Tuesday, May 24, 2005

Leave all this? What are you, crazy?

“Orr was crazy and could be grounded. All he had to do was ask; and as soon as he did, he would no longer be crazy and would have to fly more missions. Orr would be crazy to fly more missions and sane if he didn't, but if he was sane he had to fly them. If he flew them he was crazy and didn't have to; but if he didn't want to he was sane and had to .”

-- Joseph Heller

If you came to visit the locked ward where I work, you’d likely be surprised by the number of patients who don’t want to leave—who, in fact, refuse to leave, and must almost be pried out with a crow-bar. Are they crazy? I don’t know. It’s really not such a bad place, here. It’s bright and clean, and someone else does the cleaning. The food is hot and good (so they tell me—I’m not allowed to eat it. I bring cold, bad food from home.) Lots of varied activities and outings. Instantaneous medical care, even for trivial problems. Superbowl parties, World Series parties, birthday parties, dances, concerts, and magic shows. Compare this to the “real world” many of my patients experience when they leave: Crappy apartments in bad, crime-riddled neighborhoods. Neighbors who taunt them because of their illnesses. Days or weeks of waiting to see a doctor when they have health problems (yep, same as you and me). Limited transportation. Only whatever meals they prepare for themselves. No birthday parties. And so forth. So, you can see how people who value comfort, security, and sociability over personal liberty and self-determination may be reluctant to walk out the door. And that description fits a large chunk of humanity.

Every week, I am compelled by the Administration to submit a list of my patients, indicating which have met the criteria of “clinical readiness for discharge” and remain hospitalized only because they are homeless. “Readiness for discharge” is essentially the absence of the things that precipitate hospitalization: dangerousness to self, others, or inability to care for oneself. So every week I struggle with this question: If someone is behaving appropriately, eating fine, sleeping well, pleasant with others, going on trips to Wal-Mart and mini-golf, taking her medications, not threatening suicide or homicide, and generally appearing to be a model citizen—BUT tears up every housing application or rental assistance form I put in front of her, and refuses permission for us to talk to landlords or outpatient agencies—should that person be classified as “ready to go, but unwilling”, or is that person, by definition, still crazy? Is the desire to remain, unnecessarily, in a mental hospital a priori reason that someone is not mentally well? Or could it be that, under the circumstances, wishing to stay in the hospital is the most sane and rational decision— and, as such, evidence that a person is ready to go?

Wednesday, May 18, 2005

Open Letter to Mr. Blogger

Dear Mr. Blogger:

I am writing to complain about my treatment here at blogspot.com. Some while back, you began rejecting my submissions, without comment. Each post I attempted to place on my blog resulted in long delays, blank screens, and error messages. This abuse went on for weeks.

Now, I understand that “my” blog isn’t really “mine” anymore than “my” house is “mine” (currently, “my” house is 13% mine, and 87% the bank’s.) BUT, this is no excuse for throwing my efforts in the dumpster.

Finally, things got so bad that my fans or fan decided I must have abandoned my blog. Then, when I wasn’t looking, a friend commandeered my blog altogether. Yes, yes, I gave her the password (she already had keys to my/the bank’s house, so I figured, what the hell.) And, in the final straw, some anonymous someone suggested today that maybe I ceased writing because I feel unloved. Unloved! That, Mr. Blogger, is the level of crumbled despair to which you have reduced me. Now I am standing up. I want my dignity back! I want my ego back! I want my love back! I WANT MY BLOG BACK!

Thank you for your attention,

Turbo G.

P.S. Isn’t it sort of funny, when you think about it, that the bank lets me give keys to the house to anyone, without their permission? Shhh….

Thursday, May 05, 2005

I Have Taken Over This Blog

I will only turn it over to Turboglacier in return for copious amounts of Chartreuse.


So the other night most of my neighbors— ten or twelve people from six or seven houses— had a meeting to discuss recent goings-on at two other houses nearby. In attendance were the same good folks who show up whenever there’s a neighborhood issue; we all know each other by now. Lots of others don’t bother to come; they are probably the ones not terrified of threats to property value.

Anyway, I was vaguely aware of some troubles from, and between, the two houses in question. One early morning last August a woman in bathrobe and slippers came out of one house and began screaming up at the second floor of the other. The text of her monologue is too vulgar to post here, but the gist of it was that she (first woman) felt the other woman to be lacking in intelligence and other desirable qualities. As proof, she cited the fact that she (second woman) probably didn’t even know that her husband had spent the previous night engaging in intimate relations with her (first woman). She withheld this fact, though, until the very end of her rant, as if it were the clinching evidentiary fact in an elaborate legal argument.

So that was all very amusing, and there were other similar incidents which I paid little attention to. In October I gladly sealed up my windows and haven’t thought about those people since. That is, until I arrived late at last night’s meeting, to hear one of my neighbors—a petite, quiet mom of two little kids—finishing a sentence with “… and I guess when I really got disturbed was the day with the machine guns.” Apparently, some sort of hostage-like situation had happened a few weeks back, and the SWAT team came swarming down the street. Earlier, the same woman reported, she had called to report possible drug-dealing activity. The police asked her to call the DEA, and the DEA told her to be on the lookout for a large, tall man driving a rental car with out-of-state plates. If she saw this, she was to make detailed observations and call them back.

I’m not sure you can picture where I live. There are a bunch of renovated older houses, on two dead-end lanes that sort of abut each other, We have mostly nice professional-ish people, and a lot of lilacs. We don’t have much gunfire. But apparently I’ve been too busy at work to notice the crime wave (or, for that matter, to post on my blog.)

Well, we had all kinds of help at this meeting. Our local police officer was there, as well as the Community Policing representative. Our city councilor was there. The head of Public Works was there to discuss with us about sprucing up the street. These officials were all supportive and responsive (well, except the officer, who chastised the mom-neighbor for her reluctance to get involved with drug-trade surveillance: “If you want this taken care of, you can’t just cower in your house and hide!”)

We all felt bonded, neighborly, and safer. We drank wine and coffee. We brought up other problems of mutual interest: Who owns that red car that’s always blocking the way? What’s that smell of natural gas people have noticed? It turned into a bit of a where-have-you-been-all-winter springtime block party reunion. We caught up on recent vacation exploits, summer plans, job changes, and child development. I learned that the three-year-old next door knows my name and asks after me frequently. Overall, it’s almost worth having the SWAT team on your street if it results in a neighborly experience. Especially if you’re at work the day the machine-guns come through.