Monday, May 9, 2016
The Happiness Hotel
The first thing I see when I open my eyes is the flickering, flat screen TV mounted high on the wall. My eyelids are heavy and I don’t know if it’s day or night. I crane my head forward and squint, hoping to find the time on the TV screen, but it’s a chore. I lay my head back down on the pillow, wondering why I’m in a hospital as I succumb to sleep.
My body jerks, waking me from a nightmare. I’ve been in the hospital roughly a week, but this is the first time I’m actually aware of my surroundings. I now realize I’m in here because I downed a bunch of sleeping pills in an attempt to end my life. It’s my second failed attempt in a few months and I’m anything but happy that I lived to see another day attached to this screwed up head of mine. In an ideal world, they would open up my skull, find the faulty wires in my brain and replace or reroute them. To get to that hypothetical point, however, we’d have to experiment with the brains of living people and that practice is considered unethical. Instead, we go to therapists and talk about our problems so they can speculate on what is wrong with us. It’s like trying to fix a car without looking at the engine. So, here we stand in the twenty-first century, treating the most important and misunderstood organ in the body as though we were stuck in the Middle Ages. I contacted several neurological researchers prior to my second attempt, offering up my brain for whatever radical procedure they could concoct. I told them I would waive my right to sue. They wanted no part of it. One researcher suggested I call a suicide hotline. If they ever find a cure for what ails me, it certainly won’t be in my lifetime.
A police officer enters my room. I should know by now from my previous attempt that he’s here to transport me to a psych ward, but my head’s still foggy. The task of getting up from my bed to sit in a wheelchair is far more difficult than I thought. The deputy wheels me to his patrol car and helps me get in the backseat before driving away. My nerves, as always, are shot. It doesn’t help that the officer stares at his dashboard-mounted laptop more than the road. He pulls into a facility I’ve never been to before. As he escorts me inside, he tells me he’d be glad to drive me to my upcoming court appearance. I can’t, for the life of me, figure out why I have to go to court. Before I can say a word, he quotes me a price of $160 for his court transportation services. I laugh because he can’t be serious. “That’s the going rate,” he says. He is serious. I assume everyone knows I’m broke.
I sit in a small room next to an administrator. “Do you have any thoughts of harming yourself or others?” she asks. It’s a question I’ll hear repeatedly during my stay at this particular psych ward. I always answer ‘no,’ cautious of the consequences that come with an admission that I do, here and there, have thoughts of harming myself or others. I answer more questions and fill out forms before the administrator gets up to leave. I wait and wait as they process me into the system. I’m tired and growing agitated. Finally, a hospital staffer leads me to a door where he swipes his badge that allows us into a facility that I can’t leave until they say so. I go to my room and fall asleep instantly.
A knock at the door wakes me up the following morning, way too early. It’s my court-appointed attorney. Why do I need an attorney? Is it considered a crime in the state of Texas if you attempt suicide? He leads me to a room and closes the door behind him. He fills in the blanks, but I’m still half-asleep. I think it has something to do with whether or not the court finds me to be sane or insane. Several years ago, I tried to get power of attorney over my mother. I spoke with a lawyer who asked me if she was sound of mind. “No,” I replied, thus ending all hopes I had of making decisions for her, legal or otherwise, despite the fact that I’m her son. The “system” is seriously broken. I’m distressed that I’m heading in the same direction as her, regardless of the steps I take to prevent it. “How long will I be in here?” I ask my attorney.
“Not long,” he says. “We like to call this ‘revolving door therapy’ because once the taxpayers and the insurance companies see how much it costs, they want nothing to do with it.” I wonder how the taxpayers and insurance companies would feel if they knew how much it was going to cost by setting me and my fellow patients loose on the streets? Being that my head’s not right, this place, so far, is a necessary step for me as a transitional phase. The only problem is - what am I transitioning to? My roommates don’t want me back after my latest attempt and I can’t say that I blame them. The last time they saw me, I was crawling around on all fours claiming to be possessed, at least that’s what I was told.
The room I have to myself is short-lived as they move a new patient into the bed next to mine. They have me on fifty milligrams of an antipsychotic medication. My new roommate is on the same medication only he’s taking eight-hundred milligrams. I’m shocked at the amount he’s on. He tells me he may have shot a man while on this medication, but he’s not sure. I’m skeptical. The low dose I’m on puts me to sleep. How can you possibly function, much less shoot a man, while taking that much medication? The answer comes a half hour later as he proceeds to dress himself as though he can come and go as he pleases. He looks under the bed and asks me what I did with the suitcase. He’s convinced that a relative is here to pick him up. I can see the lights are on, but nobody’s home. Through no fault of his own, he can’t be reasoned with and he’s not going to sleep anytime soon. Either way, they have him on way too much medication. Out of all the people here, I will come to like this guy the best. He’s a good guy. He’s just straddled with a brain that no one in their right minds would choose. And, yet, there’s no shortage of individuals in our society who view mental illness as a shortcoming, despite the fact that our knowledge of the brain is limited. I have no idea what’s going on inside his head, but I need some sleep. I ask the staff on duty to put me in another room. They go to my room to check on him. They take one look at him and agree that I should be moved. Once again, I have a room to myself. I fall asleep for a couple of hours before they wake me up and rush me back to the room I was in before, minus the roommate. A new patient is on the way and I have no idea why I have to be moved to make room for this individual. The lack of sleep is making me less sane than I already am.
The fact that it’s Christmas Eve is lost on me, save for the cupcake and cider we get as a gift. My immediate concern is the future because, as of now, it has no clear definition. I could’ve been released today, but I have nowhere to go and nobody wants to take in a 44-year-old with no money who has tried to kill himself twice in the last couple of months. The last time I was in a psych ward, I wanted to leave. Now, I have no other choice but to try and stay here as long as I possibly can. But, as always, I will find a way to sabotage that.
Other than medication, the only way to cure what ails you mentally, according to those who work here, is to attend the many group therapy sessions they put on throughout the day. Treating mental health as a “one size fits all” program is not the right approach. Some people are better left alone. Be it a good day or a bad day, group anything is not for me. A few days removed from trying to kill myself is a definite no-go. Arts and crafts; coloring; yoga; music therapy in which someone breaks out a guitar and sings to us - none of this will help me transition to a future of uncertainty. My arguments against group therapy fall on deaf ears. In fact, the more I refuse to go, the more they try and push it on me. In this place, group therapy is the Jonestown Kool-Aid and I’m not drinking it… that is, until I get hungry. They offer snacks for participating in “group” and when I show up after group is over, the snacks are all gone. So, I begrudgingly sit in on one. The discussion descends into a conversation on race that makes me wish the government would place a moratorium on the subject. The individual running this session is powerless to gain control over the situation so group therapy comes to an abrupt halt. This isn’t a free government-run program, mind you - this is a private institution that I will get billed for.
The following day I speak to a therapist. “Do you have any thoughts of harming yourself or others?” she asks.
I look at her and yawn. “No,” I say. This time, I’m telling the truth. The problem is, the answer to that particular question fluctuates throughout the day. They do have me on medication, but psychiatric meds can sometimes take four to six weeks before they actually work right. Time is not exactly on the side of those with mental problems. I ask her a question regarding my insurance. She confesses to me with a shrug that she doesn’t even have insurance of her own. There’s a dirty little rumor running through psych wards that, if you own really good insurance, they will milk every last dime of it before sending you on your way. If, however, your insurance isn’t so good, your time in the psych ward will be limited, no matter how crazy or dangerous you may be. And why would a for-profit company keep you there if they’re not being paid? I’m all for capitalism, but for those with mental issues, it’s a bad business model.
“How do you feel about the future?” she asks.
“I don’t have anywhere to go when I get out of here, so I don’t have a future as far as I’m concerned.” My answer irritates me and I direct that irritation towards her. “If this place was really professional, it would be more concerned with me not ending up on the streets rather than have me doing arts and crafts or yoga or some other mindless bullshit that’s not going to help me.”
“What are you talking about?”
“Group therapy - it’s fucking stupid.” Coming off a suicide attempt and being holed up in a mental institution leaves you with the feeling of having nothing to lose, thus you tend not to overthink the words coming out of your mouth, even if they are childish.
She jots down something in her notepad and looks up. “What would you like to do?”
I’m stunned. No one has asked for my input, thus far, because only the people who work here, apparently, are qualified to know what’s best for me. “I’d like to write.”
She pauses for a moment and then nods. “Okay.”
My mind is now occupied with a pencil and a small notebook, courtesy of my therapist. Day and night, I write and edit like there’s no tomorrow. This is interrupted, of course, by the drumbeats of group therapy. “You cannot stay in your room all day,” a nurse tells me. “It’s not healthy. You should go to group therapy, it will do you some good.” I voice my displeasure with group therapy and the nurse ignores me. No matter how many times I refuse to attend, they still show up at my door and ask me if I’m going. Hunger, once again, gets the best of me. I want a snack. I enter the group therapy room and head straight for the snack basket. I grab two granola bars and stick one in my pocket. I eat the other one. I pick up a container of juice and swig it, before reaching for another. I grab a pack of cookies and put that in my other pocket. I dare someone to call me out. What are they going to do? Tell me to never come back. I sit down and prepare myself for group. Before the therapist can utter a word, a patient enters the room, yells something unintelligible, and slams the door behind them with the force of a hurricane. My nerves shatter and fall to the floor. I get up, dejected, and leave the room. I ask the nurse to give me something for anxiety.
“Why did you leave group therapy?” she asks, dumbfounded. Now would be a good time to ask if I have thoughts of harming others.
“I’m busy,” I say, when asked if I’m going to attend group therapy. I don’t even bother looking at the individual who asks me that question. The hunger in my belly tells me to grab a few snacks, but I won’t give them the satisfaction. Another knock at the door irritates me as I know what’s coming - a tech peeks his head in the door and asks me if I coming to group. I shake my head.
“Okay,” he says, “but, just so you know, when they see you’re not going to group, they’re going to assume you’re okay and send you on your way.”
I shrug, emphasizing my displeasure. He closes the door. I’m furious. I take his words as a veiled threat. There’s something more behind this group therapy bullshit. Is his bonus dependent on my attending group therapy? Are the health insurance companies pushing it? I get up and pace the hallway, waiting for the moment when group therapy ends. As the session comes to a close, I watch as the participants scurry over to the snack basket and pluck it until it’s empty. I enter the room and ask the tech to take my blood pressure.
“Sure,” he says, “give me one second.” I follow him as he enters another room and fiddles with the blood pressure machine. He asks me to sit down as he places the cuff around my arm. The results speak volumes as my blood pressure is through the roof. Madness and f-bombs spew from my mouth. I want to take the blood pressure machine and break it like an electric guitar, but there are handicapped patients nearby. I storm off to my room.
I take a break from writing and take a shower. As the warm water washes over me, I’m suddenly struck with suicidal thoughts. Hanging myself would be the only possible route to leave here in a body bag, that is, if I don’t botch it again. They already confiscated my shoelaces, as well as the drawstring from my hoodie. I have sheets on my bed, though. I inspect the shower area for a potential site where I could tie off a bedsheet. Once I’m out of the shower, I inspect every corner of the room. I get on top of the heating unit and run my hands over the rail that holds the blinds. A thought enters my head. I get down from the heating unit and write it down before it disappears forever. My suicidal tendencies are pushed aside, for the time being, as my mind is distracted by the need to write.
A knock at the door, once again, wakes me up at the crack of dawn. Do any of these people work in the afternoon or evening? It’s a young lady who introduces herself as my therapist. “You don’t look like my therapist,” I say.
“Yeah, she’s away on vacation for the holidays… anyway, uhm, I see you haven’t been going to group and I don’t think you’re ready to be discharged just yet, so I think it would be best if you were kept here a little longer, okay?”
I nod my head, relieved, though I’m taken aback as her answer completely contradicts what I was told previously.
“Do you have any thoughts of harming yourself or others?”
The nurse hands me the medications I take in the evening. I take the anti-psychotic pill she gives me and place it under my tongue before swallowing some water. I go back to my room and remove the pill from my mouth and place it on the bedside table. I would rather write than fall asleep right now. I stay up way too late before finally taking my pill and dozing off. I’m roused from my slumber by a patient screaming bloody murder down the hall. The staff rushes to her room only to find that she wants a snack. This routine will repeat itself throughout the night as the staff indulges her each time. I’m wide awake the following morning as another unfamiliar face claiming to be my therapist enters the room. She starts to say something before being interrupted by another piercing scream down the hall. She calmly waits for the scream to end before informing me that I am being discharged.
“Wait, what? - They just told me yesterday that I was fine - I mean, I’m not fine. That’s what they said. I’m no good. I need to stay here.” Words are flying out of my mouth way too fast to make any sense. I catch my breath. “You can’t just tell someone they’re not okay to leave one day and then discharge them the next. I have nowhere to go.”
“They told you yesterday you weren’t leaving?”
“Who told you that?”
“My other therapist.” She looks at me with genuine concern.
“Okay, give me a few minutes and I’ll try to figure out what’s going on.”
Hours pass before I see my therapist again. She leads me to a room and closes the door behind her. She confirms my suspicions that insurance is behind all this, that is, they will no longer pay for me to stay there.
“Can you call your roommates and ask them if they will take you back temporarily until you get back on your feet?”
“They’re not going to take me back, trust me.”
“What if I called them?”
“Okay,” she says, as she gets up from the chair. “I’ll give them a call and you go call your employer to see if you still have a job.” Before I can say a word, she exits the room. She’s putting the apple cart before the horse. I need stability in the form of a roof over my head before I can even think about going back to work. I need money to pay for my medication because this place isn’t going to supply it. I will be nothing short of a disaster without medication, but that’s of no concern to this place. She returns to tell me what I already know. She apologizes and gives me a voucher that will allow me to stay one night in a homeless shelter downtown. From there, I’m on my own. And I’m not the only one who will get the boot on this particular day. They will discharge patients who have serious medical conditions. They will discharge another who, in his own words, is a danger to society. All of this will be done to bring in new patients who have resources in the form of insurance. How else will this facility make money?
As I exit the hospital, still wearing the blue paper-thin scrubs administered to me, the head honcho reminds me that I still have an outstanding balance that needs to be paid. I question him as to why I was told yesterday that I needed to stay here longer, only to be discharged today.
“We feel like you are well enough to leave,” he says with a big grin on his face, never once mentioning that insurance, not my mental state, is the reason for my sudden departure. I shake my head and exit a facility that seems to be more dysfunctional than its patients. I will call my last lifeline - a friend from work - and ask if I can stay the night. He tells me I can stay until I get a full paycheck, which puts my mind at ease. My future is filled with uncertainties, but it’s nowhere close to what many of my fellow patients will face. It’s a realization that makes me feel both lucky and sad.