head
   He who fights with monsters should be careful lest he gaze long into the abyss... only to find his own reflection.

Arbour-Fuller Hosptital, Detox Unit 4, South Attleboro, Mass., November - December 2009

This is my diary for my inpatient stay at Arbour-Fuller Hospital, Detox Unit 4, November 25, 2009 to December 4, 2009.

These are direct transcripts from my written diary — with grammatical and spelling fixes only. I wrote throughout the day each day — entries separated by a "~" mark entries separated by some time.

As with most of these Inpatient Journals I remember little of the "nights/days" before arriving. However, in this case I started to remember some things as I transcribed my journal — and in Day One I filled in some of the gaps.

I think this was my first time being "sectioned" (a form of being "committed", or hospitalized involuntarily, but to a "detoxification/psychiatric hospital" rather than a "State Institution").

Going "inpatient" usually follows a brief ER stay due to excessive intoxication, and the in-take process is a humiliating experience: You are physically and mentally ill, disoriented and confused, arriving by ambulance strapped into a gurney, wheeled into an unknown place, only in a hospital "Johnnie"...

Day One

Arrival. Evening. Dark. Wait. Move from front to inside. Off stretcher and into a plastic chair. Within a minute several Ps come in. [from what I would later learn was a cigarette break] I avert my gaze. Their shuffling gate is slow and dejected. The last in line is a long-haired, bearded man, flipping his legs up and down, sometimes sideways -- a haphazard, wobbling walk; he had a really crooked, debarked stick for a cane -- so crooked I felt is was a crutch for something in his mind. He had his shirt up to his chest, exposing a bulbous stomach; he was picking his teeth in his wide open mouth.

"New fish," he said to no one in particular, obviously referring to me.

"Fuck," I thought. "Where the hell am I? What have I gotten myself into?"

After sitting for awhile (while paperwork was readied for me) I was called to "come for a Johnnie check." I was in a Johnnie from the hospital, and they brought another with them as they lead me into an empty patient room. They had me put the second Johnnie on my back, and then they asked me to squat, which I did. (Do people really hide shit under their balls when they come into a place like this?)

Then I was led back to were I came in, which was the main area of the unit and where the nurses did their chores [which, it turned out, was mainly filling out paperwork]. While there this time they emptied the bag of my belongings from the hospital: shoes and shirt -- can't have my bloody pants. "Save my poncho," I tell them, "I can sew it." [It was cut off of me while I was lying on the street when the EMTs picked me up.] They dug up a spare pair of pants for me; much too large and with a rubber band through two belt loops to hold them up.

Things did not happen too quickly there. Wander? Sit? "You'll be in room seven," someone says. "Can you make your own bed?" I do not recall answering that. I looked around and there is no room seven. They are numbered 401 to 411. "I am in room 407?" I asked. "No, 404," someone said handing me linens. I go to room 404 -- 2 beds, both empty -- what a relief. I made the bed and then wandered about. I got some food -- snacks -- and then got some meds, Librium and Vitamins. Then sleep.

Day Two

Everyone complains about the food.

Assessment: "Have to stop drinking cuz of self-injury... razor."

"It says here you've been cutting for 20 years. It's hard to believe that," a doctor said. I simply stood and lifted up my Johnnie.

Day Three

I don't know. It's bullshit, a fraud. When you look at the literature and then experience how the facility is run... Dual Use [dual diagnose] my ass -- every "group" is a "meeting" and AA commitments. "You can do it. Just pray to your higher power (who I choose to call God) every morning to keep yourself away from a drink or a drug, go to meetings, join a group, get active, and you will have a life second to none. I don't know how it works. But it does."

Other than that we had:

"Wrap Up" group. "What is your goal for today?" "Did you meet yesterday's goal?" "How would you rate your day?"

Then there was a "Music Therapy" group where people sat around singing.

And a "Food for Sober" group discussing the obvious roles of healthy eating, rest and relaxation.

The "psychiatric" help consisted of a 10 minute session -- in my case on the 3rd day -- at which the doctor prescribed meds. One of which I cannot get at this hospital, 2 of which I can only get one dose at night. The psych docs are not available on weekends. I asked the desk nurse to speak with someone about this. "I'll speak with the Doc."

For the detox "use" there is the standard protocol of Librium (50mg), Clonidine (0.1mg), Vistaril (50mg) and B-vitamins.

Day Four

Group. "Smoking Cessation."

Group about 12 steps but videos were shown about relapse/relapse prevention. Staff lets two "vocals" [how I describe patients who talk all the time] talk about "insults" [?] -- I intervened by asking staff; he apologized to me but said nothing to the group -- the vocals continued to mumble among themselves.

When staff left, Vocal-D [as I call him] went on a rant of, "I'll flatten him..." I went to my room and read -- the ONE comfort I have.

The hall gets noisy before "events." This one was lunch. The Vocals as well as half the rest of us hate the food. Considering the pay/status levels of the chefs in clinics [I'm speculating] the food is OK and always of the "food groups". (But no nuts/legumes.) All the food has way too much sugar and salt.

The snacks on floor are typical cellophane wrapped crackers, some plain, some with peanut butter, etc. All have sugar. Funny thing, the most, um, incoherent Ps [patients] of the group put in 5-6 packets of sugar in their coffee. The coffee is decaf.

During morning "vitals," a useless time to check for we have all been sleeping and relaxed-- During my vitals, "Please wait," the staff said twice. I again asked about the doc. "I was told I could see the Doc," I said. "Who?" "About mental health services here." "There is a doctor on call," he said, but as I stressed out at his disdain for me I blanked out about how the conversation ended. But I guess I got through to him for later a nurse called on me and I reiterated my concern over meds. (I can't remember the names.) "Med nurse said I can only take at night," I told her, "I did not ask the psychiatrist about dosages/how often, can you--" "I'll look into it," she said.

There are "check rounds" every so often. Staff-G [how I name the staff] asked how I was doing. "Rotten," I said. "I thought this was dual use..." "It is," he said. "Just read the literature you were given. When did you get here?" "Wednesday." "Holiday... weekends... mumble mumble."

~

There is no love here. There is no love in any of the Ps here.

Day Five

Still on the meds Librium, Clonidine, Vistaril, B-vitamins. My body, my muscles, feel heavy, slow to respond. It is not unpleasant. There is no "high" [they are not narcotics, of course] but the feeling invokes that curiosity of mind that I enjoy. They do not make the fear go away.

Group is called at 9:00am but Staff dicks around for 20 minutes before they show up. Even though it is called a "Community" group they open it up by reading the 3rd step of The Big Book [Alcoholics Anonymous]. A few of the vocals talk about what they think that step means -- all quite incoherent and disjointed. I was about to raise the question of whether or not this "Community" group was going to be an AA meeting, or a discussion of God -- my heart pounding and my body panicking -- when Staff-K started asking us one by one what our goals are for the day.

Most P's goals are slogans: "Keep it in the day," "Stay positive," etc. A couple were specific: "Make phone calls," "Fix my meds." Me? "I want to meet with whomever I need to to discuss my mental health and to start the discharge process."

Mentioned to staff that I need to discuss my mental health progress and my discharge progress. "Doc and social worker." They will "mention it" as usual.

I chose not to go to the cafeteria -- it is so depressing hearing the vocal Ps constantly find things to "fucking" complain about or verbally abuse staff.

Group - AA Commitment
Group - Triggers (AA)

Mentioned to the Med Nurse, "Is there anything else?" "I'll talk to the doctor."

Am on Librium protocol. No Clonidine for my vitals are too low.

The Lamictal or the [?] makes me drowsy and I've been sleeping all afternoon.

P-D tried to hurt himself. It was not surprising. He was full blown manic, talking non-stop, non-stop, to another P. And always saying [things like] he'd like to "fuck that guy up", "see a fight with chairs flying and everything..." He was always interrupting groups, always talking to other Ps about nothing when in groups.

An Aside:

The ones like him are obvious -- sitting in the back of the class in school -- making rude comments, laughing, coming up with stupid answers to the teacher's questions which the two or three "delinquents" would all laugh with each other about. ("Yeah! We showed her!") Trouble makers.

Saw SW [social worker] today -- it is recorded that I tried suicide. I reiterated the 50/50 thing about who knows -- that did not work when admitted. Perhaps a suicide attempt on my record will be in my favor come LEGAL issues. [DUIs]

We discussed many things: getting a psychiatrist; family; I have a place to stay; outpatient (partial) treatment; AA.

Day Six

5:00am! Shouting got me up. 5:00am? Some trouble or something. The guy that tried to hurt himself was put in another room.

Meds: Clonidine (my pulse was high) and Vistaril. I am past the Librium protocol.

Waiting for breakfast arguments break out. Well, not arguments, but the passing of insults.

After breakfast, the guy, Vocal-D, smashed a chair or something.

Group. Vocal-D keeps interrupting. "It means if you're here you're fucked," after the affirmation is read. "Someone's going to be fucking killed..." yada, yada, and he is finally escorted out of the room. But he comes back. "I'm telling you, someone's nose is going into his brain cells," yada, yada. "OK," Staff-S says, "Let's get your clothes and go."

~

Group. "Healthy Living." Presence is voluntary. People come and go. This one went well.

Vocal-D is back! Looking quite dejected but rage obviously boils below the surface. A staff member has to follow him around.

Group. "Relapse Prevention." A [video] tape. Part way through, Vocal-K says he does not want to watch it and asks for a "vote." "Who wants to..." I raised my hand. He walks up to me. I said something. He started insulting/threatening. I said, "That's nice," and he stepped close. "I'll..." whatever. I just ignored him and he turned, but then said back, "You're just trying to control the group."

"No, I'm not," he shouts back.

Later the group Staff (a young woman who remained silent throughout) thanked me for my help. "Was this group to view the video?" I asked. "Yes," she said. "And a discussion afterward."

["You owned him," another P said had to me after the altercation. "You owned him." Maybe. But it did not feel nice.]

Two or three minutes later Vocal-K and Vocal-D came in and walked around the room and left. Vocal-D has shouted, "Snitches get stitches around here." They were followed by Staff-S who does absolutely nothing.

Later, I apologized to Vocal-K and he did also. We both acknowledged how tempers have been high lately.

There was a Patriots game on and many were eager to watch, I too. I thought for once I'd share within a group some sense of community, family -- the shouting and swearing at goals and interceptions bothered me though, and when the Pats were so far behind at the end of the second half everyone left.

Only I and P-A stayed to the end.

I tuned in to The Daily Show, but when Colbert came on it was "TV off." I could stay up and read or play games or whatever. Shit.

Day Seven

Meds are not working -- I just feel fatigued.

At breakfast those near me constantly talked about "The fat bitch." "Yeah, she's a klepto." Obviously that P was at fault and a thief, yet it was the insult quid pro that escalated to incident to violence yesterday. What is it about "He who insults last wins?" "You bitch." "You suck." "You fat bitch." "Your mother." BOOM! "Don't you mention my mother -- I will kill you." WTF

~

Groups all day today. Staff-S went over the rules -- something he should have done right after, and every time after, someone breaks a rule the disturbs or disrupts the unit.

Group. "Relapse Prevention." Again! I thought it went. [? well, I guess]

(I skipped lunch. For why in a moment.)

In the kitchen writing this. Vocal-D, cafeteria privileges revoked, sits down with lunch: "Fucking cold food. I gotta get the fuck out of here."

(Weird thing is is that he came here voluntarily I thought, as he had said his Mother paid for his stay. Lie? Exaggeration? Truth? Who knows.)

~

During Wrap Up we went over the things we can do for support when we are vulnerable to relapsing. As Staff-L wrote things on the white board she had us write on paper our supports. I thought I had only two, one my therapist, but as things progressed I continued writing: AA, DMH (Dept. of Mental Health), Masshealth (they can provide rides or taxis to doctor's appointments for example) and Medicare.

Calling government service is always a... battle, but, expecting it, being polite, asking if this is not the right number which [number] could better help.

The moral of this? Work the system!

I opened up in this group. I don't know why Staff-L called on me first to list my supports -- I guess I was just closest -- I did so. Somehow, sometime in the group gaggle, calling friends came up. Staff-L asked me about calling friends. "I have no friends. For 10, 15 years I have been isolated." The group opened up and this was talked about for a few minutes until I had to say, "Please, can we move on to another subject."

At the end of the group, Staff-L thanked me for sharing. "I know it was painful," she said, shaking my hand. Her hand was warm and soft.

I think what I need are not anti-depressants or mood stabilizers, but anti-psychotics and anti-anxiety meds.

I did not go to lunch; the LAST thing I need right now is people coming up to me to "discuss" what I said no matter what the reason. If P-L was to talk to me I would cry.

~

Looking up at that damnable blue and white streaked sky through the outlines of trees -- forever calling, never reachable.

Alone I sit, a few tears shed from the book I was reading ("The earth belongs to the earth"), and behind me the group is gathered together to send off a few who are to be discharged. I will not be among them. I cannot. I cannot share their camaraderie, their companionship, their love -- for lack of a better term, less raw of a word for "buddy, buddy" feelings. I will not remember any of them except for P-L; but she too will fade from memory. I am not, still not, ready for friendship -- neither to have a friend or to be a friend. When I go I want to sneak away without anyone knowing.

Why? you might ask, not participate in sending off those leaving today? (And no, this is nothing like "House" [the TV show] -- no cake, no celebration of any kind, just the group hanging out together.) It will be painful. All the pain of my life will well up inside of me and over take all my thoughts. I would want to reach out and touch them all in a spiritual way -- but ghosts and phantoms will hover there among them, behind them, behind me. They will come down through the ceiling, they will come up from the floor, they will flow through the doors, and the ugly, horror of their gaping mouths will induce that terror inside me that has plagued me all my life.

~

Visit with psychiatrist and SW. The Dr is typically -- it seems to me -- incompetent to treat PTSD. I got so stressed that I do not recall much of what was said, but of all our talk of meds and "why I am here," the most exasperating thing that the Dr asked came when I was recalling the time when I first realized that alcohol was a problem (that concert in 2001) and I became emotional and started crying as I was explaining -- and he fucking interrupted me with "Why are you crying?" (Contrast this with Dr-L who slid tissues along the table and let me continue -- she had concern on her face, he did not.)

And again, anti-anxiety meds are verboten.

"But there are many meds to try," he says. "Sure," I say. "I sober up, go on meds, they don't work, I drink again. Without anti-anxiety meds I am doomed."

"But they [anti-anxiety meds] will cause you to want to drink again."

"I do not believe that at all," I say, getting angry. "But you're the doctor and I'm the patient. I guess I have no choice." So I threw up my arms and walked away.

I called my therapist immediately and left voice mail: "SW said you were not aware of my relapse," and "The so-called psychiatrist while I was crying as I explained my first getting sober..." and of his asshole "Why are crying" comment. I tried to be loud enough for the SW and Dr-X to overhear. I was so mad. (Now I know even more about the varying "styles" of psychiatrists -- males are almost militant, females tend to be, but not always, very compassionate.)

~

(Oh, yeah... "Do you exercise?" he at one point asked. "I walk a lot." "Do you do aerobics? Because," he continued, "that will help reduce anxiety." Exasperated, I calmly explained that "I do not know why even in a room all by myself I am filled with a form of terror for moving about." At one point I added, "Everybody seems to think that if I just stop drinking, eat right and exercise, everything will be fine." "But here are supplements -- or meds... blah, blah.")

~

Yesterday I told the SW of wanting a psychiatrist from Beth Israel [near by hospital] and I gave her a name. I also gave her the name of my therapist at the Trauma Center [in Brookline]. I think she called the latter. I figured she would call BI -- but she did not.

~

Wrap up went well. I feel safe -- especially because the Vocals are all gone or in bed.

P-A whose gait was horribly erratic can now walk practically normally due to Soma and he and everyone is ecstatic, really ecstatic. Me included. You should see P-A's face. "I wonder how long it will last," he laughed. We are all so used to things going bad...

He came into the clubroom and loudly stated, "I'm pain free! Pain free!" "What happened?" "Soma." "What class of drug?" "A muscle relaxant."

"Oh my God," he says, with heel on the ground, moving his foot up and down. "I haven't been able to do this for 25 years! My calves were always tight as rubber bands and now they are not."

"You were walking better, too."

"Really? You're not just shitting me?"

"No. You looked like you were walking almost normal."

P-A then got up and paced back and forth. It was true. He walked so obviously better than before.

"I gotta have witnesses for this," he said and he was off to pace back and forth for any staff or nurse he could see. Everyone was smiling and happy.

This was like a fucking miracle, not just his sudden progress, but finally, finally, after all these years of fear of people, I was no longer afraid of the few people still up in the unit. I too was pain free after 25 years!

We had a pretty good talk, P-A and I, many things of which I do not recall fully, but he said how, and P-J too, who usually remained very quiet, how I was opening up. "It started in group. Yesterday," I said. I told of how I was scared, especially during the "hectic" days of shouts and insults. They both agreed it was crazy then. But today was calm and quiet.

We talked of trees, plants and mushrooms (P-A mentioned mushrooms), and a bit about Dennis McKenna. Somehow talk then turned to my tattoos and I described the neck pieces and the kanji on my forearms, and of the one that I got in Peru that I covered up. "You were in Peru?" P-A asked, his eyes lighting up. "I spent a week in the Amazon," I said. "Doing ayahuasca."

"Ayahuasca!" he shouted and stood up. "Oh man! I knew there was something about you." And we talked at length about my experience.

Fucking wow. It is like I now know what it is like to trust and to let myself be trusted -- to offer myself up to be trusted.

~

Meds. Gone the Vistaril -- Dr-X changed it to Seroquel and at 5:00 I took one and a Clonidine. At 9:00 I took the Lamictal and the Amitriptyline. At 11:20 another Seroquel.

I feel slightly less fear, but as I lay here in bed my heart still pounds and I know, still, at any moment panic may engulf me. I am still on edge.

Hopefully I'll get lined up with an appointment scheduled (real?) psychiatrist, and see Dr-L again to tell/ask about Dr-X.

Day Eight

It is quiet. Vocal-D has a constant escort. Late last night there were two new arrivals, 20-somethings. One is a "cover-model-ish" woman who apparently packed a large wardrobe. The other is a guy and my new roommate -- we only exchanged names so far -- P-T.

P-Covergirl quickly settled in. She is obviously not detoxing; she flirts and gets close to the others, leaning against Vocal-D. WTF. Funny, she's from where I used to live.

~

Meds still make me feel fatigued and, sort of, in my muscles, relaxed. I want to do things S L O W. My heart still aches though. Still, being physically close to people is a trigger. Having to talk to the SW and Dr-L and Staff triggers near panic.

(Fuck! I am constipated.)

Saw Dr-L and related my encounter with Dr-X. Although her face did not show it (it is hard to read her) she did say she was sorry that it did not go well for me with him

She was OK with the Seroquel and I said I was feeling better, but could not tell which meds were working, and that the Vocals were either gone or under control -- she smiled then -- "Yes," she said, "that would help. But the Seroquel could be helping too."

"How are you sleeping?" Good. "Are you dizzy getting up?" No. And she increased the Seroquel dosage from 50mg to 100mg.

~

Saw the SW as well. I told her I was good, that I feet safer. I knew this was what she wanted to hear as I read her well. I apologized for my behavior yesterday and said that Dr-X had just made me upset, that his "why are you crying?" interruption was a trigger for me and I went into a panic attack.

Unbelievable, she had called my therapist and told her that she did not hear Dr-X say that (so she overheard me on the phone!). I told her that I am hyper-vigilant and that I pay attention to everything (unless she knows PTSD she probably thought I was talking shit). "He did say it," I told her looking intently in the eyes. "He did say it."

"Did you talk to the doctor about your discharge?" she asked. I told her I did know that I had to bring that up. This is a major problem here, too much [Staff] not talking to the Ps about their case. So I'll have to bring that up tomorrow with Dr-L. SW then told me that Beth Israel in Brookline would not take me but would in Jamaica Plain. "Okay," I said, and I reiterated my wanting a "partial treatment program."

We left amicably -- which I need to do from now on. Lying, exaggerating, pretending, telling them what they, the doctors and nurses, want to hear are TOOLS to use, to manage the system -- just do not do those things to yourself!

~

Group. "Anger Management." The unit should have had such a group meeting EARLIER, right after the first time tempers flared up. However, the Staff who managed the group let the Ps talk among themselves and she even went on at length about FOOTBALL! WTF

~

P-D mentioned to me that Vocal-K called and was "out of his mind." So many of us live lives of circular illogic.

Oh, yeah. They (his doctor) took away P-A's Soma PRN!

~

"Smoking is a privilege," as they say here, and issues of cigarettes -- quantities, transfers -- are a cause of great anger among the Ps. (And smoking withdrawal at 4 per day.)

~

Just before dinner another P arrived. Now there are 11 Ps here. There are 15 beds in Unit 4, 86 in the entire hospital. When a P comes in they are given a "green folder" as a way to explain the facility and the rules, regulations, schedules and P rights.

How could the be so inconsiderate to just leave a patient to sit or wander around in confusion?

(The resident at BMC/CSU [Boston Medical Center Clinical Studies Unit] had told me, after "signing in," that he would give me a tour. He did not.)

~

For 6 days now a P in the adjacent Unit frequently is heard shouting, screaming, cursing, at the top of his lungs. Why? How could they let him carry on?

~

Panic attack triggered -- someone was around the corner and I am at the TV changing channels and adjusting volume low but the buttons make a loud clicking noise -- at this point there is just fear below the surface. When I settled on a channel and sat back in the chair I was getting a panic attack -- it subsides as I dash to get my notebook to record this event. As I write I am not in a full panic attack but my anxiety is very high.

One half hour later and my anxiety is still very high. And, I had taken 100mg of Seroquel just before all this began. My heart beats so forceful that my body shakes in the chair, the notebook and pen rock to my pulse.

I feared coming here. I now fear leaving here. Not that I like or want to stay here. I fear "going there." Being back on the streets. I feel safe here. There still is that constant feeling of doom that has always been with me though.

~

I am continually amazed that so many of the Ps here have been here before -- some 5 or 6 times.

~

The Seroquel is kicking in. I feel it in my muscles, kind of loose or rubbery and warm. My balance is off. My heart still pounds! My anxiety still runs high!

~

Two more Ps arrived this evening. When we were going to dinner (a walk outside to the cafeteria) the last new P saw someone he knew and they are "yo"ing and "dude"ing. This is so fucked up. So many Ps are in and out of jail and detox over and over. "Fuck," is all that can be said.

Yet another P arrived -- as he was led by Staff-K they both said hello as if they were old friends.

Vocal-D, followed always by his "shadow," as he calls him, still talks crap to all the staff. It's constant. He thrives on conflict. He has to be the center of attention, always interrupting staff. He just won't shut up.

"And I better not get anyone [room mate] that fucking snores. No way I'm gonna put up with that bullshit. No fucking way." And round and round he goes and where he stops, we all know: Detox.

~

Poor P-J is so sensitive. I say poor because he is here voluntarily because he was prescribed benzos for way too long -- and they stopped prescribing them to him. He is tall and very thin, walks slowly, talks quietly. He was kind and considerate to me many times.

He apparently accused Staff-K of, or said harsh words to, because she said to him, "This is just the way I talk. I talk loud. I got nothing against you."

We are all too sensitive. Too many of us, as I have experienced here, are way too sensitive and cannot stand being told to wait, or, "be with you in a minute," etc. And if a Staff misunderstood them (or they misunderstood), or if a Staff forgot something, the Vocals take it so seriously that they boil with anger bordering on rage.

"I was lied to," Vocal-D said in Wrap Up (out of turn). "They said I was going to get some fruit and didn't get it. That fuckin' bitch said I didn't ask..."

What kind of person throws a tantrum over not getting a piece of fruit? A six year old.

Day Nine

It is like spring outside -- wow. Another P came in last night who was here last February. Wow to that too.

As there are now more people here, more strangers, my fear base has increased. Anticipation of having to interact with anyone starts the panic attack (PA) symptoms. My hand shakes as I write this, sitting alone in my room and the Unit is relatively quiet and calm. My heart still pounds.

Of the Vocals only D is left. I think it penetrated him a bit that shouting and swearing just gets him restrictions and a "shadow."

The cigarette policy has "no passing" of cigarettes between Ps -- even a drag. If that happens they would both get 24 hour restriction (not getting outside to smoke). There are only four such breaks a day.

I can still hear the screamer in the adjacent Unit.

Although I still feel that PAs will occur at anytime, and know that my future freedom and mind is at stake due to my DUIs, I have learned that I just have to keep telling staff and the nurses that I feel good and am positive. I am a slow learner; but also my trying to isolate myself from contact with other people suppresses my ability to learn how to conduct myself around people and to, for lack of a better term, "use" the system. Not "use" as in take advantage of, but of how to ask questions, weigh options, ask for advice, ask for names, ask, ask, ask, ask.

Every Staff and nurse is here (there) to help. Sure, you'll get the occasional jerk/incompetent Dr (nurses are by far more concerned for patients than doctors), but, as with Dr-T I had, I should have just asked for another. (I.e. getting doctor lists and start making phone calls.)

I was so fucked by having by having the fear of contacting or interacting with people. And so, as so many people do, I turned to self-medication, leading me to run right into the brick wall of suicide. And State and Government agencies do a pitiful job of making the available services known to the public. Ask anyone who has "hit bottom" where help is available and they will say, "I don't know."

~

Saw the SW and told here pretty much all of what I just wrote above. Although the meds are not really working -- at least as much as I'd like -- I told her that they were and how I felt much better; that I feel safe here; that I have opened up to some of the Ps.

What I was doing with her was working the system -- not "using" the system, but working the system.

And the system need "bleeding heart Liberals" like these in the Mental Health System because it is precisely those people who are willing to help you -- help us.

It is the "YOYO" -- the "You're on You're Own" -- type of person who says that drug abuse is the person's own moral failing, and therefore, there need be no Government services, that all that is needed are "Family Values." The hypocrisy of that philosophy is that every town, city, state is a family or sorts. What we need are "Community Values."

I think I was wrong about P-Covergirl. We addicts all have our "shields up" when in a new and strange place. P-C was undoubtedly scared upon arrival -- she worked her "tool set" of flirting and being close to people, just as my "tool set" was isolating and avoiding.

~

Groups. The last 3 days had excellent groups -- due to a very good RN: about relapse, anger and stress management. I have been speaking up, telling my story, bit by bit. Others have been opening up too. Of course, others are still withdrawn or angry. Vocal-D started shouting and threatening Staff simply because the smoke break was delayed. "Come on, let's go," he shouted first. "Someone is still waiting to locate her cigarette allocation," a nurse said.

As the wait continued, the louder Vocal-D got, the more he swore and threatened -- he is, and remains, and will probably remain, his own worst enemy. He did not get to go out with the group.

I wet along this break because the sun was out and it was so warm -- how beautiful the birds and trees and grass and sky were.

~

P-A is gone. Apparently he said, "I think I have the H1N1 flu," and they packed his stuff up and took him away. He did not have flu symptoms.

I talked with Dr-L and gave her my "I'm so positive" speech, and I am, and she said she sees no reason why I can't leave tomorrow!

~

During "Stress" group one of the new Ps turned her head around, and, looking up at the ceiling started "aaahhhh" and then fell into a seizure. "Code blue in Unit 4. Code blue in Unit 4." She turned out to be fine. Talk about stress.

~

I learned things here. Apologize when you slight someone (well, I knew that one already; being polite is a core value), patience, etc. I already had all that but... I just could ever hold on to a positive attitude, or had knowledge of the existence of health systems that actually work, albeit in a slow ad dysfunctional way.

~

There is something called "The Pepper Trick." A P who has been in a out many times says he puts pepper around and looks to see if it is still there when he comes back.

~

Ps have been coming and going -- mostly coming -- so much that I cannot keep track. The heroin addicts are in the worst pain imaginable other than physical torture. A benzo addict is also in really rough shape. Alcohol withdrawal is supposed to be pretty bad too, but I never had it, and did not have it when I arrived. Any of the affects: skin crawling, nausea, vomiting, chills, aches and pains, etc. I have ever had any of those symptoms beyond "hangover."

~

I took a Seroquel an hour ago and my heart still pounds, my hands shake, I'm off balance, etc., but there really is no relief from my anxiety. The Lamictal takes "weeks" to do anything, and, I think, because I have...

* There was a bang just now and it felt like every nerve ending in my body fired off.

...been sleeping better, that the Amitriptyline has been helping with that. Since I still can get right up out of bed in the morning without feeling dizzy, Dr-L upped the med-A dosage by 10mg.

* It just happened again. Shit. I hope this is not going to be getting worse.

~

We just hosted an AA commitment. One of the speakers was an ex-cop also suffering from PTSD. He an another speaker made so much sense. I have been for the past 2 years of therapy, 2 years of hope that, if I just had the right meds, if I just had the right... something, my pain/fear would go away and I could be the person I want to be. If only... If only... If only...

The Seroquel... worn off. The Amitryptaline... worn off. The Lamictal... I have no idea if it will or does anything. I am still filled with fear. Ad o top of it all I have fear of having a PA.

I am interrupted by: "Code 22 courtyard. Code 22 courtyard." What first comes to mind was that Vocal-D finally blew a gasket. Turns out he tried to escape!

~

I am afraid, as I was afraid for so long, that my anxiety will ever go away and I can only just try to figure out how to deal with it. And I continue to write about it here. I can incorporate it in the characters in my stories. I can seek out other people who know about, have experienced the feelings I have. That is it for now. Will it be forever?

Wrap Up. During group I announced that I was leaving tomorrow. Everyone was pleased or happy. Some offered advice. When it was over I turned the TV back on and sat back in my chair and someone asked how long I had been here. "Ten days tomorrow," I said. She was smiling. Suddenly I catch the start of a Panic Attack but it goes away as I write this paragraph.

~

P-H just talked to P-S about her seizure. He said, "I tried to catch you before you hit your head. My brother has seizures and had to wear a helmet because he would fall and hit his head. So, as I saw you looking up at the ceiling, heard you, I knew it was a seizure. So I got up and tried to catch you." She was very pleased with his talk and I bet he felt good too.

There is love in this place. It is just hidden beneath a shit load of pain.

~

This should be my last night here. I just left the "club room" where four of the younger Ps were all talking up a storm, laughing and joking and fooling around. I lie in my bed, my heart still pounds, my future still bleak. All I have is hope that all the hard work that I have to do will pay off in some way that saves me from going to jail for the DUIs that I have pending. A hope that I can find the strength to not assume my future to be bleak. I just can't dodge the shadow of fear that follows me always.

What is it? What is the cause of it? Is it because I am now alone and away from distraction and ow dwell too much on my past mistakes and the new for certain consequences? Yes. I am alone and am afraid that I will not only remain alone but will have to face all of life's challenges and trials (literally and figuratively) alone.

I have much work to do.

And it's after 11pm and Vocal-D is still being belligerent and bringing trouble upon himself. Some of us will never learn, never do the work to help themselves.

Day Ten

NERVOUS. Please don't let anything screw up my discharge today!

Met with the SW and asking how I felt I told of how I was nervous, apprehensive and anxious, but that I knew why I felt the way I did, that I know that these are normal feelings. That I was going back out into a scary world. I added that it was not like the times when I would feel panicky for no known reason. "This is good," she said. I thought I noticed a bit of "Is he ready?" in her eyes but it went away after we began talking. I signed a few forms and I am going to be leaving this afternoon.

Still have groups though, and this morning's "Community" group was pitiful. There was a new (temp) Staff (F) who was obviously nervous and confused. (He once walked right into a patient.) During group he was hesitant, nervous, repeating words; he was a fish out of water and looked scared. He just did not know how to proceed. It was so uncomfortable to have to see this.

While Staff-F was reading "The rules," P-F asked a question. Staff-F looked up and said, "Wait until I finish." Well, P-F retorted with, "I might forget my question by then and that's rude." This kind of back and forth banter escalated, leading to P-F using "fuck" as an adjective, and Staff-F then telling P-F to leave. This lasted nearly 10 minutes. Shit.

Even now I can hear, "Fuckin' can't use my own razor. Fuckin' shit place." "Dave, you want some Thorazine to calm you down?"

Shit. Fuck.

~

Dr-L issued scripts for Lamictal, Amitriptyline and Seroquel.

You know, right now, after hearing all the shouting and swearing, I am feeling scared. Oh shit, I am so fucking scared. But the source of the fear is known, and the closer I get to actually leaving this place the stronger the fear gets. fear of relapse, fear of panic attacks, but mostly, fear of the DUI charges. I don't know... I could be fucked. I don't know if I can handle incarceration -- but I am projecting and need to find something positive to think about.

I am doing the right things my attorney told me. I just hope to... the formula of the Universe, that what I have done (inpatient) and will do (partial) will tip the scales in my favor.

~

I picked up the book I had been reading and found the place where I left off. A few paragraphs later though I read a sentence that I had read before. I think that what this means is that during my panic attack mode -- when I am very anxious -- my mind seeks isolation. I read but my mind does not retain what I was reading. When scared my mind suppresses sensory input -- this is the cause or source of my blackouts I believe. (And so, Dr-B, my long ago therapist, your belief that people don't have blackouts while sober is just plain wrong.)

The screamer in the adjacent Unit is very loud today.

The day went on like most others these last few days, but I did not bother to record what went on. The "Musical Therapy" group went well and was actually quite interesting as we were to discuss the meaning(s) of "Say (...)" by One Re...

But now, 6:00pm, and for the last 2 hours I've been in a very difficult panic attack. Just now I took 100mg of Seroquel -- we shall see what it will do.

I would have left here with Ativan but that quack Dr-? fucking jerk added Seroquel to my sheet; and since that happened, Dr-L, when I asked about the Ativan (she originally wrote it on my sheet but the hospital does not dispense it at all to anybody) she said there was no need for it because of the Seroquel.

My entire life passed before my eyes then. For Ativan (and alcohol) are the only two drugs that ever suppressed the pain of a panic attack. (And I am doomed.)

I am going to start Partial next Monday. If I cannot get some meds to make the PAs go away I am doomed.

The most horrible thing in the world is to be under a PA and having to stare at the walls.

Well, it's been a fucking hour and 100mg of Seroquel does nothing.

Doom is on the horizon.

Notes
  1. What a jerk. Did he think I was making it up? Why would I fake something as shameful as self-harming oneself for so long?
  2. It actually was not a suicide attempt. I was very intoxicated and had jabbed and X-Acto knife into my arm and went for a walk down the street. It bleed a lot. Someone called the police.
  3. Kind of like some families!
  4. Something I am very poor at doing — and rarely do.
  5. I felt a great fondness for her.
  6. There was a small inner courtyard we were allowed to go into for 15 minutes a day.
  7. It's odd, that I used the word "love" there, having declared there is no love in the patients earlier, as is my writing it "less raw." The confusion is apt.
  8. As she has. In fact, reading this now I have no memory of her. Only two "Ps" do I remember: the one with the crooked stick (P-A, who was a very nice fellow), and, unfortunately, Vocal-K.
  9. I guess I wrote thinking I would one day publish it. Or just talking to myself.
  10. How I got sober for the first time is extremely emotional and very important to me. I was watching the concert dedicated to John Lennon and his music at the end of September, 2001.
  11. This is the "conventional wisdom" among psychiatry — and for some it's bullshit.
  12. Yes, I am quite cynical at times — one of my "issues".
  13. Hey, it happens. Side effect of the Seroquel.
  14. I do not do it well.
  15. By that I mean the cycle of going in and out of sobriety — and hospitals.
  16. This is a reference to a psychiatrist I once had that was a total jerk — never believed anything I said.
  17. Not really "suicide", but "self destructive behavior".
  18. I actually do not consider myself an addict, but an alcoholic -- there is a difference. But I leave what I wrote then as that is not the kind of editing I want to do here.
  19. And there it is explained in full.
  20. It is called dissociation and normally occurs for people who have gone through trauma.
  21. That's how I wrote it. I wish it were more clear.
  22. And it was. For five more years.

Medications:

Chlordiazepoxide (Librium)
Clonidine
Hydroxyzine (Vistraril)
Carisoprodol (Soma)
Quetiapine (Seroquel)
Lamotrigine (Lamictal)
Amitriptyline

#
Writing Down the Pain
I'd like just once to fall asleep feeling good about myself. Just once. Drunken stupors do not count.