Recollection: Summer, 2008, probably June.
Scene: County Mental Health Hospital, Outpatient Clinic
Characters:
Jake - Me.
LaNette - A big, black, good-smelling case worker with a warm, husky voice and a wrist brace.
Dr. O - A "seasoned" psychiatrist and director of the outpatient clinic.
At Rise: It's hot. The parking lot is full. The benches all along the circle drive are occupied with the people time forgot (or maybe who forgot time?), patients of the hospital out sunning themselves and one or two "civilians", their appointments over, clutching their non-descript brown paper pharmaceutical goodie bags, having a cigarette and waiting for the bus. As I drive along past them at the specified 5 mph, it's easy to get good looks at each of them. One man's skin is so gray that it matches his hair, reminding me of Jacob Marley from Dickens' 'A Christmas Carol'. He's smoking while his oxygen mask hangs under his chin. I pass a woman in a motorized wheelchair. She must weigh 500 lbs. She's wearing a baby doll dress. Why do morbidly obese women do that, I wonder, then tell myself to shut the fuck up (I'm having a self-righteous day, a day when I believe that God is smacking me for every negative thought or emotion I have. I have these often. I always have. A week ago I bought a silver crucifix as a security measure. I needed a reminder that there is peace, somewhere, especially when my brain is having "choir rehearsal": 10,000 voices coming together to outsing my one. I just have to make it to heaven/nirvana/???). Anyway, the fat woman smiles at me and then I feel better because maybe in making myself feel bad about her I earned it. I smile back, pass a few other people, judge them and reproach myself, and turn in to a vacant space some distance from the door.
The County Mental Health Hospital looks like something out of an Alfred Hitchcock film. If it were a person it would be Vincent Price, and if it could laugh it would sound like that laugh he recorded at the end of Michael Jackson's 'Thriller'. If it were a song it would be that one from the opening credits of 'The Shining' (the Symphonie Fantastique by Berlioz?) or the theme song from 'Halloween'. It's gothic. It's bricks are the color of old tobacco stains. It has eyes and not just the feverish ones staring down from the windows. Buildings like this excite me, especially if they're musty and drafty and falling apart. I'd driven by the CMH (as LaNette called it) hundreds of times. Now I'm a patient. Outpatient. I get to go inside and marvel at its creepiness. I almost feel lucky.
The lobby of the CMH has been renovated to the point of efficient blandness. The tile floor has been restored. No other signs of the building's faded grandeur remain. I grunt and enter the outpatient clinic, which has also been cloned to match any other (and every other) government funded waiting room on the continent: white walls adorned with cheap watercolor paintings, uncomfortable chairs, out dated magazines, a faint smell of piss or vomit, and a state-of-the-art television mounted in the corner blaring some douchebag from CNN's armchair opinion on the day's events. What a disappointment.
There are only one or two other people waiting. They don't look crazy.
The air conditioning feels good.
Who am I here to see? Dr. O, I reply. He's Irish, brogue and everything. LaNette gave me the skinny on him during our brief telephone conversation 6 weeks earlier. I'd Googled him, too: an experienced mental health professional, not like my last doctor (who probably jerks off on his prescription pad he loves it so damn much) who barely ever looked me in the eye, even when I was telling him to hospitalize me (which he did). Pill pushing asshole.
Have a seat? Sure. Out dated copy of 'Teen People'? If I must. It beats television.
When you apply for assistance through the county mental health system, you become one in a seemingly endless cavalcade of needy poor crazy folk who need their meds for free and wish to be left alone. A friend, a health care professional, had urged me to "look into it" as I couldn't afford much else. She was confident that the county program was good, the staff small but helpful, the waiting list for services long but worth getting on. My friends, my family, were all very supportive. They wanted me to get better, to be well, to get the medical attention I obviously needed but couldn't afford. I was 36 and couldn't hold down a job. I couldn't remember to take my meds. I was prone to isolation and suicidal thoughts. I was also a public figure in the local arts scene, highly lauded for my talents, respected and sought after and a bit of an enigma as I didn't appear to give a shit about any of it anymore. The decline from "on top of the world" to This had been subtle this time around. It had taken three years to get Here, and now I was stuck. I looked up and saw a recent past full of accomplishments and happiness and true love and real friendship. I looked around and saw that it had all turned gray, blurry, like a reflection in a filthy mirror.
I didn't want to perform anymore.
Those people hate me. They sit out there and they want me to fuck up. They're wondering why in the hell I'm up there in the first place. Who am I? Why do I sing like that? I can't act. God, I'm ugly. If I smile they'll see my crooked teeth and...
Push. Pull. Push. Pull...
Wait a minute. These aren't my friends! These people are using me. They're not here for me. How dare they not call for two weeks and then have the audacity to casually ask, "What's new?" when they see me again! Like I could give them a sound byte and catch them up in 2.2 seconds? Real friends would be around to witness your life. I want to be alone right now. I want to sit in my closet in the cold, perfect darkness and forget. Why weren't they there for me? I don't answer my phone because I don't want to. Ah, you have a new girlfriend and she's more important than our friendship... I see ... Yeah well my relationship was recently put through a meat grinder because of my manic bullshit... I know, it's a drag to have to hear about it AGAIN but anyway... I know I'm a burden... You don't have to say it, I said it for you... Push, pull, push, pull, push...
A Day in the Life had been...
Wake up. Rehearsal. Nap. Rehearsal. Rehearsal. Commercial shoot. Rehearsal. Fly to Chicago for an audition. Rehearsal. Produce own show. Rehearsal. Pay bills. Rehearsal. Love and laughter on the phone, through notes left under windshield wipers, through the blessed silence of a long stare. Rehearsal. Drinks. Relax. Smoke a joint. Relax... doodle... dream... be.
A Day in the Life had become...
Wake up. Didn't sleep worth a shit. Want to sleep more. Self medicate. Don't leave the house. The world is filthy and it hates you. Sleep. Sit in the closet. Did you hear about that athlete who drank antifreeze? Sounds painful. Killed him quick, though. Hm. Isn't there some antifreeze in the garage?
Something had gone wrong, that was clear. But what? No, no. No more taking pills just for the sake of taking pills. Let's mine for that black bile, that melancholia, that demon. Let's expose it this time, not dilute it. I felt ready. The care was affordable, even free to some. I had faith in my new doctor (such credentials!).
Nowhere to go but up, I thought, and stood as the nurse called my name. I had butterflies. I was equal parts anxious and terrified, like you feel on a first date. Seriously. So much seemed to be riding on this. . .
-PAUSE-
I'm a smoker. Why do you need to know that? I'll tell you why: because even though I've been smoking one pack of Camel Lights per day (with mild to moderate crossovers into American Spirit territory) for the past 20 years, I still have to rehearse the transaction scene in my head before I get out of the car at the convenience store. I have to look at who is working. Do I recognize them? Is it that chatter box with the frontal lisp who never seems to know what my "Give me the fucking cigarettes, lady" look means? Is it the perpetually new guy who makes a career out of every transaction? Will I be required to speak, to react, to say anything more than "May I have two packs of Camel Lights, please?" during my visit? Other than the obligatory, "Thanks, I don't need a receipt," I always hope not. I have anxiety attacks whenever I'm out in public, and most especially when they involve new situations or surroundings or meeting new people.
Can you now imagine how anxious I must have been to meet Dr. O that day in the summer of 2008, when I hadn't worked in months and had been suffering from a near nervous breakdown from the effects of near total isolation; when I had stopped taking my meds because somehow The Machine just knew I was trying to feed it something disagreeable; when I had been looking forward to finally meeting with a trusted expert in the field of mental health and not just my usual general practitioner?
I was entering the county's own paragon of mental convalescence!
I was putting all of my eggs into one basket.
-PLAY-
On the homepage of the "CWH" website, it says the following:
Our Mission is to ... provide high quality, comprehensive mental health care for the underserved of D County.
Our Vision is to ... be the best provider of mental health care in the community.
Our Values are... providing care that is:
- patient centered
- respectful
- accessible
- culturally competent
- financially responsible
having a staff that maintains:
- integrity
- confidentiality
- clinical expertise
having an environment that is:
Please take note of the "culturally competent" and "respectful" parts...you'll need to refer to them later...
It also says:
At (CMH), we are committed to offering non-judgmental, adaptable services that transition as you do. We look forward to working along side you to facilitate maximum potential for a healthy and sustainable lifestyle.
(I added the bold typeface.)
So I walk into what appears to be a conference room, one the color of mint chip ice cream, air conditioned to the point of perfection, and there sits Dr. O at the end of a long table, writing something on a yellow legal pad. He looks up when I enter. I immediately shake his hand.
His handshake sucks.
Uh-oh.
Dr. O is very dismissive. He's busy. I've clearly interrupted him. Even though I waited ten minutes and was called/walked back by a nurse, I have tread upon his nerves. I gulp, I sit, I see LaNette sitting at the other end of the long table. Her teeth radiate from the cool shadows.
"How you doin'?" she asks.
"Good, good," I reply, full of new optimism. "How are you?"
We chat clumsily about the weather and other things and after a few minutes the doctor begins paging through my file, reading parts of it aloud.
"Hmm...pot smoker, huh?"
"Yep."
"Joints? Bongs? Spliffs?" he asks, then pauses. "Betcha didn't think I knew what that last one was, did you?"
Now let's get something clear here. The banter you are reading is not coming from Wilford Brimley over a piping hot bowl of oatmeal. This guy is not only being dismissive, he's acting like a condescending prick.
Play along, something says behind my left eye. Be agreeable. This man is the gatekeeper to...
"Hospitalized in 2001?" Dr. O continues, eyebrows raised, brogue lilting over the waves of condescension in his tone.
"Yes."
"Holed yourself up for three weeks...smoked pot...drank a six pack a day..." He clicks his tongue. He actually clicks his damned tongue at me. "Still a practicing homosexual?"
And that's when something punched a hole in my ozone layer, grabbed me by the guts and yanked them through to China.
Did he just...?
No.
Yes.
"Yes."
From that moment on I left the room. My spirit managed to find a reservoir for the tears that had begun to well up in my eyes immediately after Dr. O'd asked the question.
I would no longer be requiring his services.
Apparently LaNette had "left the room", too.
I just now thought about Googling what the American Psychiatric Association has to say about homosexuality being a mental disorder. I thought about it right after I relived that moment with Dr. O again in fast forward, only this time I stood up from my chair and asked the good doctor:
"What the fuck do you mean, old man? Are you still a practicing mick?"
I don't know if I could ever say the "mick" part out loud, but in my mind it's totally justified and his reaction to it is priceless.
So anyway, as you can see I did not copy and paste the Psych Association's stance on homosexuality into this post. I don't need to. I don't argue that point anymore, not with anyone. I don't even entertain "nature vs. nurture" debates. I can't. I've had it. You're either on the right side of things or the wrong side, and if you feel the need to debate someone's sexual orientation then you are on the wrong side. I don't need to answer "Yes" or "No" to an unnecessary and poorly asked question like the one the doctor posed. Not anymore.
I am a person living and suffering through something known as bipolar disorder. I went to the CWH for help. Dr. O was assigned to treat me for bipolar disorder. Had he done his job, Dr. O might have made great progress with me. Had he done his job, Dr. O might have made another hard won fan of the county health system out of me. Instead, Dr. O succeeded in making me feel even more freakish than bipolar disorder and homosexuality have made me feel my entire life. He also succeeded in somehow, in some way, making me a stronger person and a more outspoken patient.
Dr. O did not show any cultural competence or respect during my brief yet definitive visit that day. As I've said, I had left the room long before that. Even before I stopped by the pharmacy for my free meds. If he or LaNette or I made any breakthroughs (which I doubt we did as I seem to remember the doctor remarking that during our next visit we'd be "sweeping out the attic") I can't say. I can say that my visit to the CMH did not live up to its mission statement.
The CMH director promptly received a letter from me outlining my visit with Dr. O and subsequent outrage. He urged me to come back, to let them show me that they really did help people, and I acquiesced. I did not see Dr. O again, however. My last visit was with a woman whose name I can't remember. She refilled my prescription and off I went.
I am once again seeing a GP at a local university clinic for all of my health needs. I make small monthly payments as I still do not have health insurance, even though I am employed full-time at a private school.
In closing, and for the record, I will copy/paste this from (oddly enough) the CNN website (3/11/09):
(CNN) -- The nation does a poor job in the ways it serves its mentally ill population, earning a D, according to a report card issued Wednesday by an advocacy group.
Three years ago, the National Alliance on Mental Illness (NAMI) gave the United States a D for its mental health care system for adults. The new report, it said, shows only marginal progress -- not enough to warrant a better grade.
Additionally, a "major dark shadow" looms as downturn-forced state budget cuts are threatening such care, according to NAMI.
"Ironically, state budget cuts occur during a time of economic crisis, when mental health services are needed even more urgently than before," NAMI's executive director Michael Fitzpatrick said in a statement. "It is a vicious cycle that can lead to ruin."
NAMI is the nation's largest grassroots organization. According to the group, one in four Americans experience mental illness at some point in their lives, and it is the greatest cause of disability in the nation.
Yours,
Jake
P.S. God didn't smack me down for the thoughts I had about Dr. O on the way home that day.
