The nurse remarked, “I need your shoes.”
I turned to face him, then returned to my blue Converse sneakers. “What?”
“Your shoes,” he said again, this time more forcefully. “You’re not allowed to have them here.”
I was about to say something like, “I know what you’re thinking, but the laces are only for show.” I’m not sure how to get rid of them. Instead, I removed my footwear and delivered it to the nurse, who placed it in a transparent plastic bag. I began to worry when I’d get them back, but quickly realized that I couldn’t dwell on it since I was so fragile that any stray thought may fracture me like an egg. That’s when I understood I’d made the proper choice by checking myself into the psychiatric unit.
The nurse handed me a pair of socks and said, “Thank you.” He led me to my room after I put them on. “Every 15 minutes, someone will open the door to check on you,” he added, his spectacles glinting off the fluorescent lights above us. He handed me a pair of dark blue slacks and a shirt, advising me to change. I walked into the restroom and changed out of the emergency room gown and into these new garments, which looked like a hybrid between medical scrubs and pajamas.
Towels, shampoo, body lotion, a toothbrush wrapped in plastic, and a travel-size tube of toothpaste were placed on the sink in the bathroom. There was no towel rack on the wall, and there was no mirror. I was in a place with rounded edges and smooth surfaces, where shoelaces could be used as weapons and doors were never totally shut.
The nurse gave me a tour of the ward when I got out. It was late at night, and the spacious, spotless hallways were deserted. We entered the treatment room, which was dominated by four long tables packed into a rectangle, past a spacious day room with a television, a couch, and tiny tables and chairs.
The nurse showed me a well-stocked bookcase and remarked, “And this is the library.” For weeks, I hadn’t been able to focus on anything other than my own despondent and worried thoughts, although reading had been one of my greatest joys. Now I was looking at the shelves with trepidation. I’d checked myself into the psych ward because I needed to be under the care of a psychiatrist right away, but maybe now I’d be able to read again. I chose Reviving Ophelia by Mary Pipher and My Story by Sarah Ferguson after carefully analyzing all of the titles with the nurse waiting at my side.
My sock-clad feet moved quietly across the linoleum floor, silent as a whisper, as the nurse took me back to my room.
I saw the psychiatrist the next morning, who was accompanied by six medical students and a resident, who was the first to speak.
He inquired, “Were you admitted via our emergency department?”
I answered, a bit defensively, “I wasn’t sure where else to go.” “I tried calling around for a psychiatrist, but they were all booked up.” There were waitlists for some of them, but they were extensive… “
He smiled and nodded.
“The psychiatrist I saw in the ER yesterday said I matched the requirements for admission,” I said, afraid they’d say I didn’t belong here and I’d have to start seeking for assistance all over again.
The resident said, “Why don’t you tell us what led you here?”
I tried to order my thoughts by closing my eyes. I informed him about my breast cancer diagnosis a year prior, as well as my bilateral surgery, reconstruction, and radiotherapy. “I have chronic pain in my nerves and joints, and the mastectomy was my 11th operation,” I said, realizing that I sounded like I was reading from a screenplay. I thought I knew what to anticipate in terms of pain, but the recovery following that procedure was agonizing. I was in a lot of discomfort physically, and it was also affecting my mental health‘
“How so?” he said, a hand raking over his dark blond curly hair.
I told him I’d been waking up every day feeling dismal and miserable, as if I didn’t know how I’d get through the day. I was in a lot of pain. I swallowed, recalling the stinging agony, which felt like a bra’s underwire was under my skin, cupping my implants. I admitted to him that I couldn’t concentrate on anything. It would have been a huge achievement if I had gotten out of bed before my daughter arrived home from school.
“Had you ever felt like that?” he said, and I shook my head. I informed him that I had been diagnosed with anxiety and was taking medicine for it, but that the mastectomy and reconstruction were completely different.
“How did you feel throughout the radiation?”
Better. It was exhausting, but not nearly as painful, and I didn’t feel as hopeless.
With his hands clasped in front of him, the occupant nodded. I started weeping as I noticed the shine of his gold wedding band. “I’m sorry,” I apologized. “It’s only that today is the 14th anniversary of my wedding.”
“It’s all right,” he said.
With the backs of my palms, I wiped my cheeks. I gently stroked the 2-inch scar on the left side of my neck and informed him about the previous operation I had a few weeks earlier to replace a degenerating disc in my cervical spine with an artificial one. I was nervous, despairing, and unhappy all of the time within a few days, just as I had been after the mastectomy.
The resident inquired, “Were you able to chat to anybody about how you were feeling?”
Yes. My spouse and close friends were always sympathetic, and I’d feel better for a while, but the sensations would always return. I lost my appetite and began waking up in the middle of the night, unable to sleep again. My thoughts would spin in circles, replaying ridiculous things I’d said years before or fantasizing about a job I didn’t obtain. It was as if I was trapped in a loop in which all I could think about was how I’d already screwed up or how I was about to screw up, and I didn’t have the energy to think about anything else.
The attending psychiatrist moved closer to my bed, taking a step forward. “How do you think you’ll feel better?” she inquired.
I indicated that my primary care physician is unable to diagnose mental illnesses. I keep returning to the thought that perhaps a new drug might assist now. “However, the waiting lists for every psychiatric office I phoned were so long,” I explained, resuming my explanation.
Her black eyes were gentle and tired as she responded, “That seems sensible.” “We can assist you in finding an outpatient psychiatrist, and we’ll boost the amount of your anti-anxiety medicine.” I’d want to start you on an antidepressant as well. “Does it sound right?”
“It sounds fantastic,” I responded, almost weeping again with relief. “It sounds fantastic.”
“It’s all right,” she said. “You should be able to go home tomorrow if you accept the meds properly.” “We’ll come back to check on you later,” she replied with a smile.
I picked up a folder that had been in my room the night before after the team had departed. There was a self-assessment for patients to complete among the other documents. I wasn’t sure whether anyone would ask for it again, so I opted to fill it out.
The top half was labeled “Strengths,” and the bottom half was labeled “Weaknesses,” with the patient checking the boxes next to the ones that corresponded to them. After all, I’d put myself into a closed psych facility, so I imagined I’d check all the “weakness” boxes. However, as I read it, I realized that I possessed nearly all of the “strengths” listed: I was educated, had a permanent residence, and a supportive family. I was financially secure, could communicate effectively, had a large social network, and could work part-time. I didn’t pick the religion option in the “strengths” part since I only go to synagogue on the high holidays.
I’d worked for a reproductive rights organization a dozen years before. One of my coworkers coined the expression “interlocking systems of oppression” to describe how seemingly trivial inconveniences might have far-reaching consequences. Taking many days off work for mandatory doctor’s appointments, for example, may result in a woman losing her job. This checklist seems to be used to measure someone’s socioeconomic level rather than their mental health. Except that the two are so tightly linked: anxiety, depression, and other mental health disorder
s may all be exacerbated by a lack of a solid family life, supportive relationships, or steady job.
And I considered how the “strengths” I possessed were likewise intertwined. I wouldn’t have had the professional security to check into a psych facility on short notice without fear of losing my work if I hadn’t gone to college. My husband and I met via college buddies, and our combined wages allowed us to purchase a home in a secure area. While mental health disorders can affect anybody, rehabilitation is dependent on a variety of circumstances, not all of which are under the patient’s control.
I blinked, recognizing how long it had been since I’d been able to focus on a concept that brought me outside of myself and forced me to consider an issue more fully. It felt amazing, like if the never-ending cycle of misery and worry had slowed enough for me to catch my breath and reclaim my capacity to think and focus.
Later, a social worker dressed in a pastel pink sweater entered, and we discussed scheduling an outpatient psychiatric consultation. She inquired as to if I could pay for the appointments out of pocket, since doing so would substantially expand my possibilities. Her brows flew up when I said I could, before her countenance returned to its pleasant neutrality. I had an appointment for the following week an hour later.
I finished both novels by the evening and had promises from the doctor, resident, and nurses that I would be dismissed the next day. Before going to bed, I took my first antidepressant, the little tablet flowing down my throat effortlessly, and then turned out the light.
But I didn’t fall asleep. Instead, I focused on how much more at ease I felt now that I had a psychiatrist, meds, and a treatment plan in place. The relief was breathtaking, and I wanted to wallow in it for as long as I could.
But then I remembered what I’d had to go through to acquire that relief. I used to think that being admitted to a psychiatric institution meant you were suicidal or had a mental breakdown; even at my worst, my melancholy and anxiety were controllable.
I wasn’t ashamed of being in a mental institution, but I couldn’t deny that I’d had to leave my life in order to seek care. I had to “other” myself in a manner I’d never had to before in order to obtain assistance for my chronic pain or cancer: I’d had to leave my family and home on purpose in order to get treatment as soon as possible. I’d got to embrace the fact that I didn’t know how long I’d be gone and that I’d have to consent to being treated as someone whose mental health may lead her to hurt herself or others. Checking into the ward seemed like stepping across a line: on one one, I was someone who could be trusted with shoelaces, and on the other, I wasn’t. And it was on that side that I began to reclaim my identity.