The Weekend from Hell
Okay, here's the official report of why I ended up incommunicado and incarcerated in a hospital all weekend, starting January 28, 2011. (Warning-- foul language and aspersions cast upon the wisdom of several professions.)
After Randy's death, I'd been feeling very down and considered myself very unlucky. I think most folks can understand my feelings. However, I began to realize the depression was interfering with my work and daily life. So, I made an appointment with my primary care physician's office to reinstate the prescription I'd had previously for Wellbutrin. It had worked well before, so I was confident that would be all I needed to even out the peaks and valleys of my mood swings. My appointment was for late Friday morning. Dante and I went with the idea of having a bit of lunch and taking care of a few errands while we were out.
As usual with my PCP, I had to see her PA (physician's assistant). No big deal. I had a short list of problems to discuss, such as a bruised and swollen left foot from where I fell, and I wanted to request a hearing test. My tinnitus has been getting worse. I'm concerned about having enough hearing loss to need artificial aids. I mentioned them all, as required, to the nurse who took my vitals. The PA was more concerned with my depression, and I willingly answered all her questions. What I didn't know was that two of her questions were of huge legal importance. In the state of Florida, NEVER answer, "Yes" to these two questions:
1. Have you ever considered suicide?-- To me, that question is broad enough to cover my entire life. I don't know anyone who hasn't, at one point or other in a long life, to have entertained the notion for perhaps a brief moment. I have, at several points in my life, so I answered, "Yes, it's been awhile."
2. Have you got a plan of how you'd do it if you did want to commit suicide? -- I'm an author. I research anything that might be a plot point to its logical conclusion. Since at least two of my characters considered suicide, I researched it. I also have friends in the medical profession, including two that worked in an ER. They told me what sort of OTC pills could be taken to ensure death. You can't un-learn information. To me, the question was the same as when I plot a murder mystery for the Majesty Mystery series. Thinking about how to commit murder is part of my job, but it doesn't mean I plan on picking up a weapon and doing the deed. (How would I get blood out of my leathers??) So, I considered the question theoretical and answered honestly. "Yes, if I ever wanted to do myself in, I'd use X method. It's less messy and effective."
I had no idea I'd just sealed my fate. You see, Florida has a law called "The Baker Act." If someone seems to be a danger to themselves or others, they can be locked away in a psychological ward or facility for up to 72 hours for observation, with or without their consent. To that PA, I'd just said, "Yes, I plan on killing myself, and I know how I plan to do it."
The PA asked if I'd mind checking myself into the hospital for observation over the weekend "while they adjusted my medication dose" because I'm on blood thinners and allergic to certain medications. It's a reasonable precaution on the surface, but I knew I wasn't allergic to Wellbutrin. She promised I'd not have an IV. I was dubious and uncomfortable going to the same hospital where my DH died, but I shrugged and agreed. What I didn't know was, if I hadn't agreed, there was a police officer waiting to put me in handcuffs and take me there. I'd been "Baker Acted." (Note she did nothing for my foot or hearing.)
Dante and I went to lunch and discussed his taking me to the hospital and how he'd return home to ensure my comfort by bringing my laptop, flash drive, and a few things like clothing. Then we drove casually to the hospital and went to the ER, as instructed. I spent a few moments texting my daughters to let them know I was going into the hospital for observation. Since texting is very difficult for me, I told them to phone Dante for details. That would be the last anyone heard from me for three days. Shortly thereafter, a security officer arrived and led me back to what I now know to be the "security beds" of the ER. I was installed in a bed, given the usual hospital gowns, and my clothing and purse removed. They promised they'd lock my purse up for safekeeping in security, and my clothes would go upstairs with me. The gown was just temporary and part of procedure. (Truth was, all clothing must be checked for forbidden items like shoelaces and then washed in case you bring lice onto the ward. I would not see my clothing for several hours, and that would not include my tennis shoes.)
I also discovered the ugly truth that "No IV" doesn't mean "no needles." They had to get blood work from me. Dante returned with what would be my normal hospital stay comforts. Most of them were removed and not returned to me, because they were judged as "dangerous" to either me personally, or to the patients. This included the binder containing the first few chapters of my WIP and some research materials showing different sexual positions (m/f, for once). Even my Alphasmart word processor was judged too dangerous. Only six books and some oddments of clothing like a nightshirt, robe, and a pair of slippers passed. Even some of my cosmetics weren't brand new, so they could not be brought onto the ward, just in case they contained hidden contraband. Being that it was now late evening, Dante was shooed away and told he could visit "tomorrow." (Yeah, from 4-6 PM on Saturdays, Sundays, Tuesdays, and Thursdays. That's it.) The doors closed on his shocked and bereft face with a metallic clang of doom.
Only then, while being interviewed by the charge nurse, did I discover I'd been "Baker Acted" and the ward was now my prison for the weekend until I could see "my" psychiatrist on Monday. The psychiatrist who worked weekends was extremely reluctant to release patients of other doctors, even if that patient had never seen that psychiatrist! No, she did not use the word "prison." In fact, when I objected to being betrayed and "incarcerated," the charge nurse gently but firmly informed me that I was not imprisoned despite the fact that the exit doors were double-locked and I could not leave of my own free will. "It's for your own good." By the end of the weekend, I hated that phrase.
Even I am smart enough to know better than to stand up, snarl, and let my anger show. To have even raised my voice was to ensure I'd be labeled "dangerous" and I'd end up with a sedative in a hypodermic. Still, my words could be a whip even if I never rose in volume, and I let the nurse know that I had been deceived into being there, I was not in the least actively suicidal, etc. She calmly informed me that she was well aware I was probably not harmful, but she had no authority to release me. I would have to convince the weekend psychiatrist, who was not known for releasing patients. She patted my arm sympathetically, and suggested I look on the weekend as a respite from my troubles. I was in no mood to be placated, but permitted her to lead me down the hall to the room I'd share with another woman all weekend. She brought me a sedative, since I was clearly so angry I would not sleep without chemical assistance.
Eventually, I fell asleep wondering if there really was a demon named Murphy who had been specially assigned to me. Since I'd been given a packet "homework" that suggested I keep a journal, I decided to make all my journal entries addressed, "Dear Murphy."
In the morning, I discovered I have a reaction to the sedative I'd been given. While it works to help me sleep, in the morning I pay for that sleep by retching up the non-existent contents of my stomach, my toenails, and even the memory of any food I may have had in the past 24 hours. What a lovely way to start the day. Needless to say, I missed breakfast. However, despite my illness (Hello, Murphy!) I waited my turn to speak to the psychiatrist. I was now wearing the same clothes I'd worn the day before, and was green about the gills, but I marched in defiantly to speak to the psychiatrist.
I have little good to say about the psychiatrist. English was definitely not his first language, and if ever there was a man who stubbornly would stay upon the path of least resistance as long as he did not exert himself, it was Dr. Y. I doubt he cared that I'd been deceived. I doubt he cared that I did not belong on that ward. He was there as a placeholder to monitor the inmates' mental health, prescribe pills as needed, and then he could leave. Even when I patiently explained that, as an author, I'm used to plotting and research, and I'd of course studied all manner of death in the thirty novels I'd written to date.
When I used the word, "incarcerated" to him, he gently protested. "You are not incarcerated, Ms. Austin. You are here for your own good."
"Really, doctor? Are those double doors at both ends of this ward locked?"
"Am I free to leave of my own free will at any time?"
"Those two conditions mean I am imprisoned by the definition of the word, Sir. Look it up. No matter whether you like the term or not, the results are the same. I am here, behind locked doors and not allowed to leave. Therefore both terms of incarcerated and imprisoned both fit."
"No, no! You are Baker Acted. You are here to ensure you do not harm yourself or others."
"Have I not proven to you that, while I can answer yes to those two fatal questions that damned me to this imprisonment in a loony bin, I am not actively suicidal?"
"Ms. Austin, I beg you not to call this place by that epithet, and I repeat that you are not imprisoned. You may feel free to be as angry as you wish, but this is for your own good."
Don't you just hate circular logic? Just as I was ready for a good primal scream, he ushered me out the door with those hated words ringing in my ears. For his edification, my response was, "And you may use whatever excuses you wish to allow you to sleep at night."
The noisy dining room was overcrowded, and I'm fond of my personal space, privacy, and quiet. I got none all weekend. My roommate was a delightful woman I'll call DG. She had put herself in the ward, and considered it a respite from the stresses of life. She urged me to make the best of a bad deal and try to treat the weekend like a visit to a slightly shabby hotel. I counted to ten and reminded myself that logic did seem to be in short supply in the loony bin, and that lack was not limited to the inmates.
Perhaps you might call this a bit of luck, but there was no therapist available on weekends to engage the inmates in therapy sessions where we were asked such ridiculous questions as, "Name 25 things you like about yourself" and "Do you need help figuring out your goal for the day?" (Lady, my goal is to get the hell out of here with my mind intact.) The inmates actually cheerfully got out coloring books and crayons and praised each other's art. (I tried not to whimper aloud.) One rather manic young lady suggested we all put on a play based on a medical drama, and one of the other manic-depressives jumped up and began to extemporize a theme song. (She can't sing, but she was enthusiastic.) No one could agree on which one of the male inmates got to play McDreamy, and none of the female inmates was willing to "dress sexy." Much to my relief, they didn't ask me to write the script, even though some had already learned I was a published author.
I swear to you all, the inmates are treated like overgrown pre-school children. Besides coloring books, you could color with markers on paper plates, and the very best could be taped to the locked cabinet doors where other amusements were hidden. We had snack at mid-afternoon, and a snack just before bedtime. My intelligence and mature age were insulted so often, I began to be more than a bit stressed with reining in my growing anger, frustration, and humiliation. I burned the first Wellbutrin out of my system like blowing out a match in a hurricane.
One small joy was that those who were ambulatory and willing were permitted an escorted visit out onto an enclosed patio and allowed to soak up sun and fresh air for about half an hour. Two of our keepers went with us, and the male nurse was clearly there to wrestle any inmate who made a leap at the fence in a bid for freedom. All too soon, the "patio time" was declared over and we went back up the stairs, through the locked double doors, and back to the chilly halls of the ward.
By the time Dante and the other family members had phoned in to beg for permission to enter and provided the proper passwords, get a security wand passed over their bodies, and then required to sign in, and finally they had to hand over their keys, cell phones, cigarettes and lighters, any sharp objects, and the gifts brought to the inmates thoroughly inspected for things like ribbons, balloons, and contraband…then and only then could the visitors enter the dining hall to be joyously greeted by the inmates. All inmates who did not have a visitor were ushered away to a smaller recreation room so they didn't get upset that they weren't graced with company.
Here's where I have sympathy for the inmates. The truly bereft looks that replaced hope when all the visitors had been admitted were horrible to see. One wife had talked all day about her husband and how she looked forward to seeing him and how much she missed him. He never showed up all weekend. A young mother waited by the door, hopeful that her mother would show up with pictures of her two-year-old son. The mother didn't show up until her daughter was released. Others, with drooping shoulders and defeated looks, shuffled out ahead of their keeper. They weren't permitted back until Dante, one of the last to leave, had the door shut safely behind him and we were all locked in again.
I'll grant that the food was decent, plentiful, and mostly healthy. The nurses tried to help me find some food that wouldn't plug up my lap band, but this meant I often went without a full meal unless I was able to trade foods with another inmate. For one meal, all I could eat was the string beans and the dessert of canned peaches. No one wanted the crusty meatloaf and mashed potatoes swimming in congealed grease thinly disguised as gravy. As hungry as I was, I pushed that plate away. One of the nurses took pity on me and brought me peanut butter and a graham cracker to hold me over until snack time. She was very sorry, but until I could speak to the dietician on Monday afternoon, but they couldn't change the meals to something more compatible with my lap band. I was stuck with the "normal" meals until then. I felt sorriest for the one Jewish inmate. His meals were as pitiful as mine, perhaps more so.
Sunday was no better than Saturday, except that I was only polite to Dr. Y. I had resigned myself to losing three or four days. I answered his questions about how helpful the medication was so far, etc. Our visit was short and chilly enough to leave frost on the files in his office. The best I can say is that he rescinded the Baker Act on me Saturday, but wouldn't sign the release papers. I was forced to wait until Monday's visit with "my" psychiatrist.
By then, I'd had a new horror added to my tortures. They'd discovered from the first blood draw that my blood thinner wasn't at expected levels. So, Sunday and Monday mornings before the dining hall even opened to allow me a cup of (decaf) coffee, I had a visitation from the phlebotomist. Anyone who knows me well is probably wincing in sympathy. I am a "hard stick" and consequently lab draws are sheer torture. Yeah, before 7 AM. Lovely way to start the day. They ignored the warning that dipshit of a PA had put that I was needle phobic. They wanted the blood draw, and that was that. The fact that I was now so stressed that my blood pressure had risen to "high" levels, and even the nurses expressed distress at how it had risen so "fast" didn't matter. The fact that there are finger prick devices doesn't matter. The blood draw is cheap and easy.
On Sunday, that bastard Dr. Y added twice-daily shots of Lovonox in my belly atop everything else. This is a blood thinner. For many, the needle is tiny and a minor sting. For me, every shot meant a bruise about the size of my palm and a stinging and sore belly. He cruelly arranged for these shots instead of merely making the phone call to my doctor to get my Warfarin pill dosage increased. It was easier to simply order the shots and stress me out further rather than pick up the phone and make the call. Do you see why I call him lazy?
By Sunday afternoon when the visitors waited at the door, I was as pitifully needy as the rest of the inmates. I'm not afraid to say they came dangerously close to breaking my spirit. Anyone can break, and my stress was close to shattering me. If someone could have seen my mind and heart, I'm sure they would have seen the spider web of fractures forming. My hands shook, and I was growing numb. My back hurt from my shoulders hunching. When not required to be in the dining area or out on the patio, I hid in the room I shared with DG, reading voraciously. The books were my lifelines to sanity.
So were Dante's visits. I lived for the two hours when he held me in his arms and whispered encouraging words to remind me my incarceration was limited to 72 hours. Without his visits, I think I would have cracked and become the suicidal mess they thought I should be.
In fact, I've begun to shake just typing this. I think I'll stop now and finish later.
Monday morning finally arrived, and I showered and dressed with a crumb of hope that perhaps I could convince Dr. G that I had never deserved to be incarcerated in the first place and I should be released immediately.
However, that demon Murphy wasn't done messing with me. All the bad-for-me food I'd begun to eat had begun to mess up my digestive system. I'd known, of course, that I'd pay for eating things I shouldn't. Unfortunately, I'm also a stress-eater. That's why I had to get the band in the first place. So, my digestive system began to rebel, starting with painful cramps while my bound-up bowels tried to evacuate themselves explosively. Needless to say, I lost my place in line twice while I dashed back to the bathroom.
Finally, finally, I was there when Dr. G called my name. I practically wept, but held my chin up, determined to prove I did not deserve to be incarcerated.
I'll say first off that I like Dr. G. He impressed me almost immediately with a charming combination of competence and humor. He listened to my story, from start to finish. He asked pertinent questions. He agreed that, while I did have depression and a need for Wellbutrin, I was not suicidal. I could have kissed the top of his cute balding head. He recommended that I make an appointment to see his psychologist wife in Riverside. I agreed, somewhat reluctantly I admit, but she did sound like someone I could like.
Dr. G pulled out a prescription pad without another word. I watched him scribble on it a moment, before the question burst forth from me. "Doctor, please gladden my heart by telling me you will release me?"
He smiled up at me. "My dear let me give you a clue. When in a hospital, if a doctor pulls out his prescription pad, you may be assured he will release you." He handed me the prescription for my Wellbutrin.
I danced out the door and could have done cartwheels down the hall, except for my advanced age and the fact that I've never been able to do cartwheels. For the first time in nearly 72 hours, I could genuinely smile with real joy.
Murphy wasn't quite done. He had one more jab at my nerves. It seemed Dr. G did not sign a certain piece of paper needed for my release. This was not discovered until lunchtime. To keep myself busy I packed and stripped my bed. I knew Dante was tantalizingly close, in the tiny waiting room just outside those locked doors. That was more torture, to know freedom was but a few feet away and waiting on me. The last two waiting for release was the young mother and I. Eventually she too got her papers and was escorted out those damned doors. The staff in the office went on about their business. In time, I could bear the waiting no more. I went to my former room, purloined a box of tissues from DG, and sobbed hopelessly. At long last, I was broken. In fact, I will say for the first time in many years, I would have chosen suicide, if that were my only escape from that horrible ward.
If it had been their intention to keep me from suicide, they chose exactly the wrong method to achieve their ends. I was not suicidal when I went to see my doctor's PA, but by having removed my freedom, tortured me, and finally they had won. I was at last what they'd insisted I must be- I was so deeply depressed and hopeless that I would have indeed put a gun to my forehead and pulled the trigger.
Why the nurse who found me was surprised to find me bent over and sobbing in that dark room, I can only guess. Surely one who is so educated and working in a psych ward could put two and two together. Yet, she did have the nerve to be surprised. Why, the signed document had arrived five minutes after the previous woman's via fax. Gee, it might have been nice to tell me instead of ignoring me!
My "too dangerous" items were brought from storage and placed on a metal cart. I had to look through them all to verify nothing had been left behind. What sort of idiocy was that? I'd never even seen what had been in the bags Dante had brought, because they'd been deemed "too dangerous" for me to have on the ward! Still, I made sure the stuff was all mine. I didn't want anyone else's possessions. I wanted mine, and my long-denied freedom.
At long last, she opened the doors and led me out. Dante, his face hopeful, peered around the corner and ran to me for a bone-cracking hug. Both of us were so tearful, we could barely see.
The PCT who was my escort and final keeper, accompanied us downstairs to the security office. I presented them with my yellow security paper, detailing those valuables taken from me that first night. At their request, I impatiently checked to make sure every valuable listed on the paper was now in my possession. At the PCT's suggestion, Dante went to get the car.
At long last, the PCT and I walked through the doors and into fresh, free air. I stumbled to the car, and with shaking fingers, buckled myself in. We drove away and did not celebrate until I walked through the threshold of my own home, safe at last.
For those who have asked, yes, I am considering calling a lawyer. I would love to have someone –including Dr. Y, especially—charged with holding me against my will without cause and the entire hospital charged with a breach of my civil liberties.
In fact, I'd love to challenge the whole Baker Act and the way it is used. In principle, it's a good law. In practice, if someone can be locked away on the basis of two questions with no chance of appeal or mediation, then there's too much leeway for abuse as I suffered. Once Dr. Y signed that paper rescinding the Baker Act on me, I should have been immediately at liberty to leave. There was no reason to hold me there, and I was forced to stay.