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Maybe, Maybe Four Large Glasses of Water
Psych hospitals are remarkably different from one another after you pass through the commonality of mental illness. The first one I ever saw was in New Orleans and suffice it to say, resources were poor. I remember giant, schizo-affective Lionel grabbing my arm and me hoping he didn’t break it. I was astoundingly scared at my helplessness in his grasp ( 6’2″, 260, all muscle). One day Annie somehow managed to stand up, normally an easy feat but she was in four-point restraints and had a bed frame running the length of her posterior, arms, and legs out like DaVinci Man. She robot-walked toward me exclaiming, “gonna rape you white boy.”
Two weeks later, Lionel was a cuddly bear and Annie was wanting to get back to her kids. Psychiatric meds are expensive, have substantial side effects, and require access to the medical system. They can also turn insanity back to some semblance of normal.
The intake lobby had this white woman, in a 100-person sea of black women, seek me out and manipulate me in to helping her. She hid her craziness and hoped her charm and race would influence me. Sadly it did and an older black nurse pointed out where I was missing something in her history. But she also indirectly showed me I wasn’t immune to racial bias in my actions, a lesson I’ve kept close to me.
Senior year of medical school I had a fun tour of the US for a few rotations. One was the psychiatry department at UC Davis outside Sacramento. I remember a gorgeous college girl in Mill Valley named Simone, with a convertible Triumph no less … but that’s another story as is lying to the cops about firearms when they woke me from sleeping it off in my old Bronco 2.
Bobby had a closed head injury. He was 49, looked 65, and was a meth addict who pissed off the wrong person and was irreparably damaged by the man who used his skull like a basketball. He was tied at the waist but his arms were free, nervously fingering the brain surgery scar and plotting escape. “You got any scissors, man? We can go to my mom’s, she’s got cold Cokes, you like cold Cokes, my mom’s got cold Cokes.”
Marge was an Indian, I’m unsure which tribe. She was 55 and not at all connected with reality in many areas, especially regarding fluid intake. She came into the ER with critically low sodium and they instituted the usual fluid restriction protocol. She was hiding the fact that she had psychogenic polydipsia, aka compulsive water drinking by mentally ill people with defective thirst centers. Nobody realized she was crazy until her sodium kept dropping and they found her drinking water out of the toilet like a dog. Water was cut to the room and she slowly improved. I saw her when she was on the mend, although I was pretty sure she’d be back, given her line of reasoning. “Hey doc, you know what I’d love? One large glass of water. Actually maybe two, maybe two laaaarge glasses of water. Maybe three, maybe three laaaaarge glasses of water. Maybe, maybe four laaaaaaarge glasses of water….”
“You’re not going to stop are you?”
“Maybe, maybe five laaaaaaaaarge glasses of water.”
Ah, maybe she’s in heaven now. Marge is at Lake Lebarge perpetually guzzling away for eternity, never satisfied but always doing what she craved.
I left the room. I was always good at psychiatry, perhaps it takes one to know one theory of life. I almost considered it until I met all the psychiatrists. Oof, they’re a nutty lot.
The difference between a neurotic, a psychotic, and a psychiatrist: The neurotic builds castles in the sky, the psychotic lives in them, and the psychiatrist collects the rent.
Published in General
Nothing to add, but nice vignettes.
Not a comment/controversy generating kind of article. Glad you liked it. I had been meaning to immortalize these folks.
Sounds like my family except they would want four large glasses of whiskey.
God bless doctors.
That quote at the end is certainly worthy of a quote of the day.
My cousin did a rotation in med school through a psych ward. In her first week she had her nose broken and three teeth knocked out. She didn’t last long.
I kept thinking of 100 bottles of beer on the wall when I was reading that. Drunk minds think alike or something.
I hated psych. Scared me to death. When those doors locked behind me, all I could think of was every horror movie I’d ever seen. We get a few through our preop area from the state hospital. The folks that work there have the patience of Job and are great with the patients. Everybody has their calling.
I love that you took to heart what the “older black nurse” told you. That’s what makes you a great doc. You never think you have all the answers.
That’s the “marge of Lake Lebarge.” One of my favorite poems.
(Shut up, @arahant)
Yeah Arahant, shut up!
The reference was pure ADHD and unplanned until I typed it.
Pure ADHD is the best kind.
How true. Wow.
What MarciN said. Wow. (If I want to use this quote somewhere/sometime, should I just contact you through R. for permission – and your full name?)
It’s a borrowed quote from an anonymous source
I love that poem as well. I found a first edition of Service’s Songs of A Sourdough in a used bookstore and grabbed it. It is a delight to read. I like the whole thing, but especially
Oh, good. I was going to borrow it too, but I was just going to steal it.
I like Dennis Miller’s AD-OCD: Attention Deficit Obsessive Compulsive Disorder. It’s where you’re constantly changing what you’re completely obsessed with ;)
Doc, glad these folks taught you, stayed with you, and can come to us through your evocative words: Thanks for bringing their uniqueness forward for us. (Wonderful closing quote, too.)
Psychiatric meds are expensive, have substantial side effects, and require access to the medical system. They can also turn insanity back to some semblance of normal.
Our society is about to shortchange the legitimately sick mentally ill even more due to the current frothing and whimpering about opiod addiction. Of the several trillion frustrations I dealt with as the father of a son suffering from schizophrenia, one was that mental health and substance abuse are bound together in funding and treatment programs. Who is going to get the most attention from these programs, the “worried well” kvetching about their emotional boo boos or the organically disabled?
I would support more funding for the opiod addiction crisis if I could get an answer to one question: is there any scientific proof that sending an addict to a spa like Promises of Malibu is any more effective than joining Narcotics Anonymous for someone who truly wants to turn their life around, as opposed to the vast majority looking for a way to salvage their job or relationship, or avoiding the pokey.
Some comedienne that I can’t remember:
The neurotic builds castles in the sky, the psychotic lives in them. My mother cleans them.
There is more benefit from N/A than any rehab center IMO, but NA teaches that it’s a disease rather than a choice which is a quibble I have. Relapse rates for opiates are 80-90% after their hand holding spa. NA has a high dropout rate but those who stay tend to stay sober.
Tough road you have but your boy is lucky to have a family that cares, it makes all the difference in the world.
I have been diagnosed with schizophrenia and have spent a great deal of time in psych wards; am inclined to agree that many or most of those there fall into the category of the worried well, but am not convinced that is a bad thing. My experience of psych wards is very different from what Doc Jay describes; I never encountered anyone violent, and most of the people there were totally sane and just depressed, or trying to get off of drugs. There were always a handful of people who, like me, were seriously out of touch with reality, but the majority were always basically sane, and I am very grateful for that. I don’t feel that I was shortchanged by their presence; I would not have wanted to be in a place where everyone was just as crazy as I was :) One thing I noticed: the worried well, or those struggling with just straightforward depression, were always asking for more and different drugs. The people like me who really needed drugs virtually always refused to take them, unless under extreme duress. But still, the presence of the worried well made the psych ward a relatively pleasant place to be: if everyone there had been as ill as I was, it would have been a nightmare.
The hospitals are remarkably different. I worked at one near Salem Oregon that was of Ken Kesey fame, probably more neurotics than reality challenged and nobody violent. There are multiple different levels for different kinds of cases.
Nothing even came close to the ghetto. Underfunded and filled with folks from the fringes of society without resources and often family.
I’m glad you’re here with us JAC. ;-)
Thank you, Doc Jay :) I was lucky; my parents and then later my husband visited me virtually every single day that I was in the psych ward, and I was there for a lot of days. If on a particular day they couldn’t make it, they would make sure that someone else did. It made all the difference; as far as I can remember, I was always the only person there who received visitors every day. Most of the people there rarely or never had visitors, which is especially horrible when you consider that many or most were there because of suicide attempts. There are a few people, like me, who seriously need medication: most of the people I encountered in the psych ward needed a family more than anything else, and it was glaringly obvious that they didn’t have one. Unfortunately, no amount of money or funding can solve that problem.
It makes me feel happier and more hopeful to have you here, JAC.
My loved one (BiPolar One with Psychotic Features) was also the only person in the psych ward who was visited every day. It was so incredibly sad. Also, as far as I know, the only one who, upon being stabilized, was released into the arms of a family prepared to do whatever it takes to help her recover and stay sane. (We’re now celebrating two years without a hospitalization! Yay!)
Getting the medications right, and then developing the habit of taking them in the right order and at the right times…? How they imagine that a solitary schizophrenic without a stable home is going to manage this, I don’t know. Especially since, statistically speaking, he won’t manage it. He’ll go off his meds, and after much suffering, he’ll be back in the hospital again, expensively, tragically miserable.
Don’t get me started.
I, too, must quibble ;)
I’d be immensely disappointed in you if you didn’t.
Thank you Kate :) I am so glad that your loved one is doing well!
Speaking of hospitals, I’m getting a knee scope and a carpal tunnel tomorrow. The curse/blessing is I’ll not be typing for a while.
Both procedures should be a piece of cake. No narcs after either, hate those things. I am stocked up on a 10 pack of pot gummy candies though if I need to sleep. I’ll report my hallucinations at some point if I go chasing rabbits and remember what the door mouse said…
Get well soon, we will miss you while you are gone!
Doc beat me to it, but: Me, too, JaC! Your ability to get to the heart of the matter – and your willingness to point out incongruity and plain old absurdity – in daily life, are gifts to us. Thanks for being here!