Tuesday, May 3, 2011

Hospitals and Hell: Part II

For part one, see Hospitals and Hell: Part I.

This is the second part of my story of my inpatient stay in a psychiatric hospital subsequent to my breakdown following the two-year anniversary of Stephanie's death. It's been a strange journey, one in which I've discovered much about myself and much about others -- some good, some bad. I hope you'll read...

My first morning on the ward was surreal and frightening. I awoke before dawn, having only gotten a few hours of sleep, to the sound of someone ranting on and on in a trembling voice. This ranting woman was alternately preaching, slipping into idioms, and railing at the staff about how they were treating the white people so much better than they were treating her and the other black people on the ward. It is worth noting that the two night staffers on the ward were both black women. Every now and then one of them would ask her to keep it down, but mostly they did nothing.

I lay in my bed, listening to it all, my hands shaking. Turning to the wall, I dissolved into tears. I was all alone. My partner had told me to say goodbye to her and to the boys. Two more children had been ripped from me, and a sense of hopelessness had descended. At that moment, I truly wished I had not gone to the hospital, that I had just ended it when I had a chance. All I could see stretching out before me were years of endless loneliness and an empty home. When she did that to me the morning before, she took all hope away from me. It didn't occur to me at the time that she couldn't possibly have been in love with me and done such a thing. At the time I thought I somehow deserved to be treated that way. That I had somehow earned it.

I wondered who would read to the boys. I wondered who would help Tom plant the vegetable plants we'd started.

I've never been so afraid.

That first morning was a blur. I got my morning medication, and in it, they had a Haldol for me. I refused it. I said, "I've never taken Haldol. Why do you have that in my meds?"

"It's for if you're really upset," the nurse said.

I couldn't argue that I wasn't "really upset," but I didn't want to be zombified. I took my thyroid medication and shuffled into the line of people waiting to go to breakfast. I didn't have a comb or any slippers. I was disheveled, wearing disposable scrubs and socks, and it was in this get-up that I went to my first meal in the facility. (It wasn't until later that I learned that they would give me disposable slippers, too - on request.) One of the other women in line, an overweight woman with several teeth missing, leaned over to me and said, "You'll love their breakfast here. It's fantastic!"

Instead, I found the eggs and sausage to be inedible. I munched on dry raisin toast instead, washed down with decaf coffee and apple juice. My appetite was gone anyway. Nothing would have been appealing to me. In fact, for weeks I'd had no appetite. I ate sporadically, if at all, and I slept little.

"Do they have real coffee?" I asked.

Everyone at the table shook their heads. "The only way you'll get caffeine is if someone from the outside brings it to you."

So it was contraband. Patients weren't allowed caffeine or nicotine. Almost everyone had a little plastic "puffer" that was supposed to help curb the cigarette cravings. They frantically sucked on the little pipettes and chewed them nervously. Though I don't smoke, I began to crave one of the puffers, wishing I had something to calm my nerves besides the occasional Xanax.

By the time we returned to the ward, the ranting patient had been given a shot of something to calm her down, so she was back in bed. Two more schizophrenic patients were on the ward, and they seemed to receive the lion's share of care. The other female wore the same outfit day in and day out, and she often soiled herself. She was very racist against those of us on the ward who were white, but I once made her laugh because I lost my balance on the pilates ball in the gym. We both laughed over that. I felt sorry for her, but I was also a little afraid of her. She had a dead quality to her gaze that seemed dangerous.

The male schizophrenic patient, from what I learned later, had started out his stay by dropping his pants in the common area and jacking off in front of the women there. Now he was subdued and polite.

When we returned from breakfast, the shift had changed, and two new staffers were watching us from their seats against the wall. Codes were written next to our names on a big whiteboard. I later found out that these codes were all about whether we were on suicide watch or simply "observation" and noted how many minutes the staff interacted with us during a shift. We were reduced to codes and numbers, medications and statuses.

Because of my special medical needs, the nurse's station was supposed to be adequately stocked with catheter supplies and equipment. The hospital where I'd been taken to the ER made phone calls to find me a bed in a hospital that could accommodate my medical needs. Instead of doing so, however, the hospital had one catheter tray that I was supposed to re-use, and it was several sizes too large. I ended up bleeding and in tears - again - because of the pain. I had no choice, however. My medical needs did not resolve just because of my psychological needs. My sense of hopelessness and helplessness deepened.

Mid-morning, my vital signs were taken and a technician drew blood. I returned to my room, in tears again. I was afraid. Everyone was a stranger to me, and after hearing the other patient ranting all morning, I was more on edge than ever. I prayed for sleep that didn't come.

In the early afternoon, the psychiatrist came to get me. I met with her in a small room off the common area. Finally, I was speaking with someone of intelligence who treated me like a human being and not just a psych patient. She was kind and took the time to get to know me a little. I shared with her that I had a problem with the catheter equipment and she immediately took it upon herself to try and find out why they hadn't gotten in the supplies I needed. She said that she'd have me transferred if they couldn't meet my needs. At that moment, I wasn't sure I'd accept a transfer to anywhere but home. I wasn't sure they were going to do anything to help me, and I wasn't sure I wanted the help.

Incredibly kind, she noted that she knew I was a fish out of water. She'd read my patient history and knew that I was an educated woman and that it was my first admission to the hospital for depression. She suggested that I could ask for a notebook to journal, and she further asked me to do a little homework for her, mapping out my history for her and letting her know if there had been any periods of high energy or elevated mood, to see if there was a pattern to that. We talked about the grief and how it had impacted me. We talked about my recent history of not sleeping, of taking care of two young boys and how overwhelmed that had made me feel. She asked if she could contact Kim. I provided the information. At that point, I didn't know if there was still an "us", but I figured Kim might be able to give some input to help me. At that point, she was on her way with the boys to a wedding in Charlotte, one that I was supposed to attend with her.

At lunch, I barely ate again. Everything tasted like gravel and sat heavily in my stomach. Nothing felt good to me. All I wanted was to feel like being alive, but with the recent events, any joy I'd had was gone.

I called Kim later in the afternoon and talked to her while she drove. She seemed kind enough, but she was distant. She'd been distant for the last several weeks, and it seemed that now that she was getting well, she didn't need me anymore. The balance in our relationship had shifted to a very cold, dark place. Suddenly, I felt like a caged animal. I wanted to get out of the hospital and try to mend things with her, though now I'm not sure why I thought they could be mended. I later found out that she had announced - almost immediately - that she was single again and on the market. I was cast aside like last night's casserole. Instead of being there for me when a wound opened up in my heart, the way I'd been there for her when the wound opened up in her belly, she abandoned me.

After that phone call, any hope I had was gone. Though I didn't say anything to the doctors, I was still feeling suicidal. I'd never been treated so callously by anyone who said they loved me. I've never been cut off so coldly.

That first afternoon was busy. A nurse came and took me to see the medical doctor between lunch and dinner. I was led into a small examination room and asked to put on a paper gown. A doctor with a handlebar mustache and a thick accent came in and poked and prodded me, asking me a rapid series of questions. My hands shook, as I didn't know what to expect. How much could a doctor do in a psychiatric hospital? What was he allowed to do to me? I felt very little control, but he made it quick and was kind to me. He said that because of hospital-borne infections, I should use a fresh catheter every time. But the hospital still didn't have any supplies, and I had precious few on hand in my bag, which Paul still had in my car.

The ward got quiet that evening as the weekend approached. From my roommate, another woman who had been admitted for depression related to grief, I learned that the weekends were quiet and lonely, something I didn't need more of. It would give me, I knew, too much time to think. Gradually, I began to talk more to my roommate and the other patients. If I had to be there, I figured I should try to keep myself busy, though all I really wanted to do was sleep.

On Saturday, I had a visit from Paul. He brought me some clothes from home and the small stash of my own catheter supplies. I could tell by the look in his eyes that he was quite worried about me. He tried to reassure me that he would help me in any way that he could, that I should focus on getting well.

"Stop thinking about Kim," he said. "She's obviously not that concerned about you."

He was so angry that she had let me drive away that day, knowing that I was suicidal. At the time, I was too deep in my illness and sadness to think about it, but later I wondered why an ER physician would not know the protocol for dealing with a suicidal person. The thing is - she does know what to do as a physician, but she doesn't know what to do as a person, as a partner. As my partner, she didn't care enough to stop me.

Later, I learned (from the babysitter) that she called her friend and ex-lover Katherine, crying and asking her what to do -- after she let me drive away. (She didn't cry when I was there. The tears were all to get attention and sympathy from Katherine.) Katherine supposedly told her to do nothing. Of course that's what she'd tell her, because finally I was out of the way. Shortly after Kim and I got together, Katherine told Kim what a big mistake she'd made by not sticking around. Kim made sure to read me all the messages. It was all very unnecessary and painful, but Kim didn't seem very concerned about my feelings. But when she would say Katherine's name, she would hold her name in such awe. I always knew that the two of them would be the end of "us."

On Sunday, I woke up with pain and a fever. It was my worst fear - another UTI while in a hospital not equipped to deal with it. The nurse checked on me and gave me an Ativan - an anti-anxiety drug - to help me deal with the pain. I'm not sure what that was supposed to do, but I took it. She said she'd have the doctor come in.

It was late afternoon when he finally showed up and - from across the room - said he'd order some Cipro and pyridium for me. He also made sure that I had pain medication ordered, another mix-up they'd had. My pain management was all messed up, as was my bladder care. It was all conspiring to make it quite difficult for me to get better.

As it turned out, they never got the meds for me. The pharmacy tech left without dispensing the meds, so I had to go another day and night without medication for the infection. Monday morning, the kindly psychiatrist made the nurse go to the pharmacy and get the medication for me. She was quite frustrated over the whole thing, and she understood when she found out that on Sunday afternoon, I had signed the 72-hour request for discharge. I would be discharged no later than Tuesday at 2 pm. She spent more time with me, reviewing the history I'd written out for her, and she correctly diagnosed me with bipolar type II. She started me back on medication to treat it.

Some part of me - the stupid part - still had hope that if I were out of the hospital, Kim would come around. I still had hope that I could just go home and get back to my life and back to work right away. Little did I know that I had so much further to go before I'd be ready for that. More about all of that in the next post.

Peace - D


Mental P Mama said...

Wow. I am glad you are on the road to yourself. And, I wish you could erase Kim from your memory bank. That was not a relationship.....strength and light coming at you from here.....

the walking man said...

When you get you settled into the new you then you can rethink the old you and figure out where the new you is going based on the old you's past experiences. But get settled in first.

RiverPoet said...

Thanks, both of you. I am getting a great amount of assistance in putting my life back together. The outpatient support I'm receiving is so much better than the inpatient support. But the hospitalization did what it was supposed to do - it kept me alive to tell the story.


Daryl said...

MPM is right .. and lots of hugs from me ..

TSannie said...

Hang in there, my friend. You are SO worth the effort. And Lauren is correct, that was not a relationship - at least on her part. Good thoughts to you.

Syd said...

Time to move on and focus on the solution in your life. Kim was not a solution. She was part of the problem as I see it.