Category Archives: Natchaug Hospital

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

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

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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 7th 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.

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*** 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!
Art, colored pencils, Drawing, Hospital, Natchaug Hospital, Surrealism

Artist Trading Cards: Egg, Goose, Frog and more…

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Flying Goose, Eye in Eggshell, Blue-spotted Frog, and Face/Eye Abstract

 

All of these “trading cards”, 2.5 inches by 3.5 inches. Many were done at Natchaug Hospital and  are original one of a kind art. They are for sale. Tell me which one(s) you would like. We can work it out. (Payment is always in art supplies equivalences, by the way. No “cash” or other monetary payments accepted.)

 

Purple Cone flowers,  Best in Show, No Exit from the Bin, and Mighty Manfred Makes an Entrance

 

Biohard Balloons; Blue Flipflops; cartoon nude; vivid abstract

 

Blue cup and Saucer; Man in Flower; Woman in ruffles with earrings

 

Health, Health Care Reform, Hospital, Mental Health, Natchaug Hospital, Seclusion and Restraints, Trauma, Uncategorized

Open Letter to Deborah W., MD, Chief Medical Officer, of N Hospital

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It has been a week since my discharge from the Adult Unit at N Hospital. After a week of recuperation and stabilization at home I feel compelled to write you via the open forum of a letter on this blog. It may or may not get your attention directly but I feel certain it will be read by someone on the N staff. Perhaps that way it will eventually reach your eyes. If not, so be it.

Our encounter on Monday the 27th of August was extremely brief and not particularly noteworthy. While I have much to say that never got said then, I owe you nothing, and by the same token, expect nothing from you either. That said, to any of my readers who want to understand the intent: I write partly in my defense against what I feel were gross misunderstandings (leading to unnecessary trauma), and partly to record publicly – on record as it were – what really happened over the last 4-6 weeks.

Please, Dr W, or any other reader: Do not dismiss this letter out of hand as the peevish complaints of a disgruntled but troublesome patient. I understand how you might be tempted to do so, especially because you — or at least Dr P and L.H. APRN – claimed in their infinite wisdom to be able to detect signs of an Axis II Borderline Personality disorder (despite the concomitant presence of an Axis I psychosis ). I know that labelling me “borderline” was always just another way to dismiss me and my concerns as “mere,” that is to say as meaningless or manipulative, the “mere” attention-seeking of a manipulative PITA*.

Nevertheless, it ought to have been obvious, it ought to have been needless to say — but clearly was not — that no one could possibly know what my baseline personality was like from the past four weeks at N nor in fact from any of my past four stays there. What was clear to many early on, including me, was that this hospital stay at N abounded not in norms but in extremes, from start to finish, extremes I might add both on my part and on the part of hospital staff as well.

My friends and family know that I am not generally someone who has screaming fits or throws things or strips naked and parades around in public, all modesty thrown to the wind. So too, N staff: So far as I knew or had seen since 2010, they rarely became physical with patients  and not once in all the times I had been there had physical contact devolved into anything even resembling a fight or violence. Instead, kindness, compassion and empathy were the primary tools. The best staff were as slow to lose their tempers or act on negative emotions as a live gecko was to do a cancan under the noonday desert sun.

I knew those things, and until August I believed it automatically made N a superior place, a sanctuary immune to the sorts of failings I’d found in so many other hospitals.  That was why I insisted on N this time even though it meant waiting two and a half days at W Hospital Emergency Room, never moving off the gurney in the barren cubicle I was placed in, monitored by a camera not so subtly hidden in the large TV screen. I knew of no other hospital where I could be safe, both from myself under the influence of command hallucinations, and just as important, from any staff impulses towards the use of violence to achieve control or discipline.

How could I have known that from the first morning after I arrived, staff behavior was to be stunningly “un-N-like,” as erratic and extreme as my own would turn out to be. My entire stay was in fact characterized by physical assaults by staff, punishment and trauma that began the moment I woke up that first morning.  I responded poorly to this, as anyone might, by regressing into more and more primitive behaviors. But how did “you,” that is to say, the N staff, respond to me? Not by taking a step back and seeing how things could change for the better. No, instead, you, they decided to blame the victim, to say, “She’s misbehaving, she’s ‘doing these things on purpose,’ she is volatile, unpleasant and emotionally unstable…” Et Voila! There I was, diagnosed, improperly but officially with “Borderline Personality Disorder!”

As many of my readers know, I have written extensively here, at wordpress.com, Wagblog, about psychiatric units and hospitals and have until now always held N in the highest esteem. N was always the gold standard, the touchstone against which all other  hospitals in the state were measured. I believed that N had the right ideas, the right philosophy about patient care, hired the right people and trained them properly. I trusted that the hospital understood the critical importance of trauma-informed treatment. Ever since my 1st hospitalization at N in December 2010 -January 2011, when S. H. was director of nursing, I felt I’d found a truly safe place, an asylum in the best sense of the word, where troubled patients would never be brutalized by staff more bent on coercion and a lust for power than compassionate care.

I have been hospitalized at N four times now. The first three times bore out these high expectations, but this last time was unmitigated disaster, revealing how much things have changed, and how, under the auspices of the wrong leaders even N has been willing to permit a few “bad eggs” to damage patients with impunity, rather than take an honest look at burned out employees – including those at the highest levels, RNs and psychiatrists included –keeping them tenured out of a misplaced loyalty, refusing either to re-educate them or to remove them from direct patient contact.

There were three separate instances of physical violence to which I was subjected  between July 31 and August 27th . The very first morning after I had been admitted and placed on one to one for safety, I remember I sleepily turned over in bed and scrunched down again to catch a little more sleep when the person sitting with me suddenly insisted that I place my hands outside the covers where she could see them. This was a strange request, since they had been under the covers all night, right up until that second. Dumbfounded, and freezing cold, I resisted and ignored her, fairly certain that she would not make a federal case of the request once I fell asleep. Instead, she repeated herself, louder and louder. She actually approached the bed and tried to bully me verbally into putting my hands above the bedclothes, telling me that being on constant observation required that my hands be visible at all times. This was news to me. Never in my experience at N had anyone required such a thing. I continued to resist, though any impulse to sleep had left me by then. By this point, it was strictly on principle.

Well, she was intent on winning the battle and instead of negotiating a solution called in reinforcements in the persons of two male mental health workers. Unable to verbally force me to uncover myself, they initiated physical contact, attempting to pry my blanketed fingers away from the blanket in which I had wrapped myself. The female stood aside, but continued to threaten to deprive me of all coverings if I did not comply with her order. The tussle went on. I vehemently kicked at them whenever they laid hands on me, though I spoke not a word the entire time. At last, they gave in and left me alone. I never found out why. Perhaps they saw the brutality they were inflicting on me. Or perhaps they were called off. I do not know. All I know is that that particular rule was never again inflicted on me.

After they left, and a new sitter arrived, I lay in bed, breathing hard and feeling bitterly betrayed. What the F just happened? Dismayed and disappointed, I could scarcely believe I was really at N and not at the torture chamber in the south eastern part of the state again. The consequences of this betrayal left me physically and psychologically speechless. What had happened to “my” N? Try though I might to let myself talk, I remained mute for 8 days.

I won’t go into the long and involved story of the second assault, except to say  that it involved  poor judgment on the part of my social worker and evening nurse. OTOH, an assertion of power by another nurse assigned to me nearly twenty four hours later was overkill and an act of punishment and revenge. She can deny it left, right and silly, and maybe her RN superiors believe it, especially because they have a stake in it. But I know contempt and the smile of sweet revenge when I see it, and I knew the enjoyment in her smile that Wednesday. Assault #2, which involved a rather violent physical altercation and restraint, nevertheless had a bearing on assault #3. What follows is the story of that third assault on my person. In places I quote almost verbatim from my journal entries, which I wrote at the time. When I am not quoting, I assure you that the account is very similar to the journal’s “horse’s mouth” and merely states the same things I wrote there, but with better words and fewer punctuation marks.

I do not remember how it started. I suspect I had been screaming or yelling about something. All I know is that the RN Supervisor for the afternoon, a woman I will called D came into my room after my upset and just stood there. At one point in her obdurate silence, she accused me of an unprovoked attack on it the nurse, K, who had taken revenge on me the day before. She called K  one of her “ best nurses.” Incensed at this I assured her she didn’t know the whole situation. When she said she knew enough, I told her to leave my room.

“I’m staying right here,” she said giving me a baleful look. I pointed out that I already had a 1: 1 and did not need a 2nd person in the room. She only continued glaring at me.

“Get out,” I screamed, “get out of here!”

No response. No reaction, except for a slight recoil from the loudness of my voice.

I threatened her then. I admit it and I am not proud of it. I threatened her. I took up a box of crayons and looked as if to hit her. Everyone cried out, “No, no, P!” And I put it down. But I continued to cry out, “Leave! Leave! Leave me alone!” She only stood her ground and stared.

That’s when I lost it. I picked up a chair and threatened to throw it at her. This is what she’d been waiting for. She could’ve laughed or made a calming gesture or simply backed away and let the mental health workers gently disarm me and all would’ve been well. But no, D liked to escalate rather than de-escalate, so she yelled out, “Escort her to the quiet room!” Before I could offer to walk there myself, Brad and someone else picked me up by the armpits not even allowing me to walk and dragged me.  Because they didn’t even ask me if I would walk freely, under my own steam, I fought them, twining my legs around  theirs as if to try and trip them.  Then to add insult to injury they dragged the blue therapy chair out of the room instead of leaving it there for me to rock in and calm myself. Now, inside the tiny, now empty windowless cell, despite the bright mural painted on the walls, panic rose in me. I looked around, remembering how S H had assured me that no one would ever leave me alone in there unless I wanted them too. I begged D for someone to stay in there with me. S the mental health worker saw the panic and offered to, but D was furious and ordered her out.

“No, she is to stay in here alone!” She made everyone leave, and following them out, she slammed the door shut behind her.

I was horrified. All the memories of locked seclusion returned to me in an avalanche of terror. In my mind, memory told me it would make no difference if I went to the door to beg to be let out, or for a blanket or someone to talk to. Experience, all my long experience had taught me: there was to be no mercy no help nothing would change no one would respond no help nothing no matter what I did. I was and would be abandoned to my punishment until–well–until I had no idea how long it would last. No one told me a thing. Utterly terrified, instead of banging on the door and begging for release, I backed into the farthest corner. I wanted to meld with the wall, shrink back into the wall board as far away from the room as I could get. A howl climbed my throat. I tried to hold it back but I could not. When I screamed, I screamed not to anyone or for anyone but out of sheer mortal terror, the sort of terror that any animal must feels when its leg is smashed in a trap and knows his life is coming to an end. Screaming brought no relief though. Screaming brought nothing, it certainly brought no one into the room to help me. There was only thing I could think of that would that bring relief and that was to relieve myself. So I did, in the only way I could: I stripped off all my clothing and peed a huge puddle of urine on the floor. I had to. I do not know why. Removing my underwear I found inside the crotch a forbidden pencil. I’d not been allowed writing utensils for eight long days and just that afternoon I had used this pencil to sketch my first portrait since I’d been there. I wrapped the pencil in my clothing, knowing that if someone saw it they would confiscate it again.

Too late. A commotion behind the door and they were upon me, all of them, wrestling my naked body to the floor and prying the wad of clothing from me, smashing my glasses in the process so that one lens came out of the frame.  In the melee, someone grabbed my medical bracelet right off my flailing wrist. They pinned me down. I knew what they had in mind. IM meds. But no one had offered me oral medication. “I want oral meds. I’ll take oral meds you can’t inject me, you haven’t even offered me oral meds.” I asked for Zyprexa. Not Haldol or Ativan but Zyprexa, the PRN I had on order.

They refused to get Dr. T, who signed off on the seclusion without ever seeing me, to change the emergency meds — which I didn’t really need but which were going to be ordered anyway, as a mater of course — to Zyprexa despite my psychiatric advance directive distinctly requesting no benzodiazepines of any sort. However, fearing any further confrontation, I swallowed the pills. Everyone got up and left except for the nurse supervisor. I stood up and surveyed the room. Urine ran everywhere.

“How can I stay here?” I asked her. “There’s pee all over the place.”

She surveyed the wet pads and floor. “Deal with it,” she said, and walked out, locking the door behind her again.

I was spent. There was nothing left in me to fight or scream or object. I simply lay down on the mat, amid the puddles of urine and curled up in a fetal position. Sleep never came; it was too cold for that. I just lay there, eyes open, my naked back to the window. 10 minutes passed. 15 minutes. I heard the mental health worker at the window ask the supervisor if she could let me out. “She is lying there calmly, I think she’s sleeping.”

“Give her another 10 minutes,” was the reply.

Another ten minutes went by and another.

The mental health worker kept asking if she could let me out. Finally, about an hour later, the door opened and S entered.  I didn’t bother to turn over or look at her. I scarcely raised my head.

“P?”

In a dull voice, I answered the requisite questionnaire, as if that were adequate debriefing. Then two other staff members attempted to clothe me in hospital issue johnnies, one over my front, one to cover the back. I allowed them to do this but as soon as they let me go and I was free to proceed out of the erstwhile “Comfort,” now Terror Room, I ripped off the johnnie coat covering my naked backside, and walked half-exposed to my room, deliberate and uncaring. Who gave a fork? What could they do to me now? What could anyone do to me? Fork everyone! They were dead to me. I was dead to them. It was over. It was over. I was dead meat. Just meat. I didn’t give a fork about anything.

More than any other incident, this one was the last straw. Whatever repercussions I deserved for threatening the RN supervisor that evening, however evil I felt for being the devil, there remained in me enough human pride to resist such treatment, enough to say that even I did not deserve to be treated as harshly as D had treated me. Not only did she deliberately test me, she lost her temper and I was her victim. I have reason to believe that most of the staff members who witnessed what happened that night believed she went too far. Some would actually say so in as many words to me, though others were cagey and feared repercussions should it get back to her.

All I knew was that I’d been treated like an animal. What did that supervisor or anyone else expect in response? Did she really think I would become docile and obedient, chastened, a meek and compliant patient?  Violence begets violence. It always does. From then on I was not the same. I was not better either, no. I grew markedly worse, and worst of all, no one could predict anything about my behavior. No one knew what would happen next, what I would do, when I would lash out or scream or throw things or push someone or even hurt myself…None of those behaviors were “me” or even close to my usual, or baseline, but I reiterate: what do you expect: treat a person like an animal, and you can pretty much count on getting animal behavior as a result.

Dr. W you do not know me. Dr P, for all his discharge summaries and “progress” notes (the pages of writing are all boilerplate, meaningless, and/or second or third hand information for the most part), he doesn’t know a damned thing about me. I tried to let L. H, APRN, know a little, but by the time she was involved in my treatment, you were all so intent on seeing in me this mythical borderline personality, instead of a person who had been acutely and brutally traumatized at your hospital, that it was useless for me to expect anything.  For all L’s  pretence of understanding, she had made up her mind about me before she met me. She was largely deaf and blind to everything I said that did not fit the tidy diagnostic picture: schizo-affective, with a concomitant borderline personality disorder. How convenient that you could chalk all the unit troubles up to my problem, rather than seeing it as something your hospital staff created! Blame the victim, why’ncha, instead of taking responsibility for a number of incredibly poor judgment calls on your own or your staff’s part?

Of course as many people have asked me, why do I care what you or Dr P or L H think? Well, I do not, in fact, give a flying femptogram… Mostly I care about the decent people there — the mental health workers and the nurses who did like me and made it obvious and treated me very well and made it clear they would welcome me back (though I can never return, not now.) About Dr P and LH  and the others I could give a ratzass.  But I do, or did care about N itself, once the gold standard, for me at any rate. It was the one place where I could tell other people, “Go to N – I know people will take care of you there, people will care about you there, that’s where people will treat you well.”

The even bigger tragedy is that if no one is safe from the hospital staff at N, then the likelihood is that no one is safe in any psychiatric unit or hospital in  this state. Let’s face it. Not much progress, perhaps none at all, has been made since the Hartford Courant’s series of articles in 1998 called “Deadly Restraints.” My sense is, in fact, that since Mnanaged Care took over medicine, things are actually a great deal worse…Oh, sure, I was not four-pointed during the past stay at N, no they managed not to become that brutal, so far… but I was physically restrained and manhandled during all three incidents and I have been four-pointed at nearly every other hospital in the state up till 2010. So I would hardly say that that practice has gone by the wayside. In fact, in the  Hospital Emergency Room back in July of this year, they threatened to four-point me just for making a nuisance of myself and being noisy…

So much for not using restraints. As for not using them as punishment? I believe that in every single case when I was subjected to four-point restraints from 1980-2010, they were used as punishment, as a convenience or in revenge… I state this categorically: that not in a single instance were four-point restraints ever truly necessary to keep me safe. They were only used because they were available and the culture on the unit permitted the employment of torture to control and discipline patients. Period.

Seclusion? This practice has only increased in usage so far as I can see. The difference is only that staffs are careful to call such barren quarters the Time-out Room, and are rarely apprised as to the legal definition of either seclusion or restraint. (BTW Time-out is a disciplinary measure used to train children to behave properly…since when did psychiatry decide that patients in adult units ought to be treated like misbehaving children and sent to time-out rooms? If you want to talk about empowering patients and not infantilizing them, you do not in the next sentence tell someone to go to the “time-out room” and stay “until I say you can leave.”).

What you, Dr W et al, think about me in the end is of little consequence. I know I do not have BPD and so do the people around me that matter to me. If I care about anything having to do with N it is not your opinion of me nor your judgment or your diagnosis, I care about N because while it could and should be, it is no longer a place I trust, a place where I can direct other people for safety and compassionate treatment. Because if I am not safe from myself at N, if I am not safe from the staff at N, and I mean by staff, the doctors and nurse supervisors as well as any “rogue” RN  or MHW, then no one is safe at N and no one with mental illness is safe in any psychiatric hospital or unit in the state

That, Dr W, is by far the worst tragedy of all .

___________

*PITA = Pain In The Ass

Acceptance, Art and artwork, Brain, colored pencils, Eating, Hospital, Medication, Natchaug Hospital, Psychiatric Unit, Wisdom House

Hospital Artwork

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Me as the Ogre that Ate Manhattan

I did the last two of these at Natchaug Hospital this past winter, both of which may be obvious. The first, Under Attack from All Sides, was meant to express how I felt at the time, with the fingers pointing at me literally showing what the voices do, and the red high heel with a hand, strong, hefting that lethal looking spike — well those both belong to a certain someone I cannot name who wants me deader than dead and will do anything in her power to achieve it.

The second of the hospital pieces (I did others, but alas I gave them away and so never did have a photo of them to share…) is the last one posted here, the Ogre that Ate Manhattan, which is written partly in Spanish and partly in acronym. The message is KILL the Orgre that Ate Manhattan, but I figure you don’t need to understand that to enjoy the artwork…Not quite finished yet, but there is not a huge amount left to go…

Finally at the top is In her Hands, which is not done, though it may look it. This is a partly 3-D high relief piece, and partly a flat piece of acrylic painting. In truth a lot of it is optical illusion but not as a joke. The detail shows how her hands are painted onto the globe, not actually three dimentional at all; they just look 3-D because of how I painted them. I need to write more about more “important” things in my life, but for now this will have to do. (Addendum: I realized, days later, that I must have written the text of this very late at night, and possibly after I’d taken my Xyrem, the narcolepsy night time med. Why? Because a great deal of it was so badly spelled and some of it made no or little sense at all. I mostly do that sort of thing, dream talk, if you will, when I make the mistake of trying to write after I have taken my medication and get busy and forget that I am not “with it” entirely…so I am not aware when sense devolves into gibberish! Forgive me, anyway, if I seemed somehow sloppy if not wholly out of it!)

Pam W

Amnesia, Art and artwork, Book, Collage, Memory, Natchaug Hospital, Psychiatric Unit, Seclusion and Restraints, Surrealism, Willimantic Connecticut

Artwork from Hospital

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If the window is open, what does the mirror outside see inside the room?

As may be obvious from the brown paper at the sides, this collage is very much unfinished, both as to content and as to medium. What I mean is, this is a kind of painting with paper, so I am so far dissatisfied with, say, the blue curtain with yellow lining, because it still looks rough and is not clearly a curtain blowing in the air coming through the open window. Ditto, the open window, which is not clearly even a window, except by virtue of my titling it such. But when I finish with it, I hope all these mysteries will be clearer, including the surreal placement of a hand mirror outside an upper story window! (I said it was surreal, didn’t I?) But what I cannot help is whether or not the viewer recognizes what it is that is on the bed. Some people simply do not know what restraints look like, and have variously interpreted them as guitars or snakes or what have you. To me, it is obvious. But I guess most people have not been in such a situation, and have no conception of what they might be looking at. Perhaps a more suggestive title would help?

Another important feature of the “painting” is the frosted glass window, with the mysterious something going on behind it, again left up to the interpretation of the viewer. If you understand that this is a restraints bed, and that the window is open…what could be going on outside the seclusion room? And why is the window open? Should the bed be empty? If you could see this very large collage – 5 feet by 5 feet — up close, you would see that the mirror overhangs a very detailed garden, with all the trappings of well designed backyard floribundance, so to speak. There is a little table and benches and other accoutrements, but also a path leading up to — a garden gate, which opens onto a field and freedom.

As I worked on this collage, I was in a state of acute anxiety — with tremors and shaking and palpitations I did not understand. And every night I would weep with bodily but not conscious memories of the recent brutalities I experienced at Manchester and Middlesex Hospitals. At Natchaug they understood how degrading and traumatizing such treatment had been, and indeed how re-traumatizing. Because indeed, I had already been traumatized many times before in the 80s and 90s and early to mid 2000’s by what I thought was SOP use of such measures. Instead, when those recent hospitals used them,  cruelly and inappropriately, at a time when I knew their use was frowned upon and had been severely curtailed, it not only re-awakened the original trauma, but in a very real sense put me in emotional touch with it, the pain, the terror, the horrendous humiliation for the very first time.

I am not by any means over it. As I work on my memoir sequel, BLACKLIGHT, I am also slowly going over my hospital records with Dr Angela, aka Dr C, and it is a gut-wrenching task that leaves me drained and tremulous. But if it succeeds in returning my memories to me, all of them, I shall consider it worthwhile.

Abilify, Art and artwork, Geodon, Natchaug Hospital, Psychiatric Unit, Seclusion and Restraints, Willimantic Connecticut

Natchaug Hospital Stay #2 and Update with Picture

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Just wanted to update you on where I have been and how I am: I  spent 6 weeks at Natchaug Hospital in Willimantic, Connecticut this past July and August and though I was discharged as much improved, I  am still having a difficult time, both readjusting and well, simply having a hard time of it. Although in the hospital they did a little adjusting of meds, increasing both the Geodon and the Zoloft, I am not convinced that either one made much of a difference nor that it did less harm and more good on balance. In any event, Dr C and I (at my request) soon eliminated the 25mg increase in Zoloft, and are now dropping the 80mg increase in Geodon. She is concerned that the 240mg is making me very irritable and more upset and frantic rather than providing enough relief  to make it worthwhile. Yes, the voices are much improved, but that could be the passage of time and perhaps due to a general decrease in paranoia, who knows? All I can say is that I cannot take this general state of overwrought irascibility, a tendency to snap at anyone who “looks at me crosseyed,” as my mother used to say.

Natchaug Hospital remains a very good place, the best I know, and just as I remembered, not least because they have a philosophy of kindness and compassion towards patients. In fact, they are excellent because they have a philosophy and are not simply flying by the seat of their pants, hiring whoever comes along needing a job, burned out or not. Not only is their philosophy based on compassion and not on controlling the patient, but they see no point in rules for the sake of rules. It is clear that if there is something in the unit set-up that doesn’t serve a particular patient, the Natchaug staff will bend it as far as they can and try to accommodate each patient’s particular needs. As I was frequently told, why make someone miserable when you can make them happy? It is difficult to be happy in a psychiatric unit, and many patients are miserable because of their illnesses, but not once did I ever see a staff member add to that misery willfully and certainly not to mine. (I frankly could not say this of two Connecticut area hospitals, one in Manchester and the other in Middletown.)

One thing that makes many patients happy at Natchaug, by the way, is that caffeinated coffee is provided at breakfast, a rare blessing in in-patient psychiatric settings.  And since everything is served cafeteria style, so you can have all you want.

They used to provide hot decaf coffee on the unit itself, which was a treat. Because one very ill patient tossed a cup of coffee at a staff member, however, and she was injured, and because for some reason they decided that that patient could not be restricted individually from having hot coffee, now no one is permitted hot drinks on the unit at all. Yet, I suspect that even he would have not thought it unfair to be kept from the coffee pot! I know that in other hospitals I have had restrictions placed on me that others have not, and no one thought it wrong or unfair to me…Anyhow, I dunno what to think, but it was their policy, a misguided one, perhaps, but who am I to say? I know everyone went nuts for a while about having to drink lukewarm “swill.” Finally, though, the patients simply gave up on the “coffee” machine and did without. Anyhow, I have to admit that when I first saw the hot coffee machine, I couldn’t believe it, not because I was thrilled — though I was — but because I saw an “accident”or worse already in the making…

Note: one of the few hard and fast rules  at Natchaug is one they cannot change because they will lose accreditation: no smoking. Smoking is simply not allowed, not even on hospital grounds. While certain patients have tantrums about this and might cause an uproar from time to time in order to try to force the staff to allow them to use the courtyard to smoke “just one cigarette, just this once, please, I am absolutely desperate!” it is simply not possible. But people are allowed the patch and gum and every effort is made to help smokers quit. Even though some staff acknowledge that the policy is unfortunate, even unfair, nothing can be done about it.

I was not, however, comfortable for most of my stay there, and was paranoid a great deal of the time. Of course, I did not understand that the staff was aware of this, so when I began to come out of my delusions of persecution, it surprised me mightily to discover that they knew that paranoia was the reason for my hostility all along. Nevertheless, up to the very day I was discharged, I was hearing people talk about me up and down the hall and at the nurses’ station.

Well, that is all I am going to write for today because I am, as of  a week ago, in the middle of writing my new memoir, and as the days progress I plan to put parts of it up here, for comments and for suggestions. Feel free to do both!

I will finish here with one of my latest drawings, which represents how I felt when I was restrained at Middlesex Hospital, both the time I described in a recent blog post, and the other(s) (for which I have amnesia) when Josephine told me I was more or less “out of control”…to which I can only respond: Violence begets violence, and perhaps if they had not perpetrated on me what they did, things might not have gotten out of hand, But then, that hospital is one that is guided by the Control for Control’s Sake philosophy and the nurses were bitter and angry people…Needlesstosay, they hated me if only because I refused to roll over and play dead, if not die.

Forthwith the picture.

Pam as Dead Meat: Let's Eat!