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. 

My Time

It was a fairly normal Monday. I had a long to do list and, what I considered to be, a fairly bad case of indigestion. It was a burning, griping kind of pain, that after a half hour quite literally had me at my knees. For some reason I decided to get it checked out before heading into uni, and I arrived at my medical practice in somewhat of an alarming state, clutching the reception desk and announcing that I felt like I was going to collapse.

I was shuffled away into a back room, assigned a bed and a nurse who (typically) I went to school with. A doctor came in, they poked and prodded and told me I needed hospital evaluation. I was in agonizing pain, but had a horrible suspicion that it was indigestion…or worse…trapped GAS. I tried to convince the white coats that I just needed some pain killers, I would not..COULD NOT go to hospital for a humble fart! But my pleas were ignored, my husband was called, I was wheelchaired into the car, and after that my ability to give a fuck was seriously compromised.

The pain was akin to being in labour, without the sliver of relief between contractions. I began to panic because I literally could not do anything to get through the moments. I lost all control in the waiting room, groaning, writhing, losing snatches of consciousness, telling The Hubster – in all seriousness- that I felt it was time to call an ambulance. Nurses scurried over, took my obs, gave me some pathetic excuse for pain relief and told me I was next.

“Next for what?” I wondered. “Next to DIE?!”. In fact death would have been preferable at this point.

Finally I was taken in and hooked up to the good stuff. While the doctor syringed morphine into my vein I understood, just for one moment, the allure of narcotic intoxication. I heard them talking about me, checking my breathing, but it was all above me and I drifted up into somewhere far more pleasant.

I tested negative for the main culprits, and once the Ob-Gyn team got a whiff of my history of endometriosis I was diagnosed with endometriosis (who conveniently can only be diagnosed through surgery) and sent home.

Of course it wasn’t endo. And of course I was back again less than 24 hours later. Vomiting my guts up and unable to stray from the toilet.

A doctor came in and I was told how mighty unlucky I was to have endo pain ONTOP of a case of viral gastroentroitis and told I could go home. As the doctor left our room Hubster let out an enormous fart that he’d obviously been harboring for some time. Almost simultaneously I lurched forward and puked into a plastic bag. Yes. We’re that classy.

And this doctor dance went on for a few weeks. Back and forth, back and forth to the point where I seriously considered the possibility that I was experiencing some sort of stress reaction. Or, I WAS MAKING IT ALL UP. IT WAS PSYCHOLOGICAL.  But my wonderful GP pushed and pushed and eventually found what she was looking for.

You know its bad news when your doctor calls you at night. I sat on the bottom of the stairs  in the midst of a family dinner and listened as I was told I had something called Oesinophilic Gastorentoritis. My GP sounded quite pleased with herself as she described the illness. And so she should. This weirdo disease has only been diagnosed around 300 times worldwide. Confirmation of my condition probably gave a distinct edge to her mad diagnostic skillz.

And that was the start of it. I walked back into the living room. Announced “I’ve got that weird disease the doctor was talking about” then promptly burst into tears. Partly from fear, and partly from sheer relief. THANK GOD! There is a name for what I am experiencing! I’m not mad! (well not yet! That comes later).

That night I slept fitfully, and this time it wasn’t only the nausea keeping me awake. 1 of 300, I kept thinking. 1 of freaking 300! What is up with that?! How could I possibly have something so stupidly rare. No one knows about this disease. Even my supposed specialist had never heard of it. There is limited research. Few routes of treatment. This was beyond a joke. This was, quite literally, a kick in the guts.

Meh. Sometimes you kick. Sometimes you get kicked. Everyone has their time, I’m told. It seems this is mine.

 

Baby Steps

My doctors have indicated that I may have to learn how to manage two illnesses that interfere with each other for, what is likely, the rest of my life.

When people ask me why I am in hospital I barely know where to start. I often find myself telling people I have an “autoimmune disease”. Which of course I do. But those two words are easier to cough up than talking about the nasty, dirty, reality of psychosis, continual diarrhoea, vomiting, bowel pseudo obstructions, suicidal ideation, urinary catheters, depression, involuntary detainment, ECT, stomach pain etc etc. No one wants to hear about that (excuse the pun) shit.

And the biggest problem is these diseases love to mess with each other. My entire (almost) five month hospital journey was due to three major reasons:
1: malabsorption of my psychiatric medication due to excessive vomiting and diarrhoea.
2: taking Prednisone to counteract my OG, which instead increased my psychiatric symptoms.
3: mismanagement by poor communication between psychiatric, surgical, and gastro medical teams. Probably because no one knew what to do with me.

I trailed around psych wards with an IV and catheter. On medical wards i required my own psychiatric nurse. Medication for my bipolar negatively impacts my gastrointestinal symptoms. Medication for my OG negatively impacts my psychiatric symptoms.

In other words, it is a big fat mess.

I’m so afraid of what people will think of me when I am discharged. Am I bad mother for spending so much time away? A bad wife? Family member? Friend? Graduate? Employee? I think of some of the stuff I have done and cringe. I’m ashamed.

Years ago, in a psychology 101 lecture we learned that the true madness was defined when despite evidence to the contrary, you believe yourself to be sane, and those around you to be crazy. Indeed, the greatest difference between a locked and open ward seems to be that those in an open ward agree they are unwell and wish to change. Often those in a locked ward don’t believe they are unwell and turn against the doctors and nurses who suggest otherwise. I did this.

I was crazy.

After a brief visit home (and a good 600 or so new emails) I realized that the world had moved on. My friends who had only just announced their pregnancies before my admission had grown an entire baby during my absence, and given birth to new life. My loved ones had moved on with their lives with new jobs, hobbies and hairstyles.

What have I contributed to my family, friends and society in the last five months? All I have done is become a burden, not only to my loved ones, but to the community in general.

Today in group I expressed these concerns. Afterwards, to my surprise, one of the group members, Lyla, sat next to me at lunch. After some small talk she looked at me and said;

“Your memory will come back…my husband has Bipolar disorder too and needed ECT. It took time, but it came back.”

I wasn’t sure what to say, other than “Thank you.”

“Also,” she continued, kindly, ” I have seen my him through everything. I had to stop him jumping off a roof top. But I still think the absolute world of him. He is my everything.”

My eyes welled up with tears.

“And our son, he was five when all of this happened. He can’t remember much, and he would never want another Dad. Kids are so resilient. You are the best mum in the world for your son. And you are trying to get better. You will get better. And that is all anyone can ask. The people who love you will continue to love you…and those who don’t understand…they are not worth worrying about. You will get there. Baby steps.”

I nodded tearfully and whispered “thank you,” again.

It was when I got back to my room I realized that I didn’t need to close this chapter of my life forever, and jump back on the moving train. I didn’t need to pretend nothing had happened, and one by one answer those 600 emails. Instead I could look at it as a leaning experience. These ailments, it seems, may always hum away in the background. Something I need to accept as a part of myself rather than try and forget. Hubster even suggested, humorously, that I could look upon this experience as anthropological field research for my PhD topic. Laugh as we did, if anything this experience has taught me that stigma towards mental illness is still rife, and a topic that is important in contemporary society. One day, hopefully, I can pay back society with some solid research.

But first of all, I need to let go of the guilt that wakes me up at night, and realize that there was precious little I could change.

Baby steps, baby steps.

One White Russian

Nico was a young Russian guy who seemed to live in army pants and a hoody (hood up) with a baseball cap placed over the hoody. I had never really taken much notice of him. Until now.

I was watching The X Factor in the TV room and he sat down beside me.

” Ahhh I like this show” he said in a thick accent. “I used to watch it in jail.”
I muttered a sort of non committal “mmm hmmm”. Sadly, if there is one thing I have learned from the public psychiatric system it is that your best bet for a smooth stay is to keep to yourself as much as possible. As for the whole jail thing…honestly…after being a public psychiatric patient for as long as I have, nothing really shocks you.

“so you are back then?” he asked.

Ok. Now he had my attention.

I turned to him. “What do you mean?” I asked.

“Well I saw you being dragged off to the locked ward. A few weeks ago. Now you are back.”

“I was being…dragged?!” Since having the ECT I had forgotten a lot and I was interested in what had actually happened.

“Well, ok, not exactly dragged. But there were a lot of nurses and they were all kind of…rushing. That kind of thing. I couldn’t believe it was happening!”

“Oh.”

“Are you feeling better now?”

“Yes. Lots thanks.” Thank you ECT.

“That’s good.” he turned back to the TV. I followed suit. “I like music. I like to sing.”

“So do I.” I replied absent mindedly.

“Can you sing something then?”

“Erm, no.” Things seemed to be heading in a unwanted direction. Now seemed a better time than ever than to introduce the fact that I was unavailable. “I am married you know.” I said flashing my ring. “to a very nice man. We have a child.”

“How much did that ring cost?”

“I’m not even going to respond to that.”

He laughed. “You just did.”

This time I really didn’t respond, but put all my concentration into the TV show.

“Are you in a single or shared room?” he asked.

“Shared.” I said instinctively, not taking my eyes off the screen. In fact I was in a single room. (When I arrived at the ward for the second time I was directed to a 4 bed room, where upon arrival I found an amputee furiously masturbating. My presence, nor the fact that my bed was next to hers and the curtain separating the two had fallen down, didn’t seem to deter her. I backed out of the room and asked the staff if there was another room available. I was temporarily given a single room.)

“That’s a pity.” He gave me a wink. “If you were in single room we could..you know…use it.”

I nearly fell off the couch. “Married.” I said firmly, holding up my ring hand. “And planning on staying that way.” I started moving to leave the room, but he beat me to it. I waited until I was sure he was outside, then ran up the hall to my (very single) room. All night I was on high alert, practically expecting a night time visitor. It was the only time I had been grateful for the nurses nighttime checks.

In reality, we avoided each other for weeks. My husband visited the ward several times. Any accidental eye contact was extremely awkward, and it became an unwritten rule that if one of us was watching TV, the other could not.

But the day of Nico’s discharge our paths were to cross again. I was in the shower, and when I turned the tap off I realized I had no towels. I swore under my breath and grabbed my dressing gown (a short, summer gown. My winter version was modeled on Chewbacca, and though it was very warm I didn’t deem it hospital appropriate, so opted to pack my summer one. Though, thinking about it, in this situation my Chewbacca gown would have been far preferable.) My room was situated directly next to the laundry so I figured a quick gowned run down the hall was my best option.

I stuck my head out the door, and seeing no one around I made a run for it. Grabbed some towels, and started walking back. Suddenly I heard a wolf whistle, and I didn’t have to turn around to know who was behind me. As Nico passed me he tipped his baseball cap and gave me a wink.

“Nice legs!” he told me as he walked past, giving me a big grin.

Once I got back in my room I looked down at my bare legs and snorted. Being in a locked ward I hadn’t shaved in at least a month. Perhaps I didnt need that Chewbacca gown after all!

That was the last I saw of him.

Cheeky bugger.

PICU

The PICU, or Psychiatric Intensive Care Unit, was where I spent most of my time in the state psychiatric facility, and where I had all of my ECT. Because of this, quite honestly, I can’t remember much about this time. Luckily for me I kept a special “Things to Remember” journal, which documented funny or disturbing things that happened, details of my physical health problems including what foods to avoid, reasons why I was in hospital, and other such things that I deemed important to remember.

This post is written in consultation with that journal.

The PICU is a locked 8 bed psychiatric unit where people are detained (that’s right, we were all prisoners of the Mental Health Act) presumably because they had complicated or enduring problems.

I, for example, had the double whammy of physical and mental problems concurrently. I had been diagnosed with a very rare autoimmune disease, and had to adhere to a very restrictive diet, and was physically unwell, often needing a nurse escort to nearby hospitals for appointments and surgeries. On top of that, shamefully, I was a major flight risk, having had escape attempts at multiple hospitals, incurring the involvement of Security. I was also a risk to myself, having had a suicide attempt on the open ward, and I was completely psychotic, experiencing hallucinations and delusions. Although I joke that my diet is enough to send anyone mad, it was the most dark and out of control I have ever been. Honestly, I am glad I have forgotten much of the substance of my stay.

The other patients on the ward had similarly complicated issues.

Ann is a 50 something women who would only answer (strangely) to “Isabella” and probably has a diagnosis of mania with delusions of grandeur. She believes herself to be Princess Diana. Unfortunately she believed I was Kate Middleton, and because it was easier than trying to convince her otherwise, I was often employed to participate in her fantasies. She was extremely jealous of anyone I talked to or who visited, particularly my mother. Her sentences often started with: “My Father in law, Prince Charles” (clearly her grasp on the structure of the royal family was somewhat askew) or “When I was at Oxford/Cambridge.” She is very kind though.

Lesley was the only male on the ward and disliked this intensely. (There is too much oestrogen on this ward” he would grumble). He was waiting on transfer to an all male ward that Isabella informed him that all the patients would be criminals (she was probably not far from the truth). Isabella also accused Lesley and I of “sexual misconduct” while we watched TV…A situation very unlikely given that Lesley had confessed to me that he thought he might be gay.

Nicole was pregnant with a blackened front tooth. The baby was clearly unplanned, as she often talked coldly about the foetus, prompting beration from the nurses and Isabella.
Pregnancy did not stop her smoking habit and she chain smoked as much as she could get away with. Her favourite phrase was “I need to get out of this place…I have drugs to pick up and money to count.” She could be kind in the most unexpected ways, though. For example, she bought me chocolate I could eat from the travelling kiosk when I didn’t have access to money.

Dani was a schizophrenic musician. She was slight, strange and spent hours solving complicated algorithms on the whiteboard. We once asked her why she didn’t teach, given how much she knew. “Because I am mad!” she laughed. “Aren’t we all!” Nicole responded. True that.

Louisa was your typical mum. She was Christian, wore courderoys and harboured an intense dislike for Nicole. Overall, she seemed incredibly normal to be detained in a locked ward, and I often wondered what brought her to us. She lived rurally and claimed to be flown to hospital by the Royal Flying Doctors Service. So much cooler than being driven in the back of a Volvo. In any case, her stay in the locked ward was short.

The other inmate has been lost to my ECT memory loss. Perhaps this is due to a short stay. Or perhaps I never interacted with or noticed them. All I know is that try as I might, although my longstanding rule of psychiatric hospitalization was to avoid contact with other patients…in such a small ward, myself and those I have described became a little, strange, family. We knew what it was like to be crazy. We banded together. Us against the nurses. And strangely, (perhaps it was institutionalization), that little family helped me survive the most difficult days of my life.

The “Day Surgery” that Wasn’t

Just to complicate matters, in the middle of everything I was due to undergo a hernia reconstruction. My surgery was supposed to be conducted in The Dungeon but after several last minute cancellations I was referred to a private surgeon. When I met with him he told me my hernia looked fairly small, and like an easy job. It would be a day surgery and I “may not even need mesh”.

Famous last words.

I woke up from the general anaesthetic thrashing and screaming, like I always do. I was surrounded by staff in scrubs (including my nurse escort) trying to calm me down. My doctor appeared.

“Rachael,” he said, placing a hand on my shoulder, “we are taking you to the ward. We need to keep you in overnight. The surgery was more complicated than expected.”

I nodded then, perhaps it was the pain or perhaps it was the needle in my thigh, but I began to lose consciousness.

I woke up a few hours later on the ward. I tried to take my oxygen mask off, but my nurse escort firmly held it on. “Your stats are low.” she told me. I began to lose consciousness again.

Later on my doctor arrived. “The surgery was more complicated than expected. Your hernia was large and very deep. We had to cut through a lot of muscle and use a lot of mesh. It was good that you had it repaired.” I started to black out once more.

I woke up the next morning, feeling a little more lifelike. I took off my oxygen mask and this time no one stopped me. I turned my head and saw I had a new nurse escort.

“Good morning!” she said cheerfully. I smiled and tried to get out of bed, but was hit with strong pain. With the nurse I was helped to the toilet, and everything seemed to be going ok until I saw my gown was soaked in blood, and the blood was pooling on the bathroom tiles.

“Erm…Problem!” I alerted my nurse. She helped me back to my bed and pressed the call button. Cue a good half hour of wound dressing repair and being given strict instructions to remain in bed.

Which I did. For the next three days. The pain was intense, requiring high Schedule painkillers hourly (which ultimately resulted in unintentional opioid addiction…a topic I will cover some other time). Finally I was released…back to the state psychiatric facility anyway. My pain was improving, and I could move around. I had a few more days until my intended transfer to my last stop in the game of Hospital Hopping.

Indeed, on the Monday I was gleefully discharged from the State psychiatric facility, and checked in to a private psychiatric hospital; The Palace. I noticed that my stomach was ridiculously huge and casually asked my admitting nurse what I should do, given my recent surgery.

“Oh, I will see if we have a midwife on staff.”

My husband and I, both horrified, corrected her, telling her I was definetely not pregnant. But i couldnt even be insulted, given my size. The nurse was even more horrified, both at her faux pas and at my stomach.

“You need to go to the Emergency Department! She told us. “That”, she pointed accusingly at my stomach, “needs to be seen to.”

So what ensued was another hospital run. I brought nothing bar the clothes on my back, sure I had some sort of infection and I would be sent “home” with antibiotics.

But by the time we arrived I was having difficulties breathing I had gotten so large, and I was seen to suscpiciously quickly. I was told I most likely had a Saroma, or fluid collection over the mesh repair, and that it might need surgical drainage. I was taken to the surgical ward where I spent another three days.

On the last day my original surgeon came to see me to tell me that the Saroma didn’t need surgical drainage, and I could be discharged. “But there is something else…” he added.

Oh for the love of God, what now?! For a moment I wondered if they had seen a foetus on the scan. An immaculate conception of course.

But instead the CT scan indicated that my hernia had returned. I nearly hit the roof.

“That is possibly the most ridiculous thing I have heard!” I told him, all politeness going out the window.

“I know!” he agreed crossly. “I refuse to believe it is possible. The amount of mesh we used….don’t listen to what the surgical team tell you. It must be an imaging error….or something.”

His “or something” didn’t leave me with the greatest confidence, but quite frankly the whole situation is in the “too hard” basket right now, as my husband would say.

So basically my day surgery ended up as eight day surgery, and at the end of it all I may still possess a hernia.

Can I please catch a break? Please?

Les Miserables

“I’m in a skanky mood!” announced Isabella, waltzing into our dining area. The rest of us looked up briefly, then continued with our breakfasts.

“Well don’t be.” snipped a nurse, engrossed in the mountain of paperwork she had to complete for the day.

“I think it may be time to retreat to the nurses station..” our male resident student nurse joked. We all laughed, including Isabella. We liked Josh.

And so it goes. A fairly regular morning on a locked ward. We all had our madness, and we all accepted it.

This post again is written in conjunction with my Book of Things to Remember. The memories I have of the locked ward are kind of like the memories you have of when you are two. You think you remember something, but it’s really because it is a story that has been told so many times. I think I remember these events, but it’s really all down to my Book of Things to Remember.

Early on in my stay I opened a door and found a second TV room. Marvelous! Some time to myself, and actual choice over what to watch. I settled down on the couch then glanced out of the picture window.

It was there I saw something that chilled me to the bone.

Old people. Lots of them. White hair, perms, wheelchairs, walkers. Sitting down with blankets over their knees, heads lolling to the side. I crept up to the window and let out a blood curdling scream.

A nurse rushed in. “What is it?!” she asked, flustered. I pointed dramatically out the window. “What? That’s the geriatric ward.”

“What if I end up there?! I have been in hospital for months…what if I’m…a…” I lowered my voice, “a lifer.” By now I was in floods of tears.

“oh Rachael, you’re being silly! You will get better and out of here. I promise.” She patted my shoulder, the staff equivelent of a hug as they weren’t allowed to touch us unless absolutely necessary.

I knew she was right, but I never felt the same way about that room. Somehow that room latched onto my deepest fears that I would never get better. It wasn’t the people that made my stomach flip, but the concept. Ridiculous, as those patients had probably been admitted months rather than years ago, by caring family members concerned about memory loss and increasing fragility. Logically I knew this, but I still stayed away. And so did everyone else, and I never did find out why.

* * *

Usually we were fortunate enough to have our own ensuite in our rooms, but one day Isabella claimed hers was broken. She went to the public toilet and suddenly there was a lot of shouting.

“When someone is in the toilet, taking a shit, you don’t just fucking barge in!” growled Nicole, slamming the door closed once more.

“You’re fucking disgusting Nicole! You know that!” Isabella didn’t like any mention of bodily functions, they were far beneath her. She walked past me saying “This sort of thing would never happen at the palace. You know with your Daddy, Prince Charles.”

“I can’t deal with you right now..!” shouted Nicole from behind the toilet door. “I’m in the middle of a drug deal!”

I snapped my card on the table: “UNO!” I said triumphantly, basking in congratulations from other patients and staff.

Yeah, this kind of thing happened all the time.

* * *

One morning we were all singing. It was a terrible racket, with the din of people who could sing combined with those who can’t. Lesley looked like he was about to implode, and retreated to his room.

“You lot should be in a musical,” a nurse joked.

“yes!” Isabella piped up, “Les Miserables!”

We all fell about laughing, including the nursing staff.

“That was really funny!” Nicole said appreciatively, holding Isabella’s shoulder. “You should be funny like that more often!”

Isabella looked pleased with herself.

“No touching!” a nurse directed at Nicole.

A few days later Lesley finally got his transfer, and Isabella missed his company. She wrote him a letter, of which the envelope was covered in childlike drawings of hearts and flowers.

“Can you please send this to Lesley in the all male ward? I am worried about him. I am not sure he will survive a criminal attack.” she asked a staff member.

“Sure.” the nurse responded, absent mindedly placing it in the “mail out” tray. “Hang on a minute…what does this letter say?” she asked, suspiciously eyeing the hearts. “I can’t send anything inappropriate.”

“Oh, it’s appropriate. It just says that I am missing him and that I hope he hasn’t been killed yet.”

The nurse ripped open the envelope and read it.

“I can’t send this!” the nurse said, horrified.

“Why?” asked Isabella, pouting.

“Because it’s just…” the nurse shook her head, “no. No way is that being sent.”

Isabella stalked off and Dani and I looked at each other. What we would give to read that letter! Somewhere out there Lesley avoided a surprise oestrogen attack.

If he hadn’t been killed of course.

Yes, life was never dull with Isabella on the ward.

Lessons from a Locked Ward

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1) In the famous words of The Eagles; “you can check out any time you like, but you can never leave”. Escape is borderline impossible. And if you do succeed you will soon find yourself in the back of a paddy wagon. There are air lock doors and two story fences. There are single rooms but no privacy. Physically and legally you are detained for as long as is seen fit. The only way out is through good behaviour and compliance. You are a prisoner of the state, and the sooner you accept that fact, the sooner you will be trusted to an open ward.

2) Never mess with the nurses around handover time. Unless you are dying. And even then you will most probably be told to wait. If you really want to grab a nurses attention, go to the toilet. You will be interrupted almost immediately.

3) Money serves no purpose. Instead, follow the currency of the three C’s: cigarettes, chocolate, and Coke (the Cola kind, though the street kind would probably make you popular too).

4) Never enquire about someone’s diagnosis. It is the equivalent of asking why someone is in jail. Or why someone only has one leg. Or what’s up with that speech impediment. You get the point.

5) Hospital pants are entirely underrated. Comfy, free, and you don’t have to wash them. Winning!

6) No matter how nice the nurse or hideous the patient always remember the golden rule that it is “us against them”….

7) … Except for student nurses. They are awesome. A midway point between you and authority.

8) When in doubt smile and nod (except when it is Nico propositioning you).

9) Locked wards lack structured therapy as the patients are usually too sick to participate. Generally your possessions are removed as well. Get very adept at entertaining yourself. And by entertaining I mean watching Deal or No Deal.

10) If you only remember one thing, make it this: there is always someone crazier than you.

The Twinless Occupational Therapist

The major advantage for hospitalization on an open ward, was the increased availability of activities. Days are long in a psychiatric ward with nothing to do, and there are only so many times you can play UNO.

In The Dungeon there was Hydrotherapy classes and a lonely art room. In the State Psychiatric Facility there was occupational therapy. After weeks in a locked ward I was excited to Finally be able to participate. At 10:00 am exactly, I walked to the occupational therapy area, and realizing I had gone to school with the therapist did a little about turn and headed back to my room. Talk about a close slave!

From memory the therapists name was John, he had a twin brother and played electric guitar. We took Art together and our paths tended to overlap fairly frequently due to a mutual love of music.

The next morning I forgot about Occupational Therapy, and was lounging in the TV room reading a paper. Suddenly the therapist appeared.

“Hi! I’m John, the Occupational Therapist. Do you want to make a mosaic table with me? No one else seems to be interested.”

I could have died. One of the top situations you do not want to meet someone from your past; in a psychiatric hosptial…as a patient (only topped by at the the gynaecologists). But he looked straight at me and showed no sign of recognition. I quickly assessed that:
1) he wasn’t who I thought he was
2) he didn’t remember me, (most likely due to my disheveled appearance), or,
3) he had astounding professionalism and was pretending not to know me. There was probably something in the staff rules pertaining to this.

I considered any of these assessments better than the alternative, and not wanting to be rude I stood up and followed him to the Ocupational therapy area where multicolored tiles, grout and a picture of a sun were waiting. We went about sorting the tile pieces in silence until I couldn’t stand it anymore.

“Do you have a twin?” I blurted out.

“No, not that I recall.” the John replied, looking vaguely amused. (assessment 1).

“That’s weird. I thought I saw your twin yesterday. But,” I paused, “maybe it was you…” I trailed off, realizing I was making a fool out myself. “Also…” I started, feeling honesty was the best policy, “you look ridiculously like someone I went to school with. And you have the same name. Except I’m sure he had a twin. But maybe he didn’t.”

“Did your twin die?” Katherine, a mild mannered senior enquired, walking up to the table. “I had a twin that died once. But it was before I was born.”

“Well…I definately don’t have a twin…I do have a sister, but she is younger.” John said, clearly used to this sort of debacle, Katherine walked off, and I cleared my throat awkwardly.

“Well, it’s good we have sorted that little mystery out!” I concluded. “I don’t have a twin either. If it helps.”

God, this was turning into a disaster.

But John, ever professional, smoothly moved on; setting up the mosaic pieces and asking me some basic questions about myself, and I was relieved to find out that we had gone to school together, making me partially rather than completely mad (Assessment 2). And, I began to realize, it was pleasant talking to someone who didn’t greet you with “Welcome to my space ship!”, or “its time to take your Lithium.”

I attempted to regain my reputation by talking about my successes, my family and my PhD, rather than the time I spent in a locked ward, or running away from security. John continued to project exactly no recognition of me, (assessment 3) of which I was ever grateful. I began to look forward to Occupational therapy once more and the Sun mosaic was nearly finished before I was discharged.

I could have sworn he had a twin though..!

Chicken and Rice

I have done a few diets in my time. The low carb diet and the no carb diet. A gluten free diet when I had a similar bout of GI distress. A Weight Watchers diet when I was trying to shed some baby pounds (or, more likely, Lithium pounds). I had a brief eating disorder as a teenager (not exactly a diet I suppose) and I have always been “almost vegetarian”; meaning I only like certain meats. But nothing was to prepare me for The Diet.

You see, my diagnosis of Oesinophilic Gastroenteritis has only one treatment. Steroids- specifically Prednisone. But Prednisone has the side effects of depression, mania and psychosis, and thus a Very Bad Idea for me to be on. Seeing me descend quickly into complete insanity, my doctors in the Dungeon quickly weaned me off the drug, and because they had absolutely no idea what to do with me, they referred me to an Immunologist.

The immunologist suggested a six week elimination diet, whereby all potential irritants to my GI tract were removed. I was to avoid wheat, dairy, eggs, nuts, soy and seafood. This, in theory, was a Very Good Idea. In practice, however, it was a nightmare.

I was an inpatient for those six weeks and at the mercy of the hospital kitchen. All the kitchen could find to feed me was chicken with rice. So that’s what I was fed twice a day for over a month. Chicken and rice.

After four weeks or so of this diet, I began to dread mealtimes. Chicken. Rice. Chicken. Rice. Twice a day, every day. It was doing my head in. It even continued in between hospitals. Once I was admitted to the state psychiatric facility I was still finding chicken and rice underneath my closh.

One evening in the locked ward, when dinner arrived at the little hatch in our dining area I felt myself losing the plot.

“if I see another chicken breast with rice I will….” I glanced at the warning look the nurse handing out plastic cutlery was giving me,” most definetely not kill myself. There is going to be chicken and rice under there.” I continued, pointing accusingly at my tray.

“It might not be.” the nurse responded hopefully.

“It will be.” I replied darkly.

I lifted up my closh, and indeed there was chicken and rice (albeit with an apologetic garnish of parsley). “See!” I said triumphantly. “That’s it. I can’t do this anymore. I’m not eating this tonight.” I took the tray back to the hatch.

“if you don’t eat you don’t shit. And if you don’t shit, you die.” offered Nicole helpfully.

“Thanks Nicole.”

“This is getting a bit silly,” the nurse admitted. “Look, is there any way we can get Rachael something else to eat tomorrow?” she asked the young Asian lady from the kitchen.

“Ah. Yes!” the lady answered, nodding vigorously.

My heart leapt. How had I never thought to ask for a change before?! Possibly because my ECT had wiped out my ability to even remember what foods I had to avoid.

“Don’t count on it,” Nicole said, after the kitchen lady had left. “She can barely speak English.”

“Thanks Nicole.”

The next day I wondered if Nicole was right. If the kitchen lady had understood what was being asked. If, in such a big hospital, they wouldn’t accommodate change. Nervously I lifted my closh. It was then I squealed with delight. Something new! The kitchen lady understood! I lifted my plastic fork and prepared to tuck in to something different.

Chicken and veggies.