In 1999 I left the psychiatric unit on pass. While out, I took an overdose that put me in the ICU on life-support for a month. After two weeks on a medical unit, I was returned to psychiatry where I languished for five months. For the first month I was deemed in need of treatment, thereafter I was considered well enough to leave.
The problem was that there was nowhere for me to go. I had multiple chronic illnesses (which I later would learn either were caused by or exacerbated by psychiatric medications) as well as ongoing depression so I was considered to be “dual diagnosis” and there is no place that takes dual diagnosis patients.
Finally I was discharged to a Loretto group home for the mentally ill. Within a matter of days, they asked me when I was going to start going up and down stairs to do my laundry. They had admitted me without fully understanding that the answer was “never.” I lasted two weeks and then was returned to inpatient psychiatry to continue serving my sentence. There was no place for me.
The discharge planner was compassionate but had me as a low priority. There were patients she could place in a matter of hours; I was taking weeks, months. I began to put a number on my door every morning: it was the number of days I’d been on inpatient psychiatry. It was just a number, no words. If someone would ask me what it meant, I would explain. Every night, the staff removed the number. Free speech? On a psychiatric unit? Nonsense.
Days turned into weeks, weeks into months, and I lingered. Inpatient psychiatry is a nightmare—people screaming, sobbing, running, alarms going off, much bad craziness. It is not a healthy place. It most certainly was not a place where a person who did not need psychiatric treatment should have been forced to stay but there was no other place for me.
Finally I told Dr. Nasri Ghaly, my psychiatrist, that we had to have a meeting with all the involved parties. He agreed, so the discharge planner put together a meeting of about two dozen people. On one side of the conference room were nurses, case managers and social workers from St. Joseph’s Hospital and its Home Health Care Agency; on the other side were the same characters from Onondaga County Long Term Care Resource Center. In between were doctors, lawyers, a minister and me.
I had to sit and defend myself as the two contending teams gave all the reasons why they shouldn’t-couldn’t-wouldn’t take care of me. It went on relentlessly, each side quoting regulation numbers justifying their position and the lawyers writing down the numbers. I sat between Dr. Ghaly and Dr. Cohen, my psychologist, trying desperately not to cry.
Finally, Dr. Ghaly, who is a Coptic Christian of deep faith (he carries his keys in his left pocket and his rosary in his right pocket), spoke up. He said, “This woman is sick. Who will help her?”
Complete silence followed his remark and then slowly the conversation began again. Within minutes, they all were back to their previous bickering.
Again, Dr. Ghaly said, “This woman is sick. Who will help her?” This time the silence held for a minute and then one of the nurses from St. Joe’s pulled out her cell phone and called her boss. Then one of the nurses from the county did likewise. In ten minutes they had a plan worked out whereby I would have a safe discharge.
So two days ago the doctor told me he couldn’t admit me to the hospital because Medicare would not pay for my care because I can’t take drugs. He followed this with the explanation that he didn’t want me to be held responsible for the bill. That was very nice of him, but I suppose he has a house, a mortgage, one or more cars, several dependents, and who knows what other financial assets and liabilities.
I explained to him that I have nothing, and you can’t get blood from a stone. Let them send their bill. They can’t put a lien against Social Security Disability because it is considered subsistence living. What’s a four-year-old power wheelchair worth? A three-year-old laptop computer? I live in a rented apartment and sleep in a rented bed. I own nothing of value; I have nothing to lose.
Yesterday I went to see him and the medical student who was shadowing him, a small girl of some Asian heritage—petite, long black hair, personable. The doctor and I talked. I told him the story of how Dr. Ghaly got me out of inpatient psychiatry. We talked about the history of intolerance to medication. The young woman got me tissues when I started to cry. The doctor wanted to know just exactly how suicidal I am: “Not too” means you can be admitted to a medical bed; “Seriously” means you can’t go to medical and have to go to psychiatry.
I told him that on the way to the appointment I had figured it out. I would commit suicide by physician. I would turn myself into some emergency department, give them my symptoms and then become mutely acquiescent. They would do their tests and then give me their drugs. When I would have a reaction then they would give me more drugs and so on until they killed me. All I have to do is not tell them about my rare disorder.
In the end, the doctor said he would admit me to his hospital on Monday. Hey, why not? Let the hospital eat the bill that Medicare won’t pay because I can’t take drugs because I was poisoned by one of their doctors.
As I was leaving the building, the medical student approached me. She said she was sorry, and she would pray for me. I said that I appreciated that since I no longer can pray for myself. Then I told her to commit her career to changing the system so that when she is sixty-five, she will not be seeing any patients like me.
She wept throughout our conversation.