Category Archives: Abuse

Final presentation of “GOING SANE”

Would love your opinions and anyone to share this if they can! The slide show i mean…below…

https://1drv.ms/p/s!AoRt2vNBR5wniy8G–EOk7GXN9X4Going Sane

Anti NAMI Lies at JulieMADBlogger.com

PLEASE go to the embedded link to finish reading JULIE MAD BLOGGER;s  following article, which was succinct and brilliant.

“The following is my commentary on a “fact sheet” from NAMI New York. This is some material from the URL http://www.naminys.org/nys/educational-materials/ Here, what you see in italics is what I have copied verbatim, directly off the NAMI page. Here and there I am replying, as I see fit, with commentary of my own, in non-italics.

Here are some important facts about mental illness and recovery:

Please note: Much of what NAMI tells you ain’t facts!

  • Mental illnesses are biologically based brain disorders. BTW, the “brain disorder” theory was disproven almost immediately after it was proposed. There is no scientific evidence of any brain disorder in those with the so-called major mental illnesses such as schizophrenia or bipolar. They cannot be overcome through “will power” and are not related to a person’s “character” or intelligence. The implication here is that these so-called “brain diseases” are permanent conditions that will not go away on their own nor can they possibly be transient or outgrown. This is false, as many are indeed temporary, or can be overcome by changing one’s life circumstances, growth, maturity, improved physical health, changing one’s environment, nutritional changes, or improving one’s relationships.
  • Mental disorders fall along a continuum of severity. Even though mental disorders are widespread in the population, the main burden of illness is concentrated in a much smaller proportion — about 6 percent, or 1 in 17 Americans — who suffer from a serious mental illness. It is estimated that mental illness affects 1 in 5 families in America. 
  • The World Health Organization has reported that four of the ten leading causes of disability in the US and other developed countries are mental disorders. The implication here is that the disability is caused by the mental disorder itself, however...http://juliemadblogger.com/wp/2017/01/28/nami-fact-sheet-lies/#comment-2796

THANK YOU DOC, ECT SAVED MY LIFE…Ooops! Maybe not…?

Terrified Patient Having Shock Treatments
Terrified Patient Having Shock Treatments

ELECTROSHOCK AS HEAD INJURY

http://ECT.org/effects/headinjury.html

Report prepared for the National Head Injury Foundation

September 1991 by Linda Andre

Committee for Truth in Psychiatry

 

INTRODUCTION

Electroshock, variously known as electroconvulsive therapy, ECT, shock treatment, or simply shock, is the practice of applying 70 to 150 volts of household electric current to the human brain in order to produce a grand mal, or generalized, seizure. A course of ECT usually consists of 8 to 15 shocks, administered every other day, although the number is determined by the individual psychiatrist and many patients receive 20, 30, 40 or more.

Psychiatrists use ECT on persons with a wide range of psychiatric labels, from depression to mania, and have recently begun to use it on persons without psychiatric labels who have medical diseases such as Parkinson’s disease.

A conservative estimate is that at least 100,000 persons receive ECT each year, and by all accounts this number is growing. Two-thirds of those being shocked are women, and more than half of ECT patients are over the age of 65, although it has been given to children as young as three. ECT is not given at all in most state hospitals. It is concentrated in private, for-profit hospitals.

ECT drastically changes behavior and mood, which is construed

as improvement of psychiatric symptoms. However, since psychiatric symptoms usually recur, often after as little as one month, psychiatrists are now promoting “maintenance” ECT—one electrical grand mal seizure every few weeks, given indefinitely or until the patient or family refuses to continue.

THE EVIDENCE FOR ECT BRAIN DAMAGE

There are now five decades of evidence for ECT brain damage and memory loss. The evidence is of four types: animal studies, human autopsy studies, human in vivo studies which use either modern brain-imaging techniques or neuropsychological testing to assess damage, and survivor self-reports or narrative interviews.

Most of the studies of the effects of ECT on animals were done in the 1940s and ’50s. There are at least seven studies documenting brain damage in shocked animals (cited by Friedberg in Morgan, 1991, p. 29). The best known study is that of Hans Hartelius (1952), in which brain damage was consistently found in cats given a relatively short course of ECT. He concluded: “The question of whether or not irreversible damage to the nerve cells may occur in association with ECT must therefore be answered in the affirmative.”

Human autopsy studies were done on persons who died during or shortly after ECT (some died as a result of massive brain damage). There are more than twenty reports of neuropathology in human autopsies, dating from to 1940s to 1978 (Morgan, 1991, p. 30; Breggin, 1985, p.4). Many of these patients had what is called modern or “modified” ECT.

It is necessary to clarify briefly here what is meant by “modified” ECT. News and magazine articles about ECT commonly claim that ECT as it has been given for the past thirty years (that is, using general anesthesia and muscle-paralyzing drugs to prevent bone fractures) is “new and improved”, “safer” (i.e. less brain-damaging) than it was in the 1940s and ’50s.

Although this claim is made for public relations purposes, it is flatly denied by doctors when the media is not listening. For example, Dr. Edward Coffey, head of the ECT department at Duke University Medical Center and a well-known advocate of ECT, tells his students in the training seminar “Practical Advances in ECT: 1991”:

The indication for anesthetic is simply that it reduces the anxiety and the fear and the panic that are associated or that could be associated with the treatment. OK? It doesn’t do anything else beyond that…There are, however, significant disadvantages in

using an anesthetic during ECT…The anesthetic elevates seizure threshold… Very, very critical…

So it is necessary to use more electricity to the brain, not less, with “modified” ECT, hardly making for a safer procedure. In addition, the muscle-paralyzing drugs used in modified ECT amplify the risks. They make the patient unable to breathe independently, and as Coffey points out this means risks of paralysis and prolonged apnea.

Another common claim of shock doctors and publicists, that ECT “saves lives” or somehow prevents suicide, can be quickly disposed of. There is simply no evidence in the literature to support this claim. The one study on ECT and suicide (Avery and Winokur, 1976) shows that ECT has no effect on the suicide rate.

Case studies, neuroanatomical testing, neuropsychological testing, and self-reports that remain strikingly similar over 50 years testify to the devastating effects of ECT on memory, identity, and cognition.

Recent CAT scan studies showing a relationship between ECT and brain atrophy or abnormality include Calloway (1981); Weinberger et al (1979a and 1979b); and Dolan, Calloway et al (1986).

The vast majority of ECT research has focused and continues to focus on the effects of ECT on memory, for good reason. Memory loss is a symptom of brain damage and, as neurologist John Friedberg (quoted in Bielski, 1990) points out, ECT causes more permanent memory loss than any severe closed-head injury with coma or almost any other insult to or disease of the brain.

Reports of catastrophic memory loss date to the very beginning of ECT. The definitive study of ECT’s memory effects remains that of Irving Janis (1950). Janis conducted detailed and exhaustive autobiographical interviews with 19 patients before ECT and then attempted to elicit the same information four weeks afterwards. Controls who did not have ECT were given the same interviews. He found that “Every one of the 19 patients in the study showed at least several life instances of amnesia and in many cases there were from ten to twenty life experiences which the patient could not recall.” Controls’ memories were normal. And when he followed up half of the 19 patients one year after ECT, there had been no return of memory (Janis, 1975).

Studies in the 70s and 80s confirm Janis’ findings. Squire (1974) found that the amnesic effects of ECT can extend to remote memory. In 1973 he documented a 30-year retrograde amnesia following ECT. Freeman and Kendell (1980) report that 74% of patients questioned years after ECT had memory impairment. Taylor et al (1982) found methodological flaws in studies that purport to show no memory loss and documented deficits in autobiographical memory several months after ECT. Fronin-Auch (1982) found impairment of both verbal and nonverbal memory. Squire and Slater (1983) found that three years after shock the majority of survivors report poor memory.

The highest governmental authority on medical matters in the United States, the Food and Drug Administration (FDA), agrees that ECT is not good for your health. It names brain damage and memory loss as two of the risks of ECT. The FDA is responsible for regulating medical devices such as the machines used to administer ECT. Each device is assigned a risk classification: Class I for devices that are basically safe; Class II for devices whose safety can be assured by standardization, labeling, etc.; and Class III for devices which pose “a potential unreasonable risk of injury or illness under all circumstances. As a result of a public hearing in 1979, at which survivors and professionals testified, the ECT machine was assigned to Class III. There it remains today, despite a well-organized lobbying campaign by the American Psychiatric Association. In the files of the FDA in Rockville, Maryland, are at least 1000 letters from survivors testifying to the damage that was done to them by ECT. In 1984 some of these survivors organized as the Committee for Truth in Psychiatry to lobby for informed consent as a way of protecting future patients from permanent brain damage. Their statements challenge the assumption that survivors “recover” from ECT:

Most of my life from 1975-1987 is a fog. I remember some things when reminded by friends, but other reminders remain a mystery. My best friend since high school in the 1960s died recently and with her went a big part of my life because she knew all about me and used to help me out with the parts I couldn’t remember. (Frend, 1990)

I haven’t had a shock for over ten years now but I still feel

sad that I can’t remember most of my late childhood or any of my high school days. I can’t even remember my first intimate experience. What I know of my life is second hand. My family has told me bits and pieces and I have my high school yearbooks. But my family generally remembers the “bad” times, usually how I screwed up the family life and the faces in the yearbook are all total strangers. (Calvert, 1990)

As a result of these “treatments” the years 1966-1969 are almost a total blank in my mind. In addition, the five years preceding 1966 are severely fragmented and blurred. My entire college education

has been wiped out. I have no recollection of ever being at the University of Hartford. I know that I graduated from the institution because of a diploma I have which bears my name, but I do

not remember receiving it. It has been ten years since I received electroshock and my memory is still as blank as it was the day I left the hospital. There is nothing temporary about the nature of memory loss due to electroshock. It is permanent, devastating, and irreparable. (Patel, 1978)

 

ECT AS TRAUMATIC BRAIN INJURY

Both psychiatrist Peter Breggin (Breggin,, 1991, p. 196) and

ECT survivor Marilyn Rice, founder of the Committee for Truth in Psychiatry, have pointed out that minor head injury as a result of trauma often occurs without loss of consciousness, seizures, disorientation, or confusion, and is thus much less traumatic than a series of electroshocks. A better analogy would be that each individual shock is the equivalent of one moderate to severe head injury. The typical ECT patient, then, receives at least ten head injuries in rapid succession.

Proponents as well as opponents of ECT have long recognized it as a form of head injury.

As a neurologist and electroencephalographer, I have seen many patients after ECT, and I have no doubt that ECT produces effects identical to those of a head injury. After multiple sessions of ECT, a patient has symptoms identical 😮 those of a retired, punch-drunk boxer.. .After a few sessions of ECT, the symptoms are those of moderate cerebral contusion, and further enthusiastic use of ECT may result in the patient functioning at a subhuman level. Electroconvulsive therapy in effect may be defined as a controlled type of brain damage produced by electrical means. (Sament, 1983)

What shock does is throw a blanket over people’s problems. It would be no different than if you were troubled about something in your life and you got into a car accident and had a concussion. For a while you wouldn’t worry about what was bothering you because you would be so disoriented. That’s exactly what shock therapy does. But in a few weeks when the shock wears off, your problems come back. (Coleman, quoted in Bielski, 1990)

We don’t have a treatment. What we do is inflict a closed-head injury on people in spiritual crisis.. .closed-head injury! And we have a vast literature on closed-head injury. My colleagues are not eager to have literature on electroshock closed-head injury; but we have it in every other field. And we have considerably more than people are allowing for here today. It is electrical closed-head injury. (Breggin, 1990)

There has never been any debate about the immediate effects of a shock: it produces an acute organic brain syndrome which becomes more pronounced as shocks continue. Harold Sackeim, the ECT establishment’s premier publicist (anyone who has occasion to write about or refer to ECT, from Ann Landers to a medical columnist, is referred by the APA to Dr. Sackeim) states succinctly:

The ECT-induced seizure, like spontaneous generalized seizures in epileptics and most acute brain injury and head trauma, results in

a variable period of disorientation. Patients may not know their names, their ages, etc. When the disorientation is prolonged, it is generally referred to as an organic brain syndrome. (Sackeim, 1986)

This is so expected and routine on ECT wards that hospital staff become inured to making chart notations like “Marked organicity” or “Pt. extremely organic” without thinking anything of it. A nurse who has worked for years on an ECT ward says:

Some people seem to undergo drastic personality changes.

They come in the hospital as organized, thoughtful people who

have a good sense of what their problems are. Weeks later I see

them wandering around the halls, disorganized and dependent. They

become so scrambled they can’t even have a conversation. Then

they leave the hospital in worse shape than they came in.

(Anonymous psychiatric nurse, quoted in Bielski, 1990)

A standard information sheet for ECT patients calls the period

of most acute organic brain syndrome a “convalescence period” and warns patients not to drive, work, or drink for three weeks (New York Hospital-Cornell Medical Center, undated). Coincidentally, four weeks is the maximum time period for which proponents of ECT can claim alleviation of psychiatric symptoms (Opton, 1985), substantiating the statement made by Breggin (1991, pp. 198-99) and throughout the ECT literature that the organic brain syndrome and the “therapeutic” effect are the same phenomenon.

The information sheet states as well that after each shock the patient “may experience transitory confusion similar to that seen in patients emerging from any type of brief anesthesia.” This misleading characterization is belied by two doctors’ published observations of patients after ECT.(Lowenbach and Stainbrook, 1942). The article begins by stating “A generalized convulsion leaves a human being in a state where all that is called the personality has been extinguished.”

A compliance with simple commands like opening and closing the eyes and the appearance of speech usually coincide. The first utterances are usually incomprehensible, but soon it is possible to recognize first the words and then sentences, although they may have to be guessed at rather than directly understood…

If at this time patients were given a written order to write their name, they would not ordinarily follow the command…if then the request was repeated orally, the patient would take the pencil and write his name. At first the patient produces only scribbling and has to be constantly urged to continue. He may even drop back into sleep. But soon the initial of the first name may be clearly discernible…Usually 20 to 30 minutes after a full-fledged convulsion the writing of the name was again normal…

The return of the talking function goes hand in hand with the writing ability and follows similar lines. The muttered and seemingly senseless words and maybe the silent tongue movements are the equivalent of scribbling.. .But as time goes on it “is possible to establish question and answer sessions.. .From now on, the perplexity of the patient arising from his inability to grasp the situation pervades his statements.

He may ask if this is a jail. ..and if he has committed a crime.. The efforts of the patient to re-establish their orientation almost always follow the same line: “Where am I.”… know you” (pointing to the nurse)… to the question “What is my name?” “I do not know”…

The patient’s behavior when asked to perform a task such as to get up from the bed where he lies demonstrates another aspect of the process of recovery.. .he does not act according to voiced intentions. Sometimes urgent repetition of the command would set off the proper movements; in other cases beckoning had to be initiated by pulling the patient from the sitting position or removing one leg from the bed.. .But the patient then frequently stopped doing things and the next series of actions, putting on his shoes, tying the laces, leaving the room, had each time to be expressly commanded, pointed out, or the situation had to be actively forced. This behavior indicates lack of initiative…

It is possible, indeed likely, that a patient and her family could read the entire information sheet mentioned earlier and have

no idea that ECT involves convulsions. The words “convulsion” or “seizure” appear not at all. The sheet states that the patient will have “generalized muscular contractions of a convulsive nature”.

Recently Dr. Max Fink, the country’s best-known shock doctor, offered to let the media interview a patient right after a course of electroshock… for a fee of $40,000 (Breggin, 1991, p. 188).

It is common for persons who have received ECT to report being “in a fog”, without any of the judgment, affect, or initiative of their former selves, for a period of up to one year post-ECT. Afterwards they may have little or no memory of what happened during this period.

I experienced the explosion in my brain. When I woke up from the blessed unconsciousness I did not know who I was, where I was, nor why. I could not process language. I pretended everything because I was afraid. I did not know what a husband was. I did not know anything. My mind was a vacuum. (Faeder, 1986)

I just completed a series of 11 treatments and am in worse shape than when I started. After about 8 treatments I thought I had improved from my depression.. . I continued and my effects worsened. I began experiencing dizziness and my memory loss increased. Now that I had the 11th my memory and thinking abilities are so bad I wake up in the morning empty-headed. I don’t remember many past events in

my life or doing things with the various people in my family. It is hard to think and I don’t enjoy things. I can’t think about anything else. I can’t understand why everyone told me this procedure was so safe. I want my brain back. (Johnson, 1990)

 

LONG-TERM EFFECTS OF ECT ON COGNITIVE AND SOCIAL FUNCTIONING

The loss of one’s life history–that is, loss of part of the self–is in itself a devastating handicap; but added to this unique quality of ECT head injury are the cognitive deficits associated with other types of traumatic brain injury.

There is not now nearly enough research on the nature of ECT cognitive deficits, or of the impact of these deficits on social roles, employment, self-esteem, identity, and long-term quality of life for survivors. There is only one study which examines how ECT (negatively) affects family dynamics (Warren, 1988). Warren found that ECT survivors “commonly” forgot the very existence of their husbands and children! For example, one woman who had forgotten she had five children was furious when she found out her husband had lied to her, telling her the children belonged to a neighbor. Husbands frequently used their wives’ amnesia as an opportunity to reconstruct marital and family history, to the husbands’ advantage. Clearly, Warren’s study suggests there is much to explore in this area.

There is currently no research which addresses the question of how best to meet the rehabilitative and vocational needs of ECT survivors. One such study, proposed but not implemented in the 1960s, is described in Morgan (1991, pp. 14-19). Its hopeful conclusion that “with enough data, it may some day be possible to deal therapeutically with ECT-damaged patients, perhaps with some radically new approach to psychotherapy, or direct re-education or modification of behavior” has, a generation later, not come to pass. Funding sources such as the National Institute on Disability and Rehabilitation Research must be encouraged to sponsor such research.

The research which exists shows that sensitive psychometric testing always reveals cognitive deficits in ECT survivors. Even given the differences in available testing methods, the nature of these deficits has remained stable over 50 years. Scherer (1951) gave tests of memory function, abstraction, and concept formation to a group of survivors who had received an average of 20 shocks (using brief-pulse or square wave current, the type that is standard today) and to a control group of patients who did not receive ECT. He found that “lack of improvement as between pre- and post-shock results may indicate that shock has injured the patient to the extent that he is unable to achieve his premorbid intellectual potentialities, even though he can shake off the intellectually debilitating effects of the psychosis.” He concluded that “harmful organic results in areas of intellectual function.. .may nullify the partial benefits of the treatment.”

Templer, Ruff and Armstrong (1973) found that performance on

the Bender Gestalt test was significantly worse for persons who had received ECT than for carefully matched controls who had not.

Freeman, Weeks and Kendell (1980) matched a group of 26 ECT survivors with controls on a battery of 19 cognitive tests; all of the survivors were found to be significantly cognitively impaired. The researchers attempted to attribute the impairment to drugs or mental illness, but could not do so. They concluded that “our results are compatible” with the statement that ECT causes permanent mental impairment. The interviews with survivors revealed almost identical deficits:

Forgetful of names, gets easily sidetracked and forgets what he was going to do.

Forgets where she puts things, can’t remember names.

Memory poor and gets confused, to such an extent that he loses jobs.

Difficult to remember messages. Gets mixed up when people tell her things.

Said she was known in her bridge club as the “computer because of her good memory. Now has to write things down, and misplaces keys and jewelry.

Can’t retain things, has to make lists.

Templer and Veleber (1982) found permanent irreversible cognitive deficits in ECT survivors given neuropsychological testing. Taylor, Kuhlengel and Dean (1985) found significant cognitive impairment after only five shocks. “Since cognitive impairment is such an important side effect of bilateral ECT, it seems important to define as carefully as possible which aspects of the treatment are responsible for the deficit,” they concluded. Although they did not prove their hypothesis about the role of an elevation in blood pressure, “It is important to continue to search for the cause or causes of this impairment. If this important side effect could be eliminated or even modified, it could only be a service to patients…” But there is no separating the so-called therapeutic effects from the disabling cognitive effects.

A study-in-progress designed and implemented by members of the National Head Injury Foundation (SUNY Stony Brook, unpublished thesis project) with the same size sample as the Freeman et al study uses a simple self-scoring questionnaire to evaluate cognitive deficits in both the acute and chronic organic brain syndrome stages. The study also elicits information about coping strategies (self-rehabilitation) and about the amount of time it takes to accommodate to deficits.

All respondents in the study indicated they suffered from common symptoms of head injury both during the year after ECT and many,

many years afterwards. The average number of years since ECT for

the respondents was twenty-three. 80% had never heard of cognitive rehabilitation.

Only one-fourth felt they had been able to adjust to or compensate for their deficits by their own efforts. Most indicated they were still struggling with this process. Of those few who felt they had adjusted or compensated, the average number of years to reach this stage was fifteen. When those who had adjusted or compensated were asked how they did it, the most frequently cited answer was “hard work on my own.”

Respondents were asked if they would have liked acknowledgment of or help with their cognitive problems during the year after ECT, and whether they would still like help regardless of how long ago they had been shocked. All but one of the respondents said they would have wanted help in the post-ECT year, and 90% said they still wanted help.

In the last several years with the increased availability of neuropsychological testing, increasing numbers of ECT survivors have taken the initiative where researchers have failed, and have had testing done. In every known case, testing has shown unmistakable brain dysfunction.

Patients’ accounts of cognitive deficits from diverse sources

and across continents remain constant from the 1940s to the 1990s. If these people are imagining their deficits, as some shock doctors like to claim, it is unthinkable that patients over five decades should all imagine exactly the same deficits. One cannot read these accounts without calling to mind the description of minor head injury in the National Head Injury Foundation brochure “The Unseen Injury: Minor Head Trauma”:

Memory problems are common.. .You may be more forgetful of names, where you put things, appointments, etc. It may be harder to learn new information or routines. Your attention may be shorter, you may be easily distracted, or forget things or lose your place when you have to shift back and forth between two things. You may find it harder to concentrate for long periods of time, and become mentally confused, e.g. when reading. You may find it harder to find the right word or express exactly what you are thinking. You may think and respond more slowly, and it may take more effort to do the things you used to do automatically. You may not have the same insights or spontaneous ideas as you did before.. .You may find it more difficult to make plans, get organized, and set and carry out realistic goals…

I have trouble remembering what I did earlier this week. When I talk, my mind wanders. Sometimes I can’t remember the right word to say, or a co-worker’s name, or I forget what I wanted to say. I have been to movies that I can’t remember going to. (Frend, 1990)

I was an organized, methodical person. I knew where everything was. I’m different now. I often can’t find things. I’ve become very scattered and forgetful. (Bennett, quoted in Bielski, 1990)

These words eerily echo those of the ECT survivors described by Dr. M.B. Brody in 1944:

(18 months after 4 shocks) One day three things were missing, the poker, the paper, and something else I cannot remember. I found the poker in the dustbin; I must have put it there without remembering. We never found the paper and I am always very careful of the paper. I want to go and do things and find I have already done it. I have to think about what I am doing so that I know I have done it.. .it is uncanny when you do things and find you cannot remember them.

(One year after 7 shocks) The following are some of the things I forget: the names of people and places. When the title of a book is mentioned I may have a vague idea that I have read it, but cannot remember what it is about. The same applies to films. My family tells me the outlines and I am able to remember other things at the same time.

I forget to post letters and to buy small things, such as mending and toothpaste. I put things away in such safe places that when they are needed it takes hours to find them. It did seem that after the electric treatment there was only the present, and the past had to be recalled a little at a time.

All of Brody’s survivors had incidents of not recognizing familiar people:

(One year after 14 shocks) There are many faces I see that I

know I should know quite a lot about, but only in a few cases can I recall incidents connected with them. I find I can adjust myself to these circumstances by being very careful in making strong denials, as fresh personal incidents constantly crop up.

38 years later, a woman who had 7 shocks wrote:

I was shopping in a department store when a woman came over to me, said hello and asked me how I was. I had no idea who she was or how she knew me.. .1 couldn’t help feeling embarrassed and helpless, as if I were no longer in control of my faculties. This experience was to be the first of many encounters in which I would be unable to recall people’s names and the context in which I knew them. (Heim, 1986)

The deficits in storing and retrieving new information associated with ECT may severely and permanently impair learning ability. And, just as the NHIF brochure states, “Often these problems are not encountered until a person returns to the demands or work, school, or home.” Attempting to go or return to school especially overwhelms and commonly defeats ECT survivors:

When I returned to classes I found I couldn’t remember material I had learned earlier, and that I was totally unable to concentrate… My only choice was to withdraw from university. If there was one area in which I had always excelled, it was in school. I now felt like a complete failure and that I’d never be able to return to university. (Heim, 1986)

Some of the things I tried to study was like trying to read a book written in Russian—no matter how hard I tried I could not get the sense of what the words and diagrams meant. I forced myself to concentrate but it continued to appear gibberish. (Calvert, 1990)

In addition to destruction of entire blocks of pre-ECT memories I have continued to have considerable difficulty in memory with regard to academic pursuits. To date, of embarrassing necessity I have been forced to tape-record all education materials that require memorization. This has included basic classes in accounting and word-processing materials. I was forced to retake accounting in 1983. Now, I am again forced to retake a basic one-semester course in computerized word processing. Currently, I am finding it extremely embarrassing and hurtful when fellow classmates (however innocently) refer to my struggles in grasping my study materials, thusly: “You are an AIR-BRAIN!” How can I explain that my struggles are due to ECT? (Winter, 1988)

I started school full time and found I did much better than

I could imagine remembering information on field placement and classes—but I couldn’t understand what I read or put ideas together—analyze, draw conclusions, make comparisons. It was a shock. I was at last taking courses on theory.. .and ideas just didn’t remain with me. I finally accepted the fact that it was just going to be too much torture for me to continue so I quit my field placement, two courses, and attended only one discussion course until the end of the semester when I withdrew. (Maccabee, 1989)

It is often the case that the ECT survivor is disabled from

her or his previous work. Whether or not a survivor returns to work depends on the type of work previously done and the demands it makes on intellectual functioning. The statistics on employment of ECT survivors would seem to be just as dismal as statistics on employment of head-injured persons in general. In the SUNY survey, two-thirds of the respondents were unemployed. Most indicated that they had been employed prior to ECT and unemployed since. One elaborated:

At the age of 23 my life was changed because after ECT I experienced disabling difficulty understanding, recalling, organizing and applying new information and also problems with distractibility and concentration. I had ECT while I was teaching and because my level of functioning had changed so dramatically I quit my job. My abilities have never returned to pre-ECT quality. Pre-ECT I’d been able to function in a totally individualized sixth-grade classroom where I designed and wrote much of the curriculum myself. Due to the problems I had after ECT I never returned to teaching. (Maccabee, 1990)

A nurse writes of a friend at one year post-ECT:

A friend of mine had 12 ECT treatments in September-October 1989. As a result, he has retrograde and anterograde amnesia and is unable to perform his work as a master plumber, cannot remember his childhood and cannot remember how to get around the city where he has lived all his life. You can imagine his anger and frustration.

The psychiatrists have been insisting that his problem is not ECT-related but is a side effect of his depression. I have yet

to see a severely depressed person fight so hard to regain their ability to think clearly and be able to go back to work again. (Gordon, 1990)

She has stated clearly the impossible situation of ECT survivors. There can be no help for them until there is recognition of the traumatic brain injury they have sustained and its disabling effects.

REHABILITATION

ECT survivors have the same needs for understanding, support,

and rehabilitation as other head injury survivors. If anything, it could be said that their needs may be greater, since the massive retrograde amnesia unique to ECT can precipitate an even greater crisis of identity than occurs with other head injuries.

Neuropsychologist Thomas Kay, in his paper Minor Head Injury: An Introduction for Professionals, identifies four necessary elements in successful treatment of head injury: identification of the problem, family/social support, neuropsychological rehabilitation, and accommodation; Identification of the problem, he says, is the most crucial element since it must precede the others. Tragically at this time it is the rule rather than the exception that for ECT survivors none of these elements come into play.

This is not to say that ECT survivors never successfully build a new self and a new life. Many courageous and hardworking survivors have—but they have until now always had to do it alone, without any help, and it has taken a sizable chunk of their lifetimes to do it.

As time goes on, I have made a great effort to regain the maximum use of my brain by forcing it to concentrate and to try to remember what I hear and read. It has been a struggle… I feel like I have been able to maximize the undamaged parts of my brain.. .I still mourn the loss of a life that I didn’t have. (Calvert, 1990)

Survivors are beginning to share their hard-won strategies with other survivors, professionals who would help them would do well to listen to those whose daily business, even decades after ECT, is surviving.

I tried a course in general psychology, which I’d had As on in college. I quickly discovered that I couldn’t remember anything if I just read the text.. .even if I read it several times (like four or five). So I programmed my materials by writing out questions for each sentence and writing the answers on the back of the cards. I then quizzed myself until the material was memorized. I have all the cards from two courses. What a stack… I memorized the book, practically… and worked five to six hours a day on weekends and three or four during the work week… It was quite different from when I was in college. Then, I read things and remembered them. (Maccabee, 1989)

She also describes her own cognitive retraining exercise:

The main exercise consists primarily of counting from 1-10 while visualizing, as steadily as possible, some image (object, person, etc.) I thought of this exercise because I wanted to see if I could practice using the right and left sides of my brain. Since I began this I think I read that that isn’t what I was doing. But, it seemed to work. When I first started the exercise I could hardly hold an image in mind, much less count at the same time. But I have become quite good at it and I relate it to an improved ability to deal with distractions and interruptions.

Similar exercises, in fact, are practiced in formal cognitive rehabilitation programs.

Often self-rehabilitation is a desperate, trial-and-error process that takes many lonely, frustrating years. A woman describes how she taught herself to read again after ECT, at age 50:

I could process language only with difficulty. I knew the words, how they sounded, but I had no comprehension.

I did not literally start at “scratch”, as a preschooler, because I had some memory, some understanding of letters and sounds—words—but I had no comprehension.

I used TV for newscasts, the same item in the newspaper, and tried to match these together to make sense. Only one item, one line. Try to write it in a sentence. Over and over, again and again.

After about six months (this was daily for hours), I tried Reader’s Digest. It took me a very long time to conquer this–no pictures, new concepts, no voice telling me the news item. Extremely frustrating, hard, hard, hard. Then magazine articles. I did it! I went on to “For Whom the Bell Tolls” because I vaguely remembered I had read it in college and had seen the movie. But it had many difficult words and my vocabulary was not yet at the college level, so I probably spent two years on it. It was 1975 when I felt I had reached the college level in reading.(I started in 1970.) (Faeder, 1986)

One survivor for whom the slow process of rehabilitation has taken two decades expresses the hope of many others that the process might be made easier for those being shocked in the ’90s:

I might never have thought that rehabilitation was something that ECT patients could benefit from until I was examined in 1987, at my request, at a local psychogeriatric center because I worried that perhaps I had Alzheimer’s disease because my intellectual functioning still caused me problems. During the psychological testing, which extended over a period of two months due to scheduling problems, I observed that my concentration improved and I functioned better at work. I reasoned that the “time-encapsulated” efforts to concentrate and focus my attention carried over. The tests were not meant to be rehabilitative, but they somewhat served this purpose—and convinced me that sequential retraining or practicing of cognitive skills could be beneficial to ECT patients. Of course, this was almost 20 years after ECT…

I hold a responsible, though poorly paying, job as an administrative assistant for a professional organization—performing at tasks that I never thought I would be able to do again. I might have been able to do them earlier if I’d had rehabilitation training. At this time I am concerned about the plight of ECT patients who are still struggling. While these ECT “complainers” are at risk of becoming increasingly depressed—and perhaps suicidal—because

of their disabilities, professionals continue to argue about whether or not ECT causes brain damage using insufficient and in some cases outdated data.

I wish that some brain trauma research and rehabilitation

center would accept a few ECT patients and at least see if practicing or “reprogramming” of cognitive skills could result

in improved performance. (Maccabee, 1990)

In 1990, three ECT survivors were treated in the cognitive rehabilitation program of a New York City hospital. Slowly, attitudes and preconceived ideas are changing.

 

ECT IN THE ’90s

ECT has gone in and out of fashion during its 53-year history; now on the wane, now making a comeback. Whatever happens in this decade (ironically designated by President Bush the Decade of the Brain), ECT survivors cannot afford to wait until a favorable political climate allows them the help they need. They need it now.

There are some hopeful signs. The 1980s saw an unprecedented boom in ECT (medical malpractice) lawsuits citing brain damage and memory loss, to the point where settlements are steadily increasing for those with the stamina and resources to pursue legal redress. The ECT machine remains in Class III at the FDA. ECT survivors are joining head injury support groups and organizations in record numbers.

State legislatures are toughening ECT laws, and city councils

are taking courageous stands against ECT. On February 21, 1991, after well-publicized hearings at which survivors and professionals testified, the Board of supervisors of the City of San Francisco adopted a resolution opposing the use of ECT. A bill pending in the New York State Assembly (AB6455) would require the state to keep statistics on how much ECT is done, but its accompanying strongly worded memorandum opens the door for stricter measures in the future. In July 1991 the Madison, Wisconsin city council proposed a resolution to recommend a ban on the use of ECT. (Shock was banned in Berkeley, California in 1982 until the local psychiatrists’ organization overturned the ban on a technicality.) The council’s Public Health Committee unanimously agreed that accurate information about the effects of ECT on memory must be presented to patients, and they are writing a resolution to contain full and accurate information. And in August 1991 ECT survivors testified, and a manuscript containing accounts of memory loss by 100 survivors was presented, at hearings in Austin, Texas, before the Texas Department of Mental Health. Subsequently the Department’s regulations were revised to contain a stronger warning about permanent mental dysfunction.

A CONCLUSION

It is difficult, even in so many pages, to paint a full picture of the suffering of ECT survivors and the devastation experienced not only by the survivors but by their families and friends. And so the last words, chosen because they echo the words of so many others over the years, belong to a former nurse estranged from her husband and living on Social Security Disability, fighting in the legal system for redress and working with an advocacy group.

What they took from me was my “self”. When they can put a dollar value on theft of self and theft of a mother I would like

to know what the figure is. Had they just killed me instantly the kids would at least have had the memory of their mother as she

had been most of their lives. I feel it has been more cruel, to

my children as well as myself, to allow what they have left to breathe, walk, and talk.. .now the memory my kids will have is of this “someone else” who looks (but not really) like their mother. I haven’t been able to live with this “someone else” and the life I’ve lived for the past two years has not been a life by any stretch of the imagination. It has been a hell in the truest sense of the word.

I want my words said, even if they fall on deaf ears. It’s not likely, but perhaps when they are said, someone may hear them and at least try to prevent this from happening again. (Cody, 1985)

 

 

 

REFERENCES

Avery, D. and Winokur, G. (1976). Mortality in depressed patients treated with electroconvulsive therapy and antidepressants. Archives of General Psychiatry, 33, 1029-1037.

Bennett, Fancher. Quoted in Bielski (1990).

Bielski, Vince (1990). Electroshock’s Quiet Comeback. The San Francisco Bay Guardian, April 18, 1990.

Breggin, Peter (1985). Neuropathology and Cognitive Dysfunction from ECT. Paper with accompanying bibliography presented at the National Institutes of Health Consensus Development Conference on ECT, Bethesda, MD., June 10.

 

Breggin, Peter (1990). Testimony before the Board of Supervisors of the City of San Francisco, November 27.

Breggin, Peter (1991). Toxic Psychiatry. New York: St. Martins Press.

Brody, M.B. (1944). Prolonged memory deficits following electrotherapy. Journal of Mental Science, 90 (July), 777-779.

Calloway, S.P., Dolan, R.J., Jacoby, R.J., Levy, R.(1981). ECT and cerebral atrophy: a computed tomographic study. Acta Psychiatric Scandinavia, 64, 442-445.

Calvert, Nancy (1990). Letter of August 1.

Cody, Barbara (1985). Journal entry, July 5.

Coleman, Lee. Quoted in Bielski (1990).

Details of Electrotherapy (undated). New York Hospital/Cornell Medical Center.

Dolan, R.J., Calloway, S.P., Thacker, P.F., Mann, A.H.(1986). The cerebral cortical appearance in depressed subjects. Psychological Medicine,16, 775-779.

Faeder, Marjorie (1986). Letter of February 12.

Fink, Max (1978). Efficacy and safety of induced seizures (EST) in man. Comprehensive Psychiatry, 19 (January/February), 1-18.

Freeman, C.P.L., and Kendell, R.E. (1980). ECT I: Patients’ experiences and attitudes. British Journal of Psychiatry, 137, 8-16.

Freeman, C.P.L., Weeks, D., Kendell, R.E. (1980). ECT II: Patients who complain. British Journal of Psychiatry, 137, 17-25.

Friedberg, John. Shock Treatment II: Resistance in the 70s. In Morgan (1991) pp. 27-37.

Frend, Lucinda (1990). Letter of August 4.

Fromm-Auch, D. (1982). Comparison of unilateral and bilateral ECT: evidence for selective memory impairment. British Journal of Psychiatry, 141, 608-613.

Gordon, Carol (1990). Letter of December 2.

Hartelius, Hans (1952). Cerebral changes following electrically induced convulsions. Acta Psychiatrica et Neurologica Scandinavica, Supplement 77.

Heim, Sharon (1986). Unpublished manuscript.

Janis, Irving (1950). Psychologic effects of electric convulsive treatments (I. Post-treatment amnesias). Journal of Nervous and Mental Disease, III, 359-381.

Johnson, Mary (1990). Letter of December 17.

Lowenbach, H. and Stainbrook, E.J. (1942). Observations of mental patients after electroshock. American Journal of Psychiatry, 98, 828-833.

Maccabee, Pam (1989). Letter of May 11.

Maccabee, Pam (1990). Letter to Rusk Institute of Rehabilitation Medicine, February 27.

Morgan, Robert, ed. (1991). Electroshock: The Case Against. Toronto: IPI Publishing Ltd.

Opton, Edward (1985). Letter to the members of the panel, NIH Consensus Development Conference on Electroconvulsive Therapy, June 4.

Patel, Jeanne (1978). Affidavit of July 20.

Rice, Marilyn (1975). Personal communication with Irving Janis, Ph.D., May 29.

Sackeim, H.A. (l986). Acute cognitive side effects of ECT. Psychopharmacology Bulletin, 22, 482-484.

Sament, Sidney (1983). Letter. Clinical Psychiatry News, March, p. 11.

Scherer, Isidore (1951). The effect of brief stimulus electroconvulsive therapy upon psychological test performances. Journal of Consulting Psychology, 15, 430-435.

Squire, Larry (1973). A thirty year retrograde amnesia following electroconvulsive therapy in depressed patients. Presented at the third annual meeting of the Society for Neuroscience, San Diego, CA.

Squire, Larry (1974). Amnesia for remote events following electroconvulsive therapy. Behavioral Biology, 12(1), 119-125.

Squire, Larry and Slater, Pamela (1983). Electroconvulsive therapy and complaints of memory dysfunction: a prospective three-year follow-up study. British Journal of Psychiatry, 142, 1-8.

SUNY (State University of New York) at Stony Brook (1990- ) Dept. of Social Work. Unpublished masters’ thesis project.

Taylor, John, Tompkins, Rachel, Demers, Renee, Anderson, Dale (1982). Electroconvulsive therapy and memory dysfunction: is there evidence for prolonged deficits? Biological Psychiatry, 17 (October), 1169-1189.

Taylor, John, Kuhlengel, Barbara, and Dean, Raymond (1985). ECT, blood pressure changes and neuropsychological deficit. British Journal of Psychiatry, 147, 36-38.

Templer, D.I., Veleber, D.M. (1982). Can ECT permanently harm the brain? Clinical Neuropsychology, 4, 61-66.

Templer, D.I., Ruff, C., Armstrong, G. (1973). Cognitive functioning and degree in psychosis in schizophrenics given many electroconvulsive treatments. British Journal of Psychiatry, 123, 441-443.

Warren, Carol A.B. (1988). Electroconvulsive therapy, the family, and the self. Research in the Sociology of Health Care, 7, 283-300.

Weinberger, D., Torrey, E.F., Neophytides, A., Wyatt, R.J. (1979a). Lateral cerebral ventricular enlargement in chronic schizophrenia. Archives of General Psychiatry, 36, 735-739.

Weinberger, D., Torrey, E.F., Neopyhtides, A., Wyatt, R.J. (1979b). Structural abnormalities in the cerebral cortex of chronic schizophrenic patients. Archives of General Psychiatry, 36, 935-939.

Winter, Felicia McCarty (1988). Letter to the Food and Drug Administration, May 23.

 

 

 

For copyright information, contact Linda Andre, (212) NO-JOLTS.

 

OPEN LETTER TO JOSEPH LASEK MD: I FORGIVE YOU

Dear Dr Joseph Lasek, as a recent Alyssum guest, i loved your testimonial on the Alyssum website. Your compassionate writing painted an entirely different picture of the man who just a year ago signed an order refusing to release me, a woman who had not been able to speak aloud for days, (indeed i have a history of having been completely mute for months at a time) from 5- point restraints until i spoke out loud.

Yes, the nurse Annette Brennan wrote that order, and informed you not only that i could speak but that i “refused to” and so you, yourself told me in no uncertain terms, that i would remain in restraints until i obeyed your orders.Despite lying quietly and complying with the restraints, triggering an assessment every 15 minutes, your staff refused to ask me the necessary questions to remove even one restraint and left me alone in that room, time after time, motionless and mute, all because they and you had decided to force speech out of me.

Why? Did you believe you had the right to do this? What had i done to you to make you so angry with me? Why didn’t i have a right to communicate however i chose to or needed? I understand that you believed that i *obstinately* refused to speak to you…and you may continue to choose to hold that belief. I cannot change how you think and i refuse to defend my muteness in the face of your ignorant assumptions.

What i will assert is that the use of restraints has never been or should never be about the power you hold over one of your patients, and it should never be about your power to force a patient in restraints to do something you want her to do. In most parts of the world, and in most people’s minds, for you to force me, by means of physical coercion, to speak out loud would be called torture. What else is it?

What did it matter really why i did not speak? So what if i was obstinate, or unable to form words…neither reason matters a fig. Your only justification in keeping me restrained was if you knew or had determined by communicating with me that i was a danger to myself or others. But time and again, you did not even try to find that out, no.

You assumed things, yes, you assumed that if i kicked the nurse, whose groin inappropriately pressed against my bare feet, a sexual maneuver on her part, that i was aggressive. But you refused to ask me what happened or how i felt or what was going on. You used none of your apparently great capacity for empathy when it came to finding out from me what was going on and how to end the situation as quickly as possible (as you claimed was your desire).

If you really wanted me out of restraints asap, why did you refuse to let me communicate in any fashion except speech. You would not even phrase your sentences in such a fashion that i could answer them with a shake or nod of my head.

So this went on for hours, my frustration and anxiety growing since i was told you refused me even 1/2 mg of Ativan for sleep, for mercy sake. Finally nurse Manusukhani asked me the safety questions at 5:00 am and i answered them all, still mute, but satisfactorily. But the restraints were not removed. No, i was left alone for another hour. When the nurses returned they wanted me to write an essay with a safety plan with one hand, upping the humiliation and degradation till i could not take it any more. I simply shut down and refused.

You won, then. You broke me. I have suffered from that torture every day since that night, a year ago. i did not speak aloud that night, and the next shift took me out of the restraints even though it contravened your orders, because they understood it was an illegal order.

How did you feel about that, feel thwarted, angry? Probably, since you had not been able to successfully break me, break my back and force me to speak…sorry, sorry sorry,

The thing is, my speaking had nothing ever to do with you nor my refusal to speak, that was always only your interpretation. Alway only yours and the nurses interpretation. No one ever asked me why i did not speak, they just made assumptions and always they had negative connotations,,,

Why did they always think the worst about me? They knew nothing at all about me. Dr Malloy had never taken any history, and never talked to me, except to talk at me and dictate to me what he would do if i did not obey his orders. What did i do to deserve this? I had an advance directive before i came into VPCH. Did you ever see it before or during the time i was in restraints? It advises to never use restraints or seclusion as i will only get worse and be further traumatized, but it also provided multiple suggestions for what nursing staff can do instead of restraints or seclusion, none were tried in the minutes before Brennan brought that restraints bed into the room.

I think, from your Alyssum testimonial, that you are probably a very nice guy. I liked very much what you wrote there, and i think alyssum is a wonderful wonderful place. I will never go back to a hospital so long as alyssum, is available to me in any fashion. hospitals only and always torture me. People like you misunderstand and hate and torture me, and seem to get pleasure doing so. I do not understand why…

Now i have to tell you, if you have gotten this far, that i have filed a formal complaint against you with the board of medical practice. If i had been been permitted to speak with you and nurse Brennan and the others face to face and use non violent communication techniques to resolve what happened between us, maybe i would not have had to do so. But the psychologist Elliott Benay would not get people to talk with me, as i proposed and instead told me to do what i had to do.

So complaints were filed and the hospital has already been cited for violation of my rights. What will happen will happen. It wont be bad for you, as you can imagine, nothing bad ever happens to doctors, who always walk away from their misdeeds with a slap on the wrist with a wet noodle; their patients suffer the agonies of hell or iatrogenic illness,you know this or you ought to. I dunno what else to say, you are likely preparing a mental defense of yourself and your actions even as you read this, rather than seeing that perhaps i write the truth, and preparing an apology that might go a long way towards healing the suffering you caused me.

Do you think psychiatrists ever apologize for anything? No, i think it is something they cannot bring themselves to do, not to a patient, it would cost them too much pride and suffering, they would rather the patient suffered…

Nevertheless, I forgive you.

Sadly, forgiveness does not seem to heal or help my suffering, or not yet, possibly because i do not believe you will read this letter. Much less respond. Of course you will not respond, who am i but a stupid mental patient?

no, i will tell you who i am. I am a three-time author, one book of mine was a best selling memoir from St Martins Press for many years. I am also an artist and poet, who, if you will forgive me a tiny bit of pride, will one day be more famous than you ever will. Mark my words. *You* may never hear from me again personally, but someday you will see and hear my name often, just wait.

Sincerely, from the 63 year old woman you kept in 5-point restraints last November, because she could not speak.

Pamela Spiro Wagner

–——

so i went to the commissioners hearing to appeal the APS unsubstantiated decision about Annette brennans part in the above, you can find my account of these events elsewhere in my blog if you do a search on VPFH…anyhow, she took umbrage at my asking her not to call me Pam but Miss Wagner, and rubberstamped the Aps results despite my lawyer arguing on my behalf and my presenting a half hour case…here is her decision, which says nothing about the hearing,

img_1534 img_1535

Restraint Chair Use at RRMC

image

Please note that i am reposting this frorm a week ago as it got accidentally deleted, but i cannot repost the comments. Anyone who wishes to recomment is welcome to.

It all started when i bodily “escorted” the nurse,KJ out of my bathroom, where I had situated my mattress, and had her leave my lunch on the table outside. I had been vocalizing loudly and softly virtually only the three words, “oswall wistofi matootam” for days uncontrollably, and over the past hour i had screamed at the top of my lungs from my room, which the nurse had to have heard but made no response. When she simply left my lunch at the table, i felt utterly ignored and abandoned, and in a rage of certainty that she was plotting against me, picked up the cup of coffee and threw it straight at her. With unusual accuracy, it found its target in her center. My next lob hit only the wall.

In certainty of repercussion, i slammed my door and waited. Soon the usual code was called, but instead of burly men bursting in the door, i heard them packing up the sitting area for quite some time, and it knew it took them some several minutes to prepare an injection of my medications. But my terror only increased, so i grabbed a chair to defend my self. Finally they opened the door. KJ in an oh so nice voice said, “pam, i have medication for you.” And they quickly grabbed the chair and four men upended me and laid me on the floor near the bed frame, which was covered in my artwork and books. It took quite some time for the staff to methodically pack up all items they feared, apparently, might go flying at them afterwards ( though if proper protocol had been followed from tHe first, nothing would have).

This proper protocol, by the way, had been developed by another nurse and i after much discussion of my detailed advanced directive and my intense horror of locked seclusion and mechanical restraints, both of which i have experienced in abundance and usually for discipline or convenience, almost never for any truly emergent reason. That said, i believe the first nurse, KJ had lost her temper with me, and decided not to follow this protocol on the unit because she wanted to punish me, as will be demonstrated by what followed.

Having brought the two IM medications with her, which the protocol for agitation we had worked out calls for, she eventually called for the men to deposit me on the bed frame so she could inject them, one in each leg. She did so. Then, instead of having them keep me in a protective hold for as long as i needed to calm myself and potentially fall asleep, which usually took little more than 10-15 minutes, she said, she was having everyone leave and locking me alone in my emptied room. I screamed aloud at this. “I have an advanced directive! You cannot do that!” I pleaded but they forced the door closed against me and locked it.

I screamed to no avail and then started hitting my head in terror against the door in an effort to get them to open it. This worked in a short time, and three aides were sent in. We sat on the bed frame and they actually held my limbs, i thought in such a way as to comfort me. Little did i understand the truth, because even as i very quickly calmed down, soon through the door, the same angry nurse pushed a big prison-issue restraint chair. She yelled at me, “now you are going to have to sit in this!!!

I yelled back, “No!!! No restraints. My advance directive says so!”

I want to interrupt here to quote the government’s own research. SAMHSA’s issue brief #1 March 2010 on promoting alternatives to the use of seclusion and restraints says:

“…the use of seclusion and restraint has often been perceived as therapeutic to consumers. This misconception has been challenged and refuted. Increasing research has identifed the role of trauma in mental and addiction disorders. Research into trauma and trauma-informed care identify common themes about the impact of trauma and how traumatic life experiences can impede an individual’s ability to manage his or her own behaviors or engage in appropriate behaviors in the community.

“Also, there is a common misconception that seclusion and restraint are used only when absolutely necessary as crisis response techniques. In fact, seclusion and restraint are most commonly used to address loud, disruptive, noncompliant behavior and generally originate from a power struggle between consumer and staff. The decision to apply seclusion or restraint techniques is often arbitrary, idiosyncratic, and generally avoidable . Moreover, some studies indicate that seclusion and restraint use leads to an increase in the behaviors staff members are attempting to control or eliminate.”

But they grabbed me and forced me into that chair and despite my struggles and terrified screams of protest they forced nine straps around my body, yes, 9-point restraints because K— J—-, RN, was still angry with me and refused to utilise our calming no-restraints, no seclusion protocol. This protocol had not only helped me but had also since then, so i was told, been used to calm and help other agitated patients without seclusion cells or mechanical restraints after i insisted that the unit staff start doing their “best to avoid restraints” with everyone, not just for me because my A.D insists on it.

Once strapped in to that horrendous chair, i screamed at the nurse, “You are just punishing me!” And calmly, she answered back, “Well, you threw hot coffee at me, what do you expect but punishment!?”

Then she walked out of the room, leaving two aides in the room to tighten the straps so tight that i could not move and felt the circulation in one hand go dead.

In horror, i shrieked for help. I pleaded for anyone to help me, for god’s sake. What the hell were they doing to me?!? Please just help me, someone!!? It upset the other patients to hear this just outside my room. I even begged them to put me in regular 4-point restraints on a bed where at least i could relax and fall asleep. Why hadn’t the nurse not brought me to the seclusion room to begin with, where the walls and door were all were padded if she was not going to follow the protocol?

In the end, it took two hours and two episodes in that terrible chair before they freed me.

That evening, as a response to the trauma, i defecated on the rug in the dining area, and painted with feces on the wall.

Surely this is no way to treat an animal, let alone a troubled psychiatric patient, especially not when there is already a calming,non-violent protocol set up to deal with her when she is agitated?

I say, chairs like this need to be trashed. Once a hospital orders one — and where do they get them? From prison suppliers!) they will use it. They say they use it for emergencies only, but as i have shown, once they have such a chair, it will be used abusively–always, always, always.

The only way to end seclusion and restraints is to stop it now and. For good. The more hospitals dilly-dally saying, soon, we will when we can, they will never stop. There will always been someone to say, no, what about this or that. But abuse is abuse and restraints are abusive by definition. Stop the use of a restraint chair and bed and all use of mechanical restraints by stopping. And then you will find a way to deal with problems arising that work better.

The painting i did below depicts the chair they held me in, minus the waist strap but with the toe restraints.

“There is no negative space, only the shapely void. Hold your hands out, cup the air. To see the emptiness you hold is to know that space loves the world.” P. Wagner
Pamela Spiro Wagner
rutland regional medical center
Rutland vt 05701

802-747-1855 until i can use my cell phone

Five Point Restraints At Vermont Psychiatric Care Hospital (cont)

After they had me trussed up in restraints…No, let me back up a bit, because it was not that easy…Hannette was the point person, shall we  say, the person who had my head between her hands and was cradling it, “oh so gently” as she “oh so soothingly” commanded me to CALM DOWN RIGHT THIS MINUTE!” Again and again, she subjected me to these absurd demnds as if I could possibly do so upon her order. And as if I ever would do anything but attempt to writhe away from her clammy awful grip on my ears that nearly deafened me to her voice even so.

 

Finally the job was done and they had fastened a thick plate of velcro across my chest so I could not even sit up or do more than bend my neck a bit to see their handiwork, briefly, before i lost strength and had to lie back down. But I was emotionally overwrought with the situation, and what had happened in the space of only minutes.

 

WTF? How could this have happened when all I ever wanted was an Ativan to calm down and help me speak? And now what?

 

But they just trooped out, with Annette leaving last,  saying, “You will tell us in WORDS when you are safe enough to be released, or you will remain in restraints.” She then departed too.

 

Although two monitors were posted silently in the adjoining room, I could not see them for my position, nor were they permitted to speak to me, as  I knew from prior experience. I let out a scream that echoed through the empty chamber like a banshee howl but it made no difference. Yes, I could hear Chelsea from somewhere, — a sweet  female staff member who remembered my Advance directive and the other times I had been restrained — saying, “Pam, take a deep breath, try to stay calm, I am here, you are not alone…” And I mentally thanked her. But as soon as I could remember that she was there, she was taken away, removed by someone who was told not to talk to me….and so it went. A Dr. Lasix came to me within the half hour and told me he wanted me to come out of the  restraints as soon as possible but I would have to agree to talk with him. What did I have to say to that?

I could not respond with a shake of my head or a simple nod so I remained silent. He shrugged and left.

Several people attempted to engage me in conversation, but as no one phrased their comments as Yes or NO questions, I had to remain still. I was not unwilling to answer, simply unable to. But time and again they told me I was “unresponsive” or non-compliant, though I was calm and had been rewarded with the requisite assessment to possibly come out of restraints every fifteen minutes. But no one let me, because they would not let me answer their questions without speaking aloud.

 

The hours passed. First one then two then three. Finally the nurse Jennnifer decided to relent and allow as how I might answer the safety questions with a shake or nod of my head.

 

“Will you remain safe and not hurt anyone?” she asked me, standing above me.

I nodded my head.

 

“Will you remain safe and not attempt to harm y0urself?”

 

I nodded again.

 

Will you get up go back to the unit to and to your room and continue to behave safely if we let you out of restraints?”

 

Nod nod nod.

 

Jennifer seemed happy with my responses but also at a loss as to what to do with them. She paused. “Okay, thank you Pam. I have to go back and confer with Hannette and see if she will agree to take you out of restraints now that you have agreed to be safe.”

 

She left, turning her back, promising to be back within a few minutes.

 

Instead, it took a good half hour, and when she did, both she and Hannette arrived with a plan. “We have decided that we want to free up one hand and you will write a safety plan with the free hand. Then we will approve it and if it is adequate we will see about taking you out of restraints.”

 

I frowned. Even as she spoke, Hannette had moved to the end of the gurney where my stocking feet lay exposed. Her belly squished against my toes and soles of my feet, and I felt an immeidiate disgust and worse. I felt instant revulsion, as if I were being deliberately molested by someone who knew I was helpless to resist. So I kicked at her mightily.  If I could have spoken in words I would have yelled something too, like “You effing …something or other…!” but alas, I could say nothing in protest, only scream, and kick. This did have the effect I wanted of getting her to stop and move away. Someone told her to move past me at the head of the bed next time and she did…

 

But the safety plan writing thing was their way of upping the ante abominably. How dare they? They had already illegally kept me restrained in FIVE points for far longer than necessary, just because they wanted to prove a point and force me to speak. without even offering me Ativan to calm down let alone to promote speech. Now this??? I flat out refused. And so somewhat triumphantly they trooped out, leaving me alone again, still in restraints at 6:00 o’oclock in the morning.

 

I knew I had to remain as still as possible to earn yet another assessment within the next fifteen minutes. But my muscles and veins hurt becuase I had remainedstill for so many hours, and no one had done any range of motion exercises on me, actively or passively. I was  becoming afraid that I would develop a blood clot if I did not move my limbs on my own, and no matter what they interpreted it as, I began a methodical program of movement. I carefully circled each leg ten times in each direction, the restraints clanking as I did do. Then I bent each knee up and down, up and down. Ditto with my arms, until I was satified that I had exercised them at least a minimum  and could relax into the required absolute stillness for the next fifteen minutes so I could earn an assessment.

 

Finally, Jennifer returned a final time. But this time it was only to tell me that they were leaving for the night. “First shift will have to take you out of the restraints. It is too let for is now.”

 

when end I herd this, I let out a bnshee scream of exhaustion and utter frustration, but it was too no avail. Only when first shift finally came on and found me still in restraints at 7:00 am did they relent and give me Ativan and take me out by 7:30.

 

 

 

 

 

 

 

 

 

 

 

 

In 5-Point Restraints For Six Hours At Vermont’s State Hospital VPCH

 

Fist Protesting Restraints
Fist Protesting Restraints

I admit i had been slamming the doors at 2 o’clock in the morning but this never triggered anything before from the unbelievably patient and forbearing staff at Vermont’s Psychiatric Care Hospital, Unit D, except some bemused bewilderment at what had set me off and offers of PRNs to help calm me. After all, with only two other patients on the floor and those two either stll awake or dead to the world, it really did not matter if I raised a ruckus. But this time, because Hannette was the nurse on duty, my nemesis, it mattered a great deal more than it ought to have.

 

Instead of letting me slam my door a few times and cool off, as i had so often before. or if not, then opening the safety door so when I slammed it it closed only on air, thwarting my attempts to make noise….instead of any of these non-personal interventions, Hannette decided to take another route no one else had ever done. She came right into my personal space and inner sanctum almost no one ever violated without asking me first. Not only did she enter my bed room, but she came right to the door way of my bathroom where I had pulled my mattress and situated my small bedroom stall inside there underneath the shower head.

 

I stood on the mattress, by the toilet, higher by a couple of inches, boosted by the mattress. But Hannette pushed up close and yelled at me, “You will not slam any more doors tonight, do you understand?! You WILL CALM YOURSELF right this instant!”

 

That was like yelling at me, BE spontaneous! Yeah, right. I had gone to the med window at this state hospital I had been committed to weeks before, asking for a second tiny dose of Ativan for severe anxiety and because I had been unable to speak for a few days. The next day the people from my recovery residence were coming and I needed to be able to sleep to meet with them in good form and i had to have a voice to speak with them…

for years catatonia and mutism have intermittently plagued me, and it was only in 2003 that we discovered how effective Ativan was for catatonia…later on, when mutism was the bigger problem, Dr C decided to try it, seeing it as as a feature of catatonia, with good results.

 

However, here at VPCH the on-call doctor,Lasix,  knew nothing about my relapsing mutism, nor my need for Ativan. He only knew about my complaints of sleeplessness and anxiety. So called around 1:30 AM he refused me a second .5mg dose and ordered me to try to relax on my own and sleep for another hour, before he would consider a second dose.

 

This is what occasioned, at 2:00 AM my panicked outburst of door slamming. But I did not start the melee that ensued. Properly the trigger was Hanette’s grabbing my wrists. She restrained me in such a fashion for some reason, but now I dunno why exactly. Maybe she saw my mute shaking my fists at her as threatening. Even so, she ought to have just backed away from me, having cornered me in the bathroom, where I felt threatened by her!

 

As it was, however, she approached closer and grabbed my wrists, another mental health specialist nearby saying at the same time, “we dont want to go hands on here at VPCH.”

 

“Then don’t grab my wrists!” I screamed silently. But reflexively and in terror, I bent to nip her fingers with my teeth in order to get her to release me.

 

Well, that of course was where all hell broke loose… and much more to say but the library hours end now so I have to leave this for tomorrow when I can spend more time at the hospital computer.

 

 

———

So, what happened next you can guess.  She yelled for help and help arrived in seconds in the form of staff prepared to go “hands on” not only to stop me from biting her but to actually restrain me completely.

 

As they  bodily hoisted me off the floor, screaming wordlessly, one man asked, “What now? And HAnnette answered promptly, “Seclude her!”

 

This horrified me. Not again, not a third time in weeks. not in Vermont where they were trying so they assured me everywhere to reduce these events to zero…This was ridiculous.

 

But Hannette had had it in for me ever since the episodes early on in my stay — when there had been forced medication, something my Advanced Directive had explicitly advised against for good reason, and which the “good doctor ” had for some reason seen fit to decide to go for anyway…with predictable consequences. So for several days as a result I had been a version of the Exorcist’s  Linda Blair over that first week or two and that is only a small exaggeration. The foul language spewing from my mouth in hourlong torrents was utterly uncharacteristic of me, both in kind and sheer amount.

 

But it was now nearly week three and after I had filed a grievance, the forced meds had been stopped and so too my involuntary Linda Blair imitations. Only Hannette it seemed still held those horrors against me. Everyone else had been both forbearing during those horrendous days and extremely forgiving afterwards. What is more, during my outbursts, even when I tossed chairs and overturned tables, no one had over reacted or punished me for the extreme and extremely disruptive behaviors i had exhibited at the time, no one.

Only once, when I became apparently dangerous, did the charge nurse put me briefly in five point restraints. and that was when I literally splashed urine all over him and other nurses and urinated on the rug in public and then hit him and two other people…But at no other time did they even come close to suggesting involuntary procedure such as meds or seclusion or restraints. Or at least not that I knew of.

 

Now here i was being dumped in seclusion largely because Hannette had grabbed my wrists, standing too close to me in my own bathroom!

 

Worse was to come. After the panoply of staff dashed from the room,  I ran after them in anger but they closed the door and locked it, locking me in alone.

Hopeless, I sat back down on the mattress dazed and sad but not moving. I heard them talking  but scarcely listened, trying to calm myself and wondering how long they planned to keep me in this god forsaken room. Then I heard someone say, “She has her glasses and watch. We have to get them!”

 

Soon they piled in again, all of them on top of me at once, peeling off my two pairs of glasses and watch and my medical band. And then they searched me for pockets of which I had none. All this time I was screaming, wihout verbalizing a word…and fighting them in protest at the intense violation of my person. Then as they tried to dash off I followed closely and almost escaped the room with them. This time they did not succeed in closing or locking the door, no, because I was wedged in-between. So someone said. “Back inside!” and we all moved as one back towards the mattress.

 

I thought they were going to use the maneuver Scott , that charge nurse. had used the other time, to twist my arms and legs in such a way as to make it difficutl for me to untangle myself and give them time to get out before I could follow. Not pleasant for me but not painful either and rather clever nonetheless.

 

But no, instead, to my dismay I heard Hannette call, “Get the Bed.”  The  BED??? For what? What had I done to deserve The Bed????

 

But the bed was gotten and within minutes I was trussed up in FIVE POINT RESTRAINTS for nothing more dangerous that holding up my fists at Annette and nipping at her fingers when she herself had grabbed my wrists!!!!

 

The worst is yet to be related alas. much worse. But I do not have enough time tonight in the library to explain it all and I need to post it tonight or it will be lost. I go home to MRR on Monday , which may be news to many who have been wondering where I am or have been.

 

It has been a long long journey and it is not over yet. More tomorrow on this story and perhaps I can also catch you up on other parts of it as well. In the meantime  know that VPCH is by and large a good place all told, just not a place to call home, not if you have any life of your own left to live.

 

Tata for now.

 

Pam

 

 

 

 

 

 

 

 

 

 

 

My Statement to the Police About July Assault in ER

Dear Reader,

This is only part of what i have not been able to write about for months. And there is a great deal more. Now that “Mike” is formally being charged with Assault, i feel i can share this much. In the future i will say more. But for now, at least i will share this statement that i wrote for the police, some weeks later, which is only a second statement, as they already had the statement I originally wrote the very day the assault happened.

Alas, I do not have a copy of that statement, which another ER nurse had to transcribe for me as I was not permitted the use of an ink pen at the time. It was also after I had been illegally but forcibly administered IM Haldol, despite the fact that the record itself shows that I was lying on my bed in my room with my headphones on and the lights off. The record also shows that  an order for PRN 4-point restraints was entered into my chart at that same time. And this PRN order was kept there for the entire 8 days that I was held captive in that Emergency Room, a matter that the lawyer’s grievance deals with but for which a mere grievance seems hardly adequate.

Let me start at the sort of beginning, which is to say only that I had been hospitalized by force at R— at the State Hospital Unit there — and I will talk about that experience in a whole different post. But after 6 weeks I was discharged to a step down facility largely because I had so alienated the hospital doctor that he wanted to get rid of me…Let’s face it. I told him each time I saw him, “Get lost, I do not want to talk with you, You are useless!” Needless to say, this did not go over well, useless though he may have been. And though I found the Social Worker very helpful and so too many of the nurses and mental Health workers and the Occupational Therapist was wonderful as well, but ONLY THE DOCTOR mattered. At least in his own mind, and so he arranged to discharge me somewhere I would no longer get under  his skin or on his nerve i.e. anywhere but in his hospital!

That this step down facility had no medication supervision, beyond opening a safe and having a resident take whatever she or he wanted, this mattered little to the doctor, apparently. Despite his insistence that I needed the medications to such an extent that I have been on a so-called ONH or “order of non-hospitalization” for months now, meaning that wherever I am, I can be hospitalized if I do NOT take the meds, as contradictory and gobbledigoookish  as that sounds! SO I was sent off to  R–, Vermont, to await a bed first at Alternatives and then a more or less long term placement at MRR in Brattleboro, where I am today. (Though how I got here was not via that route as it turned out.)

But in R, Vermont, I did not last longer than a week at the step-down facility as I failed to take the meds and I suppose this is why I ended up trying to set my hair on fire, after receiving commands from “on high.” That is also why I was at the ER when what I describe below occurred.

I knew when the staff member left me alone in the ER, after she walked away and left me there, that I was sunk, that I was going to end up back in the hospital, and with that realization, my heart plummeted. I did not want this, I did not want it. I  decided then and there to do all i could to be compliant  with the doctor and the crisis team, even more so than I already had been, which was plenty. I asked if I could take 10mg of Zyprexa. I even suggested it before the Crisis Team could get there. But it did me no good. They took one look at the report from the step-down facility staff member, who told them about how I had waved lit cigarettes near my just-washed hair and singed it, and they decided — in the lingo of Emergency Crisis teams, that I was “a danger to myself” and could not leave and had to be hospitalized against my will. This would not do. I said as much. I said,”I do not want to go to any hospital. I do not do well in hospitals. I want to go back where i was. Please do not make me go to a hospital. I want to leave”. And with that. I got off my gurney, as I recall, and I am sure the hospital chart can correct my memory if faulty for details now, and proceeded to walk slowly towards the door. I walked slowly because I did not want to trigger an assault by the goon squad. And I did not want to scare anyone into thinking I was doing anything besides deliberately and consciously choosing to leave. But as I did so, a man, a nurse, followed me. I walked slowly out the main door, still dressed in hospital pajamas, since where was I going to obtain any clothing? And I took about 10 steps when he yelled at me, “You go any farther and  I am calling the police!”

Now I will let my statement take over the account.

“I want to scream to someone that i saw in the eyes of the nurse who attacked me someone who recognized Satan and that was why he started screaming at me so uncontrollably before i did anything as “Pam” to “deserve it.” Do you understand this? This should have been obvious to anyone watching the video, but i do not yet know where we go off camera…i only know these facts: that he told my body that if it took another step away from the hospital (i had already walked slowly out the main hospital doors) he would call the police. I believe i shrugged and said, “Go ahead and call them.” Then i decided, remembering the Springfield VT police brutal tactics not to trust them in R—– and so i turned around maybe fifteen feet from the double doors deciding to return and proceeded, again slowly, back towards the entryway. It was then that this nurse started to scream at me. i was shocked at this, because i had already reconsidered and was returning under my own steam. i objected to his screaming and i asked him, likely also loudly, why he was screaming at me when i was already complying. He continued screaming even louder and then he grabbed me and bear-hugged me in a suffocating restraint hold that set me off big-time. He is a big man, and i could not get away from him. He dragged me into the hospital lobby, where, desperate for release, i kicked backwards at his shins.

This must be what so enraged him that his reaction was to throw me forcefully to the ground and jump on top of me, mashing my face into the carpet in such a frenzy that i feared he was going to kill me. I could not breathe or even scream for several long seconds as he continued to grind my face into the carpet. I was terrified for my life and did not know when or whether he would stop. Finally –i never knew what made him stop – maybe someone came out of the nearby ER and saw him attacking me? Whatever was the case, he hauled me back to my feet. At this point i was breathless and extremely frightened, but i nevertheless screamed at him in fury, “You rapist!” I may even have screamed, “You fucking rapist!” I really don’t know. I only know “rapist” was the worst thing i could think of to call him as he had violated every ethic of nursing and emergency care-giving possible and as far as i was concerned he had raped me just as completely as any man who violated my sexual parts.

Unfortunately for me, this only served to further inflame a man already too out of control for explanation, except as someone who felt face to face with Satan: his reaction was to haul off and slap Pam’s face, to shut her up, grabbing my mouth so i couldn’t scream that word any longer.

Maybe someone came out and helped her at this point but I do not recall, even though it might have happened. The next thing i remember is screaming from inside my room in the Emergency Department for a long while and when the police officer appeared, begging him to listen to what the nurse had done. He clearly did not believe me. All he did was leave a statement form for me to fill out –i repeatedly informed him that the Emergency Department staff did not permit me access to pens — and he told me i would have to somehow transmit my statement, signed and notarized, to the police station on my own.

In the meantime, i overheard the same nurse, who i believe was called Mike, telling falsehoods about how i had run into traffic while heading towards the train station. I objected loudly and vociferously. All i got for this was to be restrained yet again, this time by the same police officer among others, and despite my repeatedly asking what medical emergency justified it, to be forcibly injected with Haldol, a medication that my Advance Directive — which the ED had noted and logged in that very night– explicitly directs is never to be administered. This same drug was given to me against my will and over my strenuous objections, even though i lay on the bed the whole time. I was not overtly agitated by this time. At no time was i was more than tearful and most certainly never out of control.

I later complained of ribs (left ) pain — from how hard Mike had compressed me either in his restraint hold or when jumping on top of me, and knee abrasions (right) the latter from being dragged on the carpet. i told the ED personnel several times that night and over the next few days i spent in the Emergency Department. They never looked at my ribs or my knee to appraise these injuries, not until a few days later when Dr Sandy C——     ordered x-rays.
Because no one would document these injuries i was forced to photograph them myself in the mirror.

Ribcage bruise a week later

I Will Be a Gadfly or Die!

How very similiar Michael and Charlie look...and and no wonder, since they share the same sadism genes!
How very similiar Michael and Charlie look…and and no wonder, since they share the same sadism genes!

In the next few days I will be writing and having a guest post from someone but today I want to write about a frustration that has got my goat bigtime. It has to do with the letter that I wrote to Kathryn Power, “bigwig” at SAMHSA or, for those of you who wonder what the letters stand for, the Substance Abuse Mental Health Services Administration, for Region One, which covers the New England region.

 

Apparently she took my letter very seriously, which I did not know. This may have been because I never received her reply, if she sent one, having given her the wrong return address ( I did not know the proper one where I was to be living at MRR in Brattleboro.) Or it may be because she failed to copy me on any of the emails she sent to any of the parties she subsequently wrote to, both in the Federal government and at the state level. Whatever the case may be, apparently she wrote to several officials, including the Connecticut Department of Mental Health and Addiction Services and possibly the Department of Protection and Advocacy ( which dumped me completely after assuring Susan Stefan, Atty at law known for her work against seclusion and restraints, that they were working closely with me). I never knew this, nor have I learned the outcome of these contacts. I only just today received faxed records of these initial emails.

 

So I know that Ms Power contacted Mirian Dephin-Rittmon who is the new commissioner of mental health in Connecticut. I would like to think that Ms Dephin-Rittmon responded somehow, but I have no such evidence, and if the response from Patricia Rehmer, her predecessor, is any hint of what I could expect, then the answer will b: NOTHING, nada, zilch, a big fat zero. And why is that? Because in Connecticut the Commissioner of Mental Health and Addiction Services, while she may nominally be serving all citizens with mental health problems, actually has no such mandate. Not at all. She serves in fact ONLY those who are hospitalized in STATE facilities, which are extremely limited, and how lucky for her, and in fact for them, because they get protections that none of the rest of us ever got.

 

It was not that we were not indigent and also on Medicare and Medicaid, and also on SSDI and possibly on SSI. Most of the patients at general hospital psychiatric units in Connecticut, if they are repeat offenders of any sort, are usually on assistance of this kind. How could they not be? Most have been “disabilified” – that is, disabled and made into disabled-thinking persons — by medications if not by illness and by the systematic undermining of their personhood by the State. (I know, that is an argument that needs to be enlarged, but elsewhere, elsewhere…) But they are not in State facilities, decidedly not. Why is that? Because courtesy of the State Government, most state facilities, especially for adults, have been closed down or turned into prisons.

 

So if you need a hospital, you must go to a general hospital psychiatric unit where the Commissioner of Mental Health and the Department of Mental Health actually have no jurisdiction or sway. Literally the only way you can get into the safety zone of a State Hospital, that is to say, into the ONLY state hospital that now exists in Connecticut, Connecticut Valley Hospital, is by being thought such a bother to the nursing staff at a general hospital that they want to get rid of you, and they send you off to CVH for “longer term treatment.”

 

But this, mind you, is a punishment, it is not something that they do out of caring or attempts to render better treatment. Not at all, and I should know. After all, I have been threatened with such “treatment” several times, and the last time was when I was at New Britain Hospital in 2014. There, because I was labeled “a borderline” and therefore dismissed as manipulative and dramatic. Every word I said was disregarded…Nothing I could say was taken seriously. And every act was regarded as willful and deliberate. So they could justify punishment and torture as my just desserts, and they tortured me by dragging me to the seclusion cell for swearing under my breath, and four-pointed me for hitting my head lightly against a wall, after they stripped me naked in the cell and I begged for a blanket they pointblank refused me ….

 

You see the picture? I was “so impossible to deal with” that they were going to “send me away” as punishment and in revenge.

 

We all knew this, we all knew that CVH was the last stop, their last resort and final punishment for those of us so obstreperous as to object to their outrageous brutalities and keep objecting rather than bow our heads and submit. In the end, because I was so determined to get out, to escape to Vermont, I did, I gave in and gave up and submitted, and it worked. I played their game and got out of their abysmal unit. I submitted, for which I cannot forgive myself…

 

My point here though is that it is only when a patient has been deemed such a pain in the ass that she is sent away, sent down the river to CVH that Pat Rehmer or Miriam Delphin-Rittmon ever comes into the matter. Before then, they are not interested or concerned with what happens or happened for that matter. They do not give a damn. Not that they don’t care about torturous seclusion cells or four-point restraints in general, it just ain’t their juris-my-dicktion to care about what happens to patients in city hospitals. Sorry, but it ain’t. So they don’t pay attention. They just can’t and so they don’t. It is, as my friend Josephine says, always as if newly minting the expression, what it is!

 

That said, there is Capitol Region and the Connecticut Mental Health Center too, but they serve exclusively the uninsured, so that of course was not for me, who have been covered by Medicare and Medicaid for years. So lucky me, I could luckily go to New Britain General Hospital and be tortured by the likes of Michael E Balkunas, with utter impunity because DMHAS has no oversight or jurisdiction over these psychiatric units, NONE WHATSOEVER.

 

Did Kathryn Power not understand this when she wrote to Miss Miriam? Apparently not. She might have believed that the Commissioner of Mental Health in Connecticut could or would do something to help a mentally ill elderly citizen who had been tortured in a psychiatric unit in Connecticut. Foolish Kathryn! And then maybe she thought that Protection and Advocacy could be called upon to help me as well? Oh, what a sad, sad day for Ms Power when she learned, or did she, that P and A in Connecticut has no interest in helping anyone? Did she really think I had not applied myself to anyone for help before I went to her? Where does she think I have been for the last year? Doing nothing? I have tried and tried and tried and tried. But no one answers and no one does a thing!

 

Oh, I could laugh if I were not so broken and so sick at heart. But I will not let the fuckers win because then the torture will just continue unabated. No, I will continue to nip and snap and irritate Mikey B. and the nurses at W-1 at HOCC in New Britain until they themselves cry “uncle” and change their ways. I will not stop until they are stopped in their brutality and stop hurting people. I will never cease this campaign until I know that patients at W-1 are safe from harm or W-1 is closed down and I am certain that Dr. Balkunas has lost his license for good.

 

But the worst thing was that Ms Power finally sent the letter to the Office of Civil Rights (OCR) in Boston which was directed to open a Complaint! Yes! But just whne I had hope for this, bizarrely enough, they closed it on the basis, get this, that my complaint “alleges abuse at MANCHESTER MEMORIAL HOSPITAL IN APRIL OF 2008″ — Say what?????? Huh? !!!!! My letter does no such thing. It never mentions Manchester Hospital at all.  Why would it? I had never even been there in 2008 or before 2009. And the first time I was EVER at MMH was in October of 2009, so WTF??? THis is so bizarre and so outrageous and so disgraceful a reason to deny my complaint a basis to go forward that I have had it…To say in the first paragraph that I allege torture at New Britain Hospital in 2014 and then in the fourth or fifth paragraph to somehow segue in this extreme non-sequitor to alleging something in Manchester Hospital in 2008, when I was NEVER THERE…just gets me down completely, because  you know, no one in the chain of information who saw this and they did, NO ONE CALLED THE OCR  on this or told them to get their act together and fix their mistake,.no they essentially let it go and made me suck it up…

FUCK THE THE ASSHOLES I cannot take this shit any longer.  FUCK THE WORLD I WANT TO GET OFF! I have had it. I’ve had it, No one gives a damn about anything…I give up.

Hartford COurant Article (that won’t be) about Michael E Balkunas, MD, Chief of psychiatry at HOCC

Patients placed in Seclusion or Restraints are to be debriefed afterwards. To see standards of care, see below this reprint article.

I moved to Brattleboro Vermont on February 4, 2015, leaving my home state of Connecticut where I’ve lived for nearly 60 years. l had to move because of the horrific psychiatric abuses I experienced in Connecticut hospitals and my fear that if ever I were hospitalized again I would be killed.

I feel guilty, however, just getting out without accomplishing something to stop what continues to happen in Connecticut psychiatric units and hospitals.

The experience of mechanical four-point restraints – leather cuffs that are tightened around the wrists and ankles to immobilize a patient to a bed – or being isolated by force in an often freezing seclusion cell is almost universally terrifying. Nevertheless, both cell and/or restraints are routinely employed to curb loudness and undesirable behaviors at the Hospital of Central Connecticut on Grand Street in New Britain. I know this because I was subjected to both seclusion and restraints multiple times in the spring of 2014, despite a diagnosis of chronic paranoid schizophrenia, as well as PTSD that was triggered by precisely this sort of thing.

Bizarrely, the hospital psychiatrist, Dr Michael E Balkunas, treating me at HOCC challenged my PTSD diagnosis. “Patient misperceives her treatment as traumatic,” he wrote in my chart. Well, maybe so, but I don’t know how I can be accused of misperceiving three entire days callously abandoned alone, tied to the four posts of a metal bedstead at U-Conn’s Dempsey Hospital (for trying to escape the locked unit) as anything but brutality, even if it was in the 1990s. I also think it is nearly by definition traumatic to be forced to defecate in one’s own clothing while tied to a bed which is what they did at Hartford Hospital’s Institute of Living in the winter of 2013. This was after I was told to lie down and place my own limbs in the leather cuffs (“as a consequence but not a punishment”) for walking away from the very same “Side Room” that I had just been assured was “not a seclusion room unless you call it a seclusion room.”

Again, maybe I misperceived being grabbed and held face-down and nearly suffocated numerous times by staff at Yale Psychiatric Hospital in August 2013, who injected 10-20 milligrams of Haldol, a known drug of torture. Maybe this was just kindliness that I misunderstood as traumatic, maybe it was merely a “psychotic misperception” on my part? Maybe, and maybe not.

Nevertheless, the fact remains that in the ED of New Britain’s HOCC, a security guard in May 2014, grabbed me by my left shoulder immediately after he was warned by the nurse that it was my left shoulder that had a rotator cuff tear.

My New Britain chart records that I was admitted to that hospital, and to the IOL and others with a detailed Psychiatric Advance Directive, the first page of which states that seclusion, four-point restraints and forced medication invariably result in regression to “primitive states and severe worsening of symptoms.” It also makes several concrete suggestions how better to deal with me when I am upset. Even though I spent many hours on this document, Psychiatric Advance Directives have no legal clout in Connecticut and doctors can and do ignore them freely.

Perhaps because of this, HOCC staff literally forced me (“escorted me”) to seclusion and/or restrained me again and again. They took to stripping me “for safety’s sake,” and even though I put up no resistance, they had the male guards spread-eagle my limbs while still naked and put restraint cuffs on without even covering me.

Is it any wonder that what resulted was someone who would wash her hair in her own urine, defecate on the floor of her room and smear feces on the wall? Yet Dr Balkunas, the director of W-1, the general psychiatry unit at HOCC claimed that my trauma was imaginary. Why? Because treatment cannot be traumatic. He simply never got the connection between my horrendous decompensation and his so-called “therapy.” Maybe he never appreciated that he was torturing me, like a person who ripped the wings off butterflies as a child. Someone like that would not have understood how those creatures suffer either.

——————–

These are the NURSING De-Briefing standards for after restraints and/or seclusion:

APNA STANDARDS

DEBRIEFING AFTER RESTRAINTS/SECLUSION

Standard: As soon as possible, following the release from seclusion or restraint, the nurse, the person and others as appropriate should participate in a debriefing.

– See more at: http://www.apna.org/i4a/pages/index.cfm?pageid=3730#Release

Intent: A debriefing is done with persons who have been secluded or placed in restraints to:

  • Discuss and clarify any possible misperceptions the person may have concerning the incident.
  • Ascertain the person’s willingness to involve family or other caregivers in a debriefing to discuss and clarify their perceptions as well as identify additional alternatives or treatment plan modifications.
  • Support the person’s re-entry into the milieu.
  • Identify alternative interventions to reduce the potential for additional episodes.
  • Hear and record the person’s perspective on the episode.
  • Ascertain that the person’s rights and physical well-being were addressed during the episode and advise the person of processes to address perceived rights grievances.
  • Address any trauma that may have occurred as a result of the incident.
  • Modify the treatment plan as needed.

NONE of this was EVER done, ANYWHERE, in any hospital I have ever been in. Why? Because they all knew perfectly well what they had done to me and WHY…Not because I was dangerous to anyone, but as punishment…Naturally they did not want me to have a chance to tell anyone.

– See more at: http://www.apna.org/i4a/pages/index.cfm?pageid=3730#Release

The Marionette and the Golden Pot: Does Art Mean Anything?

Maybe this is meaningful, since I was thinking about con-artists, and maybe not…but I did not know what I was drawing or why until hours later…

Does Art Mean Something and if so, What?
Does Art Mean Something and if so, What? (unfinished drawing)

Article about Michael E Balkunas,MD !

I moved to Brattleboro Vermont on February 4, 2015, leaving my home state of Connecticut where I’ve lived for nearly 60 years. l had to move because of the horrific psychiatric abuses I experienced in Connecticut hospitals and my fear that if ever I were hospitalized again I would be killed.

I feel guilty, however, just getting out without accomplishing something to stop what continues to happen in Connecticut psychiatric units and hospitals.

The experience of mechanical four-point restraints – leather cuffs that are tightened around the wrists and ankles to immobilize a patient to a bed – or being isolated by force in an often freezing seclusion cell is almost universally terrifying. Nevertheless, both cell and/or restraints are routinely employed to curb loudness and undesirable behaviors at the Hospital of Central Connecticut on Grand Street in New Britain. I know this because I was subjected to both seclusion and restraints multiple times in the spring of 2014, despite a diagnosis of chronic paranoid schizophrenia, as well as PTSD that was triggered by precisely this sort of thing.

Bizarrely, the hospital psychiatrist, Dr Michael E Balkunas, treating me at HOCC challenged my PTSD diagnosis. “Patient misperceives her treatment as traumatic,” he wrote in my chart. Well, maybe so, but I don’t know how I can be accused of misperceiving three entire days callously abandoned alone, tied to the four posts of a metal bedstead at U-Conn’s Dempsey Hospital (for trying to escape the locked unit) as anything but brutality, even if it was in the 1990s. I also think it is nearly by definition traumatic to be forced to defecate in one’s own clothing while tied to a bed which is what they did at Hartford Hospital’s Institute of Living in the winter of 2013. This was after I was told to lie down and place my own limbs in the leather cuffs (“as a consequence but not a punishment”) for walking away from the very same “Side Room” that I had just been assured was “not a seclusion room unless you call it a seclusion room.”

Again, maybe I misperceived being grabbed and held face-down and nearly suffocated numerous times by staff at Yale Psychiatric Hospital in August 2013, who injected 10-20 milligrams of Haldol, a known drug of torture. Maybe this was just kindliness that I misunderstood as traumatic, maybe it was merely a “psychotic misperception” on my part? Maybe, and maybe not.

Nevertheless, the fact remains that in the ED of New Britain’s HOCC, a security guard in May 2014, grabbed me by my left shoulder immediately after he was warned by the nurse that it was my left shoulder that had a rotator cuff tear.

My New Britain chart records that I was admitted to that hospital, and to the IOL and others with a detailed Psychiatric Advance Directive, the first page of which states that seclusion, four-point restraints and forced medication invariably result in regression to “primitive states and severe worsening of symptoms.” It also makes several concrete suggestions how better to deal with me when I am upset. Even though I spent many hours on this document, Psychiatric Advance Directives have no legal clout in Connecticut and doctors can and do ignore them freely.

Perhaps because of this, HOCC staff literally forced me (“escorted me”) to seclusion and/or restrained me again and again. They took to stripping me “for safety’s sake,” and even though I put up no resistance, they had the male guards spread-eagle my limbs while still naked and put restraint cuffs on without even covering me.

Is it any wonder that what resulted was someone who would wash her hair in her own urine, defecate on the floor of her room and smear feces on the wall? Yet Dr Balkunas, the director of W-1, the general psychiatry unit at HOCC claimed that my trauma was imaginary. Why? Because treatment cannot be traumatic. He simply never got the connection between my horrendous decompensation and his so-called “therapy.” Maybe he never appreciated that he was torturing me, like a person who ripped the wings off butterflies as a child. Someone like that would not have understood how those creatures suffer either.

Google Review of Michael E Balkunas, Unit Chief of W-1, Adult Psychiatry, Hospital of Central Connecticut

NOTE: THIS may be Dr Michael E Balkunas’s forgotten relative, also apparently an MD or he plays one on TV, I dunno! All I know is that the men look amazingly alike!  They could be cousins like the twins on that Patty Duke show many many eons ago…What is important to remember is that they DO share a certain number of aberrant genes, and I believe that one of theirs leads to sadism…

(Note that My GOOGLE Review (edited)  follows)

How very similiar Michael and Charlie look...and and no wonder, since they share the same sadism genes!
How very similar Michael and Charlie look…and and no wonder, since they share the same sadism genes!

In May 2014, Michael E. Balkunas, MD, chief psychiatrist of the W-1 unit of the Hospital of Central Connecticut in New Britain, angered by my rejection of him because I could not speak (he refused me the use of any writing materials) decided to diagnose me with Borderline Personality Disorder despite having asked for in-put from my family and my outside psychiatrists who all stated that no such BPD or any PD symptoms ever existed. He did this despite my having been admitted with a decades-long Axis 1 diagnosis of paranoid schizophrenia (and with PTSD since 2009 due to hospital brutality and abuses).

I believe he added the PD diagnosis in order to justify the implementation of an inhumane Behavioral Treatment Plan which resulted in four-point mechanical restraints and the use of a horrific  and freezing seclusion cell. As my Advance Directive stated clearly, even at the time, none of these modes of “treatment” in the past  ever led to anything but disaster.

At HOCC I was repeatedly secluded and even restrained, naked in a spread-eagle position, in 4-point leather cuffs for many hours, yet never was this because of any behavior indicating “imminent danger of causing serious bodily harm to self or others” as the Centers for Medicare and Medicaid require. They did this to me always and only because I was too loud, or because I disrupted the unit “milieu.”

Before I was double-locked into one of W-1’s soundproof isolation cells, the nurses might have the male security guards strip me naked “for safety’s sake.” No matter how compliant I was, they always injected me with three “punishment drugs.” Even when I said I would take them orally or offered my arm, they could choose to push me onto my face on a bare mattress, forcibly hold me down until I couldn’t breathe, and administered them in my buttocks.

I informed the guards about CMS rules regarding appropriate uses of seclusion. To their credit they seemed taken aback, but in the end they were always willing to follow orders and to inflict pain in order to ensure my rapid compliance.

Dr. Balkunas insisted again and again on the diagnosis of BPD yet he never treated me with any modality but antipsychotic drugs and never wrote about my exhibiting any BPD symptoms in his notes. In fact his whole stated rationale for starting commitment procedures to the Connecticut Valley State Hospital was that “antipsychotic drugs take time to work.”

The staff of Nurses and Mental Health Technicians at New Britain General Hospital W-1 and most certainly Dr. Michael Edward Balkunas, Adult Psychiatry Unit Chief, must to be re-educated about the evils of employing punishment or torture in mental health care. They should be given, in addition, many hours of intensive in-service training on trauma-informed treatment. But frankly, as a penalty for the extraordinary and sadistic abuses they long inflicted (knowingly with impunity) upon the mentally ill taken into their care, they deserve nothing less than to summarily lose their jobs and their licenses to practice — for good.

Listen Up Collage -- A message more than art.
Listen Up Collage — A message more than art.

POEM THAT CAN FORGET BUT NOT FORGIVE

THE POEM THAT CAN FORGET BUT NOT FORGIVE

 

This poem is afraid

because I am afraid.

This poem is always cold,

and shivering, making my teeth clatter

like cheap tin tableware

on a bare plate.

This poem wants to die,

and be rescued too late

to regret it.

 

This poem has been all its life scared,

and still is: scared, trembling

on the brink, trembling,

knowing the truth that lies

beyond the lies

told over and over,

though it has never been taken in.

 

This poem has a voice

small, smoke-rasped, hungry,

and it has much to say

about what really happened

when no one else was there

to stand to protest.

 

This time it wants to be heard.

This poem wants to be heard!

It will spit and curse and claw

out bejesus if it has to,

this poem means to be heard!

 

This poem will tattle-tale

sit back and smile smugly.

This poem will wring satisfaction’s neck

and revenge will taste like chocolate.

This poem is sad as water, poor as sand.

This poem wants to live well,

but it doesn’t know how.

 

© Pamela Spiro Wagner, 2009 (from WE MAD CLIMB SHAKY LADDERS, CavanKerry Press, Fort Lee, NJ)

I may have posted this before but it is especially relevant at the moment because i have been mute for more than 6 weeks now and do not know why it has lasted or what to do about it…

You Can’t Really Change Your LIfe, After All, Can You?

You Spew Poison into the World
You Spew Poison into the World

 

Of course you can’t change your life. Your “giants go with you wherever you go,” as Ralph Waldo Emerson wrote many many years ago, and it is still sadly true.

 

I left Connecticut, thinking I could escape, at least the hospital torture, but I cannot escape the voices that hate me and the demons that I carry with me, the fact that I burden the world, poison it when I exist in it, and that wherever I go I leave a slime of pollution and hatred..I cannot help that. It is a genetic flaw, no matter what good I try to do, the generosity I practice, the kindnesses I have done and preached, it all goes for naught in the end, when the poison leaches from my marrow and through my skin and permeates the world. People feel it then and run away, screaming…

 

I know this and feel it. and I cannot take it any longer. I have had it. Lord knows I have tried and tried to obviate it, to deny it, to remove the stain or fix it, but it has never worked. I am done. I can’t do it any more. It is over. I cannot deal with the voices and the evil that I am and cause any longer. It is so clear to me that others want this end from me too, because although they talk a good game about help and programs to assist me, they actually refuse to make them available to me, and deliberately– DELIBERATELY —  turn a deaf ear when I overtly say, I NEED HELP NOW…How much more obvious and clear spoken can I be?

I will NOT beg for my life or my skin. No. I do not deserve that. And if not one wants me alive or intact, then there is a reason for it…and I know what it is, as I have stated. So if I get the message that “this is it” today, at my appointment again, that We HAVE NOTHING FOR YOU, that YOU ARE ON YOUR OWN, that “we do not really care what happens”. then it is OVER…I cannot care for myself, the devil, and I know what must be done…

I have done all I can, I really have. Do not try to tell me I haven’t tried for 62 years as bravely and carried on ALONE as I could possibly do it and be. But I cannot do it any longer, I am sorry, But this is it. Either PROVE to me that YOU CARE THAT I EXIST AND DO NOT WANT ME TO DO…whatever.

 

No , in fact YOU cannot do anything, any of you out there. Frankly. This is strictly between me and the folks here tasked with making sure I am safe and it is clear that I have poisoned all of them already, I have used up my quota of caring and assistance and that is that. It’s gone. It’s over. I’m gone. GET LOST. YOU BAD RUBBISH. We have had it with you. You are worthless shit.

 

Goodbye.  I don’t know what will happen to me. But I can’t do this any longer.

PRESIDENT OBAMA LECTURES DR MICHAEL E. BALKUNAS ON THE MISTREATMENT OF PSYCHIATRIC PATIENTS

angry obama

I think everyone who can play this file will find it both instructive and illuminating and actually very very …”interesting”…So go ahead, Mikey. LlSTEN TO YOUR PRESIDENT!!!!! Tee hee.

MICHAEL E. BALKUNAS, MD: LISTEN TO THIS RAP – YOU MUTHA FUCKA!

Okay so here is another rap lyric. I suggest that you try to play it on an apple or iphone/ipad device as people have said that these won’t play with Internet Explorer. Perhaps because they are created through Garage Band and with ITunes? Anyhow good luck! (This is a TRUE STORY about what happened in the New Britain General Hospital in May 2014, Hospital of Central Connecticut…NOTHING IS IMAGINED OR MADE UP IN fact things were much worse even than this song describes….) If these end up being popular enough, I will redo them with a good microphone and perhaps a video…

DR. MICHAEL E. BALKUNAS, SHRUNKEN-HEAD MUTHAFUCKA RAP

Doctor Balkunas, you think you can fuck with me?

Doctor Balkunas, you think you can punish me?

Doctor Balkunas you head shrunken mofucker

G’wan, have another headfucking think on it, mofo…
They brought me by ambulance, silent and broken

Terrified, mute, and on an “involuntary”

Not even speaking and mentally ill

I could make no choices, every word unspoken.

Do you know what it means when I say I was mute,

when I could not speak and words did not work

and the world was too loud and my head was too full

and there was no bridge and no hand to pull

me out from that in-between. Even security

wasn’t there to protect me, only nurses and from me

and even the first nurse who coldly appraised me

grabbed my one book and then took my phone and fled

as if she were plotting to fuck with my head

because she had only to ask me and take it politely,

and promise to take care of things, and do it nicely.

Such fierce flames of outrage surged in me, and anger!

So not even thinking, I went running after her

wanting just to reach her and grab my book back from her

Little did I know the reaction if I touched her.

Mike Balkunas, you thought you could fuck with me?

Mike Balkunas, you thought you could punish me?

Mike Balkunas, you thought you could shit on me?

Mikey, you mofo, have a new headshrinking think on it.

Quicker than quicker everyone was sicked on me,

from the aides to the orderlies, even the nurses.

Burly armed guards went piling up hard on me,

and the worst of the worst was patients made versus me

a 100-pound 60-year old lady of five foot three

upset that my two last possessions were snatched from me

without any reason or rhyme in the world really

by the usual criminal in the ER, the head RN

who knew I was powerless alone in that warren

of ER rooms, so she had me dragged me to seclusion.

where I had to bare-knuckle the dark in confusion

battling anguish and fear, with the voices’ profusion.

So to get someone to come in and hear my screaming

I pulled all my clothing off, for clothes had no meaning.

Mike Balkunas, you think you can fuck with me?

Mike Balkunas, you think you punish with impunity?

Mike Balkunas, you really think you can shit on me?

G’wan, Mofo, Have another headshrinking think, now, Mikey…

I screamed from the base of my lungs for an hour

but was utterly ignored by all who had power

to relent or release me. I hadn’t a notion

of what else to do, to get help or attention

or have them return to the room, but to start

hitting my head and even tearing apart

things I could throw, chair, clothes and chart.

Then came the goon squad of six beefy men

who easily brought me facedown on the floor again

I screamed and I struggled but it did me no good,

if you fight them they justify all that they would.

Much better to lie still and let them abuse you

and get discharged and hope against hope you can sue.

The ER in peril from the dangers I posed

such a monster as me, poorly muscled, unclothed,

they wanted me, mute, completely shut up.

so they rammed three injectables into my butt.

Mike Balkunas, honey, you thought you could fuck with me?

Mike Balkunas, sweetie, you believed you could punish me?

Mike Balkunas, sweetheart, you thought you could shit on me?

Aw, little boy, Balkie, do your headshrinking mofo thing with it…

Mikey? Mikey? Mofo…I’ll bet you won’t forget me for a lo-o-o-ooong time, will you?

Ha ha ha!

I wish to god I could forget you. You mofo. You mother fucker. Let this rap song be a lesson to you, not to fuck with poets and writers or you’ll get written into a history you might rather be forgotten.

Doctor Michael Balkunas, dare you fuck with me now?

Doctor Michael Balkunas, dare you punish me now?

Doctor Michael Balkunas, you head shrunken muthafucka

Mofo, Mikey go fuck another headshrinker and think on it.

TO MY “PROTECTOR” AT THE MENTAL HOSPITAL: NO THANKS!

 Mushroom-Head in Four-point Restraints: Cannibalism as RAPE by Michael Edward Balkunas, MD, the instigator…

Raped at New Britain General Hospital thanks to  Michael Balkunas MD's orders...
Raped at New Britain General Hospital thanks to Michael Balkunas MD’s orders…

TO MY “PROTECTORS” AT THE MENTAL HOSPITAL

You nurses who, wanting a quiet shift, shackled me into four-point restraints: you ought to have known better: violence only begets more violence…

I came to you, broken —

speaking only splinters of syllables –

“ma-ta-o-tam, ma-ta-o-tam..”

on fire to burn down

the house of my body,

for the meaning of my life

but I was not nice,

not nice, not nice, no,

I was not nice and quiet enough

for the balm of art supplies and human kindness.

Your uniforms ex-cruciated me, tying me

me naked to the four corners of a bed

so your eyes could flay me, the silent shame

gouging my brain to a darkness

years later still vacuumed blank.

Nurses, healers, thieves,

racked there, I lay helpless before you,

even as you raped what was left

of my human dignity.

So intent on getting satisfaction,

you violated my soul

with your smirks

and conspiratorial smiles.