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.