Category Archives: Seclusion and Restraints

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

September 2, 2012 Phoebe Sparrow Wagner 10 Comments

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 1^st 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 27^th. 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 2^nd 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 .

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*PITA = Pain In The Ass

Health, Mental Health, Psychiatric Unit, Seclusion and Restraints, Trauma

Psychiatric Crisis Intervention: How to Avoid Restraints and Violence

June 16, 2012 Phoebe Sparrow Wagner Leave a comment

*Note that when I write of a psychiatric crisis, I mean a patient who is not actively on street drugs. I cannot speak to any situation where someone has been taking unknown quantities of unknown chemicals. In such a situation I have absolutely no experience.

That said, I would like to tell you a few simple things about dealing with an unarmed, undrugged person who seems agitated and paranoid. It is true that I speak of myself, but I believe that the only difference between me and a two hundred fifty pound man, is only size and the fear factor. I think that there is no reason on earth why he would not respond to the following interactions just as well as I know I would.

First all of, remember that the person you are dealing with is indeed agitated, and is if paranoid by definition terrified. Keep that uppermost in your mind, because everything you do will be evaluated by her in terms of what threat it poses. If you frighten her or threaten her, she will become much more unpredictable, and the probability of violence increases enormously.

Never approach such a person with a show of force.Not even if she is being “loud” and disruptive. You gain nothing by such brute force methods, and you lose a great deal…Ganging up on a patient who is paranoid only puts her in the “fight” mode. After all, she is already frightened and you have cut off her only perceived avenue of “flight.” Why escalate a crisis situation, making it worse, upping the potential for a violent response. If the situation has already devolved into accusations, yelling and swearing — all three signs of increasing anger and desperation — that is a signal that whatever you are doing is making the paranoia worse; at such a time the best thing to do is NOT to worsen the situation by pushing back, responding with equal anger, and making demands and ultimatums. No, instead back off and WAIT. The person most likely has not had access to a weapon or anything to hurt herself or others, so patience is a virtue and can be put to good use here.

Usually a patient who is paranoid will not do anything of her own accord but try to escape the situation. But if you force the issue, if you prevent her from escaping to a comforting place or from her own feelings of fear by permitting her what she needs to calm herself, or worse, attempt to do something to her that she could perceive as an attack – for instance, if you try to force medication, or grab her or simply threaten her with a group of staff or guards approaching en masse, you may very well provoke her to respond as anyone would when attacked, i.e. with self defensive maneuvers.

Why be surprised, when several people try to rush her and grab her to hold her down for IM medication, or simply gang up on her in some misguided attempt “to calm her down,” if she then responds with apparent aggression? After all, it is several of you against the one of her and it is surely understandable that she feels threatened. Her life feels in danger and in such a situation all bets are off as to what she thinks she must do to preserve her safety.

If you really want the situation to end well, refrain from threatening or attacking her, no matter how impatient you may feel. Instead, choose one calm, unthreatened and unthreatening person, preferably of the same sex or somehow compatible with the paranoid patient’s personality, and have that person approach to a safe distance (safe for the paranoid patient, not just “safe” for the staff person or for lack of a better term, “negotiator.” The negotiator is safe so long as he or she does not threaten or attack the patient, who is much more frightened than the negotiator.

Approach to a safe distance and possibly sit down, calmly and in a relaxed position, so that she understands that you are not scared of her but also not angry or threatening. If necessary, you might indicate that the patient is speaking too loudly for you to hear her, or too rapidly, but that you are there to listen and talk, when she can lower her voice or slow down. Do not speak loudly or angrily yourself. Talk about anything at first. Don’t talk about the patient or what is going on and do not argue or demand. order or talk about your expectations of or for her. Try to talk about calming external things. Does she like nature, art, sports, reading? Is she cold? Hungry? Can she take some deep breaths? Maybe she would like to sit down now, too? Finally, when she can, would she like to tell you what is going on? There is plenty of time, no hurry. It is important to find out what the problem is…

It may be you fear that she will attempt to self-harm or hurt someone impulsively. If the latter, keep everyone a safe distance away. And emphasize the possibility of violence so that they will stay away until the all-clear. Then talk to the person in a soft voice and gently remind her that you know she doesn’t want to hurt anyone, not even herself, that she is already in enough pain…What does she need, right at this very moment, to help her feel better? Then negotiate a way to get it for her, or something that will do as a substitute or an approximation.

It isn’t that hard to negotiate a calm solution to this sort of crisis, without violence or retribution, when you don’t threaten the person and are truly on her side. But you must never lie to her or to swoop down upon her immediately afterwards to put her in restraints. The point is to bring the crisis to a peaceful resolution. It is not a contest you must somehow win, and then punish her because you were scared and got angry. Exacting retribution is unconscionable and if that is your impulse you need to have a talk with your supervisor. Negotiators and other employees who do such things need to be reassigned to other areas or other jobs. They do not belong in crisis intervention settings.

Now I am certain that you can think of other scenarios where four point restraints are absolutely essential. If so, I would like to have you describe one. We can discuss this because I am becoming more and more convinced that Seclusion and Restraints CAUSE more mental illness and suffering than they relieve. How would you feel if you found out that by putting a patient in four point restraints even once, you may have caused enough trauma to induce more self-injurious behavior, plus PTSD? I believe this happens. I also believe that it is terribly dangerous for the sense of self and the self–esteem and the relationship between the patient and ANY health care provider of any sort at all. I see nothing good to come from restraints. NOTHING. I do not even see them as providing safety, not in the long run and scarcely in the short run since those who are restrained tend to become more violent not less. Why will people not learn that the “catch more flies with honey than vinegar” works with people in every instance?

But talk to me. Let me know what you think. A confession: I once wrote an Op-Ed for the biggest state paper around her that suggested that restraints could be an okay form of treatment if patients were taught to ask for them voluntarily! (I cring just thinking how I toed my sister’s “party line” about the helpfulness of restraints. She learned that sort of thinking from being the attending psychiatrist at Y__ Psychiatric Institute where they taught patients to ask for wet packs or to have their wrists chained to their belts all day long… The difference between us is that she still believes in that sort of brutality.)

Art, Art and artwork, Health, Mental Health, Mental Illness, Middlesex Hospital, Seclusion and Restraints, Trauma, Uncategorized, Zyprexa

“The Scream” plus an update…

June 6, 2012 Phoebe Sparrow Wagner 2 Comments


: In the midst of re-experiencing trauma, sometimes all you can do is scream, even if it is silently and only in paint…I hope this speaks to some of you who may feel as I do, often or even just once in a while. It took a lot to get this out, but I felt I did convey what I felt.

I am reposting the next one, a very painful if a not very skilled drawing, because I made some changes. I put a very mean smirk on the face of the woman in the front, who is meant to be facing us and pointing over her shoulder, though it was hard to get this in, given how little space I’d left myself… Also, I wanted to change the face of the man kneeling on me, and strength the look of the grip of the hands on me. If you compare the old version to this one, you will also note that I am purely naked here where as in the other, I have underpants on. This is the accurate one, but I didn’t understand that at the time I started the drawing. Alas, or perhaps this is good, I am rapidly recalling things I had not for two years about my experience at Middlesex. At least I remember stuff that happened BEFORE April 28th. For the other two restraints incidents, I still have no recall whatsoever or what I suspect is mostly confabulation drawn from what I read in my chart, though of course I cannot be certain. In any event, what I am remembering is not good at all, and I cry a lot…it is very difficult, and I feel so very very alone, because NO ONE understands and can talk to me, or more to the point can even stand to listen to me talk or cry about it. But it is difficult even to keep it under wraps all the time. If you have survived trauma, I think you know how it is. And that is why I avoid people when I think I cannot be “good enough company.” I don’t want to bring my friends down, but I cannot control the tears and shakes when they start…But the picture forthwith. Although it is disturbing as is, be aware that in the real incident, there was a great deal more violence, and more guards and staff members involved…these are just a paltry few. I simply didn’t know how to draw a crowd or a crowded room yet!

Takedown at N-7 — This is the incident before they used 4 point restraints on me that I so obsessively describe in Wagblog…Of course I take some poetic license with drawing the bed there and at the ready, as it was not there or ready or even in that room and I was quite calm and certainly no danger to anyone by the time they decided to punish me

Takedown on N-7 Prone Restraint Detail: Me, naked — and this is a hospital?

This next picture I did as an attempt to express the guilt and shame I feel over having been traumatized at all. But I do not think I succeeded at all. Why? Because it became too intellectualized, with symbols like the Scarlet A and the guilt-crucifix, and even the hands wringing in shame, rather than pure expression…I want to do it over again if I get inspired to do so.

Shame, Guilt and Ghosts — Shame Guilt and Ghosts is my attempt to portray my feelings of guilt at even having felt traumatized by so small an injury…but this doesn’t do it successfully, not so it seems to me at any rate.

The next three drawings were just “fun” or for practice ones. The first two are presents for Tim, simply because he likes cars and is so wonderful to me. The third was an exercise in drawing two people together, and was copied from an “old master”, the name of whom I simply cannot recall at the moment. It might have been — nope I don’t dare guess! I would have to get up and search for the book, and I ain’t gonna do that at the moment — too danged lazy. Anyhow, here are 1) two 1973 Volvo Sportswagon ES 1800 2) jaguar XJS and 3) the sketch taken from the old master’s painting.

: 1973 Volvo ES 1800 with British Racing Green “colour” in the background to represent the color of Tim’s car.

Jag XJS — My third car drawing for Tim, a Jaguar XJS (I forget the date but I believe it is the mid 80s (if I am not mistaken).

Herr Goose new incarnation — Herr Goose after revisitation for repairs…Click on the photo to make a close up and you will notice neck “feathers and the difference it makes with old fully decorated version.

: I sketched this detail from an old master’s painting found in an art book. Wanted to capture the two women together, and the angle of their heads (I actually didn’t do a very good job but there you are!)

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NOTE: As I wrote this, “dream” talk, that is to say, nonsensical writings seemed to keep appearing in the middle of what I wrote. I seemed to find myself in another world every few minutes. I would write about that world, then “come to” and start writing about the subject below again as if nothing had happened. But when I reread the paragraph it made no earthly sense whatsoever, being an amalgam of two entirely different trains of thought. So a caveat: if some of what follows devolves into gibberish at any time, forgive me, and be patient. You can email me to alert me, if you wish, that would help. But otherwise, know that I will eventually come back more able to proofread and catch such idiocies…and fix them. For now though, you are on your own. (The reason for these brain blips, I think, may be, but may not, the fact that I took a very small amount of Zyprexa today in order to be able to read and concentrate. 2.5 mg 2X a week should not make me gain weight, according to Dr C, But we thought it might do some good, without doing the usual harm. So I agreed to try it out once more, just at the minimal level as a PRN. Well, I find that I am very sleepy, have been ever since I took the pill, except for when I took a walk and for about 1/2 hour afterwards…and I do think that I slip into dreamworld while awake, and literally dream while writing this. Hence the gibberish.

*********

I have put the statement I read to the CEO and various administrators etc of Middlesex hospital on Youtube if anyone is interested in hearing it read outloud. Do a search for “Psychiatric restraints and seclusion abuse” and you should be able to find it if this link doesn’t work: http://www.youtube.com/watch?v=vhZybDwMbzA (I realize that I read it without much feeling, but it is hard to do so accurately and also look up at camera, and read without losing my place. Anyhow, it might be worthwhile to check it out.

The newest sorta development in the “case” this week was that a lawyer from the hospital, or someone who told my advocate he was a Middlesex Hospital lawyer, asked Wiley R (who is behind me 100%) “what does Pam want, what can we do to have her drop the complaint or withdraw her complaint to the DOJ and Joint Commission?”

Now everyone I told this to almost to a one, and immediately said this meant, “We are willing to pay handsomely in order to buy a gag order from her” I had trouble digesting such crassness, but to a one, those to whom I related the words of this inquiry told me the lawyer was insinuating something about paying me off. I mean: money. I felt slimed, completely slimed. For a few days this was the sole topic of my conversation, but to make a long story short, after I had decided to ask for several sessions with the hospital psych unit staff, educational sessions with me, to teach them how better to deal with patients, and have them experience forced restraints themselves…and so forth, my brother and I met with WR my advocate from the Protection and Advocacy (for persons with disabilities and mental illness) Office, and he informed us that the lawyer really was offering nothing, not even an official apology. Clearly, if so, then my real desire, to do hands on, face to face work with the staff that had so tortured me, was going to be out of the question, utterly forbidden. So we just decided in practically the same words, to let them “swing” in the wind.

In point of fact, when WR said that the DOJ might bring them up “on charges” if it was warranted, I asked him why I didn’t do that myself. He looked at me, and then narrowed his vision looking at a point beyond me. “Hmm, let me ask around and I’ll see what we can do.” I hastened to assure him that it wasn’t malpractice I was after. I knew that I had no real case, even if the statute of limitations hadn’t just run out a week or a few weeks ago. After all, what lawyer is going to take me on one a contingency basis, and what jury would find for me in any event, seeing as how I did not die in their “care” nor suffer “grievous BODILY injury” which of course is all that counts…as usual. I am not sure what sort of case I would have in any sense of the word now at all…But as I told him, that is in his hands, and certainly is his bailiwick (and if not his than that of my lawyer-friend, Sharon Pope’s. If there are other “cases” to be made of any sort, I am more than game, I am ready and on alert to go and do whatever is needed in the pursuit of justice and reform of the Middlesex Hospital psychiatric system. It was really shameful, and despite the Public Health Department’s so called investigation, it was such a shameful joke, that despite WR’s impassioned plea to investigate MY case, and the psych unit in particular, they did no such thing. All they did was go back to spring 2011 (ie looked at the records of the entire hospital, or one of two representative records from most of the units, except for Psych so far as I could determine…) and do a random case study to look for general evidence of irregularities. Sure, they found some, and one case even involved the ER use of unnecessary or at least excessive use of restraints in a dually diagnosed young man…

But NOTHING was even looked at that had anything to do with what they did to me, or even the psych unit in particular. NOTHING was specific to my complaint, so I don’t know how they expected this evaluation to give them any sort of reasonable results. They may or may not have censured or sanctioned the hospital. I did not read the entire huge file of support the bill got over the years. But I got the drift and the worst punishment meted out for repeated violations seemed to me to be a whipping on the wrist with a flimp ramen. Period.

Yet I was punished by the psych unit staff time and time again.

I know, I know! I was loud, I was angry, I was impossible to “handle” — I know this. Partly this was par for the course for a Lyme disease flare up for me. But I think Lyme wasn’t all of it. Why else was I so irascible (aside from them giving me Abilify without the requisite Geodon…) if not in response to perceived and real threats from them? I am not generally irritable and snappy at Natchaug, and never was at Hartford Hospital in the 80s and 90s. ONLY at hospitals where the standards of care are coercion and control and abuse is the name of the game do I react with anger and hostility…I wonder why.

More to tell, more to say, but as I wrote in the first paragraph above, sleep is overwhelming my desire to do just about anything. I will try to get back to this asap.

Brain, Empathy, Health, Health Care Reform, Memory, Mental Illness, Poetry, Psychiatric Unit, Psychiatry, Seclusion and Restraints, Trauma

Useless Psychiatric Mediation and a Poem

May 15, 2012 Phoebe Sparrow Wagner 2 Comments

(Before I write this blog entry, I want to send this message:To certain people from Middlesex Hospital who read this and are following developments in my case against you please be aware that I know who you are and I am watching you. You do not and will not get away with what you did nor with what you are doing now.)

That said, let me tell all the others of you out there what happened at the mediation- meeting-that- wasn’t, this morning at Middlesex Hospital.

As you know, I have been wanting this meeting for a long time, but when I got there not only did I discover that they were playing the game of “Oh, I had no idea that you wanted a mediation meeting, I didn’t know what this meeting was about at all…” but that the CEO had actually cancelled on last Friday the people that he had arranged to meet with me. So in fact the only people who came were administrators, not anyone who had treated or dealt with me on the unit itself, except the doctor who saw me for the last 11 days of my 6 week stay. He may have been the director of the unit, but he was hardly the main doctor I saw, despite what he claimed.

Anyhow, the meeting was extremely — well, first of all, it was largely a waste of time, because NOTHING was said of interest to me. Except that Dr Grillo, the unit director, after I read what follows, actually had the gall to claim that restraints were entirely appropriate…He said nothing whatsoever about what they did to me. OTOH, I can understand why. After all, he had already been told that we were writing the Department of Justice and the Joint Commission regarding his unit, so he must have felt supremely threatened. Naturally he could not have admitted wrong- doing. Not that any god, excuse me, doctor that I have ever met has ever admitted doing anything wrong or ever apologized. God forbid, a doctor apologize! No, that would be too hard and too demeaning for them to ever do. Better that they go along and permit torture and abuse than that they admit that there was wrong done to a patient on their watch, much less that they personally even made so small a thing as a leetle eensy meestake…

Well, I know what they did to me and I know it was abusive and wrong, and so far, except for Dr Grillo and that lot, NO ONE I have ever met outside of Middlesex Hospital has ever ever agreed with him and said, Yes, in fact the use of restraints was proper and necessary, and they were right to do what they did to you.

So take that, you watchers from MH. I hope you tremble in your boots for torturing me so. Because you never apologized, and wouldn’t’ meet with me to talk about it, it serves you right whatever happens now. I came down there today , and it took all the courage I could summon up to do so. I came down there, after two nights without sleep, just to meet with you and talk about what happened on April 28, 2012. But you couldn’t be bothered to deal with me, and so now you will deal with the DOJ and JCAHO. And too bad for you if that means that heads roll and some of you lose your gd jobs. I do not care any more. I tried, I tried to reconcile and talk with you about it, but you didn’t have the courage to do so, you wouldn’t deal with me, and so now you can deal with the powerful ones, and not me. Now I don’t give a damn what happens to you.

Meanwhile, this is what I was going to read to all of you, and what I did read to the hospital CEO and the administrative personnel, and what the advocates are sending along with the letter to the DOJ and JCAHO.

STATEMENT TO N-7 TREATMENT TEAM & CEO OF MIDDLESEX HOSPITAL et al.

Although I have a longer statement, I first want to read you a poem that I wrote about my experience here. It is only half a page long, but like any decent poem, it says a great deal in few words. The expression “Long pig” means a human being intended for eating.

TO MY PROTECTORS

I came to you fractured,

splintered to syllables,

all-fired to incinerate

the house of my body

where the devil lived.

But I was not nice,

not nice, not nice, no,

I was not nice enough

for balm and kindness,

or to win back my art

or my writing supplies,

so I upended a trashcan

on top of my head

and uniforms nailed

me, naked X, to a bed.

It gouged my brain.

Freight train. Tank.

Two years: still blank.

Nurses, doctors,

thieves: you knew, you

knew. You made of me

pulled pork, long pig

X-posed and pinioned,

not quite a specimen

for your knew the subject

and your objective :

your satisfaction showed

as you struggled to hide

your smiles.

I was admitted to North-7 in extremis: confused, psychotic, and traumatized. Exquisitely vulnerable, my sole comforts were doing art and writing. These were also my strengths. Yet instead of using these to help me, you consistently employed them against me–withholding supplies as punishment when you felt I was not behaving nicely and worse, using loss of them as a stick when they were most needed. The first time this happened was on April 9^th, nine days after I had been admitted. I had been using glue sticks freely to make a large collage for several days. Angry at me for yelling at her, one of the senior nurses whom I won’t name, decided to withhold them. She would no longer give them to me until, as she put it, “the team puts them on your treatment plan.” This frankly felt like such gratuitous punishment, and so unnecessary, not to mention counterproductive, that I could see nothing in it but petty revenge. Nevertheless, not myself and not in control, I screamed, “Fuck you!” and ran to my room. Luckily, Christobelle from OT, the one person who consistently treated me not only with understanding and kindness but with respect and dignity as well, came in shortly thereafter carrying two gluesticks. I do not know whether she knew of these new restrictions or not, but I was grateful.

On another later occasion, I had been using my soft felt-tipped markers, which my old treatment plan permitted me until 10pm. That treatment plan had been changed, however, and the new, more relaxed one said nothing about markers, so it seemed to me that I was now allowed markers in my room just like anyone else. However, around 10pm, someone called Bob came in demanding them. He threatened that if he had to ask, quote, “a 3^rd time you’re in for trouble.” My pulse ratcheted upward. Uh, oh, uh oh. Why was he doing this? Was he deliberately baiting me, trying to pick a fight? He could so easily have discussed my understanding of the new plan. It wouldn’t have been so hard to figure out a compromise. After all, they were just Crayolas, not carbon steel knives. I was sick of the power plays, and sick of the way staff just wanted to control me instead of talk to me and of how they insisted on domination at all costs. Well, this time I was not going to give up without a fight, and it seemed that a fight was what Bob was itching for. Instead of negotiation and attempting to find a compromise, Bob reached out to grab me, which I construed as an assault. I screeched, “Don’t touch me!” Someone else grabbed me from behind. I kicked and punched. Someone told me later it was Ruth I kicked. In my journal I wrote this: “she was furious enough to lie and scream that I caused an uproar ‘every single night and I’m sick to death of it!’…”

I fought them then, clawing and screaming, trying in vain to resist, my body flailing as the chart itself notes, my heart hammering. Why were they doing this to me over a few markers?! I wanted to scream. Why were they being such bullies? They were hurting me! But of course there were several of them against the one of me and they were much stronger than I at 102 pounds so naturally they overpowered me. They literally dragged me to the so-called time-out room and dumped me on the floor, ordering me to calm down. Then they closed the door. No they didn’t lock it, but they kept me from leaving by leaning against the door.

You know, I don’t know why you bothered calling it a time-out room. No one could use it at will. And when you put me there, I didn’t ask to go – I was forcibly dragged there — and I didn’t want to stay: you kept me there by force so it was the same thing as seclusion, literally and legally. Time-outs have to be voluntary, you have to be able to come and go if and when you want to. When it is forced, it is by definition a seclusion. Period. That cold barren room was not a time-out room. Who did you think you were you kidding?

And listen, did it never occur to you that it was always your treatment of me that generated my behavior, yes, the negative behaviors as well as when I was in control? You could have found out what was going on by talking with me. Instead, you decided to dismiss everything I said and did as manipulative and acting out so you didn’t need to listen to me. Perhaps you thought this disregard was kept secret from me, but I knew it at the time and it caused me enormous anguish. All I wanted was to be treated like a human being. All I wanted was to talk to someone and be listened to. But all you did was make assumptions. You never checked them out with me to find out if they were true and they almost never were. Assume makes an ass out of U and me…But mostly it does terrible damage when the assumptions are wrong. I was so afraid, I was so terribly afraid, but you never knew the half of it. All you did was to dehumanize me, ignore my pain and order me to shut up and be quiet. I know I was difficult for you to quote unquote “handle.” Hell, I was difficult for ME to handle. But I do not have a personality disorder. Ask anyone who knows me. Ask my family. Ask the psychiatrist who saw me from 2000 until 2009, ask the psychiatrist I see now. But you decided that you could detect borderline traits (somehow transmogrified into the full-blown disorder upon discharge…) despite the presence of an active psychosis. By decreeing that I had such a disorder, you put me in an utterly untenable position, because then you had a justification, so you thought, for taking nothing I said at face value. To me it felt like nothing less than soul murder and I will tell you that this particular form of soul murder makes a person want to die. It makes a person want to bash their brains out in public just to get someone to acknowledge them and take them seriously.

April 28.^.April 28, 2010. You wrote in my chart your interpretations of my behavior that day and of what happened. Yes, your nursing and physician notes were supposed to be objective but dispassionate as they may have attempted to sound, all observation is but interpretation. I repeat: All observation is interpretation. Now I want you to know what happened from my point of view. (I know that some of you have been snooping around, reading my blog just as you did during my hospital stay, but you will have to sit through this anyway…)

At around 7:30pm, so the evening nurse reported in my chart, I “walked into the dayroom” and if one can believe this, without any provocation I “began shoving and turning over chairs. I then, quote, “picked up the patient trash can and put it over my head.” Staff ordered me to what they called the “time-out room.” Nursing notes report that I refused and, I quote, “went to bed instead.” Because I had not followed her direct order, the nurse wrote that “security was called and patient required security to carry her to time-out room as she refused to move or walk.” No, I simply lay on my bed, mute, trembling with terror when the phalanx of guards roared in.

Despite my lack of resistance, the guards physically took hold of me – unconcerned apparently with my known history of rape and of recent trauma — and took me from my bed where I was calming myself in the least restrictive environment. They physically carried me to the seclusion room and together with staff they forcibly prevented me from leaving.

This is what I wrote in my journal: “It was (freezing in that room) and they wouldn’t give me a blanket so I didn’t stay long…This only led to more goons pushing me back… this time strong-arming me and forcing me to a seated position on the mattress before quickly leaving but not locking the door.”

The nurse wrote this: “Patient refused to stay in time-out room… Patient attempted to shove staff, kicked at staff to get out of room. Patient was instructed several times to sit on mattress and stop pushing at and kicking staff. Patient refused. Seclusion door locked at 7:55pm.”

At this point both records state that I stripped off all my clothing. But the official records record only that fact, and that I then “was changed into hospital garb” and that I immediately stripped these off too. In my journal I wrote something else in addition that is rather revealing: Left alone in that room, I decided, and I quote, “they’d have to give me a blanket if I was [naked] so I quickly undressed and just hid under the mattress for warmth. This caused a stir for some reason and I was forced to put on hospital pj’s and lie down on the mattress. This would not do, not without a blanket which they continued to refuse me.” So once again I took them off and got up and tried to push through the woman barring the [temporarily] unlocked door. She called for reinforcements and they came. In fact, they came en masse.

“At this point” my journal continues, “they again subdued me and told/asked me why I was fighting. I said [it was] because I needed someone to talk to. That was all I wanted, just someone to talk to. One guard seemed taken aback. All these personnel hours wasted when all I wanted was a half hour of one person’s time? It seemed to strike him as ludicrous as it did me….

“Why don’t you just ask to use this room when you feel anxious or upset?” he then asked me.

“I do, I have!” I replied

“Well?

“They always say it has to be reserved for an emergency.”

He seemed completely flummoxed by that reasoning but there was no arguing with Policy so he fell quiet. Finally they decided to leave, telling me to be quiet and lie down.

I did. I did. But I was cold and I begged for a blanket.

“Sorry, it is too dangerous. You will have to sleep without one.””

Why was it so dangerous when I was on one to one and had an observer at all times? It made no sense. And why wouldn’t they just give me a sweatshirt and socks then? Or turn up the heat. How did they expect me to sleep, I was too cold!”

But this last categorical refusal was just too much. No, no blanket, no nothing. Just shut up and freeze. “That was it, I’d had enough! I dashed at them head-first and they parted, only to grab my arms and try to stop me. Someone twisted my right arm and held it behind my back, but I knew how to get him to stop it, so I tried to bite him and he briefly loosened his grip. I twisted my own arm back to me and my left pinky, held, closed tightly onto something, hooked so tightly it wouldn’t budge. My legs, the right one, grabbed the thin leg of a woman behind me, making her lean back off-balance and lose her grip on me. Then I switched to holding both my legs in a death grip around the legs in front of me. It didn’t matter one iota that [I had taken off my clothes again to get a blanket and] was naked…Anyhow, they eventually overpowered me.”

As one guard shoved me onto my stomach on the hard floor, his knee in my back, he muttered in my ear, “You bite me, I’ll teach you a lesson you won’t forget!” Then he mashed my cheek hard against the dirty linoleum till I was breathing dust.

I knew he was capable of hurting me, they all were. I also knew that people can die during prone restraint as the Hartford Courant and others have documented. Adrenalin flooded me, my pulse threatened to rocket out of control but I knew I had to calm down. Very deliberately, I forced myself to lie still, barely breathing.

Fortunately, when I stopped resisting, they released me and let me sit up. Someone gave me a sheet to cover me. The room cleared, except for a tech who was on 1:1 with me. She apparently was now allowed to talk with me, and for this I was supremely grateful. We conversed calmly. The door to the seclusion room had been left open, a big relief.

However, people were still talking in low voices outside the door. I heard someone trot down the hall, heard the open-and-shut of a cabinet door. I asked my 1:1 what was going on. “Don’t worry. They are just getting you some meds or making up a bed for you.”

“A bed?” I said. That gave me a bad feeling…Then I understood what was going on. “Uh, uh. They can’t put me in restraints, I am calm and it is illegal to restrain someone who is not a danger to self or others. You know that.” I repeated it loudly, loud enough so the other staff could hear me. I began to tremble, but forced myself to remain as composed as I could, mustering all the arguments I could against the use of restraints. A nurse entered the room then and asked me to come down the hall. Did I need an escort or could I walk there by myself. “Oh I can walk by myself. But you can’t put me in restraints, I am calm.” I was barely able to speak. I felt dizzy and short of breath but I tried desperately not to show it because I was afraid that if she knew how terrified and upset I was that it would actually give them justification. Nevertheless, I followed her to the empty room — my heart went cold, I could feel urine leak — I felt like “dead man walking” when I saw that in fact they had fastened four-point restraints to the bed.

I entered the room filled with staff members and guards. I told them over and over that I was calm and willing to take PRN meds. I said I knew they were punishing me and that they knew it too. No one contradicted me. The nurse in charge ordered me to lie down on the bed. I protested. She threatened that if I didn’t “they would assist me.” I was terrified of another assault. In fact I was so terrified just of the physiological consequences of fear itself – the flood of adrenalin and painful tachycardia — that I made myself get it over with. I lay down on the bed. Gritting my teeth, I said nothing even when they pushed aside most of the sheet that covered me.

I meant to remain silent. I meant to remain completely still in order to shame them. But when they pulled my wrists right over the edges of the bed, shackling them painfully below the level of the mattress, and spread- eagled my ankles to the corners of the bed, I broke that silence and objected — vociferously. I was appalled at their barbarity but my protests did nothing. I fell silent and let them do what they wanted. Finally satisfied, they trooped out, some of them actually smiling, leaving me alone in the room. I fell asleep quickly, a narcoleptic stress reaction. Nevertheless, no one returned for an hour. They extracted a pledge of obedience from me before taking off the shackles.

“When they released me,” I wrote in my journal, “my back hurt so badly I could barely walk and…my scapula muscles felt as if they had been separated. ‘I plan to sue you for doing this to me.’ I said as calmly as I could as I left the room. Nobody reacted.” As I wrote in my journal the next morning, “I woke in severe pain, the muscles in my chest felt torn from those that connect it to the shoulder… the pain went clear through to the scapula.”

That was not the end of it. Once you treat a human being in such a fashion, all bets are off as to how she behaves from then on. I no longer cared what you did to me after that. When you threatened me with restraints a few days later, I dared you to do it. I egged you on and so you did. My capitulation showed subsequently when I stripped naked multiple times, even voided on the seclusion room floor and smeared urine on the walls. You reduced me to an animal. I hope you were pleased with the results.

From what I witnessed, many of you — on the nursing staff at any rate– took no pleasure in your jobs. You apparently didn’t want to work in psychiatry, and wanted nothing more than peace and quiet and an easy day’s work. When one of you actually screamed at me, after that staff assault occasioned because I didn’t hand in my crayons on time, that you were “sick and tired” of listening to me every night, that was stupid and nonsensical. How can any hospitalized psychiatric patient be expected to worry about what makes a nurse comfortable? By rights it should be the other way around.

I think what it comes down to at the North-7 secure unit is that you expected patients to meet your needs and make you happy and you tried to force us to. In my case, and in at least one other patient’s that I witnessed, you even tried to physically assault us into doing so. But what a farce. Patients in the outer unit warned me to get out of there; they told my friends they were worried staff would hurt me. They were right. By the time I was discharged, I had almost no memory of what had happened over the previous 6 weeks. It is only in the last couple of months that anything has returned to me. Yet every single day since my discharge, when I least expect it, something triggers a thought or bodily memory of my stay here and instantaneously my heart starts hammering, I get dizzy because I can’t breathe, and I tremble and cry just thinking about it because I’m right back in that seclusion room and April 28^th is happening all over again…

Now, I don’t expect to recognize any of you. How could I? I still don’t remember much except those episodes I wrote about, and some little snippets here and there. I am told that some of you will be nursing staff on N-7 and some my so-called treatment team. Well, if you were my treatment team and you just turned a blind eye to what went on, for that you are just as guilty as if you accomplished the acts yourselves. Of course, the worst of it mostly took place in the evenings, in relative secrecy and when few were around. But if you knew it was happening nonetheless and If you approved, well, then, I have nothing to say except shame on all of you.

I felt helpless and utterly alone. Frightened beyond belief. No one defended me, no one helped me or came to my rescue. No one except Christobelle Payne. Christobelle treated me with compassion and kindness. She always made sure that I had gluestix and magazines for my artwork, even when your every impulse was to withhold them as punishment. I cannot tell her how grateful I was and how grateful I remain to her for treating me so humanely. I have never forgotten the oasis of kindness she provided in your North-7 desert.

Apparently no one else on the unit understood how to behave humanely or to treat patients with respect, or no one else gave a damn.

Punishment is the nature of what you did to me. You lost your tempers and you punished me. The result was that you permanently damaged and traumatized me. I believe you did what you did absolutely on purpose and I believe you did not care what the consequences would be to me.

Some of you deserve to lose your jobs because of it and because of what I’d venture to guess you have been doing for a long time to other patients. Perhaps you will. You all need to be thoroughly retrained, if that is even possible. Certainly the secure side of the unit needs to be completely reorganized and re-staffed. But that is not my job. You’ll find out what will happen after the Department of Justice and the Joint Commission do their thing.

I hope you remember me and what you did to me for a very long time. Unfortunately, I know I may never be able to forget you. I wish I could, believe me, I wish I could.

Art and artwork, Collage, Psychiatric Unit, Seclusion and Restraints

Collage — Updated but still unfinished

November 8, 2011 Phoebe Sparrow Wagner Leave a comment

Still working on it, frantically. Much changed, but better I think. I hope so at any rate. My friend told me that the curtains are actually close to being done since at a distance they are perfect. Only need height fixed and a curtain rod. THe left one needs a bit of work, but not a lot. So now I need mostly to straighten up a few lines and clean up the mirror or decide whether to keep it a hand mirror or recapture the original idea of a mirror standing on the lawn as my original drawing had it. So in case I haven’t posted it before here is the preliminary sketch first:

Preliminary Sketch for Collage — This is the sketch I did of the collage, largely because I was fearful that I could not accomplish my vision for it without one.

And this is the collage as it is now, and nearly finished. I see now that I also need to add back the second set of restraints, and a top molding for the window, as well as the sill molding and certain shadows. Also clearly the mirror needs to be fixed and other things, but you can see what it will be like when done. If, however, I do not finish it completely in the crunch to Friday, well I will exhibit it as a work in progress!

Reflection on Room in Ward 101 - unfinished but updated — Title is tentative, still undecided. Reflection on Room in Ward 101. A reference to book "1984" where the Ministry of Love was where lies were taught: Love is Hate, Peace is War etc

Acceptance, Art and artwork, Collage, Forgiveness, Health, Mental Illness, Psychiatric Unit, Recovery, Seclusion and Restraints

Photos from “Reflections on a Psychiatric Seclusion Room”

October 22, 2011 Phoebe Sparrow Wagner 1 Comment

Reflections on Psychiatric Seclusion and Restraint Room — Reflection of Seclusion and Restraint : There is hope and freedom somewhere.

NOTE: this is a link to the finished collage, sans border of which I have no photo: https://wagblog.wordpress.com/2011/11/13/reflection-on-room-101-in-ward-d/

I now call this Reflections on Room 101 in The Ministry of Love, as a reference to Room 101 in the book “1984” by George Orwell. The place where recalcitrant prisoners faced torture with the things they feared most in the world.

I want to post today some photos from the progress I have made on my large collage of the restraint room (seclusion room) in a psychiatric unit. I must say that it gives me the shakes whenever I work on it, or at least whenever I look at it afterwards, and certainly when I photograph it. But I think that the fear and heart-racing palpitations are slightly diminished compared to this time a month ago. Possibly. That is what I am hoping for at any rate. The process of doing this is my attempt at “exposure therapy” I suppose, because I cannot live with what feels like PTSD any longer. (I know, I know, according to the New Rules, you cannot, by definition, have PTSD unless your life was mortally threatened; unless you experienced a tsunami or earthquake, mass murderer, or Hurricane Katrina, it does not count as “real trauma,” so say the doctors, and they should know, right? After all, they are the ones who defined the illness, and keep redefining it, and who made it up! Well, since they have the initials MD after their names, standing for Missed Diagnoses, I dunno if we can trust them on anything as important as deciding for us what it is that counts as traumatic. It seems to me that WE ought to be the ones telling THEM, no?) Be that as it may, let me change paragraphs and resume the discussion I left off so abruptly above.

Whatever the case, I do suffer with heart-racing fear and sweats and tremors that make it difficult even to take a clear photo of the collage after working on it but whether it is PTSD, I care not. All I care about is 1) communicating the experience, or at least what the rooms look like, and 2) purging myself of the residual fear.

I don’t want to go on any further with that. It truly does cause me great anxiety. And I prefer to work on the collage and on forgiving the specific people who did those things to me. It is likely that they had grown to hate me, forgetting that I was a troubled and profoundly ill person because I was also loud and frustrating and violent…(treated with violence didn’t make me any more docile, I might add). So things only escalated and escalated, when from the start their goal was to have a quiet unit that ran smoothly and had everyone get discharged in a matter of days, no questions asked. They did this by helping no one, by talking to no one, and by questioning no one. All they cared about was making sure that everyone stayed “safe” for as long as they were in their clutches. And that they would say so until they left. BUT I said I was working on forgiving them, and trying to see them as tired human beings, flawed but human. It does me no good to get all riled up again.

so I will leave it here, with the photos of the art. I will add only that I plan to redo the curtains, since as it is the blue competes with the sky. Also there will be a curtain rod, and such…But as you can see, it is still a work in progress!

Now you can get a better idea... — You see the mirror now, and the bed with the restraints? The garden below the window?

What the mirror outside sees in this room, locked from outside the inside... — No those are not “banjos” on the bed…Look closer. This is a psychiatric unit…

Mirror is real... — But so is everything it sees and reflects…

There is Freedom Out There — Behind the mirror, beyond the window, an open garden gate…

Hospital, Mental Health, Poetry, Psychiatric Unit, Seclusion and Restraints, Uncategorized

Video of Poem: “How to Read a Poem” plus Update

October 9, 2011 Phoebe Sparrow Wagner 4 Comments

I am not sure what to think of this video. I certainly did not give permission for it to be used, nor did I approve of the final product. But I would welcome all opinions, should anyone wish to share. Please do not click on Like or Dislike buttons to give opinions. That only tells me you dislike my posting it, not the video itself…But maybe I am too sensitive.

I see that it will not insert directly here so I am placing the link to it here instead.

HOW TO READ A POEM: BEGINNER’S MANUAL

First, forget everything you have learned,

that poetry is difficult,

that it cannot be appreciated by the likes of you,

with your high school equivalency diploma

and steel-tipped boots,

your white collar misunderstandings.

Do not assume meanings hidden from you:

the best poems mean what they say and say it.

To read poetry requires only courage

enough to leap from the edge

and trust.

Treat a poem like dirt,

humus rich and heavy from the garden.

Later on it will become the fat tomatoes

and golden squash piled high upon your kitchen table.

Poetry demands surrender,

language saying what is true

doing holy things to the ordinary.

Read just one poem a day.

Someday a book of poems may open in your hands

like a daffodil offering its cup

to the sun.

When you can name five poets

without including Bob Dylan,

when you exceed your quota

and don’t even notice,

close this manual.

Congratulations.

You can now read poetry.

https://www.facebook.com/video/video.php?v=1759323499617

_______________________________________________________

As for the update, well, I sent most of the important material from which I derived the last blog post about the restraints episode to the Office of Protection and Advocacy and by the afternoon of that very same day, I got a call from them telling me that they were going to do an investigation! Not maybe, but yes. This was quite a surprise. I did not expect to hear from them so soon, much less so definitively. They do not take every case after all, but pick and choose from the many complaints that come their way. I have run into so many roadblocks that I was afraid that there too I would be shoved aside for other more important matters. But no, I think they too found this matter outrageous.

So I will keep you posted as to what happens. They want access to my chart, which I will give them, but I will also fax them the pages from my journal too, as I want them to have contradictory accounts to counter what the “official” record says. Though that says enough that is not quite legal by itself.

I have been cleaning my apartment for 2 days and it is still a wreck, but I need to frame all my artwork for a show I will be doing in early November, at OpenStudio Hartford and I cannot do anything until I have space in my apartment. It is getting better, at least there are “paths” to walk through! But there is still a lot to be done, and I am already very tired of cleaning. How on earth do I make such an atomic mess of things so often? So needless to say I cannot write much today, but I did want to let you know of this latest development.

TTFN or TaTa For Now

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

Artwork from Hospital

September 27, 2011 Phoebe Sparrow Wagner 1 Comment

Open Window and Outside Mirror — 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

September 25, 2011 Phoebe Sparrow Wagner 3 Comments

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.

Eating, Medication, Prisons, Psychiatric Unit, Psychiatry, Schizophrenia, Seclusion and Restraints, Violence

Mental Illness and Authority: Part II

February 14, 2011 Phoebe Sparrow Wagner 3 Comments

I started the post below as a response to a very kind email from “Mary” but it eventually got so long and involved that it became more of an essay than a letter. I hope she will understand why I put it here, rather than sending it to her alone!

_____________________________________

First, here is her letter to me:

Thanks, Pam. I learned from your very well written account, “On Psychiatry and Authority.” I felt like I was in the room with you, it was so descriptive. I recently had a call from a man who is bipolar. He said while off his meds, he was in an encounter with his girlfriend and was arrested on domestic violence or disturbing the peace charges. He told the officers he was a psychiatric patient, but of course, jails have become America’s answer to mental illness. The police threw him into a cell after booking him, then released a police dog on him in the isolated cell rather than simply locking the door. He said the dog ravaged his leg, exposing bone, and he was taken to the hospital. There may have been a time when only black mental patients were treated this badly, but the caller was white. I wrote about more murders and abuses against mentally challenged people in my blog – Letter to Mary Neal’s Terrorists – http://freespeakblog.blogspot.com/2010/10/letter-to-mary-neals-terrorists.html

I am still undergoing much censorship, Pam, likely because my advocacy to decriminalize mental illness is a threat to the private prison industry. Over half the inmates in America are mentally ill. If they are released to community care under AOT programs or treated as hospital inpatients rather than prison inmates, depending on their offenses and functionality, it would not be more expensive for taxpayers, but it would negatively impact prison profits.

As I read about your brutal treatment in the hospital, I was so sad. Here I am advocating hospitals rather than prison, and you were treated that way by psychiatric professionals. The only way I can continue after learning what happened to you and others who were in abusive hospital environments is by thinking about people like my caller who was not only tossed in an isolated cell naked, but a vicious dog was sent in to attack him after that. I also think about my brother Larry who was murdered under secret arrest because police were fed up with being his psychiatric caretakers. Although hospital care is only marginally more humane than incarceration in some cases, there are fewer permanent physical injuries and murders among hospitalized patients.

Thanks for sharing your experiences.

Mary Neal
Assistance to the Incarcerated Mentally Ill
http://www.Care2.com/c2c/group/AIMI

And my response:

Thanks so much for your email and sympathetic understanding of the traumatic aspects of my so-called “treatment” at Muddlesax Hospital last April. Such treatment was, at other hospitals especially in the 80s and 90s and even in the early 2000s, so much worse — I mean in terms of real physical violence perpetrated against me while being literally, bodily, forced into restraints — that I was almost reluctant to write about such a relatively mild incident. But the humiliation of having to put myself into restraints was almost more unbearable than the, in some sense, honorable freedom to resist! It just riles me completely…How dare they put me in such an untenable position? Then again, I suspect it was intentional.

Nevertheless, I am very much aware that in Connecticut hospitals way too many people have died while they were in restraints, and this in the not so distant past. In fact it was investigative reporters at the Hartford Courant back in the late 90s —and their article entitled, I believe, Deadly Restraint — that served as a national catalyst in getting hospitals to stop the wholesale use of seclusion and restraints. At the very least it started a national discussion about the use and abuses of force in psychiatric hospitals and (I think) juvenile detention centers. (God forbid anyone at all should care about jails and prisons however…Those people obviously deserve it, they are criminals after all… Right?)

But even though most hospitals in Connecticut claim to have reduced the use of force to the most extreme cases, (they will force medication though, through the use of forced medication hearings) I do not believe that can be so. Because I cannot believe that I alone “deserve” seclusion and restraints and yet I have been subjected to such abuse time and time again. Until 2005, I was put in S + R at least once almost every time I was hospitalized and quite often multiple times, for many long hours. After 2005, I would say the incidence was reduced by about half. That means that half the hospitals still indulged in this abuse, one of them, as I wrote earlier in this blog, employing them almost every day for a week and a half!

Of the hospitals that did not physically restrain me, most were still abusive, but more subtle about it…For instance, they would put me on Constant Observation, but then tell the “sitter” not to speak to me. Or they would institute the common but for all the commonness of it, still abusive policy, of making the one-to-one person being ignored sleep with her hands and head completely uncovered. Now, all hospitals are freezing these days, I do not know why. But it was well known that you had to bring a sweater or sweatshirt everywhere, because the air-conditioning would be out of control and everyone was too cold no matter the season. So to have to keep your hands exposed all night was cruel. But the reason that they insisted on it clearly had nothing to do with it being “safer” for the patient. No, it was punishment. That is ALL. The whole purpose of one-o-one in those places was punishment. You could not talk to the sitter, one, and the sitter had to follow you even into the toilet. And all the while deliberately ignoring you if you spoke to her..So what was the point, if they kept the close eye on you they were supposed to, they knew you could not hurt yourself. So the point was simply to humiliate and torment the patient so they would beg for “freedom” and pretend or at least mouth the words “I am safe.” Those magic three words were all that were needed, but you had to say them so that the nurses could hear.

For many years, I believed that this was a hospitals-wide, state-wide, business as usual policy, the no-talking, hands exposed rules, and that it was reasonable. Until I went to Natchaug and Sharon told me that Natchaug didn’t believe that one-to-one should be “punitive” in any way. And by the way, she said that word, “punitive,” not I. Nevertheless, at Natchaug, no one made me sleep with my hands outside of the covers and the sitters freely spoke with me. In fact, once they understood that I needed them not to share their own lives with me, because then I would feel the need to take care of them, something that would not be helpful to me, they wanted to find out specifically how they could help me.

But back to the use of restraints. I am only 5’ 3” and from 2005 until 2010, I weighed between 92-105 pounds. Surely I could not have been that great a threat to anyone. In fact, at one hospital, one I will not name, fearing them so much I wouldn’t put it past them to take revenge, they had a somewhat better policy of dealing with agitated patients. At a Code Orange, staff members from every unit converged on the “victim” (sorry but that is how it felt) and “held” her until she could calm herself. Now, this “holding” often consisted of pinning her bodily to the floor, which itself could be anxiety provoking. And at least once, in my case, a male nurse who openly detested me, tried to pin me to the floor on my stomach, which I had read was something to be avoided as people had died when held down prone, as opposed to supine (on the back)! But in general the technique worked, if the victim was held down long enough. Basically, if he fought, there were enough people holding him down to allow him to exhaust himself without doing anyone harm. And then, when exhausted, he would calm down and either take PRN medication, or assure the head nurse that he would be okay now. It worked, though, no matter what I thought about it, or of the people doing it. And it did avoid all use of restraints, though of course by itself it is already a form of restraining people, it just avoided the use of mechanical restraints. That though, still makes a big difference…

Forgive me if I segue again into another digressive subject for a minute or two, but the subject of 2010, which recently turned the decade corner into 2011, brought to mind the fact that having taken Zyprexa (most of the time) since then has caused me to gain a fair amount of weight, another subject that is near if not dear to my heart. Oh, the damage that psychoactive drugs do! How dare doctors blame us, the people with schizophrenia, for it? Don’t we have enough trouble without being blamed for the side effects of the very medications that they prescribe? Do you know that for decades, and sanctified as Truth in psychiatry textbooks, they insisted, without any reason and making less sense, that schizophrenia itself was the cause for so many of us to be obese? That was utter nonsense to my way of thinking. Every single memoir about sz that I ever read revealed that the author had been thin UNTIL she or he was treated with antipsychotic drugs, and then, blammo, food becomes the enemy. Yet the shrinks actually insisted, against all the evidence, that it was the illness and not the drugs that was behind the huge % of patients exhibiting this “signal obesity”.

Well, all along I thought they were full of shit, pardon my french. No, I didn’t just think it, I KNEW it. I had not a doubt in the world. And you know what? I was right. The latest research has borne out precisely what I’d asserted all along: when investigators looked at a population of people with schizophrenia that for one reason or another had never taken antipsychotic drugs, they discovered that this neuroleptic-naive group was thinner than average, and that it was in fact the drugs that had made us obese, sometimes massively so, rather than schizophrenia. And it just infuriates me, not just the obesity, it is not just the weight gain the drugs cause, it is the fact that we patients have been blamed for something that they, the doctors and nurses and their GD drugs, inflicted on us. Maybe it is especially difficult for me, with my history of anorexia and my intense wish simply to disappear, but what about those who will die from drug-induced heart disease or diabetes?

I know, I know, Mary, you may be on the other side of this argument, or it might appear that way, because you want more treatment to be available, not less. I do in general agree with you: Prisons are overflowing with the mentally ill, who should never have been there in the first place. In fact, I think the prisons are overflowing with an awful lot of people, especially those of a certain darker-hued skin, for little reason more than the very color of their skin! I mean, tell me why Robert Downey Jr and Lindsey Lohan, aside from their celebrity status, get caught again and again with drugs and cocaine etc, yet are sent off to posh rehab centers, with a smile. But should you happen to be an unknown, POOR, god forbid mentally ill person of a darker hued skin (and let’s face it, a light/white South African immigrant would not be treated the same way as a dark-skinned someone with Nigerian roots!) if you are that person and you offend in some way just 3 times, well, then, you are sent away to one of California’s really “posh” ha ha ha penitentiaries FOR LIFE! Things like that just make my blood BOIL. And don’t get me started on the insanity of our drug laws!

But forgive me for going so far astray. It is just that the whole subject of prisons and what we do to people in them is a really sore point with me, and not just how we treat the mentally ill there, though that is about as atrocious as it can get…Need I even mention the “extra beds” in unused supermax prisons being used to house “unruly” MI prisoners? It makes me want to scream and throw up at the same time.

Well, no doubt this “essay” is both incoherent, in the sense that it doesn’t cohere properly, and just plain incoherent! I admit to a bit of laziness, as it is late at night, and i need to take my MEDS and go to bed. So, at the moment, I am not going to polish and fix it. I am going to pretend that since this is “only” a blog I can get away with shoddy ill-organized writing, and call it a night. Which is what I am doing forthwith…Good night, and thanks, Mary N, thanks a million again.

Psychiatric Unit, Psychiatry, Seclusion and Restraints, Uncategorized, Violence

On Psychiatry and Authority

February 13, 2011 Phoebe Sparrow Wagner Leave a comment

My writers group gets together once a month, when we discuss the single page of prose nonfiction or fiction, or usually in my case a poem, that we have written to the one or two word “prompt” chosen the month before. While I had to miss this month’s meeting, due to exhaustion, I did write (or rewrite) an essay as well as a poem. The poem I cannot share, for reasons I have reiterated many times: if I publish it here, I won’t be able to do so in any hard-copy journal. However, I feel comfortable putting the essay here, since it is mostly a rewritten and reworked piece of an earlier blog post…So if it seems very familiar, it is. I wrote it in fact not so long ago, but I have polished it and turned it into a piece of writing with a beginning a middle and an end, with a few other details I have discovered from sources like my journal since then.

PS I apologize if I repeat myself on this topic once again, but you can see by the repetition itself how much trauma incidents like this one, but also most of the others, which were much worse for being truly violent, inflict upon people…

========================================

S & R

Maybe I was disruptive. Perhaps I frightened other patients. I do not know why otherwise they would have forced me into that barrenness known as the “Quiet Room.” That it was just the same old seclusion room, prettified with another name did not escape me. I begged for a blanket, but no deal. Freezing, I pulled the thin mattress over me instead. They yanked it off in the typical psychiatric nano-second then eliminated it from the room altogether. Now I had only two hospital johnnies and my rage to keep me warm.

I remember that I yelled a lot, and that I wouldn’t stretch out on the cold linoleum to “calm myself.” I begged the one-to-one nurse to talk to me. She only turned away and told me to lie down on the floor. I complained again that I was cold. She said nothing, only barred the doorway. Getting no response and still agitated, I tried to push my way out. Two “guards,” who though deliberately keeping just out of sight, were on alert, and they shoved me away from her. I yelled again and shoved back. One of them asked what was wrong with me, why didn’t I just ask to talk with the nurse instead of physically resisting? I did ask to talk, I told him, but she refused to, they all did. He wrinkled his brow as if confused by this answer, but with a shrug that said it wasn’t his job either, he ordered me to stay inside the seclusion room and to “just lie down and stop making trouble, if you want to get out of here.”

About what happened next, I remember little. I only know that suddenly I found myself face down on the floor and with a commotion of people around me. Some man had pinned my arms behind my back and he was angrily mashing the left side of my face into the floor.

When they let me up, I yelled that I was not in prison and they had no right to treat me that way. But at least, I discovered, I was finally allowed to talk to the nurse and to stand out in the hall with her. That was progress, I thought. Then I heard staff in low and serious discussion some distance away. Someone sprinted down the hall in the opposite direction. I had a bad feeling about it and asked my one-to-one nurse, “What’s going on, what are they doing?” She responded, “They’re making up a bed for you.” “A bed? What sort of bed?” That’s when I understood that she meant a restraint bed. “Wait a minute. You can’t restrain me! I am out here, calmly talking to you. You haven’t even offered me a PRN and I am willing to take one. But I am not a danger to myself or others, and you cannot legally put me in restraints.” The nurse remained silent. She refused to look at me. My heart began to race. I shouted down the hall, “I will not let you use restraints on me. I am calm and you are not allowed to do this.”

When finally staff members approached and asked me to follow them, I complied. I knew that if I didn’t they would have reason to say I “deserved” whatever they did. In my room, I found there attached to the bedframe were the straps and shackles of four-point restraints.

“Listen, I am calm and I am not a danger to myself or others,” I carefully declared. “I will take PRN medication. I do not need restraints.”

“Lie down on the bed, Pamela,” one nurse told me. Again, I refused, saying that this was punishment pure and simple. They had neither cause to do this nor any legal right. She responded, “We will ask you one more time to lie down on the bed, Pam, or the security team will assist you.”

At this point, I understood that they were going to use restraints as a form of discipline and would do so no matter what I said. It was completely illegal but they were out to get revenge and they would use any reason I gave them to excuse such measures. If I “made” them force me into the restraints, it would only prove that I deserved them. More humiliated than I have ever been in my life, I sat on the bed.

Ignoring my protests, they went ahead and shackled me to the bed, my arms below the mattress and my legs to each lower corner and then without a word, they left. Except for an aide monitoring me through the door, partially ajar, I was utterly alone: humiliated, degraded, helpless. I couldn’t help it. Against my every determination to stay strong, resolute, and angry, I let out a lung-bursting howl. I didn’t care who heard me, who I frightened, who I disturbed. I howled for myself and against all the injustices and cruelties that had ever been perpetrated against me. And I howled for every other so-called mental patient that had ever been shackled to a bed by medical professionals who claimed to be helping them. Who thought they could justify brutality by calling it therapeutic.

Lyme Disease, Mental Health, Psychiatric Unit, Psychiatry, Seclusion and Restraints

Natchaug Hospital Stay and Comfort Room

January 19, 2011 Phoebe Sparrow Wagner 3 Comments

I have been away since December 17^th, in the hospital yet again. This time the experience – at Natchaug Hospital in Willimantic — was vastly better than the previous two and not abusive at all. I want to tell you about this, but first let me go back to what happened to get me there.

In the beginning of December I began to have trouble again. The “people” came back with their jeering and mockery and commands. A general confusion assailed me. In my journal I recorded many “cries” of MATOOTAM! : “Kill the Ogre that Ate Manhattan” which many of you know means me. I also began to burn myself under the influence of those command hallucinations. I still believe this was all a Lyme disease relapse, but I had been on antibiotics previously for 8 years – with positive tests for Lyme and other tick-borne illnesses intermittently during that time — without being cured, so there was and continues to be nothing but symptomatic treatment. This means, as my new psychiatrist, Dr C, argues, at least temporary use of the hated, and loved, atypical antipsychotic, Zyprexa. I already am taking Abilify and Geodon, as well as Lamictal for mood stabilization and possible temporal lobe seizure activity. However, as has happened before, these were not effective enough to carry me through such a crisis, which is why I was encouraged to take Zyprexa, 20 mg to head off anything worse. Despite my resistance – I really hate the immediate increase of appetite and weight that accompanies taking it – I did so, I assure you. But the damage was already done and the crisis took on a life of its own, so to speak. By mid-December, I was no longer “safe,” the code word my visiting nurse among others uses for my listening to the commands the “people” give me. She didn’t know how true that was, though, until I finally admitted it after four days of what I will only describe as obedience to those same commands. I saw Dr C that Thursday, and though she was uncertain of my safety, she decided that I would talk with her every evening until I saw her again the following Tuesday.

The truth is, I do not really recall most of this, neither intellectually nor emotionally. I have had to be told and to refer to my journal in order to recount all of the preceding. However, I do remember what happened next. In addition to the reappearance of the People, I began to experience what I called “brain blips.” These were very brief episodes in which I felt as if my brain suddenly did a somersault, a little like the feeling when your heart skips a beat, except that it was in my brain and accompanied by a terrible dread and feelings of impending doom. After the fraction of a second in which the blip occurred, I would come back to myself – it felt as if for an instant I lost consciousness, but the blip was so very brief that it didn’t seem possible. These episodes were terribly frightening, even though nothing ever happened during or after them, not at least of the dreadful sort I feared.

That Friday evening, my heart racing and my mind itself awry, I was in another world, so confused that I wasn’t quite sure what was going on. I managed to call Dr C, who prescribed Ativan. It was too late to call the nurse to pick it up for me so I got in the car to drive the mile to CVS but as soon as I pulled out of the parking lot, the other world took over completely. I do not know how I actually got to the drugstore. I recall only that I could barely hear or see for the pandemonium in my mind but that I was aware enough of the danger to drive only 20 mph the entire way. Once there, however, I didn’t know what to do. I didn’t know how to get home and I forgot about getting the Ativan altogether. Somehow I managed to tell the pharmacist that something was wrong, that I couldn’t drive home, but she thought I meant that the car had broken down, and called a cab for me. I went outside to smoke a cigarette and wait for it, but I was so scared of the shoppers who came and went – the drugstore was open 24 hours a day so anyone in the area who needed something after 10pm came there – that I was unable to take more than a few drags, hiding behind a pillar. I returned to the pharmacist and whispered that there was something terribly wrong, with my brain, that as I felt, bugs had infested it and that I was in another world. Finally she understood and called an ambulance.

I won’t go into the drive to the ER except to say that I was so “out of it” that I wasn’t even upset that the EMTs made me get on the stretcher right in the middle of CVS and that everyone saw me being taken out of there. Once in the vehicle, I tried to explain to them that despite the large wound they would discover on my leg, there was something wrong with my brain itself, that this was not a purely psychiatric matter and that I needed medical, neurological care. Indeed, I still feel that way, but much good that did. Once a “mental patient” always a “mental patient” it seems. I admit, though, that having burned my leg did not help much. Still, I tried to explain that I needed an MRI of my brain, that something was wrong, a bleed or parasites or something! You can guess their response: of course, they summarily dismissed all of that and quickly had me packed off to the psych section of the emergency room. Although this is a very comfortable, large and separate unit of the ER, with single cubicles for each patient and a TV but also a video camera in each one, I waited 3 days before a bed was available for me, some 25 miles or more away at Natchaug Hospital, a psychiatric hospital in Mansfield Center, in Connecticut.

I name the hospital openly – as opposed to the others I have written about — because it was amazing in so many ways that I want both to sing its praises and to “advertise” it so to speak, to describe what a really good psychiatric hospital ought to be like. It is true that most people were in for a very short time, Connecticut having virtually no long term beds any longer, not even in the state hospital, but whether acute care or for somewhat longer stays, Natchaug was quite simply the best place I have ever been. From the food, to the – well, let me go into more detail rather than a mere summary (though in my opinion, the food was indeed a cut above that in any place I have been in, both in availability, and, with a salad bar at every meal, quality.)

Upon admission there was, to my dismay, a requisite “clothing and body search.” This procedure was done in such a way as to preserve as much dignity and privacy of one’s person as possible but I feared at first that it boded ill for the rest of my stay. Also, I discovered that although there were, I think, two private rooms, I had been assigned a double, a semi-private room, with a roommate already installed. This was upsetting to me, as I had almost always had a single, or been moved to one because the unit staff either felt I was too disruptive or unable to tolerate the stress of a roommate. However, when I saw how the semi-private rooms were carefully partitioned with a floor to ceiling wall in between the bed areas, I was much reassured. Although I eventually did for a short time have a private room, or a double that was designated as private – I frankly do not remember why! – I was not bothered by either roommate that I had while there. The one who did try to get me to – Oh, I dunno. I just am no longer one to “socialize” with other patients and I simply did not feel like getting to know her, or to excessively “sympathize” or otherwise expend my limited energy on her problems. I feel a little bad about this, but this one roommate, the second one, at first tried to involve me in her “stuff” and even left a journal or something next to my bed “for you to read to find out more about me.” Well, this was so very intrusive, and nothing I had asked for at all, that I rudely, but decisively said, “Why would I want to do that?”

I know that I would have been terribly hurt and humiliated by someone’s saying such a thing to me, but on the other hand, I would never have been so forward with a complete stranger either. In any event, she quickly took the papers back and left the room. However, a day later, she seemed to have no hard feelings, and we got along, if distantly at least as well as I wanted to.

Where was I? Well, I will tell you that the worst thing about my stay, and I suppose unavoidable, since I was there over the holidays, was that I had three different doctors for the three weeks I was there. but the best things were two, or more, but two in particular. One was that there was NO seclusion room, that is to say, the seclusion room that they used to have was not only now designated at the Comfort Room, but in fact was comfortable, and open at most times for use by anyone needing comfort. In it, there were thick mats on the floor, a Grandma Moses-like mural painted on all four walls by artist staff members and best of all a “therapy chair.” This is a very large and comfortable rocking recliner that is built in such a way as to elevate your legs, while you recline against the back, and let your feet dangle over the end. This allows the person to position the very lightweight chair near a wall so as to be able to lightly touch the wall with the feet and keep the chair rocking with little effort all the while lying back and relaxing. Their next improvement planned is to get headphones, wireless, or MP3 players with a selection of music for additional relaxation and comforting.

I usually tell staff at hospitals that they “cannot keep me safe” and indeed “prove” it by obeying in some fashion the commands the People give me…This never exactly endears me to anyone, and in fact has more often than not earned me a reputation as very difficult, even as having a “borderline personality” as an Axis 2 diagnosis (not true). Be that as it may, I was in fact kept safe at Natchaug, and when I was not, I was on a very helpful rather than punitive 1:1 or constant observation. At Natucahug, one-to-one staff were supposed to talk to me, rather than kept from doing so as at other hospitals, “so that you won’t come to like the attention too much.” The few times I became very upset, screaming, just screaming, at the top of my lungs, and rather than choosing to go on my own was escorted to the Comfort Room, by “staff assist” people (there is no “Dr Strong” goon squad of uniformed security guards), the door to the room was open and someone talked to me the entire time. Thus, when I left, on my own, when I felt calmer, I also felt that the reasons that I had been so distraught were also alleviated.

Also, although Natchaug, like any other hospital, did have a restraints policy, they did not use them a single time the entire three weeks I was there. In fact, though there was a very disruptive, troubling patient there the entire time (for once it was not I) I do not believe they even came close to considering using them. This time I believe it when they said that they almost never have to use them at all.

But the very best thing about my stay was something quite serendipitous: it turned out that the Director of Nursing for the whole hospital is Sharon H, the very same APRN who had been head nurse during my many stays at a Hartford hospital, and who had taken upon herself to supervise my care, or at least seemed to have in some sense “taken me under her wing.” Sharon is, and always was, both extremely bright and compassionate beyond words. She is also insightful in a way that I found the first two doctors I had were not, and if the third was, I did not have a chance to find out because I saw her only 4 times. It is true that Sharon had the advantage of having known me well, if 17 years ago, but still, she seems to have this ability to size up a situation, at least with me, and both to calm me if necessary and to suggest a solution that simply fits…I have to say that I felt especially well taken care of. Sharon made sure she saw me every afternoon, though this was above and beyond the call of any duty.

This description scarcely does my stay at this hospital justice. Although, like any hospitalization, it was not an easy stay, nonetheless I can only say that I cannot thank Sharon and the Natchaug staff enough for all that she and they did for me.

(PS Forgive any typos I have not yet corrected but it is getting late and I am too tired to go back and check for them at the present time…Lazy me!)

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Natchaug Hospital Stay and Comfort Room

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STATEMENT TO N-7 TREATMENT TEAM & CEO OF MIDDLESEX HOSPITAL et al.

TO MY PROTECTORS

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HOW TO READ A POEM: BEGINNER’S MANUAL

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S & R

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"While I breathe, I hope"