IT'S NOT
A RIGHT, IT'S A PRIVILEGE: Four Days in a Psychiatric
Ward
by
Karen Bell
Suffering-curious as it may sound to you-is the means
by which we exist, because it is the only means by which we
become conscious of existing; and the remembrance of
suffering in the past is necessary to us as the warrant,
the evidence, of our continued identity.
--- Oscar Wilde
Part I
Two paramedics accompanied me out of Holyoke Hospital,
located in Springfield, Massachusetts. The head paramedic ,
a stocky Italian-looking fellow, made inane jokes to his
partner, a young kid about my age. He had long blonde hair,
tied back into a ponytail. If he hadn't been so innately
goofy, with that hollowed-chest look and if he hadn't
stooped when he walked, he might have even looked cool.
Once in the ambulance, he did put on a good radio station,
and I was disappointed that he never turned it up. The
Italian sat in the back with me and my bags. Between asking
me questions, he would yell to the blonde in front and give
directions.
"Make a left up here, I said," while glancing back in my
direction with a look of exasperation as if to say 'see
what an idiot I have as a partner?' I looked back at him
dully as if to answer 'does it look like I care?'
Heedlessly, this man continued to talk and ask questions.
Only half of me even listened. I did remember him asking me
if I had a gun. Odd question, I thought. I answered
truthfully: not here.
"You don't have one in your bag right?"
"Oh no," I answered, of course not. He sighed with relief,
scanned my attire, and mumbled something about the fact
that I didn't look like I would carry a gun. Message
received loud and clear: I'm white and look middle-class.
Therefore, there's no need to worry.
After parting from my escorts and ushered onto the ward,
The Fowler Wing of Noble Hospital in Westfield, I was
brought into the nurses' station. I was told to leave my
bags there. I hesitated. To walk out of sight of my leather
briefcase, wallet and imported leather jacket seemed
unwise, yet I reluctantly agreed and followed a man into a
back room. Several people kept interrupting my interviewer,
who seemed hurried and distracted anyway, and offered to
'finish up' for him; he finally agreed. I learned that the
"populations" on this unit weren't segregated. I learned
that there were designated smoking times, five per day:
9:30 am, 12:30 pm, 3:30 pm, 5:30 pm and 9:30 pm, each 15
minutes long. My matches and lighters were confiscated;
only staff light cigarettes. I learned that, unbelievably,
I was in a locked unit. The windows were escape-proof and
the mirrors some aluminum alloy in which you viewed a
distorted image of yourself.
I could have band-aids but no antibiotic ointment without a
doctor's order. I could take a shower, but staff would have
to unlock the door for me. I could lock up valuables but if
I wanted any of my stuff in the locker, they would have to
open it for me all the while standing over me and asking
what it is I'm getting. All of my medication, including my
vitamins, were confiscated, and I could only take them if
their doctor okayed it, and that took hours to do. I was
allowed no day time passes until my treatment team decided
I was normal enough again to join the community for a few
hours. Caffeinated drinks were simply forbidden altogether.
The first night I came to the psychiatric wing of Noble
Hospital I was relieved. I had begun the hospitalization
process early that morning and due to problems with one
hospital and my insurance company, the entire ordeal had
lasted eight hours. After being shown my room, I
immediately took a shower. I hated the liquid soap they
gave you as a substitute for shampoo. It smelled like what
I imagined lye soap smelled like during the Civil War.
Nevertheless, I thanked the staff for it and settled in for
the night.
My roommate's name was Jo, a nickname that didn't fit her
at all. She was a timid, petite frail woman in her 50s who
acquiesced to everyone around her. She was not one to upset
the standard order. She was amiable and polite, and I was
grateful she just wasn't psychotic, and to my relief, she
left me alone. The night before I had gone to sleep
instantly, but at 5:30 am I was awakened by noise in the
room. Since Jo was obviously a person who lived on minimal
sleep, I too, would have to adapt myself to her insomnia. I
lay in bed until 7 am, when I was informed that I needed to
get up for bloodwork. I sleepily got dressed and sat out in
the hallway waiting for the nurses.
The Fowler Wing looked like a co-ed college dormitory. It
had one long hallway, the ends of which were locked. Along
each side were bedrooms, with two twin beds in each, as
well as different meeting rooms in between the bedrooms.
There was a sink opposite the beds and a bathroom adjacent
to the bed near the door. There were windows with curtains,
and you could look out and see a green lawn spotted with a
few trees. Beyond the lawn was a residential street and
some small homes opposite the hospital. I would look out
occasionally but the screens which were keeping us secluded
were so thick and made with such small mesh, the view
seemed more like a grid map of an imaginary neighborhood. I
opened the curtains for the light during the day, but I
avoided gazing out of the window since I had no outside
'privileges' and didn't know if and when I ever would.
As I waited for my bloodwork that first morning, I mused on
how out of place I already felt among the schizophrenics,
drug addicts, and other patients. I had come to the
hospital of my own accord, hoping to break an unusually
long depressive episode that was on a collision course to
suicide. Having learned to live with depression (at 25, I
already had 15 years under my belt) I am capable of knowing
when intervention is necessary, when I can't do it on my
own. This particular episode, well into its second month,
commanded drastic measures, and hospitalization seemed the
only panacea.
The nurse finally called me into the examination room, and
the phlebotomist stuck a needle in my vein, (I like using
my right arm when giving blood not only because the vein is
easier to find but so every phlebotomist can notice my
tribal arm band tattoo that I'm so proud of). I asked her
what tests were being taken. She obviously felt it would be
a waste of my time and hours to explain and simply said it
was "admission bloodwork," and that she didn't know the
names of the tests. Before I could get irked by her
incompetence, another nurse listed off the test:
bilbirubin, glucose, thyroid etc. I wanted to be sure I
wasn't having bloodwork done that I'd already had done
recently elsewhere. If I had told them not to perform one
of the tests, I imagine the entire nursing staff would have
been personally insulted by my non-compliance of standard
procedure, or they may have just thought the request part
of my symptomology.
Breakfast was served bright and early at 7:30 am. After
finding the meal very unappetizing, I decided to forgo the
dish all together and got myself a box of cereal instead.
I'd hardly eaten the day before, and I was still hungry
after eating the Bran Flakes but was also too anxious by my
new surroundings to explore and find something else to eat.
I went to my room to wait what seemed like a very long time
for our 9:30 am cigarette break. And I got to meet with my
psychiatrist.
The most significant person in all of our lives was, of
course, our psychiatrist. There were several working with
all of us, and I regret to only have one story to tell
about one man. Dr. Allen was a short well-built Jewish man
in his 40s and going bald. He was quite attractive and
intelligent. He had amazing control over his facial
expression so much so the wrinkles around his eyes appeared
only rarely and then only when he deigned to smile. During
my first visit, in the very pathetic, vulnerable state I
was in, I was convinced that he was the first Jewish Nazi
I'd met. He had sequestered me in a nuthouse, trapped in a
surreal bubble of madness, and he denied me my freedom in
the form of immediate discharge. I was "too high risk."
Although it had initially been my idea to be hospitalized,
I suffered miserably for my mistake. 'I didn't belong with
these people!' I thought indignantly. Outside of
intermittent contacts with staff, I was forced to be in the
company of degenerate, sick and insane people whose lives
up to that point had been utter failures. I became
hysterical at being secluded and locked up. I demanded my
release; I begged for my release (I remember saying
pathetically, crying at the same time, "Don't do this to
me"). This behavior only encouraged Allen to escort me out
the door of his office saying pedantically "You need to sit
and think about why you're depressed." Not only was that a
futile task, having tried and failed to answer that
question for the last fifteen years of my life, but I had,
in the meantime, failed to get what I wanted: my car, my
home, my work, my life.
By morning's end, I had already finished being hysterical
over the injustice of my situation (and hating Dr. Allen
all the while) and was playing mental games to distract
myself. I had each cigarette break time memorized, and I
was amusing myself by calculating how many cigarettes I
could smoke in a day. Deciding that two cigarettes were the
most I could smoke at once, I figured I would be able to
smoke half a pack at the maximum. Later, a fellow
in-patient told me some very significant information:
patients could smoke whenever they wanted during the night.
You just had to ask the nurse to light your cigarette. Now
I began again ratiocinating. Of the two comparable
necessities, smoking and sleep, which was more important?
Fortunately, my roommate's insomnia helped me decide. That
night I smoked as much as possible when I couldn't sleep.
The smoking room, also called the lounge, was a large
conference room with soiled couches and chairs, many with
cigarette burns in them. It was also the only room with a
TV. The administration felt it prudent to limit how much
the patients watched, and the TV sat mute for most of the
day. The ingeniousness of the Fowler Wing administration
was remarkable. There was no on/off button anywhere on the
set. After fiddling with a few buttons in vain, I realized
they must have a remote. When to turn the TV on or off was
one less decision I got to make in my new life.
I also noticed that the lounge was the 'Fowler Wing
Library.' It was replete with Reader's Digest Condensed
Version books and some very old magazines. I discovered a
few New Yorkers, and I immediately hoarded them in my room.
The total number of books in the library came to around 50.
None looked interesting and most were mainstream pulp
fiction. I was glad to have brought my Norton Anthology of
Short Fiction as well as my still unfinished copy of War
and Peace. However, I avoided War and Peace as I was stuck
in the part of the book where Napoleon resurfaces, and
considering my situation and state of mind, I just couldn't
concentrate on battles and bivouacs right then.
While waiting for our first smoke break, we had what was
known as 'community group.' All of the daily meetings were
called such and such 'group,' in an effort, I believe, to
sound chummy- although it was hardly what I considered fun.
At community group, a staffperson would tell us the news of
the day, mostly to explain procedures to the new patients
who had been admitted the night before. Staff explained
that some of us would be in either A or B discussion
support group. Our names were listed on an eraser board in
the hall with either an A or B next to it, and we were to
go look to find out which group to join. As my primary
counselor, Jan, explained to me later that evening, I was
in the "high-functioning" (A) group: "Since you're
obviously high-functioning and can keep a conversation
going, you'll be in the A group," she had said with
significance, as if I should feel privileged to learn this
information.
The A group started at 9:45 am, after our deserved
cigarette break, and was forty-five minutes long. There was
one staff whose role was to observe and make germane
comments when appropriate. After waking at 5 am every
morning because of Jo, I was usually somnolent throughout
and rarely spoke. I would look at my watch as the time
slowly crept to 10:30. Two more hours until a cigarette. I
had begun organizing my day, what little of it was in my
control, by those cigarette breaks.
The people in A group, my fellow high-functioners, were
solidly supportive of one another and made laudatory
comments concerning the staff and the ward. It appeared to
me as if I alone would be the voice of dissent. On that
first day though, I remained silent, but these were my
thoughts.
The staff of the Fowler Wing were, well, some were very
unprofessional. They simply did not see you. It was the
first time in my life that I understood that invisibleness
that Ralph Ellison wrote about in Invisible Man.
Unexpectedly, they all seemed to know our names. That is,
they often responded to your query by a "Yes, Karen..."
with a resigned sigh. I learned to ask as few questions as
possible. It quickly became frustrating to wait and wait at
the nurses' station only to be told that whatever you
needed was not available. For example, I wanted one of the
medications that I had brought in with me and which was a
prn (as needed) medication. I could take it whenever I
wanted, only they had all my medications. No, my meds were
not there but in the pharmacy where they were being kept
and besides, one needs a doctor's order for that sort of
thing. Come back later, I was told. I heard one female
staff, who I held no particular love for anyway, tell a
patient who said he was hearing voices, "oh well, at least
they'll keep you company."
The male staff with whom we had to interact were especially
difficult. Your presence at the nurses' station, where both
staff and nurses worked, was definitely an inconvenience to
male staff, although many of the female staff had the same
attitude. Their jobs involved paperwork- couldn't I see
that they were busy? One, an older, thinly shaped man,
would get you what you asked for or would open the locked
shower door (what, were we going to do water torture on
ourselves?) without so much as a glance or word while
obviously thinking about a topic far removed from the task
at hand. Sometimes I would amuse myself by saying
"thank-you" to them and also respond "you’re welcome" for
them since they were not able to complete the exchange
themselves.
The paradigm under which the employees of Fowler Wing
worked consisted of a definitive status difference between
themselves and the patients. They were normal; we were not.
This rigid dichotomy was lapidary and intractable. It was
part of the system, and not one of us or them would dare to
question it.
At a little before 11:00 am that day, I lay in bed brooding
about my situation, feeling completely immobilized. By the
time 11:00 am came, I had turned in a 3-day discharge
notice, one of the few rights I still had under my
voluntary admission status. I would be leaving at 11:00 am
in three days, on Saturday.
The rest of the day I was introduced to the other types of
groups I would be attending. They were usually geared for
the more purblind patients, i.e. "low-functioning," and I
stiffly sat through them watching silently while patients
answered questions, mostly incorrectly, about side effects
of their medication. There was an arts and crafts class
which I pointedly refused to attend, to staffs'
disapproval. I didn't like arts and crafts at age 8 so why
would I like it now? The art teacher reminded me of a
caricature of the smiling and enthusiastic kindergarten
teacher who puts her kids' childish drawings all over her
refrigerator and house and schoolroom. She was well-meaning
and nice, but I just didn't dig the scene. There was a
group for almost every hour, and by the end of the first
day, I vowed never to use the word group with a positive
connotation again. To eternal damnation I send you, foul
word! The word group has always, since then, immediately
brought forth in my mind a mental image of the Fowler Wing
psychiatric ward of Noble Hospital, one I shall never
forget.
On the second day of my institutionalization, I had become
assimilated and I found the entire situation amusing. I
even began playing pool with the schizophrenics. The
patients themselves were what provided most of the
entertainment. There was Sid Vicious, a young schizophrenic
who looked and dressed like the bassist of the Sex Pistols.
If the real Sid Vicious had lived I can only imagine him in
the form of this guy, whose name was Gabe. Sid Vicious was
alive in this kid, just as if he'd popped right out of a
page of Option or Spin. He wore an old T-shirt, on top of
which was an old flannel shirt, tight jeans, old yellow
work boots and had straight short black hair that was
always sticking out everywhere. His hands shook noticeably
when he held a cigarette. Only this Sid was too far down
the highway of madness to ever be capable of playing in a
band although one could reasonably argue that the same was
true of the real Sid Vicious. I came to like Gabe, although
he really never said much. When he did say something, he
did it with such seriousness and sincerity it was really
humorous. I remember once we were all in the lounge smoking
and someone said something of no consequence to Gabe, and
he brusquely replied, "Get off my back!" It became a big
joke with us although we weren't sure he even understood
why it was so funny. Another time, I was walking past the
nurse's station, and I saw Gabe standing there, telling
them quite calmly, "I'm having a seizure." I laughed to
myself and continued walking. When I think of him now, I
still smile. He was so young; it doesn't seem fair that he
should be so fucked up.
Jim was admitted that day. I'd heard staff allude to his
previous stay at Fowler, and I took a closer look at him
although he was strikingly noticeable anyway. He looked
like a cross between an ex-con and a Grateful Dead
follower. He most definitely was an ex-con, but as to the
verisimilitude of his musical interests, I could only
guess. (Later I found out he was of the 70s heavy metal
generation.) He was so huge and intimidating that at first
I avoided him although I would often stare at him from
afar.
He was a tall, broad man in his 40s although he looked
younger. He wore combat boots with the laces untied, above
which tight-fitting jeans accentuated his huge muscular
legs. The most impressive thing about him, however, was his
face and voice. His complexion was reddish in hue with long
thick cheekbones and a high forehead. He had a large red
mole, the same shade as his face, next to his nostril on
the right side. His eyes were small and blue, and his long
wavy hair, cut short on the top and sides, was brown with a
touch of dyed blonde on the top near his forehead. He
talked with a deep baritone raspy voice, so deep and
slurred, it was difficult for anyone to understand him. He
had several prison tattoos on his forearms, those black ink
tattoos that become indistinct quickly and are in that
category of ex-girlfriend's names and war slogans. However,
I never got close enough to him to see the designs. Later,
I asked him if he'd gotten his tattoos in prison, and he
said some of them. He told me he had 30 tattoos on his body
and that he wished he hadn't gotten the ones on his arms
because he "was sick of looking at them."
He'd called 911 and told them that he needed to be
hospitalized because he would either kill himself or kill
someone else. He told us the story of his "old lady" who
seemed paranoidly jealous of him, his girlfriend's senile
mother who lived with them and drove everyone nuts, how
he'd been on Valium since age 11, and how he'd met his
girlfriend in detox. Called a detox romance, they had
fallen in love and had been together for seven years,
including the times either he or his girlfriend were
hospitalized or in respite. He'd taken 30 valium and had
had a quart of whiskey the night he'd called 911. This was
not apparently an overdose attempt since he knew it
wouldn't kill him, having taken 100 before with the only
consequence that he'd slept 72 hours. He had been to Fowler
two years prior, and we were eager to hear about how it
used to be run, similar to how Solzhenitsyn describes the
old prisoners' tales of imprisonment under the Czar or
under Stalin in the Gulag Archipelago.
Jim was one of the nicest men I've met. He would help the
elderly people on the ward; he would readily give away his
food; he would talk and eat with anyone. He had this way of
telling his stories that you couldn't help but laugh. If
I'd had been able to I would have readily hugged him when I
left, but his "old lady" was there visiting, and I was
afraid I'd make her jealous. I miss him and our late night
smoking group.
There was Don, a man whose amiability endeared him to a
number of friends of both sexes. He was a chronic alcoholic
and claimed to have been in and out of VA hospitals over 90
times. He reminded me of many of the melancholic men I'd
heard speak at AA meetings. He had a good manner about him,
was cross to no one, friendly to everyone, but nevertheless
was a complete failure in life. His persistent hope in a
better future amazed me; he was already in his 40s and the
only thing he'd managed to do was to fuck up his family and
himself with drugs and alcohol.
Then there was Ian, a big burly fellow with long frizzy
black hair in a braid down his back and a beard and
mustache to accentuate it. He was the lascivious one of the
group, often approaching women and saying inappropriate
things. He was the first person, other than staff, to talk
to me. "Come on..." he'd drawled, "where's your smile, yes,
yes, I can see it!" chaffing me in that irritatingly
flirtatious way some men have. I watched him with other
women and noticed that I was not the only target of his
indiscriminate affection. I maintained a high level of
awareness, an antennae of sorts, when around him. I was
just waiting for him to get out of line, as I intended to
come to the defense of whoever he was harassing. I was
disappointed that by the time I'd left, he hadn't provoked
anyone, and I never got the chance to act heroic.
Part II