This was previously published in several other
venues, and is posted here in May, which is designated “National Mental Health
Month”
Up From Bedlam
“Bedlam” is the name of aLondon
About 1948 I accepted an invitation to visit theMissouri State
Hospital
About 25 men lethargically pushed dirty mops in a continuous circle across a warped and splintered wooden floor. Their eyes were vacant, their faces expressionless. Some of them were drooling, one man‘s sexual arousal was obvious but ignored, now and then one of them would laugh mirthlessly at some secret inner-minded humor. The one stubble-faced attendant, in filthy white clothes, chain smoked and lounged impassively as his custodial charges marched their purposeless, endless treadmill of mindless desperation. They were more suggestive of inmates than patients.
The ambience in the female area was different only in gender. There was no circular floor mopping, but each of the patients was supposedly occupied in some useful activity. One skinny, pale-faced type approached me with an explicit sexual proposition stated loudly in colorful street vernacular. In the laundry room a cheerful, heavily perspiring fortyish woman stuffed grungy gray bed clothes into a tub of tepid water which matched the color of the sheets. I thought she was an employee.
In times past psychiatric hospitals were sometimes referred to as “Snake Pits”. That is defamatory to snakes. I got a dose of reality that day which has never left me.
Move forward a decade.
With a newly minted doctoral degree in my hand, I reported to theKansas City Psychiatric Receiving
Center
The common room was bright, cheerfully furnished, no gender segregation for most patients. There were a few semi-zombieized patients who were being moved “up” from more restricted levels of care, but most of them were sort of doing their own thing. A few women were knitting with blunt brittle plastic “needles“ which they had to check in and out when they wanted to use them, a few were playing cards or checkers, one man was doing a chess solo. A couple of patients were pacing, driven by inner demons, but disruptive behavior was infrequent. Two female nurses and two or three male Psych Techs were actively involved with the patients, distributing meds, answering questions, or just chatting.
PsychiatristJohn
O’Hearne Don .
About 40 years old, clean-shaven, neatly dressed, with an educated vocabulary
and an easy manner. Dr.
O’Hearne John
said cryptically, “Wait a few days”. About a week later Don
was in a “rubber room”, stark naked and filthy from his own feces, talking in
staccato gibberish about his plans for world reform. A year later he was still
in the hospital, having his cyclic battles with his inner demons. Terrible
waste! As other medications became available I hope he was able to resume
somewhere some semblance of his former life.
Now move ahead thirty more years, another city, another hospital, another man. A clinical psychologist, a professional with four university degrees, he was in the grip of a major depression.
Even doctors get sick. (his symptoms appeared in adolescence, but no one recognized them). At 2 o’clock one morning he was sitting at his desk, ripping pages from his typewriter because he couldn’t write a coherent paragraph. The next morning his wife and his secretary each took him by an arm, walked him firmly to the car, and delivered him to a psychiatric hospital.
The first night he crawled on his hands and knees in the bathroom, afraid the staff would find some pills he had spilled, pills with which he had been medicating himself and smuggled in. The treatment he received was excellent, highly professional, effective. After a month in the hospital, 6 months off work recovering at home, medication (which he will gratefully take for the rest of his life) monitored by a very good psychiatrist, an understanding, supportive boss, and a wife who is a shoo-in for sainthood, he is back doing his thing, doing well.
I was that man.
“Bedlam” is the name of a
About 1948 I accepted an invitation to visit the
About 25 men lethargically pushed dirty mops in a continuous circle across a warped and splintered wooden floor. Their eyes were vacant, their faces expressionless. Some of them were drooling, one man‘s sexual arousal was obvious but ignored, now and then one of them would laugh mirthlessly at some secret inner-minded humor. The one stubble-faced attendant, in filthy white clothes, chain smoked and lounged impassively as his custodial charges marched their purposeless, endless treadmill of mindless desperation. They were more suggestive of inmates than patients.
The ambience in the female area was different only in gender. There was no circular floor mopping, but each of the patients was supposedly occupied in some useful activity. One skinny, pale-faced type approached me with an explicit sexual proposition stated loudly in colorful street vernacular. In the laundry room a cheerful, heavily perspiring fortyish woman stuffed grungy gray bed clothes into a tub of tepid water which matched the color of the sheets. I thought she was an employee.
In times past psychiatric hospitals were sometimes referred to as “Snake Pits”. That is defamatory to snakes. I got a dose of reality that day which has never left me.
Move forward a decade.
With a newly minted doctoral degree in my hand, I reported to the
The common room was bright, cheerfully furnished, no gender segregation for most patients. There were a few semi-zombieized patients who were being moved “up” from more restricted levels of care, but most of them were sort of doing their own thing. A few women were knitting with blunt brittle plastic “needles“ which they had to check in and out when they wanted to use them, a few were playing cards or checkers, one man was doing a chess solo. A couple of patients were pacing, driven by inner demons, but disruptive behavior was infrequent. Two female nurses and two or three male Psych Techs were actively involved with the patients, distributing meds, answering questions, or just chatting.
Psychiatrist
Now move ahead thirty more years, another city, another hospital, another man. A clinical psychologist, a professional with four university degrees, he was in the grip of a major depression.
Even doctors get sick. (his symptoms appeared in adolescence, but no one recognized them). At 2 o’clock one morning he was sitting at his desk, ripping pages from his typewriter because he couldn’t write a coherent paragraph. The next morning his wife and his secretary each took him by an arm, walked him firmly to the car, and delivered him to a psychiatric hospital.
The first night he crawled on his hands and knees in the bathroom, afraid the staff would find some pills he had spilled, pills with which he had been medicating himself and smuggled in. The treatment he received was excellent, highly professional, effective. After a month in the hospital, 6 months off work recovering at home, medication (which he will gratefully take for the rest of his life) monitored by a very good psychiatrist, an understanding, supportive boss, and a wife who is a shoo-in for sainthood, he is back doing his thing, doing well.
I was that man.
That was 27 years ago, a third of my
total lifetime. That was the birth of 5 great-grandchildren ago. That was a
quarter of a million miles of travel in 20 countries ago. 27 busy, active,
years I would have missed had there not been some caring, competent people to
pick me up when I crashed, some skilled professionals and some incredible
pharmaceuticals. Years I would have missed if some people had not been
struggling for 700 years to bring mental health care up from Bedlam.
Had I been born a few centuries, a few generations earlier, I would certainly have worn Bedlam’s chains, or mopped a floor, or sharedDon ’s
cyclic nightmare in the rubber room.
Mental illness has always afflicted human beings. Many of its victims made significant contributions of great benefit to society.
Martin Luther Abraham Lincoln Vincent Van
Gogh Isaac Newton , Charles Dickens , Ernest Hemingway , Winston Churchill, Mike Wallace Nobel laureate John Nash
Progress is being made. Bedlam is history. Psychiatry and psychology have made remarkable gains in understanding and treatment. But there is a long way to go. Mental illness is still stigmatized. Public attitudes are way behind the realities of modern treatment.
We are not crazy, or insane, we are sick.
Sick like you who have diabetes or migraine headaches or ulcers or problems with any other part of your physical equipment that doesn’t work like it should. You take medicine routinely so you can function effectively. So do we. But we are treated differently than other sick persons.
Insurance companies usually pay a percentage of the cost of mental health care. Not long ago my primary care physician wanted me to have a series of tests. My wife and I are fortunate to have excellent health insurance coverage, which is simply too expensive for many people. Probably most people.The hospital and physicians bills looked like a page out of the national debt, but didn’t cost us a nickel out-of-pocket. But on my quarterly check-up visit to my friendly shrink, the same insurance company pays only 50% of the cost, which is about the price of a tank of gas or a meal for two at a mediocre restaurant. Go figure.
This year, about 168,000 Coloradans are, or will become, mentally ill. (That’s a terrible term, but I don’t know what else to call it). Disorders of their body chemistry, which are known, understood, and treatable by methods which exist in this state. About 40% will be unable to get treatment. The majority of these will get worse, their illness progressing until they are disabled or homeless. A few will commit suicide.
And it’s all so unnecessary. But so are a lot of sad things in life. Whining doesn’t help, or complaining, or thinking there is nothing to be done. There is plenty to be done. Some of it you can do. And what we do will make a difference. We must simply keep whacking away at this particular piece of “outrageous fortune”.
I am very glad some people, long ago, thought there had to be something better than Bedlam.
© 2012 Jack Wilson
Had I been born a few centuries, a few generations earlier, I would certainly have worn Bedlam’s chains, or mopped a floor, or shared
Mental illness has always afflicted human beings. Many of its victims made significant contributions of great benefit to society.
Progress is being made. Bedlam is history. Psychiatry and psychology have made remarkable gains in understanding and treatment. But there is a long way to go. Mental illness is still stigmatized. Public attitudes are way behind the realities of modern treatment.
We are not crazy, or insane, we are sick.
Sick like you who have diabetes or migraine headaches or ulcers or problems with any other part of your physical equipment that doesn’t work like it should. You take medicine routinely so you can function effectively. So do we. But we are treated differently than other sick persons.
Insurance companies usually pay a percentage of the cost of mental health care. Not long ago my primary care physician wanted me to have a series of tests. My wife and I are fortunate to have excellent health insurance coverage, which is simply too expensive for many people. Probably most people.The hospital and physicians bills looked like a page out of the national debt, but didn’t cost us a nickel out-of-pocket. But on my quarterly check-up visit to my friendly shrink, the same insurance company pays only 50% of the cost, which is about the price of a tank of gas or a meal for two at a mediocre restaurant. Go figure.
This year, about 168,000 Coloradans are, or will become, mentally ill. (That’s a terrible term, but I don’t know what else to call it). Disorders of their body chemistry, which are known, understood, and treatable by methods which exist in this state. About 40% will be unable to get treatment. The majority of these will get worse, their illness progressing until they are disabled or homeless. A few will commit suicide.
And it’s all so unnecessary. But so are a lot of sad things in life. Whining doesn’t help, or complaining, or thinking there is nothing to be done. There is plenty to be done. Some of it you can do. And what we do will make a difference. We must simply keep whacking away at this particular piece of “outrageous fortune”.
I am very glad some people, long ago, thought there had to be something better than Bedlam.
© 2012 Jack Wilson
