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mental health for everyone
November 05, 2004
As our relationship entered its death throes in early 2002, Chandra begged me to get back into therapy and onto the medication I had stopped taking when my insurance ran out. The pills had run out days after I was laid off my job in February, the victim of a reduction in force of one. My health insurance, such as it was, lapsed at the end of the month, creating great concern in my parents, who nevertheless continue to toe the conservative line on national health insurance.
I was living with Chandra, working hard to find a job during that vast employment drought of 2002, paying some rent, and trying to make myself a little useful with small household chores, like installing a sink, building a pergola, learning what a “pergola” was, and installing garage doors openers, drywall, microwave ovens, etc., all of which she graciously accepted in lieu of rent in some months. On a steady diet of unemployment checks, I was making my credit card payments and still paying for the brand new, gently pre-owned Lexus LX-450 I had bought in December, believing that I would not only continue to be able to afford the payments, but that I was soon to embark on a life that necessitated a big, lumbering SUV.
By July, the relationship was over. There would be no immediate or foreseeable need for a big, lumbering SUV, and I was quickly a homeless, jobless guy in a Lexus with unemployment running out and a need for serotonin-balancing meds. I was finally directed to the county’s mental health clinic over on the east side of town.
The wait at the clinic was the worst I’ve ever seen in the medical industry, or even in the car repair industry. I could easily go there and wait for half an hour to see the administrator downstairs, before being sent upstairs to wait two or three hours for a 15-20 minute appointment with the psychiatrist du jour. Apparently, the thought of having less than completely sane people sitting and staring at each other in a small waiting area for hours failed to disturb the county or the psychiatrists that worked there.
So, for months of visits to the clinic, I had Catch-22 in hand, dragging myself through the classic with difficulty. Two years later, I still have not finished the book, or even motivated myself sufficiently to rent the video. I tried to stay pressed to the storyline, but it was difficult reading about crazy people when you were surrounded by the real thing.
One day, it was the guy in the Confederate flag cap, who looked as if he were carved out of a single piece of stained sandstone, that was lecturing the waiting room on exactly how to kill a man with a single, hopefully provoked blow to the throat.
“They don’t tell you about it, but they can teach you how to kill a man if you hit him right here.” He demonstrated with a quick jab at his own throat, and the large woman that was his primary audience recoiled slightly, her eyes wide in terror. “They taught me how to do it, but I had enough of that shit.”
Another day, I was swept into a small crime drama. A woman in the primary waiting area sat clutching a giant brown plastic trash bag, which contained possibly food, possibly clothes, or possibly the still-warm remains of her ex-husband. At some point, she got up to go to the restroom, and left the bag resting right next to the door. Nearby, a mother and her son, who sported a trucker’s cap, discussed loudly the fact that his sister had run off with the disability check, and that they’d kick her ass if she tried to come back home. Resting quietly in agreement on that point of family business for a moment, their eyes came to rest on the plastic bag.
I kept my head down, reading and re-reading carefully one paragraph of Mr. Heller’s masterpiece. But I saw out of the corner of my eye the mother walk casually over to the bag, pick it up, then stuff it into her own massive canvas tote bag, not even examining the contents first.
When the bag’s owner emerged, she immediately began screaming that her bag was gone. I knew the scene was about to become ridiculous, but, egged on by a mix of a desire for justice and a desire for mayhem, I looked up just enough to catch her eye, then twitched my head in the direction of the mother and son.
Just then, I was called by the administrator, and I slapped the book closed and hustled away, as I heard the Springerian ruckus behind me erupt.
On what would become my last visit to the clinic, I was scheduled to see a nurse practitioner instead of a psychiatrist, presumably because all the psychiatrists had killed themselves and/or each other, or left to join the circus. I may have seen one psychiatrist twice. Jeopardy has less turnover than this place.
After another interminable wait, I was called into an office, where I waited a bit longer. Finally, the nurse practitioner appeared and introduced himself, but I was in shock - he didn't just resemble, he was sometime David Letterman star Larry “Bud” Melman, the short, white-haired, goggle-glassed old man who played the blinking straight man to a number of Letterman’s gags.
Nurse Larry Bud plopped down in the chair in front of me. Wide suspenders over his short-sleeved white dress shirt kept his black polyester long-waisted pants pulled across his wide, not so-long waist, where they were free to bulge as if he were in the middle of his period and retaining just a whole lot of water.
Nurse Melman studied his fingernails for a moment, perhaps running through the vast pharmaceutical database shielded behind glasses that seemed as impenetrable as the Oval Office’s windows, and that had the same horribly distorting optical effect. Then he reached into his desk, pulled out a small tool, and proceeded to clip his fingernails.
He asked a few questions, namely: he noted I had worked for the insurance department almost a decade ago. How was that? Would I consider working for the state again?
From these two questions, he arrived at a diagnosis. “Well, it seems like you’re doing pretty well.”
No wonder people here never seemed to get better, only angrier. “Well, but then, you haven’t really asked me how I’m doing, have you?”
Larry Bud was clearly unprepared for any input from the patient. He looked up at me for the first time and put the fingernail clippers back in the drawer. He asked a few questions about the medications I had tried. I told him that any medication that had no effect other than leaving me almost totally unable to taste food would certainly drive me to kill others or myself.
He pondered this, disappeared wordlessly, then returned with some papers. He handed me a poorly copied flyer and began discussing the alternatives… lithium being right up there as a strong possibility. Lithium. I knew only the following of lithium: that it was a primary ingredient in notebook computer batteries. Cool. I knew a friend in law school that was on it. I remember having to go get her apartment manager to let us in several times when she wouldn’t show up at school, answer the phone, or the door for up to a week. I knew the Nirvana song, knew it was a Nirvana song because Kurt Cobain had been on lithium at some point. We all see how that went.
My eyes began to blur, and I felt my lips tighten. I told him I’d just like to try a higher dose of what I was taking. He shrugged, I picked up the prescription from the office with the parrot in it, and my patronage of the county mental health system was over.
Walking out, I looked down at the vial of pills in my hand. The $26 check I had written for it would surely bounce. I walked out past the people waiting, yelling at the receptionist, smoking and mumbling to themselves outside the door. Perhaps they glanced up as the alarm on my Lexus SUV beeped loudly, perhaps they wondered about it, but perhaps they knew it just didn’t matter.
Posted by Rob at November 5, 2004 07:45 AM