So I’m in Upstate Medical Center’s emergency room, admitted at 5:00 p.m., requesting a glucometer check, insulin, and a psych consult. They put me on a stretcher in the hallway and leave me there for about five hours. My glucose is 400-something.
The head of the ER comes to see me. A young guy, he sits down next to me in the hallway. The conversation doesn’t go well. He keeps telling me that he’s trying to help me, then gets mad and storms away, announcing that he’s going to discharge me. Some kinda help.
A nice woman comes by, says she’s the emergency room manager, and asks me if there’s anything I need. At various times she brings me water, food, and information. A more useful kind of help.
Another time a psychiatric resident comes. She is from Paraguay; then another psychiatric resident joins her and he obviously is foreign –born, too. A nurse, who looks exactly like Dale Avers, a nice professor of physical therapy whom I used to know so I have a positive transference to the nurse, is doing something to me.
I tell the psych residents that I have learned from experience that if two doctors are matched for specialty, training, age, sex, and everything else, but one is American-born and the other is foreign-born then I always choose the foreign-born person because I have learned that American-born doctors are in it for the power, prestige and money, whereas doctors raised in a foreign culture are practicing medicine for some other reason. They have a level of kindness and courtesy toward the patient that American-born doctors lack.
The nurse—standing facing me with her back to the residents—is making some funny faces that I can’t interpret. After the doctors leave she leans down and whispers in my ear, “I had never noticed that, but you are so right!”
The resident from Paraguay mentions that Dr. Megna is the head of inpatient psychiatry and I immediately want to go there. Dr. James Megna and I went around decades ago at Hutchings Psychiatric Center. I think he went out of his way to help me or did something wrong and got called on the carpet for it. (It was well before I became an activist; I didn’t file any complaint against him.) And here’s the important thing: Jim Megna, in addition to being a psychiatrist, HAS A DOCTORATE IN PHARMACOLOGY. Is he, or is he not, the best person in the world to talk to about how insulin makes me suicidal?
So the doctor from Paraguay leaves, giving every indication that she’s going to recommend psychiatric hospitalization, but it has to go to the attending psychiatrist first.
When the attending comes, it doesn’t register to me that that’s who he is. We talk some then I get mad and he walks away. And this, my friends, is why people with psychiatric disorders are homeless: doctors won’t treat them. You can have any bloody kind of hallucinations or psychoses you want to, but you are not allowed to have anger. I will bet you that the last contact a homeless person has with the system is a psychiatrist who won’t tolerate the patient’s anger. The attending psychiatrist, BTW, looked all American.
In 48 hours, Upstate has put seven psychiatrists at my bedside: two to get me off suicide watch, then two in Observation, the attending of whom said she really didn’t have anything to offer me, and she didn’t know what to tell me, and she’d been in this position before.
And oh, BTW, they all agreed that I didn’t need inpatient psychiatry. And when I asked for a therapist to see me on medical, I was told that they don’t do that. Upstate Medical Center, with its $7 billion dollar budget, 9,165 employees, and status as the biggest employer in Onondaga County, is so deeply committed to the separation of mind and body that if you are in a medical bed then you cannot get a psychotherapist to come to your bedside for emotional healing.
And at an earlier time, when I was speaking to a physician assistant in Observation, I asked about alternative therapies: did Upstate have acupuncture, massage, hypnotherapy or any other thing? And he said: “zero.”
Incredible. The last study I looked at, done by a Harvard physician, found that a third of all patients use some form of alternative medicine. (The doctor had anticipated the percentage to be in the single digits.) And of those who used alternative therapies, fully three-quarters reported that they did not tell their physicians for fear of their displeasure.
And at the National Institutes of Health (NIH), which has a budget about the size of the national debt, less than one percent of the budget is being spent on research into alternatives, and by “alternatives” we are not talking about some new-age monkey shines with power bracelets. We are talking about acupuncture and herbals and things that have been in use for thousands of years, and still are used in other cultures—in Great Britain the National Health Service will pay for homeopathy because the Royals use it.
The NIH budget is prepared and voted by rich white American-born men. Doctors and lawyer-politicians get together and set the agenda for what pleases them, which is not at all what the citizens want.