A Night in the Psychiatric ER

by

06/13/2004

462 1st Ave, New York, NY 10016

Neighborhood: Manhattan

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It’s like this: I’m bipolar. Manic-depressive. Heavily medicated and mad as a hatter when I’m not. I have had so many days of smelling colors and hearing lights, so many brushes with the law, that I have gathered up the stories and been given the go-ahead by a young, hip literary agent to write the young, hip, bipolar memoir. I am an MFA-toting poster child for the displaced, tattooed, weird-haired, psychotically depressed, dubiously artistic, and terminally fucked-up.

And so it was that I spent a night in Bellevue.

I will attempt to give you the Reader’s Digest Condensed Version of the events that brought me there, will refrain from going off on one of my favorite rants and excoriating the American health insurance system, or lack thereof. Suffice it to say that I hadn’t taken my Depakote, the mood stabilizer that keeps me from thinking I’m a winged pink extraterrestrial capable of leaping from the Williamsburg Bridge (which is, in a cruel twist of New York City sublet fate, just outside my front door), for a good ten days. Why? Because, after two years of pretending we were still married in order that I might remain covered by my ex-husband’s shitty HMO, the powers that be discovered our deception, and unceremoniously cut me off. This left me working as a body piercer, struggling to crank out a book proposal, and resorting to sordid and illegal acts (the subject of another story altogether) in an unsuccessful effort to pay $450/month for the drugs that make me fat and sleepy.

You can pretty much see where this is headed, but in the name of gory details, I’ll continue.

One day, shortly after scraping together that month’s installment of my exorbitant rent, I found myself with no more Depakote and three dollars to my name. Fast-forward a few more days of equivalent financial despair, and after a bout of sleeplessness comparable to a David Blaine stunt, I found myself in the back of an ambulance, my skin covered in obscenity-laden Sharpie-marker poetry, being told by a well-meaning paramedic that I was a very pretty girl and I should really just try to smile a little bit more. Although this should have been my first big clue that I was a one-way passenger on the Anne Sexton express, I was at the time too whacked out on the Trazodone procured from a heroin-addict friend to notice.

They wheeled me into Bellevue at 11:17 pm. After sitting next to a man gagging on a piece of steak for about ten minutes (and being treated to a running commentary on the exact location of said piece of lodged meat from the three bored triage nurses), I was taken through a series of progressively grimmer and more finger-smudged double doors to the psychiatric emergency room. There I was besieged by a guy who told me his name was "X" and demanded I give him my sweatshirt.

"Why?" I asked, frantically tapping out Icicle Works’ "Whisper to a Scream" on the linoleum with my foot. I’d been watching the new wave channel nonstop for three days, and I had three different songs running through my head on rotation.

"Because you could strangle somebody," said X. "Or somebody could strangle you."

"I have no plans to strangle anybody or be strangled," I said, but he persisted, and when he also reached for the scarf tying back my hair, I took both off and threw them at him.

Nothing mobilizes everygoddamnbody at Bellevue like throwing something at Staff. Three orderlies came at me out of nowhere, snapping on purple Nitrile gloves in record time. "Okay," X said, his eyes asparkle like the Marquis de Sade in scrubs, "you’re getting medicated."

In a flash of rapid-fire negotiation, I promised to take Ativan by mouth if they would just get someone to give me some fucking Depakote as well. A paper cup with one white pill was shoved into my hand, I was given a cup of water, and I was told that the Depakote was negotiable based on my behavior.

And therein lies my fundamental problem with psych wards: depression is seen as a condition for which one should be punished, swiftly and severely. I have never been in inpatient treatment where bedside manner was a concern. It’s more like a hierarchy of replicant sadists, with the (inevitably white-haired male) doctor trailed by a waterfall of nurses, then med students, then orderlies. As one descends each tier of the mental health inferno, brutality is more and more inextricably compounded by ignorance, until one ends up as I did, being wheeled roughly down the hall on a stretcher by an attendant in Fubu, who declared to another (purple nails, labret piercing), "She shoulda gotten a fuckin’ needle in the ass."»

I spent the next four hours on that stretcher, in that hallway. Beside me a woman who bore a more-than-passing resemblance to Chloris Leachman snored and whimpered in her sleep. In front of me a Chinese girl with disheveled pigtails folded and unfolded a page from a magazine, sobbing and cursing in Mandarin. I watched her cry for a good long time before an attendant came to see what was the matter. He sat on a stool at the foot of her bed, studied her with his hand on his knee and his elbow in the air, and at long last offered up his professional opinion and pronounced her a Crybaby. A moment later he was joined by a nurse who lay a folded sheet on the stretcher (pillows, I would later learn, are not permitted in the loony bin at Bellevue), pushed her down, and made a quacking-duck motion with her hand.

"Do you know what this means?" asked the nurse. "Boo-hoo. Boo-hoo. Troublemaker."

"Please," I asked, "could you stop talking to her like that?"

"She don’t understand," said the orderly.

"She don’t speak English," added the nurse.

At some point in the night, though I hadn’t yet been given my drugs, I was given a private room. I had a serious headache from the insomnia and crying and Depakote withdrawal. The pressure inside my skull had built to a crescendo punctuated by the persistent, slaphappy rhythm of XTC’s "Mayor of Simpleton," and I proceeded to barf all over the floor. Repeatedly. The only thing I’d managed to eat or drink all day was a bottle of cranberry juice, and as I was projectile-vomiting a red stream comparable to the elevator scene in The Shining, the aforementioned white-haired leader of psychiatric nephilim stopped by and stood in my doorway.

Now, let me pause a moment here to put this situation in context. This man had a half-dozen underlings and a brand-new manila folder to tell him what was wrong with me. I had, by this point, been in the hospital almost seven hours. They had talked to me, poked and prodded me, taken my blood and urine. There were, at his fingertips, approximately seven million ways this man could have found out what my deal was. But there in the hallowed halls of John Berryman’s home away from home, he looked down at me, shook his head, and said, "Drug addict."

The following morning, when I had stopped puking (we are now at fourteen hours without Depakote and counting), I decided to approach this man about his therapeutic method. I was put off for two more hours, at which point I caught him in the hallway, was told to wait for him in the patient lounge, and sat watching incredulously as he got his bag and jacket and walked out the door and disappeared.

That day, I watched as the Staff ate their take-out pancakes (patients were given individual boxes of Cheerios and slices of Wonder Bread in individually-sealed packets.) I listened to their ongoing critique of The Day After ("That scene with the guy? And the little boy? Where the guy tells the little boy they’re all gonna die? I woulda kicked him in the nuts,") and pondered the state of mental health care in America today. It took me seventeen hours to finally get my Depakote, and when, on discharge, the social worker handed me a weekend’s worth of pills, she made sure I knew that "99.9% of doctors would NEVER do this for you. You’re really getting treated like royalty." At that point, I had been called an addict, been stripped of my clothing and assigned a pair of pajama pants that wouldn’t remain snapped, and made aware with no small eyeroll that my request for a Styrofoam cup of water was a major inconvenience.

Were the snippy, heavily glottal-stopped exclamations of annoyance I heard flung about so freely in Bellevue specific to New York, where those who talk to themselves are a dime a dozen? Is so-called psychiatric care so far removed from the Hippocratic oath that we approach it with the same no-nonsense, move-‘em-in-move-‘em-out mentality that governs the rest of our interactions on this island? For basic geographical reasons, I can’t compare Bellevue to some sanitarium in Wisconsin, but I have my suspicions.

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