D for Dungeon

SCGH

I sat there in shock, as a psychiatrist told me I would be admitted to hospital – voluntarily or otherwise. The hospital had a bed for me, and I was to get there as soon as possible.

Sure I’d been down, and sick…but…was I really that bad?

I was told I could choose between the psychiatric ward at my local hospital, or a ward in the states only stand alone public psychiatric facility. The state psychiatric facility houses a forensic unit which probably contributes to it’s bad reputation. Additionally, there had been reports of nurses being stabbed by patients, patients being killed by staff, successful suicides on site.

“Bedlam! Absolute bedlam!” I thought. Did I want to be be admitted to a hospital whose official title used to be the “Insane Asylum”. A hospital that resulted in the neighbouring suburb officially changing it’s name so it wouldn’t be affiliated with the facility. A hospital which, to my uneducated knowledge, only REALLY CRAZY people went to?  Hell, no! I wasn’t crazy. I just needed a few days to get my medication sorted out.

So “The Dungeon” it was.

I drove home, called my husband, and started packing. Ironically I already had a suitcase packed, for the national conference I was supposed to be speaking at the following week. I took out my high heels and hairspray and replaced them with pyjamas and a pillow. That  cut deep.

Later we arrived at the Emergency Department. I walked up to triage and whispered “I’m here to be admitted to the, um, psychiatric ward.” I felt so ashamed. Such a failure. This was self stigma at its finest. It’s funny how I prided myself in wanting to take action against mental illness stigma – even choosing a PhD in the topic. Yet when I became unwell I immediately stigmatised hospitals, my illness and myself.

I was kept in the emergency department for some hours. I answered question after question, about my oesinophilic gastroentoritis, my bipolar disorder and my state of mind. I was given a white gown and a hospital bracelet. Eventually a bored looking nurse came to transfer me to the ward.

“D’ya want a wheelchair?” She asked, snapping her gum.

“Oh, no thanks.” I answered.

“Ya sure? It’s a long walk.”

“No.” I said firmly. Actually I was sick, tired and weak from the physical illness. But I wasn’t going to let anyone take that last shred of dignity I had.

The nurse wasn’t kidding when she said it was a long walk. We walked and walked in an awkward silence for what seemed like forever. Up and down halls, through corridors. Finally we reached “D” block where the ward was located. But to my surprise we had to walk down a flight of stairs to access it.

THE WARD WAS IN THE HOSPITAL BASEMENT.

It got worse when we arrived. The ward was dark and dingy. The carpet tattered and stained. Walls were peeling and in need of a good lick of paint. There was a concrete courtyard in the middle of the ward, with a few lonely benches. The nurses station looked weather worn, and contained by a large glass window ( presumably to keep us crazies out). No one came to meet us. No one was at the nurses station. We sat on a shabby couch for ten minutes waiting for something to happen.

It took all my self restraint not to run screaming.

To put things in perspective, although the main hospital was old, it was clean, refurbished and friendly. The medical unit next door to the ward boasted leather sofas, plants and stylish decor. It was made abundantly clear the priority did not lie with mental health. (Thankfully, now, a new mental health unit is being built within the hospital – however this does not explain the lack of care The Dungeon was supplied over the past thirty or so years).

When a nurse finally arrived I was given a brief tour of the ward. Bedrooms, a dingy TV room with a plate full of apples individually wrapped in plastic (plan for licking each apple indiviudally: foiled), a locked medication room…and that was about it. I was shown to my room, which I shared with three other women, said my goodbye’s to The Hubster, then got into bed.

applesscgh

This is just for a few days. I told myself. Just to get my medication sorted.

The next morning I overheard a man talking on the phone, trying to describe to his friend how to get to the psychiatric ward.

“You go down the main hallway…it’s like, forever, man. Walk until you reach a dead end. Then take the stairs. Down, not up. We ain’t got no higher ground here. We’re block D. D for Dungeon!” Then he laughed heartily.

D for Dungeon. I liked it.

Little did I know that The Dungeon would be my home for the next nine weeks. 

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Purple Gloves

Incarcerated again.

My hospital in the home team came on Saturday, and were not happy with how my mental state was progressing. After much angst from my behalf, the decision was made for hospitalization. I refused to go back to The Dungeon, so they admitted me to the state psychiatric facility, which, ironically, is far more modern and clean than The Dungeon.

I was admitted as an involuntary patient and assigned to 1:1 obs. I fell asleep in the cell like room that those on 1:1 supervision have. Suddenly I woke up with a team of nurses entering the room wearing purple gloves.

“what the bloody hell now?” I thought. In my experience, nurses in purple gloves generally mean unpleasant physical examinations.

But no, they ransacked my room, took all my possessions, stripped my bed and gave me a canvas gown to wear. I can use my possessions only under supervision. Apparently the whole raid is to keep me safe, stop me strangling myself with a bed sheet, that kind of thing.

It’s ok, it’s temporary, and I will get through it.

But if there is one thing I have learned….never trust nurses wearing purple gloves.

Down the Rabbit Warren

This time, my doctor gave me little choice over my hospitalization. She looked me in the eye and told me I could go to my local hospital as a voluntary patient on an open ward, or if I refused she would section me as an involuntary patient in a locked ward at the state psychiatric facility.

Of course I cried, I told her i was fine….it was just a bad day. I pleaded and begged, but she held fast.

“Ethically, I can’t let you go home” she told me. My mind went a million miles, wondering how on earth I was going to tell those closest to me that I was a giant screw up. Again. A failure of a mother. Again. I’m a PhD student researching mental illness, I should be on the OTHER side of the fence. This cannot be happening.

The days preceeding my admission had been nothing short of strange. I wandered around in a foggy vagueness. Blips of craziness punctuating my constant level of physical illness. But having the equivelent of gastro for 6 weeks would drive anyone a little crazy?

Wouldn’t it?

On the day of my admission I put a pretty dress on. I dropped my son of at daycare, kissed him good bye and went to the shops. I bought a few items we needed for the house then sat down to a large meal at a cafe. I ate approximately four bites before rushing home and being ill. I had planned to clean the house and pay the bills, because I wanted everything to be perfect. I wanted everything to be perfect because I knew I was going to die. I didn’t have a plan and I can’t even say it would have been suicide…but I had a strong gut feeling that I wouldn’t be in my house that evening. I was done. Something had to give.

Six hours later I was being shown to my narrow hospital bed, I guess I was right. Before I even knew it was happening I was falling down the rabbit warren again.

Admission

My admission was precisely that. A public admission that something was horribly wrong. But it took me a long time to get to that stage. I denied it, faked it, hoped that it would just go away on its own. Three medical professionals on five separate occasions recommended hospitalisation. But I shrugged it off, wiped away my tears and convinced them that I was ok. I wasn’t.

They call it a mental illness. But I believe in an inextricable link between the mental and the physical. Just as a physical illness may spawn mental distress, a mental illness can have profoundly physical side effects. In fact, to call it a mental illness surely denies how physical the mental can become. Before my hospitalisation I had shook, vomited, hyperventilated, lost weight and bled. But nothing like what was about to happen.

One day, a few weeks before I was admitted to the mother and baby unit, I was suddenly struck down with the most unbelievable abdominal pain. I managed to stumble into the living room where Hubster sat, and cry out ‘something is not right!’ before collapsing. The pain was intense, comparable only to childbirth. I screamed at the top of my lungs. I lost all feeling in my limbs.

 

I spent four days in hospital in a narcotic haze. Eventually I underwent an investigative surgery, and the usual post operative pain was a blessed relief after the horror of the previous pain. The surgery showed nothing except some pre-existing endometriosis. Nothing ‘physical’ to explain my phantom pain.

I know now that that hospitalisation was the pivotal point in my journey. It was the moment where my body simply shut down, the mental strain having been too much for too long. It was the moment where I realized something was very wrong. I screamed out of physical pain, but also out of mental torment.  What was mental had finally become physical. Becoming physical was the only way I was spurred to seek help.

The problem was that just because I was ready to accept help, didn’t mean I would be offered it. I paid a visit to my GP and psychologist, and they both agreed that I needed urgent assistance. However, despite popular belief, unless you are outwardly behaving in an extreme manner, psychiatric hospitalisation in the public sector is remarkably difficult to achieve. To obtain a referral to the MBU it seemed I had to be first referred to my local mental health service. From there I would be assessed by a community officer, who would determine whether I needed a psychiatric assessment. The psychiatrist, who would be meeting me for the first time, and would only talk to me for an hour, would have complete power over my treatment plan.

I was frustrated by the seemed bureaucracy of it all, but I comforted myself by believing I would be receiving help within days. Instead I was offered an appointment for a weeks time. Now a week may seem like nothing, but by this point I was deep within a mixed state, and I was desperate.

Psychosis had set in and I peered out the windows, sure that the police were after me. I searched Hubster’s desk, his belongings for evidence. Evidence of what? I’m not sure. I paced around the house, unable to keep still, forgetting to eat, forgetting to sleep. Hubster had locked away anything I could use to hurt myself, so I sat on the bathroom floor staring at the toilet cleaner, wondering if it would do the job. I kept crying to Hubster “I can’t do this, I can’t wait a week, I can’t keep going”.  Looking back, I don’t know how I did.

But I didn’t have much of a choice. I could present to the emergency department, but I knew I would be hospitalised in a general psychiatric ward without Master D. My best option was to wait it out, to get through the days, and to get a referral to the MBU.

Finally the day of my appointment arrived and I sat down in the psychiatrists office prepared to be as open and honest as I could. Calmly, I told him everything that had been happening, all the symptoms I had. I didn’t mince my words, and I didn’t leave anything out. At the end of it all he looked at me and said “I don’t think you need to be hospitalised, Rachael. I think your problems are to do with sleep deprivation, I can prescribe some pills to help you sleep”

  I was stunned. Had he not read the referral from my GP and psychologist, which clearly stated “it is in my opinion that Rachael be hospitalised”. ? Had he not just listened to all the symptoms I had described? I tried to tell him that I didn’t think my problems were to do with sleep, he told me that I was “overriding his professional opinion”. At that moment I realised that if I wanted help for being ‘crazy’, I’d have to stop acting sane. So I let the psychiatrist have it. I raised my voice and argued and cried. Soon enough he was printing out referrals and calling up the hospital. Funny that. Before I left he told me that he thought I would only be in the MBU for a few days, a week tops. Of course ;). 

Finally a few torturous days later I walked into the MBU for an assessment, wondering if they were going to turn me away. I can’t remember what I said, or what my doctor said, or how I acted. All I remember is my doctor standing up and saying “You clearly need to be hospitalised Rachael, we have a bed ready for you down the hall”. After the appointment with the psychiatrist I was so doubtful that I would be admitted to the MBU that I hadn’t even packed a bag. So we needed to go home first and collect some things.

Finally I lay down on the hospital bed. It was the end, or was it the beginning? I had done it, I was safe. I was relieved, scared, and everything in between. But most of all I was exhausted. I went to sleep – for the best part of three days I’m told.

And that’s all I can remember – for the first 3 weeks anyway.