working hard and the high cost of health care

I have read before that Americans are the hardest working people in the world--we work longer hours, take fewer vacation days, etc.

Employers continually demand that fewer employees do more work with less resources. Those that push themselves to their limits [and beyond] are rewarded with more responsibility and thus more work to do...but hey, they are given a raise and a new title to hang on the wall. Regardless of the 'rewards', this creates stress at very high levels.

High levels of stress over a person's work life years takes a high toll on mental and physical health--all along the way.

The highly stressed workers have health problems and need to see the doctor more often, have more procedures to diagnose, need more prescription medicine, and health care costs go up--along with health insurance premiums.

I wonder...if modern day slaves [employees] were treated more humanely...wouldn't the health of such people improve? And with the improving employe health...healthcare costs would drop...the employee would likely be even be more productive. Happy, healthy employees equal happy and loyal customers.

Hmmmmm.....just food for thought.....

The Mental

April 16, 2007

Without the tormentors,
There'd be no tormented.

Without the abusers,
There'd be no abused.

Without the bullies,
There'd be no bullied.

Without the compassionless,
Perhaps there'd be compassion.

Without the careless,
Perhaps there'd be care.

Without the irresponsible,
Perhaps there'd be responsibility.

Without the ignoring,
Perhaps no one would be ignored.

Without the violence,
Perhaps there'd be peace.

But without the tragedies,
There'd be no TV.

Poem--sort of #1

Do you ever wonder what became of me,
Past guardians of my sanity?

Do you ever wonder what I do,
The same thing I ponder about you?

I often see you in the night,
Still holding up that darn flashlight.

I hear your words time and again,
I sometimes think of you as friend.

You made a difference in my life,
So forevermore, I laid down my knife.

Tonight, I wish you a gentle good night.
Tomorrow I will rise with all my might
To make it through another day,
Survive whatever comes my way.

Without your life, I wouldn't have mine,
I send my love and thanks...I hope you don't mind.

I Do Not Recall this Part of the Contract

Once upon a time--back around 1990, the buzz phrase among the psych nurses on the unit I was on--my last hospitalization--changed into a rather infuriating chorus: "What's the Pay Off?" The theory being that each one of us was getting something positive [the Pay Off] for our crazy behavior and way of thinking...in addition to our self-harm stuff [from suicidal ideations to self inflicted you-know-what]. It was maddening to us. It was like a slimly disguised accusation of "if you want to be happy all you have to do is snap out of it!" So we were not amused even after multiple reassurances that that was not the intention at all. [And the trust and morale level dropped even further on the unit.]

Anyway...after my release one of the patients I became friends with [we met in Aftercare] started a conversation one night on the phone about why we did not just snap out of it and get well. We played fill in the blank or complete this sentence: "I do not want to get well because...." The conversation ended when we were having trouble breathing because we were laughing so hard. Here are some of the answers I still remember:

"I do not want to get well because..."

1. my therapist needs a new car.
2. my therapist will end up homeless without my business
3. I LUV therapy!
4. I am contributing to my therapist's continuing education
5. I will be the patient who will make my therapist/doctor famous!
6. I need more experience before I can write a best seller about my life.
7. No one ever asked me if I wanted to.
8. I DO NOT RECALL THIS BEING PART OF THE AGREEMENT WHEN I STARTED THERAPY!

I remember during my first hospitalization that Watergate was nearing its climax and then suddenly President Nixon resigned. And I remember thinking at the time...the world out there has gone crazy...and I am the one locked up?

I still wonder about this at times....I got better through the years and have been a functional participating citizen--working full-time and paying taxes. [I am deteriorating now and picking up speed but I have contributed quite a bit into Social Security that I will likely never see a penny of.] I sometimes reflect about how hard I worked and what I went through in order to enter the 'real' world and hide my insanity well enough so I was accepted. And I wonder why on earth I went through the hell that I did. The world is crazy and growing moreso by the day...if you doubt me, watch the news. The pay-off for being a participant in society is that I get to pay taxes, owe money, be a slave to my employer...I can be abused, a victim of a crime, be falsely accused, fired or laid off. Yes siree bob...I can be a member of the rat race! I can watch the cruelty of others to the helpless. I can the exploitation and the injustice. I can observe politicians and elections Tell me something, all you people out there....what is the pay-off of enduring this insanity? What is the pay-off of participating in it? Because you know what? I just can't see it. And why do you want me to "get cured" and join you in it? Misery loves company, right.

To any mentals out there reading this...beware...the push to cure you is a cruel trick...don't fall for it. And to you OUtsiders out there...you really need to come up with something better as a reward than paying taxes, bills, politics, the silent suffering all around you, the rampent injustice, and the freedom that others have to inflict pain and torture upon you.

I should have asked more questions before asking for help oh those 30+ years ago. Even as I watch my slide backwards--further than I ever was before--while I feel some fear since the authority figures will have the ultimate POWER over me once again, there is a vague feeling of relief. For I know the darkness and I know the shadows well...there is safety there.

The Challenges of Relating in Relationships

It is often difficult to adequately express myself or what I am feeling to you Outsiders. In my current sub-topic of relating to medical healthcare professionals, lets talk about how to describe symptoms when asked. One of the most difficult questions commonly asked is: on a scale of 1 to 10, how do you rate your pain? Since I practiced the art of never expressing pain growing up my pain tolerance sky rocketed--it is unusually high. So pain can be difficult for me to rate on a scale that is presented as "standardized" [explain how that can be since pain cannot be objectively measured?] That leaves me with trying to quickly think about how to translate or convert my level of pain to one that is appropriate for the level of injury or illness so that appropriate medical care will be done. I learned that translation is necessary when I reported a pain level of a 4 for pain that kept me awake at night crying. But since I reported a 4, I was sent away with instructions to get some OTC painkillers...and to quit whining. Didn't do a thing for the pain or my frustration level with dealing with doctors. I have learned that if I multiply my pain level by 1.5 to 2, then the care I get makes the pain bearable or sometimes even eliminates it. But I have to stop and do the calculations in mind. So if a mental is slow in answering, it is likely because they are trying to figure out how to express it so that the doctor understands and takes enough action to alieviate at least some of it.

Trust and respect. These are critical in any relationships I have with anyone I encounter--especially those who are supposedly charged with helping me get better. Trust and respect are earned things--and they are usually earned by evidence of intelligence, a sense of humor, and the quality of being "safe" in the earnee. A staff person or doctor in a hospital who displays a distinct deficiency in cerebral activity is likely to be a target of acting out behavior or overt or perhaps covert manipulative manuvers--especially if I have become very irritated by them. During one hospitalization the door opened one afternoon and all these young women in white uniforms came marching into the unit and then fanned out into patients' rooms. I learned they were nursing students and had come to experience a psych unit. I found this interesting and obeyed when told to go to my room so the student assigned to me could find me. I did so and found that the student was very respectful and listened to what I said...I tried my best to answer her questions in such a way that she was not frightened and she understood.

A day later, a different group arrived on the unit. That particular group irritated the hell out of us. My student was so condescending and rude to me that I shut down completely and waited it out until she left. Later the other patients and I worked out a plan...because we were told another group would be arriving the next day no matter how we felt about it.

We were already in our rooms when the next group arrived...waiting. Some of us acted catatonic. Some acted out. Some drooled and twitched. Others shouted at furniture in the room. The staff went bonkers...not to mention the students and their faculty. The students couldn't leave fast enough. We weren't treated as specimens again. We were delighted...we also lost all privileges for several days but we didn't care as long as they weren't coming back.

TM

Relationships--me and them

The Great Escape tale needs to wait a bit. I have other things on my mind tonight.

I mentioned previously how naive I was when I was younger--my teenage years. Then I was diagnosed and entered the mental health care system. What little ability I had left inside to trust other people, the world, the cars on the freeway, etc, disappeared. It was a matter of survival.

I never ever forget who has the power when I interact with people--especially medical people. I watch what i say carefully so as not to end up somewhere I don't want to be i.e. another hospitalization. Having learned after about 20 years that I could maybe trust again...and I was going to have to if I was ever going to get better, I also learned that by baring your soul to a therapist, you have left a door open to your pysche and if they so choose, they can inflect incrediable pain with a few well chosen words. They know where the scars are and can reopen them so fast you can't even try to block the attack. I also know that in a court of law, my word against a health care professional's is like a stick fence against a tsuimami. In fact, my word won't stand up to anyone else's who has not sought professional help or been diagnosed...yet. --mischevious grin--

So what characterizes my relationships with mental healthcare professionals? Caution. Watching carefully the body language, expressions, the eyes in order to know when to fold the conversation and walk away.

Relationships with other healthcare professionals....doctors...as in MDs.....SIGH It does not matter what symptom I may be having...even running a fever it seems...but as soon as I answer the question what medications I am on--thereby revealing that I am a psych patient--then my symptoms suddenly become something to not take seriously at all and to catagorize me as a hypochondriac or the symptoms are a manifestation of my depression. I have been so frustrated at times...I have this very satisfying fantasy of going berserk in the exam room and smash everything to pieces, throw a chair or the stool at the doctor while screaming my head off...and then very calmly saying, "Doctor, there is no reason for alarm. All of this is just in your head." However, since I am not a violent person, I will never know that satisfaction. I've had nurses do the same thing to me as well. It takes a long time to find a doctor who will listen. I finally have I am pleased to say...I think. Now I have a ton of physical diagnoses and have to take even more meds than before! Hmmmm....perhaps I should not have looked so hard for a doctor who would actually investigate my symptoms!

A little off the subject...but I want to share my pet peeve with MDs...in the years gone by, the doctor examined you, ordered tests, interpreted results, and planned the treatment. All you had to do was comply. But now doctors often ask ME if they should order an x-ray on my injured body part, do I think the treatment plan will help, what do I think the problem is, etc. EXCUSE ME but YOU are the one who went to medical school and passed your boards so why are you asking ME? It doesn't matter what I think! I am the patient! If you need the help of your patient who has not been to medical school to practice medicine, then I think I will just hang out my shingle and open my own medical practice. I don't WANT to make major decisions about things I know nothing about. Could we have a meeting of the minds at some point and stop this insanity? Pretty soon I'll have to assist in my next surgery...Jeesh! Someone please explain to me why it is that I am the crazy one and the doctor asking my advice is not???? And I have observed doctors do this to non-diagnosed people too! Ok....I think I feel better now. And if there are any doctors out there reading this...please keep your questions to yourself or better....go ask a nurse!

TM

Relationships on the unit-part 1

In this post, I am referring to inpatient hospitalizations #1 and #2. These occurred in the mid-70's on a one-size fits all locked unit.

I have to admit I was very naive when I shared a poem with my psychiatrist during an appointment that I had written titled "The Death Wish". Then I announced that I while I really appreciated all his efforts to help me I was very sorry to tell him that I was going to kill myself. But I thanked him very much for all he had done for me. I hoped he wouldn't be too upset.

He asked if I wanted to go in the hospital. I thought he was out of his mind! Hospital! Why would I go in the hospital? I wasn't sick or injured--yet. And if I wanted to die, going to a hospital was counter-productive! He explained what he meant. Oh crap. I thought that stuff was only in the movies, tvs, or books.

So there I was...18 years old and locked up with other mentals, alcoholics, junkies, and a teenager who had murdered his stepfather after he escaped from the closet he had been locked in for all of his life. He took a shotgun and killed him. He really was a nice kid and kind of like Rip Van Winkle...didn't know how to even work a soda machine! Or even what a bed was. Sad. He did learn quickly though.

The first hospitalization was 6 weeks long. The second one was 8 weeks. By the time the second one was finished, I had been enculturated into the subculture of psych patients. We have our own rules and codes of ethics.

A patient was brought in one night to sleep over. He was being transported to the state hospital but he didn't know that. One of the junkies found out by overhearing at the nurses station. I was there when he told the guy who was going to the Big Place for a long long time. He looked at us and said "Thank you, man. I'll never forget this." He escaped that night. We were all rounded up for questioning by the head nurse the next morning but we just stared at her like she was crazy. She finally stomped off saying, "I KNOW you guys had something to do with this!!" We laughed about that for a long time afterwards.

The unit had a Halloween party. One real suicidal mental lady was in the nurses station in the kitchen area preparing punch or something. I was sent in to assist. I thought that was crazy...both of us suicidal and putting both of us around knives and the medication supplies. But yet...I liked her and I wasn't about to let her do anything to endanger herself and vice versa. It was like...I don't care what you think, you are a wonderful person and don't you dare hurt yourself! But me--I am the one to die. Oh no, you don't!

We look out for each other.

Next blog will be about my Great Escape and the orderly who came after me. Now that is a telling story!

Normalcy

I think it was Margaret Mead, a cultural anthropologist, who wrote that normal behavior in a culture was defined by the behavior of the majority of the people in that culture. I never realized that mental health was a democratic process! But if it was...then the patients in a mental unit would be the normal ones--by the numbers. And the staff would be the abnormals! But the staff are the authority figures--the Power. So it could follow that normal behavior is defined by those in power--authority figures. Then again, those in power are enforcing what they learned during their education which was based on what the majority believes, approves, and allows to be taught from approved published material!

So is this a valid corollary: Truth is defined by what the majority accepts as truth? E gads! Sounds like something out of 1984!

And if history is validated by eyewitness accounts, could I change history writing "erroneous" (according to current experts) eyewitness accounts for future generations? If my views of the world were the only ones left after the Great Flooding because the ice caps are melting...I believe the future would be very different from the way it is now and will be forever, amen. Better or worse? Each person must choose the world they create around them and thus the world in the future. For me, it would be better.