I am incensed and may be hard put to find the right words to describe the precipitating event. A friend and colleague phoned me yesterday to tell me he was suicidally depressed and had admitted himself to a psych hospital. He asked me to come and visit him. I told him I would come in the early evening. For me, such a promise become an irrevocable duty, especially when my friend is likely already feeling lonely and abandoned as he is recently divorced (acrimoniously).
I arrived at the lobby of the hospital to find 3 armed guards milling about, inside a security area which looked just like the ones at an airport. A young woman in front of me eventually had a conversation with one of them, which I could not hear. She handed over all her personal belongings, including her phone, at a window and went in. I then told the guard the name of the person I was there to visit. He asked for the unit number. I did not know it. He said, then, I can’t come in and suggested I call a family member of my friend. I told him that to my knowledge, none lived nearby and I have no contact with them. He said I should call my friend. Of course, his cell phone had been confiscated and the one patient phone on the unit in which he is imprisoned is constantly busy!
I then asked that he contact the administrator on call. He refused. I told him my friend was admitted suicidal and asked me to please come visit him. He said “I don’t blame you for being upset.” I could barely contain myself and only said, I used to work at this institution as a physician and he could be sure I would be raising hell over this event. When such a condition arises in a hospital, the usual thing is to call the administrator on call. In reality, they exist to prevent lawsuits. I went outside.
The reason for armed guards and turning a hospital into a prison is the fact that, about 5 years ago, an insane and/or evil individual shot and killed several people in the lobby. This completely inhumane situation represents the typical US institutional response to unrealistic demands for perfect safety, coupled with the absurd demands of HIPAA (Health Insurance Portability and Accountability Act).
This law, typical of federal law nowadays, burdens or prevents most all normal, caring human behavior as to sick people and makes it difficult to transfer medical information when patients actually wish to do so. All the while, while purporting to protect privacy, the federal government simply exempts itself from the law’s strictures whenever it likes. In effect, no one’s confidential medical information is protected from government snooping. Of all the institutions which might use my confidential medical information to harm me, none has the overarching power of the state – from which I have little or no protection!
I found myself outside the hospital, furious and worried that my friend would be desperate when I didn’t show up as promised. I used my phone to look up a health system help line. After the requisite hold, someone answered and said – naturally – her office could not help with that. I brought the governor to bear on my anger and told her I am a physician, retired from the medical center which runs the psych hospital, that my suicidal friend was also a physician retired from there, and that he asked me to please visit him. She eventually connected me to a clerk (not a guard) sitting at the desk in the same lobby I had just left. She said she would call the unit and ask the patient to call me with the unit number. I extracted a promise she would do so immediately.
After waiting 15 minutes, I called my friend’s therapist, who also treats me (and who had recommended that my friend call me). He is the one who gave me the phone number on the patient unit, enabling me to reach my friend earlier and promise to visit. I needed that phone number because when my friend called my cell phone earlier that day to tell me of his admission, the call went to voicemail; since I get so many robo-calls, I only answer those I know. My friend had not left me a call back number.
The therapist answered, said he was at a meeting, but took the call when I immediately vomited the problem on him. In the middle of that call, call waiting went off. My friend was calling and gave me the unit number (Today I sent an email apology to the therapist for having interrupted him and for having rung off abruptly). I then left my phone and other belongings in my car (so I didn’t have to hand them over)(they took my keys as well), and went in through numerous locked doors to a hospital unit whose decor was inspired by the tower of London.
The visit to my friend went well and did us both some good. It turned out that the young woman who had been allowed in at the beginning of the ordeal was my friend’s daughter, whom I didn’t recognize as I had not seen her in 15 years. Long story shortened, with my wife’s assent, I invited him to come stay with us for some time after he is discharged. He has had a hellish past few years with two major residence moves, two job losses, a nasty divorce (including a huge financial hit), and the serious mental illness of one of his other daughters.
I love this man as a brother. I have always had an affinity for him. In recounting this in our conversation last evening, I said my affinity likely comes from the fact that I see much of myself in the mirror of my friend. As one who also lives with dysthymia, depression and anhedonia, there, but for the grace of God… I don’t really know why it is, but, so far at least, even at my darkest, I don’t think about self-harm. For whatever reason, I have a very strong survival instinct and want to stay alive – even if I am suffering, I somehow continue to put one foot in from of the other – to witness as much of the future unfold as I can.
Although I cannot affect the future, I feel an intense stake in how it turns out for humanity. Notwithstanding my delusional earlier beliefs that “progress” had exempted us from possible extinction, even at the existential level, much is in doubt. If our existence as a species continues, what it means to be human – given advances in genetics and computer engineering – may well change dramatically and possibly not for the better.
To fend off the darkness, I also try to be useful to others as I am able. I do it regularly in my work as an anesthesiologist. That is what keeps me going and why I can’t retire. I explained to my friend that if he stays with us, it would not be a burden; it would be a privilege. His allowing us to be of service by staying with us, my wife and I will experience as a gift received. It will allow us to feel good about ourselves by doing an act which is neither complicated, stressful or difficult – quite unlike the effort it took to merely visit him while he is so well “protected” by the state and the institution of “caring” in which he finds himself.
This execrable episode is emblematic of what is wrong with bureaucratic, technocratic and metastatic government and highlights the fascistic relationships which devolve with large non-governmental institutions. The combination disempowers individuals from moral action and even simple kindness. It infantilizes them, makes them wholly dependent; coerces them to submit to minute, unknowable, often-absurd rules. In short, it dehumanizes us all, thereby setting the stage for any of the horrors which have recurred throughout recorded history, as to which most assuredly believe, “it can’t happen here.”
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