Here’s the reason why us psychiatric types are so angry at the medical types: you keep conceptualizing mental illness the way you do physical illness. Physical illness is IN the body: pneumonia, appendicitis, cancer. These are things that are wholly owned by the body and can be treated in the body without reference to anything going on around the body.
Mental illness—if there is such a thing—is interactional between the patient and society. It is an unhealthy response to an unhealthy situation when there appears to be no other option.
A girl-kid gets depressed because her mom is over-controlling; a boy-kid gets schizophrenic because of childhood trauma; multiple personality disorder (or whatever it’s called today) occurs most often in girls as a result of pediatric rape, in boys from growing up on a military base. A grownup gets depressed because he’s lost his job in an economy that is equally depressed and not likely to offer a new job.
Medical illness is in the body but mental illness is in the mind, which is impacted by the social environment. Mental illnesses are social diseases and you only can treat them effectively by treating the community.
At the Iroquois Nursing Home, they took away my power wheelchair, left me in a back room with a woman with dementia, and surrounded me with Bhutanese people who couldn’t speak English. It was madness and I attempted suicide.
Removed to Crouse Hospital, I ceased to be suicidal. The suicidality was not IN ME; it was in the relationship between me and the Iroquois. At Crouse, they repeatedly asked me if I was suicidal; the answer was “no.” But when they asked me if I would go back to the Iroquois then I said I would kill myself.
It is not manipulative; it is being realistic about your own limits and needs. After the insulin attempted-suicide, I knew that the CFIDS was going to cause me to become really sick, and without adequate care I would have unendurable suffering. In the hospital, I expected to receive adequate care.
I have always become suicidal when the level of care is substantially below the level of need. When a really sick person is denied adequate care, what do you expect? Shall I lay here in my own vomit and excrement for an endless time, or shall I end it?
The problem is that the doctor uses his power and authority while ignoring the patient’s wishes. If the patient says she can’t go home, then the doctor should say, “Why not?” instead of saying “We can’t keep you here.”
Here’s a story: Dr. Ghaly had an old man on inpatient psychiatry. The old man’s only support was his sister, upon whom he was totally dependent. Every day she came to see him, took care of his laundry, paid his bills, and so forth. He would be discharged into her care.
So Dr. Ghaly comes in to discharge the patient but a nurse quietly and firmly tells him he shouldn’t. She offers no good reason, but is certain. Dr. Ghaly has an exceptionally long, thoughtful conversation with the patient but can find no reason to keep him in any longer. But there’s that nurse. She’s a young one and it’s highly irregular for her to be telling a doctor what to do. Dr. Ghaly shrugs and decides to keep the patient for one more day.
That night, the patient’s sister dies.
There is more to treating a patient than reading lab results and ordering drugs. There is the mystery. The human being exists as part of an interconnected web. The chiropractor had a large room with five treatment tables. One day he cracked a patient’s neck and it re-set with a loud bang. Every other person in the room reacted it to; I burst into tears. Steve says he sees it all the time—what happens to one patient is felt by all the patients. Our nervous systems are interconnected.
To only look at lab results and government diagnostic codes is to miss the entire point of caring for a human being. You’ve got to look at the patient. You’ve got to listen to the patient. You might even try—God help us!—TOUCHING the patient. If the doctor feels like he is being manipulated, it is because the patient is trying to tell him something really, really important and he’s refusing to listen. What medicine calls “manipulative behavior,” business calls “effective problem solving.” The doctor doesn’t know the all-and-everything of a patient’s life; he knows ten minutes. And if he doesn’t have the humility to listen then the patient is in big trouble.
It is, as I have written so many, many times, all about power. Doctors have it and patients don’t. In the Year of the Beast I learned that Big Government absolutely backs the doctors. We are in an untenable situation because doctors are putting their service to the government ahead of their service to their patients. Consequently the patients—also known as citizens—are regularly being mistreated.
Here’s the question to physicians: were it not for government insurance, government oversight, and government codes, how would you actually be treating your patients? Spend one day asking yourself how you would do it differently if there wasn’t government interference between you and your patient.
I see the revolution coming . . .