Category Archives: Violence

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

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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,

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Guns R Us…Why should Sandy Hook Surprise Us?

Don't shoot!
Don’t shoot!

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

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

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

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

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

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

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

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

JAKEgmGun

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

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

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

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

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

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

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

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

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

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

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

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

In-Patient Psychiatric Abuse Can Be Subtle (and not so)

I will be rewriting this for my new memoir, but wanted to try out the episode here, in part, though I have not yet rewritten it…I have been rereading my many journals that I have retrieved from storage in preparation for really seriously writing this thing, and it was one of the first events recorded that I happened to dip into. It is in a relatively recent journal, but I was reading randomly and I just happened upon it. It very much upset me, as just as I read it, I remembered it very clearly. I had no amnesia, it was only that I have been in so many hospitals in the past 3 decades that I cannot separate out one from another, nor tell what happened where or when.

Subtle abuse? In fact, I don’t know that the episode I relate here is an example of subtle anything. I can only say that at the time I had no idea that it was abusive. I felt that perhaps I deserved it.  I had no idea that it should have been reported, that someone should have defended me, that anyone…Well, you will get the drift upon reading the following brief description of one incident, among the way-too-many that have happened to me over the past 5-10 years in Connecticut hospitals. All I can be sure of is that if hospital staff do these things to me, I am fairly certain that they must do them to others…In which case, that Hartford Courant article in 1998, “Deadly Restraints” which was supposed to have changed everything both in Connecticut and around the country in terms of in-patient treatment of the mentally ill, that article did little to nothing. I would say, in fact, that treatment has gotten markedly worse over the decade. Compared to my treatment in the two decades before this past one, I was never abused as much in the 80s and 90s as I have been since Y2K and 2000.

For once, what I write of here does not involve restraints per se, at least not immediately, but as you will see it involves abuse, physical abuse, just the same. I have transcribed this from my journal from a few years ago. I have edited it, but most of the edits I made were for clarity or to convert partial sentences to full ones, though in a couple of places I had to flesh things out more. But here ’tis, what happened to me at a general hospital I spent a fair amount of time in, in Fairfield County, where my twin lives:

“After a run-in with Karen again, I apologized and we had a decent talk. I took off my coat for once, went to Wendy’s communication group and did okay. Then I was sitting in the alcove talking with Mark about my dread at every anniversary of JFK’s assassination when a hullabaloo started near room 306 at the other end of the hall. It seems a woman was having a heart attack. I immediately felt the floor fall beneath me: I was to blame, my inattentiveness, my raucous, hyena laughter, my evil had killed her!

I knew that I needed to take my 4 o’clock medication for what little it would do, but no one called to announce them or for me to take them. My ears rang, booming! The air was full of blaming and criticizing voices, so maybe I didn’t hear, but I think they just didn’t call me. I rang the intercom buzzer at 6:45 and was told that Jamie, the medication nurse that night, would be back from supper around 7 o’clock. I rang back at 7:05 but he was still gone, so I waited another 15 minutes since no one told me that he had returned.Finally at 7:20 I pushed the intercom button to ask if I was supposed to skip all my 4 o’clock and 6 o’clock medications. They now said Jamie was waiting for me. But why hadn’t he called to let me know he’d gotten back from dinner? Slowly I managed to shuffle up to the medication door again, zipped to the mouth in my coat and balaclava hood, verging on stuckness, only to find there was no Geodon in my cup.

“So I don’t get my 4 PM medications,” I whispered in stunned panic, too afraid to simply ask for it.

“Nope” was Jamie’s only answer.

I was flabbergasted, completely stunned. My second prescribed dose of BID Geodon was what I’d been waiting patiently for ever since the patient in room 306 had her heart attack. After Jamie ignored me, giving me no explanation, I just turned, took my 6pm Ritalin, then dropped the DIxie cup of water and all the other pills on the carpet. In a daze, it took everything in me to start making my way down the hall towards my room again.

Then I heard footsteps pounding up behind me and suddenly Jamie was in front of me, blocking my way. “You’ll go back there and clean up the mess you made right this instant!” he bellowed and pushed me towards the med station. I stared through him, tried to walk away, but he blocked me again and again pushed me backwards until finally I gave in, relaxed and let myself succumb to his pushing. I didn’t walk though, I merely fell backwards to the floor, saved from injury only because he grabbed the front of my coat as I fell, and lowered me to the floor. I curled up in a ball like a porcupine, hoping not to be killed. Well, he was in a rage and forced my hands down, away from my shoulders, and unzipped my coat. Then he ordered me to get up and clean up the mess again — what mess really? A few pills on the floor, and a little water that would dry? I refused. I curled up on my side and closed my eyes, responding to nothing. He threatened me with restraints. At that, I gave up resisting, knowing resistance would give him the excuse he wanted. I let him pull my coat off my limp body. And I remained limp as he carried me to my bedroom where he dumped me coatless on the bed and thundered away. I was triumphant, however. No restraints! I’d figured it out. If you refuse to resist, if you don’t fight back against their power plays, they have no excuse to justify putting you in restraints. They cannot put someone who is completely silent and limp into 4-point restraints. What would be the point?

Nevertheless,  I was cold and felt exposed in only my T-shirt and jeans, and with no coat to protect me, nor others from me. So I got up and grabbed a sweater and started bundling myself into hat and  hooded scarf. Suddenly Jamie barged in again. I backed away and fell onto the bed behind me. In a fury that was unbelievable to me, he leapt onto the bed and pinned me down, knelt so his knees trapped me and I couldn’t move. Then he unbuttoned my sweater and tore it off me, ripped off my hat and scarf, then without a word proceeded to empty the room of any clothing that could possibly cover me, including my shoes.

This was too much to bear. But I said and did nothing in protest. How could I? I had no words, no sense that I had rights of any sort. All I did was huddle against the wall under a blanket and whimper, “I didn’t mean to kill her. I didn’t mean to cause a problem.” Jamie, who had left with all my things, stormed back in and angrily lectured me on how I was guilty of  “just wanting attention!” I wept silently. All I’d wanted that entire afternoon had been my 4:00 pm medication, and to be left alone to deal with repercussions of having killed the  patient in 306. I was too stunned to respond and could only whimper over and over, “didn’t mean to kill her, didn’t mean to cause a problem.” Still furious, but getting nothing from me and spent, Jamie finally left for good.  After a while, I looked around at the nearly empty room, and there on the night table was the pen Lynnie had left behind that afternoon. Jamie had overlooked it in his rampage. I had no energy to get off the floor, and no paper to write on, so I did the only thing I could, and  I began writing on the wall. “I didn’t mean to kill her, didn’t mean to cause a problem,”  I wrote and wrote. I wrote until I physically could not write any longer, I wrote until my hand gave out.

That was not the end of the evening, but it was the end of the interchange with Jamie, RN and it’s all I wanted to go into for tonight as it is getting late, very late and I needs must go to sleep.

Mental Illness and Authority: Part II

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

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First, here is her letter to me:


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

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

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

Thanks for sharing your experiences.

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

And my response:

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

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

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

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

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

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

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

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

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

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

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

PW

On Psychiatry and Authority

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

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

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S & R

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

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

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

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

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

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

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

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

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

Schizophrenia and Traumatic Treatment: Continued Use of Restraints and Seclusion

Please note: For my final take on what happened at Middlesex, please jump to this link: https://wagblog.wordpress.com/2012/05/15/useless-psychiatric-mediation-and-a-poem/   (added in September 2012)

First, before I start my post today, I wanted to share my newest artwork, which is a colored pencil “painting” of a woman who lives in my building, whom I will call Rose. She did not ask me to paint her; she was simply someone who sits quietly for many hours in the community room, and so was a good subject for a portrait, and a photo. I also happen to find her a very agreeable person, one of the nicer ones here (most are gossips and backbiters, or if not most, then the most vociferous and visible of the residents). I think she will be quite pleased with how it turned out, so long as she does not expect anything but a portrait that is faithful to life, rather than an idealized one. I believe, however, that Rose is very down to earth and knows what she looks like, and will appreciate what I have painted.

Rose, intent on her needlework
Rose intent on rugmaking
Rose comparison of painting with photo

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Now I want to discuss, yet again, the use of restraints in Connecticut psychiatric units, particularly as it pertains to my treatment there. As I recall, I have not gone into much detail about the last hospital stay, back in April and May, largely I think because it again was so traumatic and in many ways similar to the previous one, that I could not bear to contemplate it.

However, as very little as I recall, I do remember more of the stay than the complete amnesia I still experience for the stay in Manchester, back in October or November of 2009. When I say I have a loss of memory with regards to this other hospital stay in the spring of 2010– in Middletown — I meant it more for the specifics of certain episodes. And for any of the people there who staffed the unit. (Except for Christabel the OT).  With regard to much that occurred I believe a lot could be brought back to me, under the right circumstances. I do, for instance, continue to have an overall memory of what the place looks like and where my room was and some details about what happened. What I do not, and did not remember, not even the next day, was most of what precipitated the use of restraints and seclusion during this stay. Or at least, of the two or three incidents of S and R two are jumbled together, so that it takes some mental probing for me to straighten out any of it. but one incident remains too clear in my mind for comfort though even at the time, or immediately afterward, as well as now, I have no idea what was the actual precipitant.

Anyhow, what I recall of  that episode is this: I had been taken off Geodon, which I took regularly with my  Abilify up till then, both in order to boost its antipsychotic properties as well as to temper any Abilify-induced irritability. The irritability was physical as much as mental — and with the resultant tendency to get into verbal fights and arguments with anyone who, as my mother used to put it, looked at me crosswise. I have no idea why they did this, took me off Geodon, given that I know I explained the rationale for the use of two antipsychotics. But many MDs seem to find this objectionable, however effective. Perhaps they considered the 20mg Zyprexa, which they had talked me into taking on an acute basis, would be an adequate substitute for the calming effect of the Geodon. They had wanted to stop the Abilify, too, using Metformin, a diabetes drug, for weight control, but I had insisted on taking it both in an effort to combat Zyprexa’s tendency to cause weight gain, but also because I believe that it is the Abilify that has so massively enhanced my creativity.

So there I was, on Abilify untempered by Geodon, and taking Zyprexa, which induces its own “upsetness” when my weight invariably increases…I assume that I must have been hostile, loud, and disruptive, for I do not know why else they would have made me go into the seclusion room. I do remember that I could not calm down, and that in the flimsy johnnies they had clothed me in, I was freezing, so that even when the nurse doing constant observation told me to lie down and rest, I was unable to do so for all my shivering. I begged for a blanket, but no deal. I pulled the entire bare mattress over me as a covering. Well, this was apparently seen as a self-destructive act, or something, as immediately they pulled it off me and dragged the mattress itself from the room. Now I had nothing for warmth, except my own anger at having been treated  in such a fashion.

I remember that I was yelling a lot, and that I wouldn’t lie down on the cold linoleum and “calm myself.” No, I wanted to talk, and begged the nurse to do so. Instead, she only turned away and told me again to lie down on the floor. Well, this enraged me, and I went to the door to complain again. She said nothing, only stood in front of the open door so that I could not leave. Finally, getting no response, and still anxious and “het up” I suppose you could say, or over-activated by the Abilify, I tried to push my way through her into the opening. Immediately two “guards” pushed me back into the room. I yelled at them, and pushed back. One of them asked me what was wrong with me, why I didn’t just ask to talk with the nurses instead of resisting physically…I looked at him and said that I did ask to talk, and she refused. He seemed somewhat surprised by that. Nevertheless, he ordered me to go back into the room and lie down.

I was having none of this dictatorial behavior on their part, and as I recall, at one point — no, I do not remember what happened. I only know that suddenly the guards were on top of me, and one had pinned my arms behind my back and was pushing my face into the linoleum floor. It was as if I were a recalcitrant inmate of a prison and this was a cell “take-down.” I was hurt and I was furious.

When they let me up (and why they had pinned me to the ground I have no recollection, only that when they let me up, I was finally allowed to talk to the nurse nad stand out in the hall with her. I heard some talking behind my back and a commotion, followed by feet going down the hall away from us. I had a bad feeling about it, and asked the nurse, “What are they doing?” She responded, ominously, “They are preparing a bed for you.” “a bed? what sort of bed? She remained silent and I understood that they were putting restraints on my bed…”You can’t restrain me, I am out here calmly talking to you. You haven’t even offered me a PRN and I will tell you now that I would be more than willing to take one. But I am NOT a danger to myself or others, and you cannot legally put me in restraints.” The nurse continued to remain silent. My heart began to race. I called down the hall, “I will not let you use restraints on me, I am calm and this is not allowed.”

Some of the staff approached me and told me to come down to my bed room with them. I complied, because I knew that if I didn’t they would have some reason to say I “deserved” to be restrained. When I got to the room,   I found I had been correct: there on my bed were the straps and shackles of four-point restraints, attached to the bed frame.

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

“Lie down on the bed, Pamela” someone told me. I refused, saying that this was punishment pure and simple and that they had no cause to do this nor any legal right. “I will ask you one more time to lie down on the bed, Pam, or the security team will help you do so.”

At this point, I understood that they were going to use this form of discipline on me no matter what I did. That they were out to get revenge and that they would use any excuse to excuse such measures. So if I “made” them force me into the restraints, that would by itself prove that I “deserved” them. So, more humiliated than I believe I have ever been in my life, I sat down on the bed, then lay down on my back and said out loud, “I am now placing my limbs into four-point restraints, and I want a record of the fact that I am calm and not resisting and that I have asked for a PRN instead.”

It was no use, though, as they went ahead and shackled me, then left me alone in the room, except for a staff member monitoring me through the door, left partially ajar. My heart was racing with rage, and I could feel the pain of such profound humiliation surging through me. But I did and said nothing, I think, because I was going to prove to them that the drastic measures and punishment they had inflicted on me was WRONG. After about an hour and a half someone came back and let me out. I was neither compliant now, nor placated and as soon as I was free and out of that room, I let it be known, loudly  that I intended to file a complaint. But no one said a thing, no even spoke to me the rest of the night…

THAT is what I remain so traumatized by, at least with respect to  this time: the utter humiliation of what you might call “cutting my own switch,” along with the clear understanding — even mutual acknowledgment — that they were punishing me.

This continues to preoccupy me, that is when I allow myself to think about it, or when I continue to try to read the records of that stay, which records I only a week ago obtained (having sent for them many weeks ago…). I cannot help but re-experience the same brutality and the same extreme and exquisite humiliation, and once again it hurts beyond belief. The worst thing perhaps is that when I told my family about what the staff had done to me they didn’t come to my support, they didn’t unconditionally defend me. They didn’t even  seem to care, or to believe, that I had done nothing to “deserve” four-point restraints (as if anyone deserves them). Another family would have automatically come to their member’s defense and declare that NO one deserves such brutality, and that as their family member I should never have been treated that way. Another family would have done  –oh forget it!  No, my family is always so eager to please the staff and to believe that I am in the ‘wrong” at these hospitals, to believe that I am at fault, (this is the story of my life!) that they simply told me I must have caused their use of such brutal methods of control by my own behavior, I surely deserved it, and besides “what else could they do?” Shackling me, calm and rational, me to a bed was clearly the only option and entirely justified…So much for MY family’s loyalty and compassionate support, huh?

Well, bitterness solves nothing, so I won’t dwell on the last subject, but I will say that if I can, I intend to file an unoffical complaint, or barring that, an official one. The problem with the latter is that I will not then be able to confront my persecutors. whereas if I did so unofficially, it might yet be possible, if only to avoid a messy public affair. After all, I could easily write something…No, I won’t go there. For now, I only wanted to describe what continues to occur at Connecticut psychiatric units, despite the regulations and general disavowal of the use of cruelty in the treatment of those with mental illness. It still goes on, it just happens behind the closed doors of the hospital and the continued use pf seclusion and restraints as discipline and as a salve for frustration, depends on the assumption that no patient will bother, after the fact of discharge, to do anything about it, except try to forget.

Things are better than this, but do not feel it!
Note the linoleum and bare mattress. I have never seen a windowed seclusion room!

The Mentally Ill in Prison and Out-patient Commitment Laws

Dear Pam,

Thank you for the link to the Dr. Manny Show. There are indeed many faces of mental illness. Some people have mild cases and are able to work and function at the same level as anyone else.

Congress passed mental health legislation in 2008 providing for workers who have psychiatric dysfunctions to be covered under their employers’ health insurance at the same rate as employees with physical illness (certain exclusions apply). That was a positive step. However, acute mental patients do not benefit by that law, because severe mental illness is often too debilitating for victims to work, especially without the psychiatric treatment they need. In fact, people with acute schizophrenia, bipolar disorder, PTSD, and other conditions frequently resist treatment even when it is available to them.

Unfortunately, 1.25 million mentally ill Americans are currently imprisoned for offenses ranging from simple vandalism or disturbing the peace to murders. Last January, Rep. Eddie Johnson (D-TX 30) introduced H.R. 619, a congressional bill to resume Medicaid coverage for inpatient psychiatric care for patients in crisis and for people who require long-term containment in a secure treatment environment (such as patients who have done violence).

H.R. 619 is an important bill that deserves our support. It was largely the removal of Medicaid funding several decades ago that led to criminalizing mental illness. That in turn led to many other problems, such as overcrowded prisons and a burdensome prison budget. Hundreds of thousands of acute patients were “de-institutionalized” in the 60’s and 70’s only to become homeless and/or prisoners. Thousands of acute mental patients continue to be dismissed from mental hospitals and prisons without subsistence assistance and provisions for continuous monitoring and treatment under programs like Kendra’s Law.

Assisted Outpatient Programs like Kendra’s Law have been proved to reduce homelessness, arrests, hospitalizations, and incarcerations by up to 85% (among New York participants, compared to their circumstances three years before becoming program participants). The impressive rate of reduced arrests and incarcerations also indicates that community safety was improved significantly as less crime was done, and it also follows that the prison budget was lessened by helping patients with living arrangements and mandating continuous psychiatric care for ex-offenders and former inpatients who often lack the wherewithal to make wise treatment choices and avoid psychiatric crises.

Assistance to the Incarcerated Mentally Ill (AIMI) supports Rep. Johnson’s bill, H.R. 619, as well as NAMI, Treatment Advocacy Center, and many other mental health advocates who believe resuming funding for inpatient treatment is best for patients and for America. In fact, 100% of police officers I polled agree that prison is not the place for severe mental patients, where they comprise 60% of the inmates kept naked in solitary confinement cells.

I solute Congresswoman Johnson, a former psychiatric nurse, for introducing H.R. 619, and I hope everyone who is concerned about human and civil rights will support the bill and end the discriminatory practice of punishing Americans for being sick. I pray for another bill to be introduced to address the second cause of mental illness having been criminalized in America – the lack of continuous care and subsistence assistance for released prisoners and former inpatients. Kendra’s Law should be applied nationwide so that acute mental patients will be treated, not punished, for having a common, treatable health condition that requires monitoring and care just as diabetics and heart patients receive.

Inpatient hospitalization was not included under the national health care plan, so it is very important to pass H.R.619 as a separate bill. Please write an email to your representatives tomorrow and ask them to co-sponsor the resumption of Medicaid for psychiatric hospitalization and to institute Assisted Outpatient Treatment progams, which would not only be more fair and humane to sick people and their families, but would also save taxpayers billions each year as our prison rolls decrease.

Thank you, Pam, for this forum and for the useful information that WagBlog always has. I will share the link to the Dr. Manny Show with many people at my Care2 Sharebook and at FreeSpeakBlog, where we often publish mental health news as well as other matters that have to do with promoting human rights for prisoners.

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

PS Please VOTE for H.R.619 to replace prisons w/ hospitals for acute mental patients. The link below will take you to OpenCongress.org where you can use your voice to say to our elected officials, “We care about the least of these, His brethren: naked, sick prisoners.” (Matt.25:36) http://www.opencongress.org/bill/111-h619/show

While many Americans celebrate the health care reform bill’s victory, please agree that millions of citizens should not be left imprisoned or live under the threat of prison because their health care needs were omitted. Put the “NATIONAL” into health care reform by supporting H.R.619: Medicaid funding for psychiatric hospitals instead of prison cells for mentally challenged people – a change that will save money and restore lives!

Thanks in advance for voting. Please invite others!

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Dear Mary

I think you know that I was quite ill until starting in 1996 when Zyprexa came out, but not truly until 2005,  when a complete transformation occurred. However, when I relapse, I “relapse good” — as my medical record from the October hospitalization attests, with nearly constant locked seclusion or restraints for 6-8 days etc. Nevertheless, I am with you, though reluctantly, as I also know how terrible the side effects are of some of the older medications are as well as the newer ones, and the horrible state of affairs when a harried or burned out psychiatrist simply rams them down your throat without consultation at least after the acute psychosis resolves and you are able to discuss such things.

When I was in Manchester Hospital, I begged to be put back on my anti-convulsants and the Abilify/Geodon combination that had served me well for many months, believing, with reason, that I was suffering from a flare-up of my neurological Lyme disease, an illness that had always and invariably produced severe psychiatric symptoms. I needed, I knew, an increase of those drugs rather than a wholesale change to the “old drug” Trilafon. But did the doctor listen to me? No, he did not, despite my  ability to say as much to him, my psychosis consisting not of incoherence but of paranoia and command hallucinations to  harm myself in order to atone for being the Devil…I could and did argue with him, vehemently, and steadfastly, refusing to take the Trilafon, until he instituted a standing restraints order for every time I was non-compliant.

These are the sorts of things that trouble me about  forced treatment and/or outpatient commitment laws. It is not that I think people suffering from severe psychiatric illness do not need or deserve treatment, only that the treatments available are not always effective or tolerable. And until they are, I am not sure that the only way to go is only to force medication on everyone willy-nilly, not, at least against their protestations of extreme discomfort. At the very least every effort must be made to find a medication or medication combo that keep the psychosis at bay while making the person as comfortable as is humanely possible…which is difficult when a psychiatrist is saddled with a hundred patients to see in a week. It took Dr O and me six years or more to find  the right combination of drugs, and to titrate them precisely enough to treat my symptoms,  reducing them significantly while keeping unpleasant side effects to a minimum.

There is much about the treatment of the mentally ill that is so disgusting I cannot begin to cover them all here, though your comment is very thorough, which is why I have put it up  as a regular post. I appreciate your links to sites that do so as well. You did not mention one horrific situation: where under-utilized supermax prisons now house “uncooperative mentally ill prisoners” whose lack of compliance or cooperation is due solely to their illness. Though it is well-known that such brutal conditions drive “normal” or reasonably sane prisoners to insanity, can you imagine the brutality of forcing a psychotic individual to reside in such isolation? (Note however that in years past, as you know, isolation and seclusion of disruptive patients in hospitals was also the norm, since “overstimulation” from the outside world was considered to cause their agitation…I have been in hospitals where, in bare seclusion rooms, I was not permitted access to letters or phone calls, visitors or even reading material. As for restraints, they too were inhumane as I was shackled SPREAD- EAGLE, to the four corners of the bed and not, as even then was considered proper, with my legs straight and my arms in position by my side. This treatment moreover was considered normative for agitated psychotic patients rather than cruel in the extreme  as recently as the 1980s in some municipal hospitals in Connecticut.

I  recommend the book, THE DAY THE VOICES STOPPED, by the late Ken Steele, who wrote of his experience as a 14 year old with the savage isolation policies in NY hospitals in the 60s and 70s,  treatment that today seems literally incredible.

Well, I thank you for your contribution to my blog, Mary. You are welcome here at any time. I will post as many of your comments as I can.

Sincerely,

Pam W

Poem: Life without Hope of Parole…

STATE PROPERTY

The Walls: what prisoners call the Washington State Penitentiary at Walla Walla

Freeworld: everything beyond the Walls

For A.

You’ve been owned by the State

since you can’t remember when,

body, mind and what’s left of your spirit

shackled to a prison more shattering

than the Walls, where at 18 you ended your life

in the freeworld. Hadn’t the big house

always beckoned, ever since the first time

you entered a home and found it

no refuge but a place of pain

and abuse, of neglect so battering

you ran straight into the arms

of a detention center

where at least no one pretended to care?

Who cared anyway about just another

juvenile delinquent with a mouth

to feed? It was hard to say

when mere delinquency — a word

that meant only that you’d left,

that you’d “left completely”

but left what was left to the imagination,

left home, left hope behind, left off caring —

turned from trying to survive to the criminal.

Homeless, hungry, no better educated

than an arrested ten-year-old,  you

stole bread, stole something middle class

and valuable and we, a nation

of Javerts, were too righteous to split hairs

and see you. But somehow an innocent

was killed and now you are up against the wall

in Walla Walla, amidst the teem

and clangor of that crazy

noise-filled space, with no hope, no hope

of freedom and even if it kills you

this time you swear you will redeem yourself,

reclaim and save yourself from the death

of that which still remains humane

in you. One aching brick at a time,

some walls are built, others torn down.

Outside the canteen window,

snowy egrets build their nests,

a beaver slaps the water with its tail.

I don’t remember exactly what happened to place Andy (not his real name)  and his sister in the care of the State, but I know that certain authorities found them huddled in the bathroom of their house or apartment, hungry and dirty and frightened, and from then on nothing was the same. They were separated, for one thing, and Andy lost track of his sister for years. Foster care was a travesty. Though there are, I know, many good foster families and truly giving and loving people who do fostering out of the goodness of their hearts,  Andy did not meet those. Most of the time his  foster parents only wanted the extra cash and he was lucky if he was fed adequately and had a bed of his own. He was often beaten and had to work for his food. Desperate, he made the first mistake, but one that probably set him on the road towards the situation he is in today. He ran away. But for a foster child, a ward of the State, running away is truancy, a juvenile offense and several such episodes, he was considered incorrigible and sent to reform school, where he learned only more survival tactics and more violence.

You see where I am going with this? It may be true that some boys rise above this, some boys find it within themselves to turn their lives around and make something of themselves…But I do not believe that they do it themselves. I believe that some caring adult, someone, anyone, steps in and makes them believe in themselves. Andy never had that. He knew only abuse and more abuse, in the many homes he resided in and later in the various juvenile  centers to which he was sent.

Finally, in a home as a teenager, he turned 16 and , he was an adult in the eyes of the state, no longer their problem, and he was turned out onto the street, unceremoniously, with no skills, no money, voila, no — nothing, but the clothes on his back and was told to get a job and make a life…This is crazy of course. Totally and completely crazy. But that is what happens, at least in Andy’s state, and I suspect in more states than I want to know about. Where do you go when, on your 16th birthday, your foster family wakes you early in the morning, and instead of presenting you with a special birthday breakfast and a birthday present, tells you to dress and get lost, get going, you’re an adult now and not worth anything to them anymore? I cannot imagine what on earth I would do.

Andy fell back on the skills he learned in reform school, like petty thievery (how else was he to get food?) and lying. And he ran with a crowd doing much the same thing. I do not know where or how he coped otherwise, nor where he slept, whether it was indoors or out of doors, nor for how long. I only know that at one point things escalated, and there was a gun involved, or perhaps it was a knife, but in any event, an innocent person was stabbed, or shot, and of the entire group only Andy was apprehended. But Andy was no snitch, and so he said nothing when pressed to tell who his “accomplices” had been, not even when threatened with a life sentence. which is what, in the end he received: Life without HOPE of parole. At age 18. Life without HOPE…

What does that sort of sentence mean, precisely? Well, for one, it means Maximum Security, because all long sentences are put into Max, esp lifers. It also means that at least in Andy’s prison, they wouldn’t bother to educate him or allow him to study for his GED, let alone a college degree. Why waste the money or the time on someone who was never getting out, never returning to the freeworld? It meant a lot of things, but mostly it meant hopelessness. And that was the hardest thing to deal with. That and the fact that you owned nothing, that you could count on keeping nothing, that nothing was yours. At any moment, everything you had in your possession could be confiscated, trashed during a cell search or simply ruined by flooding of the tier by prisoners protesting various atrocious conditions of their incarceration.

Andy knew that if he was to survive, he had to give up all attachment to things, to  everything outside himself, and to know that he was himself, a person, and that no one could take that away from him. He had to know that he could rely on himself alone, and to trust that, no matter what they did to him. And they did plenty. You can read about the Hole, but what really happens there, and even beforehand is truly an abomination. During a cell extraction for instance,  the squad, preparing to overpower the resistant convict, terrifies by virtue of their appearance and their “firepower.” To say that pepper spray is used is to deliberately mislead the public into thinking that the procedures are relatively harmless. A huge blast in the face of a chemical that makes one feel as if one is suffocating and cannot see is applied through the door window, until the convict is gasping and on his knees. Then the real extraction occurs, with an entire team subduing the prisoner, hogtying him in some instances, and removing him from the cell, which will later be trashed during a search.

People are disappeared, people are beat up, people die during a cell extraction, or simply when the guards are angry or sick of someone they can’t easily control and the death is hushed up. People die and nothing is said when a new prisoner is shown to the bunk they once occupied…

Andy has written a book length manuscript about his experience in the worst prison in his state, and  the entire book follows a prisoner through one day in the life of the main character. I think it is magnificent. Andy went from a 7th grade education to writing like a college grad, teaching Spanish, and many other accomplishments, including authoring two book-length manuscripts and a full-length play. I am hoping to find a publisher to take a look at his novel/ memoir. If you know of anyone who might be interested, would you please get in touch with me?

Hospital, Hypomania and How Hope Eventually Returned…

Pretty tame for a seclusion room, but this one is in a school so it has carpeting not linoleum...The thought that little kids are held captive inside is pretty disgusting through.

I wrote in the post below that for three weeks in October I was in Manchester Memorial hospital (a new unit for me. To explain, the hospital you are sent to in this state these days is a total crapshoot. Sometimes the ER can admit you to theirs, but if it is full, as it so often is, they can send you literally to any hospital in the state that has an empty bed.. With the governor having decided to close one of the few state facilities still open and the municipal hospitals so over-utilized that an average stay was 5-7 days only, you can imagine how inadequate any attempts at treatment are. I do not mean to diss the hospital staff in general. Some do mean well and are appalled at what their jobs have devolved into, others however seem not to care that they are no more than warders in double-locked secure psychiatric units where few are admitted truly voluntarily or at least only on an emergency basis and yet no one can stay until healed. Generally speaking, one stays only until such a time as they are either no longer acutely suicidal or no longer a danger to others… That said, I have to be somewhat circumspect about what I say and the judgments I make as I was and tend to be when in any hospital so paranoid that I simply cannot draw any reasoned or reasonable conclusion about the staff or the treatment there, since it is always more or less (and usually more) through the lens of my sense of  personal attack and persecution. In truth, I scarcely remember any of the details or even the gross facts of this particular hospital stay. In fact, I have had to be told second hand, or even third hand, most of what I did there and/or of what happened.

I can say a few things from memory, though, and the picture I posted above is relevant to that: I remember being hauled off to the seclusion room and more than once. (I do not have even the slightest scrap of memory why…which is unnerving, and yet also a relief, as it protects me, possibly, from memories I might not wish to have…I hasten to add however that my lack of memory is not psychological, but neurological: we were warned by my Lyme neurologist that I should not have ECT while I still had CNS Lyme disease as it was likely to produce untoward CNS effects that could not be controlled or predicted. Since then, my short term memory has been particularly affected, among other things (e.g. olfactory hallucinations).  IN other hospitals, the seclusion room usually had a mattress in it, something upon which you could lie down, and were expected to, in fact, since you were given medication and expected to calm down and sleep in general. At other hospitals, I stayed in the seclusion room for an extended period of time, either because I was extremely disruptive (NOTE: see posts about Natchaug Hospital regarding this) or extremely psychotic. At those times I was usually permitted other items in the room, such as magazines and some small personal things to pass the time with…But during the month that is ending, I was literally manhandled into the room and dumped on the floor — hard linoleum — stripped, forced into a johnnie coat (I had to beg for 2), and summarily left behind, the door locked decisively between me and whoever was posted at the observation window.

I remember screaming, I remember begging for a mattress to sleep on, I remember begging for something to cover myself with for warmth or at a minimum for the heat to be turned up as I was thin and it was notoriously cold on that unit, and there was nothing whatsoever in the seclusion room to buffer the air conditioning. No deal. They just told me to be quiet; actually, I do not believe they even said that, but just, No. I do not remember much more than that. In fact, though I have been told the next, I do not actually remember it: there was of course no bathroom facility, and not even a bedpan in the room. Someone told me later that I defecated into a cup…But I do not see how that is more reasonable than that I did so into a bed pan…Why would I have a cup in there  if I did not have a bedpan…No, I believe that in both instances I have been told about, I peed and defecated directly onto the linoleum. If I did so, I cannot explain it. Perhaps I was simply desperate and they did not provide any other mode of relief. Maybe I was angry at them, and did it to “get back at them”? (This was suggested to me as a motive by the person who told me that I was not the first and would not be the last person to do this in that room…which was both a small source of relief, to not be unique, and yet to have done it as a kind of revenge?!  I did not want to believe that I would or could be so primal in my anger…But then, I have done it before, if you recall…

After that — and my memory wants to “see” this, feels it almost can and almost does, but I cannot be sure that it is memory rather than a mere confabulation  after the fact, having been told the bare bones of it by Carolyn (Lynnie) and others, who themselves only heard about it but did not see it either…after that I believe I crossed the room to , hoping there was no slant in the floor that would make the puddle slide towards me, and lay down in a heap and fell asleep.

Or did I? Did I? Or were there consequences to my act? I know that at some point in my “stay” — seems so mild to call the brutality of my hospitalization merely a “stay,” as if at a spa —  I was put into restraints and kept there a very long time. Was it for a separate incident, or was it connected to…Aahhh, wait a minute, yes, I do know, I do know…I remember now…For some reason, and I do not quite remember why, except possibly I was just so sick of everything that was happening, and so…I remember taking off the hospital pajama pants that were way too big for me anyway, and never stayed up and had no ties to pull around my waist and so were useless. I pulled them off and wound them into a narrow rope, which was easy as they were made of very thin material, then I formed them into a kind of slipknot,  fitted it over my head and around my neck and pulled on the  one end that had to be pulled for the knot to tighten, holding the other  like a kind of ballast (I don’t remember entirely how I did this only that it felt dreamlike, how easy it was to accomplish). I have forgotten what I was thinking, if I thought at all. Probably I did not think, I was that far beyond any rational thinking, even beyond any rational “wanting” in the sense of really wanting to die or not.

In any event, it seemed to take a long while before anyone noticed, and then a whole crowd of people were suddenly upon me, and they didn’t seem to know how to get the noose off  or how to loosen it. I held the end that slipped tightly in my fist, having no desire to relinquish it, though at the same time having I suspect no real desire to die either, that they could not easily free it. I heard someone yell to cut the knot. I remember thinking that was silly, why didn’t they just untie it? But it seemed that that was not possible, or at least that it was taking too long.  Then there was a pair of scissor up at my throat where the knot was — it seemed that  only bandage scissors could be found and those were not easily accessed — and someone was ripping at it, and then it was torn away and my neck was freed.

Stop. I have to stop here. Memory now fails me. I can only speculate what happened after that, because it literally blurs into nothingness. Goes blank. Goes back into the vault wherever all my lost memories go, perhaps never to be retrieved, if never fully or adequately formed. All I can do is try to reconstruct what might have happened next. I am pretty certain that it was after this that I was put in restraints. It would make sense. After all, what else could they do, and what would make sense? If I wasn’t safe in a seclusion room, in a hospital that in fact DID resort  to seclusion and restraints, it seems only likely that restraints would be the next measure taken. So I have to assume that it was for that reason I was put in four point restraints. Also, since the doctor I had been assigned to, thought a sadist by many on the unit, was  also the director of it, it was likely his call that led me to being kept there for more than 12 hours, and maybe as many as 18…I honestly have no idea in the end how long he kept me in such a fashion, only that I was not released even after I had fallen asleep…

That is almost the sum total of what I can, as a kind of “hard copy” memory, remember on my own. As you can see, even with those few memories, I had trouble and some help in recalling them.  I have some vague sense that a great deal went on during those 2 and a half weeks when I was largely insensible to what I did (at least to the extent that I did not recall it from moment to moment). During the last half week when I finally cracked the paranoia that kept me imprisoned, my memory did not improve, only my temper and the distance I kept from and my anger towards those who I had earlier felt were working in cahoots to hurt me. My impression then was only that some people were angry with me, but I did not know why, that some people resented me…But I could not figure out why. The ones who seemed to brighten when I smiled and help nothing against me told me gently a little about what I had done or how angry etc I had been, but only vaguely. They did not seem to understand that I had literally no memory of the previous 2 and a half weeks, or if they did, they did not seem to want to refresh my memories, perhaps feeling that it would be unkind, I dunno.  In any event, I learned a little about the “Pam” that some thought they knew, or that some people thought they had met and known for those 18 days…and that others had believed was in there all along and were now  glad to see emerging…But it was very confusing. And in all that confusion, I also had to deal with the fact that the new doc who had taken over after the sadist doc was removed from my “case” thanks to Lynnie’s intervention,  had decided that his philosophy of short hospitalizations would take precedence over whether or not I was fit for discharge, and so I was to leave on Tuesday…I had no choice, and so as I prepared to leave, I also had to “prepare a face to meet the faces that you meet.” (a quote from “The Love song of J Alfred Prufrock” by TS Eliot). But I was also growing more and more revved, more and more anxious. and I had no one I trusted enough to talk about it with. I certainly could not tell the day nurse. (I don’t think I did, but I do not actually recall one way or another). I knew she disliked me intensely, for all that she tried to pretend otherwise.

In the end, I did leave that Tuesday, though even as I got into Josephine’s car and she pulled out into traffic, she told me I didn’t seem right to her, that she didn’t think I was well or ready to leave. That fact seemed clear to almost everyone I saw that day. And not long after that I grew so talkative and revved that no one could get a word in edgewise…This was so emphatically not like me that thank heavens everyone put up with me, and no one, NO ONE, rejected me or gave up on me for it. I do not remember anyone being cruel or saying, GO away, you talk too much, or you are being too egocentric etc. I recall in fact only kindness and some humor injected into the situation, but mostly kindness. They all, my friends, as well as Elissa, the RN, seemed concerned as I rocketed higher, and yet seemed to feel uncomfortable and not at all happy with how fast I was speeding. Sure, Dr B diagnosed it a hypomania, but I  had thought hypomania was an enjoyable state, not this unpleasant adrenalinized racy state that felt so terrible to me. I hadn’t taken Ritalin in 3 weeks, but I didn’t even want to now. No, taking stimulants for Narcolepsy was nothing like this. This felt terrible and  neither Ritalin nor even Adderal had ever felt so terrible. There was no pleasure or even alertness that made me want to do things and study and write involved now. I got a little more cleaning done, true, but only because I was trying to exercise off anxiety, not because I had pleasureable energy. In fact, had I been able to slow down, I would have gone to bed to sleep it off!

Eventually, Dr B upped the Topomax and I think we had already increased the Lamictal and eventually over the course of the next week, I came down to my usual state of semi-sleepiness and was able to restart the Ritalin (after some discussion about why I take it…He is still new to the situation and my narcolepsy)

Well, that is about all I can tell you about the hospitalization just passed. But there was more to it, and what I know about it, though the facts are vague, is that there was something massively wrong…It felt like the Y2K meltdown in some ways, esp in my lack of contact with — reality, memory? Is there a difference? I feel that this was very different from my usual post-lyme hospitalizations, that I was in a different state, and so did others. It frightened me more, and it was more violent. Certainly the treatments were more violent, but that also implies that I was too. Lynnie keeps telling me she will talk to me about it. But so far, she has not… Do I really want her to?

Up All Night…

 I was up all last night and most of the night before, checking out various places around the state and their relative, which is to say their absolute elevations above sea level and comparing them, hoping to find a suitable place to relocate. I need to move soon — within the next year or so — as the Antarctic ice cap could slide off at any time, not to mention the possibility of Greenland producing such a profusion of freshwater that sea levels would rise precipitously and catastrophically…

 

What am I talking about? Global warming and one of the most predictable consequences of climate change…. The scenario, as I foresee it, is this (and keep in mind that I am being utterly selfish, thinking of no one but myself here, no one but me and my own small circle of family and friends…): I live in the Connecticut Valley, inland it is true, but at sea level with nothing between us, nothing literally between my building  and the ocean  but the valley floor. If and when the ocean level rises there is nothing that will stop the water from simply flowing right on up the valley. It will not even need to climb a slope as, according to Google Earth, this building is literally only 10 meters above sea level. Even if there is some ground higher than that in between, the water will simply find a route around the high points, making islands of it, and continue flooding wherever else it reaches.

 

Why am I making such a big deal of this? After all, I’m 56, I’m practically elderly. I should think of the younger ones who…But I admit it, my biggest fear in the world is drowning, and I cannot / will not sit around and wait for that to happen, no, I must do something to prevent such a fate now, while I still can. According to Google Earth, even my twin sister is on relatively high ground  – 600 feet – compared to me, even though she is closer to the shore and further south. Nevertheless, she has not put out an invitation, even when I pointed out the disparities of  our elevations. My younger sister, too, resides in the Valley, but she is farther north, in Massachusetts, and at 66 feet is somewhat higher in elevation. However, just a couple of miles out of town, the area not far from her is 300 meters above sea level, so she can get out of Dodge easily when the floods come. I wish she  would move so she wouldn’t be in harm’s way at all. I simply know that she will not listen to me if I bring it up so it is useless to try to get her to prepare. In the meantime, since I cannot count on my twin or any family member or friend to take me in, I must try to find an apartment on my own. I must  get myself to a new town — which one?– somewhere in the northwest hills, where the elevations are the highest and pray that the worst of the worst scenarios does not happen. 

 

Yet I know it will, and I cannot bear to think of the hundreds of millions, possible a billion people who live along the world’s coastlines who will also be in danger when the flooding starts. My concerns are neither more nor less serious than any of theirs, only more conscious. It could be better not to be so aware of what is to come: ignorance of the inevitable  must surely be less painful than the agony of knowing a devastating future without any ability to change it.

 

When I contemplate the certainty of mass panic, the evacuation and stampede inland, the fruitlessness of it all, my heart pounds with a horrible anxiety, being unable to bear thinking about so many people suffering…It is then that I wish to be dead myself, wish to have it all be over. I  myself have nothing to offer those suffering millions upon millions, though god knows I would if I could. If I myself cannot save them or help them, I cannot bear to witness the end of the world either. No, I would rather not be there for it. If a billion are going to die, then let me die before they do! I do not want to be left behind in such a world–

 

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Someone ought to do a film on American prisons and the making of a “violent criminal”– from his/her start in the State system of juvenile care (foster, psychiatric and otherwise) to juvy to the vicious cycle of imprisonment and abuse in the so-called “correctional system” until institutionalization and/or brutal three strikes laws make it permanent…Those who somehow think that most violent convicts freely choose to become violent are fooling themselves or are willfully ignorant: the prison system creates violent criminals, period.

 

 Abu Ghraib did not arise de novo, out of some new bizarre impulse from “rogue military elements”. No, we exported U.S. prison guards to Iraq who knew the tricks of the trade because they already used them in American prisons. Yes, the hoods, the dog leashes, the humiliating nakedness and don’t forget the torture — all are regularly practiced, with impunity, in American prisons. Yes, even President Barack Obama still exempts as legal and reasonable, the use of torture in prisons and during the punishment of prisoners.  

 

In fact, the Geneva conventions read as follows: Article 1

 

For the purposes of this Convention, torture means any act by which severe pain or suffering, whether physical or mental, is intentionally inflicted on a person for such purposes as obtaining from him or a third person information or a confession, punishing him for an act he or a third person has committed or is suspected of having committed, or intimidating or coercing him or a third person, or for any reason based on discrimination of any kind, when such pain or suffering is inflicted by or at the instigation of or with the consent or acquiescence of a public official or other person acting in an official capacity. It does not include pain or suffering arising only from, inherent in or incidental to lawful sanctions.

 

So even the Geneva Conventions agrees that while torture consists of inflicting severe pain on a person by official instigation or consent,  it seems to be allowed in the case of prisoners….EXCUSE ME? Prison guards can beat a manacled naked prisoner senseless and leave him in the “hole” for weeks, even months, no one saying a word about it, and it is fine with President Obama and fine with the Geneva Conventions? Well, I don’t think it is FINE at all. Especially not when the so-called resistant prisoner happens to have mental illness and is in “seg” because of it. Especially not when the prisoner is an 18 year old who just graduated from juvy, where he was sent after having spent years being shunted from one abusive “home” to another, molested in one and raped in another…and where he was not, beaten until he ran away and was sent to reform school. Now, in the Big House for armed robbery, is it any wonder he is both scared out of his wits and violent?