It is Easter and I hurt. The Neurontin must be increased but even so I doubt that it will do any good. Bipolar II depression is supposed to be treated with a mood stabilizer and a mood elevator, i.e., an antidepressant. There are no more antidepressants I can use. Also, we have eliminated four of the five stabilizers, therefore, Neurontin is all we’ve got with which to work. And I’ve been feeling lousy most of the last two weeks. Maybe we’re just not increasing the Neurontin fast enough. Or maybe we’re trying to use a stabilizer as an elevator.
Some good things happened today—one or two moments here and there—but I don’t feel like talking about them because . . . I don’t know, maybe because it’ll make me cry.
I woke up at 5:30 a.m. Bad pain in my shoulder. Took Tylenol. Took orange juice in the event of low blood sugar. Went back to bed and cried. Took Ativan. Slept, finally. Was awakened for church. Felt terrible. Didn’t know whether to get up or not. Got up. Shouldn’t have.
Went to church. Drank Ensure. Cried. Got took home. By Steve. Ate leftover Chinese. Slept for nearly three hours. Came back to hospital and cried. Watched movie. Talked to Mom. Cried. Guess I’m pretty depressed.
Tomorrow’s my 103rd day in captivity. [I had been on inpatient psychiatry at St. Joseph’s Hospital for 103 days because they couldn’t find any place to discharge me. I had both physical and mental illness, and no care facility would accept both.] Appointment with Paul. Big deal. Dr. Ghaly was supposed to do acupuncture for my shoulder last Friday. He forgot. Saturday he said he’d do it but didn’t show up.
Tomorrow? I will no longer have Nicole from Physical Therapy as part of my health care team. And if I were not in a hospital—on a psychotic unit?—would she dare speak to me the way she does anyway? And if I was not in a hospital then I would be getting better medical care. Hospitals are for acute care. I have been here 103 days and need routine follow-up care for chronic illnesses. I am not getting that care.
For example, I was suffering from diabetes mellitus II, controlled by diet. I routinely took my blood sugar, it routinely averaged out to about 100, and I routinely saw my doctor at the Joslin Clinic. Then I was admitted to Intensive Care, my blood sugar went up to an unspecified level, and I was put on insulin injections. After being admitted to the psychiatric unit, finger-sticks were done on a regular basis, my blood sugar levels dropped, and I was taken off insulin and put on Glucophage.
After more time passed—and because I, and I alone, was paying attention to my glucose levels—the internist was called again and I was taken off medication and left to control my diabetes with diet again. Then we started me on the Neurontin—ah, screw all this. I’m just getting myself worked up. The bottom line simply is that the internist considers himself too busy to follow me, the nurses—ah, crap. Just understand this: No routine medical care takes place on an inpatient basis.
My vision has gotten very, very, scary bad—and nobody listens and nobody does a damn thing about it. Fuck everybody.
Addendum What I would not learn until years later is that inpatient psychiatry is not under the jurisdiction of the NYS Dept. of Health. All those medical things over which the Dept. of Health has jurisdiction do not apply to inpatient psychiatry.
Inpatient psychiatry is under the jurisdiction of the NYS Office of Mental Health.
Psychiatric units imbedded in hospitals such as St. Joseph’s, Upstate Medical Center and Community General are, in fact, not hospitals in the traditional medical sense. State psychiatric “hospitals,” such as Hutchings Psychiatric Center, are not hospitals at all. If you need medical evaluation at Hutchings, you are trucked down the street to Upstate Medical Center’s emergency room.
I am “dual diagnosis,” i.e., I have both bipolar depression and multiple physical illnesses, most resulting from improper drug treatment of depression. On inpatient psychiatry I cannot get a food tray brought to my bed, or my wheelchair pushed, or help with a shower, because those are considered to be medical issues.
Mental health counselors—the college graduates who provide direct patient care on inpatient psychiatry—are not trained to give showers. They are the first line of reporting for patients—many of whom are elderly and disabled—about medical problems and they have no medical training.
After I got off a month on life support, I was returned to inpatient psychiatry. I was forbidden to get out of bed because I was too weak to stand or walk. One morning the staff didn’t bring me my breakfast tray or any liquids. I have a rare kidney disease called nephrogenic diabetes insipidus; it was caused by unmonitored lithium. It has broken down my kidneys so that I urinate constantly, even when I’m not drinking. Several times a year I would dehydrate and end up in the Emergency Room.
So there I was on inpatient psychiatry at St. Joseph’s Hospital, too sick to get out of bed and not getting any liquids. I recognized the symptoms and realized that I was slowly dehydrating into a coma. I ran the bell. Jennifer the aide came. Knowing nothing at all about my illness, she judged me and found me immoral: she decided I was faking. She refused to bring me “any liquids until you ask nicely.” When I wanted the bell to call a nurse, Jennifer took it out of my reach. Slowly lapsing into unconsciousness, I was at the mercy of a judgmental girl with no medical training.
Years later I applied for a job at Onondaga Case Management but got shot down. Jennifer was on the committee making the hiring decision.
Psychiatric treatment is not dispensed on the basis of service to sick people. It is based on power over weak people.