What is real? Is anything true and factual? Or are we all just deluded and mad as hatters? This is a serious question.
What I recall and what was written down in my chart about a certain four days in July 2012 are so different it is difficult to figure out whether my experience was fact in any sense of the word or, as “they”claimed, simply paranoid and delusional. Of course there is some truth in paranoia and delusion, since even a paranoid’s beliefs are based in feelings that arise honestly and from a foundation, I firmly believe, in true things sensed but unacknowledged. Feelings always have their own veracity. But whatever the philosophers may say about the fiction of facts, still there is, there must be, something more to the consensual world of what happens than mere perception.
I mean, either that security guard in the Emergency Department last July deliberately attempted to strangle me, or he did not. Either it happened or in some fashion I imagined it. It is that simple, isn’t it? Yes or no, red or green, one or zero. Like a digital configuration, there’s nothing vague about it: either it happened or it didn’t.
There are records. I know what the ones they wrote say, as far as they go. But how to interpret them since so little was written down, and unless my memory is so completely at odds with reality as to have confabulated the entire episode – which by the way, is what they claimed all along – how to explain the discrepancies when so much is not even mentioned. That they whisked my gurney into a seclusion room and assaulted me en masse is my version. In theirs, the room change is noted only in passing, and of the IM medication all that is said is that it was given “NOW”. Nothing else of the incident I recorded in great detail in my journal some days later, and raged about from the first day I was admitted to the day I left. In fact, I’m still outraged, months later.
I wanted to go home, they wanted me to stay. That I was abjectly terrified of being kept there meant to them that I was “paranoid.” I claimed I had no problems and had never been diagnosed with a psychiatric disorder. That was a problem for they had more power than I did as well as my lengthy psychiatric history on their side to prove I must be crazy to make such a claim. Worse, I was loud, demanding, and in my increasing panic, getting angry. They saw my screaming as a threat. Even though I was blind to what was going on, any onlooker could have seen that I could not win and in the end of course I lost mightily.
But let me go back towards the beginning.
It didn’t help that I had arrived at the ED by ambulance and immediately refused to have my “vitals” taken, asserting that I was “fine!” I then accused the nurse of just wanting to get paid for taking them. In short order I was whisked to the so-called “purple pod” where the psych patients were buried for hours until the on-call psychiatrist deigned to come down to see them.
“Here,” someone said, thrusting a hospital johnnie and a pair of pajama pants at me. “Undress and put these on.”
I looked down and saw that I was already wearing pj pants from another hospital. No one ever knew the real nature of what I wore — they simply passed for scrubs — and they were so comfortable that I kept them on day and night. “I’m already wearing pajama pants. I only need to change my shirt,” I said.
“No, you are wearing very nice blue slacks. Now, put on the pajamas, or do you want a couple of strong men to put them on for you?”
“Actually,” I sniped, “they are hospital pajama pants. I pilfered them from –“ and I named the hospital. But I made a show of undoing the snaps so they would see that I was going to comply. The last thing I wanted was anyone touching me or “helping” me undress.
Soon an APRN, came by and I thought, Wow, they are quick here, maybe it isn’t so bad being taken to a big hospital. Maybe I can get discharged from here in no time. Unfortunately, she was there only to do a 15 second “physical exam” that consisted of looking in my mouth and listening to my back with her stethoscope. Period. Pronouncing me cleared for a psychiatric interview, she rushed off to clear someone else. Then I sat on the gurney in my cubicle and waited. And waited.
I remember being cooperative for what felt like a long time. I tried to sleep, and I listened patiently to what was going on around me. I swore that I would simply hold my breath and bide my time until someone saw me, so that, calm, I could present my case and they would see I was safe and sane enough to be sent back home, not admitted or sent to some hospital against my will. But it was taking so long, it was taking hours for someone to see me, and I knew they were doing it to me on purpose. Did they think I, too, was drunk or on drugs just like the others here? I started to complain that I had waited long enough and needed to see someone. I was NOT drunk, did not need to dry out. Where was the doctor? There was nothing wrong with me, I did not need to be here. I wanted to go home!
Things started happening then. Memory fails me however and even the chart, which I just obtained a couple of days ago leaves out way too much. All it says is that I was uncooperative, then irritable, screaming and combative. Meds were “offered”.
I remember this: When I refused to take soul-deadening Haldol by mouth, they descended on me, wheeled my gurney into a solitary room and jumped on me, intending to inject me by brute force. In the struggle, a guard gripped my neck and compressed the arteries, strangling me. I tried to get the nurse’s attention, burbling through forcibly compressed lips that I could not breathe. But her response, attending only to her needles and not even looking at me, was an impatient, “You’re all right!” In a pulse of panic, I jerked away as she started to shove the first needle into my arm.
“Damn!” she cried as a rush of blood spattered us and the needle danced away from my skin. “Hold still!”
I’d hoped to get some respite from strangulation but instead of letting go of me, the guard reasserted his grip on my neck and pressed down harder. I felt the light go black as blood failed to reach my brain. Darkness descended. Sounds grew confused and dim. Suddenly I knew that I could die, that this was how patients had been “accidentally” killed during notorious restraint episodes in Connecticut. I did the only thing I could: I went limp, hoping the nurse would get the injections over with quickly and that the guard would not kill me before she was through.
One, two, and then, astonishingly a third needle punctured my arm. She wiped my deltoid muscle with an alcohol wipe then removed herself from the gurney. “All done,” she said, removing her gloves with a smack and she nodded, indicating the door.
With a cruel leisure, the guard let go of my neck, but he leaned down as he did so and muttered in my right ear: “That’ll teach you a lesson about bringing a JCAHO case against M— Hospital…” Then he and all the others strode out of the room, leaving me alone in what I had already been warned was a soundproof room where you can “scream all you want, but no one will hear you.”
In other circumstances, I would have screamed, soundproof or not, as the door was left open. But nothing was ordinary anymore. A guard – thuggish bully, no doubt a reject from the police academy — paid to protect people, had just partially strangled me in revenge for – what? What had I done to him? My case against that other hospital should have meant nothing to him. But what was clear to me, trying to get a breath and calm myself, was that I was not only not protected in the this ED, I was in mortal danger. I could not scream or rage in outrage, I could not even complain or demand to see a patient advocate. My life was imperiled. Still panting, trembling, in shock, I lay in the semi-dark of that single room and prayed — not to any god, mind you, but simply for my life, prayed to get out of that ED alive. I promised myself that I would not say or do anything “wrong,” would comply with everything they asked from then on in order to survive the night. But it was a long night ahead of me and I had no idea whether or not the guard would come back and finish the job. I was so terrified my teeth chattered. I felt a hollow coldness inside me of unutterable fear. And there was nothing I could do but lie there and hope he did not return.
I did not name the hospitals in the piece above, though I usually do, and I refrained from doing so because I do not know whether what I am going to write now is indeed true or not. But if it is not, then I do not want certain people being alerted to this blog post and reading it and taunting me with “Yehaw, we got away with it!” Read on, and you will see what I am talking about further on.
So as I said, I am in possession of my chart, the entire thing, 60 pp for a mere four day stay in the hospital about which I speak, including an approximately 10 hour stay in the ED. In it, there is absolutely no evidence that anyone ever took me or what I had to say seriously at any time. Everything I said was dismissed as paranoid and delusional, grandiose, disorganized or confabulating. (BTW Confabulate does not mean lying, it means to unintentionally “fabricate imaginary experiences as compensation for loss of memory.” But whatever they thought I was confabulating I have not the faintest idea. Or memory. Alas, the chart says nothing of what I spoke about.)
What has completely upset the applecart is my own statement, written in my journal and elsewhere: “Why on earth would that guard care whether or not JCAHO was involved in that other hospital?” On that thought rests everything, because of course, he had to have cared mightily to have wanted to strangle me for it. Or did he? Did he care, and in fact did he try to strangle me, and did he even say those words in my ear? I am serious.
You have to understand something: Once, years ago, I heard, or hallucinated, hospital nurses announce over the public address system in nearly the same words how they were going to “teach me a lesson” about — whatever it was I had done…and I knew I had heard it, knew I was hearing it at the time, except for the fact that I was on the phone with my sister at that time. I held out the phone in the air so she could hear it too, but she told me she heard nothing, assured me that I was hallucinating. What I described was not only unlikely but so beyond the realm of the likely that she was certain it could never have happened. “Its just your voices, Pammy,” she said, “you have to trust me, you are hallucinating.”
So remembering this, it gives me pause. For why would that guard care about JCAHO and that other hospital in the first or even the last place? What could it possibly mean to him? Security guards are usually hired from outside agencies so his over-involved concern with another hospital’s accreditation suddenly seems to me absurd. And if he did not care, why would he have tried to strangle me? Oh, maybe he did hold me down too hard, and I felt that, yes. But if I could speak, then I know I could breathe, so I was not actually being strangled either.
Perhaps I was simply frightened? And could it be that in fact he never said anything at all? That I “imagined” those words, hallucinated them, and then continued to believe that I heard him say them and that he wanted to kill me, all the time since then? Could it possibly be that some of what the hospital personnel said was true — NOT all of it, but some part of it. That I was in fact hallucinating and delusional? It doesn’t make their behavior right. It doesn’t justify throwing me into seclusion and injecting me with IM meds when I was not a danger to myself or others. It doesn’t even make admitting me to the hospital the proper thing to do in the first place. But, but, but…if I have heard people say things, visible people say things that they simply have not said, when they have not said anything at all, and I know this has been the case, then it is, I admit, just possible that what happened at the ED this summer might be another instance of the same…It pains me to think this. It frightens me to think that I could have been so mistaken for so long.
But what’s more, I worry that I am wrong to believe I might be wrong! That the guard DID say what I think he said, did intend to strangle me, and that I am giving him what he wanted: I am letting him drive me into believing I was/am crazy!
I do not know what to think. And I may never know for certain what happened. Not about this. However, one fact that I can corroborate in the record I am painfully aware I “knew” for months: I was given 3 IM drugs during that episode. Yet you only have to read my chart to see that I was given only 2: Geodon and Ativan. The third drug, Haldol, was canceled immediately after it was ordered. The records clearly state that only the Geodon and Ativan were ever administered. This is so striking an error of memory that it too makes me think again about trusting what I was certain I heard in that terrifying room where they held me down and injected me.
I don’t know what to do with this…I don’t know how to handle it or deal with it. It doesn’t feel good, or give me any sense of relief. I dunno how I feel. Just shocked, I guess. And perturbed, because I don’t know what else I have experienced that never “really” happened.
6 thoughts on “Am I Crazy? Hallucinations, Delusions or Consensual Reality”
You are most welcome, Pam, I’m so glad my words could help.
I just want to add this, though: most of the security guards I worked with so long ago were very good people. There was only a small percentage of guards who had that scary macho-swagger itching-for-trouble attitude. You find people like that in every segment of the population, as I’m sure you know. But it truly did seem to me that a higher-than-average percentage of such types are drawn to work that allows them to wear a uniform and carry a weapon and push people around. These types are more like children playing at cops-and-robbers, than adults doing a serious job. On a typical day, standing around in a security guard’s uniform watching the world go by is the most boring job on the planet. When finally “something happens,” these “Make My Day” gungho-types come alive, and in the worst way.
As for the job of nursing… that’s a very different thing. I worked for a couple of years as a nurse’s assistant, before I finally went to nursing school. Nursing is HARD. Really, it’s an almost impossible job. There are never enough nurses, meaning most hospitals and nursing homes are chronically understaffed, and therefore there is never enough time to get everything done that needs doing. The work is absolutely overwhelming at times. You can work your entire shift at a flat-out RUN and STILL not be able to do it all, and do it “right.” You need 6 hands, you need a stomach made of cast iron, you need a backbone made of steel, and you need feet that can take an unbelievable pounding. A person can go into nursing with a heart of pure gold, caring and compassionate and empathetic to the max, and the day-in-day-out unrelenting MISERY you see all around you will either kill you, or make you harden your heart in self-defense. As a nurse ini a busy hospital, a nursing home, and most especially in an emergency room, the world is one big gaping aching wound, a bottomless pit of sorrow and need, and nothing you do is ever nearly enough. You need to be in 10 places at once, doing 10 different things, and almost everyone demands and criticizes, if not the patients, then very often their family does the complaining. Stay in nursing long enough, and it is almost impossible to hang on to both your sanity, and your heart. This is why I could not do it! I only worked one week in an emergency room, this was as part of my nurse’s training, and that one week of non-stop, often life and death emergenies, almost did me in!
As I read your vivid, beautifully written description of what you endured last July, I could SEE it in my mind. In the eyes of the nurses, you were not a suffering human being with worth and dignity and rights no less important than their own, you were merely an unwelcome interruption, a problem to be dealt with, quickly and firmly and with a minmum of fuss and paperwork. This was not YOUR fault, it was the fault of the system, for want of a better word. But knowing how HARD nursing is, does not in any way excuse the harsh, hateful, disrespectful attitude you were shown.. yet it does, in my mind at least, explain it. I have seen and experienced it myself, from BOTH sides of the medical charts, this harsh, disdainful attitude. I hace witnessed this, both as a nurse-in-training, and as a patient. When you’ve been called from the bedside of a child whose body was crushed less than an hour ago in an automobile accident, and his mother is dead, his father is hanging by a thread, and if the child survives, he will most likely never walk again… and here is a patient who has nothing visible wrong with her, only she is “inexplicably” freaking out – the disdainful, put-upon attitude from the medical personnel who simply do not “get” the first thing about the very real horror of psychological distress, is very real. It’s not your imagination, and it’s not your fault, either. It’s just that they don’t get it, and they are overworked and exhausted and stressed and overwhelmed with the horrors of life in the trenches.
I hope you know what I am trying to say here? To you, in your time of extreme duress and suffering, the snappy bitchiness and cold-heartedness of the medical personnel, coupled with the terrifying physical roughness of the guard, must have felt so very personal. But YOU were not the real target, in my opinion. The nurse was probably (inexcusably!) bitchy because she was already behind in her duties when you were brought in with your immediate pressing needs, and the guard was probably an overgrown boy playing macho-cop-wannabe, who finally got to see some adrenilin-pumping ACTION.
Someday, if they live long enough, that guard, and the nurses, will become old and infirm, and they will most likely experience, in some fashion, what it is like to be the one who is disempowered, hurting, fearful, and in need of compassionate help, while being treated like they are nothing more than an unwelcome interruption, a pain in the ass, an unimportant, non-person. Someday, I believe, it all comes back around. At least, that’s my hope!
All I can say to these things, Rachel, is WOW! I may have to rethink my blog post. Maybe some of what I thought was not delusional but did in fact happen. For instance, I wrote so often that I got those 3 shots. Now I am thinking, maybe i did indeed get them, because why would I pass out so immediately from a mere 20mg of Geodon and 1 mg of Ativan. But with 5 mg of Haldol added it would make more sense. As for the guard (I refuse to call them security guards as they provide NO security and are in my opinion out of control thugs) I think he may indeed have compressed my neck, if only by holding me down in such a way as to restrain me roughly. Whether or not he intended to strangle or kill me, I dunno. And I have no idea whether or not he said those words, only that they do echo precisely what those nurses said or I hallucinated they said over the hospital PA system about my phone call, which they claimed to have recorded and were also replaying over the same PA system…So if those were the same words, perhaps it was only a hallucination. But perhaps only the words, not the rest of it. Thank you SO very much for validating as much as you have. I truly appreciate your contribution to this site and hope you will continue to offer what you know and have experienced. It is so welcome!
OH….. Pam. I completely relate to this post. I am deeply thankful that I have found your blogs, and your book. I’ve ordered a hardback copy of your book from Amazon, I’m so looking forward to reading it.
Is anything more traumatizing than not being able to trust your own perceptions? I don’t think so.
I have so much swirling around in my head that I could say about all this, it’s hard for me to sort it all out, but I will try.
15 years ago I went through nursing school. One of the things that was greatly impressed upon us in our training was the fact that medical charts are Legal Documents – therefore, you must be ultra-careful about what you write in the charts! Also, there is so much charting and other paperwork required, to meet the legal demands of insurance, etc., that it is truly impossible to do the charts “right,” and still find time to do the actual job of patient care. So… just because important happenings are not recorded in your medical chart, that should by no means be taken as proof that it did not in fact happen, in some fashion.
As for that security guard…. sigh… I’ve led a strange life… about 20 years ago, for part of one year, I worked as a security guard in a bank. The security guard who trained me was one very scary dude. All he did was talk about his wonderful collection of guns, and his beloved hobby of shooting those guns, and bragging that he would have made a satisfying career out of being a hit man, if it weren’t for these pesky laws against being paid big money to commit murder! I became so alarmed by this fellow’s homicidal rantings and ramblings that I told our boss all about it. The male boss, a retired U.S. Marine, dismissed my concerns out of hand. “People who talk about killing never do it,” he said.
A few months after I left that job, the hit man wannabe shot his fiancee. It was an accident, of course, he having so little experience with guns….
I am so sorry for this latest cruel trauma you have endured, Pam. Just being treated so roughly is enough to put any person at risk of losing touch with reality. As the late Viktor Frankl, MD, PhD, survivor of nearly 3 years in Nazi concentration camps, said in his life-changing book, Man’s Search for Meaning: “An abnormal reaction to an abnormal situation is normal behavior.”
I believe that is probably what happened with you this past July. You were thrust against your will into an abnormal, traumatizing, soul-annihilating situation, which undoubtedly unleashed multiple memories of similar traumatic indignities in the past. You were being treated, not with the kindness and compassion that you needed and deserved, but with palpable disdain. Harsh thoughts and hateful emotions are communicated, far more than with words, via body language, facial expressions, the eyes, the tone of voice, the “vibes” – even a so-called dumb animal instinctively knows when it is not safe, when the people in charge are not to be trusted.
A nurse, concentrating on giving injections in the proper way and in the proper amount, is not going to be paying any attention to what exactly a security guard is doing, or saying. Also, if she realizes after the fact that she gave an injection for which the order had already been cancelled, I am sorry to say that too many nurses, AND nurse instructors, are NOT going to admit that in the chart. I know this, for I’ve witnessed it firsthand. It’s sad, it’s illegal, immoral, and potentially deadly dangerouw, yet it is true.
As for having a run-in with a security guard who has a homicidal attitude? I’m sorry to say that they are not at all uncommon, either.
Did your terrified, traumatized mind fill in the blanks with words he did not actually say, as a way to make some kind of sense from what he had done to you? Maybe. But the fact remains that your autonomy, your power, your rights as a human being, were taken away from you, and you were thrust into a terrifying, traumatizing, abnormal situation. For you to be put into such an extremely abnormal situation, particularly in light of all the old trauma memories it undoubtedly evoked in your mind, an abnormal reaction on your part in such an abnormal situation is, really, truly, Normal Behavior.
Dear Rossa and Kate,
You two are great! I so appreciate all that you wrote. Rossa, you are right on the mark, so far as I am concerned. If I understand you correctly, what I heard the guard say was what my own mind “made him say” because I was terrified, and became certain that people were angry with me about the issue and that it would cause problems…or something like that. Or at any rate that my own concerns created the hallucination that seemed to have this guard say words that in all likelihood he did not say. (Or did he? I am so conflicted! Even now, I find it astonishingly difficult to believe that it might not be fact, might not have happened precisely as I experienced it. That is, I experienced something, yes, but that the guard did not actually say those words. Everything in me rebels against that interpretation, even though I was the one to offer it.)
It did hurt me, Kate, their barbarous treatment of me, from start to finish. And when I read the chart and found that they had discounted literally EVERYTHING i said as paranoid and disorganized and delusional, well…I think if they had approached me with more respect and treated me with a semblance of dignity, things would have turned out better both in terms of my behavior and their “satisfaction with me”…But I have ceased to expect anything of the sort from establishment psychiatry. They are so much into paternalism and control and coercion and barbarity that I have little hope that it will change from within. Nevertheless, I do intend to pursue the cases I have against these hospitals, in terms of illegal seclusion and restraints usage and I won’t stop until all use of those brutal “psychiatric interventions” ceases entirely.
Thank you so much for your comments. You really helped me to feel stronger about the train of thought I pursue here, and yes, despite those nagging doubts…
Pam, thanks for writing about your experiences. Honestly I think we’re both a bit crazy. I still get pulled into believing things that my saner half knows are not real. What hooks me is that there are some elements of truth contained within the overall delusion. Like everyone, I want the Truth, but Truth can be elusive, especially since we are all such subjective beings. What does seem to be true in your story is that the means for helping people who are mentally ill and upset in a hospital setting are quite poor. The use of physical force, restraints and forced medication comes across as rather barbaric. I have no personal experience with this. Somehow I’ve stayed outside the hospital system except for one night’s voluntary stay. But I am sure that if I were treated the way you have been treated repeatedly, it would shock and hurt me deeply, too.
I do think you mis-perceive some things and get pulled into some conspiracy beliefs. It’s the nature of our illness to do this, which is why we have to stay vigilant and question our own assumptions and inclinations. It’s an uncomfortable way to live sometimes, questioning and doubting a lot of the time, but it must be done if we are to hold onto the saner side of ourselves. I know for sure though that you are a wonderful, creative individual with an excellent mind and you don’t deserve to be mistreated. Wanting to be treated with dignity is not crazy.
Not having experienced life as a psychiatric patient, except through my experiences with my son, I hesitated to comment on your post. However, I have learned about the condition of “schizophrenia” from reading a lot about it and refusing to accept the traditional biochemical explanations, so, if you will indulge me, I’ll chip in my two cents here. The older I get, the more I realize how fallible memory is for everyone. In situations where people actually hear voices, the latest sensible thinking (Hearing Voices Network) says that the voices are a projection on one’s own fears and traumas. You were very stressed when you entered hospital. I would tend to think that the guard didn’t and wouldn’t say those things about JCHO, but in your terrified state, you projected that onto him. It’s interesting that you are re-thinking the events and accepting the possibility that what you heard might be your truth, but not what was said. I do apologize if I’m putting words in your mouth.
In your last post (can I say again how brilliant that piece was?), you talked about your botany instructor. In your intuiting the universe by almost spontaneously knowing the names of plant species, to a mainstream psychiatrist, you were exhibiting “grandiosity.” I saw this with my son when he was in first year university. He told me that he “knew” all the material in his calculus course.His professor obviously didn’t think so. My son failed the course, needless to say. Herman Hesse has the best, most uplifting and humane way of looking at transcendence. He writes that science has invented the name “schizomania” for it, but he quickly goes on to say that schizomania is the beginning of all art and understandiing.
If you’ll indulge me further, I had a life-changing experience, that wasn’t meaningful like yours, but it demonstrates to me how our mind plays tricks on us. I took a Shakespeare course when I was in fourth year university. I knew that it would be a challenge because I had difficulty understanding Shakespeare. I wrote the mid-term essay and then left for my Christmas holidays. In Januarz, back in class, before handing out the papers, the professor started to read aloud from some of the answers the students had given. He paused, and then pulled out a paper that he said was the best student writing he had ever read. I didn’t pay much attention but I sat up when I realized that it was my paper he was reading from! Those words were exactly mine! I was flabbergasted and very excited and proud. When the papers were handed out, I mine was not amongst them. The professor said to the class that if you didn’t receive your paper you were to come and see him after class. I approached his desk, mentally rehearsing my humble response while anticipating all the compliments that were coming my way. He handed me the paper. I got a D! The humiliation! How was this possible? It was only possible because that wasn’t my paper he read, it was somebody else’s. I could have written that paper. My higher self obviously thought I had the ability to do so, and that’s what I would have written had I not been so unsure of myself and suffering from poor self-esteem. I went straight from the classroom to the registrar’s office and dropped the course. I laugh about it now. It wasn’t the beginning of my art and understanding. It took my son’s diagnosis of “schizophrenia” many years later to start me on that course. I’m sure if I took that course now, I’d a least get a B!