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"I don't know what to do with you. You're hallucinating, you're paranoid, you're having panic attacks and rage seizures on a daily basis, you're losing weight at an alarming rate, you're carving words with double meanings into your flesh, and you've confessed a desire to 'assassinate' yourself and several others - on moral grounds, nonetheless! The point is, you're case is both severe and paradoxically odd. You're just more than I'm qualified to handle".
That was not the first, nor would it be the last, time I had been called crazy, or even that a psychologist had told me that they were "unqualified" to treat me. I've also heard from others that I am "beyond them", "impossible", "too far out", and my personal favorite "an enigmatic paradox".
Each time I've heard a speech like this it has been followed by one or both of the following suggestions; "Sign your self in," and "Find a new therapist". In most of these occurrences I have refused both. However, twice when it was advised that I check into a "hospital" and refused, about a month later I was forced into a locked ward because of something I had done. So when I became severely incapacitated awhile back and my current therapist along with my mentor and my girlfriend brought up the idea of institutionalization, I, after a week or two of debate with myself, reluctantly acquiesced.
I arrived at the hospital a little after nine the following Monday night. From the main building of the place, a secretary redirected us up a forebodingly winding dirt road to an ominous three-story brick building that looked like it should have gargoyles perched over its huge, cathedral-like double doors.
The first order of business was a lengthy interview, and a pile of paperwork that may have once been a small redwood.
"And you're seventeen?”
"Have you been here before?"
"Have you ever been to a mental hospital before?"
"Same sh*t, different day."
At that the man named Kenny who was conducting the interview allowed himself a small chuckle, "You're going to be alright, girl."
My father and I signed about half of a dozen forms, most of them releases, a few of them waivers and one consent to treatment form that also included an agreement to abide by hospital rules and not try to run away. After all the paperwork was taken care of, an awkward silence fell among the three of us. It was a moment before I realized why, but it hit me hard. As if someone had hit fast-forward, the next thing I heard was the echo of the heavy metal door slamming shut behind my father. This was it.
The man named Kelly led me through a set of double doors and up a spiral staircase. The spaces between the flights of steps were fenced off, and I noticed that the windows had not only bars over them, but thick sheets of plastic as well. When we reached the adolescent unit, I handed over my luggage for inspection, along with anything I had of value or that I wasn't allowed to bring into the ward. Into a little bag with my name on it went a number of things, including a pocketknife, a promise ring, a bandanna, and some change. My cigarettes, lighter, and a book of matches from my pocket, were all tossed into the garbage. The man named Kelly left, and I was shown to my sleeping quarters by a short, tired-looking blonde woman. After a few hours of staring wide-eyed at the wall listening to my roommate's nightmares, I finally managed to slip into unconsciousness.
The next morning I woke up a little before seven, sick to my stomach. After a brief argument with one of the staff members, I acquired a few packets of crackers, and looked around the room while I ate. There was a packet of paperwork on the bedside table that hadn't been there the night before. I picked it up.
1. Are you angry often?
2. Do you feel sad often?
3. Do you ever want to hurt yourself?
4. Do you ever want to hurt other people?
The questionnaire consisted of about thirty or so questions in like fashion, most of which I answered "yes" to. Remembering that I wasn't alone, I looked to the other side of the room. My roommate, a skinny brunette girl who looked to be about thirteen was straightening her hair in front of a Plexiglas mirror that was attached to the wall. She introduced herself as Liz, and when I said nothing, she assured me that it wasn't so bad there.
Around 8:30 or so staff members came to each of the rooms instructing my fellow patients and I to line up for breakfast. We did as we were told, and we were led back the spiral staircase into a small cafeteria. We were assigned seats, two to a table. There was to be no talking between tables and we had to raise our hands and ask for permission before we were allowed to get up to get our food. I was seated across from a pudgy girl who questioned me relentlessly in a thick Spanish accent.
"What's your name?"
"That's a man's name".
"Well, I'm a bit mannish. Who are you"?
"That sounds mannish too".
Chrisdalya explained the program to me in her less than articulate manner. The program is based on a level system. The level a patient is on determines what they are allowed to do and largely influences when they will be discharged from the hospital. A patient's level is decided by the amount of "behavior points" they accumulate. Behavior points are awarded to a patient every hour they "program" without incident. If at any point a patient is to break the rules, refuse a treatment, or appear to not be engaged in groups, they are not given points that hour and may have points subtracted from them. "Programming", I soon came to realize, is the perfect word to describe the hospital's efforts. The place is a glorified correctional day care center.
At the point in our conversation at which this realization came, so did another; I needed a cigarette. I sought out one of the nurses, which took about an hour, to ask for the nicotine patch I was supposed to have gotten before breakfast. She informed me that the resident doctor had yet to sign off on it, and so I'd have to wait.
By the time I was in my first occupational therapy group, I was pissed off. I was having serious withdrawals, and I was doing a work sheet with questions like "If you were going to a job interview, would you wear pajama bottoms or slacks?” And besides that, the reality of my situation was becoming clearer and I was afraid. I was locked in a building with these strangers who have no idea what they're doing, and they had total control over me. If I had been this afraid the previous times I had been institutionalized, it was one of the things I had blocked from my memory. I had made a terrible mistake. As soon as the thought formed I felt the anxiety that I had been muzzling become fear. The lights went dim and I started to shake. I gave up on writing and tried to focus.
"Al? You need to pick up your crayon and keep writing".
I was suddenly freezing cold, and my thoughts were starting to jumble together.
"Al, this is not the way to start group. If you want to get off safety and out of here, you need to be programming".
I stood up and tried to explain and to ask for my medication, but only managed to mumble incoherently.
"Alright, if you're not going to cooperate I'm going to put you in time-out. Come with me".
I made another failed attempt to communicate, and when I didn't follow her out of the room she reached for me. As much as I had been keeping it at bay, talking myself out of it, ignoring it, I broke into a panic, and ran into the room the woman had been trying to get me to. She chased after me and stood in the doorway, watching. The terror had all but taken over, and I knew if I didn't stop it, it would become unbearably excruciating, the unimaginable kind of suffering that would make someone who loves life with the greatest passion unable to stop themselves from attempting suicide if only to keep from having to go through one more agonizing second of it. I would have taken that route myself, had I not been equally afraid of death. Because I was, however, I was paralyzed by fear. I crouched in the corner with my knees drawn up in front of my face, carving crescents into my palms with my fingernails, trying to keep my composure enough to get what I needed before it was too late. Then I stumbled over to where the woman was standing and held myself up with the doorway.
"C-Can I have an Ativan, p-p-please? I -"
The woman cut me off and eyed me suspiciously. "Did you not get it this morning for some reason?"
"N-No its, a, uh, a PRN. As needed f-for anxiety..."
"Well you'll have to wait until the nurse is done giving meds in the kids unit."
"P-please, you don't understand, I can't take it much longer, once it t-takes me, I have to stop it now..."
The woman, Jordan, stepped away and called the nurse on her walkie-talkie. She returned after a few moments and said "The doctor hasn't signed off on your medications yet, so you'll just have to deal with it for now."
My heart froze. Somehow, as the fear then continued mounting, I managed to talk to Jodie in a frantic race to get her to let me try something else, before it wouldn't work.
"Could I do something then, anything? Haldol, Valium, Xanax, uh, I could call someone to talk me down, or let me, let me g-get in the shower, or-"
She cut me off again. "I said you'll just have to deal with it. Its time for OT, so you can either do that, or sit in here."
"Please, you d-don't understand, its excruciating-
"It’s not time for showering or phone calls-"
"Don't you make exceptions for emergencies?"
"What're you going to do when you get out of here? People aren't going to make exceptions for you your entire life-"
"They d-do for things like this, this is the definition of f*cking exceptional!" I shrieked. "If I was anywhere but here I could make a phone call, or t-take a shower, or t-take my medication! I can't control this and I can't handle it! What if I was a diabetic having a seizure? Wouldn't you give me a cookie even if it wasn't snack time?"
At that Jodie coldly stated "Come out when you've calmed down", and fell silent. With the last of my will I dropped onto the floor, trying anything to get a hold on myself, but failed. The fear took over, and I can't even begin to explain the horror of it, so I will not make an attempt. I writhed around on the floor in agony, screaming gutturally at the top of my lungs and tearing at myself. Finally, the terror backed down into a manageable fear, and I nearly passed out from exhaustion. I exited the room and was escorted to clinical group, since occupational therapy was over for the day. Clinical group turned out to be a game called "Moods" that was designed for children who have trouble identifying emotions.
I put up enough of a fuss that they called the resident doctor the next night to see me in person. I talked her into writing me a doctor's order that would allow me to shower any time I needed to, and made a few other arrangements to try to ensure that the events of that day were not repeated. We also discussed and selected a new medication to try me on, because I made it abundantly clear that I would not take anything they gave me without researching and approving it myself. I also finally got my nicotine patch.
The next week passed as slowly as I have ever known one to. The arrangements I had made with the doctor, along with my new medication and the patches I was given made the rest of my stay bearable, but I was worse there than I had been at home. Nothing they did there actually helped me, but I did manage to fake it well enough that I "programmed" successfully and persuaded my assigned clinician that I was ready to be discharged. I was released in record time.
The day I was to leave I had my things packed before breakfast. My roommate and I exchanged contact information before saying good bye. I filled out the patient survey, in which I had a lot to say, and as soon as my father showed up and signed the paperwork I flew out the door. On the car ride home, I realized something.
"Damn. Dad, I just remembered I left one of my favorite books on the bed back there".
"You want to go back?" he asked.
"Hell no," I replied. "I'd have to be crazy".