Counterpoint Winter 2018 • Commentary • Page 22
By Phoebe Sparrow Wagner
In May 2014, mute and psychotic, I was taken to the emergency department of Connecticut’s New Britain General Hospital, also known as Hospital of Central Connecticut.
More than a couple of years have passed since then, so instead of relying on memory, I will use what I wrote shortly afterwards. Some of this has been taken from the secret journal I kept in that hospital, a journal that I was forced to scribble on pieces of torn-up brown paper waste-basket liners, surreptitiously mailing them to a friend the moment I finished writing.
I had to do it this way because a housekeeping staff member had told me that nurses instructed her to throw out everything in my room, including my mail, each time they found a reason to seclude me, which was nearly every day, and sometimes more than once a day.
But before I was admitted, I came into the emergency department by ambulance, having been given the “either the easy way or the hard way” choice by the police. I did not resist or fight, nor was I restrained in any way in the ambulance.
I was mute, which had deeply concerned my visiting nurse, and I was mostly passive. I merely handed the EMTs my medication sheet and my detailed but clear psychiatric advance directive. On this document was vitally important information about my trauma history and how to deal with me in a crisis, including provisions for when I might be mute.
Even though I spent many hours on it, psychiatric advance directives are virtually worthless in the state of Connecticut, and doctors can and do ignore them freely. Much as Vermont doctors do.
The first ED nurse’s note reported that “patient arrived via EMS after VNA called for increased anxiety. EMS reports patient refused to speak but wrote down, ‘Sunglasses block hate. I don’t want to hurt anybody.’” (Sunglasses are “hater-blockers” yes, but they block other people’s hatred. The RN never got my point, and I was mute with no way to communicate the distinction.)
“On admissions patient refused to speak to this RN. Patient pointed at her head when asked why she was here. Patient nodded ‘yes’ when asked if she was hearing voices but refused to answer other questions.”
At 15:19 another nurse wrote:
“Patient not responding verbally to this nurse, this nurse looked through her art book and placed it back on her stretcher then patient picked it up and slammed it down on the stretcher and pointed her finger at the book. Unable to get patient to communicate. Patient pulled sheets over her head. Patient still in street clothes, will patient [sic] as is until examined by MD.”
What is not said here is that this nurse never asked me whether she might look at my art book. She just took it. She refused to allow me any other means of communication besides speech. When I was unable to obey her, she did not inquire as to why I did not speak nor apparently did she attempt to make inquiries from anyone else why this was so. If she had provided me with means to write, I might have been able to tell her what had happened in the previous two weeks at home.
Instead, she appeared to become angry and from then on refused to permit me any mode of communication other than the one she preferred. I was later given a hospital gown and told to dress myself or I would be forcibly assisted in doing so.
The RN then recorded what happened after a meal was given to me that I did not eat, as it was not vegetarian.
“Patient ate nothing [but she] wrote messages with ketchup and French fries, [saying] ‘I need a crayon.’ This nurse told patient she needs to speak because she can, patient threw everything on her table on the floor, food juice, etc. Patient then picked up fries from the floor and started eating them and gathered more and putting them in the bed with her and kicked the other food away in the observation area.”
“Patient went to the bathroom, seen coming from the BR with paper towels then observed writing with her finger on a paper towel with something, first thinking it must be ketchup, then maybe jelly, then this nurse go up to check and patient found to be writing with her own feces, some paper was able to be removed, other paper with large piece of BM patient threw at this nurse.
“Pt moved to room 42 [seclusion] then patient got out of bed and snuck around corner and tried to attack this nurse from behind. Patient to be medicated and restrained. Patient licking feces off fingers, would not let nurse wash her hands.”
In point of fact, I never attacked or even tried to attack her or anyone else. The timeline written in the chart does not even make sense.
What really happened was that due to my need to communicate, I wrote my needs with ketchup on the paper box the meal came in. Then that, too, was taken away from me, and the nurse came up to me and instead of speaking to me, handed me a NOTE she had written (the irony of this is beyond belief!) saying, “I will not speak to you or give you anything to write with until you start speaking to me.”
At this point, I was livid and also so desperate to write I had no choice but to use whatever I had at hand. So, I went to the bathroom and had a bowel movement and took some feces back to my cubicle and I tried to write journal entries about what was happening to me on paper towels.
This did not go over very well with the nurse or anyone else. But I never attacked her or even tried to assault her. Instead, she snuck up on me and snatched my art book out from under me and raced away with it, holding it up in triumph as she did.
I was so furious that without even a thought as to possible consequences, I raced up behind her to get my book back. That was all.
I never assaulted her, I never so much as touched her. She suggested as much when she wrote, elsewhere in my chart, “Public safety was able to get to patient first.”
The two guards, holding me down in room 42, decided they wanted an excuse to four-point me, and though one of them cautioned that they had no reason to do so, the other one told him not to worry, “We’ll find a reason.”
Later I learned that they had invented my attacking a nurse as justification.
The admitting doctor never asked me what did happen. He never tried to find out the real events of that evening, he simply designated me as manipulative and “volitional” – a “borderline.”
He had already conceived an intense antipathy towards me, so by the time he came by to see me on the W-1 psych unit the next day, he had made the decision not to let me communicate by writing. Therefore, his intent right from the start was not to let me tell him what was going on.
I was to be admitted on the basis of his judgments from a single evaluation during which I could not communicate in any fashion, from which evaluation he drew the diagnosis that in addition to schizophrenia, I had a probable “borderline personality disorder.”
He spoke to no one in my family nor my longtime nurse or doctor nor my friends – and he did not even hear from me, yet he drew the snap conclusion that I had a personality disorder?
On what basis? How could he possibly diagnose a personality disorder, seeing me in such traumatic circumstances and for a few minutes only?
In point of fact, what likely happened was that he took a disliking to me and diagnosed me with something that in his mind justified his later egregious treatment of me, and in particular justified his not allowing me to write instead of speak.
I cannot otherwise explain his behavior. Nor can I understand his astonishment at my response when I did not react well to punitive ministrations. Did he think I would respond positively?
But there are hospital policies that hurt everyone, not just me.
I want to explain what “deserving” seclusion or restraints and being “violent” at the New Britain hospital meant in 2014. I also want to tell you something else even more important: In Connecticut, the staff at almost every psychiatric unit or hospital says something like, “We only use seclusion or four-point restraints when absolutely essential, when a patient is extremely violent, and cannot be controlled in any other way.”
Trust me, I know. They said this sort of thing to me in every hospital since 1985, including hospitals in Vermont.
But what you need to know is that they are not talking about some 400-pound man hopped up on PCP, waving a machete. No, they are talking about someone like me.
So, let me tell you about me. I turned 62 years of age in November of 2014. I am 5 feet, 3 inches tall, and until I moved to Vermont, I weighed maybe 108 pounds on a good day. I have been consistently described as “poorly muscled.”
Not only was my right shoulder injured by staff encounters at New Britain’s general hospital, but I before I was hospitalized there I was unable to use my left arm for much of anything.
Okay, so am I truly violent? What did I do to deserve hospital brutality? Or should we say, their “protective measures”?
This same doctor, director of psychiatry there, wrote of me that “while in seclusion or restraints patient would often scream.”
The doctor further claims in the chart that he repeatedly “asked if patient would like to speak to him, please,” but what he fails to note is that he refused to permit me any possible mode of communication and when I could not utter a word, he peremptorily walked out on me.
He noted that, yes, I threw my bed-clothes at him, but failed to mention that he would not acknowledge my gestures or try to figure out what I wanted to say. Instead, he stood up abruptly, turned on his heels and left.
I admit that having already been secluded, four-point restrained and forcibly sedated in the ED, and then called a liar when I denied that I had ever assaulted the nurse, I was upset at being unable to make him stay or attend to me.
So, I did the only thing I could do to make noise. I got up off the bed, which was the only furniture in the room, and slammed the door after him. I meant only to make a noise to express my frustration, but unfortunately it caught him in the shoulder.
His reaction was itself swift and violent in the extreme, and extremely personal. Enraged, his face went beet-red.
“Seclusion! Seclusion! Restraints! Restraints!” he bellowed. Before I could assent to walk there, I was bodily dragged down the hall by my injured shoulders to one of the most horrifying seclusion cells I have ever seen.
There were two, each locked from the outside, completely barren and cold except for a concrete slab of a bench set into the wall, with a plastic mattress on it. Nothing else. No commode, no bedpan, nothing but two cameras in the ceiling.
They shoved me inside, locked the door and the outer door, then walked away.
I urinated on the floor in my panic. I took off my clothes. Wordlessly, I screamed – wanting someone to talk to me. I wanted warm, dry clothing to wear, but there was no response.
I did what I had to. I knew what would happen, but I was freezing with the A/C on full bore and at 108 pounds and a history of frostbite I could not tolerate it. Furthermore, with neither a watch nor any clock on the wall, I had no inkling as to how long they were keeping me there. It might be two hours or 20, or it might be three days.
I took the johnnie I had removed and rolled it into a rope and tied it around my neck. I didn’t want to die. I just wanted someone to come in to check on me. Then finally I would be able to beg for a blanket.
The intercom did crackle to life eventually, and someone spoke. “Take that away from your neck. Now.”
Still mute, I gestured to indicate I was freezing: “I need something for warmth!” But this was a battle I was destined to lose.
Eventually, but not so quickly as to show that they had serious concerns about my safety, guards and nurses entered the room, bringing a gurney. Grabbing me, they hoisted me onto it and without even covering my nude body, they locked me into leather restraint cuffs, in a spread-eagle position, despite my groans of pain and protest.
Then to cap it off, they refused me a blanket. Someone tossed a small towel over my private parts, and that was all.
I was summarily injected with three punishment drugs ,and an aide was positioned at the door. Then the goon squad trooped out.
I howled in wordless rage. The aide just looked away. Exhausted, I finally quieted and I tried to signal my desperate need for water and for warmth.
Even when the aide finally acknowledged my requests, which I mimed with difficulty from the restraints, she stated that a blanket was unsafe, a pillow unnecessary and that it was my own screaming that had made me thirsty. So I would get nothing.
The experience of being shackled to a bed in four-point restraints or being isolated by force in a freezing seclusion cell is universally terrifying.
Nevertheless, both such a cell and/or four-point restraints are quickly employed to curb “undesirable behaviors” at New Britain General Hospital.
Staff literally forced me (“escorted me”) to seclusion and/or restrained me multiple times. Male guards stripped me naked “for safety’s sake,” and even though I put up no resistance, the same guards four-pointed me, separating my limbs into a wide-spread-eagled position – a visual rape they clearly enjoyed – then they shackled my arms above my head and my ankles open wide.
I did not resist. I did not say a word. But they put their hands around my neck and squeezed tight while the nurse injected me in the buttocks.
Is it any wonder that what resulted was someone who would wash her hair with her own urine, defecate on the floor of her 24-hour-videotaped bedroom and smear feces on the wall?
Yet the esteemed director of W-1, the general psychiatry unit at New Britain General Hospital, claimed that my trauma was imaginary.
Why? Because treatment cannot be traumatic, so he contended. He simply never got the connection between my horrendous decompensation and his so-called “therapy.”
Maybe he never appreciated that he was torturing me, like a person who ripped the wings off butterflies as a child. Someone like that would not have understood how those creatures suffer either.
I moved 150 miles away to a different state shortly after being released. My concern is for the people who are still being tortured on that unit. I did not leave my home of 60 years just to forget about this. Justice must be served in order for change to happen.
It is often claimed that we long ago left behind the days when psychiatric patients were stripped and beaten with a birch rod as “treatment,” but after what happened to me from the 1980s to 2016, all I can say is to that is: Have we? Have we really?