Monthly Archives: December 2006
THE FARM: AFTERMATH
You may be wondering how things ended up at Gould Farm, how I happened to leave the place, whether it was a happy or tragic ending. Certainly, the story was headed for tragedy, because one weekend on our staff-supervised trip to the village, I had headed off secretly and purchased a bottle of aspirin and hidden it in my room when I got back; we had single rooms and were not supposed to keep medication of any sort, even over-the-counter meds, in our rooms, for reasons you can probably guess at fairly readily. My intention wasn’t to kill myself. I wanted power. I wanted power in a place where I had no power. Every morning we were given our medications in little brown envelopes. Every evening we were expected to return these envelopes with the pills removed from them (taken, hopefully, by those for whom they were intended). We were not allowed to keep any quantity of pills beyond what we needed for the day, and some “guests” had to be given their pills in two or three times daily increments. For this reason, and for the reasons stated in my previous blog entry https://juliemadblogger.wordpress.com/2006/12/30/farm-living/, I, as a sovereign individual who lived and breathed and had real feelings and hurt deeply inside, felt so discounted, that I needed to have a quantity of pills in my possession to feel any sense of self-empowerment whatsoever.
I didn’t know what I would do with the pills, except that I did recognize their importance. I knew something big was going to happen, and that it would happen soon. I knew I couldn’t bear much more of the loneliness, the tedious work, the daily frustration, and mostly, the growing exacerbation of the symptoms of my illness. Something was going to snap and I knew it had to do with the pills, but I couldn’t, or wouldn’t, put two and two together….
Charles Capers, MD was a smart doctor. I needed a smart doctor, and Capers happened to be the outside doctor that visited Gould Farm once a week, and though that week I wasn’t scheduled to see him (we saw him once a month), Nancy Smith, the one nurse at Gould Farm, took me aside one Thursday morning and told me, “Dr. Capers wants you to take Lithium. I’ve put some in your envelope along with your usual Thorazine. Three hundred milligrams lithium carbonate. See if it helps.”
Dr. Capers and Nancy were the two redeeming features of Gould Farm for me, the two gems, who, in the end, saved me. Nancy listened. Nancy even hugged me a few times. Capers was a strange fellow, a Texan, but he knew his meds and was also someone, to my relief, that I could talk to about my symptoms, and he would respond in a kind way.
Imagine that you are having a blood sample taken. You roll up your sleeve, and say a few words to the phlebotomist, who applies a tourniquet and pokes around to find an appropriate vein from which to draw blood. He wipes the area with alcohol, then says, “Just a little pinch.”
What he means is that there will be a jarring discomfort, and then further discomfort as the blood is sucked into the tubes, then the test is over with and the phlebotomist will bandage up your arm and you’ll be through.
But what of the initial, “jarring discomfort,” during which you, for a nanosecond, believe you are going to die from the prick, during which you, for the next nanosecond feel an indescribable shooting pain in your arm, during the next, you see yourself fall, and come nearer, and nearer and nearer to death–all this prior to your blood entering the tubes?
What if this initial “jarring discomfort” were to last and last? What if it lasted for five, ten minutes? What if it lasted for days or weeks?
This is the stuff of mental illness.
And friends, that evening, and over the course of the days and weeks that followed while I began a course of treatment with Lithium, the needle removed itself from my arm.
So the outcome of Gould Farm was a good one for me, but not for the reasons most people thought. The environment, 99 percent of the people, and certainly the work itself were no help. It was Lithium that helped me. Gould Farm provided the backdrop, and I won’t forget that. It would have been nice if those crackerjack doctors I had seen years before Gould Farm could have tried me on Lithium, but there’s no sense in looking back on things that way. I left the farm and returned to my apartment in Vermont, where I attended practical nursing school briefly. Although the events that followed were less than fortunate, I see the introduction of Lithium into my life as one of the biggest miracles I’ve experienced.
SENT TO THE FARM!
In researching aggression in dogs, I learned that sending an aggressive dog to the idyllic “farm” is not a cure, but a myth. Such a farm does not exist.
So it is with people. In earlier centuries people were frequently sent to country settings for a “rest.” I highly recommend reading “The Yellow Wallpaper” by Charlotte Perkins Gilman about a woman sent to “rest” in such a place. Virginia Woolf, my favorite writer, was brought to the country on many occasions with a private nurse to relax and heal. The idea was that the stress of city life pushed many people over the edge–did it? I don’t know. The isolation of living in the country could do it to one, as well. Statistics bear this out.
I found out that the “farm” cure, for me, was a myth, as well, when I stayed for five and a half months at Gould Farm in Monterrey, Massachusetts, in 1984. This slideshow that I am about to show you was put together at a much later time, but it accurately describes the farm as I knew it then; little has changed. Take a peek now, then continue reading my article:
Seems ideal, doesn’t it? So why aren’t there more places like Gould Farm dotting the countryside? Why aren’t more patients enrolled in such programs?
First of all, what they didn’t tell you in the slide show was that it costs over $200 a day, out of pocket, to stay at Gould Farm. That’s right. Do your math. It’s like owning a second home. The price is on par with the most exclusive halfway houses I’ve seen. They offer a sliding scale but don’t be fooled. Gould Farm is for the rich. I mean the rich.
Patients, who are called “guests,” have to work 30 hours a week on top of paying over $200 dollars a day to stay at Gould Farm. This is hard labor, folks. I’m talking about shoveling cow shit, carting pail after pail of maple syrup out of the woods in miserable weather, mopping floors day after day, shoveling snow for six hours until your back breaks, and so on and so forth. This is not meaningful work; these tasks are menial and boring.
The speaker states that Gould farm is a place “where stigma does not exist.” Actually, Gould Farm is a place where illness is ignored. Their PR literature doesn’t state this, but once you start at the farm, you are told that you are not allowed to talk about your illness or your symptoms with other “guests,” or about hospitalizations or suicide attempts. The latter I can understand but to ignore symptoms? To pretend you’re not hurting inside? To pretend you’re normal and stuff it? You later find out that none of the staff want to talk about illness or symptoms, either. I think they are trained this way.
The slideshow does mention “treatment.” What treatment? Yes, “guests” (I hate that word) meet with an outside psychiatrist once a month. The psychiatrist comes to the farm and meets with patients for med checks, and bills the patients separately. This is the treatment. “Guests” learn to stuff their feelings, hide their illnesses, ignore their symptoms, and fake being “normal,” so they can lead “productive lives,” and this is the “healing” that the slideshow talks about.
1984: This is my fifth hour shoveling snow. At lunch I went into my room and took off my boots because my toes were killing me. I noticed the toes on my right foot were frost-bit. It’s useless to tell my supervisor. Randy S had the same problem and he was told to get warmer boots and get back to work.
Who can I talk to? It seems that the guests don’t really talk to each other or relate on a meaningful level, or have any sort of closeness whatsoever; everyone seems to be in a world of his own. I tried to strike up a conversation with Dave P, but he winced in pain when I mentioned “father.” Maybe his had died, but of course it was yet another taboo subject. Ryan H and Joy L talk to themselves all the time. I am so lonely.
I tried talking to the staff. They’re just as bad as the guests. I tried talking to Tim M about the Monsters in my head that tell me to kill myself, and Tim grunted a reply. Grunted, like an animal! Why won’t anyone talk to me?
We are so isolated here at Gould Farm. No one is allowed to have a car. We aren’t within walking distance of town, by far. They take us into the village once a week for supplies, and to Pittsfield, a small city, once a month. We are not allowed to have visitors. We are allowed home visits once a month if we can afford transportation. Once a month.
I call my parents collect all the time because there’s no one else to talk to, but they get mad at me because I’m running up a phone bill. I call them and I cry and cry: “Put me in a hospital!”
The Silver Ribbon Campaign refers to neuropsychiatric disorders, and then writes “mental illness” beside it, in quotation marks, as I have.
Which would you rather have?
I say it’s a toss-up.
Lately I’ve been feeling over-stimulated, and certainly, going to the site, www.silverribbon.org, which is about the most cluttered .org site I’ve ever seen, didn’t help matters, but folks: the Silver Ribbon campaign is worth taking a look at. The ribbon was created in the 1990’s to honor the Decade of the Brain, proclaimed by then President George H.W. Bush.
(Let it be known that G.H.W.B. was in office also when the Americans with Disabilities Act–the ADA–was enacted. Thank heavens some good has come out of that family!)
All of you know about the symbol of the Pink Ribbon, for breast cancer awareness. I recently purchased two Pink Ribbon bras–mind you they were on sale–which are, well, pink, decorated with a pink ribbon on the back, from www.onehanesplace.com. I suppose for an added $100 or so I could have purchased some bonus features like a beeper built into this breast cancer awareness bra that reminds me to keep my yearly mammogram appointment, and a “tickler” that reminds me to refrain from applying deodorant that day. Or perhaps for an added $1,000,000 I could have purchased the built-in self-examiner. But seriously, folks, if you wear a pink ribbon, everyone will understand its meaning. If you wear a silver ribbon, you might invoke some curiosity and conversation.
The Silver Ribbon Campaign supports “brain disorder” awareness, not “mental illness” awareness. Big difference here. Supporters are stating here that mental illness is a brain disorder and by continuing to call it “mental illness” we are perpetuating the stigma we are trying to eradicate. Furthermore, “brain disorders” covers more than “mental illnesses”–including autism, brain tumors, brain injuries, epilepsy, Huntington’s disease, Parkinson’s disease, and other illnesses and disorders.
How accurate is the term “mental illness,” anyway? I think it’s very accurate, even if it depends on how one defines “mental” and how one defines “illness.” I’m not going to get into definitions of each word separately because I feel that defeats our purpose here.
(Here are some politically incorrect words I’d rather not be called: ballistic, ape, nuts, crazy, off my rocker, losing it, bonkers, playing without a full deck–even if you are my friend, and especially if you are a doctor.)
Whether you want to say you have a mental illness–totally different than calling yourself mentally ill–or to say you have a brain disorder, wearing the Silver Ribbon will spark conversation and you may be asked what inspired you to support the Campaign for the Brain.
Here’s the age-old question: to tell or not to tell. To come out or to stay closeted. Let me tell you this: If you have chosen to wear a Silver Ribbon, and I say chosen, because the act of putting on this ribbon is as symbolic as wearing a crown, you must explain it to the extent that an explanation is required. It is your duty as wearer of the ribbon. To some, “This Silver Ribbon symbolizes brain disorder awareness,” is enough. Others may want to know more. You can refer them to websites and organizations, but eventually, some may want to know how you came to be connected to this ribbon.
I have a mental illness called schizoaffective disorder.
I also have an eating disorder.
I take medications, which help reduce my symptoms.
I see a psychotherapist to learn to cope with my illness, and to cope with life’s stresses, which are made more difficult for me because of my illness.
I have supportive family and friends, a warm place to live, food on the table, clothes to wear, a telephone to contact these friends and family, laundry facilities, stores nearby, the MBTA (though fares are going up in a few days), an MP3 player, dreams, pencils, a computer, and an internet connection, so I can write to all of you.
Hi folks, I thought I’d provide more proof that my apartment is clean:
This is a view of my living room, now cleared out. Note that the floor is clean but I’ve left the dog toys intact. I’ve been sleeping on the couch lately because that is what QB preferred. The couch is covered with all kinds of crocheting that I did. Of course you can see the stability ball and weights. The ugly box on top of the bookcase is actually filled with bicycle stuff. I plan to get a plastic tote box instead–looks much neater. Most of the artwork is mine except for the parrot, which was stitched by a friend of my grandmother’s, George Olsen, a sailmaker. The faded photos are of Hoofy as a puppy.
Here is the bedroom. As you can see, I’ve got not one but two bikes. One is an old (1972) Raleigh ten-speed, the other is a Burley recumbent. When I was thinner, I was an enthusiastic bike rider, and I hope to get back to it soon! To the left is my bed, covered with bags of clothes for charity. Until I cleaned this place, I couldn’t walk from the “office” (where the corner desk and computer are) to the bedroom. I had my bureau in the way. I’ve moved the bureau so that the area is passable.
Puppy will like it.
I spent all day Christmas day (sad!), the day after, and today, cleaning. I used about 40 tall kitchen trash bags and produced about ten shopping cartfuls of trash to bring outside to the dumpster, and seven bags of clothes for charity. I rearranged the furniture, cleaned everything including closets, and finally vacuumed.
I challenge anyone who thinks they had a more productive Christmas.
My plan is to get a new bookcase and some kind of rug for the center of the living room. Where I will get the money to pay for these items is still a mystery to me.
I think “Puppy” will like the new setup.
Happy New Year.
I feel very sad today. I miss QB! I can’t get the sadness out of my heart, and I can hardly wait for this “holiday season” to end. Here is a photo of my dog Hoofy, who lived from July 23, 1977 until July 3, 1987.
I found the photo today, while cleaning out my office. Handsome guy, isn’t he? No, he’s not a longhair Shepherd, he’s a Belgian Tervuren! As you can see from his facial expression, he was intelligent, alert, and sensitive. He brightened ten years of Christmases for me.
This Christmas, I have no dog to keep me company, and life seems dismal indeed. I’ve got the radio on, but I’d much rather hear a bark or two, or the jingling of keys indicating that my canine dude wants to go out. I hold out my hands periodically, expecting a dog to come underneath, wanting a petting or two. I get all kinds of junk mail from Petco, PetSmart, and other places advertising gifts I can give my dog. What can be worse than having no dog to shower with gifts?
I have saved a fair number of toys that QB hadn’t yet played with, and some that he barely touched. I have about three-quarters of a box of Iams Puppy Biscuits. These will not go to waste. They are designated for the new arrival, wherever he or she is, whenever he or she comes, and that, my friends, is my comfort. I clean the house in anticipation of this arrival. I weep seeing photos of Schnoodles, for that is the breed I will acquire, a Poodle/Schnauzer mix. I revel in making up names. (No, I will not tell you what they are, though you, dear readers, will be the first to know!) Forgive me for being overly sentimental, but there are moments when it is completely, inarguably appropriate; this is one of those times.
IT TAKES A BALL
As part of my recent spending spree, I’ve purchased a stability ball. For those of you who are wondering what one is, a stability ball is like a large round balloon, only sturdier, so that it can withstand the weight of any person seated upon it. The ball is typically 65 cm in diameter, but there are also 45, 55, and 75 cm balls. The stability ball is used for much more than sitting–it is a wonderful tool for exercise! Lie on your stomach on the ball, reach down, and do push-ups! Or lie with your shoulders on the floor and your calves up on the ball, body straight in a plank position and try holding that position for a half minute. You’ll feel your core muscles strengthen after only a few such poses on the ball. I have been using stability balls at the gym for several months, and now at home every day for about a week, and I can feel the benefits already.
But before I could work out on the stability ball, I had to pump it up. It came in a box completely deflated and folded up, smelling brand new and rubbery. On careful inspection I was able to find a hole in the ball. The pump came as a round bellows accompanied by a blue shaft, both plastic. Assembled, the pump looked like this:
Conceivably, the contraption could have been pumped by foot, but I chose to squeeze it with my hand instead, and the round bellows, which thrust air deftly through the shaft and into the receptor ball, seemed to take pleasure in my compressions. A definitive rhythm ensued. To make certain that I was pumping correctly, I manipulated the shaft, gently at first, then with an up-and-down motion, smoothly, yet with urgency and excitement, because the ball was filling now, its sides glistening, round, inviting. I felt my breath come in and out rapidly, and a feeling of warmth fill my torso. To make sure I kept up my pumping with adequate strength–for the tension was filling me now–I held the pump between my legs, rather at my crotch, and pumped the air, my breath spilling out into sound, more–more now, more, more–until the thrusting is in me and I cannot bear it another moment, and then more and more–yes, yes, yes–
They say working out raises one’s sex drive. I say it happens even before you start.
“IT’S ALL IN YOUR HEAD”
Guy D (not his real name) is treated in the emergency room at a local hospital for mania. While getting up from a chair, Guy twists his leg and feels a sharp pain in his knee. More concerned about impending hospital admission than a twinge in his knee, Guy ignores the sensation until he arrives, by ambulance, at the hospital where he is to be admitted and treated. By then, his knee is significantly swollen and he experiences pain while walking. He says to the doctor, “I think I injured my knee at the other hospital.”
The doctor responds, “What about your knee?”
The doctor, a psychiatrist, responds, “I’ll have the medical doctor look at it. Meanwhile, I’ll give you something to get your mind off your knee, some Risperdal [an antipsychotic]. And something to help you sleep.”
The psychiatrist leaves. Given that it’s a weekend, Guy won’t be seeing the medical doctor until Monday. Before he turns in for the night, he shows the charge nurse his knee. “Yes, that does look swollen,” she says. “Why don’t you go to bed now, give it a rest.”
Later, someone from physical therapy, having gotten the word that a man in the psychiatric unit is experiencing knee pain, brings up a set of crutches. The nurse sends the crutches back downstairs, saying that Guy “cannot be trusted with such objects.”
The medical doctor looks at Guy’s knee on Monday. He prescribes ice packs and Ibuprofen for swelling. He forgets to ask Guy if his knee hurts.
Again, a young fellow comes up from physical therapy with a set of crutches, and is turned away.
Three weeks later, Guy is released from the psychiatric unit.
Diagnosis: Torn meniscus, surgery required.
Diana B (not her real name) has a lengthy history of psychiatric hospitalization and drug abuse including heroin use, and is currently attending a methadone clinic. At one time she was extremely overweight and opted for gastric stapling. She lost a fair amount of weight afterward. She lives with her parents who berate her for being a “failure” at life. She has one son.
When Diana develops severe abdominal pain, she decides to go to the local emergency room. The result is as she expected: the attending physician looks at her chart, then at her, and says, “You want painkillers, right?”
“I want treatment.”
“And you want painkillers.”
“Aren’t you going to do an x-ray, or an MRI?”
“I don’t think anything’s wrong with you.”
Diana is turned away, and her abdominal pain continues to worsen. She chooses to go to a different emergency room, where the staff doesn’t know her, in hopes of getting medical care. But when Diana gives a list of the medications she takes, including a lengthy list of psychiatric medications and methadone, she is turned away again.
Finally, Diana returns to the doctor who performed the gastric stapling, and asks if he can help her. He runs some tests.
Diagnosis: dislocated gastric staple, surgery imperative.
Diana is immediately hospitalized, in a psychiatric unit. She undergoes surgery four months later.
As some of you may know, I have had trouble with eating disorders in the past. Here is a very interesting article on the causes of eating disorders. I find the biochemical aspects especially fascinating. Not everyone is alike. Patients are as different and varied as are the stars of the universe; don’t let “specialists” try to fit you into their molds of what they think a person with an ED is or should be. Speak up and be active in your care. Don’t be afraid to ask for medication if you feel you can benefit from it; I waited too long to ask and would have been better off if I had been more assertive. If your therapist doesn’t seem right for you, ask for another. Don’t waste your time with someone who isn’t right for you because you’ll never get that time back–time only moves forward! You deserve the best care. You are a good person. You deserve the opportunity to grow. thrive, and enjoy a happy life.