Monday, November 1, 2010

My life exploded (Part IV).

Day 3
The night was mostly uneventful. It consisted of me waking up, feeling like crap, walking over to the nursing station, taking more Tylenol, going back to sleep, waking up feeling bad again, tossing and turning, putting my sheets back on, etc.

By the time it's morning, I no longer feel like sleeping so much and decide to acknowledge the pile of papers that I had been given upon arrival to the unit. I sift through them: some kind of form about being involuntarily committed to the mental health unit; a big packet full of information about their adult recovery program. I'm expected to participate in group sessions; shower, come to meals, keep my room clean, make my bed, wash my clothes. Visitors are allowed once a day. I may be granted to go outside if I obtain a special pass from my psychiatrist. The list went on..

I decide to take a shower and wash my hair. Bathing, that's compliant patient behavior, right? I scrub my torso until my skin becomes raw; it's impossible to get the adhesive off from the series of electrodes that I had worn. I towel off, put on the one remaining pair of clean underwear that I have, and finish getting dressed. I have no hairbrush, but eventually manage to get the flimspy hospital comb through my thick, knotted hair. I braid my wet hair. I make my bed. I sit down on my bed and read the one book I have with me: My Stroke of Insight.

One of the psych techs knocks on my door.
"I just wanted to let you know that you can get breakfast down the hall." She said.
I look up. It's Megan, one of the people I had oriented with when I first started working at the hospital. We had gone to high school together. Her expression changes when she realizes I'm me.
" Umm....I'm really sorry to see you here. What happened?"
"I overdosed."
There was an awkward silence.
"Well, I know this is kind of weird," she said "but let me know if you need anything."
I nod. She walks away.

I'm not hungry. I don't want to get breakfast. I don't want to sit with other people. I do want to get out of here, though, so I walk out into the hallway. I look at the other psych patients sitting around the table eating, and tell myself that I'm just an observer, I'm just a journalist doing an expose. I'm not like everyone else. This is the only way I know how to get through things.

I walk into the eating area and pour myself a cup of coffee. I take a piece of fruit.
"Do you want a bagel?" Asks one of the nurses.
"What kind?"
"Do you want it toasted?"
"Um, okay." I reply.

She hands it back to me a few minutes later. I'm not allowed to use the toaster. I guess it would be too easy to strangle myself with the electric cord, or stick my hair in the toast slots and light myself on fire. I sit down across from an overweight, bearded man in his fifties who has a huge plate of eggs with American cheese melted on top and is incoherently talking to himself. I spread some cream cheese on my bagel with a plastic spoon. I open my book so I don't have to talk to anyone. I take a few bites of my apple.

At the other end of the table a (most likely) transgendered person who appears to identify as female sits and eats some bacon while talking to a young, withdrawn Latino girl next to her. It seems like both of them have been here for a while, they seem at ease around each other. The transgendered girl is dressed in a hot pink tube dress with black leggings. She looks like she isn't more than twenty. She twirls her shoulder-length brown hair and continues to chat.

I take a bite of my bagel, and then pick up the remnants of my lunch and throw them in the garbage. I walk back to my room in my slipper socks. I still have no shoes.

I look at the schedule posted outside my door: community meeting at 8:30, group therapy (DBT - Dialectical Behavioral Therapy) at 9:00. One of the nurses comes up behind me with a paper cup of water and some pills.
"Are you E?" He asked.
"Here's your Celexa and some more Tylenol, if you feel like you still need it."
I take the pills and go to my room.

The minutes tick by. Finally, it is about 8:30. I walk out into the lounge to attend the "community meeting." A lot of people are already sitting down, so I quickly grab a spot on a love seat next to a grey-haired woman who looks nervous and exhausted, but comparatively benign. Patients continue to filter in, and finally one of the nurses begins to speak.

"Hi everybody," she said cheerfully. "I'm Michelle, one of the nurses, and this is the community meeting. First off, I have a couple announcements. Our washing machine and dryer are currently broken, but if you are having a laundry emergency, then let me know, and we'll figure something out. If it's not an emergency, please wait, we should have it fixed in the next day or so..." She continued on about meetings during the day, the procedure for getting a "pass" to go outside (where to everyone's dismay, is a no-smoking area). "Now I'd like all of you to tell us your name and one goal that you'd like to accomplish today. E, let's start with you."

I force a smile and hear myself saying, "Hi, I'm E, and I'd like to become familiar with the routine on this unit." At least that's over.
I listen to the other peoples' goals:
"I'd like to color, today. And I'd like to see the male psychiatrist, not the female one. Do I have to see the female one?" The girl in the hot pink tube dress asked.
"I'd like to see my family," a young guy with a cane said.
"I'd like to change my sheets," someone else said.

Finally, the meeting comes to a close, and now it is time to go to DBT. I walk into the meeting room. A chipper recreational therapist comes into the room and tells us that the person who normally does the DBT won't be leading it, and that she's going to lead today's session. She starts to launch a conversation and asks each person to "name on thing that you are proud of that has happened in the last week." Here we go again.
"I was proud that my brother came to visit me."
"I was proud that I got to go outside."
"That I'm feeling better. I'm really proud of that."
"I was proud that I called my friend."
"I was proud that I got a perfect score on my chem exam." I say quietly. I hate this kind of stuff. I seriously hate this stuff.

The conversation takes a turn and then the recreational therapist asks us to talk about recreation and how mental illness has effected that.
"Well, I used to go roller skating a lot, but then I got a really bad spider bite and now I can't go at all and now I'm really fat."
"I used to make a lot of jewelry, but now I'm too depressed to get out of bed or even watch TV, so now I don't do that anymore."
Dr. Martin pokes his head in and asks me to exit with him. I never thought I would be glad to see him again, but at that moment, getting stuck with him seemed like the lesser of two evils.

Dr. Martin walks me out into the hallway.
"Can we talk for a while?" he asks.
"Sure," I say. We sit down in two chairs in the corner.
"So, how are you doing..?"
"I'm fine. How are you?"
"Great, thanks. And how are things going on the unit," he asks.
"I don't know what you want me to tell you. I don't feel like this is helpful for me, but if you would like me to stay, I will cooperate with your routine and do whatever you would like so that I can get out of here as quickly as possible," I reply.
He nods. "So you would like to go home."
He rubs his chin. "Do you still feel like harming yourself?"
"Any suicidal plans?"
"I'd like you agree to follow up with someone on an outpatient basis."

Eventually Dr. Martin agrees to let me go home, and not long after my husband arrives. I chat with my husband for a few minutes.
"We'll have to be careful around MiniMan with the MRSA." He says.
"What MRSA?" I reply.
"When they ran the cultures on your finger it was positive for MRSA."
"Dr. Nolan told me it was just plain old staph..."
"I don't think the cultures were back that early." My husband replies.

I get a sinking feeling in my stomach. Had I not washed my hands well-enough? Had I gotten this at the hospital (where I work closely with patients who have MRSA all the time); had I gotten it at the grocery the grocery store; had my husband brought it home from the nursing home where he works? I felt guilty, and so hugely screwed by healthcare. I take care of all these people who are sick and sometimes dying, and this is what I get, MRSA?

When I used to work in the hospital there were always clear boundaries that separated me from patients. I know that must sound strange or maybe insensitive, but I think it was one of the ways that I compartmentalized; patients were like a subspecies. My patients might have MRSA or VRE or some other form of nasty resistant bacteria, but I didn't; they were sick, but I was healthy; one patient was on a forty-eight hour psych hold, but I was stable; my patients wore hospital gowns, but I wore scrubs. I was finally forced to realize we weren't so different. It disturbed me.