Mary Corbliss is a mental health counselor on Unit 3-6. She is small, in her mid-thirties, and has long, mouse-brown hair. She presents as a sweet person, with a mouth that she frequently gathers up in a doll-like smile.
Mary Corbliss needs to be the center of somebody’s universe. A single woman of no apparent sexual orientation, she lives alone in a small house that she rehabbed. Mary chose to become pregnant without a known partner; the pregnancy did not result in a live birth. On 3-6, Mary works best with the dependent population: adolescents and the frail elderly. With the adolescents, she is less apt to work with them to grow toward responsible independence and more apt to put herself in a position to be viewed as the ultimate compassionate provider: Mary will take care of you.
Her position with the staff is similar. In a non-union hospital, Mary is the essential union steward. She has a reputation for organizing the younger staff members—mostly counselors—and representing their interests to higher staff. Mary intervenes on behalf of her perceived constituency and generously offers to work out problems, rather than teach others how to solve their own problems. The message is repeated: Mary will take care of you. Some counselors refer to her as “Our Mary,” as in “Our Mary wouldn’t hurt us.”
Mary is bitter about the fact that despite her years as a mental health counselor—she has worked on 3-6 for seven years—her assessments of patients are not accorded the same respect as a nurse’s. Her opinion may be given, but often it is not solicited or regarded. Rather than upgrade her position by returning to school for additional education, Mary has worked to downgrade some unit activities and have them done by counselors. She has had some success: until a year ago, nurses did all patient admissions; now, counselors also do them. Consequently, when I came to 3-6, Mary Corbliss admitted me.
I was in a state of extreme distress, in substantial part precipitated by the trauma of Eddie and CPEP. I was frightened, and not able to give a great deal of information about what had transpired in the year since I last had been discharged from 3-6. Other than a cursory check of vital signs, Mary did not seek any information about changed medical circumstances.
When a patient is admitted to 3-6, the patient is assigned a “primary.” The exact domain of the primary is never made clear, but it includes composing your treatment plan. Neither the patient nor her physician participate in filling out the Treatment Plan—a form that consists of several pages and is printed sideways on 8½ -by-11-inch green paper. The Treatment Plan is created by “nursing”—often a counselor—and then is presented to the patient, possibly for discussion, doubtfully for revision, but always for a signature. During the admission interview, I told Mary I did not want to sign anything, including the Treatment Plan; consequently, the plan was never even shown to me.
Whenever a patient’s primary is working, that staff member is assigned to the patient. And, always, a patient must first address all needs and concerns to the primary staff member. During the first week of my hospitalization on 3-6, I was confused way beyond normal levels. I often asked for, and was given, help by Mary. Mary was the center of my world on 3-6, and she was happy. However, after a week of rest, a stable environment, the companionship of others, and daily therapy sessions with my psychiatrist, I was substantially returned to a normal level of emotional functioning. In short, I grew up; I was no longer needful. Mary, however, still was.
My previous hospitalizations on 3-6 should have taught me the danger of not needing Mary. One of Mary’s behaviors is to bring a patient things from her personal belongings, even though there are strict boundaries in place about what is appropriate between staff and patient. When my belongings were lost by the Unit 3-6 staff, Mary brought me a new nightshirt; when there weren’t enough hangers on the unit, Mary brought me some from her home; when dietary screwed up my dinner tray, Mary brought me food from her own supply. It is not an easily discernible line between what is healthy and what is unhealthy. The distinctions are subtle, but in time an unhealthy relationship becomes unbalanced; one person is using another to fill some unspoken need.
Mary would not let me give back to her. For example, when a visitor brought me a shirt that was not my size, Mary would not accept it as a gift. Mary needs her patients to be in her debt. With Mary, you cannot have a mature relationship in which there is equal give and take: you must understand that you only take, and Mary always gives. It becomes uneasy, unpleasant, and, ultimately, degrading. You are kept in Mary’s debt.
You ignore Mary at your own risk. I did not ignore Mary out of spite or with any deliberation; I just went on with my life. I was doing a fairly good job of taking care of myself on 3-6; I didn’t ask for Mary’s help—and she didn’t offer it. Mary did not offer help; she needed me to ask. When I did not ask, she stood aside and watched. What she saw was me talking to Charles. (To be continued)
For the antidote to inpatient psychiatry, see Dr. Nasri Ghaly at http://annecwoodlen.wordpress.com/2010/12/29/dr-nasri-ghaly-psychiatrist-part-3/