Tuesday, July 29, 2008

CATATONIC

July 29, 2008

“You’re too red to work here.” Abigail was warming up to me. She had called me a conceded bitch the day before. Thus far she had had twelve elector shock therapy treatments. I found out she was open to doing the electic so felt a little better about the whole thing. Rico was thrilled to be moving out of the hospital to La Casa.
“Whooo, hooo.” He scurried down the hall way his arms jumping up and down in the air in pure delight. Have you seen the shit hole you are about to live in? I suppose it’s better having a moment of fun before you entered hell and even better to enjoy the idea of moving on then being restrained against your will to a place you didn’t know. He ran by Oni. I found out about Oni earlier that day in rounds. Oni was catatonic.

"Catatonia is a syndrome of psychic and motoric-disturbances. In the current Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association (DSM-IV) it is not recognized as a separate disorder, but is associated with psychiatric conditions such as schizophrenia (catatonic type), bipolar disorder, post-traumatic stress disorder, depression and other mental disorders, as well as drug abuse and/or overdose."

In other words, we are not really sure what the fuck it is. Since the doctors weren't totally sure where catatonic surfaced from or were it fell on the desert of crazy, Oni was a case study for us to try and learn from. We walked into the hall and he was standing still with one arm straight out in front of him and the other by his side.
“Hi, Oni. Can we talk to you for a moment?” Nothing.
“This is our team of doctors, nurses and social workers and we would like to ask you a few questions.” Nothing.
“Do you know why you are here?” He made an eating motion. He was fiercely skinny and hadn’t had anything but an orange in the last two days. He also had long thick nails but that was the lease of his worries.
“Can I move your arm?” Dr. Mask moved his arm to the side and Oni left it there like a diving board.
“Can I touch your forehead?” Before Mask could glean the surface of his skin, Oni was on the ground on all fours staring straight ahead like a dog staring at a rat he’s about to pounce.
“Ok, well not now. We’ll come back another time.”

Later that day, I walked to my hole and Oni’s mother was standing there, in the hallway, staring in disbelief at Oni’s strange postures. Her face was white and her mouth was agape like she was staring at a terrible thing. She was still. He was still, then he walked over to the wall and starting playing his imaginary piano next to the wall.
“Come on Oni, don’t you want to watch TV with your mother?” The nurses were trying to get him to spend some quality time with his mom in the common room, but he just stood there. Then he walked over to his bed and lied down. A nurse took the pillow out from under his head to try and get him up and his head didn’t move. It stayed there floating in the air sideways like he was still resting on the pillow. He didn’t like to be touched and his mother had not moved since she got there. Her face was stuck in stone and her puffy cheeks were now gray. I walked away and went to my hole to do some paper work. Later when I walked back down the hall, I saw him in a catchers stance near the floor. His mom was still stone but her eyes were blood shot as the tears seemed to rake her eyeballs and never seemed to stream her face. Maybe if she blinked her tears would get a break and pour out of her eyes but they were still, stoned, in a state of utter fear, shock, and unknowing pain. This was her son. She was his mother. This was his mother. And he was her son. And neither of them could say a thing, or move, or touch each other. Not that they didn’t want to, but they were in such a state of mental pain that that was all they could do. Just stand there and stare straight ahead with a deep face of nothingness.

Thursday, July 24, 2008

The IMD (Institution for the Mental Disease)

July 14, 2008

THE IMD’s – IT WAS A SMELLY FIELD TRIP
It was like a race track for the mentally deranged. Around and around and around they would go, walking in a loop around the facility waiting for a cigarette break. It was a smelly field trip. I sat in on one of the treatment rounds which occurred every three months for the inmates. Kitty. She had a nice long strand of pearls and serious issues about seeing the dentist.
“If it doesn’t feel good, it ain’t good.” Her go to reason for not wanting to have her teeth checked out. Then there was Sue. She was a quiet Asian woman with a pink floral top. She had a restraining order for stalking a guy she was determined to marry so she wasn’t going anywhere anytime soon. Next was Archie. Archie was a black man with twisted dreads that shot out of his head like antennas. The psychologist went through the list of questions and people responded on a scale in their own idea, or experience with the individual: 1) how is he physically, 2; intellectual function, 3, 2; response to stress, 3; thought process, 4; social interest, 4, 3, 3. The numbers seemed to be tossed out into the air based on people’s moods at the time. Those numbers determined whether or not the jailed could move onto another racetrack that may have some outdoor space.
“Do you know the names of your meds?”
“I don’t know.” Archie was providing honest answers to the panel of queries.
“You’re taking …….” She ripped off about eight or nine different meds.
“Do you like the food here?” The cooking department was eager to hear if his culinary skills were up to par.
“No.”
“You are 6’0” so you should weigh about…”
“I was 6’9” when I came from prison.” The cook ignored his response and continued.
“When you go to the canteen get something healthy.”
“I only have a dollar.” The table was ready to wrap up the update.
“How are you going to get discharged?”
“Right now I’m finding myself. I’m not getting any younger; I got kids you know. I have a rap label and the meds are messing with my thinking.”
“Ok, thanks, goodbye.”
And he was out and the final contestant took a seat. Megan. She had a black shirt with shiny florescent indiscernible images sprinkled randomly across her chest.
“We see here that you have been taking a lot of Motrin.”
“I have a dislocated shoulder.”
“Then you will need to see a doctor.”
“No doctor. I don’t want any cat scan on my shoulder.”
“You can’t keep taking Motrin without a doctor evaluation.”
“We’ll see. We’ll see.” She was adamant and there was no chance for her to bend. The cook stepped in.
“Do you like the food here?”
“Since I’ve been the vice president I think it’s a lot better. I heard people say they want steak which doesn’t make any sense because we have no knife. People here not have their heads on right enough to discuss their opinions.”
And so it goes. They’ll see her in another three months. Maybe by then she’ll be president of whatever club discusses the lack of steak.

July 16, 2008

I’d rather be in a dog kennel than at an IMD. And I’d rather be acute than about to enter the pavement after living in a dingy dollhouse establishment with the curtains laying low and a line of chairs to sit on with him or her next to you or do they have assigned seating at 2:45 in the afternoon when I happen to drop by and they are there doing nothing, in terribleness. Nothingness at least is nothing but terribleness is terrible.

I visited the sub acute facilities today and they have a pool, TV, space, a less putrid stench. And the “wall” that people go AWOL over is easier than a kid trying to get over a pool gate to go for a swim when he will most definitely drown. It is all ass backwards. If you are bad off, and “pace too much” you get to be in a wing with lots of open space. Open space versus a hallway to walk down until you round a corner to the next one, then are back at the beginning and it has been twenty three times so far this hour.

Saturday, July 12, 2008

INSIDE THE INSANE - WEEK TWO

WEEK TWO

July 7, 2008

It’s week two and I haven’t felt the need to puke, which is good. I carefully turned by head in the halls to see if anyone was in the secluded cell and, thankfully, no one remained.
“Where is that woman from last week?”
“Abigail? I don’t know. She’s around.” Rebecca said like it’s Tuesday. Rebecca was a five foot nothing immigrant from Nicaragua whose family came to this county with nothing. She had a masters in social work and psychology and seemed to have seen it all.
“Oh.” I really didn’t want to know what Abigail was “around” so was relieved a bit.
“Becca, can I go home now?”
It was the same guy with the same shirt and the same tormented face with the same line.
“I put the paperwork in.” Rebecca said as she opened the door to the offices and closed him off.
“Here is your desk.” She pointed to a nightstand with a foot of space for my notebook.
“Robin sits here.” I was to share the hole with another social worker.
“She’s kinda stupid.”
“Great.”
We did some paperwork and then Rebecca went to visit Kimberely to see where she wanted to live in a voluntary facility.
“I can’t be near my mother. I will try and kill her and go at her with a knife if I’m with her.” You got to respect her honesty and so she settled on a facility on the other side of her demon.

July 8, 2008

Sang Pak. She was Asian. She was bipolar with a history of hyper sexuality. She was also a prostitute, twenty three years old, and was raped.

She walked along the side of the hallway and Rebecca approached her to talk to her about going to an IMD.

“Sang, hi, I’m Rebeca.” She stopped suddenly.
“Hi.”
“This is Erica.”
“Hi, how are you?” I smiled.
“I don’t know, good, I don’t know what to say.” She was nervous to answer how are you cause somewhere along the line it wasn’t said right and now was on the bench of uncertainty.

She stamped her right foot every few seconds and was my first Asian bipolar encounter, or Asian anything.

July 10, 2008

“Lamar. What are we going to do about Lamar? Any ideas?”
“We can open the door and maybe he’ll walk out.” The rounds were on the light side today, yet, beneath that remark was the truth that after all the treatment in the world sometimes you just don’t know what to do with a patient.

As a medical case worker it is my job to meet with the staff: doctors, nurses, social workers, and randoms that I had no idea what they did, and gather as much information about a patient possible to present them to the gatekeepers to find the right place for them on the totem pole of incarceration. It seemed like too much responsibility for someone like me, someone with zero medical experience. I was the one who read the chart, wrote a synopsis and then pass it over to the gatekeepers. It seemed like a go between job but so much seemed to appear between the cracks that could mean someone sits on a waiting list for months or gets in in a week. It all seemed so important yet at the hospital level they have one purpose: ascertain the client and get them stable enough so they can move them out, then pass them off to the next branch of the tree. I was the monkey swinging from branch to branch passing on information and who the hell trusts a monkey with information that help house a patient. Let me explain. Politically the hospital wants their patients out so the social workers job is to facilitate this so they tell me what they need to say and want me to hear to make sure this happens so if a patient is acute they may spin a tiny lie and say they aren’t. Yet I know from the rounds that the doctor says something else. So what I choose to write based on crossing input swings through the trees and files fall here and there leaving a MID with 13 beds open and waiting to be filled and no one in them cause the files are on the forest floor.

I sat in the common room while Rebecca spoke with a client about going to an FSP. A disheveled black man rolled himself into the room in a wheel chair. He had a dirty Afro, slouched shoulders and a mean frown across his face.
“Hi.” I was being friendly.
“Hi. I’m Lamar.” I recalled the meeting earlier that day and how Lamar was a dead end case and wondered why.
“How are you?”
“I’m pissed. I had a clean white shirt in my locket to wear outside and they take it. These assholes hate me.”
“I’m sure they don’t hate you. They are trying to help you.” I felt so stupid saying cause if I were him I could give a fuck if anyone was trying to help me when I just wanted my shirt to go outside.
“No. They assholes.”
I let it go.

Monday, July 7, 2008

INSIDE THE INSANE - GREETINGS FROM AN INSANE ASYLUM - Social Worker 101

July 2, 2008

It was like going through an earthquake all fucking day. I walked into the dungeon with locked doors every few feet and that hospital smell that seeps into your fingers and nests in your fingernails and no matter how much you try you can’t shake the thought that you are going to have to get used to that smell. That greasy sick been in bed way to long with no caress soap stench that made my empty stomach find itself vomit to suppress as much as the look of white fear on my shockwave face.

I have to tell you I didn’t expect to be close to crazy, and I mean crazy unlike any crazy I’ve ever slipped as a normal word that people use without any consideration to the real meaning until it’s walking down a hall with slice marks on the neck or walking in a room and it’s standing in a walking circle mumbling God only knows, for real, what while you kneel down to speak to a new client that tried to kill her mother and needs to hear her options for her next move out of the hospital. It’s something like that.

I think my white face turned to shaking hands when I walked by a woman in a room in solitary confinement standing watching a wall then moments later I heard a bang and a raucous exploded as she tore off her clothes and smeared shit on herself.

The day stared out peaceful. I sat in a meeting with table of doctors, interns, psychiatrists, social workers and myself. We went through all fourteen clients and spoke about their current status. Dr. S, the kind of guy you want to be friends with cause he’s soft and sarcastic, sat at the head when the alarm went off like a fire bell.
“Erica, did you lean on the alarm?” He smiled and I sat up real straight without realizing he was kidding. There was an episode in the hallway that required the alarm for assistance. That bell must have been used two weeks ago when a nurse was pulled into a room by a 300 pound client., why are they called clients? I have no fuckin idea, and thrown on the floor to be raped and barely escaped thanks to that alarm. She’s now at home resting for a few weeks cause she’s dealing with shock. That’s another type of earthquake.

July 3, 2008

Is it crazy or a mix of coming out of the wound and having your witchcraft parents sexually abuse you and so you’re left with consent ional sex with your sister and then a web for a wrist of white lines to remind you that at 20 you did that to yourself.
“I want to go and have a life. I want a job.”
“Well we think it’s better for you not to be in your old environment cause it may not be healthy for you.” Aka you were in a gang and we don’t want you to return to that place.
And being in a gang infested neighborhood never even crossed his mind as a sat back.
“I just need to be away from my family.”
And that is why family makes wounds that we heal and the person continues to suffer cause family is all.
“Ok." We can find a facility in Hawthorne for you.”
“Ok. Sounds good.”
He nods and his plastic rosary sits on a thread across his shirt next to his nightstand with two magazines.
And the nurse walks in a panic looking for her pen that she can’t find.
“Did you see my green pen? I think I dropped it.”
I’m thinking why is she ruffling through his closet and clothes and magazine drawer, it’s an invasion of privacy.
And only now stop and think that maybe a pen was hazardous. But I thought he was safe and ready to build a new life for himself away from his white scars when she was adamant to find her pen. She said it was green and she really needed it. I think she had a pen that she loved and lost it, not that she was afraid he had it and would hurt himself. He was on his way to making a life for himself and I am sure that will be the case. Senor Cross across his neck.

I walked into this hard walled world thinking it was something never even gave a brief moment to think about and now, it’s beyond putting on my socks or climbing a sand dun, however, somehow I know I am here. I am here and have a special spirit or gift or ability or whatever you want to call it, to reach these people inside their eyes of no one knows me; I don’t know myself; but that connection between not knowing and having a person that is not knowing but both have a thread of recognition of humanity, a brief moment of yes. Yes. That is what I have to offer and have for these souls that wander in the halls alone in their disheveled hair and shrunk shoulders among doctors and nurses and others that are just passersby. Inside there is something not them and them more than the others and That is what I will find and seek out to the best of my mind.

It’s day two and the shock and fear factor is not physically showing itself in the draining of blood from my face, or slow back peddling from the bed with Nicole quiet and peaceful hearing about the outreach program while the other guy walks in circles rambling. And I am fascinated that after a couple days I am already building a tolerance to I still don’t have a term for it, and wonder when or why this situation will become normalcy so that only those inside the ward know how to deal and the rest of the world sits at their desk and eats cheese pastries or yells in their blue tooth plastic piece of shit to yell non sense crap into the other end of that poor recipient. What’s the difference? One is living large on a psycho scale mixed with environmental toxins and find themselves in a square hall wandering around, and the guy on the phone never knows chronic anything yet lives a life on chronic nonetheless. Or willingness of not knowing paralysis of the sprit that rises beneath all psychotically disorders and environmental bullshit to be aware, and want to be something, someone other than now.

It takes guts to stay in a locked facility and mean it, voluntarily, than a car filled with false notion of a life void of meaning than love for life that transcends all obstacles.

I’d rather not be in an institute so help me God. But I’d rather not be in a car alone with myself void of reasoning or thoughts for something better, for more than I am now. People ride in their bluetooth vehicles spating bullshit malarkey to assholes on the phone and never stop to think if what they are doing really matters. If it’s what they want to do or become or wake up to. They just do cause it’s all they know or wanted. Fernando knows what he knows and never had the chance to know what he wanted. And now he has a chance to dream about what he wants, he doesn’t know it, which is grand disadvantage, but at least he knows what he wants and is ready to make it happen.

I started to pray to my grandfather’s spirit. He worked, lived, in a hospital delivering babies so much that he holds the record for the most babies delivered in a hospital since WW2. So I called out to him for the ability to smell the tiles and walk by bodies with uniforms and an elevator that overruns itself then stops with a drop so much that anyone on the brink of I can not deal may just barf right about now. And I felt the yearning to feel something was enough to walk forward and swallow fresh without a cold palm or deep bowl eruptions. Calling on a dead one that you never knew to love, but do regardless, does the job. He was something there for me to focus on, and it made me breathe, which was the hardest out of all the hard things to do that first day. Breathing was Mount Sinai.

He tried to cut off his head with a large cash on his neck cause he thought he gave aids to his wife an unborn child cause he had sex with two prostitutes. And THAT was the worst of his worries. Not the gash on his neck or the thoughts to kill himself out of harsh guilt over two prostitutes. Why is it that men can sleep with a hundred prostitutes and never take a deep breath of reflection and another has two acts of sex and tries to decapitate themselves?

Deep different confeludid systems of the brain i guess.