Saturday, May 31, 2014

Mike's Story Part 37: New Year's Day in Bellevue

By Jenna Orkin    

As a companion to this post, see Mike's article on entitled, "New Year's at Bellevue."

January 1, 2007


Email to Ray with the heading "mike's phone number:"




they're trying him on lithium today. i was going to visit him at 1 but he says he doesn't see much point. 'there isn't much to talk about here.'  we may speak later about whether i should visit him at six.

   in a couple of days they'll decide whether he can leave. they think maybe he should stay 'upstairs' (in the long term wing?) for a few more days to see how the lithium is working. they have the option of holding him if they think he's going to 'hurt' himself.

  Ray calls to check in. He has not seen the email. I give him an update.

  "If you look at Valium closely," he says, "it's in the alcohol family. I don't know what Mike told the doctors..."

   "[His outpatient psychiatrist] knows he was in AA."  She recommended a Bellevue therapist who was familiar with the organization but Mike said that wasn't a criterion; he wanted someone who was intelligent and who understood his situation. 

"Certain points are non-negotiable," he elaborated.  "I did write a book. I did have my computers smashed. I did find the government involved in some nasty activities."

  "I'm not sure they made the connection," Ray says.

   He wants to talk about setting up a regimen for Mike to get out for at least half an hour a day, preferably twice a day. This is a notorious time of year, no getting around it. and today is the bleakest of New Year's days.

   I tell him about the email from the prospective buyer.  The tone of it is friendly: Mike can quote from his own work but the buyer still wants the intellectual property rights. 

   “Do you know what he does?” Ray asks.

   “For a living?  No.”  Buying and selling companies?

   ”Snake oil salesman.  He has a website, sells [an alternative form of medical treatment.]”

   ”My God, he really is a snake oil salesman.”  Of course, the alternative treatment might be effective.

   “He wants the subscriber list.”

   “To sell the [treatment] to?”

   ”Yes.  That’s the intellectual property.”

   That doesn’t sound like intellectual property, I think.  Also, wasn’t the subscriber list excluded from the contract?

   ”Also if there’s a movie deal,” I say.

   ”Ah yes,” Ray agrees.


2:30 Call from Mike. He's being subjected to fifteen hours of Honeymooners reruns.

   "Jackie Gleason just doesn't do it for me anymore," he says.

   "I always found it a depressing show," I say. "You said it was supposed to be."

   He sounds livelier. I ask him if he wants me to come at six.

   "I won't be able to do anything but say, 'I want to come home,' and cry."

   "That would be a good thing. Nothing wrong with that."

   “The other male patients just sit around talking about ways to commit suicide.”

   "Is that therapy?!  Sounds like criminals going to jail and learning how to be better criminals.”


   I tell him what Ray said about Valium being related to alcohol. He reminds me of how I've seen him drink in moderation and without getting drunk.

   I say that isn't the point. I’m not sure how the dose of Valium that he's on relates to a drink.

   "I've testified on alcohol many times," he says. "I don't need to lecture you on it but this is fine." 

   Although it's clear he doesn't care whether I visit or not, I go to see him at six.  He’s wearing hospital drab over his jeans and T-shirt.  Having been taken off Effexor, he's antsy to leave and gossips about the other patients.  Crying is not on the agenda.

   The male patients are watching TV; the women, separated from the men by design, are on the other side of the doctors’ Observation Room.  Mike has a private corner, also on the other side, from which the doctors can observe his behavior. 

    The news is on.  Mike wants to watch a report about cops who shot an innocent escapee from Katrina in the back seven times.

   “See that guy behind me in the glasses?  On the cell phone?  He keeps saying, ‘If I had a 38, I’d blow my brains out right now.'”

   A small man in pajamas that are four sizes too big is wheeled out of the ward.  As he passes, he shakes Mike’s hand.

   “So long, Michael,” he says.  “I made it to upstairs.”

   ”Congratulations,” Mike says.  “That’s what you wanted, right?”  Upstairs is anathema to him but to each his own.

   A report has come on about the season’s second snowstorm in Colorado.  Another patient says civilly, “I thought that was a hot state, an arid state.”  He has a Hispanic accent.  Like the other patients, he treats Mike with respect.

   “You’re maybe thinking of Arizona,” I say.

   “Or parts of New Mexico,” Mike adds.

   A stout woman shouts in Spanish and rattles the exit door.

   “When she first came, she cursed everyone out in the name of Jesus,” Mike comments.

   “You see that all the time on the subway,” I say, wondering why this woman was brought in, of all the loonies New York is home to.  Her shouts are coherent, if loud.  “Perhaps she’s not so much crazy as ill-mannered.”

   “She’s been heavily medicated,” Mike says.  “I just want to go home.  How’s the apartment?”

   He must really hate it here if he’s homesick for my apartment which is dark, looks out on a construction site and lacks any vestige of nature.   “I miss dental floss,” he says wistfully.

   ”I can relate to that.”

   “This is worse than Venezuela.  But the doctor who was here today thinks I might be able to leave tomorrow.  What did you do today?”

   ”Remember how I told you this is the hub of the universe for Indian grocery stores?"  Bellevue is on First Avenue and 27th.  The Indian grocery stores are around 28th and Lexington.  "On the way here I bought three kinds of curry paste.  One is from Kashmir!”  These days, of course, you can get the same products at the local supermarket.

   He smiles indulgently.  What kind of sustainability nut am I?  A hypocritical one.  Or maybe he's thinking about my food preferences which seem to him so alien.

   “And I wrote.  It’s always a satisfying day when I do some writing.

   'Have you seen a newspaper?”

   “Someone had yesterday’s Post.  This is the first time the news has been on TV.”

   “There’s a huge effort going on to interest children in what most people call ‘classical music.’  The Met did a kids' production of The Magic Flute.  It’s really successful.  If there was going to be a world in a generation from now, this would be important.”

   Sectarian violence has escalated in Iraq since the hanging of Saddam Hussein a few days ago.

   “That was intended,” Mike says.  Of course.  Divide and conquer, in addition to which, it gives the U.S. an excuse to "stay the course."

   Since he’s off the Effexor, he’s able to go to the bathroom again.

   “Is that my cue to leave?”


   “Ok.  I understand these priorities.  Call me if you want me to come tomorrow at one.”

   “I may be leaving,” he reminds me like a kid who’s afraid he'll be abandoned at school.

Friday, May 30, 2014

Mike's Story Part 36: Bellevue 2

By Jenna Orkin    

   This account is different from the previous post on Bellevue.  I remember some of the scenes in both but not when they took place.  I think there were two visits to Bellevue but it's possible that my notes were simply written at two different times.

   December 31 2006  10:30 PM     
   Back from Bellevue, with the bag his psychiatrist told him to pack in case his assessment allowed it.  (It didn't.)
   We’d been lying down when he said, “I chose the location.”  He did not need to add, "to kill myself.’
   “Are you going to tell [your outpatient psychiatrist]?  Because this is the sort of thing I’d have to report.”
   He nodded.  “I know.”
   "Which is why you told me,” I realized.
   He turned towards me, nodded again and smiled.
   At 4:00 p.m. he woke up from a three hour nap saying urgently, “Where’s that sheet?”
   He consulted the slip from the Effexor for side effects.  He was suffering fourteen including anxiety, sleeplessness, loss of appetite, difficulty in urination, constipation, itchiness and loss of libido. The last symptom had nothing to do with me, he assured me, but I wasn't convinced.  He had innumerable reasons to write me off.
  "I woke up thinking, ‘I have to read the insert,'" he said, ever the detective rising to the occasion. "Kelly O'Meara wrote about anti-depressants.  Some of them can cause suicide."
  He called Bellevue where the doctor on duty said that for suicidal thoughts or a rash, he should come into the emergency room.
  “Where does it itch?” I asked.
  He pulled down his pants and I noted a slightly raised red patch on his upper left buttock.
  “As a mother,” I said, “if they told me to bring the kid in if he had a rash, I’d probably bring him in with this and they’d probably say, ‘It’s nothing.'”
  He called his outpatient psychiatrist, who called her friend at Bellevue.  Five minutes later his outpatient psychiatrist called back to say that her friend would be going on duty at five.  It was 4:15.
   “We can leave now,” I said.  “But you haven’t eaten anything since this morning, right?"
   ”Right.  That’ll take care of itself.”  And he set about packing with the efficient determination of the old Mike.
   I emailed our two Peak Oil activist friends that our New Year’s Day get-together tomorrow was probably off.
   On the train Mike was silent.
   ”What are you thinking about?” I asked.
   "Getting there.”
   “When you left for Venezuela, Carolyn wrote how you hugged and cried, then said, abruptly, ‘We will not touch anymore.’"  This was so he could go into "samurai mode."  “Are you feeling that way now?”
   He shook his head.  “There will be hugs later.” 
   He had once asked me not to hug him in public - like Alex when he was nine, saying in the park, “Don’t call me ‘darling’ in public.”  But in Mike's case, maybe it was because he was afraid he would cry.
   The waiting room was empty but for a patient who coughed and called out in his sleep, flailing his arm.  I moved away from him.
   “He’s heavily medicated,” Mike said.
   An imposing female cop told the man, “Cover your mouth when you cough.  You’re coughing on these people.  Here, move away; come sit here.”  Mike took my hand.
  A man was wheeled out of the ward and disappeared down the hall, probably drugged.
  “Great,” said Mike.  “That’s me.”
      He promised to tell X [the Bellevue psychiatrist] the whole story:  How he had "a location" and "a way." 
   “No offense,” he said, “but there was something about being in that apartment on New Year’s Eve that scared me to death.”
   His comment raised the unspoken question of how he’d feel about the apartment in three days time, when he would probably be released.
   “How would it be if I had a dog and a horse?”
   “I don’t know.  But you don’t.”
   My hunch was it wouldn't have made much difference.
   He looked at his watch. 
   “Seven thirty.  Time for my valium but they told me not to take it.”
   A few minutes later he cried; quietly, because he was in public, but with abandon.  I held him discreetly.
   “This is my life,” he cried.  “This is what I have to look forward to.”
   The female cop at the desk absorbed this new data but had the grace not to stare.
   The temporary catharsis subsided.  Ten more minutes of limbo.
   "Did crying help at all?" I asked.
   “I don’t know,” he whined in his, “Stop interrogating me,” voice.
    I entertained a fantasy of walking out of the waiting room.  Instead, I teared up.
   ”I’m sorry,” he said.  “Was I short with you just now?”
   I nodded.
   ”I’m sorry.”  He hugged me.  “I think the crying helps a little.  Valium keeps me alive, breathing, but it doesn’t make me feel better.  Plus, it’s Valium.”
   At eight thirty he said, “I’m taking the second Valium.”  He swiftly opened his suitcase before anyone could stop him and downed the pill.
   That mini-drama over, we resumed our positions as bumps on the waiting-room chairs.
   “I want to bolt.  If I could get past the guard, I’d just go out there and kill myself,” he said.
   “That’s why they have all these guards and those doors.
   'I think this feeling is probably what you were running from when you fled to Venezuela.”
   He pondered this.  “That’s interesting.  You think I was ready back then, in Ashland?”  As though I had as much insight as he did.
   "Depending on what one means by ‘ready.’” One of our misunderstandings has resulted from the literal way he’s interpreted my words.  When I had used the term "manic" or "depressed," he took pains to explain the diagnosis wasn’t certain.  I told him it was shorthand; "manic" was the term I used to describe the state of mind in which he multi-tasked on the phone, at the computer, with a cigarette, ten hours a day.  He was a quick study and adapted to the looser terminology.
   “But I also wanted to consult for the government..." he said before returning to reflective mode.  "That means I was thinking about suicide in July.”
   I mentally responded, “It probably goes back a lot further than that,” but decided to keep that thought under wraps.
    “I also think it’s why you needed to leave Venezuela so urgently.  You had to leave Saturday.  Then when there was a flight Friday, you had to leave Friday.”
   “Oh, well, in Venezuela, I would have killed myself.  I know that...
  'Always, ‘Got to go; got to go...'" He lapsed back into reflection for a few moments.
   'What a great place to spend New Year’s Eve,” he observed sarcastically, looking around.
   “It’s perfectly fine.”
   The staff were kind and wearing New Year’s Eve hats.  Granted, it gave them the air of characters in Clockwork Orange but if one could extricate oneself from that sinister turn of mind, there was much to appreciate.
   “What you’re complaining about is what’s going on inside your head.”
   An EMT from the Fire Department brought in a drunk woman who tried to leave, complaining loudly, “I can’t stay; I can’t wait two or three hours.”
   “She has the right idea,” I thought.  She got much more prompt service than we did.
   The nurse’s cell phone rang and the drunk woman danced to it.  The cop joined in.  X, Mike's Bellevue psychiatrist, appeared at the door and discreetly asked the nurse, “Do you need a stretcher?”
   ”No, she’ll come quietly.”
   The drunk woman was led into the ward where she carried on a loud, but now muffled, conversation.
   “Did you see her left forearm?” Mike asked.
   “Yes!  Was that from heroin?”
   Although the cut marks were on the outer part of her arm, I thought she’d run out of veins on the inner portion.  I'd read about a play - by a 28-year-old woman who killed herself soon afterwards - in which a heroin addict out of options injects himself in the eyeball.
   Mike winced.  “Heroin is injected into the veins on the inner portion of the arm.  Those cuts were self-mutilizations, mutilizations, mutilations."  The Valium had scrambled his neurons.  "They’re usually self-inflicted by people who’ve been sexually abused.”
   A man was wheeled out of the ward with a strap around his chest tying him to the chair. He was followed by a beautiful young girl who changed into street shoes and left.
   “I wonder if she was a patient or a visitor,” I said.  “She was wearing the no-slip slippers.”  
   ”Everyone has to wear those.”
   ”I thought they were just so that patients couldn’t kick.”
   ”Shoelaces can be used for hanging,” he said impatiently, “You can’t bring them in.”
   He pulled a loose thread in his jeans (a pair Alex had never worn but which I'd kept around for five years. "You see the benefit of hoarding?" I had said triumphantly when three of the pairs I'd found fit Mike.)  When he couldn’t rush to the bathroom to pluck a noisome nose hair, a loose thread would do.
   An inch long hole appeared in the jeans.
   "The seams of my life," Mike said, voicing the observation I'd suppressed.
   We watched some patients on the other side of the door wandering the hall of the ward; they did not inspire confidence.
   "[My clinical psychologist friend] learned to speak 'schizophrenese,'" I told Mike. "They make sense if you speak their language.
   'You know, 'idiom,' 'idiosyncrasy,' and 'idiot' all derive from the same word. It has to do with speaking a language which no one else understands."
   "Great," said Mike. "I speak a language that many people understand.
   'If anything dramatic happens," he instructed me, "tell [a FTW subscriber.] She's a sweet woman."
   "If I get committed long term." 
   His Bellevue psychiatrist called him in to the ward where someone was being strapped to a stretcher.  The guy had a large, eclectic audience:  Doctor, nurse, patients.
   Back out in the waiting room, a nurse told a cop about her five-year-old son who already did single digit addition and subtraction.
   “You’re going to have a problem with him when he starts school,” warned the cop.  “He’s going to be bored.  They’re going to be calling you in for teacher’s meetings.  He should skip a grade.”
   Mike returned from his interview with the Bellevue psychiatrist.
   “72 hours,” he said and began taking off his belt.
   “The status you’re under,” said the nurse, “the only thing you can keep with you is your underwear.”
   ”Oh, that’s not what the doctor told me,” said Mike.  His outpatient psychiatrist had thought his status would be more stable but her information didn’t have the depth or breadth of the Bellevue psychiatrist’s.
   “You can give her a hug,” the nurse told him.
   He hugged me but without conviction; his mind, elsewhere.
   I turned to leave.
   “Don’t you want to watch him go in?” asked the nurse.
   I stayed.
   “You can wave, Mr. Ruppert,” she told Mike.
   He turned and waved, ever polite, obedient.