My Four Weeks On Another Planet, by Brian Segal

Filed under: Regular Contributors, Brian Segal, Themes, Wheelchairman of the Board 

“Like many people, I felt that seeing a psychiatrist would somehow stigmatize me. If you’re a diabetic and take insulin no one questions you. But if your disease is of the mentally interesting kind…well…that puts you in a different category entirely.”

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I suffer from an anxiety disorder. I also have multiple sclerosis. It is difficult to say whether or not my anxiety stems from nerve damage that has occurred due to the multiple sclerosis. Comorbidity is a distinct possibility, but since it’s almost impossible to establish whether nerve damage has resulted in psychological secondary issues there is no point dwelling on it.

I suppose the word “suffer” makes it sound as if I sit around feeling sorry for myself. I use the word only because it seems like the best way to describe what it’s like to live with General Anxiety Disorder (GAD).

Obviously, there is a lot more to living with a mental condition than attaching a simple label to it. There were times when I felt as if there was never a time when my days were not threatened by my nameless fears. For a long time I lived under a cloud that was, in a real way, consuming me. I endured long spells of insomnia, and along with that came a near-total lack of appetite that caused me to lose almost 30 pounds. (I guess it was my own version of the South Beach Diet!) The only problem was that, since I’m 5′10″ tall and weighed 150 pounds, losing 20 to 30 pounds was not a good idea.

I guess I’m a lot better at concealing my emotions than I thought. Even my family was not aware of how much of a struggle each day was for me.

My lack of sleep only compounded my heightened state of anxiety. I sought out medical help, not psychiatric help, and was prescribed an antidepressant. I had an adverse reaction to the drug and ended up in the hospital. Since I had only taken the medication for a few days, the effects were short-lived. Although I was in a medical wing of the hospital, a psychiatrist paid me a visit and asked some questions concerning my insomnia and what I thought the reasons were for it. She asked if I would like to see a psychiatrist associated with the hospital. She gave me a number to call and left it up to me to make the decision.

Like many people, I felt that seeing a psychiatrist would somehow stigmatize me. If you’re a diabetic and take insulin no one questions you. But if your disease is of the “mentally interesting” kind…well…that puts you in a different category entirely. I felt as if giving in to seeing a psychiatrist would be tantamount to auditioning for a role in One Flew Over the Cuckoo’s Nest. (Please note how I said “giving in,” as if this was some kind of insult to my ego.)

A few weeks after I was discharged from the hospital, I decided to call and make an appointment to see a psychiatrist.

I was given some medication to try to help alleviate the anxiety I was feeling. It seemed as if I was the poster boy for all the possible negative reactions one can have to a new medication…

The timeline is difficult to follow, but somewhere down the road I got to the point where the anxiety was becoming too much for me to deal with. On a visit to the psychiatrist I mentioned that I had been finding myself staring at a bottle of Ativan and wondering whether or not I should swallow it (the pills, of course, not the bottle).

At that point, she suggested that perhaps I needed some time in the hospital. I did not disagree with her. What followed were four weeks of nightmarish frustration and general disillusionment with the psychiatric medical system.

Since I had voluntarily admitted myself to the hospital, I was placed in an “open” wing. There is a second unit in the hospital’s psychiatric section which is called “High Care.” (And no, this is not a section where people sit around smoking joints and discussing whether or not Alice really was in Wonderland.) This is a locked section, where patients are under much more intensive supervision.

My first evening there was uneventful. Since I had not been sleeping very well, I was given something that let me sleep through the night. The following morning, I awoke at about 7am feeling quite rested. It was the best night’s sleep I’d had in quite some time. I went to a common room, where everyone eats breakfast together. Since I had not been eating very well, I’d been drinking one of those high protein mixtures every morning. I wasn’t taking any medication at that point, so I did not join the eager lineup of patients waiting to get their mind medicines.

One thing I should say before I go on is that, once you enter the psychiatric ward at this particular hospital, it is quite evident that very little money has been put into its upkeep. It took a nurse three tries before she could find a bed for me that worked. By that I mean the first two beds did not operate when plugged in. The dingy walls on my ward were decorated with shabby and torn laminated paintings. The rooms had metal lockers for your clothing. The nurse who was on duty when I first arrived said (in frustration) that the hospital “seemed to ignore this section.” All the other units on my floor had recently been renovated and redecorated. The other units’ floors were shiny new linoleum. The other units’ walls had been freshly painted. Even the furniture inside the other units’ rooms had a faux wood finish. Perhaps it seems like something insignificant, but it definitely made a difference to me.

After a delicious breakfast of chocolate flavored Ensure I wandered back to my room. It was then that I discovered there was only one shower I could possibly use, and that I needed the help of an orderly to use it. My own home is adapted to my personal needs. I am able to take a shower on my own. The situation in the hospital only compounded the feeling of helplessness I felt at the time. The orderly was friendly enough. (Actually, during my entire stay in the hospital he was perhaps more understanding and empathetic than any other person I met there.) I guess no one at the hospital could ever conceive of the fact that someone with a physical disability could also at the same time have a mental disability.

The hospital’s own web site advertises (yes I know “advertise” is a strange word to use in the context of describing a hospital) that patients receive psychotherapy as well as psychopharmacological therapy. In all the four weeks that I spent at the hospital, there was not one instance of any structured psychotherapy whatsoever. Perhaps the most in-depth session I had was with a social worker who was convinced that I was depressed because I’m no longer able to drive. I tried to explain that due to my optic neuritis, along with the fact that my left hand had less fine motor control than it previously did, it was no longer safe for me to drive. She and the nurses, who were in the room at the time, did not seem convinced. I found it quite odd that these people were trying to convince me that something that had become unsafe for me to do was the cause of the way I was feeling.

I became friendly with some of the other patients. It seemed that most of the people there were being treated for clinical depression. All of the treatments revolved around drugs or, in a few cases, electroconvulsive therapy (or ECT as most people called it). ECT seemed to be being used as a last-ditch effort to treat depression where drugs had failed.

Activities during the day were minimal. For about 90 minutes in the mornings, we had one activity that revolved around seeing an occupational therapist. Perhaps I never quite understood the whole point of the exercises. Simply getting people to socialize seemed to be the primary goal. I do believe it would have made more sense to structure activities according to patients’ abilities or specific needs.

I spent most mornings doing crossword puzzles.

I was lucky enough to go home every weekend. Getting a break from the terrible monotony of the hospital was quite a relief. I never quite understood the explanation (or lack thereof) that I was given when I complained about the lack of activities. Many patients spent most of their time in their rooms asleep. Many others simply wandered and paced up and down the hall.

I suppose that if they made the surroundings too comfortable, no one would want to leave. Because…obviously…the psychiatric ward of a hospital is where any sane person wants to vacation.

Usually I would see the psychiatrist assigned to my case once a week. We spent about 15 minutes discussing my request to go home for the weekend and how I was feeling. The medication I’d begun to take did not seem to be doing very much, at least as far as I could see or feel.

I’d like to go back to what I mentioned before, concerning the general physical state of the psychiatric ward. There was only ONE person from the hospital’s housekeeping staff who was assigned to clean the entire ward. Floors did not get washed on a daily basis, and the bathrooms and showers were at times filthy. When I left the hospital I filed a formal complaint concerning a number of issues. The hospital ignored the complaint so I went to the next step, which was filing a complaint with the provincial ombudsman. One of the results of that was that a second person was assigned to cleaning the floor.

I don’t want to focus too much on the general physical atmosphere of the place; it’s just that I want to give people who read this an idea of how pervasive the lack of care was, both in terms of patient needs and the need to upgrade the patients’ physical surroundings.

It didn’t take long to become habituated to the daily routine. Breakfast came in around eight o’clock, and patients were expected to be in the dining room around that time. The daily routine revolved around meal times, and medication times. As I stated earlier, there was little else to do. The occupational therapist would try to get all the patients involved in some activities between about 9am and 10:30am. Other than that, tedium seemed to be an almost planned daily event.

The nurses seemed to spend almost all their time in the nursing station, which was located at the midpoint of the hallway. I fully understand that they had reports to fill out, and at change of shift they had to meet with the staff coming in to discuss the events of the day. But since this was not a medical ward, there were no IVs to change or any of the other daily duties of a nurse working with patients who were in need of physical care. The door to the nursing station was closed more often than not, and knocking on the door would usually elicit a response along the lines of, “We’re busy.” I’m not quite sure what they were busy doing. Their attitude at times seemed to be that they were doing the patients a favor by interacting with them. And some were simply unprofessional. They would leave the nursing station intercom on (albeit by mistake) and discuss various patients’ psychological states. When someone knocked on the door to tell them they’d left their intercom on, they simply looked embarrassed and turned it off.

I spent a total of four weeks at the hospital. At the end of the fourth week, I spoke to the psychiatrist who had been assigned my case and told her I didn’t see any purpose in my staying there any longer. She agreed.

The memory of those four weeks is made up mostly of fragments. The single incident (or perhaps I should say series of incidents) which will remain with me for a long time occurred during the last three days of my stay. As I stated previously, the psychiatric ward was made up of two sections, one open and one closed. I was discharged on a Friday. The Wednesday before I left, a young Chinese man came to stay in the open unit from the closed unit. Initially I was not sure if he spoke much English. He kept to himself. In fact, he seemed to do very little except pace up and down the corridor. He would smile if you said hello, but otherwise said almost nothing at all. Late in the afternoon, on that Wednesday, I noticed that while he was walking up and down the hall he would say to himself, “I am not crazy.” He did that for hours.

The following day he seemed a little more animated. While he still wouldn’t engage in conversation, his pacing seemed to have lessened and he seemed more at ease. Later that afternoon, though, his pacing began again. This time, after an hour or so, I could hear him say as he walked by, “I am crazy.” Once again this went on for a few hours. None of the nurses seemed to pay any attention to it at all. Early in the evening, after supper, there was a new dimension added to his pacing: Now, along with his almost rhythmic “I am crazy,” there were tears rolling down his cheeks.

I pointed this out to a nurse, who simply said that perhaps there was “too much stimulus in the open ward.” The solution they came up with was, of course, to return him to the closed unit.

It is very difficult for me to summarize those four weeks in the hospital without focusing on all the negative memories it evokes. I have changed, and I hope that in the future I will be able to deal with situations that arise without the feeling of being overwhelmed by them.

To those who wonder why I haven’t divulged the name of the hospital: there really is no point. It would serve no purpose.

To this day, I still feel as if the four weeks I spent there were less as a patient and more as an observer of events.

Brian Segal is living in the country north of Montréal. He was diagnosed with multiple sclerosis about 16 years ago and, when asked, tells people he is retired (It sounds a lot better than telling people you are on disability insurance). He is happily married, no children, but one very friendly husky cross. He also has the good fortune of living in his own home, not a home.

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