There is a short life cycle of a mental patient on a psych ward. There has always been a cycle for me when I get hospitalized for being suicidal. There are a lot of the same people there with individual variations. I recognize the types. There’s a point where I think, “Ah, I know how to be here.” It’s happened to me enough times that I think I’ve got it. “Yep, this is how it goes.” Last night, I had a common dream about being hospitalized and being aware of the cycle.
The last time I was hospitalized was February 2013. After eight ungodly hours sequestered in St. Peter Hospital’s ER after I hurt myself, I arrived by ambulance. It’s a long drive from Olympia to Kirkland’s Fairfax Psychiatric Hospital.
I remember more characters from that hospitalization than usual. I generally forget the most notable people in a week or two. This time after being in the hospital for five days, they were etched in my mind so strongly that within a few days I wrote down all the patients’ names I could remember, their ages, and short biographies. Sixteen patients followed by seven staff members similarly identified, whether they liked their jobs, and if not their life plans. Once I made these lists, I was able to let go of preserving them carefully in my mind.
When hospitalized, the first thing is to identify staff members I like. This is basically an assessment of resources. These are the people I will go to to ask for things. Washing clothes, special medication, admission questions, making a phone call. That sort of thing.
Since my previous hospitalization, psych staff had realized that cell phones violated patient confidentiality. Therefore, we turned in our phones and shared a community phone. Patients would answer it and yell the name of who it was for. Not a particularly confidential methodology. This also required not hanging on the phone forever to friends and loved ones. During therapy sessions, the phone was off limits.
The next thing on my agenda was to identify patients I liked. These would be the people to follow around and learn the ropes. This is the best source for learning how meals work. I follow them, sit with, and get to know them. First making small talk, then gradually going deeper.
I noticed Pat right off. She was a pixie sized, British woman who road a Harley. She was a quick buddy and confidant.
I saw a tall, handsome African American man named Abraham who used a cane. I found out later he’d recently been diagnosed with MS. Feeling like his body let him down, he was struggling with letting go of his identity of being physically strong and a family provider. It flung him into a deep Depression.
Stacy with long red hair was an RN in an ARNP program who struggled with lifelong Depression. She was so depressed and suicidal that she could barely function. She was one of my roommates. She was walking in a boot for an injured foot. There were three beds to a room. Stacy, me, and Terry. There’s always a patient or two who barely talks. Terry was like that. I learned there was a more severe unit called “North.” There are always nicknames for things in wards. We were in “Central.” Terry was recently moved from North. You never ask people why they’re there. Eventually, most people volunteer. Silent, Terry remained a mystery to me because she never shared her story.
There are always a broad range of ages as well as abilities. Some people talk a lot. In fact, so much I wished they’d stop. Others mumble which can include rocking. A finite number communicate fairly normally. Those people easily share their stories. Most of the stories are very sad. This is to be expected. It’s not like we’re at summer camp or in college dorms.
Every hospital ward has different rules to learn. I have to make my peace with them. Meals were eaten in the cafeteria three times a day. We all trooped down a long hall. I hung close to Pat. It was after a couple meals I learned that I had to wear shoes to meals. Because I had neuropathy in my feet, I tended to walk around in my socks.
Due to the neuropathy and the pain medication I take because of it, the first order of business was to get my assigned psychiatrist, Dr. Peters, to approve my prescribed pain medication. It’s a delicate action that requires a bit of finesse. I had a legitimate need. I was not drug seeking. I told her I would take the least amount possible. We agreed on one in the morning and one in the late afternoon. I liked her. She didn’t waste time but listened well. I didn’t see her very often once my psych meds were arranged.
We were assigned to groups for group therapy and activities. Two sessions in the morning; one in the afternoon; and one in the evening. There were breaks and snacks. The rest of the time some patients watched television and the rest of us sat around a table coloring pictures with colored pencils. This was my favorite activity. Coloring and talking. It was one place where I learned about fellow patients. Eventually, I would get clues about what they thought of me. Although, no one ever said a word about the wound on my arm.
There were regular outdoor breaks in a closed yard. This was for smokers but most of us availed ourselves of an opportunity to get outside. It was February in Seattle. It wasn’t too cold or too wet that week. It was also an opportunity to talk to staff members I liked as they were chilling outside too.
Across from us in another ward were those recovering from addiction. We only crossed paths in the cafeteria. I carefully watched the tone of the staff and patients in the addiction recovery unit. There was a difference in how the two communities acted. There was less trust and compassion among the addiction recovery staff and patients. I detected a certain assumption that everyone was always working an angle. I might have made this up but I resolved to stick with the craziness business and not get thrown into that group at any point in the future.
Terry barely spoke at all. I could tell she was very distressed not just in whatever her diagnosis was but something big was on her plate. She suffered from frequent headaches. I did learn she was a pitcher on a boy’s baseball team which interested me. But, that was about all I got.
Stacy, my other roommate, only talked to me at night in the dark while we laid there staring at the ceiling not sleeping. My bed was in the middle.
“You know how I broke my foot?”
“No. How?”
“I walked twenty miles to the ER. I was suicidal. It took all night.”
“Why did you walk?” I asked.
“I didn’t want to ask anyone for help. By the time I got there, my foot had a compression fracture.”
“It’s okay to ask for help, you know?”
“I didn’t want to.”
I felt very sorry for Stacy making that long lonely walk, thinking she didn’t want to ask anyone for a ride. I felt lucky I had people to ask for help. I soon learned that what we talked about at night was off limits during the day. She just wasn’t interested in talking in daylight. We only had a night time relationship. It was another marker of her loneliness. She told me she had only been out of Fairfax for nine days when she had to come back. The staff hadn’t changed from the first time and treated her kindly.
On the other hand, Pat was a highly entertaining. She was outspoken with that very cute British accent. She road a hog all over the place and was determined to ride down to see me in Olympia after we got out. Her diagnosis wasn’t clear to me. She said she had been diagnosed as Bi-polar for ten years but Fairfax psychiatrists said she had PTSD and Anxiety Disorder. Married to a gay rancher in Colorado for 15 years, her current husband was an ARNP. She said she loved being a bureaucrat in London. I had to wonder just how long ago that was.
I learned more as we colored. Another woman, Sheila, in her early sixties seemed equally lost. Her son had brought her there. Her husband had died in November. Sadly, he was a drinking alcoholic for twenty-two years of their marriage. She had kicked him out a year ago. He finally went to treatment and had died in the detox facility. They had exactly one month of his sobriety to make amends before he died of liver failure. She was afraid to go home before Valentine’s Day. When she was discharged, she signed up for day treatment consisting of morning sessions at the hospital.
Another night, Stacy talked to me about her history of being suicidal. She told me about her mother’s long frustration with her struggling with wanting to die. She said, “Finally, my mother said, ‘Well, if that’s the way it has to be for you to find relief...’” As a mother, it broke my heart laying in the dark unable to reconcile the inexcusable betrayal of a mother giving permission to her daughter to kill herself.
The next day was the only time I spoke to Stacy during the day about our night time conversation. I cornered her in the bedroom that afternoon and said, “Stacy, I just want to tell you I thought about what you said. As a mother, it is never okay for a mother tell her daughter it’s okay to kill herself. It is never okay. There’s no excuse. I could never condone saying that to my daughter.” Stacy politely nodded that she heard me but said nothing. I’ve often wondered what happened to Stacy.
For other patients, I actually learned things about them in therapy sessions. Abraham was 42. He was diagnosed with MS the year before. He quickly lost his incredible physical well being and strength. He was terrified that he could no longer defend himself. In frustration, he had quit all his doctors, gone into his room at home with the lights off and curtails closed, and just sat for months. Finally, his wife got him into the hospital.
Coming from North as an involuntary commitment, Terry had freedom restrictions on the ward. Terry and I had specially locking bedside tables for our CPAP machines which was how we ended up together. I had never adapted to my CPAP but it was there. One night, a staff member came in to check on Terry. She found Terry trying to strangle herself with a towel in our bathroom. Unobtrusively, I witnessed Terry being taken to a closed room. She had to surrender her clothes and put on a strange stiff, uncomfortable dark green garment with Velcro closures. I resolved to avoid that outcome at all costs.
Each morning, I asked staff to get a pain pill. I learned to do it before breakfast. Otherwise, the wait could be interminable. Tom tended to be in charge of medication. He was the slowest med deliverer I had ever seen. It took him forever to dole out meds. It made me crazy (using the term loosely). While standing in the pharmacy doorway waiting for my medication, he said he’d been there a year and liked his work. That made one of us.
At 4 p.m., I’d ask for the second pain pill. It was after shift change and before dinner. Every day, the staff person would remind me it was my last one for the day. I wanted to say, “I know that, goddamn it,” but restrained myself. I surmise they had to operate based on the lowest communication denominator.
I often walked with Samuel to meals because we both walked slow. At 6’4”, he was a big African American man with an odd gait. He had been at The Evergreen State College, worked in schools, and hoped to get a state job in Olympia some day. He was exceptionally kind. When he was discharged to outpatient treatment, he shook my hand. I never learned where he lived. I just liked him.
Naturally in a mental ward, I never know what stories people tell are true. Carol at 26 said she was a figure skater and had a job offer in Colorado as a coach. She was on a 72 hour involuntary hold. She said she started Olympic training when she was young and said her skating was on YouTube. Her parents came to visit. It was pretty obvious that her issue was an eating disorder of the not eating enough variety. She didn’t seem all there literally and figuratively.
Michelle said she worked at Department of Social and Health Services. I only saw her for two days. She spent her all of her efforts trying to get a transfer to St. Peter Hospital in Olympia. She said she felt ignored at Fairfax. Given that all of her observable efforts were toward getting transferred, it wasn’t surprising she felt ignored while she ignored everyone and everything at Fairfax.
Kimmi was Hawaiian and transgender. At 30, she was beautiful and fun. She told me she was an airline attendant, currently working in customer service, and wanted to be a waitress. I didn’t delve too deeply. I just enjoyed her sparkle.
We had art classes. We had various types of group therapy. The therapy value seems to be just to get people to talk. In fact, it’s mandatory to take turns talking regardless of the therapy motif. I have no problem making stuff up to talk about. It’s painful to watch others struggle to find words. Usually, they have been trying to fly under the radar. Eventually, the spotlight turns on them.
Aaron was a tall, well built white man. As a staffer during gym period, it was obvious he was very athletic. He could barely restrain himself and had lots of energy. He had a BA in psychology but looked exactly like an undercover FBI agent. He was trained as an EMT, wanted to be a firefighter, and was leaving in three weeks for an EMT job. He and Kimmi played dodgeball. They were both very muscular and didn’t pull their punches playing against each other. If they had played with the rest of us, we would have been creamed.
My favorite staff person was Lisa. As the RN charge nurse, she worked long days. With long blondish, brown hair, she was very fit and the mother of two boys. She was bright and very efficient. If I needed something, she was always my first choice. She was the one who came and found Terry with the attempted towel suicide.
I had conversations with Linh, a Chinese-Vietnamese American staffer. At 23, she had a BA in psychology. She talked about not knowing if she wanted to go into nursing or continue psychological staffing. As a human resource professional, I’m always interested in people’s jobs and life plans. She told me she felt parental pressure to be a professional. I’m always of the “do what you want” frame of mind. I don’t think that was helpful.
Sitting around the table coloring, Mary was over 50 and said she had lost 170 pounds. She was a short, round bodied woman who didn’t talk much. She took a liking to me. In art class, I made a purple and green bracelet. She asked me if she could have it because they were her favorite colors. It was an easy thing to give. She lived in Everett and needed to move closer to the hospital. A friend was going to help her find an apartment. When she learned I was leaving, she hugged me and asked if she could come with me. I wish I could have helped.
There was one guy in particular that was universally disliked. Rob was very off balance. He talked too much and got in people’s faces. He knew everything about everything including government secrets and was happy to tell us about them. He was an involuntary patient monitored closely by staff.
In the psych patient world, there is a significant difference between voluntary and involuntary. Voluntary meant I could leave any time, possibly against medical advice, but I could leave. Involuntary meant a patient had been placed there by the court and couldn’t leave until released. Involuntary may or may not mean something about the severity of the condition. However, it does mean that there’s probably an ugly story involving outsiders about how they got there.
As Pat and I got to know each other better, we shared more about our lives including our daughters and her granddaughter. She told me when I came in I looked stiff with my shoulders up around my ears. That’s pretty much what happens to me when I’m tense. Ultimately, we shared email addresses and phone numbers. After discharge, we exchanged a few emails but then she fell off the radar. I sent her several unanswered emails. I have no idea what happened to her which is the nature of transitory relationships. Ronnie calls it “significant relationships with insignificant others.”
Another patient I was curious about was Edmundo or Ed as he preferred to be called. He was a Mexican American with three boys aged 1 to 11 who also came from North. He proudly stated he got up at 4:30 every morning, did stretches, and read the Bible for two hours. He told me he had “peace in his heart.” I was left wondering why he was there. I also noticed he wasn’t up early in the morning doing stretches or reading the Bible. Maybe that was his non-patient schedule.
As the days passed, I felt more and more like myself. It was time to leave. I asked Lisa on the morning of the fifth day if I could go home because I was ready. She said, “I was wondering when you were going to bring that up.” Arrangements were made and Ronnie was called.
Ronnie picked me up late Monday afternoon for the long drive home. It was a bright, sunny day. I said my good-byes, refreshed from my psychiatric reboot, ready to re-enter my life. Because I arrived in an ambulance, I hadn’t seen the outside of the hospital. I didn’t realize it was an official mental hospital until I saw the sign. We loaded up my meager belongings in the Prius.
As Ronnie left the parking lot and started driving, I was shocked by the quickly moving traffic and intensity of sights and sounds. After the slowness and faint boredom of hospital life, the world was busy and overwhelming. There’s a little fear in getting out tempered by being with my partner, on our way home to see our cat and dog, and being in the world followed later by returning to work. It’s also a bit joyful remembering what my life is and that I’ve chosen it. Suicide has not dogged me since. Still, I never forget that Depression is easily aroused if I fail to attend to self care.
L’Chaim.
Joceile
1.26.2020
[Names have been changed. Pictures of Fairfax ward sparse patient beds and seating in day room.]
