Dis Dat and da DSM IV

I see the journey, the path I have taken like the wake of a great ship.

The other night as I crawled into bed I had a weird phenomenon. It was not a flash, not a lightning strike. There was no veil, no sharp pain. Lying in bed though, my eyes closed I saw a hundred tiny lights, like a night sky full of stars. I have never seen this before and they remained for almost a minute before they faded away. I don’t know what caused it, crawling under the sheets, bouncing a bit to get in a comfy position. I used to worry about everything and I would sit and evaluate any anomaly. Sometimes I would discover a new detachment or whatever was going on would simply fade away. I used to ask my doctor about them all. I just don’t worry about these things as much as I used to. Its a quick deal to see if there is a new detachment. Once I do this I just move on.  There has been the slow march of inevitability with my vision and bad things just keep happening. Its like falling. You can only fall so many times before you actually injure yourself. I hate it but there is nothing I can do about it.

I moved to the main hospital, a 150 bed medium sized all purpose jack of all trades hospital where I became slightly responsible for a small part of it, the 28 bed third floor psychiatric unit. It had a pretty crappy reputation but I was part of a small group, director of nursing, program manager, new unit therapist and me the intake coordinator hired to make it better. Being in the hospital was a huge advantage, less overhead, less pressure.  As an intake coordinator I worked some pretty odd hours, hung out in the emergency room way too much evaluating people and taking crisis calls which ultimately I got pretty good at taking. It is not the job to be a suicide hotline or a therapist. The job is to get them to come in for an appointment where they can be evaluated and you can either admit them or refer them. Intake calls could be funny, could be sad could even be scary. I spent ninety minutes one night with a person who said they had a shotgun and it took me that long to figure out they had no gun they just wanted someone to talk to them. Ultimately I hung up on the person and I did warn them that if they did not want to set an appointment I was going to do it with the admonishment that they could call the suicide hotline. For every call like that I also had one of these.

Ring Ring

ME: “yada yada blah blah how can I help you?”

Caller: “Yea man, my friends said I should I call you”

MS: Noticing he sounds wasted, “What’s going on?”

Calle: “Yea we were doing some Freon, you know huffing.”

Me: “Uh Freon, like for your air conditioner?”

Caller: “Yea anyway I did it and my friends say I passed out and sort of stopped breathing and turned blue for a second or two.”

Me: “Wow, did you call an ambulance?”

Caller: “Well we weren’t sure the Freon caused it, lots can make you stop breathing right? So I thought I would try it again and yep it happened again. Do you think it was the Freon?”

Me: “Yes I am pretty sure it was the Freon.”

“Caller: “What should I do?”

Me: “1. Stop doing the Freon. 2. go to the emergency room immediately.”

Caller: “Oh ok thanks.”

I learned a lot about stigma and just complete disregard of emotional pain. I had a nurse tell me they always could tell if someone was paranoid because they would not look at them instead looking at a place behind them. If they turned around to see what you were looking at then they were paranoid. I called the guy an idiot.  I shared that with an ER doctor and he called the nurse over and confirmed the story and also called the guy an idiot. I loved the emergency room.

I also ran a lot of groups. Technically I was responsible for the anger management group but in those days patients were in the hospital for five days or so and it was impossible to really run an anger management program. In the hospital I ran for the first time into a weird phenomenon of people who worked in the mental health field who had once been helped by the mental health field. This was especially true of addicts. I do not particularly have any problems with addicts, or recovery. In treatment though addicts tend to be a strange group who believe that only other addicts can possibly help them, can possibly understand them. The recovering addicts who work in the field tend to fall into two groups addicts with many year of recovery and addicts with only months of recovery. There seems to be little middle ground.  So one day a patient asked me how many years of recovery I had and I replied that I was not an addict and he walked out of my group which was not an addiction group.  When the group was over I followed up with the patient and we had a really nice discussion until a mental health tech walked into and berated me because addicts only could be helped by addicts. I had a few problems with this, one, it is not true, two it was done in front of another patient and three DON’T DO THAT. I took the high road and asked this tech to come into my office where I proceeded to tell her that it was my experience that you should never discount people who wanted to help. I was effective with Schizophrenics yet I was not a Schizophrenic. She said clearly you are not an addict. I said that was true and that I was proud that I didn’t have any addiction that it was a horrible disease  that took a lot to recover from. She wanted to argue with me and I stopped her. I told her that my real issue was not her beliefs but that she had argued with me in front of a patient and that if she ever did that again to me I would make sure she never worked at the hospital again. I did not know I had this power but I said it like I did. She walked away in a huff and I spoke to he program manager and she never came back.

Whatever you believe my experience tells me that it takes all kinds. If you discount people because they don’t have the same experience as you then you are actually limiting yourself, cutting down your chance of making it through whatever it is you are dealing with. There is a reason I became a social worker. I believed and still do that it s a calling, that only a few people can do. I have never met a social worker I didn’t just love.

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