Admission: A Story of Solidarity and Survival

Mike Alvarez
23
1014

As soon as I walked through the sliding doors I heard a scream. The EMT escorting me from the ambulance didn’t seem fazed by it, but I could feel the hair on my arms and neck rise, as if electrically charged.

The nurse manning the front desk asked me to sit, so I did. She disappeared behind a wood panel door. Minutes later, she reappeared with a white Styrofoam tray. “You look hungry,” she said, placing the tray on my lap. “Why don’t you eat while we get the paperwork started?”

I looked at the tray’s contents: apple sauce, buttered bread, turkey with gravy, chocolate milk. They reminded me of grade school, of childhood’s simplicity. When I peeled the plastic wrap, I noticed there was no knife, just a spork, napkin, and straw.

The moment I dipped the spork into the apple sauce, the piercing scream returned. This time, it didn’t stop. There was no mistaking it; the scream belonged to a child.

I imagined a boy no older than eight: helpless, pinned to the ground by two orderlies, his voice the last remnant of his agency. Terror-stricken by the sight of a needle in gloved hands, the boy would kick and flail and then yelp when needle finally broke skin.

I almost lost my appetite.

The scream turned into quiet sobs until all I could hear was the compressor churning in the nearby water cooler. The boy must be sedated now, lying in a pool of urine, saliva trickling down his chin. His hands and face, his white T-shirt and trousers, would be caked with feces — or so I imagined.

The silence was unnerving. I looked in the child’s direction but concrete walls obstructed my view. Powerless, I resumed eating. The apple sauce was runny, the turkey dry, and the bread stale, but I wolfed them down all the same. For weeks I’d eaten nothing but crackers and soda.

The nurse returned with a wooden clipboard. “If you could just sign these when you’re ready.” I looked over the forms, reading only the bold and italicized letters before signing away my claim to normalcy. The fluorescent lights overhead lost their intensity, the white walls their glow. Even the pervasive smell of hand sanitizer was suddenly neutralized.

My perceptions no longer belonged to me. Here, I would be told what I was seeing, thinking. Feeling.

*

I was admitted to a mental hospital after I attempted to end my life. This was a decade ago, when I was a junior in college. As a freshman, I suffered from fits of anxiety, constantly afraid that my actions would endanger others. Once, I thought that the Snapple bottle I’d dropped in the middle of the street would puncture tires and cause cars to slam into each other. Another time, I found a box of matches on the bus, and upon touching it, imagined the bus exploding. Somehow, my mind insisted, I would be responsible. I was literally the crazy person on the bus that afternoon.

Over time, my anxiety exploded into horrifying, persecutory delusions. I thought my actions were under constant surveillance — that the white van outside my dorm had tapped my landline, and that the men inside the van had cameras drilled into the walls and ceiling. They sought evidence to incriminate me for the unspeakable crimes I’d never committed. Never had I felt so alone.

One day, I decided that enough was enough. I tried to ram an X-Acto knife into my throat, the same knife I’d been using to cut my left arm whenever I felt like I was about to burst. Fortunately, I fell unconscious, and I woke up the next morning, unscathed, with the knife still in my hand. When I revealed this and other suicide plans to my psychiatrist, she immediately called the hospital and, with my consent, had me admitted.

It became apparent to me upon admission that I would not get the help I was seeking, at least not in the form I’d expected.

“Do you eat three meals a day?”

“Do you get eight hours of sleep?”

“Has college been stressful?”

“Has work been stressful?”

“How often do you think about dying?”

“How often do you think about suicide?”

I was asked the same questions over and over, as if the doctors didn’t have my case history in their folders. I felt like a piece of data, with a backstory that bore little or no relevance, another person to plop into an existing profile or mold. They asked me “yes/no” questions and “how often” questions because “why” questions weren’t on the checklist as they were too open-ended. But why is what really matters. It’s what stands between yes or no, happy or sad, by the fence or in the river.

The impersonal processing continued during Vitals at six every morning. On my first morning in the adult unit, I woke up to a nurse’s loud bellow: “Time for vitals!” The nurse banged on my door, then the doors across the hall, until she’d banged on every door in the unit.

The sun had not yet fully risen. All I could see between the metal bars outside my window were slabs of dark blue, broken up into smaller squares by the wire mesh. I put on my only pair of socks, a black pair with pin-sized holes. I slipped my feet into my shoes and my arms into the sleeves of my trench coat, which I had used as an extra blanket the night before. The doctors and nurses always turned down requests for extra blankets. They said something about patients making nooses, which didn’t make sense because one blanket was more than enough. Nights were especially cold as a result.

A single-file line snaked its way to a chair in front of the nurses’ office. When my turn came, I took a seat on the chair. “Lift up your sleeve,” said the orderly. I pulled up my right sleeve. “No, no, the other one,” she said. I wasn’t comfortable with people looking at the dozens of cuts on my left arm. They begged too many questions, elicited uncomfortable stares. “Well, what are you waiting for?” the woman finally snapped.

The orderly took my blood pressure and temperature. She didn’t look in any way perturbed. She wrote the measurements on her clipboard — 98.6 and 122/60 — and without looking into my eyes said, “Next.”

*

Inside a mental hospital, one experiences a dilation in time. Every tick of the second-hand becomes more palpable when you are waiting for the announcement that you’re ready to be discharged. It may come tomorrow, it may come weeks from now. The wait can be maddening.

But time flows differently when spent with company. It quickens. You wish you had more of it. Or perhaps it would be more accurate to say that the protraction of time in a mental hospital hastens the formation of friendships. Friendships, after all, are our bulwark against the slow dread of isolation. They’re a necessity in maintaining our sanity. It was the other patients, not the staff, that paved the path for my recovery.

I experienced that spark of human connection when I was sitting in the dayroom one morning, struggling to hold back tears. I had promised myself that I wouldn’t let others see me at my weakest, but the reality of my unreal situation was finally getting to me.

Suddenly, from across the room, another patient made his way towards me. It was Glenn, a half-American, half-Korean guy with broad shoulders and red streaks in his hair. I hadn’t realized I was outwardly distressed. “What’s wrong, Mike?” he asked.

Bottle it up, I chastised myself. Don’t let him see your moist eyes. But as soon as I covered my face, my tears emptied onto my hands.

Glenn sat next to me, putting an arm around me. Soon, other patients were gravitating towards us, and before long there was a huge tangle of bodies. In the dreariest places, the smallest display of compassion can become a beacon.

“You shouldn’t sit too close,” I said. “I don’t want any of you getting into trouble because of me.”

“Screw the rules,” said Glenn.

“Yeah, arm’s length my ass,” said Gertrude, a short black woman with an infectious smile.

These same people stayed by my side when I was told by a staff member that I wasn’t on “the list,” which meant that despite my best behavior, I still didn’t have Level 2 privileges. No eating lunch in the hospital cafeteria. No going out for fresh air after lunch. My newfound friends stayed in the dayroom with me, eating soggy pancakes instead of barbecued chicken until I finally made it on the damn list.

But my time in the unit was not all bad. There was also laughter, plenty of it. Mischief became our glue — enough to irritate staff members, but not enough to get ourselves into trouble. We came up with names like Humpty Dumpty for the egg-shaped doctor, Square Face for the expressionless nurse, and Pincer Hands for the lobster-like resident who always clutched his clipboard. We did not dare address the staff by these names of course, but the childish giggles they provoked amongst us raised a few eyebrows.

One particular staff member was the target of much contempt. We called him the Mole —  because he looked like one, and because he was always spying on our activities. One afternoon, as we were waiting for group to start, the Mole entered the windowless classroom.

“Today, we’re going to talk about the food pyramid,” said the Mole, fumbling with the stack of handouts under his arm. To our dismay, he was that afternoon’s facilitator.

“Again!” exclaimed one of the more seasoned patients, an elderly woman knitting an afghan. I understood her frustration. The day before, we had to listen to the importance of drinking eight glasses of water per day, which I could never recall doing.

“It’s important to eat lots of fruits and vegetables,” continued the Mole, “like spinach, broccoli, mushrooms, and….”

“The mushroom isn’t a vegetable,” Tamara interrupted. “It’s a fungus.”

“Excuse me?”

“You heard her,” said Gertrude. “Fungus. F-U-N-G-U-S. Fungus.” I loved the way she enunciated each syllable, how her shoulders see-sawed up and down, how each letter was accompanied by a snap of her fingers.

The word “fungus” made the Mole cringe, as if someone was telling him for the first time that he’d been eating diseased toenails. He shook his head in utter disbelief. “No, no, that can’t be right.”

“But it is!” Tamara, a biology major, took the painstaking effort to explain what makes the mushroom a fungus. “First, mushrooms don’t have roots, stems, or leaves. They have filaments. Second, they reproduce through spores, not seeds. And third, they’re not green because they don’t have chlorophyll.”

I was impressed with her intelligence and clarity. So were the other patients. But the Mole wasn’t having it. “Well I don’t believe it,” he said firmly. He didn’t believe it because to him, Tamara was just another madwoman.

“Someone suffers from delusions of omnipotence,” Gertrude said in sing-song.

“More like impotence,” I muttered under my breath.

Laughter.

I looked at the Mole. He looked right back at me. His face had turned puffy and red, like the tomato he’d said was also a vegetable.

Childish as we were, humor was a survival tactic, a means of turning our private despair into communal laughter. If we could make the space within the unit’s dismal walls our own, then we could someday reclaim the selves we had lost.

*

I didn’t think being released from the mental hospital would be a sad day, but it was. And that day was inevitable for everyone. It was customary, but not required, for outgoing patients to attend group one last time, so I did. I wanted one final chance to say goodbye to my friends.

The staff member leading group passed around a stack of index cards and a bundle of no. 2 pencils. “I want each of you to write three goals for today,” she said. “Three realistic goals.” She looked in my direction. “If today’s your last day, leave the card blank.”

The patients wrote as I sat in my chair, watching. Then one by one, they read aloud each item on their list.

“Sleep for eight hours straight.”

“Eat a full meal.”

“Speak with my family.”

“Attend all groups.”

“Take a hot bath.”

“Win a game of poker.”

“Write a new poem.”

And so on, and so forth. I’d never felt so excluded. My time in the hospital was up. There was nothing left for me to do, no goal for me to write. All I could do was listen to the words lengthen the distance between me and the people who, in a short period of time, I’d come to call friends.

Walking through the sliding doors, the same ones through which I’d entered, I felt like a neonate that just exited the birth canal — unable to stand on its own feet, frustrated with its inability to walk, and confused about its place in the world. In the weeks and months ahead, I’d find that I had even less in common with the ordinary people surrounding me, the difference being that I was institutionalized and they were not. I had to recreate myself from the ground up, to reassemble the pieces sundered by my so-called mental illness.

It has been said that every person with a mental health condition has their own destiny. Winding up behind institutional walls was my destiny. Had I not, I wouldn’t be alive now. I survived not because I received excellent care from the staff on the ward. On the contrary, the treatment was far from excellent; it was objectifying and cold, not at all what a human being who’d lost all sense of human connection needed. It’s not surprising that many end up in suicide behind locked doors.

I survived because I felt, however fleetingly, my experiences mirrored by others. Knowing that our burdens are shared by another, even if we don’t speak of these burdens, can make this impersonal world we live in a little less dark and lonesome. In meeting others like me, I learned to have faith; faith to become so much more than my condition.

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23 COMMENTS

  1. Thank you for this. As I read it I realized that it was like you were describing my very experience when I was held in the “hospital”. Like you, my real treatment was given to me by my fellow “patients”, acceptance, concern, compassion, empathy. Like you I ended up in the “hospital” because I tried to kill myself. The reason I decided to try and live was not because of anything that the psychiatrist said or did, but was due to the care that I received from the people who lived with me on the unit. I will never forget the night that I was alone in the men’s tv room with my head dejectedly down on the table. I heard the door open and someone walk into the room but didn’t look up. All of a sudden there was a hand on my arm and a voice I’d never heard before telling me, “Hey man, it’ll be ok; everything will be all right”. I looked up into the face of the young man who never, ever talked on the unit! I was totally amazed. And he was right, everything did become ok in the end.

  2. Reading this helped me to understand that I was a “frequent flyer” because I found companionship in these horrible institutions. Not with any of the cold, distant paternalistic staff, but with my fellow inmates.

    I remember the forced injection and restraints, the “quiet rooms”, the endlessly repetitive groups of nearly fatally boring content (meant to be a “treatment component”), the smell of disinfectant, the herding of inmates through a tunnel system (because I was indoctrinated when state hospitals were still a thing)…
    I am so very, very glad that you found a way to keep your identity intact through this and teach me and allow me to remember how awful it all was and, thereby, to appreciate how good my life is now. Thank you!

  3. Fantastically written, very moving testimony! As always, it is love and compassion and shared humanity which heals. Perhaps the psychiatrists and the mean staff have never had this experience themselves and are in need of some hugs from the residents/inmates, who appear to understand far more about “mental health treatment” than the staff does!

    • But if the “inmates” ever tried to hug a staff person they would be in trouble because then they would be “breaking boundaries”. It’s always interested me that staff can break our boundaries all the time in all kinds of various ways and never get called down about it. But if a “patient” ever reaches out and actually touches a staff person it goes into their charts that day as unacceptable behavior. We have a band system where I work (ding, ding…..it’s time to salivate now dogs) based on behavior modification and touching staff can get you a band deduction pronto, no questions asked. People with lower level bands never get to leave the unit for other places like the gym, or going to the canteen for the weekly treat.

      • I have always thought that “boundaries” have become an excuse for avoiding genuine human interaction. And you’re right, they have also become a power exercise for staff who have big control issues. I find it pitiful, as genuine human contact appears to me to be the #1 antidote to “mental health disorders.” The whole industry is corrupt and disturbed. They are the ones who need healing!

        • I agree with you one hundred percent. To hug us or to ever interact with us on a truly human level whereby real connections were created and maintained would open them up to the possibility of having to look at their own “messy stuff” inside of themselves. So, it’s simply easier to claim “boundaries” and never have to see us as real human beings.

          I believe that the only way true healing takes place is through the making of human connections, knowing that someone cares about us enough to sit with us in our difficulties.

  4. “If today’s your last day, leave the (goal) card blank.”

    That says it all. Release, not captivity, is when your REAL goals – not your “realistic” goals – begin, yet psychiatry didn’t give a fuck about them. Fortunately, it sounds like you have a lot of goals today. Good on you for not letting psychiatry kill them all.

  5. Great article Mike. Thanks for sharing this. Everything about that place sounds cold and depressing except for the “patients.” There has to be a better way. Real food. Real knives and forks. Compassionate staff. No vitals at 6 am. No forced treatment. Extra blankets. A nice facility. Unrestricted access. Open door policy. I’m sure you could design a better place. That line about the fungus is really funny. You’re an excellent writer.