along with a doctor whom I regularly beat on the golf course, or shall I side with a person who will be angry, incoherent, ignorant and might try to hit me? Duh, let me think . . .” So Barbara got committed.
On inpatient, she was obstreperous, defiant and generally objected to what she called “all this shit.” In other words, she was mentally healthy enough to see that inpatient “treatment” was neither nice nor helpful. She fought back.
The inpatient system will not tolerate people who fight back, so her doctor—voluntarily but under substantial pressure from the staff—decided that she was not improving in the teaching hospital, that is, she failed to become submissive and compliant, therefore she should be moved to a state hospital.
Being transported to a state hospital was done by state police and in a straightjacket. This was not medical transportation; this was criminal.
A straightjacket is made of canvas heavier than what is used for firemen’s gear. It opens down the back. When your arms are put into the sleeves, they cross over your chest. Then, instead of ending in cuffs, the sleeves are sewn into the opposing sides of the jacket.
My friend was being taken away from me and to a terrible place. I stepped forward to hug her—and found myself with my arms wrapped around a large bundle of rough canvas. She could not hug me back. We stood there with my arms around her, tears streaming down our faces.
My world, and welcome to it.