I spent about three years locked down on inpatient psychiatry and the word “laughter” only conjures up three images.
The first is of Gary, who works as an entry-level counselor. He is extraordinarily intelligent, middle-aged, and has a master’s degree in divinity. He also wears his hair shoulder-length and rides a motorcycle. Gary came to his job through an odd set of personal circumstances but he has stayed because he likes the work. Gary says that when a person is in such crisis that he is admitted to acute care then he also is most open to making real change. Gary wants to be there to help the process.
Because of Gary’s intelligence and life experience, and the fact that he was a fully formed adult before he entered the psychiatric system, Gary is very aware of just how absurd it is and he makes fun of it. Nobody has ever figured out how he gets away with it while working on inpatient. One of the stories Gary tells is about his first contact with psychiatry.
Gary was a normal, healthy, working adult when his marriage went on the rocks. His work supervisor became sufficiently concerned about Gary’s level of distress that he referred Gary to a psychiatrist for evaluation. Gary had never before had a standard psychiatric interview, which included the psychiatrist asking him if he thought people were watching him.
Gary was working as an ordained Methodist minister and he lived in the parsonage of the church he served. A parsonage is pretty much like public housing: you live in it for very low or no rent while other people make the decisions about when—or if—you will get a new refrigerator, whether the leak in the roof really needs to be fixed, and what color the walls will be painted. The decisions are made by a church committee that thinks it has the right to run your life just because they own your house.
The week before the psychiatric interview, a member of the church board of trustees had come to Gary and said, “Folks driving past the parsonage late at night are seeing a lot of lights on. We really think you should cut back.” So the psychiatrist asks Gary if he thinks people are watching him and he says, “Yes.” Then he tries to explain about the parsonage thing.
The psychiatrist also asks Gary if he thinks God talks to him. Gary replies that he thinks God talks to everybody; it’s just that he’s in a profession where he’s paid to listen. And so the questions go.
A week later, Gary goes back to the psychiatrist for the follow-up interview. She tells him that he has schizophrenia and needs to enter into immediate and intensive treatment. He said, “No, I need to get a divorce from the woman who’s making me crazy,” and walked away.
Gary tells this story to the group he runs to make the point that you should, first, trust yourself and your own intuition about what’s right for you. The unspoken subtext is that psychiatrists don’t know what they’re talking about. Gary only tells this story on Saturday mornings when there are no psychiatrists on the unit.
The second memory of laughter on inpatient psychiatry came from a female patient. You are not allowed to enter another patient’s room so one night my roommate and I ended up standing in the hall while this woman and her roommate stood inside their room. We were all talking when this woman started telling her story.
She was a prostitute suffering from depression, so she was taking an antidepressant. She got busted on a soliciting charge and trucked off to the Public Safety Building, wherein people get locked up under the criminal code as opposed to inpatient psychiatry, where people get locked up under the mental health code.
Well, this woman decided that she wanted to sleep through the whole Holding Unit thing, so she took a couple extra antidepressants, expecting them to facilitate sleep. Next thing she knew, they were hauling her ass out of Holding on a stretcher and her heart was beating ten thousand times a minute: it was a side effect of the antidepressant.
Of course, this is not an intrinsically funny story but she had us in hysterics of laughter by the way she told it. There is neither laughter nor entertainment nor good humor on inpatient psychiatry. What there is, occasionally, is a single person who can see how intrinsically absurd life is, and make fun of it.
Molly was another such a person; she was the first person who made me laugh on inpatient psychiatry. She was a petite, middle-aged woman with dark hair and horn-rimmed glasses. She also had a biting wit and a talent for story-telling. Unfortunately, Molly was tormented. We did not know what hurt her, but periodically she would lose touch with reality and sit—sometimes for hours—staring into space, untouchable and unreachable. When Molly was good, she kept us laughing; when she was bad, we were afraid for her.
I later heard that Molly was taking a night course in college English. The professor assigned the class to write about some life experience. Molly, finally daring to come out of the dark place she was lost in, told a true story about herself and her feelings.
The professor gave her a failing grade and criticized her in class. Molly went home, totally trashed her apartment, then killed herself.
I know a lot of dead people. One of the horrors of growing old is that you know how the stories end. When you are young, you only know how the stories begin.
Inpatient psychiatry is where people go when they are at their worst. It’s sort of like the cancer ward for people whose sickness is mental or emotional. Ain’t much funny about it.