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
This post was promoted to the Main Feed by a Ricochet Editor at the recommendation of Ricochet members. Like this post? Want to comment? Join Ricochet’s community of conservatives and be part of the conversation. Join Ricochet for Free.

There are 69 comments.

Become a member to join the conversation. Or sign in if you're already a member.
  1. MarciN Member
    MarciN
    @MarciN

    I’m sure it will all go well.

    We will keep the lights on for you. :)

    • #31
  2. Judithann Campbell Member
    Judithann Campbell
    @

    Nanda Panjandrum (View Comment):

    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!

    Thank you, Nanda, you guys are making me feel all warm and fuzzy :)

    • #32
  3. Nanda Panjandrum Member
    Nanda Panjandrum
    @

    Judithann Campbell (View Comment):

    Nanda Panjandrum (View Comment):

    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!

    Thank you, Nanda, you guys are making me feel all warm and fuzzy ?

    What else are pandas for?…

     

    • #33
  4. PHCheese Inactive
    PHCheese
    @PHCheese

    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…

    Doc, have you been going to the Comedy Club a lot lately?

    Laughing at those knee slapping jokes.

    • #34
  5. Doug Kimball Thatcher
    Doug Kimball
    @DougKimball

    I’ve Always Been Crazy

    I’ve always been crazy and the trouble that it’s put me through
    I’ve been busted for things that I did, and I didn’t do
    I can’t say I’m proud of all of the things that I’ve done
    But I can say I’ve never intentionally hurt anyone

    I’ve always been different with one foot over the line
    Winding up somewhere one step ahead or behind
    It ain’t been so easy but I guess I shouldn’t complain
    I’ve always been crazy but it’s kept me from going insane

    Beautiful lady, are you sure that you understand
    The chances your taking loving a free living man
    Are you really sure, you really want what you see
    Be careful of something that’s just what you want it to be

    I’ve always been crazy but it’s kept me from going insane
    Nobody knows if it’s something to bless or to blame
    So far I ain’t found a rhyme or a reason to change
    I’ve always been crazy but it’s kept me from going insane.

    Waylon Jennings (RIP) Chandler, AZ

    • #35
  6. Nanda Panjandrum Member
    Nanda Panjandrum
    @

    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…

    The Chaplain Panda is “on it” for you, Doc!  Will miss you…

    • #36
  7. The Reticulator Member
    The Reticulator
    @TheReticulator

    DocJay: She was hiding the fact that she had psychogenic polydipsia, aka compulsive water drinking of mentally ill people with defective thirst centers.

    Uh, oh.

    • #37
  8. Chris Campion Coolidge
    Chris Campion
    @ChrisCampion

    DocJay (View Comment):

    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.

     

    I have problems around this idea, too.  It is a choice.  You might wake up one day and get leukemia; you don’t wake up one day homeless, living under a bridge with a needle in your arm.  You had to actively choose all the steps to get there.  Over a long period of time.

    Calling it a disease might help in the short run.  Once you put your face back on and return to the real world, though, you’ll have to choose.  Every day.

    Get started.

    • #38
  9. Isaac Smith Member
    Isaac Smith
    @

    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.

    I am not aware of data, but my guess is the closer a program is to the lean, spare, no BS basics of AA and NA the more effective it is for those who have reached the point where they will stick with sobriety even after they have remembered why it was that they sought self-anesthesia in the first place.

    • #39
  10. Isaac Smith Member
    Isaac Smith
    @

    DocJay (View Comment):

    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.

    Not to mention demanding a name change

    • #40
  11. Merrijane Inactive
    Merrijane
    @Merrijane

    Wonderful writing! Drew me in right away.

    • #41
  12. Kozak Member
    Kozak
    @Kozak

    So I managed to avoid doing my Junior Psych rotation, until the end of my senior year. They finally caught up with me and was told by the dean ” do it or come back next year”.  So I ended up doing it the last quarter of my senior year.   I walked on to the locked Psych ward at the VA, and they buzzed me and my classmate in to start our rotation.  My classmate, forgetting what we were told wore his Med Student short white coat onto the unit ( strict hierarchy at North Western. Med Students, short white coat, interns and residents, long blue coats, fellows and attendings long grey coats).

    One of the patients took one look at him and hurled a cup of hot coffee in his face.  His labcoat reminded her of another medical student who had “violated her trust in him”.

    So guess which one of us picked up the patient?  Yup.  My classmate couldn’t “have a therapeutic relationship” with her so I got her.  She was quite the handful. A flaming psychotic with delusions of grandeur.  She told us she had been appointed by President Nixon as the “Secret Secretary of the Treasury”.  She could fly. We caught her trying to call Buckingham palace to try and tell the Queen her secret plan to end the Falklands war.  She became convinced I was her son, and she fell “in love with me”. By the end my rotation she was no longer in love, threatening to fire us all since as Treasury Secretary she was out boss.

    Before the rotation ended I told my classmate if I had any idea of what was to come I would have dived in front of him and taken that hot coffee in my face.

    • #42
  13. Ron Selander Member
    Ron Selander
    @RonSelander

    Doc,

    Great writing. Thank you for this!

    I greatly appreciate your transparency. When you get real, you really get real!

    • #43
  14. Chris Campion Coolidge
    Chris Campion
    @ChrisCampion

    I’m thinking I’ll be a little less cute ‘n snarky next time I visit the doc’s office.

     

    Although a pump-fake with a cup of coffee ought to level-set the conversation.

     

    • #44
  15. Bryan G. Stephens Thatcher
    Bryan G. Stephens
    @BryanGStephens

    I used to live the outside version in case management.  This is all true to a State Hospital.

     

    JC thanks for being brave and sharing.

    • #45
  16. Percival Thatcher
    Percival
    @Percival

    Doctor: Do you have any guns in your house?

    Me: Why, what do you need?

    • #46
  17. wilber forge Inactive
    wilber forge
    @wilberforge

    As always, well writ. With that being said, my exposure has been to the outcomes of said Keepers of such Institutions. This may fall afar from your experience, save it begged a question on which side of the bars some belonged. The human complexities do continue to astound.

    Not to mention of the poor soul who happened to be a guard in a Womens Prison once met, a completely wrecked soul, left unable to cope.

    The resolution is that we will always have the fragile and or damaged among us. Care for them with all the humanity we can and not let them vote Democrat !  My Bad, so sue me.

    • #47
  18. Mole-eye Inactive
    Mole-eye
    @Moleeye

    Snaps to you, @judithanncampbell, for candor!  I’ve been following Ricochet on and off for years and assumed, when you wrote on the subject, that you were psych doc or high level therapist.  And if I just insulted you with that comment, please forgive me.

    Anyway, it sounds like you are bearing your cross with  wit, insight and compassion.  Go girl.

    Your comment about fellow patients needing a family more than anything else is so true.  Reminds me of one day in court, when a Spanish-speaking witness asked me what was going on in a different case where we were seeking a mental health commitment.  I explained and she gasped, “Pobrecito! No tiene familia?”  (Poor guy!  Has he no family?)    So much for our superiority over Third World traditional cultures.

     

    • #48
  19. Poindexter Inactive
    Poindexter
    @Poindexter

    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. For years I had carpal tunnel that could power a small city, in both hands. About 10 years ago I had both hands done at the same time. I recovered quickly and was cured; I wish the same for you.

    • #49
  20. Judithann Campbell Member
    Judithann Campbell
    @

    @moleeye: Thank you so much, I am not insulted at all, thank you for the compliment :)

    • #50
  21. She Member
    She
    @She

    Kate Braestrup (View Comment):
    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.

    Me neither.

    My 52-year old close relative with a decades-long history of paranoid schizophrenia, bipolar disorder, concomitant mental issues and drug and alcohol addictions has been involuntarily admitted at one point or another to almost every psych ward in Western PA (there are a lot of them).  He’s been in jail.  He’s been in community support programs.  He’s lived with us for extended periods of time while we supervise and monitor his meds.  He’s been in short and long-term treatment.  When he’s not round the bend, he has good relations with his family.  He’s a sweet guy.

    Once he goes off his meds, though (it’s a cycle, perhaps a choice, but it seems inevitable), we lose him to drugs, paranoia, lowlife “friends” who take his money, beat him up and leave him for dead, and squalid living conditions, sometimes indoors, sometimes out.

    We don’t stop hearing from him, though, via disgusting, abusive, threatening, escalating phone calls, text messages, emails, and manipulation of our friends.  Our life quickly becomes just as much of a Hell as his.

    Sooner or later, thankfully, he’ll be scooped up by the police, often during the commission of a crime, found to be irrational and a danger to himself or others, and taken to the psych ward.

    The first question he’s asked is “can we tell your family you’re here?”  And the answer is always , “No.”

    That’s why my relative doesn’t get any visits from his family when he’s in treatment.  Because he, a seriously, chronically, mentally ill patient, with a distorted view of reality, is in charge of his medical care.  And that’s why, most of the time, after they’ve shot him full of enough meds to calm him down, he’s able to refuse further treatment (it’s his right), and he’s back on the streets within seventy-two hours.  And usually back in the hospital within weeks.

    We. Can. Do. No. More.

    Please support Representative Tim Murphy (R) Western PA, in his efforts to help the families of those who suffer from mental illness have the right to be more involved in their care.

    Wonderful post.  I love the tender, yet clear-eyed portraits of the patient. And the humor.  Sometimes, that’s the only thing that helps.  Well, one of the only things.

    • #51
  22. The Reticulator Member
    The Reticulator
    @TheReticulator

    She (View Comment):
    Please support Representative Tim Murphy (R) Western PA, in his efforts to help the families of those who suffer from mental illness have the right to be more involved in their care.

    I am not going to explain how I know this, but I can promise you that that can be abusive, too.

    • #52
  23. She Member
    She
    @She

    The Reticulator (View Comment):

    She (View Comment):
    Please support Representative Tim Murphy (R) Western PA, in his efforts to help the families of those who suffer from mental illness have the right to be more involved in their care.

    I am not going to explain how I know this, but I can promise you that that can be abusive, too.

    Oh, I get it.  There is no perfect solution.  I can only speak to my situation.  I used to wonder how the families of the mentally ill could stand back and let them get into the state they do, and then not visit them in hospital, or why they didn’t take better care of them when they got out.

    Now I know, at least in some cases, why that is.  And I know the agony, heartache, desperation and misery that some families go through to come to that realization too.

    And I no longer judge.

    • #53
  24. DocJay Inactive
    DocJay
    @DocJay

    The Reticulator (View Comment):

    She (View Comment):
    Please support Representative Tim Murphy (R) Western PA, in his efforts to help the families of those who suffer from mental illness have the right to be more involved in their care.

    I am not going to explain how I know this, but I can promise you that that can be abusive, too.

    I’m not sure it’s worse than no family at all but a family member with a personality disorder or a twisted agenda is rough.

    One of my flock has a Borderline sister with a nursing degree who manipulates and doesn’t like sis too medicated but disaster always follows which she meddles.  I think the borderline likes the chaos and failure, twisted lady.

    Then there’s the bipolar with the naturopathic family member who hates ” all meds” but the rest of the family keeps her away from medical advice after the last fiasco long ago.

    • #54
  25. DocJay Inactive
    DocJay
    @DocJay

    She (View Comment):

    Kate Braestrup (View Comment):
    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.

    Me neither.

    My 52-year old close relative with a decades-long history of paranoid schizophrenia, bipolar disorder, concomitant mental issues and drug and alcohol addictions has been involuntarily admitted at one point or another to almost every psych ward in Western PA (there are a lot of them). He’s been in jail. He’s been in community support programs. He’s lived with us for extended periods of time while we supervise and monitor his meds. He’s been in short and long-term treatment. When he’s not round the bend, he has good relations with his family. He’s a sweet guy.

    Once he goes off his meds, though (it’s a cycle, perhaps a choice, but it seems inevitable), we lose him to drugs, paranoia, lowlife “friends” who take his money, beat him up and leave him for dead, and squalid living conditions, sometimes indoors, sometimes out.

    We don’t stop hearing from him, though, via disgusting, abusive, threatening, escalating phone calls, text messages, emails, and manipulation of our friends. Our life quickly becomes just as much of a Hell as his.

    Sooner or later, thankfully, he’ll be scooped up by the police, often during the commission of a crime, found to be irrational and a danger to himself or others, and taken to the psych ward.

    The first question he’s asked is “can we tell your family you’re here?” And the answer is always , “No.”

    That’s why my relative doesn’t get any visits from his family when he’s in treatment. Because he, a seriously, chronically, mentally ill patient, with a distorted view of reality, is in charge of his medical care. And that’s why, most of the time, after they’ve shot him full of enough meds to calm him down, he’s able to refuse further treatment (it’s his right), and he’s back on the streets within seventy-two hours. And usually back in the hospital within weeks.

    We. Can. Do. No. More.

    Please support Representative Tim Murphy (R) Western PA, in his efforts to help the families of those who suffer from mental illness have the right to be more involved in their care.

    Wonderful post. I love the tender, yet clear-eyed portraits of the patient. And the humor. Sometimes, that’s the only thing that helps. Well, one of the only things.

    Rough road there.  Not that it helps much but I understand the situation and sympathize.

    • #55
  26. Bryan G. Stephens Thatcher
    Bryan G. Stephens
    @BryanGStephens

    She (View Comment):

    Kate Braestrup (View Comment):
    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.

    Me neither.

    My 52-year old close relative with a decades-long history of paranoid schizophrenia, bipolar disorder, concomitant mental issues and drug and alcohol addictions has been involuntarily admitted at one point or another to almost every psych ward in Western PA (there are a lot of them). He’s been in jail. He’s been in community support programs. He’s lived with us for extended periods of time while we supervise and monitor his meds. He’s been in short and long-term treatment. When he’s not round the bend, he has good relations with his family. He’s a sweet guy.

    Once he goes off his meds, though (it’s a cycle, perhaps a choice, but it seems inevitable), we lose him to drugs, paranoia, lowlife “friends” who take his money, beat him up and leave him for dead, and squalid living conditions, sometimes indoors, sometimes out.

    We don’t stop hearing from him, though, via disgusting, abusive, threatening, escalating phone calls, text messages, emails, and manipulation of our friends. Our life quickly becomes just as much of a Hell as his.

    Sooner or later, thankfully, he’ll be scooped up by the police, often during the commission of a crime, found to be irrational and a danger to himself or others, and taken to the psych ward.

    The first question he’s asked is “can we tell your family you’re here?” And the answer is always , “No.”

    That’s why my relative doesn’t get any visits from his family when he’s in treatment. Because he, a seriously, chronically, mentally ill patient, with a distorted view of reality, is in charge of his medical care. And that’s why, most of the time, after they’ve shot him full of enough meds to calm him down, he’s able to refuse further treatment (it’s his right), and he’s back on the streets within seventy-two hours. And usually back in the hospital within weeks.

    We. Can. Do. No. More.

    Please support Representative Tim Murphy (R) Western PA, in his efforts to help the families of those who suffer from mental illness have the right to be more involved in their care.

    Wonderful post. I love the tender, yet clear-eyed portraits of the patient. And the humor. Sometimes, that’s the only thing that helps. Well, one of the only things.

    This is one of the reasons I am not a libertarian. The pain I have seen in families, desperate to help a loved one, but powerless to force the help that is clearly needed. I am so sorry you have to live this.

    • #56
  27. dajoho Member
    dajoho
    @dajoho

    Another great post, always intrigued.  God speed on the surgeries Doc.  Do you smoke those gummy’s then when the munchies come on you can eat ’em too?  Could start a never ending spiral…

    • #57
  28. DocJay Inactive
    DocJay
    @DocJay

    dajoho (View Comment):
    Another great post, always intrigued. God speed on the surgeries Doc. Do you smoke those gummy’s then when the munchies come on you can eat ’em too? Could start a never ending spiral…

    Over and done with.  Feel fine.  No narcs , just celebrex.  I did eat a quart of Baskin Robbins last night, equaling my yearly total of ice cream.

    I think I’ll stay with whiskey as a vice.

     

    • #58
  29. She Member
    She
    @She

    DocJay (View Comment):

    dajoho (View Comment):
    I did eat a quart of Baskin Robbins last night . . .

    Reminds me of a conversation I had once with my (thankfully former) son-in-law, in which he said “Hey, did you hear, Ben-and-Jerry’s” (sorry, I know they’re lefty goons) “are going to start making single-serving containers of ice cream”

    “Oh,” I replied.  “I thought those were single-serving containers of ice-cream.”

    You’re probably better off with the whiskey.  Although this Damson and Sloe-Gin ice cream (UK only) is the best ice cream I’ve eaten, ever.

    • #59
  30. Nanda Panjandrum Member
    Nanda Panjandrum
    @

    Yay, Doc!

    • #60
Become a member to join the conversation. Or sign in if you're already a member.