What a Difference a Few Days Make

Back in 1959 (when Bonnie and I were all of 10 years old) Dinah Washington recorded a pretty little melody called What a Difference a Day Makes. If you'd like to hear that pretty little melody, visit this site.

During a discussion with Bonnie's doctor over the phone, on May 2nd, I was informed that we needed to meet to discuss Bonnie's refusal to sign the consent required to begin treatments. I agreed to do so, and on May 4th, a Thursday, I fortified myself with medication and drove to the hospital. After having parked in the lot on the south side of the hospital, I crossed the street and headed for the disabled-accessible door that I had used on previous occasions. It was my unlucky day - there was some sort of reconstruction being performed, and the entrance was roped off. I was forced to hobble a block to the east to the next available door, which had a flight of eight steps leading up to it, and in the vestibule, another eight steps leading down. The extra two blocks and 16 steps did nothing to make me feel better.

I made it to the ward at around 9 am. The desk attendants were quite surprised to see me (normal visiting hours are from 3 to 8 pm.) I explained, once I had regained my breath (the walk had consumed most of my small reserves) that I was there to meet the doctor at her request, and they eventually let me in to see Bonnie.

As we had not seen each other since April 19th, you may well imagine the scene that then took place. The doctor came into the room not long afterward to introduce herself, at which point Bonnie curtly asked if she and I could have some time alone. I was a bit nonplussed, as I was eager to discuss matters with the doctor, and I knew that she would be leaving around noon to attend a seminar. After having spent an hour or so talking with Bonnie, I went out to the desk in search of the doctor. We did finally have a short discussion in the small lounge while the staff was cleaning Bonnie's room.

I explained to the doctor that, if Bonnie's consent was not forthcoming, I would be happy to sign in her stead, as I was eager to have the treatments begin. It was at this point that the doctor became slightly evasive, indicating that she didn't think that would be allowable and that, since Bonnie had demonstrated no sign of progress, she had begun making arrangements for Bonnie to possibly receive treatment at the Rochester Psychiatric Center.  At no point did the doctor inquire of me whether this would be inconvenient for me.

The meeting, from my point of view, was rather unsatisfactory and vaguely unsettling. To make matters worse, the haze of pain occasioned by my first real exercise since leaving the hospital on April 21st was interfering with my concentration, and I wasn't quite certain that anything had actually been settled.

Sometime during the afternoon, an attendant came into Bonnie's room , introduced himself to us, and indicated that he would in some capacity (perhaps as nurse) be involved in Bonnie's case once she had been moved to the Rochester Psychiatric Center. This, you may imagine, was cause for dismay, as I had not, I thought, been properly consulted with as to this action, and it seemed that it was being presented to me as a fait accompli.

Over the weekend, I had a discussion with a friend (who accomplished some helpful research for me, and who encouraged me to take action), and on Monday, May 8th, I sent this email -

Dr. Brewer, i am sending this in a small amount of desperation. My wife, Bonnie, who you last treated for clinical depression in early 2000, is once again in the Psych Ward at Strong Memorial. This time, however, despite my assurances and her records, the attending physician seems to want to transfer Bonnie to the Rochester Psychiatric Center.

Since you personally have treated her, you understand how well Bonnie responds to ECT treatments. Bonnie, as on former occasions, is refusing to sign the consent forms. If it is at all possible, as I believe I may have done on the previous occasion, I am willing to sign the forms in her stead, so that her treatment may begin in an expeditious manner.

I am unwilling to see Bonnie transferred, as it would cause a large disruption in both our lives. It would be far easier if Bonnie were to be treated sooner rather than later, and I am unsure that if Bonnie were to be transferred, her records would be transferred with her.

I ask you to please give this matter some consideration, and if possible smooth the way for us.

Any help that you may give us in this matter would be greatly appreciated.

Thank you for your time and attention.

Sincerely,

Walter

 

As I explained in a previous post, when next I spoke to Bonnie's doctor, her attitude had altered, and I discovered that Bonnie had been assigned a doctor expert in ECT. What I did not realize until this last Friday was how very close matters had approached to having reached a different outcome. Among the papers that any patient receives upon being assigned to the ward, I discovered an envelope containing this missive, dated May 10th and addressed to Bonnie -

 

Bonnie

SMH Inpatient Service 2-9200

 

Dear Ms.          ,

 

A hearing was held on this date to discuss the recommendation of your treatment team that your care should be transferred to the Rochester Psychiatric Center.

 

It appears to me that you would benefit from continued inpatient care, and that a transfer to a close facility would not inconvenience your family. I am therefore recommending that your treatment team make the necessary arrangements for your transfer to Rochester Psychiatric Center so that you might receive long-term care that is indicated. (Emphasis mine.)

 

That's how close it came, my friends. If I had not sent the email on Monday, Bonnie would most likely have been transferred that week, and I might have returned to the ward to discover that she was no longer there (needless to say, no one felt the need to inform me of this letter or the imminent transfer.)

 

One could wish that, at least here in Rochester, family members were held in some small regard, rather than being treated as something to be scraped off one's shoe.

 

Bonnie is to receive two more treatments, on Tuesday and Thursday, and one of her nurses indicated that there is a very good possibility that she will be released Friday.

 

As of today, Bonnie is recovering well, but her powers of concentration leave something to be desired. She had managed to acquire a book from somewhere, and she did make frequent attempts to read it, but it seemed that she was making no real progress. I am going to keep a close eye on this development, and if it continues beyond the end of treatment, I may have to make arrangements for maintenance treatments on an outpatient basis.

 

When I was released from the hospital back in April, I was told by my friendly and kind (and patient) attendant that unspoken hospital policy is to discharge patients as quickly as possible (I believe I have seen this referred to elsewhere as "treat 'em and street 'em".) If this is true (and there is some basis for believing that it is), it is an indictment of our present health care system that must be investigated in some respect, so that patients are not released before everything has been done to assure that they are ready for release. If you or someone you love find yourself in need of health care, all that I can say to you is, be vigilant.

 

Peace.

 

 

Meditations

I have received very good news. Bonnie, if all goes as planned and hoped, will be returning home this Friday, recovered from our shared journey through the perdition of depression. This represents a best-case scenario, in that although her treatments were begun later than expected, the quantity has been halved, it having been determined by her doctor that further treatments are at this time unnecessary. I have seen for myself the vast improvement in her condition and am thrilled to once again embrace the vivacious person that I know Bonnie to be.

It was closer than I had ever expected - my next post will reveal just how close, but long-term institutionalization has been averted and our life together, with some modifications, will reinstate itself and continue forward, thanks in great part to the prayers, thoughts and good wishes of you wonderful people whom I have met through this marvelous medium called the Internet, and am proud to call friends.

I have lately been rereading some of my more recent journal entries, reflecting on the experiences that I never expected, nor really desired, to have shared in a public forum. Nevertheless, I am neither a rock nor an island, and an experience such as I have undergone is almost impossible to countenance in solitude - it was necessary to my peace of mind that I reach out to a few people, to share my pain, and to those of you who responded to my need, I cannot thank you enough. I am still here and writing because of you, and I have to hope that that will suffice.

The personality with whom I share a body, that "cold, dead being" who only comes forth when I am beset by intolerable stress, has admirably accomplished the tasks that were required of him, and is once again returning within, to the rest he has so deservedly earned. It is perhaps unfair of me to characterize my alter ego in such a fashion, but it is descriptive only in an emotional manner. I am normally an unambitious, easygoing, somewhat lackadaisical (for which read lazy) and complacent person, and without that other side of me to display the iron determination that I cannot, I would, in all probability, be lost. I speak of this other side of me in the third person, because I neither really know nor understand him. He is inside me, there can be no denial of that fact, but we do not communicate. The times that I have made entries in the journal these past few months have occurred when I was in the foreground - my other half is grim, stolid and uncommunicative. It is perhaps necessary that this be so - I might otherwise have been crushed beneath the weight of despondency with which I found myself freighted.

I have been in a quandary as to whether to continue on with the journal - it has sometimes seemed too monumental an undertaking. I have never kept a paper journal, relying on my memory to stand me in good stead. Now, though, it is, I think, invaluable - I am glad of the opportunity to look back, to see where I’ve been, to understand where I now am, and to perhaps receive at least a dim glimpse of where I may be headed. And reflecting upon it has allowed me to realize something - while the entries may appear to be all over the map, there are at least two underlying themes that represent personal wayposts of sorts - creativity and love. Without either of those two attributes, I would not be the person you have come to know. The Creator has endowed me with the capacity to demonstrate these qualities, to what extent it is not for me to judge, but I am supremely thankful that they constitute a portion of who I am.

I must take this opportunity to say a word or two about mental illness. All too often, even in these supposedly enlightened days, many uninformed people still consider mental illness to indicate a character flaw, to represent some sort of moral failing on the part of people so afflicted. Nothing could be further from the truth. It will in future be demonstrated, I believe, as with so many other afflictions of the body, that there is a genetic basis to the illness. The brain is as yet a comparatively poorly-understood organ, and what we do understand represents still but a drop in the ocean of medical knowledge. The brain is the seat of our intelligence, a complex and delicate biological computer, and as many of you have experienced, mechanical computers are prone to crash occasionally. How much more so, then, is the computer we bear in our skulls likely to suffer a breakdown? The components of our brains are so much more fragile and interdependent than those of a personal computer. How many of us can honestly say that we go through life on an even keel, never deviating from the emotional course we have set ourselves?

Enough of this blather. If you have today told a loved one how much you care for them, tell them again - and again -and keep on telling them. We all need to know that we are loved, that someone truly cares about our welfare, that we have companions on the long and sometimes lonely road of life.

I wish you all limitless love, and unending

Peace.

A Tribute

CONTEMPLATIVE

E  X  I  G  E  N  T

L U  S T R O U  S

E  L  U  S  I  V  E

S  O  U L  F  U  L

T A L K A T I V E

E C  S T A T  I  C

 

Peace.

Chapter 3 - The Dominion of Night

It's always comforting to hear from old friends, isn't it?

         HUNTER AND HUNTED: THE DARK RAMBLER

                         The Dominion of Night

     So. I understand that you have wished never to hear from me again. Worse luck for you. You will tell my story.

     I am a consort of the night. She is a glorious, captivating inamorata whose soft zephyrs gently caress me as I slip through the folds of her gown, ever in pursuit of the one who requires my service. The night is my mistress and protector, embracing and cloaking me from the probing eyes of those who would circumvent my mission of mercy. Nothing must frustrate me in the completion of my goal, the cessation of some unfortunate’s misery.

     It is needful that I spend a modicum of time in discreet reconnaissance, following my unknowing client and learning the routes and routines I must know if I am to successfully complete my task. There can be no avoiding this necessity - without this knowledge there is a chance that I might be taken unaware by some unsuspected circumstance and diverted or prevented from performing my act of compassion. To this end, I must clothe my person in garments of deepest ebony, that no hue or glimmer might betray me to the unsuspecting denizens of the deep hours of the night or shallow hours of the impending morning.

     Prior to this portion of my purpose I must, of course, first select the person who will most benefit from my compassion. This is a crucial and delicate objective - there are so many souls in this world that suffer the throes of spiritual torture. I must choose one who is so overburdened that the spirit cries out for relief, one who desperately wishes release but is prevented from personally carrying out an act of suicide by the iron bonds of religious belief.

     To discover who might most require my kindness, I often frequent the innermost precincts of whatever city I have fetched up in, for to those locales have the most wretched gravitated, whether through need or greed. The mean streets and low dives of the inmost urban landscape are fertile territories, blossoming with the bitter fruits that it is my calling to harvest.

     I invariably begin my quest by roaming the darkling streets, directing my senses to those whom I pass, feeling for their inner pain. Many there are who suffer, but only in subdued fashion - their perturbations register only as would a quick caress, barely skimming the surface of my empathy. Others, however - ah, those others, whose silent, visceral cries of agony exert a sweet, constant, desirable pressure upon the naked pelt of my talent - it is them by whom I am beguiled, they who will receive the blissful release of their torment through the agency of my finely whetted blade.

     I have been graced with a photographic memory, a faculty that greatly facilitates my efforts at determining the person to whom I will devote myself. I spend perhaps a week in seeking out my ultimate choice, and when the winnowing procedure is finished, it is then that I begin the acquaintance phase of the process. My first course of action is to don my raven garments and shadow my prospect, paying careful attention to any patterns of behavior that may emerge. If, for example, my client is prone to patronize a drinking establishment (and, naturally, many are) that is where I will begin to promote my policy of seduction and solace.

     I have found that another excellent source of clients is the plethora of temporary employment agencies that have sprung up like noxious weeds in the last couple of decades, testament to the fact that employers have discovered the delightful datum that they no longer need care for their employees, that any nobody from the street can perform an entry-level job, and the savings in benefits and vacation time are enormous. If the nobodies are cunning and hard-working, they may be offered full employment at a ridiculously low salary, and glad they are to receive this beneficence. Some of my most productive prospects have come from this pool of part-timers, for they exude equal amounts of hope and despair. The contemplation of their release is as sweet music to my soul.

     Do you think me cruel and heartless? I assure you that I am not. Only by bestowing such a benison may I justify my actions, only by this method may I attempt to balance my unholy craving with an act of imperfect contrition. It is enough.

     Expect to hear from me again.

     This is the last communication that I have so far received from my interlocutor. It is possible that he may be ... busy. However, I did find this news item from the Plainfield Press interesting -

POLICE INVESTIGATE MULTIPLE DISAPPEARANCES

ASSOCIATED MEDIA

PLAINFIELD, Texas

Police are investigating the recent disappearances of four residents of the city of Plainfield. They have been reported as missing by co-workers, friends and families, and attempts to locate them have so far proven fruitless. Their names, ages and last known places of employment are:

James Earl Bottoms - 36  Sargent’s Super Mart

William Kwan - 31           Sargent’s Super Mart

Amelia Sirkin - 27           Blowmold Plastics Co., Inc.

Reynaldo Valdez - 24      Allied Depositories

Authorities request that any citizens who possess knowledge of the present whereabouts of these individuals come forward and contact Detective Joseph Grosvenor of the Plainfield PD to divulge what information they have. The authorities wish to assure citizens that no tangential questions shall be asked of them, and that any information that they may supply will be kept in the strictest of confidence.

This one's for you, Kathy. Thanx.

Copyright Malcolm Mott 2006

Peace.

Matters Proceed

Has it really been a month since I last made an entry? How time flies. I haven't felt much like writing; I haven't that much to say at the moment. I can say that after some false starts, Bonnie has now completed more than 30% of her treatment regimen, and she is every day becoming more like the dear woman that I know and love.

I should explain that since her last episode, back in 2000, changes on the psych ward, as in life, had occurred, and the doctor to whom Bonnie's care had previously been entrusted and who intimately understood her requirements had since received a well-deserved promotion and is presently the director of the entire ECT program at Strong Memorial Hospital. As such, he is no longer involved in individual treatment.

More youthful doctors today, it seems (this is only my own personal opinion) are more in favor of treatment through pharmaceuticals than through alternative treatments that may, in fact, be more efficacious. I have become inured to the fact that the opinions of family members are often lightly regarded, no matter how pertinent and informed those opinions may be. I had somehow forgotten that, as part of Bonnie's psychosis, she was wary of affixing her signature to anything, and as I was at first incapable of making trips to the hospital, I did not discover until two weeks had passed that Bonnie had not yet begun treatment because of her refusal to sign the consent forms. When I first managed to reach the hospital to talk to Bonnie's doctor, I found to my dismay that it was almost a foregone conclusion that Bonnie was to be committed to the Rochester Psychiatric Center for long-term care. Her doctor was, in effect (it seemed to me) washing her hands of Bonnie. I found this approach to be untenable for both of us, as it would keep us apart for a much greater length of time than was necessary.

Almost in a panic, I sent an email to her previous doctor, imploring him to remember how well Bonnie had responded to ECT treatments, and to please exert himself to the maximum to see to it that she remained on the ward and began her treatments. Also, I did everything in my power to convince Bonnie that she must sign the consent, because the alternative was unthinkable.

I owe a debt of thanks that I can never repay to Dr. Eric Brewer. Not only did he take time away from his busy schedule to respond to me, but his influence was evident the next time that I spoke to Bonnie's doctor. As the title of the entry indicates, things are now well in hand and under way, and I now expect that Bonnie will return home sometime in mid-July.

Bonnie is so far along now that she is once again taking an interest in things and demonstrating emotions. She has once again begun to read the newspapers that I bring to her, and she has begun requesting small items from home (she always requests scissors and a razor, but of course those items are forbidden to patients - it's a wonder they let me use my cane.) She has also begun requesting that i bring her specific food items - her first request was for a cheeseburger and strawberry milkshake from McDonalds. She has also requested Pepsi and BBQ chicken, so I'll have to see what I can do. Except for the occasional item such as rolls, fruit, and juices, Bonnie finds most of the hospital food to be nearly inedible, and after having experienced 3 days worth of it myself (along with nibbles from what she has received) I am forced to agree with her.

She has taken a dislike to particular aides and patients, and her displeasure is immediately apparent, unlike the almost zombie-like quality which she formerly displayed, and, although I am certain that it is unpleasant for the people involved, I can look upon it as a demonstration of the degree to which she has already recovered.

As for my own condition, I am as capable now as I was before my leg became inflamed - there is little discomfort now, although it is apparent that occasional flareups may continue to occur if I overexert myself. I can drive, I can negotiate the hospital corridors, and I can make necessary trips to stores, so I am at 100% operating efficiency. I have been informed by my doctor that I am now officially diabetic, but you will not be reading much, if anything, about that here. There are many excellent resources to which you can refer if you wish to learn more.

The third chapter of the 'Dark Rambler' saga has finally been completed and will shortly be posted.

Until then, as ever,

Peace.

Reprise

This is a reprint of an entry I posted a year less a day ago. There are no profundities here, it's simply a record of my feelings then, now, and always.

All You Need . . .

Love.

Love is caring and sharing.

Love is being apart and being a part, at one and the same time.

Love is always - always - being there for the other person in your life.

Love is caring enough to leave that last slice of pie, or feeling free to take it, because more can always be gotten.

Love is a smile, a touch, a kiss.

Love is a feast for the senses.

Love is a competition between partners to see who can do more for the other.

Love is sharing vulnerabilities.

Love is realizing that if you fall, there will be someone there to catch you, and carry you if necessary.

Love is knowing and not caring.

Love is velvet and steel.

Love is speaking without saying a word.

Love is knowing yourself so that you may know others.

Love is understanding that you must care for your partner before you care for yourself.

Love is having your own space, your own possessions, and being secure enough to share them.

Love is best at its quietest.

Love is communion.

Love is sometimes a journey from the heights to the depths and back.

Love is forgiving but not forgetful; it adjusts.

Love is one of the highest accomplishments you will ever attain, and is one of the hardest to achieve.

Love is and love shall be.

Peace and love.

The Walk

(Thanx go out to Celeste for the title)

Short and very, very sweet. I tested my ankle today. Twice. I can walk again, after a fashion, and tomorrow I am going to visit the hospital and my dear wife Bonnie. Only death can keep me away now.

Peace.