Tag Archives: Michael E Balkunas MD

Just Saying: Restraints and Seclusion are ONLY used as punishment

My response four years ago to an article in CT papers about the use of restraints and seclusion in CT hospitals.

“As someone who has been subjected to more use seclusion and four-point restraints over the past “decade of change” than in the two decades previous it boggles my mind that anyone would even dare to state that things are improving in CT mental health care institutions. During my nearly month-long captivity in the winter of 2013, the Institute of Living in Hartford regularly restrained me to a bed for as long as 19 hours at a time, without ever releasing me for so much as a bathroom break — I had to defecate in my clothing. I was not even released to eat. When I was not in four point restraints “for not following directions, I was in seclusion, which they called the “Quiet Room” and not seclusion, but by CMS definitions, it was seclusion as I was separated from the rest of the patient population by force, and was not permitted to leave the room I was isolated in.

The one time I did actually saunter away, walk down the hall to look out the window, and return to my non-seclusion Quiet Room, I was punished with immediate use of four point restraints, into which I was placed without a struggle, hoping that would make it easier to win my freedom. Alas, for me, there was no way to earn freedom from restraints I never “deserved.” The entire point was discipline, and that would last as long as the staff wanted me to be in shackles to learn my lesson. There was literally nothing I could do, –stay calm, sleep, quietly ask for release — nothing, until they were finally satisfied that I was submissive enough to obey their orders, some 6-19 hours later. But I had to cry Uncle, and submit to a set of degrading humiliating “debriefing questions” that assured them that I took responsibility for my own being restrained and that my behavior would henceforth conform to their norms.

I was surprised to see Natchaug Hospital being given good ratings of any sort. One of their chief psychiatrists on the Adult Unit, a longtime presence their Chief Idiot Emeritus psychiatrist you might say, Paul Pentz MD was so insouciant about this job as to be nearly incompetent, but probably hard to fire even for negligence. HIs name I have mentioned . He routinely did drive-by visits with his patients– a wave in the hallway might not be a completely standard morning meeting, but it happened often enough that peatients knew that would be all of this doctor they would see for the day. He routinely discharged patients with GAF scores at or around 60, the highest “global assessment of functioning” that one can have and still be rated “disabled” — not because he knew this level of functioning to be the case, but because it made him and his psychiatric ministrations at Natchaug look good. After all, if person comes in with a GAF in the 20s, and barely able to function, and you discharge him or her a week or two and some drive-by counseling sessions later with a GAF of 60, you must be doing a terrific job, esp for a 75 year old doctor not too keen on using anything like trauma-informed or patient-centered care. I had never left a hospital before Natchaug with a GAF higher than 40, but suddenly I rated a 60….by a doctor with whom I never spoke.

Natchaug Hospital, when the nursing director was Sharon B Hinton, APRN, was a decent place, because she made certain that abuses like restraints and seclusion rarely to almost never happened under her watch. I know, because I was there about three times during her administration. I also knew her when she was Hartford Hospital’s psychiatric Head Nurse at CB-3, where she and her never failing humanity and respect for the dignity of every patient made all the difference in the world. I might have come from an abusive hospital in the early 90s, like University of Connecticut’s Dempsey Hospital, which in those days four-pointed people to an iron bedstead, by shackling them spreadeagled to the four corners of the bed, a stress position that is not just tantamount to but is in fact torture. But I would be rescued by someone finding me a bed at Hartford Hospital, where Sharon would discover me arriving there in tears and tell me, unfailingly,”Its not you, Pam, you did nothing wrong, It is the hospital that treats you badly…We don’t have any problem with you, because we treat you well and you respond to it. When they treat you with cruelty, you respond badly…That’s very normal.”

But as to Natchaug…Bravo if they have done away with restraints completely. They had not done so when I was there last in 2012. Nor with seclusion, which was imposed in mostly a disciplinary and arbitrary fashion. Largely it was used to force medication on loud obstreperous patients or for angry fed-up senior nurses to take out their peeves on patients they didn’t particularly like (e.g. me). I still remember one APRN demanding that I be dragged to locked seclusion, and left there alone (despite all Sharon’s previous assurances that such would NEVER happen, that someone would ALWAYS remain in that room with me if I ever ended up there.. Alas, Sharon had left by then, so rogue nurses like D could have their way…) and when I peed on the floor in panic, and took off my clothes they rushed in to take them away from me, and inject me with punishment drugs, then made me stay for an hour alone on the pee-soaked mats, freezing cold, pretending to sleep and calm myself just to convince them I could leave and not bother anyone. I managed to do so, or at least the APRN D. got over her fit of pique and finally released me, but I was not really calm, and when they finally draped two johnnies over my naked body so I could decently traverse the distance to my room, I left, disrobing as I went…Who gave a damn about my flabby flat behind? I certainly did not. And it served them right if everyone got an eyeful…served them right..

Natchaug’s biggest problem was and probably still is a lack of staff cohesiveness and bad morale between the staff nurses and the well-educated techs/mental health workers who were all very dedicated college grads but were treated like grunts…The MHW’s did most of the important patient contact, but were not trusted to write patient notes, or the notes they wrote were never read, or accorded any import. This was not just despicable but very unfortunate in more than one instance during my stay, as the notes they took personally might have saved me from some terrible misunderstandings and outrageous misdiagnoses that harmed me terribly..

Most places use techs who are trained by shadowing for a day or two, which means, badly trained, if at all…

You have to take all such in-hospital diagnoses with such a heavy grain of salt, you know, even when they are labeled with the words, “THIS IS A LEGAL DOCUMENT.” Because they get so much of fact-checkable, factual material garbled that you cannot believe a word it says. And as for diagnosis, well it is all of it opinion, one, and two, it depends largely upon whether you are a likable patient or a disliked one, what they finally say about you on any given day. No one should have that sort of power over another human being, frankly. And the idea that they can brand one for life with certain psychiatric diagnoses just sickens me.

Be that as it may, my recent last experience was beyond the beyond, at Hospital of Central Connecticut, The old New Britain General…and I expect to go back to talk to someone there about it. I always do And I have much to say to them, after the pain and rawness have worn off a little. They considered it SOP to strip me naked and leave me alone in a freezing seclusion cell without any access to human contact, unless they chose to speak to me over a loudspeaker hidden in the ceiling. If not, I was utterly abandoned, no contact or even view of another human being for as long as they wanted to keep me secluded. They also restrained me, having male security guards four-point me stark naked to the bed, before they had the decency to cover me with a light sheet, even though I begged for a blanket for warmth. (A nurse manager came in and shivered, saying “Brrr its cold in here!” but did they relent and let me have a blanket…No, clearly I was not human, didn’t need warmth.)

This is just the tip of the SR iceberg in CT in the current years, Remember this is happening right now, not ten years ago, or before the so-called reforms. Nothing is getting better. Things are worse than ever, And when you are a patient in these hospitals, you have no help, no recourse, anything and everything can be done to you and you have no way to refuse or say “no”. No one will help you, or offer assistance. They can just grab you and seclude you or restrain you without your having the power to stop them or any recourse to make them pause and reconsider. You are powerless to stop anything…And so they get away with it every time. And once it is done, who will fight for you? What lawyer will take your case if the guards hurt your shoulder rotator cuff, or bruise you up, or degrade or humiliate you? No one….so you are deprived of your human and civil rights, completely, but the hospital knows that no one cares enough to fight for you, so they get away with it each and every time, and they know this when they do it. They have nothing to worry about,….You are just another mental patient, a nobody, a nothing.

That’s what you are if you are diagnosed with schizophrenia and hospitalized in CT hospitals in 2014. A nobody that the hospitals can abuse with impunity and will. Just wait and see if any of this changes…I doubt it highly. They have no motivation to change. They don’t think they are doing anything wrong now.”

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.

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.

READ THIS, Michael Edward Balkunas, MD of Hospital of Central Connecticut in New Britain, CT, Before You Throw Another Psychiatric Patient Into Your Supermax Seclusion Cells!

Hospital Seclusion Room
Hospital Seclusion Room (Supermax Cell at New Britain General Hospital)

This is from the Special Rapporteur to the UNITED NATIONS CONVENTION ON TORTURE 2013:

As the previous Special Rapporteur stated: “Torture, as the most serious violation of the human right to personal integrity and dignity, presupposes a situation of powerlessness, whereby the victim is under the total control of another person.”14 Deprivation of legal capacity, when a person’s exercise of decision-making is taken away and given to others, is one such circumstance, along with deprivation of liberty in prisons or other places (A/63/175, para. 50).

32. The mandate has recognized that medical treatments of an intrusive and irreversible nature, when lacking a therapeutic purpose, may constitute torture or ill-treatment when enforced or administered without the free and informed consent of the person concerned (ibid., paras. 40, 47). This is particularly the case when intrusive and irreversible, non- consensual treatments are performed on patients from marginalized groups, such as persons with disabilities, notwithstanding claims of good intentions or medical necessity. For example, the mandate has held that the discriminatory character of forced psychiatric interventions, when committed against persons with psychosocial disabilities, satisfies both intent and purpose required under the article 1 of the Convention against Torture, notwithstanding claims of “good intentions” by medical professionals .

Medical care that causes severe suffering for no justifiable reason can be considered cruel, inhuman or degrading treatment or punishment, and if there is State involvement and specific intent, it is torture.

63. The mandate has previously declared that there can be no therapeutic justification for the use of solitary confinement and prolonged restraint of persons with disabilities in psychiatric institutions; both prolonged seclusion and restraint may constitute torture and ill-treatment (A/63/175, paras. 55-56). The Special Rapporteur has addressed the issue of solitary confinement and stated that its imposition, of any duration, on persons with mental disabilities is cruel, inhuman or degrading treatment (A/66/268, paras. 67-68, 78). Moreover, any restraint on people with mental disabilities for even a short period of time may constitute torture and ill-treatment.78 It is essential that an absolute ban on all coercive and non-consensual measures, including restraint and solitary confinement of people with psychological or intellectual disabilities, should apply in all places of deprivation of liberty, including in psychiatric and social care institutions. The environment of patient powerlessness and abusive treatment of persons with disabilities in which restraint and seclusion is used can lead to other non-consensual

Domestic legislation allowing forced interventions

64. The mandate continues to receive reports of the systematic use of forced interventions worldwide. Both this mandate and United Nations treaty bodies have established that involuntary treatment and other psychiatric interventions in health-care facilities are forms of torture and ill-treatment.79 Forced interventions, often wrongfully justified by theories of incapacity and therapeutic necessity inconsistent with the Convention on the Rights of Persons with Disabilities, are legitimized under national laws, and may enjoy wide public support as being in the alleged “best interest” of the person concerned. Nevertheless, to the extent that they inflict severe pain and suffering, they violate the absolute prohibition of torture and cruel, inhuman and degrading treatment (A/63/175, paras. 38, 40, 41). Concern for the autonomy and dignity of persons with disabilities leads the Special Rapporteur to urge revision of domestic legislation allowing for forced interventions.treatment, such as forced medication and electroshock procedures.

JUST THOUGHT YOU SHOULD KNOW,  MICHAEL EDWARD BALKUNAS, MD, YOU MOTHERFUCKER…BUT THEN YOU ALREADY KNOW THIS, BECAUSE YOU DO WHAT YOU DO TO PATIENTS DELIBERATELY AND WITH PURPOSE!

Trauma and Its Sequelae: A Hospital Poem on Abuse by Michael Edward Balkunas MD

TRAUMA AND ITS SEQUELAE…

 

Written months after my 4-week admission to the psychiatric unit, W-1, at New Britain General Hospital/ Hospital of Central Connecticut, in 2014 where I was “treated” and abused by Dr. Michael Edward Balkunas, MD

 

Nine days after your worst hospital stay ever

you are still wearing the shades

that protect others from you

though no one else believes they are in danger

Those staff however wrote you up

as “assaultive” and dangerous to self

and others. But they didn’t mean it the way

you do now and their description of your

behavior was neither accurate nor truthful

Often they lied, as liars do,

just for the sake of convenience.

 

Now you are a week away from meeting new “cousins”

who await your vacation in northeastern Vermont,

a place magically named the Kingdom

and the recuperation your mind-body badly needs.

Still unable to let go, you perseverate over

the half-nelson grip of sadistic guards

bent on eliciting pain.

What happened to the nurses’

“healing touch,”

their concern for “the dignity, worth,

and uniqueness of every individual”,

or their “primary commitment

to the patient?”

 

When the guards forcibly stripped

then four-pointed you to an bare mattress

they were just replaying their favorite rape

yanking each limb wide

to expose, degrade, humiliate.

Never mind the nurses’ vow to protect

the vulnerable. The official hands-off policy

protected only their own asses.

 

So how do Truth and Forgiveness Programs proceed

when so many refuse to acknowledge wrong?

The hospital broke every humane rule;

they only stopped short of murder

because you submitted,

nick of time. Yet they had the last word:

stuffing your screams

when they muted the intercom

and slammed the door between you

and the mandatory one-to-one observer.

 

No one ever is there to bear witness, is there?

That point has always been the point,

from Daddy to doctors.

and all the hairdressers and nurses in between.

They’ve made a religion of secrecy

and no one wants to know

what they don’t want to know.

 

Call it “our family’s business,”

call it “a private cut and shampoo,”

or just call it, discreetly, “treatment”–

but they can always do what they want to, to you.                          .

When they break you, they declare

you’re just “one of the family,”

no different from anyone else,

now that they’ve finally fixed you for good.

Solitary Confinement is Torture and You, Michael E. Balkunas, MD, Can Go Fork Yourself!

This is from the New York Times today:

To the Editor:

Re “When Cell Door Opens, Tough Tactics and Risk” (“Locked In” series, front page, July 29):

The events leading to Charles Jason Toll’s death highlight the dangers of prison procedures, especially for vulnerable inmates who suffer from mental illness. Particularly concerning is Mr. Toll’s solitary confinement, a disciplinary technique repeatedly identified as ineffective and counterproductive, and even as torture.

The Justice Department has found that solitary confinement of mentally ill people violates their rights under the Eighth Amendment and the Americans With Disabilities Act.

Solitary confinement worsens psychological symptoms and can trigger outbursts tied to the person’s feelings of hopelessness and loss of a sense of self through extreme social isolation and sensory deprivation.

Providing mentally ill people with appropriate and compassionate mental health care, including integration of psychiatric, psychological and psychoanalytically oriented treatments, is crucial in restoring a person’s identity, alleviating feelings of loss and distress and reducing violence.

Mr. Toll’s solitary confinement, suffering and death were avoidable, and again show that the mentally ill are more likely victims of violence, not the perpetrators.

SUSAN McNAMARA
Middletown, Conn., July 30, 2014

The writer is a psychiatrist.

_____________________________

When I was a patient in May and June 2014 at New Britain’s Hospital of Central Connecticut, Dr Michael Edward Balkunas regularly imprisoned me in a horrific seclusion cell, without a single amenity but a concrete built-in bed and rubberized mattress, for nothing more than making too much noise for the approved hospital milieu. In fact, several nurses took it upon themselves, with Dr Balkunas approval, to do the same. This became literally routine. I was NOT, as is required by the Centers for Medicare and Medicaid, in IMMINENT danger of causing severe harm to myself or others. No, I was loud, disruptive and uncooperative, and I was rude. Period.

My first reaction when the double doors locked behind me was immediately to start screaming, at the top of my lungs, from the base of my lungs. But screaming brought no one. Okay, they did soon come in at me with three IM injections, but they came back every time with IM injections anyway, because as I took to calling it, these were part of the drill, they were “punishment injections.” I was pushed onto my stomach and shoved into the mattress so I couldn’t breathe and injected whether I liked it or not. I tried to say, “STOP! I will take the injections, just don’t hold me down.”

But sometimes they didn’t listen to me, and held me down anyway, and I got scared that they would kill me, because it didn’t matter that I didn’t struggle. There were four of them to the one of me, and they expected me to fight and so they forced my face into the mattress and held me tight, hard, and with all their weight….until I felt my breath go out of me. Did they have any idea that I was NOT struggling, that I felt I was going to die? Did they have any idea that they were killing me?

I don’t know. I don’t know. All I know is that I felt in mortal danger when they wouldn’t let me just accept the injections on my own, in my arm, but insisted on giving them to me by force in the buttocks, even when I said I would take them voluntarily.

Then they would leave and lock the double doors. And I would scream, and NO ONE would respond, even though I eventually learned that they could not only hear me through the intercom hidden somewhere in the ceiling, they could also talk to me. They wouldn’t but they could have. When screaming brought no one, I would strip and urinate on the floor, and I would defecate too as much as i could, and smear everything on the walls and floor. I would even eat it and paint it on my body. I didn’t care, I DIDN’T CARE! I just wanted someone to come in and help me.

Several times I washed and colored my hair with urine, thoroughly. But no one came back for hours. The urine, which completely soaked my hair, had time to dry completely. Not that they cared or noticed. If they had, they said nothing. It was nothing to them. Only Barbara RN asked me what was in my hair, and insisted that she wash it out when finally they released me. I went with her to the shower-tub room and allowed her to do so, but only one other person was kind enough to notice and do that. Everyone else just released me and expected me to somehow be reformed and “better” after my hours of punishment.

Of course that wasn’t the case. I got worse, much worse. I started defecating in my bedroom, at any hour,for any reason, any time I was frustrated or angry. They decided I had “borderline personality disorder,” that I was simply manipulating them. They failed to see that they had traumatized and broken me. They failed to see their continuing role in my behaviors…which were getting worse and worse the more they punished me. Every time they secluded me, or four-pointed me, I regressed more.

Dr Balkunas actually decided to commit me to the State Hospital claiming it would help me “get better.” But really he was just in punishment mode. You could tell, because he wasn’t using any of the methods that you are supposed to use for REAL borderline patients….If he really believed I was BPD he wouldn’t have kept at it. But he knew from my brother, a psychiatrist too, and my own psychiatrist, that I do not have BPD, so that was bogus and just an excuse to torture me. He didn’t really think I had BPD. He just needed an excuse to use solitary confinement and he knew that schizophrenia was NOT a good reason. A very BAD reason in fact, so he invented a secondary diagnosis to use. But the thing is, there are other therapies you are supposed to use in BPD, and he never bothered to treat me with anything but punishment and then threw up his hands and said, Well, the antipsychotic drugs take time to work, so you will go to the SH until they do.

Bastard! He gave up on me without even trying to help…so-called saintly doctor. Just a bastard! Because torture doesn’t work to make me better, he decides that I am the one at fault????? Well GO FUCK HIM UP THE ASS WITH A BROKEN GLASS JAR!

Hospital Of Central Connecticut’s Psychiatry Unit W-1: Dr Michael E. Balkunas

 

I understand now why Dr. Michael E. Balkunas, the psychiatrist at New Britain General Hospital (Hospital of Central Connecticut) W-1, general psychiatry, gave up on me. He decided, even after eliciting my brother’s opinion both from a professional and a personal standpoint, and Dr Angela’s equally professional opinion that I do not suffer from Borderline Personality Disorder, to diagnosis me secondarily as exhibiting that disorder.

 

Oh, he knew I had come in with an acute exacerbation of schizophrenia and that I had PTSD. He knew that I had in my electronic medical record documents stating from other psychiatrists that I do not and never did have any personality disorder, despite in-hospital “behaviors.” But I know why Dr Balkunas diagnosed one. He did it for the same reason the other hospitalist psychiatrists have done it in the past: 1) in order to justify the use of a Behavioral “Treatment” Plan that was tantamount to torture and 2) to excuse his liberal use of seclusion and restraints in instances when they went against all CMS regulatory guidelines. And 3) in order to dismiss me and call my behaviors “manipulative and devious” instead of taking me and what I said seriously.

 

 

I also suspect, for all the second shift RN Barbara’s telling me that Michael Balkunas MD is a caring man and “never gives up on a patient” that he DID in fact give up on me. In fact I suspect that he never really tried to deal with or treat me at all, that from the first time he resorted to seclusion and restraints, he knew he had opted to terminate any treatment alliance.

 

 

But how did I figure this out? Well, it isn’t as if there ever had been any kind of alliance between us. From the first day after he admitted me from the ER, when he came into my room while I was still mute, he just walked away, saying dismissively, “I won’t talk with you unless you speak.” Immediately I understood that this man was willing to jeopardize everything about me and about my treatment in order to assert his power.

 

 

The same thing came into play after I began speaking about a week later. Now the issue was that he would not speak to me, would not deal with me at all but would immediately leave the room if I became angry and spoke with anything resembling a raised voice. (Argh, this was so many shades of Amy Taylor MD at the Institute of Living last year! — and Dr Balkunas tortured me in similar ways with predictable ineffectiveness — but powerful people behave in predictable ways, right? It seems I must have threatened their sense of entitlement. Why else take it out on me? Who am I? I’m a big fat nobody! They could have ignored me or just treated and released me, like anyone else. But instead they did their damnedest to crush me and destroy me. Why? Because in the end, I think I must have triggered some underlying feelings of resentment and impotence in these two psychiatrists and you know you do not threaten to unearth the feelings of a psychiatrist, or at least not with Michael Balkunas MD or with Amy Taylor MD …)

 

I learned very quickly, but not quickly enough, that everything about the Hospital of Central Connecticut W-1 Unit at New Britain was about coercion and control. Not about trauma-informed, patient-centered care. I don’t know how other patients managed to be discharged from there within a few days, but it would never have been possible for me. Mostly because I was simply too out of control to BE controlled by people who used such methods to undermine any possible calm and stability I might have achieved in those early days. They did NOTHING to help me but take away the very coping methods and objects that might have helped me. They used the carrot-and-stick method liberally, but mostly they used sticks. The very fact that the ED staff had seen fit to seclude me, give me IM meds twice and also to four-point restrain me naked to a bed tells you something about the brutality that reigns supreme there.

 

You know the very first thing I did was give the ER and the W1 staff a Psychiatric Advanced Directive. It was supposed to help them to help me. But instead they seemed to resent my knowing myself, and wanting them to know how to help me. They reacted badly and worked against it in every way possible, instead helping me. It appeared to anger them that I knew myself, and instead of using it, they did everything in their power to abrogate each and every section of it, right up to the section where it asked them to notify my doctor and my brother when and if they used seclusion and/or restraints despite the warnings.

 

 

No one ever called anyone in each instance that they chose to restrain or seclude me, even though I begged them to verbally at the time as well, and this document, which was at the front of my chart all along, stated in no uncertain terms that I wanted both people to be notified.

 

 

It was the worst hospitalization I have ever had, and I say that having had many serious and difficult stays. I was not just a difficult patient, I was a pain in the ass, but this was a direct result of the trauma I experienced in the ED and immediately following it on the floor. If I had not been traumatized, on the unit and in the ED, I feel certain that my “behavior,” outrageous, “disgusting,” and out of control as it was, would never have been so damaged. But because everyone saw fit to go against everything advised in the PAD, and do everything they could to re-traumatize me– even after I had a conversation with a nurse about my three experiences with date rape, even after that, she decided to seclude me, involving the forcible removal of me from my room by brute guards who bodily threw me into a cell without any mean s of communication with the world — because of this, they got the regression and degeneration and worsening of symptoms that my PAD predicted would happen. What did they expect? That I would simply thank them?!

 

 

I realized, though, the Monday morning of the week he discharged me when he came into my room and asked me how I was doing, that Dr Balkunas, who “never gave up on a patient,” had given up on me. Now, my brother had indicated to him that the “kindness” Dr Balkunas was offering to me by means of involuntary commitment to CVH would be devastating and destructive to the max. I think “Balkie” had had to think about the wisdom of actually sending me there. So he also had to think about whether he actually had any tools at all to “fix me” or cure me as he had promised. Indeed he was no miracle worker and had never held out anything, NOTHING AT ALL, by way or therapy or treatment modalities beside commitment to the state hospital to help me…so without that threat he had nothing to offer me.

 

 

The man never once sat down and even talked to me calmly and caringly. I say this because when he sallied forth with his usual opening that Monday morning, How are you? (I had decided finally, with my brother’s encouragement to “play the game.”) I answered with the socially acceptable, “fake” answer, my game plan, not expecting any real psychiatrist worth his salt to accept it, but trying to “play the game” anyway, as I was desperate to be discharged. My answer?

 

“I’m fine, thank you. How are you?”

 

Balkunas really didn’t bat an eyelash, the completely social answer was good enough for him, because he had given up trying to help me. Indeed, he had never even tried. So he proceeded, “How are you eating?”

 

“Fine.”

 

“How are you sleeping?”

 

“Fine.”

 

“Well, if things continue this way and there are no meltdowns I think you can go home on Friday.”

 

 

There were indeed meltdowns, even the night before I was discharged I had a meltdown over my supper tray. But Dr B was not on the floor much and didn’t hear of those, and everyone was so sick of me that they didn’t write them up, knowing I was to go home. And I persisted in answering those three magic questions “correctly.” Socially, as I had been taught, against my will, years ago. He never asked me a single other thing, and never talked about anything else at all after that.

 

 

The day of discharge came, and the great and caring Dr. Michael Balkunas popped his head into the room. “How are you?”

 

 

“I’m fine thank you. How are you?”

 

“Okay, I will write your discharge papers now.”

 

 

The very minute he said that and turned to leave, I put my sunglasses back on, as I saw that taking them off a week prior had served its purpose and it mattered not whether I wore them from that point on or not. I still wear them today, to protect people from my evil…

 

 

Dr. Michael Balkunas may talk a great game about helping people but he has very few tools to do so and really it is all pretence. He has medications, which are by and large bogus (though he has been educated by Big Pharma for so long he fails to understand this), and he had commitment proceedings to the state hospital, unless he happens upon a millionaire family willing to spend on their family member. I was not one of those, nor worth it. CVH – for those who are not in the know, CVH—Connecticut Valley Hospital is the last state hospital and the only long term facility for adults on Medicaid in Connecticut – being sent there would have killed me and he and my brother both knew it.

 

 

The difference was that my bother was decent enough to care while Balkunas honestly thought it would be good for me to lose my life there. And that was his treatment? Bullshit. He was a bad doctor and despite the cant, he gave up on me to boot. Well, thank god he did.

 

 

But you know, I do not forgive his accepting my social “I am fine thank you. How are you” so easily. That was insulting. He was sick of me, and considered me willfully manipulative and devious, otherwise he would not have diagnosed me with the damning BPD diagnosis, which in his hospital means just that you are a PIA, no less and no more. But he might have at least pretended to be a psychiatrist and not just a social buddy. How are you? Fine thank you, How are you? What sort of answer is that? ON the other hand, if he had asked me, what could I have said? We both know I had to get out of there and there was nowhere to go but home. He was not interested in finding out how I was, in talking to me. Not from the first. All he wanted was to medicate me. Which he did. So fuck me. How are you, I am fine thank you how are you? And it wouldn’t have made a rat’s ass worth of difference if I had not been okay, which I wasn’t, so long as I said I was fine, thank you, how are you’

 

Like I said, it was a game. That was the name of it, Play the Game…

 

So fuck Michael Balkunas. He is worthless to me, and his add-on personality disorder diagnosis means less than a fig to me. He knew I had schizophrenia and PTSD. He knew the hospital was abusing me. He knows nothing about me, never spent more than 3 minutes with me on any given day. He knows nothing. And I don’t give a flying femtogram about HOCC (the former New Britain General Hospital) except insofar as they ought to ask me back to educate them and improve the situation vis a vis their abusive use of seclusion and restraints, not trauma-informed patient-centered care at all. However since even supposedly trained Nurse Manager Jessica came around to not objecting, and approving their use, I can see that it might be hopeless to do so. Willing though I would be.

 

 

Barbara, RN on the second shift. You alone were a lifesaver and a light in a dark tunnel. I wrote in the scraps of paper I called a journal of your kindnesses again and again, and I forgive your being blind to the cruelty of seclusion and restraints, because you have lived with that culture too long, You just need to be re-educated. But you saved my life. Had you not been on duty that weekend before I was discharged, I might not have calmed enough to say to Dr. Balkunas the socially acceptable “I-am-fine-thank-you-how-are- you” mantra that was the magic ticket out of there.

 

 

I know no one on W-1 remembers me with anything but relief that I am gone and a great deal of disgust and anger. Ditto for me. I still wake screaming from nightmares about the place and a great deal of anger that I don’t want to let go of. I want to hold onto it long enough to fix the situation of W1, before I forgive anyone. Then we will see.

 

 

But for now I am off to Vermont for six weeks to stay with relatives. I hope to heal. I hope I can heal…

 

 

Take care of yourself Barbara. You would do well to find a kinder and better place to work and train. I thank YOU for everything. I mean it when I say you saved my life and sanity.

 

 

Blessings on you alone, Barbara, the rest of you can FYandGTH.

 

 

Miss Wagner