All posts by Phoebe Sparrow Wagner

Artist, author, poet

iPad Art, also Portrait and Poem: In Memoriam Howard M Spiro, MD

January 6, 2013 Phoebe Sparrow Wagner 1 Comment

The first three pieces here were done with my finger using the app, Art Set, on an iPad 2. I had never used any digital means to do art before, and in fact had just started drawing a few months before. So when I did the window curtains drawing, it was really among my earliest drawings anyway. The “hand with pencil” was just for fun, because I had nothing else in front of me to draw, and I used my right hand to draw my left, I think, though I could have reversed it. Not sure, as I was doing either one in those days. Now I tend to strictly draw with my right hand and write with my left hand… Anyhow, I must have drawn my feet in flip flops last summer, since it is more sophisticated than the other two and I don’t think I would have been able to do that sort of thing until last year.

The pencil sketch, which I took from a movie of Athol Fugard’s play “Boesman and Lena” (staring Danny Glover and Angela Bassett), I drew off the television, stopping and starting it until I couldn’t bear to not know what was going to happen any longer, and gave up and simply watched the movie…It was a terrific if also very dark play. I watched it twice in a row, one night and then again the next night. Then I even went so far as to look for the text of it, which is apparently difficult to find…I did get a study guide though, which may have the text embedded in it. At any rate I hope so. Anyhow, I had planned to do other studies from that movie but I got so engrossed in the actual play, that I failed to stop the action long enough to do so. I guess that speaks volumes for how good a playwright Fugard is (was?). In fact, I watched yet another of his plays/movies and even sent for a third, “Tsotsi,” that was unavailable any other way the following night. “Master Harold and the Boys” was incredibly difficult, yes painful, to watch, and should not have been easy anyway, not for anyone with a light skin in this country and any conscience. We are ALL implicated, we are ALL guilty…

Finally, the picture, at the bottom, is of my father. Oddly, my first title of this post (edited out) called him “my dad”; I usually refer to him as my father, but always, always, always called him Daddy..When I did this portrait a couple of days ago, it scared me: the eyes began to move and the mouth made sounds, as if he were trying to tell me something, and I was afraid, so terribly afraid he wanted to say that he didn’t want to be “there,” wherever he is…I was so scared in fact that I left the painting room and said I wouldn’t listen to him. But then my cat, Eemie, who died not too long after he did, also came around. Literally, or as literal as a dead cat can be. Visual and audible! I dunno how that can be, because she was NOT a ghost, but a real cat, really Eemie..which only adds to my consternation. Finally I decided to take a teensy bit of Zyprexa to stave off any potential disaster. This is a bad time of year for me, 5-6 months along after “the last time” and after last summer I know I have nowhere I can trust to turn to, no place that is safe for me (Natchaug Hospital is too dangerous, and they wouldn’t even take me back if I needed it, if I even agreed to go should I need to). I frankly dunno that such a tiny dose of Zyprexa makes any difference, but I had to do something…

Oh, I have a lot to say about Natchaug still, but that would take another post, and a lot of thinking. I just might post it as another open letter to Natchaug’s CMO…Because she is the one to whom I wish to speak, and who really needs to hear what I have to say. But we will see. In the meantime, I want finally to post the poem that I wrote for my father after he died. A lot of people have asked me for it. I read it at the memorial service at the Unitarian Church in Hamden, CT. Alas, I see that it won’t paste in single spaced lines nor will it preserve the proper large blank spacing where it belongs, so you should know that it ought to look a bit different on the page than it does. The only other words of explanation you might want are these: when Martha, my younger sister, read her own eulogy, her major metaphor was water and the ocean and waves, because our father, was so very fond of swimming, especially the breast stroke, or a weird kind of what seemed to me a modified-dogpaddle-cum-crawl, his head more out of the water than in. We were shocked to discover that water and swimming were the governing metaphors in my poem as well.

(You might not need this information, but in case you do, Tir Na N’Og is a mythical Irish “Land of Youth.” Island of the Seven Moons is meant to stand for much the same thing…)

This is for you, Dad.

BUOYANT

The dead cross the river, swimming.

Past drowning now,

some crawl,

some leisurely sidestroke,

some float on their backs,

toes pointing toward the sky.

Who knows what lies ahead:

Tír na nÓg, Valhalla,

Island of the Seven Moons?

No one can say for sure

if there’s any shore, far or near.

Some have cracked their teeth

on bitterness, believing

that to die is to lose all.

Others say there is only light

shining on the best of what used to be.

We dream, we dream and wake,

we wake and hope our dreams

mean something,

that the dead know more

than just the river

and that they must swim.

Daddy, keep your head up,

kick your feet, push the water

away.

Art, Reflection, Uncategorized

MORE than just my Review of CREATIVE MARK Squirrel LE Brushes and Set

January 6, 2013 Phoebe Sparrow Wagner 3 Comments

Originally submitted at Jerry’s Artarama Art Supplies

A limited edition series of CREATIVE MARK fine blue squirrel hair brushes! For centuries, natural blue squirrel hair has been one of the most cherished hairs for making high quality artists’ paint brushes. This traditional hair is extremely soft and highly absorbent, and offers several advantages over modern…

Squirrel LE Brushes and Set

Horrible, worthless brushes….

By PamWagg Artist from Hartford, CT on 1/6/2013

Pros: Fails To Glide, Rough, Stiff, Fails To Hold A Point

Cons: Poor Quality

Best Uses: Maybe Not Even For Glue, Maybe For Glue

Describe Yourself: Artist

Primary use: Personal

Was this a gift?: No

As an artist I need good brushes for all my work, and I invest in them, so when I saw these, I thought it would be a good thing to try them out. Unfortunately they were definitely nothing like the packaging asserts. Not at all. All I can tell you is that you have to say NOT to every single promise, including believing that these are even made of natural blue squirrel hair. NOT “soft and absorbent, hold lots of color.” NOT “handmade” NOT “round shape with fine point”. The tips are waxed into a pointed shape and you have to literally break off the coating to use them at all, but then you have a brush without any shape whatsoever, never mind a fine point. The brushes are quite literally worse than the cheapest department store brand. DO NOT BUY THEM. You will be wasting your time and anything else you expend on them. Jerry’s sells VERY good brushes, but these are not they.

I rest my case…

Tags: Unusable, After one use, Picture of Product

proof that these are Creative Mark brushes

Tags: Picture of Product

I wrote this review at Jerry’s site, but I wanted to add since I did write it, that the packaging pretends that these brushes are, and I quote, “entirely handmade” — the brush head is “hand-shaped and tied” and yadda yadda yadda.. But how can this be? Do they really expect us to believe that the metal ferrules were individually metal-worked? And the wooden lacquered handles, that is, painted with shiny paint, were individually painted and for that matter carved by hand? NOT! NOT! NOT! I do not for one second believe any of it and it bugs me that they think that they can get away with it. These brushes were NOT entirely hand-made, that is just plain masculine cow flops! I wouldn’t even give a hoot about the lies, if the brushes were decent but the idea that they could call this set worth nearly $70 or so, for 6 brushes, and then pretend to drastically mark it down for a once in a lifetime CHristmas sale just burns me. They are and always were crap. And they knew it. They know it now. I don’t get it. Why are people so dishonest. Wouldn’t they rather put out a decent product for a decent price and have some pride in what they make? People would buy it, then, and not complain.

But no, they would rather CHEAT people, once, but a lot of people. Once. Than have a limited number of repeat customers who were loyal to a good and trustworthy manufacturer. Oh, I will get off my soapbox but this sort of thing just disgusts me.

Health, Psychology, Psychotherapy, Sexuality

I am Asexual, I am not an Amoeba

January 2, 2013 Phoebe Sparrow Wagner 4 Comments

Let me state this plainly so there is no misunderstanding: I am tired of people thinking there is something wrong with me just because I do not have a husband or boyfriend/lover or even a girlfriend/lover or a love-interest of any kind. I am not interested in sex and have never been interested in sex for whatever reason. This does not distress me and it never would have in the past, had others not insisted that it ought to. I have finally come to the conclusion that being asexual — definition: having no interest in a sexual relationship with another person — is okay.

I am not unhappy. I get a lot done and I am likely more satisfied by my life as an asexual than someone who is sexual and without a partner. I am never lonely. And I have tons of friends. (At least 16 friends — all of whom I adore — came to my 60th birthday party!)

It has taken me, via a tortuous up and down path, a long time to come to this position. And there may well be those who shake this foundation yet, as other people’s opinions, alas, still manage to have a strong effect on me. I have never told openly the story I am now going to relate, but I think it is time. It should be an eye-opener and a warning to those who believe they have the right, even the duty to “help” a young person discover “her true identity…”

As some of you know, a very long time ago, I was a student in a medical school in Connecticut. The two years I attended med school were extraordinarily difficult ones for me and I admit now that even as I matriculated, I “knew” at an almost conscious level that I would never get through. I didn’t honestly want to be a physician. Not really. Oh, yeah, I thought I could be a good psychiatrist. I knew that I understood people and mental illness enough to empathize and help others. But the notion that I could successfully get through four years of med school and four years of residency in order to achieve that goal was something I also knew would be impossible, even as I nominally attempted to undertake it. I had no choice. It was what you did in my family. And there was no question in my mind that I could work at a “regular 8-hour a day job.” I simply didn’t have the stamina either interpersonally or physically. I didn’t know why, I just didn’t. (I also didn’t understand that I had narcolepsy, so I construed my constant drowsiness as “boredom” for everything.)

So there I was in med school, without the ability to make friends or any interest in relationships, especially having just broken up with Bruce, the one boyfriend I had had and with whom I had sex (because he pushed it). I hated it…which was why I broke it off. I know I was noticed. I felt noticed. Possibly because I made little effort to be friendly, possibly because my narcolepsy made me noticeable. I don’t know. It is not that I was or am a striking person at 5′ 3″ and 105 lbs…hardly! Perhaps it was my mere aloneness that struck people. I dunno.

Things were hard to start with, but then the voices started up telling me to hurt myself and I acted on their commands, frequently. I had horrific nightmares nightly. And I could not stay awake in class or to study no matter what I did. People had all sorts of advice and jokes for me but no understanding. They gave me No-Doz and Vivarin for my birthday, which precipitated a caffeine-toxic all-night-up of horror. They took photos of “Rip van Winkle” sleeping on the med school lobby couch and published it in our newsletter. No one knew what was really going on, at home, at night, in my bedroom when the voices took over.

I had a run-in with the student health doctor, Dr E, to whom I had gone about possible Reynaux (sp?) Syndrome. When she saw certain scars on my body she became concerned and spoke with the psychiatrist I was seeing at the time. Dr S, who was a cold man who seemed to dislike me from the start, was angry at our next appointment for “parading” my wounds and warned me against ever doing so again.

I went back to Dr E and told her what Dr S had said. She seemed perturbed and gave me the name of a therapist that she said she often referred “troubled students” to. I might consider seeing Tamara instead of Dr S. The other students liked her a lot, Dr E said. What were their problems? I asked. Dr E shook her head and responded, Not so very different from yours.

I sit nervously in the waiting room, hoping that Tamara will be so late she won’t have time to see me today after all. I feel sick to my stomach and wonder why I’ve come. Five minutes late, ten minutes late. I am just about to leave when a very pregnant woman opens the door to the office and welcomes me in. I do not look at her face but whisk myself inside, trying not to guess how many more weeks she has.

Before she asks me anything, Tamara says, “Now, I see girls who like girls and boys who like boys. You’re okay with that?”

What is she talking about? I don’t understand. Girls who like girls? I like girls, I like boys. Why shouldn’t I be okay with it? So I say, yes. And assume that even so, she sees people whose issues are very different…

I didn’t ask her. I simply assumed that she had other interests. And went on from there. But it was critical, because I did not get that she was conducting therapy as if I had agreed that I was a lesbian, and yet I had made no such admission. I did not even understand what she was getting at. Why was she so coy? Why didn’t she just come out and ask me whether or not I was gay and then tell me that she only treated lesbians and gays with issues around their sexuality?

As it turned out, she had no idea that I was not in fact assenting to her coy proposition that I “liked girls.” On the contrary, if she had asked me point blank, I would likely have said, “Me? No way. I am not even interested in boys. I couldn’t care less about sex. I like, but don’t love, boys and girls…so to speak.” But the operant word, clearly, was not “like” at all, but love, as in “making love.”

Actually, in point of fact, I would not have been able to respond at all, if I remember my former self accurately. I was nearly mute much of the time, esp in therapy, and when I did speak it was often very cryptically and with difficulty making myself clear. This may account for the misunderstanding that so horrified me in what follows.

It was a crazy-making psychotherapy for about 6 months. I had no idea what notion she was operating under, because I didn’t know what kind of therapy she “did.” Likewise, if she knew the least thing about me, it was completely mis-colored by her mis-understanding of me as a lesbian. So when one afternoon she “told” me that she empathized with me, because I had had a sexual relationship with my previous psychiatrist…I hit the roof.

“WHAT? What the F— are you talking about?!” I nearly leapt out of my chair.

“It’s okay Pam, I understand,” she soothed me.

“It is NOT okay! I never said anything of the sort! This is YOUR filthy mind! I’m out of here. Go to hell!” And with that I got up and walked out. I realized then that she was nuts. Somehow she had gotten the entirely wrong idea, but I didn’t understand how. It made no sense to me. Where on earth had she fashioned that notion? I certainly had never said any such thing…

Then her statement “I treat girls who like girls…” came back to me. And I understood more. Dr E surely knew Tamara’ orientation, her clinical expertise, so Dr E must have believed that I needed to talk about conflicts about my “homosexuality,” about coming to terms with being a lesbian, unbeknownst to me. So she had set it up that I see Tamara, believing that she knew me better than I knew myself. But what right had she to do that? And how would she know whether or not I was a lesbian? Just because I was a conspicuous loner? How dare she? She knew nothing about me! What she had done was a violation of me as bad as any man who wanted to have sex just to prove he was Mr Right!

I spent a lot of time after that utterly paranoid that I might be gay, feeling that I must be gay, certain that I was gay…I even came to the point that I accepted it eagerly. But it was never true. It was just another identity forced on me by others who would not let me be. Who would not accept that I simply have never had interest in sex or sexuality beyond a pervasive non-sexuality. My libido, my psychic energy, is invested in other things, in art, in science and in life, but not in erotic interests. And you know what? Being non-sexual or asexual doesn’t make me an amoeba or less than human.

At least 1% of humanity is asexual, has always been asexual, permanently. That’s a LOT of people. We may not be the norm, but there are enough of us out there to rate your acknowledgement and the respect you would pay to any other human being. That’s all we ask, that’s all I ask. And for you not to try to change me just because you do not like it or understand my way of being. Thank you.

(For anyone who was reading the other post when it disappeared, sorry! There was a problem!!!!)

Art, Christmas, Holidays

Peace on Earth

Image December 24, 2012 Phoebe Sparrow Wagner 5 Comments

Animals, Art

Animal Art

December 24, 2012 Phoebe Sparrow Wagner Leave a comment

Health, Mental Illness, Violence

Guns R Us…Why should Sandy Hook Surprise Us?

December 15, 2012 Phoebe Sparrow Wagner 3 Comments

We are what we do. As a society we are what we teach our children to do. And we are no better than what we allow to happen by our inaction, if we don’t act to stop it. Our gun laws permit, nay, they encourage gun use by everyone, they enthusiastically promote gun ownership and usage, and they turn a blind eye to gun ownership and usage by those who should never lay their hands on a toy gun, much less a loaded one.

Guns kill. They are not decorative or ornamental items. They are not collectors items. So let’s not fool ourselves. It may take a human agent to pull the trigger, but it is the bullet from a gun that kills. And get this straight: when a gun kills 20 little kids, it matters not whether the slugs come from a sig sauer, a glock, a .22. or a Saturday night special, what kills is a gun that does the only job it was designed to do.

When it comes right down to it, it is far too easy to kill someone when you have a gun, any gun: if you push or punch someone because you are angry, it is likely that he or she will be bruised, but they will live. It is only when there is a gun attached to your fingers that lethality comes attached as well. GUNS KILL PEOPLE. People using GUNS KILL PEOPLE, but people without guns do not so frequently kill people.

Let’s face it, Adam Lanza would have found it extraordinarily difficult to have murdered 20 children and 8 adults in less than an hour without his two handguns. The guns literally empowered him to do what he did. Without his guns, he would likely not even have attempted such a deed. Guns made him a god to grant and take away life, and in a moment of passion, he decreed that 28 people would lose theirs. Now, I don’t even believe doctors should be playing god, so I am horrified that all it takes is a gun, and Everyman has the power to do what only god should be in charge of.

Check out the website created after the Newtown, Connecticut, kindergarten shooting this afternoon, http://wearebetterthanthis.org, sponsored by the Brady Campaign to Prevent Gun Violence. God bless them, I fully support the Brady Campaign. However, I am not sure we — whoever we are — are truly better than any “this”…Who are we anyway, and what proves that we are actually better than we witness happening around us?

The stats are ominous and more than distressing. And they speak volumes about whether perhaps it’s just a big fantasy, our being any better than the murderers among us.

For one thing, you should know that while there are 34, 589 hardware stores in the United States, there are more than 129,817 licensed firearms dealers as of Aug 2012 . Of those, 51,438 are retail gun stores, 7,356 are pawn shops and 61,562 are collectors. The rest are manufacturers and importers of firearms and destructive devices.

There are also 80,000 ice cream parlors. Ice cream does 18 billion in sales a year, which isn’t bad considering an average ice cream cone costs only between $2 and $4. An average Glock 17, “America’s favorite gun,” costs around $500.00 You do the math and then tell me how easy it will be to convince gun dealers to change their ways…

But right now, why should they bother? Guns are great business! In 2010 the National Instant Criminal Background Check System (NICS) ran 16,454,951 background checks for firearms purchases. Only a small number of these purchases (78,211 or 0.48 percent) were denied. During Obama’s first term, and well before it ended, more than 50 million background checks had been run by the NCIS. This was a bonanza for the gun industry compared to the same 3.5 year period under George W Bush, when “only” 28 million such checks — background checks are an index of the demand market — were run. So clearly, if guns in the hands of the wrong people kill, chances are that more guns had to be getting in the hands of more wrong people than ever during the last four years…many many more.

Note that it doesn’t matter how many guns are purchased at one time, there is only one background check per purchase. After that, what you do with the guns and how many you have purchased at one time, is your business and yours alone… Oh and lest you think the so-called “mentally ill” would be screened out by the NCIS background check, think again. Being “adjudicated mentally ill” and barred from buying a gun is not at all the same thing as simply seeing a shrink or even being hospitalized in a general hospital, with or without your consent for 15 days.

I have been kept in a hospital against my will for even longer, but I have not been formally adjudicated mentally incompetent, or if I ever was, now that I am OUT of the hospital, I am no longer considered non compos mentis, and I could buy myself any gun I wanted to.

Frankly, I think that is only right. Why should some angry redneck be able to buy himself a Glock 17 semi-automatic handgun and I, peaceable and very, very unlikely even to pick it up, let alone use it, could not buy a sweet little .22? Furthermore, I would be far more likely to use it ON MYSELF not on others…

This last is a notable case in point, because unbelievably, suicide far exceeded homicide as the cause of gun fatalities at least in 2005. In 2005, 5.75/100,000 people committed suicide with a firearm, whereas “only” 3.43/100,000 people caused firearms homicides in that same year. Since in 2012, the suicide rate has hugely increased, probably due to PTSD in returning veterans, this ratio likely has only increased.

Approximately 34 persons are felled by guns each and every day in the US. According to the FBI Uniform Crime Report, between 2006 and 2010, 47,856 people were slain by gunfire in the U.S., more than twice as many as were killed by any and all other means.

Whether or not the suicidal mentally ill should have access to guns – and just how to prevent it, just how to define who is mentally ill would be a huge problem — I see a bigger problem with an angry man of any stripe being able to purchase a handgun. Anger is a big spur to impulsive behavior and impulsivity and guns decidedly do not mix.

So I ask you: How can we be better than Friday afternoon’s Glockencatastrophe if we buy or permit/encourage the purchase of so many more handguns than ever? We are a gun culture, we worship guns, we hav a national love affair with guns. What do we expect?

You know, one of the first rules of writing fiction is, if you “plant” a gun in the early scenes in a story, it must go off by the end…Similarly, if we have and are a gun culture, who are we not to expect to be a culture of shootings? We have the guns, how can we expect people, both good and bad, not to use them?

During the Newtown shooting, from what I gather, the shooter killed himself after he shot all the 28 other victims…All the high tech and paramilitary heavy weaponry with which the police have equipped themselves did zilch in the end to prevent mass murder. No, 20 small children and 8 adults were quickly and savagely murdered, a horrific act accomplished largely so it appears with two handguns, a plastic and metal glock and a sig sauer. The shooter supposedly had access to a Bushmaster combat rifle it is not clear that he used it for the killings.

Whatever is the case, things will become clearer in the coming days as the police reveal more information.

Perhaps I should be softer and sadder right now, perhaps I should not bring up things like slugs and guns and such at this moment. Forgive me for not wailing and beating my breast or crying but many more are doing that tonight elsewhere, so I am just going to save my breath for rage on behalf of those poor murdered children and the eight others…Any more tears added to that ocean would just be wasted salt and water.

Animals, Art, nature

SAILBOAT PAINTINGS AND A CAT PAINTING

December 8, 2012 Phoebe Sparrow Wagner 2 Comments

I am posting these four eminently “sane” paintings for a friend who wanted to see them all together here. The first and the third are still available if anyone is interested…Contact me through the About page. Availability of the others is pending.

Three Catboats in cove, in mist. ©Pamela Spiro Wagner All rights reservedThis one was inspired from a photo but is not a copy, done in colored pencils and oil pastels. — Three Catboats in cove, in mist. ©Pamela Spiro Wagner All rights reserved
This one was inspired from a photo but is not a copy, done in colored pencils and oil pastels.

Health, low-calorie, low-fat, Nutrition, Recipe

UNBELIEVABLY DELICIOUS NO FAT, LOW CALORIE CHEESECAKE!!

December 7, 2012 Phoebe Sparrow Wagner 1 Comment

Okay, so this is a reprise of something I posted before without fanfare, but I think in these cold winter months we all need CHEESECAKE, so why am I hiding this lightness under a bushel? (I know I know it is ridiculously simple too, but do not be fooled. Try it! It will amaze you. Make you knock your head and think: WHY didn’t I think of this before????) 8D

I post this especially for anyone who takes antipsychotic drugs and has a resulting weight problem, but obviously it is meant for everyone else who needs low cal cheesecake too. 8) Enjoy!

All you need to do is MIX together:

1 container of plain, no fat, Greek yogurt. Yes, you can use regular yogurt but I have found the Greek kind makes this cheesecake extra thick and delicious. Usually these are around 100 calories (also extraordinarily high in protein, if you care).

1/4^th of a package of Jello instant low calorie, no fat, cheesecake pudding mix.

Top with your choice of fruit- strawberries or blueberries, or even a few nuts or three or four semi sweet chocolate morsels (if you can actually eat that few…) et VOILÁ!

Try it, it is really an unbelievable dessert, especially if you have not had one in a long time and really want to taste creamy richness of cheesecake without guilt.

Greek yogurt: 100 cal.

Jello pudding mix 25 cal.

GRAND TOTAL for a whole 8 ounce dessert => 125 calories!!!!!!

Now, that is all I use, but if you really want a crust, Lord love you if you NEED a crust, you can do this: break up a couple of graham crackers and mix them with a little of the yogurt to moisten them and press this mixture into the sides of a custard cup and chill it a while until firm. Spoon in rest of cheesecake and chill again for a couple of hours.

Abuse, Health, Mental Illness, Psychiatry

Where Have All the Multiples Gone?

December 3, 2012 Phoebe Sparrow Wagner 5 Comments

One of the terrible consequences of the APA’s DSM is the Multiple Personality Mayhem that resulted from that fad diagnosis of the late 80s and 90s. I was hospitalized many times in those years, and I was appalled even then at how this once extraordinarily rare diagnosis was suddenly “popping out of the woodworks.” Somehow, multiples, with their putative history of extreme childhood sexual torture, were everywhere. At any time on a psychiatric unit of 18-20 beds, you might see 4 people supposedly suffering from MPD. It was absurd, but try and point that out to the professionals! No, they were much too busy creating very sick individuals out of the whole cloth of their own — the psychiatrists’– minds!

Even at the time I felt very frightened by what was happening, as I understood how difficult it was going to be, when it was all over, for such patients to come to grips with the fact that their disorders were invented for them by the doctors who wanted to have their time in the limelight. Now that the fad is over, where have all the multiples gone? Have all of them been converted to DID — that is, are they still being lied to? or has anyone decided to be honest with them and admit that the Dx was bogus all along, that they never did have MPD or any other such disorder. That their so called multiple personalities were suggested to them by the therapists and invented for them ditto.

It was a horrendous situation, and one that I do not believe anyone has dealt with completely honestly or fully to this day…Of course not. When did you ever meet a doctor, much less a psychiatrist willing to admit he or she made a terrible mistake, or say, I am sorry, I will make amends. Hah. That’ll be the day.

Art, Health, Mental Illness, Recovery

Doing Art to Save My Sanity

November 27, 2012 Phoebe Sparrow Wagner 4 Comments

They Love You So Much, You Hate Yourself... — THey Love You So Much, You Hate Yourself… © Pamela Spiro Wagner All rights reserved
This one you have to look a little closely at to see what precisely is going on…It isn’t obvious at first glance…

Picture of Health? — Unnatural Still Life or Natura Morte, as the Italians call it. Not your typical fruit bowl, I leave it up for interpretation, but will let you know that the two aqua items are from left to right a packet of Bugler cigarette papers and a bugle cigarette roller. © Pamela Spiro Wagner All rights reserved

Green Hands — A left handed doodle © Pamela Spiro Wagner All rights reserved

BioHands 1 ©Pamela Spiro Wagner All rights reserved

A left handed doodle © Pamela Spiro Wagner All rights reserved

BioHands 1 ©Pamela Spiro Wagner All rights reserved

BIOHands — BioHands 2 ©Pamela Spiro Wagner All rights reserved

Three Catboats, in cove, in mist — Three Catboats in cove, in mist. ©Pamela Spiro Wagner All rights reserved
This one was inspired from a photo but is not a copy, done in colored pencils and oil pastels.

As I have been having a hard time dealing with things, I do art and do art and do art…It is as good a way to cope as any other I suppose. Anyhow, I hope to get back to writing here soon. In the meantime, I am investigating more about temporal lobe epilepsy and schizophrenia/bipolar illness. It seems to me very significant, and at the same time strange that so many people who bear the diagnosis of schizophrenia and/or bipolar are also supposedly burdened with yet another condition that is so tricky to pinpoint, so I may also be posting more about that in the future as well.

The more I read the less I am convinced that schizophrenia, as an entity, exists, one, and two, that if there is any such thing as “schizophrenia” no one has yet figured out what it is. Which is the same thing as saying it is an imaginary/artificial illness. Don’t get me wrong: I am not saying that mental suffering and psychosis do not exist, only that no one has proven, not to my satisfaction, that there is any such illness constellation that can go by the name of schizophrenia and be recognized as such by a preponderance of physicians world-wide… That offers a lot of leeway by the way. I don’t ask for a lab test or even a set of hard signs. Only a reasonable way for psychiatrists around the world to agree on symptoms that constitutes a recognizable disease that is the same thing no matter where you go, just as measles is measles and the flu is the flu…

But there won’t be any agreement, as we know. Because schizophrenia is a cultural construct. It is imaginary and largely meaningless. Except within the society that uses it as a concept in order to disapprove of and stigmatize certain ways of being, speaking or thinking. In that sense schizophrenia is more than just a construct or concept it is a social tool. It is a weapon used to keep people in line. In western society, if one doesn’t keep to the obligatory path, some semi-acceptable social role, the result is the withdrawal of social approvals and the substitution of punishment — think drugs, hospitals, seclusion, restraints — in their place. And yet, in other cultures, the very same “out of bounds” thinking or behavior, rather than being labelled schizophrenic or “crazy” is regarded as the mystic’s path and spiritual, highly regarded rather than anathematized.

This is nothing new. It has been observed before. So why do we keep going back to beating the same old same old drum: “We need better drugs to treat mental illness.” “We need better diagnostic methods to pinpoint mental illness. ” “We need better interventions to help the “mentally ill” who cannot or will not help themselves.”…YOWCH! Yada yada yada. Maybe we continue to bark up the same wrong, wrong, wrong tree. Maybe there is NO SUCH THING AS MENTAL ILLNESS, perhaps all along there has always only been physical illness. Perhaps much suffering, emotional and mental though it may be, is not illness, just part of the human condition, and while we want to ameliorate it, we call it illness at our peril.

More to come.

African American, Art, Health, Prisons, Psychiatry, Uncategorized

Monet or Moi?

November 13, 2012 Phoebe Sparrow Wagner Leave a comment

Cove with Sailboats - oil pastels ©Pamela Spiro Wagner All Rights Reserved — Monet or me? Well, okay, I am no Monet and this time I didn’t copy him… I painted this, with oil pastels, my second imagined seascape. mostly from memory. © Pamela Spiro Wagner All Rights Reserved

Better version of the above photo of my art piece is below this post (I managed to capture the entire picture finally and didn’t cut off most of the sky…)

I have just given a speech that I want either to record for putting up here, once I upgrade to Pro, or if it gets published as an Op-ed somewhere I will point you to it. But for now, let it only be a hint of things to come…

Otherwise, exhausted, I don’t have a great deal to say today except to point people to an article that I found in Science Daily, an article that I found both obvious in the extreme, and yet which I believe most people desperately need to read. If it isn’t time now to stop incarcerating people of color, for NO reason other than the color of their skin, then I dunno what time will be right for it.

Systematic Incarceration of African American Males Is a Wrong, Costly Path

ScienceDaily (Nov. 11, 2012) — Mental health experts from Meharry Medical College School of Medicine have released the first comprehensive report on the correlation between the incarceration of African American males and substance abuse and other health problems in the United States. Published in Frontiers in Psychology on the 12th of November, the report looks at decades of data concerning the African American population rates of incarceration and subsequent health issues. The authors conclude that the moral and economic costs of current racial disparities in the judicial system are fundamentally avoidable, especially if more resources are spent on education and treatment.

“Instead of getting health care and education from civil society, African American males are being funneled into the prison system. Much of this costly practice could be avoided in the long-term by transferring funds away from prisons and into education,” says Dr. William D Richie, assistant professor in the Department of Psychiatry and Behavioral Sciences at Meharry Medical College, lead author of the paper.

Money would be better spent on treatment than on incarceration

The study highlights the fact that with regard to African American males in the prison system, individual States are paying more to lock up non-violent offenders than they are for education, since 60% of incarcerations are due to non-violent, illicit drug-related crimes. The authors also point to a previous study from 2,000 showing that the total cost of substance abuse–be it incarceration, crime or treatment–is over $500 billion per year for the US.

These and other statistics have led the authors–scientific experts often called upon to testify in court–to conclude in the paper that: “Spending money on prevention and intervention of substance abuse treatment programs will yield better results than spending on correctional facilities.”

Need more teachers of color

Even though crime rates have dropped across the country over the past two decades, incarceration rates have continued to skyrocket–with black people accounting for a largely disproportionate 38% of inmates. More alarmingly, incarceration rates for African American males jumped 500% between 1986 and 2004. And while substance abuse increases the chances of individuals’ ending up in prison, those without any previous history of substance abuse have a higher risk of substance abuse once they leave the prison system, and could more easily fall back into the judicial system instead of getting a solid job or education.

According to Richie, much of this disparity is due to a fundamental problem of perception on both sides. For example, negative reinforcement of disruptive behavior is prevalent already in preschool–young children of color are often treated more harshly for behavior similar to their white peers.

“One step in the right direction, would be to have more black teachers during the early stages of development” says Dr. Richie. “From a behavioral scientific perspective, having teachers that look like the students and the parents of students from an early age could go a long way in changing perceptions of authority for black youth.”

Getting more African American teachers means increasing the number of African Americans in the higher education system and getting them out of the incarceration system. In the end, the authors conclude, effective treatment of substance use disorders and alternatives to prison would cost the United States much less and improve the lives of African American males, their families, and the entire country.

————————————————————–

The Original Science Daily article can be accessed here: http://www.sciencedaily.com/releases/2012/11/121112090734.htm?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+sciencedaily%2Fmind_brain+%28ScienceDaily%3A+Mind+%26+Brain+News%29

And PDF of the original paper (fairly short) can be found at this site:

http://www.frontiersin.org/Forensic_Psychiatry/10.3389/fpsyt.2012.00098/abstract

Health, Poetry

SISTERS OF NO MERCY

November 7, 2012 Phoebe Sparrow Wagner 4 Comments

POEM IN WHICH I SPEAK FRANKLY, FORGIVE ME

GOMER: ER-speak for a troublesome, unwanted person in the emergency department, acronym for Get Out of My Emergency Room

So many times gurneyed in by ambulance and police escort
“dangerous to self or others,” and too psychotic
to cooperate or scribble consent, you suspect by now
you are just a GOMER to the snickering scrubs in the ER
who whisk you in back with the other disruptives
lying in beds, waiting for “beds.”

One time you dip paranoid into the inkwell of your purse
extracting a paring knife more amulet than effective protection,
they strip-search you, then, unblinking, eyeball you all night
through a bulletproof plexiglass window.
In the morning, 15-day-papered so you can’t leave,
they send you ominously upstairs.

Later, at home, the voices decree your left leg
should go up in flames to atone for the evil within,
and you listen, and you do it, you do it:
the searing flare of cobalt actually crackles.
This time you tell no one, the char too deep for pain,
until fear of worse trumps your fear of being taken away.

This is not the story of your life.
It’s not the story of your life–
but every time a hulking goon squad clamps restraints
around your flailing wrists and ankles, threatening
to prosecute you for biting those hands that shackle you,
you wonder if there will be any other…

© Pamela Spiro Wagner. All rights reserved (Please note that I request that you do not reblog, reprint this poem or save this poem for anything but personal use. The rest of this blog post may be used if you credit Wagblog properly.)

________________________________________________________

A new reader, Rachel, has had training as a nurse, and is not reluctant to share her insights from the other side of the gurney, so to speak. Her comments have been enormously illuminating to me and contain so much helpful information that I have asked her if I might post them on Wagblog itself so others might have the opportunity to read them “first hand.” I have collected all of the ones here at Wagblog (there are others on my http://www.aboutschizophreni.blogspot.com site) and will try to provide some context for each one so they make sense, if they do not by themselves.

This first comment was in response to my post, AM I CRAZY…Nov 4, 2012 — when I doubted the veracity, of fact if not experientially, of what happened to me at the ED last summer.

Here is what Rachel wrote:

“OH….. Pam. I completely relate to this post…

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 rants 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 fiancée. 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 dangerous , 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.

Rachel

My response to her comment:

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!

Pam

Rachel’s next comment was in response to my two new artworks: first the Killer Nurse collage, and then the Monet “take-off” of Argenteuil boats at evening…:

…Killer Nurse, HAHAHAHA! When I was in nursing school, a group of my fellow students dubbed themselves (oh you are going to love this): “Sisters of No Mercy.”

They were, too! By the way, I was elected class president by my fellow nurse students, an honor I did not seek out. When I realized by the end of the first semester that I am not cut out to be a nurse, I thought I could not let down my much-younger classmates who had honored me so, by dropping out! Thus I kept slogging doggedly away, and made it through to the bitter end, making all A’s or 4.0s, I’ve forgotten now how we were graded. Then I took the final big test that determined one’s eligibility to get a license, shocked myself by scoring in the top 1% in the entire nation, gave the big Class President year-end speech at graduation, got my diploma, obtained my license, and…. I worked 3 or 4 days as a nurse, hoping to get my money’s worth out of my costly education, but I still wasn’t emotionally cut out to do the hard job of a nurse and I knew it, so I abruptly quit, and let my license expire.

If you have to be a “Sister of No Mercy” to make it in that profession, you can count me out!

Rachel

Then her latest comment is again in response to my blog entry titled AM I CRAZY? and my response to her first comment.

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” gung-ho 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 in 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 emergencies, 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 minimum 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 have 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 adrenalin-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!

Rachel

Finally, the following comment concerns my post “Open Letter to Dr Deborah Weidner (Sept. 9, 2012)”

The memories this post brings back…. I was shaking inside as I read it. It was hard enough going through this kind of mistreatment as a powerless teenage girl in a state mental institution, I can’t imagine going through this now, at the age of almost-60. I’m so sorry you were put through this. Until I read this just now, I thought your emergency room mistreatment of last July was the worst you had gone through recently. But this…. I don’t know how you came through it. I think if this had been done to me, I would have permanently checked out of reality.

Your feistiness is what’s keeping you alive. The very thing in you that the “wardens” of the mentally ill want to drug and shame and torture out of you, that undying spirit of yours is why you are still here, still breathing, still functioning, and still able to coherently tell your story. You are amazing.

Rachel

Art, Health, Uncategorized

Art: Killer Nurse and Placid Seascape

November 5, 2012 Phoebe Sparrow Wagner 7 Comments

: Boats at Evening, after Monet, 11 by 14″ © Pamela Spiro Wagner All rights reserved.

I do not have a lot to say tonight after yesterday’s marathon writing session, but I wanted simply to share my latest artwork. The first one, the collage, is going to be part of a talk I give to a group in December…I won’t say to whom or where just yet. All I will say is that this is how most psychiatric nurses deal with patients: “You do what I say, or else…”

The seascape on the other hand was simply a doodle I did one day while looking through an art book. I saw this Monet of boats at Argenteuil and thought I would sort of copy it, though not really. I just didn’t have any boats or water nearby to paint, so I figured I would use his painting as a model, a close one, though I clearly did my own thing with it…(And I am no Monet!).

Health, Mental Health, Mental Illness, Schizophrenia, Trauma, Uncategorized

Am I Crazy? Hallucinations, Delusions or Consensual Reality

November 4, 2012 Phoebe Sparrow Wagner 6 Comments

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.

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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.

Happiness, Health, Life, Memory, Mental Health, nature, Reflection, Uncategorized, Writing

Miracles: Four Life Changing Events

October 26, 2012 Phoebe Sparrow Wagner 2 Comments

512px-Common_self-heal_(Prunella_vulgaris)_--_flower_head_closeup — ©Jesse Taylor (Own work) [CC-BY-SA-3.0 (http://creativecommons.org/licenses/by-sa/3.0)%5D, via Wikimedia Commons

Okay, so as a friend suggested, maybe there have been five not just four miracles, with the most recent miracle having occurred, and ongoing, about three weeks ago. But more on that later. First, a definition of miracle, so we are all clear on what I mean here.

CS Lewis, a popular Christian writer of the twentieth century and still known for his Narnia Chronicles, wrote that “a miracle is something that comes totally out of the blue…” Now, he meant something extremely unlikely, like a virgin female giving birth to a child. Now, apparently, this has been observed at least once in modern times. If you don’t believe it, and can understand the technical language, you can read the following abstract as proof. Then you can decide whether or not virgin birth still counts as a miracle:

Fertil Steril. 1992 Feb;57(2):346-9 .

Chimerism as the etiology of a 46,XX/46,XY fertile true hermaphrodite.

Verp MS, Harrison HH, Ober C, Oliveri D, Amarose AP, Lindgren V, Talerman A.

Source: Department of Obstetrics and Gynecology, Chicago Lying-In Hospital, Illinois.

Abstract

OBJECTIVE: To determine the conceptional events resulting in a 46,XX/46,XY true hermaphrodite and to report the first pregnancy in a 46,XX/46,XY true hermaphrodite with an ovotestis… (see the rest of the abstract at PubMed)

Another thinker, British mathematician John Edensor Littlewood, suggested in what became known as Littlewood’s Law that statistically individuals should expect one-in-a-million events (“miracles”) to happen to them about once a month. By these calculations, seemingly miraculous events are actually commonplace.

And of course there is the dictionary definition of miracle, which is the one commonly accepted by both religious people who believe in miracles, and those who do not believe in their existence, but who do accept the definition of the word.

mir·a·cle/ˈmirikəl/

–A surprising and welcome event that is not explicable by natural or scientific laws and is considered to be of divine origin

–A highly improbable or extraordinary event, development, or accomplishment

I myself would add a third, and relevant definition, or qualifier, which is “if it occurs in an individual person’s life, the event produces changes, beyond any that could have been imagined prior to the miracle, in a positive direction wholly unexpected and therefore regarded as miraculous.” To be cured from a terminal or crippling illness is of course a miracle. But so too to my way of thinking would be remission from a future-destroying addiction or mental compulsion. Needless to say, complete reversal of a severe mental illness would count as a miracle. And I can think of others that might be counted as less effulgent but just as miraculous.

Given those broader categories of miracles, then, I will proceed to tell you of mine. I do not know what the Course on Miracles is all about, nor anything of the Miracle classes offered online. If there are similarities, I dunno what it means, except that we came up with our thoughts completely independently. I have spoken of the following things as miracles for many years now without any familiarly with the C.O.M or any other such program.

So, onward to my First miracle. (Alas, I fear I will have to deal with the Second Miracle and the Third, Fourth and Fifth in following posts as this one is already getting long enough and will be longer by the time I am finished.) The first miracle concerned, as some readers may remember, plants, wild plants, field botany, in short, the wonders of the wild green world. But not just that, no, it was the discovery in myself, utterly unanticipated, of a bizarre and wonderful ability to simply know, almost without any idea how I knew it, any plant I came across. In fact, I must have seen them, if briefly, in some plant book or field guide, but it was truly uncanny, my ability to instantly recognize and categorize whole families and genera and then the species within them just by casually looking at any plant, flower or tree I saw, having but glanced at a simple sketch or pencil drawing of a plant the night or even a week before seeing it in the wild.

I once wrote about this miracle in my first blog at http://www.schizophrenia.com. Although the essay has a less than happy ending that has nothing to do with miracles, I will reprint the essay in its entirety here. Suffice it to say that the pivotal moment, the chairotic moment and miracle that surrounds “Prunella,” which I describe early in the piece, changed my life forever.

WILDFLOWERS ON THE ROAD TO DAMASCUS

Thirty years ago, I took the natural history course purely for exercise. I figured, what better way to stay in shape than to get credit for it? At the time, I couldn’t tell a maple from an oak, let alone one old weed from another, and it wouldn’t be easy. But just to keep off the flab would be a benefit in its own right. Since the prospectus promised daily field trips, no mention of love or awe or wonder, the last thing I expected was a miracle.
Showing up for the first day’s trip, I wore old tennis shoes of the thin-canvas Keds variety. I had no idea L.L. Bean’s half-rubber hiking boots were de rigueur for a course of this kind. What god-awful-ugly shoes just to walk in the woods! I thought in horror. Right then, I realized I’d made a huge mistake and it was too late to change my mind — I’d have to stick it out for the whole semester. I knew for sure I was going to be more miserable getting “exercise” than I ever would have with my thighs turning to mush, safe in the college library.

The teacher, Miss G, took off stomping down the path and we tramped on after her. I was last, straggling behind, half-hoping to get lost so at least I could head back to civilization. Before we’d gotten far, she halted, peering intently at something near her feet. She waited for us to catch up and gather round her, then pointed at a weed. “Heal-all. Prunella vulgaris,” she announced sternly and without passion. “Vulgaris means ‘common.’ Learn names of both genus and species. Be forewarned, ‘Heal-all’ by itself will not be an adequate answer on your quizzes.”

She stepped aside so we could take a better look. As instructed, one by one the class dutifully wrote down a description and the two names we’d been given. I was still at the back, waiting my turn without the least enthusiasm, let alone the anticipation of what, in those days, we called a “mind-blowing” experience.
“Come on, now, don’t be shy. Step up and look for yourself,” Miss G scolded me, pushing at my elbow to propel me closer.

Finally the clump of students cleared out and I had a better view. For some reason, I found myself actually kneeling in front of the weed to look at it close up. Then it happened. As if the proverbial light bulb flashed on over my head, I understood what Miss G meant when she’d said: “Weeds are only wildflowers growing where they aren’t wanted.”

Prunella, I know now, is no more than a common mint, found in poorly manicured lawns or waste ground. Yet, with its conical head of iridescent purple-lipped flowers and its square stem – on impulse, I’d reached out to touch it and discovered an amazing fact: the stem wasn’t round! – Heal-all was the single most beautiful thing I’d ever seen. The world went still. There was only me and the flower and the realization I’d fallen in love.

Since one of my other courses concerned the history of early Christianity, I knew immediately what had happened. Like Paul on the road to Damascus, I’d been struck by unexpected lightning. I’d been converted. I put away my notebook, knowing I didn’t need to write down a word, knowing I’d never forget “common Prunella” as long as I lived.

There were other miracles in my life after that, but none came close to the thunderbolt that knocked me flat the afternoon I saw, truly saw, that homely little mint for the first time. “Sedges have edges and rushes are round and grasses have nodes where willows abound.” Yes, I learned such mnemonics, which helped me as much as the next person when a plant was hard to identify. But I discovered in myself an amazing feel for botany that was like sunken treasure thousands of feet beneath the ocean. Once I knew it was there, I had merely to plumb the depths, more or less unconsciously, and gold would magically appear.

I went walking in the woods every chance I got and carried Peterson’s guides with me even into town, checking out the most inconspicuous snippets of green that poked through the sidewalk cracks. The first time I came out with a certain plant’s genus and species before Miss G told the class what we were seeing, she looked at me oddly. I began repeating this performance until once she even allowed me to argue her into changing her classification of a tricky species. If I still hung back behind the group as we walked, it was no longer from reluctance. I was simply too entranced, looking at each tree, to keep up the pace.

By December, as the semester was coming to a close, Miss G had begun using me as her unofficial assistant, asking my opinion whenever there was a question as to what was before us. Oh, I confess, I never did get the knack of birds. It was the trees and wildflowers that stole my heart entire.

At the end of the semester, we received course evaluations in lieu of letter grades. I opened mine eagerly, expecting praise. Instead, Miss G was terse and unenthusiastic: “Pamela faithfully attended every field trip, but for most of the course she failed to share her insights and established expertise with the rest of the class.” End quote. “Failed to share her established expertise“? What was she talking about? Did she think I’d already known everything she taught us? How could she not understand what she’d done for me, introducing me to little Prunella, how I’d learned everything I knew after that moment, not before?

It was the worst evaluation I’d ever gotten, the injustice of which struck me to the marrow. I went to her office to explain and found a sign on her door saying she’d been called away on a family emergency and would not be returning until the next semester. But I wasn’t returning for the second semester. I was transferring back to my original school.

I caught my ride home, spending four hours crammed into the back of an old Volkswagen bug with two other students, wordless with indignation that replayed and reverberated through my mind. How could she think such a thing? I couldn’t stop writing a letter of protest in my head as the highway flowed endlessly beneath us.

I did write Miss G, finally, explaining all she’d awoken in me, emphasizing the magic I’d discovered in her class, my new-found joy and amazement. At the end of March I got a reply, but no apology, no hint that she understood she’d misunderstood. Not even appreciation for my gratitude towards her and what her course had done for me. Just a brisk, no-nonsense note, little better than a form letter. I had the impression that she didn’t quite remember who I was, that I was just another faceless student writing to her about a natural history course she’d taught perhaps forty times in her long career as a teacher.

Whether she knew who I was or even recognized what she’d done for me mattered little in the end. What did matter was that when I met homely little Prunella, I discovered the whole world in a common weed.

©Pamela Spiro Wagner, 2004

The next posts, or in the following weeks, I hope to cover the other four miracles. If you are interested in them, and I fail to follow through, feel free to “goose” me with a reminder. My mind is a sieve and I rarely remember anything without a string tied to my thumb! 8D

Death penalty, Health, Health Care Reform, Mental Illness, Schizophrenia

Florida to execute paranoid schizophrenic tonight absent intervention from Supreme Court

October 23, 2012 Phoebe Sparrow Wagner 2 Comments

Florida to execute paranoid schizophrenic tonight absent intervention from Supreme Court.

Thanks to the excellent blog, Dispatches from the Underclass, we have the post above. It is disgusting but true that in some – too many states! – “we” are still executing the most severely mentally ill…

Acceptance, Forgiveness, Poetry, Writing

Poem about Forgiveness,Translated into Chinese

October 14, 2012 Phoebe Sparrow Wagner Leave a comment

TO FORGIVE IS

To begin 要寬恕的實是太多

and there is so much to forgive: 頭一樁要算

for one, your parents, one and two, 你父母那麼偶然的一或二次

out of whose dim haphazard coupling 於幽暗中的契合

you sprang forth roaring, indignantly alive. 你呱呱來臨,憤然降世

For this, whatever else followed, 為此, 為這帶來的一切

innocent and guilty, forgive them. 無意也好作孽也罷,寬恕他們.

If it is day, forgive the sun 若是白天,寬恕太陽

its white radiance blinding the eye; 原宥它的奪目光芒

forgive also the moon for dragging the tides, 亦要寬恕月亮帶來的潮汐

for her secrets, her half heart of darkness;原宥它的弔詭.它的暗晦

whatever the season, forgive it its various 管他冬夏秋春.寬恕季節的多端侵擊

assaults—floods, gales, storms 水患,疾風,暴風雪

of ice—and forgive its changing; 原宥它的更替變易

for its vanishing act, stealing what you love 它的掠奪行徑

and what you hate, indifferent, 把你所愛所恨無情的奪去

forgive time; and likewise forgive its fickle 寬恕時間

consort, memory, which fades 同樣地原宥它的變易不忠,連記憶也不放過

the photographs of all you can’t remember; 以至你把擁有的拍照忘得一乾二淨

forgive forgetting, which is chaste 寬恕失憶

and kinder than you know; 它實是忠貞和比你所認知的仁厚得多

forgive your age and the age you were 寬怒年齡

when happiness was afire in your blood 原宥當年的你,那時幸福在血液沸騰

and joy sang hymns in the trees; 喜樂在樹叢間高唱聖歌

forgive, too, those trees, which have died; 寬恕那些逝去的樹木

and forgive death for taking them, 原宥奪走它們的死亡

inexorable as God, then forgive God 若感上主不仁,則寬恕上主

His terrible grandeur, His unspeakable原宥祂畏人的堂皇和禁說的名字

Name; forgive, too, the poor devil 亦勿忘寬恕那倒霉的撒旦

for a celestial fall no worse than your own. 他那屬天的失足並不比你的過犯糟糕

When you have forgiven whatever is of earth, 當你把地上天上水裡

of sky, of water, whatever is named, 有名的無名的

whatever remains nameless, 通通寬恕了

forgive, finally, your own sorry self, 最後切記寬恕

clothed in temporary flesh 那包裝在短暫肉體內

the breath and blood of you 血氣正在消亡的

already dying. 悔疚的你

Dying, forgiven, now you begin. 垂死,被寬恕的你,現在要重新開始.

By Pamela Spiro Wagner, “Divided Minds” 胡思亂想

Chinese Recreation/Translation by Kenneth Leung Sep 3rd 2012, Labour Day Scarborough, Ontario

—————————————–

I received the email below very recently, explaining the poem above. The only thing missing is the translation of the title, which segues on purpose directly into the first line, and so it too is essential. I hope that Jackie’s father might one day provide that title line. Nevertheless, I am thrilled that anyone likes the poem enough to translate it. Thank you so very much, Kenneth Leung. And thank you Jackie, for sharing it with me and allowing me to share it here.

“Hi Pamela,

“I recently picked up your book “Divided Minds” and I couldn’t put it down. Thank you for sharing your story with the world. I’m an Occupational Therapist working in community mental health on an ACT team, so I interact regularly with people with schizophrenia. Your story allowed me to see how difficult it is to first accept a diagnosis of schizophrenia, and then the difficulties of adhering to treatment. I especially love your poem on forgiveness and shared it with my dad, who translated it into Chinese. I thought you might be interested in posting it on your blog so Chinese readers can enjoy it.

“Blessings,

“Jackie Leung”

Death, Health, Life, Physician-Assisted Suicide, Reflection, Suicide

To Kill or Not to Kill: Physician-Assisted Suicide?

October 3, 2012 Phoebe Sparrow Wagner 3 Comments

My brother visited me recently and for some reason we got into a discussion about whether or not we supported physician-assisted suicide. We differed on the fundamentals: Phil, aka Chip, supports assisted suicide in every sense of the word. He thinks that it should be legal for a physician to prescribe a lethal medication essentially for anyone who asks.

This horrified me. Wait, he went on to explain. In his opinion, everyone should have to push a button upon waking in the morning in order to stay alive. If you failed to push it, you die. Meaning that the day would begin with everyone choosing to live, thus having to take responsibility for making that choice. We would start with the premise that every person who “wakes up alive” has chosen to live and cannot claim rightly to be suicidal…I guess that Chip as a psychiatrist, feels too many of his patients do not want to live, but also do not sincerely want to die, and he thinks that they need to acknowledge the latter. That might be good, but I also know that there are those who are so depressed that in their involuntarily mentally incapacitated state, they might not be able to press the “I want to live” button, and thus would die, even though in a healthier frame of mind, they would have chosen to live…

For me, I agree that when terminally ill, a person should have the right to end his or her life, and should be able to do so without interference from authority, legal or medical. I also think that in certain cases, palliative or hospice care helps with this, and already has done, silently and as it were secretly for years: the administration of a sedating dose of morphine when the time is right goes a long way towards assisting a person’s “dying process.” Not a lethal dose mind you, but a dose to “ease breathing” and one from which the physician and all witnesses understand the person will likely never awaken.

(My friend Joe is another case entirely. They turned off his ventilator and dosed him with morphine after 4 years with ALS. I firmly believe that they murdered Joe outright, against his will…But no more will be said of that at the present time.)

On the other hand, let’s face it, if you really want to commit suicide, it is easy to do so if you are able-bodied and not terminally ill: just jump in front of a bus, or out of a tall building’s window. There are a dozen sure-fire ways and they have been used for millennia as an easy way out. The problem is for those who are physically so debilitated that they literally cannot “jump” or swallow the pills or whatever. Yet unless they are forcibly nourished and hydrated through a feeding tube, they can always refuse food or liquid, which it seems is not agonizing after all. That is according to what recent research and personal witness (my own) have indicated. When my friend Lynn L died – essentially from not a refusal to take liquids– she did not suffer acutely from deprivation but seemed slowly to cross into a never-never land. She simply drifted off to an endless sleep and passed away.

The idea that a physician could freely prescribe an overdose of a lethal drug to any someone who came asking for it, that just strikes me as the height of 1) irresponsibility and 2) cruelty, by someone whose job, after all, is characterized by the Hippocratic Oath: primum non nocere or “First do no harm.” If killing a patient is not doing harm, then I do not know what is. I simply do not understand how bloodying one’s hands in the act of killing, no matter how good one’s intentions, cannot but badly affect any so-called healer.

Surely there are other ways to deal with a person’s pain and suffering than to throw up one’s hands and say, well, I cannot help you feel better or live longer, so I will simply shoot or poison or – whatever – you so you feel nothing and don’t have to deal any longer.This completely disregards the inherent value of the struggle itself, and the promise of something worthwhile, if only at the very end at the moment of dying, in having faced the suffering and undergone it fully.

Look, I do not like or want anyone to suffer agony in the last stages of life, and am all for morphine use, liberal or sparing, depending on the patient’s desires and needs. But there is no absolute value in complete suffering or pain relief, not in my book. For me, I insist that I must feel my own feelings, and in that quest, I must decide to feel the pain, emotional or otherwise, rather than dull it with drugs or anything else. Yes, it hurts, but the hurt somehow feels better because it is mine and real, and not the forced dull nothingness of being drugged out of it.

If you have other thoughts about this, do feel free to share them in the comments section. In the meantime, I found this article on the very same subject at Medscape Psychiatry. It was written by ethicist and psychiatrist, Ronald W. Pies, MD and may be found in its original form at this link:

http://www.medscape.com/viewarticle/771274

Medscape Psychiatry > Ethics in Psychiatry

Do We Need ‘Thanaticians’ for the Terminally Ill?

Ronald W. Pies, MD

Posted: 09/26/2012

The Ethical Dilemma of Physician-Assisted Suicide

My 89-year-old mother had been losing ground for some years, experiencing what geriatricians sometimes call “the dwindles.” Toward the end of her life, she was beset by a deteriorating heart; an inability to walk; and occasional, severe gastrointestinal pain. My family got her the best medical treatment available — eventually including home hospice care — and she generally maintained a positive attitude throughout her long downhill slide.

But one day, as I sat beside her bed, she seemed unusually subdued. “Honey,” she said, “How do I get out of this mess?” I had a pretty good idea of what she was really asking me, but I deflected her question with another question: “Ma, what ‘mess’ do you mean?” I asked. “It’s all right,” she replied, smiling sadly, “I’ll manage.”

My mother was doing what she had always done: sparing her children from pain. In this case, it was the pain of dealing with the waning days of her life and the frustration of knowing there was no easy escape from the burdens of dying slowly. “Ma, I’ll always make sure you are getting enough treatment for your pain,” I added, taking her hand — knowing that the prospect of unremitting pain is often an underlying fear of terminally ill persons.

Yet, unspoken in my mother’s question was the issue of so-called physician-assisted dying, sometimes called “physician-assisted suicide” — an enormously heated controversy both outside and within the medical profession. In my home state, Massachusetts, the issue has come to the fore, owing to a November ballot initiative for a measure that would allow terminally ill patients to be prescribed lethal drugs.^[1] A closely related bill (H.3884) has also come before the Massachusetts Legislature’s Joint Committee on the Judiciary.

Similar to laws already on the books in Oregon and Washington state, the proposed Massachusetts law builds in numerous “safeguards”: For example, patients would be required to submit their request in writing twice, and those requests must be 15 days apart. As reported recently in the New York Times,^[2] fears regarding widespread overuse or abuse of the so-called “death with dignity” laws in Oregon and Washington have largely failed to materialize, at least according to some studies.

Nevertheless, the Massachusetts Medical Society (MMS) has long been opposed to physician-assisted suicide. In March 2012, the MMS President, Dr. Lynda Young, testified before the Joint Committee^[3] and did not mince her words. Allowing physicians to participate in assisted suicide, she stated, “…would cause more harm than good,” and she argued that “…physician-assisted suicide is fundamentally incompatible with the physician’s role as healer.” Instead, Dr. Young asserted, the physician’s role should be to ensure that the terminally ill patient “…continue[s] to receive emotional support, comfort care, adequate pain control, respect for patient autonomy, and good communication.”

With considerable ambivalence, I agree with Dr. Young. In my view, terminally ill but mentally competent patients should be at liberty not only to refuse further medical treatment, but also to end their own lives — for example, by refusing to accept liquid or solid food. Contrary to a widespread belief, voluntary refusal of food and fluids does not result in an agonizing or painful death, according to a2003 report in the New England Journal of Medicine.^[4] Indeed, medical ethicist Dr. Cynthia Geppert informs me that voluntary refusal of food and drink is now considered an accepted approach to dying in palliative care.

As Dr. Thomas Szasz has argued in his book, Fatal Freedom: The Ethics and Politics of Suicide,^[5] a liberty is not the same as a right, because the latter entails a reciprocal obligation on someone else’s part. (If I have a right to free speech, the state has a reciprocal obligation to protect that right.) Moreover, the liberty to commit suicide does not entail the “right” to have one’s physician prescribe a lethal dose of medication. Indeed, Dr. Szasz believes that “physician-assisted suicide” is really a euphemism for “medical killing” — more technically, “heterohomicide” on the part of the physician.

While I disagree with Dr. Szasz on many issues in psychiatry, I think his analysis here is essentially correct. Physician-actuated heterohomicide, in my view, is “fundamentally incompatible with the physician’s role as healer.” I believe that permitting physicians to write prescriptions for lethal drugs will eventually erode the trust that all patients should place in their physicians. More than a euphemism, “physician-assisted suicide” may be a contradiction in terms. And in my view, the very concept violates both the implicit ethical contract between physician and patient, and that between the physician and society.

To be clear: None of this means that physicians should collude in the cruel and unnecessary prolongation of dying, as is often seen in hospital settings. As physician and ethicist Dr. Fred Rosner has argued,^[6] “To prolong life is a [commandment], to prolong dying is not.” Thus, in the Jewish medicoethical tradition, “removing impediments to death” is sometimes acceptable — that is, discontinuing treatments that needlessly prolong the dying of a suffering, terminally ill patient, but without actively bringing about the patient’s death. (The distinction between “letting” someone die and “making” someone die was supported in the 1997 US Supreme Court case of Vacco v Quill,^[7]which upheld New York State’s ban on assisted suicide.)

But what about those suffering, terminally ill, mentally competent patients who will not choose to end their lives by refusing food and drink and instead seek out “assistance” from healthcare professionals? Again, I do not believe that medical professionals should participate in assisting a patient’s suicide. But I sometimes wonder whether society ought to permit somebody to do so.

For lack of a better term, let’s call such a hypothetical individual a “thanatician.” Let’s posit that carefully trained and closely monitored thanaticians would be permitted to provide medically screened, dying patients the same type of lethal medication now prescribed by physicians in Oregon and Washington — under essentially the same restrictions and safeguards.

But wait: Isn’t this proposal a cop-out? Doesn’t it merely place the moral issue of assisted suicide in the lap of the nonphysician, allowing the dying patient’s physician to shuffle off with a clear conscience? Even worse: Would the use of such death-dealing personnel amount to abandonment of the patient, as Dr. Geppert recently suggested to me?

Still other questions arise. As my colleague Dr. James L. Knoll has suggested, might not the training, monitoring, and supervising of thanaticians create more problems and headaches than it would solve? Finally, doesn’t the very notion of “thanaticians” suggest that we have lost faith in what Dr. Knoll rightly calls “the intensely personal journey” of doctor and patient?

I, too, struggle with these questions and find no easy answers. I suspect that at present, the best approach to the dying patient is through the skills of the palliative care physician. Palliative sedation, for many terminally ill patients, may be a viable alternative to managing suffering without ending life. Moreover, a careful psychiatric assessment of patients requesting physician-assisted death is always indicated, because major depression may distort the patient’s judgment as death approaches.

How we deal with terminally ill patients is a painful topic that I never discussed with my mother, who was fortunate enough to have excellent home hospice care in her final days. But I believe this is a discussion we urgently need to have.

Acknowledgment: I wish to thank Cynthia M.A. Geppert, MD, PhD, and James L. Knoll IV, MD, for their valuable comments on earlier drafts of this article. The views presented here, however, are solely my own.

Health, Health Care Reform, Medication, Mental Health, Schizophrenia, Uncategorized

Psych Meds: Are We Crazy to Take Them?

September 26, 2012 Phoebe Sparrow Wagner 4 Comments

Broken — We are broken in so many ways. Here I am naked in the seclusion room in the left lens, and the right lens is broken over the biohazard sign, a symbol that stands for so many dangers…© All rights to this picture are reserved. Please contact me if you want to use it for any reason.

On Medscape yesterday they ran an article/video by a Dr Jeffrey Leiberman, lamenting the failure of three psychotropic drugs –one for the treatment of schizophrenia, and the others for Alzheimer’s — to pass beyond either phase 3 or phase 2 clinical trials. This is part of what Leiberman had to say (please note that the emphasis is decidedly mine…)

“The brain is an organ that is orders of magnitude more complex than any other organ in the body. The brain has 100 billion cells. Each of the areas of the brain is organized cytoarchitecturally differently, and the cells connect via over 30 trillion synapses. Compare this to the heart, the liver, the gastrointestinal system, or the lungs, and there is no comparison in terms of complexity and intricacy. In addition, given the fact that we are developing treatments for brain disorders that affect mental function and behavior, the animal models that are an essential component of biomedical research and drug development are limited, because how can lower species like rodents model the complexity of human behaviors and mental disorders that we are trying to correct pharmacologically?

“In addition, the biomarkers we use to signal the effect of the treatment or prove the target engagement of a molecule at the desired location in the brain or protein in the brain are still in development and not fully validated. Thus, the complexity of the brain and the limitations of existing tools make the prospects of certainty in drug development [for brain disorders] more questionable than in other organ systems and disease areas. “Certainly the research community and the National Institutes of Health (NIH) understand the importance of redoubling our efforts to develop treatments for this important group of disorders. The NIH has recently established a new Institute, NCATS, or National Center for Advancing Translational Science, which has as part of its core mission drug discovery and development. In addition, various other Institutes have put out RFAs [request for applications]; this includes the National Institute of Mental Health, which has initiated a series of what are called the “fast programs” to identify drugs that exist within the pharmaceutical industry and may no longer be under development, but can be repurposed for study for specific disorders. A quick, rigorous study using a fast-fail strategy can determine whether these agents have the potential for further development.

“New efforts are coming from the biomedical research community as well as the NIH to spur drug development. I hope this will act as a catalyst for the pharmaceutical and biotech industries to not despair or back away from the risk of developing drugs in these areas, but rather to find the resources to support drug-development programs for these disorders.

“What is the benefit? Anyone who works with psychiatric patients knows that there are tremendous unmet clinical needs, whether in schizophrenia, depression, bipolar disorder, autism, or Alzheimer disease. With these needs come tremendous market potential, so for those who stay the course and persevere, there will be very lucrative rewards .To me, this seems like a great opportunity, and I think our partners in the private sector should appreciate this. I look forward to partnering with them to try and work in a way that uses their precious resources most efficiently but still serves our scientific goals and the needs of our patients. Thank you for listening.”

Yes, I noted the last statement, that he wants to serve science and his patients, but i could not help but feel great dismay at the other statements, including the first, that largely states what I already suspected: using animals to prove anything about human brain disorders or states of mind is downright ridiculous. All you can say about a rat’s “schizophrenia” is that it appears to “behave” in some fashion that looks similar to someone who is psychotic…but how would you know if a rat is psychotic, or hallucinating or thinking in a delusional fashion?

Come on? How would you know if a rat had negative symptoms of schizophrenia, or was depressed, or simply felt lethargic because it was hungry or drugged or sleepy or some other physiological reason. Well, you likely could not! Using animals that can not communicate with us to model human mental functioning is downright silly, and yet it seems to have only just occurred to Dr Leiberman, perhaps in his own disappointment with the glutamate-dampening anti-schizophrenia drug that just went bust…I dunno.

Once again, having read about how they are using Ketamine to treat 6-12 years olds with bipolar illness (mind you, I am not convinced that the children are actually Bipolar, only that more and more kids are being diagnosed because conveniently shrinks are allowed to drug them with Abilify and Seroquel and other adult antipsychotics and the drug companies push it on them, pay them for using it etc)

I believe that the use of psychoactive drugs and the rampant use of them is more often inappropriate than not. Truly. The very idea that Abilify and Seroquel are prescribed willy nilly for everything from insomnia to mild anxiety is just plain SCARY. Has anyone out there taking these drugs even bothered to read the side effects, or do they no longer care what they are taking? Obesity no longer scares anyone, but what about diabetes and high blood pressure, nope, I guess not, since those are epidemic too.

It truly astounds me how both those drugs, not to mention a whole host of other powerful drugs are being pushed on the American public, but we are a public that LOVES to take drugs rather than deal with problems by, well, looking at ourselves and thinking about what our responsibilites are and how we might change things…and doing some hard work and hard thinking about things…No, god forbid, why not just take a pill and forget about everything else, and if the pill doesn’t do anything, well, then, probably we are incurably ill and need to take those useless pills for the rest of our lives, because if we didn’t take them we might might might be even worse than we are taking them, right?

Not! Why do we take drugs that don’t help us, or that we do not notice any benefit from (though the shrinks are always willing to point out to us how much better “you are feeling”), drugs that might even make us feel worse in other ways.

Some people who are depressed lose all sexual enjoyment and functioning from their antidepressants, but refuse to stop the drugs because they are afraid…even though the drugs themselves make little difference in their mood, but their lack of sexual pleasure and responsiveness surely has…in a negative way. Why do they continue taking the pills? Hope? Obedience? Uncertainty? Perhaps all three…They may hope that if they take the antidepressant just a little longer, the side effects will “go away” as their doctor likely assured them, and they naturally want to be an aobedient and good patient, so they keep complying. And of course, depressed as they still are, uncertainty about the future plays a huge role, since how do they know that things wouldn’t get even worse, should they cease taking these pills that the doctor says not only will help them but somehow noticeably is helping them, whether they feel it or not.

Argh. I am reading a book, Rethinking Madness, by Paris Williams, PhD. and it is a very interesting take on psychosis and the treatment of it. He suggests that it is NOT always a lifelong condition, or that one breakdown means that one needs to be on medication for life, or in fact that even with repeated psychotic episodes, one can be on intermittent medication and at low doses. I have difficulty reading, myself, so I have not read far along, but the first case study discussed a man who became psychotic suddenly in the late 60s or early 70s when he was threatened with the draft. After that he was ill for a long period of time, in and out of madness until he met the “right doctor” at age 28 or so. I believe it was then that he made the slow transition off all medication and since he was 35 or so has been off meds altogether. And has been well. Recovered, in every sense that matters, completely.

Everything about his history would today dictate that he never be taken off meds, and would mitigate against his ever dreaming of working in the mental health system, let alone as a worker in a state hospital. Yet this is where he has been employed for many years…(I may misremember some details, but that is the gist of it.) I could scarcely wrap my mind around such an outcome…it seemed that amazing.

Yet, I cannot be envious, because I know how often I tried to get off my medications, and because I did not know how, I likely induced a recrudescence of psychosis without even understanding that was what was happening. And naturally, they put me back on the drugs again…It was not my fault, just how it was in those days. I didn’t know, and they still don’t! Even now, though, I do not know if I could get off the meds.

But in my case, I am not sure I want to, largely because I function so well on them. I write, I do art, I sleep well, I am not obese, I have no chronic physical health problems because of them…So I have no pressing need to get off the antipsychotics, nor the anti-seizure meds, which I may need due to temporal lobe epilepsy anyhow. I would like to get off the sertraline, yes, and we are working on that. But why fix what ain’t broke at this particular time? I mean, I only got out of the danged hospital a month ago, and it would seem a little, er, crazy to fiddle with things this soon, much as I wish I could. On the other hand, I don’t mind taking these meds, because by and large, I believe, frankly, that my body has re-established some kind of homeostasis and has adapted to the lowered dopamine…so it has ramped up production to a different balance, meaning that I am fine where I am, but would risk a massive overload should I stop cold turkey.

OTOH, I do not yet understand the absolutely immediate improvement in all my mental capabilities when I take Zyprexa. Yes, I eat and eat and eat. But I can read and pay attention to people telling me things to movies and the TV and just “intake” in a way that I cannot now and have not in years…And it is literally within 2 doses. That cannot be a matter of homeostasis so what is it? Can Zyprexa be the ONLY drug that actually has some beneficial effects? I doubt it. So what is it? Anyhow, any comments on these points would be appreciated. I don’t mind if you want to argue to the contrary, if you feel it strongly. I am here to hear different points of view as well. Though you know of course that I may “argue” with you back! All in friendship and good cheer.

Health, Health Care Reform, Hospital, Natchaug Hospital, Uncategorized

A Mental Health Meeting of the Minds: Natchaug Hospital Administrators Get Gold Stars

September 22, 2012 Phoebe Sparrow Wagner 3 Comments

Entrance to Natchaug Hospital — This is the front entrance to Natchaug Hospital, a photo I cribbed from their Facebook page. I am trying to paint it, but that will take a while so for now, this will have to do…Hope I am not infringing a copyright. However, as this post is all about Natchaug it is good publicity too!

After I wrote my early September post “Open Letter to Deborah Weidner MD”https://wagblog.wordpress.com/2012/09/02/open-letter-to…chaug-hospital/ ‎about my stay at Natchaug Hospital in August, I received a phone message one Saturday afternoon not long afterwards from none other than Dr Weidner herself. She left her cell phone number and asked me to call her back. Her voice was neither angry nor upset, quite the contrary, she sounded very pleasant. So, despite my heart’s clangor in my ears at the same time as it drove nearly into my esophagus with its nervous pounding, I sat down and decided to make the call “without further ado.”

“May I speak to Deborah Weidner?” I asked the voice who answered, intentionally using her first name, so she would not think I was calling on unequal terms, i.e. as a patient.

She responded, and addressed me as “Ms Wagner,” which made me feel better at once. Then, before I said a word, and believe you me, I was not going to be the first to speak in any event, she said (and I quote from a less than perfect memory here, so this is not verbatim), “I read your blog post. You are such a gifted writer. It was really a wonderful piece…” Or words to that effect.

I was both stunned and amazed. Certainly I was amazed this was the self-same “head honcho” who had essentially, so I’d felt in August, been against me at the hospital along with so many others in charge, the MD who had – I felt – given up on me, called me “a borderline”*** and gotten rid of me at the earliest possible opportunity. She could, back in August, so easily have tried to help, tried to find out what had gone wrong and make things better. But it seemed to me at the time that she had simply gone along with the general ill-will towards me and dumped me, no matter how troubled I still was.

Note that when I say, “general ill will” I mean exclusively “the management” — the doctors and social workers and APRNs…those who did the diagnosing and disposing. From the nurses and mental health workers I felt nothing but great support and goodwill, almost to a one (minus, of course, my abusers). Even of the nursing supervisors I found only that single really awful one…at least to my face.

But as for Dr Weidner, I’d felt that she too had decided to “blame the victim” instead of taking responsibility for the very real traumas, which certain “bad egg” hospital staff had inflicted on me…

However, be that as it may, it is all water that has sluiced beneath the bridge, and so as I said, I was stunned to receive Weidner’s phone call. I was even more astonished to perceive such humanity and even warmth from this woman against whom I had conceived such animosity and from whom I had felt the same.

Here she was not only praising my writing skills but speaking approvingly of a blog post that concerned my very negative month-long stay in “her” hospital.

We talked for a while. She may not have known it but I was trembling, both with anger and with anxiety. It took me some time to calm myself, to feel safe enough to answer any of her questions. Finally, she said what she evidently had called about to begin with. “I wonder if you would consider coming back to talk with me and a few other interested people here at Natchaug. I would really love to speak with you.”

I was dumbfounded for a minute. But only for a minute. Then I found my voice, and as soon as I did, I responded with enthusiasm. “Yes, absolutely. I would love to do that. Thank you. I would be more than happy to speak to you and anyone else who would listen to me.”

“Thank you, Ms Wagner. We really want your input, we want to make Natchaug a better place and I think your insights can help us to do that.”

After we hung up, I was beaming. I felt so filled with light that my smile must have been big and bright as a beneficent Halloween pumpkin. I immediately went downstairs to the 7^th floor to share the news with my friend of 30 years, a friend who had been appalled when I came home in August in such terrible shape.

_________________________________________________

Well, that meeting took place yeseterday, Friday, at 9am. Brityn, my case manager drove me out to Natchaug, and I brought with me the oil pastel painting I’d done while there, the view of the nurses station from my room. I am donating it to the adult unit mental health workers’ breakroom, after Brian, the patient relations advocate, who is both intelligent and caring and an extraordinary listener, displays it somewhere publicly for a time.

When we got there, we were met by the director of nursing, John O, APRN. Shortly thereafter Dr Kline came along and we went into a little room off the lobby. I was a taken aback at first when, while waiting for Dr W, John and Dr Kline started talking with Brityn, as if she were the only person in the room, as if, “professional to professional,” they could ignore me, a mere patient once again.

This was unconscionable. I was the person with whom they ought to have been concerned, and instead they directed themselves wholly to Brityn. It also felt infantilizing. Why didn’t they even greet me or ask how I was doing since I’d left Natchaug? They could have at the very least made small talk with me. Instead, they chatted with Brityn, someone who is not only my junior by about 30 years, but with whom they’d had no prior interactions whatsoever and whom they didn’t even know. It was insulting.

I dunno. Maybe I was too sensitive. Maybe they just wanted to include Brityn…But it didn’t feel that way to me. It felt like they were talking to her as a way to avoid talking to me, a way to simply bypass chatting with me.

To their credit, however, when I mentioned it – “You know, I am here and I am a person too. You could at least include me in the conversation…” — they apologized. But even now I do not believe they understood the problem. They thought it was perfectly acceptable — since Brityn had driven me (I wonder how they would have behaved had I simply been able to drive myself!) — to treat me as merely a patient, a “charge,” and to treat Brityn as their equal, the other professional, the only one on equal standing with them. Well fork them…It cost me a lot to go up there, not even to talk about what they did to me. Do they really think I am OVER it? They ought to be ashamed of themselves.

But I will let that go as well.

Soooo, down to tin tacks, which turned out to be the golden glue of the meeting itself.

Dr Weidner, small and blond and –somehow I want to call her “open-faced” — she seemed not to hide a lot, had what looked like a genuinely interested and caring face, though naturally psychiatrists are trained to achieve this appearance. Nevertheless, I did trust her sincerity.

This time I cannot recall if she called me Pam, or nothing at all. I do not think she called me Ms Wagner, though. I pointed out that since I understood that the post I’d written, the “Open Letter” had essentially “gone viral” in terms of the Natchaug Hospital staff itself, I didn’t feel I needed to talk much about what had happened in August. I had written all about it in detail. Or most of it…Mostly what I thought I should talk about was “How to make Natchaug a better place.”

I did that, and in fairly great detail. I will write a separate blog about all those suggested changes, and changes which would apply in spades to other hospitals. But for now, I just want to report on the meeting itself.

Dr Weidner seemed to take careful notes and when I had finished I was simply “blown away” when she said, “Pam you have so much to tell us, and are such a good teacher, but there are only the three of us here today. How would you feel about coming back and talking to the entire medical staff? Your experience as a patient and your ability to articulate it would be just invaluable for many more of us to hear.”

Well, I almost laughed in sheer belief and pleasure. “Of course. I would love to. I do public speaking and would have no problem with that. Anything at all that I could do to make Natchaug a better place would be fine with me.”

Dr Weidner also wanted to know what they could have done to make my own stay less traumatic “from the start,” especially how they could have relieved or prevented my becoming mute for so long.

I told her that from the instant that the first episode started, when that nurse or whomever said to me, “Take your hands out from under the blankets!” I felt so betrayed, felt indeed that I was back at Hallbrooke being tortured by those two abusive staff members (who were actually reprimanded for their behavior) that I became mute at that very instant.

Would I have taken Ativan despite my psychiatric advance directive’s proscription against its use? Yes, had someone gently explained its use and suggested I take it to help my mutism, just a small dose, I would have at least considered it.

But no one presented Ativan as an option…I do not believe anyone even knew about it. Except of course to force it on me against my will during the Seclusion event I described in the earlier post. Not until Dr Cappiello insisted that I ask Dr Pentz to prescribe it, and that was only after I had been unable to talk for 8 days.

As for the mutism itself? They — Dr Pentz and some of the other docs and APRNs — insisted that I deliberately chose not to speak, that I could have if I wanted to. But in point of fact, I could not get myself to speak, I woke every morning with no “inclination” to speak and no felt ability to break that barrier…and therefore I truly could not speak at all. In fact, it took hours, and maybe two doses of Ativan before I was able to speak at all even when I did take it.

After a few more words of conversation, the meeting broke up and Brityn and I headed towards the car, with the expectation that we would come back again so I could speak to a larger group of Natchaug personnel.

So that was my reconciliation with Natchaug and I left feeling like a million dollars. Even Brityn told me it was the best appointment she had taken anyone to that week.

You know, my sole worry — and I felt a frisson even as we talked about it and my worries were not immediately allayed — was when I asked if I could ever be readmitted, ie as a patient. I know, I know, why would I even want to? Dr Weidner said she didn’t think I’d ever want to come back. According to her, that’s what I’d written in my blog post. But in fact, what I said was that I didn’t think I would ever be taken back. I was considered such a PITA, why would they want me? And also because I could not see anyone for a doctor but Dr Andrei, and it seems dubious that she would see me. Why I do not know. But so be it. I liked her, never had any problems with her. But I must have done something wrong. This is twice that they have refused to assign me to her.

In truth though, 1) I have NO WHERE ELSE TO GO, no where else I could possibly begin to trust or feel safe, nowhere do I have even a history of feeling and being safe and 2) say that they do change, where else would I want to go?

In any event, since I can work with neithe Pentz nor the other doctor on the unit, because of “conflicts of interest” (i.e. he still has “feelings for me” from our days in med school together) that leaves only Dr Andrei, and I dunno if she would accept me onto her service. So, even if theoretically they would take me back – which didn’t seem at all certain, not from the vibes I got from Dr Weidner — I don’t have any idea who could see me if I were admitted.

(What the fork! I would be stuck in a snake pit like Hartford Hospital’s Institute of Living only to be brutalized again. When push comes to shove and I might need or want to be re-admitted, frankly I wouldn’t expect the admitting MD Natchaug to give a damn, no matter how many times I’d spoken to people there and how much I might have taught them. As soon as I need their help as a patient, frankly, I expect I’d simply to be abandoned to my fate somewhere else.)

Well, of course I will still help Natchaug,. How could I not want to help them? I want to help EVERY hospital in the state become as good as Natchaug and even better. But it sucks all the same.

———————————————————————————

*** Finally I want to make a brief comment about the specific words “a borderline” used early in this post, because every time I hear this phrase it makes my blood sizzle. Not only is very insulting, it stigmaties. I may not have borderline personality disorder, but I know what is meant when someone calls a person “a borderline,” and it is invariably takes the place of PITA, Pain in The Ass.

There is a difference, a huge difference between understanding the very real travails that a person with such a personality disorder undergoes daily, the emotional suffering that afflicts that person, and simply calling them names because you find them troublesome.

Empathy goes a long way, especially with someone who suffers from BPD. The idea of calling someone “a borderline” is tantamount to saying, “I suffer from YOU.” A disgusting statement if ever I heard one, one most often made by mental health professionals. Doctors who use the words, “a borderline” need 1) re-education in language and its nuances, but 2) and much more important, a re-education in COMPASSION.

Of course, that’s just IMHO…and who am I?

I’m Nobody! Who are you?
by Emily Dickinson

I'm Nobody! Who are you? Are you – Nobody – too? Then there's a pair of us! Don't tell! they'd advertise – you know! How dreary – to be – Somebody! How public – like a Frog – To tell one's name – the livelong June – To an admiring Bog!

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Source: Department of Obstetrics and Gynecology, Chicago Lying-In Hospital, Illinois.

Abstract

OBJECTIVE: To determine the conceptional events resulting in a 46,XX/46,XY true hermaphrodite and to report the first pregnancy in a 46,XX/46,XY true hermaphrodite with an ovotestis… (see the rest of the abstract at PubMed)

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A Mental Health Meeting of the Minds: Natchaug Hospital Administrators Get Gold Stars

I’m Nobody! Who are you?

by Emily Dickinson

"While I breathe, I hope"

BUOYANT

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Systematic Incarceration of African American Males Is a Wrong, Costly Path

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POEM IN WHICH I SPEAK FRANKLY, FORGIVE ME

GOMER: ER-speak for a troublesome, unwanted person in the emergency department, acronym for Get Out of My Emergency Room

Rachel

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Chimerism as the etiology of a 46,XX/46,XY fertile true hermaphrodite.

Source: Department of Obstetrics and Gynecology, Chicago Lying-In Hospital, Illinois.

Abstract

OBJECTIVE: To determine the conceptional events resulting in a 46,XX/46,XY true hermaphrodite and to report the first pregnancy in a 46,XX/46,XY true hermaphrodite with an ovotestis… (see the rest of the abstract at PubMed)

WILDFLOWERS ON THE ROAD TO DAMASCUS

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Do We Need ‘Thanaticians’ for the Terminally Ill?

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I’m Nobody! Who are you?

by Emily Dickinson

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"While I breathe, I hope"