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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.

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Members have made 69 comments.

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  1. Profile photo of Z in MT Member

    Nothing to add, but nice vignettes.

    • #1
    • August 10, 2017 at 1:19 pm
    • Like4 likes
  2. Profile photo of DocJay Member
    DocJay Post author

    Z in MT (View Comment):
    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.

    • #2
    • August 10, 2017 at 1:23 pm
    • Like11 likes
  3. Profile photo of PHCheese Member

    Sounds like my family except they would want four large glasses of whiskey.

    • #3
    • August 10, 2017 at 1:25 pm
    • Like13 likes
  4. Profile photo of Larry Koler Member

    God bless doctors.

    • #4
    • August 10, 2017 at 1:34 pm
    • Like8 likes
  5. Profile photo of Hang On Member

    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.

    • #5
    • August 10, 2017 at 1:37 pm
    • Like5 likes
  6. Profile photo of Hang On Member

    PHCheese (View Comment):
    Sounds like my family except they would want four large glasses of whiskey.

    I kept thinking of 100 bottles of beer on the wall when I was reading that. Drunk minds think alike or something.

    • #6
    • August 10, 2017 at 1:41 pm
    • Like2 likes
  7. Profile photo of Blondie Thatcher

    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.

    • #7
    • August 10, 2017 at 1:44 pm
    • Like5 likes
  8. Profile photo of Percival Thatcher

    That’s the “marge of Lake Lebarge.” One of my favorite poems.

    There are strange things done in the midnight sun
    By the men who moil for gold;
    The Arctic trails have their secret tales
    That would make your blood run cold;
    The Northern Lights have seen queer sights,
    But the queerest they ever did see
    Was that night on the marge of Lake Lebarge
    I cremated Sam McGee

    (Shut up, @arahant)

    • #8
    • August 10, 2017 at 2:00 pm
    • Like9 likes
  9. Profile photo of DocJay Member
    DocJay Post author

    Percival (View Comment):
    That’s the “marge of Lake Lebarge.” One of my favorite poems.

    There are strange things done in the midnight sun
    By the men who moil for gold;
    The Arctic trails have their secret tales
    That would make your blood run cold;
    The Northern Lights have seen queer sights,
    But the queerest they ever did see
    Was that night on the marge of Lake Lebarge
    I cremated Sam McGee

    (Shut up, @arahant)

    Yeah Arahant, shut up!

    The reference was pure ADHD and unplanned until I typed it.

    • #9
    • August 10, 2017 at 2:12 pm
    • Like9 likes
  10. Profile photo of Percival Thatcher

    DocJay (View Comment):

    Percival (View Comment):
    That’s the “marge of Lake Lebarge.” One of my favorite poems.

    There are strange things done in the midnight sun
    By the men who moil for gold;
    The Arctic trails have their secret tales
    That would make your blood run cold;
    The Northern Lights have seen queer sights,
    But the queerest they ever did see
    Was that night on the marge of Lake Lebarge
    I cremated Sam McGee

    (Shut up, @arahant)

    Yeah Arahant, shut up!

    The reference was pure ADHD and unplanned until I typed it.

    Pure ADHD is the best kind.

    • #10
    • August 10, 2017 at 2:18 pm
    • Like4 likes
  11. Profile photo of MarciN Member

    DocJay: 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.

    How true. Wow.

    • #11
    • August 10, 2017 at 2:27 pm
    • Like5 likes
  12. Profile photo of I. M. Fine Member

    MarciN (View Comment):

    DocJay: 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.

    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?)

    • #12
    • August 10, 2017 at 2:36 pm
    • Like2 likes
  13. Profile photo of DocJay Member
    DocJay Post author

    I. M. Fine (View Comment):

    MarciN (View Comment):

    DocJay: 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.

    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

    • #13
    • August 10, 2017 at 2:41 pm
    • Like4 likes
  14. Profile photo of Isaac Smith Member

    Percival (View Comment):
    That’s the “marge of Lake Lebarge.” One of my favorite poems.

    There are strange things done in the midnight sun
    By the men who moil for gold;
    The Arctic trails have their secret tales
    That would make your blood run cold;
    The Northern Lights have seen queer sights,
    But the queerest they ever did see
    Was that night on the marge of Lake Lebarge
    I cremated Sam McGee

    (Shut up, @arahant)

    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

    And there sat Sam, looking cool and calm,
    in the heart of the furnace roar;
    And he wore a smile you could see a mile,
    and he said, “Please close that door.
    It’s fine in here, but I greatly fear
    you’ll let in the cold and storm–
    Since I left Plumtree, down in Tennessee,
    it’s the first time I’ve been warm”.

    • #14
    • August 10, 2017 at 2:45 pm
    • Like4 likes
  15. Profile photo of Isaac Smith Member

    DocJay (View Comment):

    I. M. Fine (View Comment):

    MarciN (View Comment):

    DocJay: 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.

    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

    Oh, good. I was going to borrow it too, but I was just going to steal it.

    • #15
    • August 10, 2017 at 2:46 pm
    • Like3 likes
  16. Profile photo of Addiction Is A Choice Member

    Percival (View Comment):

    DocJay (View Comment):

    Percival (View Comment):
    That’s the “marge of Lake Lebarge.” One of my favorite poems.

    There are strange things done in the midnight sun
    By the men who moil for gold;
    The Arctic trails have their secret tales
    That would make your blood run cold;
    The Northern Lights have seen queer sights,
    But the queerest they ever did see
    Was that night on the marge of Lake Lebarge
    I cremated Sam McGee

    (Shut up, @arahant)

    Yeah Arahant, shut up!

    The reference was pure ADHD and unplanned until I typed it.

    Pure ADHD is the best kind.

    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 😉

    • #16
    • August 10, 2017 at 2:49 pm
    • Like13 likes
  17. Profile photo of Nanda Panjandrum Thatcher

    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.)

    • #17
    • August 10, 2017 at 3:35 pm
    • Like6 likes
  18. Profile photo of Petty B Member

    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.

    • #18
    • August 10, 2017 at 3:35 pm
    • Like16 likes
  19. Profile photo of Judge Mental Member

    Some comedienne that I can’t remember:

    The neurotic builds castles in the sky, the psychotic lives in them. My mother cleans them.

    • #19
    • August 10, 2017 at 3:38 pm
    • Like9 likes
  20. Profile photo of DocJay Member
    DocJay Post author

    Petty B (View Comment):
    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.

    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.

    • #20
    • August 10, 2017 at 4:04 pm
    • Like9 likes
  21. Profile photo of Judithann Campbell Member

    Petty B (View Comment):
    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 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.

    • #21
    • August 10, 2017 at 4:10 pm
    • Like20 likes
  22. Profile photo of DocJay Member
    DocJay Post author

    Judithann Campbell (View Comment):

    Petty B (View Comment):
    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 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. 😉

    • #22
    • August 10, 2017 at 4:23 pm
    • Like15 likes
  23. Profile photo of Judithann Campbell Member

    DocJay (View Comment):
    The hospitals are remarkably different. I worked at one near Salem Oregon that was of Ken Kesey fame. 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.

    • #23
    • August 10, 2017 at 4:33 pm
    • Like23 likes
  24. Profile photo of Kate Braestrup Member

    Judithann Campbell (View Comment):

    DocJay (View Comment):
    The hospitals are remarkably different. I worked at one near Salem Oregon that was of Ken Kesey fame. 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.

    • #24
    • August 10, 2017 at 4:42 pm
    • Like12 likes
  25. Profile photo of Addiction Is A Choice Member

    DocJay (View Comment):
    …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…

    I, too, must quibble 😉

    • #25
    • August 10, 2017 at 4:53 pm
    • Like5 likes
  26. Profile photo of DocJay Member
    DocJay Post author

    Addiction Is A Choice (View Comment):

    DocJay (View Comment):
    …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…

    I, too, must quibble 😉

    I’d be immensely disappointed in you if you didn’t.

    • #26
    • August 10, 2017 at 4:57 pm
    • Like5 likes
  27. Profile photo of Judithann Campbell Member

    Kate Braestrup (View Comment):
    It makes me feel happier and more hopeful to have you here, JAC

    Thank you Kate 🙂 I am so glad that your loved one is doing well!

    • #27
    • August 10, 2017 at 5:01 pm
    • Like4 likes
  28. Profile photo of DocJay Member
    DocJay Post author

    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…

    • #28
    • August 10, 2017 at 5:10 pm
    • Like14 likes
  29. Profile photo of Judithann Campbell Member

    DocJay (View Comment):
    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!

    • #29
    • August 10, 2017 at 5:13 pm
    • Like12 likes
  30. Profile photo of Nanda Panjandrum Thatcher

    DocJay (View Comment):
    I’m glad you’re here with us JAC. 😉

    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!

    • #30
    • August 10, 2017 at 5:31 pm
    • Like7 likes
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