I was discharged from the hospital a month ago, and folks have been asking me how I’m doing. The answer is somewhere between better and really good.
My discharge from St. Joseph’s Hospital was pretty well botched and the transition to home did not go easily. The first problem was that during the last days of my three-week hospitalization I spent most of my crying or simply staring into space. I couldn’t express any opinions or make decisions as simple as “Do you want chocolate or vanilla?” My answer was “I don’t know.” Also, time had taken a severe hit. I could not place events in time or sequence and didn’t know what day it was.
When I described my predicament to the friendly out-of-state medical social worker and empathic therapist, he said that I was suffering from institutionalization. Of course I was familiar with the term but had no real idea what it meant. What I learned is that institutionalization means that you cease to be you—a unique character with specific traits. You become a nothing, an entity that is whatever others chose to make of it.
The breakdown process began in the Emergency Dept. where, over the course of eight hours, half a dozen nurse practitioners, physician assistants and physicians came to my gurney-side and said, “So what brings you here today?” I became an automaton repeating the same words over and over again. When I got mad and refused to do it, then it was charted that I was uncooperative. It was not charted that the staff failed to communicate with one another.
In the Emergency Dept., I was denied the opportunity to sleep. Moved to Observation around two o’clock in the morning, instead of letting the sick woman sleep, I was subjected to a long litany of questions and forms to be signed, virtually none of which couldn’t have waited till morning. Sleep deprivation, for example at Guantanamo Bay, is considered to be one effective method for depersonalizing a person and making the person submissive and cooperative. It’s a form of torture that hospitals use without compunction.
At home after discharge, I sat in my recliner and looked at my bookshelves, recognizing each book and remembering how each came to be in my custody. In the hospital, when I was transferred to Unit 4-7, I was in a room that was entirely white, unadorned and sterile to the eye. I had two roommates, both of whom died, and then I was left alone to share my room with an empty bed. As my mental status deteriorated, I wondered if there was something so terrible about me that it killed people, and the hospital had to leave me alone so others wouldn’t die. Strangers came into the room at all hours of the day and night and laid hands on my body. If I objected, they got angry at me. Often they didn’t even tell me their names.
The two most aggressive acts of depersonalization engaged in by the hospital were their reactions to my intolerance of medications, and my right to speak freely. With the single exception of Dr. James Tucker, all staff—both nurses and doctors—treated my immune system problems with medications simply as if it was bad behavior. And, in ways small and large, they sent very clear and frequent messages that I was a bad person for refusing to take their medications. Medications were what they were all about, and I was not allowed to have a unique problem that prevented the safe use of medications. I was not in any way allowed to be unique or have atypical needs. It was conveyor-belt medicine but I didn’t fit on the belt.
The other aggression committed by St. Joseph’s Hospital against my soul was shutting down my blog. They did it without discussion or notification. The message was clear: I did not exist as a person worth talking to; I was just a policy problem to be dealth with by the flick of a switch. Further, they said that my blog was “malicious.” Is there any harder hit you can take than being told that you’re evil and hateful? I was writing about my life and perceptions of hospitalization. In fact, my readership during the weeks of hospitalization was the highest it’s been since I started blogging a year ago, but I didn’t know that because the hospital had blocked my access to the statistics on my blog. The official policy was that I was a terrible person and I had no access to the data that said ‘Well, yeah, maybe—but we love to read what she writes!’
Denied my individuality, told I was vile, deprived of sleep, manhandled by strangers, kept in a sterile environment with Death as a roommate, is it any wonder that I broke down? At home, I wept and was irritable. I only could tolerate other people for a couple hours then I would collapse and have to take a nap. This went on for four cruel days before I finally pulled out of it. Later, I proposed to the home care nurse that when people have trouble transitioning from hospital to home, maybe it isn’t because of the trauma of their illness; maybe it is from the trauma of hospitalization.