Wednesday, August 12, 2020

They OWN your grief

When you’re in the nuthouse and your mother dies, you don’t get a break.

I attended a staffing this morning by teleconference, for a client named David. His mother recently passed away, and the “clinical” conversation today centered in part around whether he was grieving correctly. The treatment team seemed to think that so far, he is. But they are going to keep an eye on him.

I tried to ask questions about how they can tell whether he’s grieving correctly. My questions were not welcome, and I actually became a little angry, because I think any such judgment is subjective, arrogant to an insulting and dehumanizing extreme, and frankly, BULLSHIT. 

I use the word BULLSHIT advisedly here, in the same sense that the esteemed and powerful psychiatrist and author of DSM-IV, Dr. Allen Frances, M.D., used it when he said psychiatric “diagnosis is bullshit”. I didn’t use the word during the staffing.

I was assured that a “clinical” judgment of whether somebody is grieving correctly after his mother dies is not subjective, and it’s certainly not judging the person who grieves. Judging is of course a hot-button word. I probably could have used BULLSHIT and gotten away with that, but when I accuse mental health professionals of judging patients, they are deeply insulted because their whole field is supposed to be a matter of medical science, never morality. Of course everyone grieves differently for different losses at different times. But the morality of allowing them to do so, of granting them some fundamental respect, is completely lost on these “clinicians”.

Nevertheless, the statement about David had been too clear for me to ignore: “He seems to be grieving normally but we’ll keep monitoring him in case it becomes excessive, or a clinical issue.” That couldn’t mean anything other than, there is a difference between appropriate and excessive grieving, and the expert clinicians who would be doing the monitoring of David’s grieving for the loss of his mother have expert ways of telling the difference, or technical criteria, or tests.

So I just wanted to know what these “clinical” ways of telling the difference between correct and incorrect grieving actually were. They didn’t like that at all!

Well... one type of criteria the team mentioned that I can understand is, if a person can’t sleep and isn’t eating, maybe they are grieving incorrectly. But “can’t sleep” means what? One night? Two? Five in the first week after the loss? More than half of nights two months later? Nobody knows, including David’s treatment team, because as they all admitted, everyone grieves differently for different losses at different times. This was his mother....

“Isn’t eating” might be a clear sign if the person actually loses, say, ten or fifteen pounds below a healthy weight. But what a healthy weight even is for different people at different times is arguable; and strangely, David’s treatment team didn’t bother to suggest any objective statistic like that. They simply insisted that their technical expertise, their arrogant “clinical judgment” was obviously the correct measure and the appropriate evaluation.

This evaluation or monitoring of David’s grieving certainly is subjective judging. I suspect the real yardstick, and the real motive, is what drugs do they want to give this patient? As it happens, David’s psychiatrist is very partial to SSRI “antidepressants” so the death of this patient’s mother will probably be a good excuse to prescribe them. 

I wonder whether these clinicians take drugs to grieve correctly, when people they love die. 

But then again, they are “mental health professionals” — not mental patients like David. They are trusted to choose what’s in their own best interests.

Mental patients are not trusted to know anything, especially about themselves. They are a lower order of humanity, and need “clinical” evaluation by their betters, whom they must trust. Slaves once had to trust their owners, too.

The experts even own your grieving! They judge it to be correct, or drugable. Just like the masters once owned your family, and judged whether to sell your spouse or your child down the river.

Elgin Mental Health Center is not a hospital, it’s a slave plantation. I’m for abolition.

Monday, August 10, 2020

“Hospital”

I have a client at Elgin Mental Health Center who really brings out the irony of pretending that a plantation is a hospital. Gus is a royal pain in the posterior of the drivers, overseers and masters. He’s often a royal pain for me, too, because he manages to broadcast a truly obnoxious level of complexity, even in simple situations. It’s almost miraculous, I’m not sure how he does it.

There have been several monthly staffings I attended when Tom Zubik became intensely frustrated by Gus’ long monologues or litanies of complaints about myriad details of his experience as a mental “patient”. Tom is a decent guy in a challenging (to say the least!) job. I’ve frequently felt sympathy for him, but that’s limited by my suspicion that he actually believes Elgin Mental Health Center is a hospital in the sense of an institution which intends to help people. Any such belief is self-deception, born of stupidity, gradually accumulated over many years of bad acts and lies.

This morning nice and early, Gus called me with the announcement that, “We have another serious issue.” 

This is the usual opening statement for about 80% of all phone calls from Gus. It’s almost as predictable as the opening statement for about 95% of all phone calls from MarcI Webber: “I just have a quick question for you.” 

Gus normally proceeds to tell me long narratives full of tiny details of dubious significance under which the “serious issue” he wants to tell me about is entirely buried; and Marci normally proceeds to keep me on the phone for as long as she possibly can, asking an unlimited number of questions to which she either already knows the answer, or which she knows nobody can answer. Man-oh-man, maybe my job is as tough as Tom Zubik’s!

Anyway, this morning Gus was telling me that he has this pain and that pain, and this medical problem and that medical problem, this need for medicine and that need for medicine, this disagreement with the doctors and that disagreement with the doctors.... I was trying to listen and keep track, when Gus said something about Dr. Shaikis threatening to discontinue his ibuprofen. Because Gus has so many pains and medical problems, this was looking like a very serious issue, indeed.

Dr. Shaikis is the current M.D. who deals with the real medical issues (as opposed to psychiatric stuff) on the unit where Gus is held. I don’t know him at all, I even had to ask Gus how to spell his name. 

I tried to get any clarification about why Dr. Shaikis would discontinue ibuprofen. Theoretically there could be various medical reasons. Maybe Gus takes more of it than he’s supposed to, maybe his blood is too thin, maybe some other analgesic is judged to be better in the circumstances. (I’m not a doctor, my understanding of this is entirely that of a layman.) But I was always under the impression that ibuprofen is not a very dangerous drug, especially compared to other so-called “treatments” (e.g., neuroleptics and ECT) that Gus has been prescribed during his years on the plantation.

Well, as it turns out, I’m pretty sure Dr. Shaikis is simply trying to punish Gus for being such a royal nuisance. That’s the only way it makes sense, and I can understand that very well. Shaikis has recently denied Gus several other therapeutic items that he had previously been used to, including a posturepedic cushion and a list of other things which I can’t remember. (This is according to Gus, so of course it’s a list; he probably maintains a whole spread sheet about it.)

Once again, the concept of a hospital does not work or enable any prediction of a doctor’s motive to punish his patient. That’s not what anyone would expect. EMHC cannot be understood as a hospital.

But on a plantation, slaves are routinely punished. That makes sense!

Monday, August 3, 2020

BURN IT DOWN!

This is certainly a season for violent rhetoric. I would hate to fail to contribute my share.

As plaintiffs' attorneys in five federal lawsuits against employees of the Illinois Department of Human Services, my partner and I continue to receive reports from new witnesses and new potential plaintiffs, as well as more evidence proving our current claims. Dominos are about to fall.

Several patients who have spent lots of time on the White Cottage clinical unit at Elgin Mental Health Center have come forward to say that of course Syed Hussain knew our client in one case was having sex with staff! Everybody knew this kind of criminal abuse was frequent and endemic. There was even a specific room notorious for sexual encounters between male staff and female patients. Certain staff handed the women back and forth among each other as favors, under a guise of "introductions".

Everyone is threatened into silence about this kind of abuse, and most lower level unit workers are afraid of gang reprisals for reporting it. Those in higher positions, psychiatrists and administrators, avoid all mention of verbal reports and suspicions so nothing gets written down, and no hard questions will come back from places like Springfield or the Joint Commission.

Just this morning I got a new report that a patient on N Unit was forcibly drugged for no legitimate reason over the weekend. Some night shift nurse was merely annoyed that he wouldn't do a menial task she asked of him, and though he posed no conceivable threat to himself or anyone else, she had him held down and shot up with drugs. It was punishment, to set an example.

Last week a psychiatrist who was once thought to be friendly toward a patient at Chicago Read MHC issued an unsubtle threat: "If you disagree with my diagnosis, maybe I'll just change it to a worse one, how would you like that?" The pretense of medicine is ridiculous.

I could go on and on with examples. It just makes me angry. Suffice it to say one more time: EMHC, Read, and Chester need to be closed, razed, plowed under; and the acreage they have been located on needs to be seeded with radioactive waste so no one can ever live or work there again, for at least a thousand years.