All posts tagged stigma

I Am Alien

The first thing I remember, after they left me, was waking up in a box. The sides of the box were clear, and I could see, through the half-dark, two white shapes gliding on padded feet to and fro, with stiff white headdresses.

Scratchy wrappings smelling of something that made my eyes water bound me tight and I grew very afraid.

Walking Wounded: Betrayal and Stigma

Even a few days later, I’m still stung and hurting.

A (former) friend whom I have known for years started a Facebook instant message conversation, and asked me what I’m up to. I said, I’m up to my ears writing a novel, authoring two blogs of my own, participating in a group blog (A Canvas Of The Minds), and guest blogging for others on mental-health related topics, specifically bipolar disorder.

She comes back, bipolar disorder? Are you bipolar?

Yes.

Are you on meds?

Yes.

Were you on meds when you lived here (with her family for three months, six years ago, while apartment hunting)?

Yes.

Huh. Well, good luck then.

Click.

A Shrike Impales its Dinner

I should have just walked away from it, counted the loss of another person I had thought was my friend, but I felt like I would be betraying myself, as a campaigner for mental health parity and erasing stigma, if I just let it be. So I sent her a couple of private emails to see if we could sort it out. No deal. Door closed.

The pang of that injury took me back to my very first attempt to disclose my private battles with mental illness. I was at an American Academy of Pediatrics conference. I am a lifetime elected fellow of that venerable organization. The conferences are huge, held in gigantic conference centers or spread across multiple hotels. EVERYONE is there. So I am navigating a crowded lobby, and I run into an old mentor of mine from my residency. We had been quite close, and she had always been a shining light for me. How have you been, she asks kindly. Well, I return, if you want to know the truth, I’ve been struggling with depression. She turns on her heel and walks away. I watch her back receding into the crowd, burning up with shame and racked with the chill of fear: what have I become, that friends and colleagues and teachers just turn and walk away as if I were a leper ringing a bell and calling out, “Impure, impure”?

Years later, I became very close with a neighbor on our street who was also a physician, and like me, an herbalist and energy healer. We felt a deep kinship and hung around whenever we weren’t at work. Our kids played together, our husbands liked each other. It was relaxed and fun and warm.

Even more years later, I had moved away and decided to add acupuncture to my medical toolbox, so I enrolled in an acupuncture school. First day there, who shows up, but my dear neighbor from before! We were so thrilled to be on parallel paths. She and her husband had also moved to the state where I now lived, and she had also enrolled in the acupuncture course! We switched rooms so we could be roommates; back home we started a seminar group for physician acupuncturists in the area; we stayed close.

Then I had my breakdown. I won’t go into the details here. It’s enough to say that I was immobilized by depression, catatonically immobilized, and had to be transported to hospital where I stayed for a couple of weeks. There was talk of ECT, which I adamantly refused. I got better enough to discharge; or actually, my insurance ran out and they decided I was better enough to discharge. I spent the next year completely incapacitated on the wrong meds and racked with guilt over losing my medical practice and putting my two employees out of work, and anything else I could find or manufacture to feel guilty about.

The phone rang one day and I idly picked it up: I wasn’t answering the phone that much in those days. Why bother? Who cared?

“Hello?” an eager voice greeted me. It was my friend the acupuncturist-herbalist-physician! I was so glad to hear her voice.

“Hi, D_,” I managed, trying to sound chipper.

“Well, what’s the matter? I’ve been calling and calling you but you never answer and haven’t returned my messages!” D_ could be fiery.

“Well, D_, the problem is I’ve been struggling with depression.”

“Oh.” (beat) “Good luck then.” Click.

I guess that was probably therapeutic in its way, because ever since I’d gone into catatonia I had not been able to cry. When D_ snubbed me because I was sick, I fell on the floor convulsed with sobs. I screamed, I howled, I kicked things, I looked around for something I could afford to break but found nothing so I screamed some more. I felt more betrayed at that moment than I did when I found out my husband had been cheating on me. Husbands are one thing; bosom friends are another, and being betrayed because of who I am, and the fact that I was ill, by a fellow doctor whom I loved, was just too much.

So when last week brought me another dose of betrayal, I had a flashback to the last time I was dismissed due to my illness. It is enough to be one of the walking wounded warriors, without having to endure the betrayal of stigma.

I bless us all, and bless me back, that our friends should be loyal and true friends, as loyal and true as the biblical Jonathan and David, who watched each other’s backs and took care of each other through all the ups and downs of life, loyal till death.

40 Comments

by Soul Survivor on March 9, 2013 • Permalink

Posted in Autistic Spectrum, bipolar illness, blogging, Disability, medical practice, medications, Mental Illness, Post Traumatic Stress Disorder, stigma

Tagged betrayal, betrayal by friend, bipolar, blogging for mental health, depression, mental health, mental illness, stigma, walking wounded

Posted by Soul Survivor on March 9, 2013

http://bipolarforlife.me/2013/03/09/walking-wounded-betrayal-and-stigma/

Losing It

Dr. Dina watched with dull interest as the repossessors hauled off her car and her RV and her luxurious horse trailer with the full living quarters. She watched out the window of the house trailer she had rented after the bank took the real house.

She told herself it wasn’t her fault that she had lost her medical practice, her pride and joy and the pinnacle of her career and of her whole life. But she knew that it really had been her own fault. She had stopped taking her medications because in that small town there was no such thing as confidentiality, and she didn’t want her family doctor telling her colleagues about how Dr. Dina was taking lithium and a whole alphabet’s worth of antianxiety, antidepressant, and antiepileptic drugs, to treat her bipolar disorder.

When she had moved to East Bumfuck, as she now preferred to call it grimly in her mind, she had intended to get a psychiatrist in the nearest city. But things got busy quickly, and the only time she thought about it was in the middle of the night when she was wide-awake because of hypomania. She always planned to do it the next day; but the next day was just as busy, and she forgot again.

Soon she found herself crying for no reason; and during office hours she sometimes had to slip into her private office to cry between patients. Her office nurse would knock on the door to see if she was all right, but Dr. Dina did not answer, or snuffled through her tears that she was on a phone call.

She thought maybe a lover might help. But how was one to acquire a lover in East Bumfuck?

In the Appalachian county where she had set up her practice, there was a lively music scene, and Dr. Dina happened to be a banjo player. Although she felt uncomfortable around people in general, she forced herself to go to jam sessions and dances and found herself welcome in the community of old-time musicians.

One of them, a guitarist, took interest in her. He was married, to Dr. Dina’s disappointment. But she found herself intensely attracted to him. His guitar style thrilled her to the bones and planted a smoldering fire in her innards. She loved his ready wit, and found his bulging overall-ed belly endearing.

It was a known fact that his marriage was on the rocks. Soon he began inventing reasons to do things with Dr. Dina, “just the two of us,” and before long he had filed for divorce and they were sharing a bed.

As a musical duo, they were hot. Fancy resorts had them on their regular entertainment lists. They used the money for expensive hotel rooms and champaign. Their lovemaking was so hot it threatened to burn up the beds. They fell into hysterics over the image of the hotel manager staring at the charred and smoking bed the next day,

They lived with a furious intensity. During the high times, it was martinis and champaign, and Dr. Dina would dance naked in the kitchen while Mr. Man played Django on the guitar with joyous ferocity. But when one or both was bottomed out, they lived together inside the firebox of the inner furnace of hell.

They stayed together because of the ups, and because they genuinely loved each other. He was a carpenter by profession. She had some experience with wood. So they built a bed together, a marriage bed. It was a dream they had, to build the bed that would hold and surround their love, an impenetrable cocoon to protect them from the world. But something in the building of it went wrong: what should have been a warm and loving creation turned out raspy with bickering and stony silences. It got into the bed.

After a few years of roller-coaster elation and devastation fueled by alcohol-saturated mutual bipolar illness, Dr. Dina threw Mr. Man out. The night he left, she dragged the chainsaw into the bedroom and hacked the bed into pieces.

She dragged the ragged chunks out into the driveway and stacked the remnants up teepee-style. She drenched the thing with kerosene and threw in a match. WHOOF! The fire roared into the night sky. Dr. Dina shivered in the cold, wracked with sobs, watching their bed go shooting up in flames and showers of sparks. She fed the hardwood fire with dry pine boughs until all that was left was a pile of charred remnants of their former love nest. The next day when it was cool Dr. Dina took the shovel and buried the ashes, and spread new gravel over the scorched earth of their love.

4 Comments

by Soul Survivor on March 2, 2013 • Permalink

Posted in Autistic Spectrum, bipolar illness, Disability, medical practice, medications, Mental Illness, Post Traumatic Stress Disorder, relationship, stigma, symptoms, treatments, triggers

Tagged bipolar disorder, codependence, failure, Love, mental illness, relationship, short story, stigma

Posted by Soul Survivor on March 2, 2013

http://bipolarforlife.me/2013/03/02/losing-it/

Do Mad People Fall Sick?

“Do mad people fall sick” was one of the search terms that somehow landed someone at my blog today. Oh I know, it must have been because I mentioned yesterday that I was feeling ill. This is a fascinating question, and I look forward to exploring it.

First there is the premise that there is something called “madness (“the quality or condition of being insane,”–The Free Dictionary).” The word “madness” instantly whisks my brain to the infamous insane asylum, or “madhouse,” called Bedlam, as the Bethlem Royal Hospital (founded 1330 c.e.) was called. The very word “bedlam” has made its way into the common parlance as a descriptor of an out-of-control chaotic situation, e.g., “my five-year-old’s birthday party was complete bedlam.”

So madness, by association, must be connected with chaos: a chaos of the mind that extends beyond what is considered “within normal limits.”

A term that was used to describe the profession now know as psychiatry was “alienist,” right up to the middle of the 20th century. Psychiatric hospitals were known as “Alien Asylums.” Brings up images of little green people peering anxiously out of barred windows, eh?

If mad people are aliens, that means that they are so completely different from “normal”people as to be considered to be in another class entirely, perhaps even another species.

But what about the “asylum” part? Asylum is a place of refuge from pursuit. The word actually goes all the way back to the Old Testament, where God commanded Moses to create cities of refuge in the Holy Land for people who had accidentally killed someone. Once in the City of Refuge, they were protected from being killed by the relatives of the accidentally slain one. So like the biblical City of Refuge or the Hotel California, you could check in, but you couldn’t check out.

So having established that mad people are aliens, and aliens are not normal, we can very well ask the question “do mad people fall sick?”

To answer this we must look at a more modern, but politically incorrect except for legalistic use, term: insanity. Breaking the word “insane” down etymologically we have in=not and sane, which come from the Latin word “sanitas”=healthy. So “insane”=not healthy. But we knew that already. That is why we call it “mental illness.”

So what the search question above seems to mean in this context is, “Can a mentally ill person, who is perceived (by the searcher) to be so alien that I do not even consider them to be part of my universe, be subject to the common physical ailments that we normal humans fall sick with?”

The answer, O ignorant one, is yes.

9 Comments

by Soul Survivor on February 20, 2013 • Permalink

Posted in bipolar illness, blogging, Disability, Mental Illness, stigma, triggers, Uncategorized

Tagged ignorance, madness, mental health, mental illness, stigma

Posted by Soul Survivor on February 20, 2013

http://bipolarforlife.me/2013/02/20/do-mad-people-fall-sick/

A Quandary: Mental Illness, Public Safety

Reblogged from A Canvas Of The Minds:

Due to quite a few recent tragedies, debates about mental illness have been prominent in the public eye. Perhaps they aren't as visible as, say, gun control laws or Lance Armstrong's shadiness, but they have quite a presence.

The debate is couched in terms that express "concern" for people who are mentally ill, and no doubt many commentators do feel concerned about people with mental illness.

Stigma or Witticism? You Decide.

Dearest Readers, I am in a bit of a quandary and I need your help. As some of you know, I live under a rock and rarely come out. On top of being Bipolar, I have lots of Aspergerian features and don’t play well with others. (I haven’t run with scissors since second grade, though). And on top of that, or maybe because of that, I have a lot of social anxiety and tend to run like hell when I see another human being sauntering in my general direction. I live in a building on the side of a cliff overlooking a river, with a small dog for company. For entertainment I see my therapist once a week.

I don’t own a TV and I don’t listen to the radio, so my only exposure to the “world at large” comes by way of social media, which I skim over, much like a gull will skim over a beach looking for edible bits. Therefore, a lot of stuff takes me by surprise and causes me confusion, since I don’t know the social vocabulary of the television-movie-talk radio. So I think I might have run into something from this world that I need your help parsing out, so that I can stop being upset by it. I’m hoping that’s all it is, anyway.

When people “like” one of my posts, or follow my blog, I usually head over to their blog and graze a bit, and usually leave a “like” or a comment, because I believe that is the right thing to do and it’s a great way to find new “bloggie” friends (thanks PAZ). So somebody recently did that, and I did that, and as I was browsing through their recent posts I found a post called “Bipolar blog.” Wow, I got excited! So I clicked on that one, hoping to find a new “Bipolar Bloggie” with whom I could share Bipolarness and Blogginess together. Bleeah, I was disappointed. What this person was talking about (and I am purposely NOT linking to her blog here because I feel it would be childish and nasty to “out” a person just because I disagree with them) is that her blog has grown SO fast and now has SO many followers, that since she tends to blog on two different subjects, she is thinking of splitting her blog into two different ones. Thus the “bipolar blog.” For some reason, probably because of having been stigmatized as being “crazy” all of my life on account of my bipolar illness, that really rubbed me the wrong way.

So dear readers, help me out here. Am I just being hypersensitive to an expression that is thrown around in popular culture and has become a cliché? I feel silly asking this, because I don’t know what popular culture is throwing around just now, but I need to get a clue whether I have reason to be upset by this person in particular or by society in general, if indeed this is a societal insensitivity rather than an individual one. Or, alternatively, maybe it’s a clue that I just need to crawl back under my rock and work on my novel and ignore everything else.

I mean, let’s think about it another way. Let’s say that my blog is getting really black-and-white in its thinking. It might, since I do tend to descend into black-and-white, good-or-bad thinking. I learned that in DBT and I’m frequently, but not frequently enough, on the watch for it.

Let’s say I’m indulging in black-and-white thinking, so what if I were to say, “listen dear readers, this blog is getting biracial, so I’m thinking of splitting it into a black blog and a white blog.” Would that go over very well with biracial readers? I think not. Even though I might have intended it to be a little funny, it still is not funny, because biracial people are PEOPLE, not turns of speech, and most certainly not clichés. Do you see where I’m coming from here?

I hope people will comment like crazy here, because I want to know what other people think about this issue that has my hackles up.

23 Comments

by Soul Survivor on February 10, 2013 • Permalink

Posted in Autistic Spectrum, bipolar illness, blogging, Disability, Mental Illness, Post Traumatic Stress Disorder, triggers

Tagged Asperger syndrome, bipolar, blogging, mental illness, popular culture, social anxiety disorder, stigma

Posted by Soul Survivor on February 10, 2013

http://bipolarforlife.me/2013/02/10/stigma-or-witticism-you-decide/

Blog For Mental Health 2013!

I am proud and humbled to have been pledged by Ruby Tuesday of A Canvas of the Minds as a Mental Health Blogger for 2013. It’s not an award, but a commitment to keep on blogging with the aim of erasing stigma and creating community among those of us who live with mental illness. Our Mental Health Blogger community is a place where people living with mental illness as well as their families and loved ones can come together in mutual acceptance and support. It’s awesome! So here’s the pledge:

I pledge my commitment to the Blog For Mental Health 2013 Project. I will blog about mental health topics not only for myself, but for others. By displaying this badge, I show my pride, dedication, and acceptance for mental health. I use this to promote mental health education in the struggle to erase stigma.

Here is where I’m supposed to write a short summary of my own journey with mental illness. Where to begin? I’ve had issues all of my life with PTSD and dissociation. Likewise, I cannot remember a time when I was not depressed. I ran away from home, permanently, when I was 16 and only by the grace of G-d did not die or end up trafficked to Mexico, although there were some close calls. I didn’t know I had a mental illness till I was in college and desperate to make money. There was an ad in the student newspaper: take drugs and get paid! No, really, it was a study that the Psychiatry part of the medical school was doing. So I went and applied, and had to take a whole day’s worth of psychological testing before they would give me the drugs. Some guy called me the next day and said, “You have to go to Student Mental Health right now! Your testing shows you are Severely Depressed.” Humph. I didn’t feel any different than I always felt, but if I had to go to Student Mental Health in order to get my drugs, that’s the way it was. I went. There was a nice lady behind the desk in a cozy room. She smiled beneficently and asked, “Why are you depressed?” ”I’m not depressed,” I said. “Then why are you here?” she asked. ”The Psych Drug Study made me come,” I said. She shuffled through my slim chart and said, “Your testing shows you are severely depressed.” She looked up at me with that saintly smile and said, “You get good grades. You have a good job. You’re good looking. So why are you depressed?” I stood up, thanked the lady, and walked out.

The next time I got an inkling that I might be depressed came when I was in medical school, married, with a baby who never slept. I adored him, and many years later I still adore him, but the fact is, he never slept through the night until he was five. So at that time I think he was maybe ten months old, and I had not slept since he was born. I was in the middle of my Cardiology clinical rotation. Everyone had gone to lunch, but as usual I had no appetite and was uninterested in hanging out with people, so I was sitting in a study carrel reading EKGs. My Cardiology attending came over and said, “Aren’t you going to go get some lunch?” And I said, “No thanks, I’m not hungry,” avoiding eye contact by studying the EKG. ”Look at me,” he said, and I did, mechanically. ”You’re depressed,” he said. ”I want you to go home and get some help. You need to see a psychiatrist. Please call me tomorrow and tell me what you have done about this.” And head hanging, I went home. My ex-husband came home and said, “What are you doing home so early?” since I usually stayed late studying. ”I’m depressed,” I said. He turned on his heel and walked out. ”Let me know when you’re better,” he said on his way out the door. I called somebody at the medical school whom I trusted, and told him the situation. Five minutes later I got a call from a psychiatrist, who gently demanded that my (ex) husband accompany me to an appointment on the following day. He did. The shrink explained to him that I was physically incapable of doing what I was doing, taking care of our son all night and being a medical student all day (and sometimes all night too). He explained how to give the baby a bottle.

He also gave me my first psych drug, imipramine, which not only knocked me completely out, but gave me a horrible itchy rash from head to toe. Then he gave me antihistamines for the rash. I dimly remember lying on the cool hardwood floor wishing I was dead but having no control over my body and therefore being unable to act on it, which was good. After I got over that, he gave me some other drug, which allowed me to make it through med school in one piece.

Then I got to my residency in Pediatrics, where the standard work week was 120 hours. More sleep deprivation. And still with the non-sleeping child, who, bless his heart, sleeps like a baby now that he’s in his 20′s. And then there was the husband who needed attention too. So I went to a shrink and got Wellbutrin, which is very good for some people, but me it tipped over into hypomania. Only nobody in the medical world in which I lived seemed to know about Depression and Mania and those kinds of nervous system brain sorts of things. They only knew about Show Up For Work And Keep Your Mouth Shut. I had this private joke: if one of us residents died, they wouldn’t give us time off to go to our own funeral.

As it happened, three of us residents DID die, and another one got taken out of service for accidentally giving someone the wrong medicine, which caused their death; so instead of every third night call, we had every other night, and sometimes “every every” night, which meant we didn’t get to go home much. I really don’t know how the program directors thought that flesh and blood human beings could tolerate that for three years and not kill themselves or die in car accidents falling asleep on the way home, both of which things did happen in our little corner of Hell.

Anyway. Fast forward from the late 1980′s-early 1990′s when all this shit was going down, to Y2K. That’s right, the nearly infamous Year 2000. Well, it WAS infamous for me, because a whole conflagration of disasters hit me that knocked my pins right out from under me and I ended up in the hospital. And I became disabled, just like I am now. The only good thing was that some shrink finally noticed that I’m bipolar, and put me on Lithium. But by then my medical practice was in ruins, my family life in tatters, my finances non-existent, and worst of all, I had lost my identity.

I’ve wandered around some more since then, and although I’ve just been declared permanently and totally disabled by a Federal Social Security judge (and that feels pretty rough), I’m writing more than I ever have. I’m blogging, and have become part of this wonderful community that is centered around A Canvas of The Minds. I’m FINALLY writing my book, having used NaNoWriMo for the past two years to give me the kick-start I’ve needed to get two of the volumes well into progress. I’m slowly redefining myself, and even though I still have attacks of ”the mentals,” I’m bumping along, and that’s OK.

Oh all right, that was not short. I am Incapable Of Writing Anything Short.

Now comes the part where I am supposed to pledge five other Mental Health Bloggers. OMG. How am I supposed to choose???? I’ll just start, and when I get to five I’ll stop. Maybe.

PAZ, of Melancholically Manic Mouse

Lunch, of Lunch Sketch

Nicolas, of Puncture Repair Kit

bpshielsy at The Pipolar Place

survivor55 at Bipolar and Breastless

I hereby pledge to remember to let all of the above know I’ve pledged them.

Lastly: I am supposed to remember not to forget to link back to Canvas, so here it is. I think I’ve linked back to Canvas about six times in this post, but I’m feeling kind of wacky today so if I’ve messed up in some of this stuff I hope everyone will forgive me. And feel free to let me know!

Love to everybody and sending good juju for staying healthy this winter, and looking forward to another wonderful year of Mental Health blogging together!

Soul Survivor

8 Comments

by Soul Survivor on January 27, 2013 • Permalink

Posted in Autistic Spectrum, bipolar illness, blogging, Disability, family, humor, medical practice, medical school, medications, Mental Illness, Post Traumatic Stress Disorder, Recovery, relationship, symptoms, Teenage runaway, tests, treatments, triggers, Uncategorized

Tagged bipolar, Blog for Mental Health 2013, blogging, depression, mania, medical school, mental health, mental health activism, stigma

Posted by Soul Survivor on January 27, 2013

http://bipolarforlife.me/2013/01/27/blog-for-mental-health-2013/

If It Walks Like a Duck, and Quacks Like a Duck, It’s Probably a Duck; or, The Emperor Has No Clothes On

Yup, if it walks like a duck, and quacks like a duck, it’s probably a duck. That’s one of the many medical aphorisms that I found true enough to include in my shopping bag of things to think about when considering a diagnosis. In other words, particular illnesses have hallmark characteristics. Let’s take influenza as a convenient example: high fever, body aches, headache, prostration (medicalese for “can’t move far enough to pick up the telephone”), zero appetite. Sound familiar? Yup, we could all hit a bullseye on that one from across the room. It walks like a duck and quacks like a duck.

The corollary to the “duck” aphorism is, “When you hear hoofbeats, don’t think of zebras,” which is a fancy way of stating “common things are common.”

So, to keep with out flu example, if you had a patient with high fever, racking chills, body aches, etc., you would think of the flu, rather than, say, malaria, unless you were in Africa or some place where malaria was common. It is not common in most of the Western world, so that would not be at the top of your diagnosis list.

On the other hand, I had a patient in the ER once, a beautiful 17 year old black Haitian boy, who had a fever of 105, racking chills, body aches, and a pulse of 60. Normally the higher our temperature goes, the faster our pulse goes to pump blood around the body to help get rid of toxins. So a fever of 105 and a pulse of 60 is already a paradox.

Oh, excuse me for forgetting to tell you: the boy was schizophrenic. That’s important.

I drew some blood, which looked consistent with an acute infection. Then I went to the hospital medical library. In those days they had actual books. I found the answer there, in an infectious disease text book from the 1950′s: it was typhoid fever, which you get drinking contaminated water.

I called the infectious disease consultant, all excited and proud of myself for making a cool diagnosis. I read her the patient’s chart on the phone. I got to the part about his being schizophrenic, and I though the line had gone dead, there was such a long silence.

“When you hear hoofbeats, don’t think of zebras. He has the flu,” was the flat response.

“He can’t have the flu. His pulse is 60. It should be at least 120 or more. His blood count is through the roof. He has an acute bacterial infection of some kind.”

(Snottily): “Well, if you really think he’s toxic, give him two grams of I.V. Ceftriaxone and send him home. Have him follow up with you in two days.”

I didn’t feel good about the whole thing. I drew blood cultures and gave the strong antibiotic, and watched him for another four hours. The fever did come down, and he actually looked great after the antibiotic.

Two days later he came back looking much better. He was actually able to talk now. He told me that he’d been to Haiti on vacation with his mother for a month, and just returned two weeks ago. I examined him, and the only unusual thing on exam was that the whites of his eyes were yellow. That means there is something wrong with the liver.

I called the lab and had them fax me all his results stat. Hah! The blood culture results were positive for Salmonella Typhi! He had Typhoid Fever. Now we had a problem, though. Giving the wrong kind of antibiotics at the wrong time in Typhoid can drive the bacteria into the liver, where they can live for years, making the patient a chronic carrier, like Typhoid Mary. So I had to call the snotty Infectious Disease consultant again.

“Hey, you know that schizophrenic kid from the other night? The one with the flu?”

(Coldly):” Yes?”

“Well, his blood cultures are positive for Salmonella Typhi. He’s got Typhoid Fever.”

“Who the hell told you to get blood cultures?”

“Nobody. I just thought it was strange that he had a paradoxical pulse with a fever of 105, so I looked it up. You know what they say: if it walks like a duck, and quacks like a duck..” The phone went dead.

Five minutes later, the snotty Infectious Disease specialist was at the patient’s side, examining his liver and everything else. She wrote a case report in a prominent medical journal about the “Zebra” patient we had. My name never appeared in the article, of course.

Oh, drat, I did it again. I have a personal reason for writing these posts, but I haven’t written it here. Got too wrapped up in the Typhoid case. I’ll try to do better tomorrow.

4 Comments

by Soul Survivor on December 6, 2012 • Permalink

Posted in medical practice, Mental Illness, tests, Uncategorized

Tagged medical care, mental illness, schizophrenia, stigma, typhoid fever

Posted by Soul Survivor on December 6, 2012

http://bipolarforlife.me/2012/12/06/if-it-walks-like-a-duck-and-quacks-like-a-duck-its-probably-a-duck-or-the-emperor-has-no-clothes-on/

Crazy People Get Sick Too

“Crazy people get sick too.” a professor of mine in medical school told me, as we walked through a crowded urban emergency room. He firmly emphasized to his small crowd of followers that it was nothing short of criminal to instantly brand every human being who presented to the ER (or anyplace else) with a medication list that included psych drugs, or was delusional, or disoriented, or hallucinating, or even violent, as being a “crank,” and ignoring the possibility that this person might be physically ill, just like anyone else.

I took that lesson very much to heart, even though I was not officially among the mentally ill at that point. It made all the sense in the world that mentally ill people could still get heart attacks, and strokes, and kidney stones, and life-threatening infections. It even made sense that people who were not diagnosed with a mental illness could have conditions that might mimic conditions normally associated with, say, a psychotic break or an overdose: acute liver failure can cause hallucinations and stupor; uncontrolled diabetes can cause disorientation and lethargy progressing to coma; hypoglycemia can cause uncontrollable tremors, delusions, and hallucinations progressing to unconsciousness and sudden death; brain tumors can cause auditory and visual hallucinations, personality changes, depression, mania, paranoia, and just about anything else.

Then there was the lady who kept vomiting and vomiting for almost a year. The gastroenterologists did every test in the world and it all came back normal, except for her serum electrolytes, which were screwed up from her constant vomiting. They branded her a psychogenic vomiter, which means they blamed the vomiting on something psychological and that was not their department, so they discharged her from their care. A few months later she presented to the ER, this time vomiting up fecal matter (sorry). Yes, it was really gross, and my heart went out to this poor lady, who had been branded a “crank” simply because the doctors did not know what was wrong with her.

This time the ER requested an acute surgical consult. The surgeon decided to take her to the OR the next day for an exploratory laparotomy, which means they would open her up from guggle to zatch (my terminology) and wudge around in her innards to try to find the cause of her awful condition. Luckily, I happened to be on the surgery service then, so I was pressed into service holding retractors. (N.B. anyone who has a question about any of these terms is welcome to leave a comment and I will explain. I figure that most people watch all these medical shows they have now, but since I don’t own a T.V. I don’t know what they have on them.)

Where was I? Oh yes. Holding retractors. So. When the surgeon got in there, he found, to his great surprise, a gigantic tumor in the middle portion of her small intestine. Now, the small intestine is notoriously difficult to evaluate due to its extreme length (about 20 feet) so you can’t just stick a periscope down there and look around, like you can with the large intestine. So all kinds of weird shit (excuse the pun) can hang out down there and go on with its dirty business undetected. So when he opened this lady up and found a grapefruit size tumor like a donut surrounding the tube of her small intestine, he was shocked and amazed. I was ecstatic. The lady was vindicated.

The surgery turned out to be very messy. I will not go into the particulars. I had the immense satisfaction of bringing the news of the positive surgical findings to the attention of the arrogant asshole gastro people, who pretended that they thought something was the matter all along.

Oh, I forgot to tell you, this lady had a diagnosis of anxiety disorder and was on two or three meds for it.

One piece of good news is that since then there have been many new developments in medical imaging. It is doubtful that things would have got that far without a CT scan, or an MRI, or both; and either of those would have revealed the weird tumor. But given her diagnosis of anxiety disorder, would she have been taken seriously enough to even get to the point of imaging before she started throwing up shit? I really don’t know.

Next post, I will tell you why I wrote this one.

18 Comments

by Soul Survivor on December 5, 2012 • Permalink

Posted in bipolar illness, medical school, Mental Illness, Post Traumatic Stress Disorder, symptoms, tests, Uncategorized

Tagged health care, illness, mental illness, stigma

Posted by Soul Survivor on December 5, 2012

http://bipolarforlife.me/2012/12/05/crazy-people-get-sick-too/

Tomorrow I Will Lie to My Doctor

It’s always like this when I go to see a doctor who isn’t a shrink. I tell them my symptoms, and then it goes one of two ways:

Way #1 She listens to me carefully and proposes a diagnosis and a treatment plan.

Way #2 She eyes me suspiciously, wants to know how much opiate medicine I am taking, and hands me my chart back marked “irritable bowel syndrome,” which I do not have.

Let’s play a little game: which one of these doctors had access to my psych history?

Aha, I see you have guessed right.

So tomorrow when I go to see my gastro about a little issue I’ve been struggling with, I will most definitely NOT hip her to the fact that the rest of me is stuck in a heavy depression that just doesn’t want to get off of me. Kind of like “The Blob” in the old horror movie,

Nope, I am not going to tell her about that. I am going to LIE.

4 Comments

by Soul Survivor on December 3, 2012 • Permalink

Posted in bipolar illness, Mental Illness, Post Traumatic Stress Disorder, symptoms, treatments, Uncategorized

Tagged bipolar disorder, depression, intestinal troubles, ptsd, stigma

Posted by Soul Survivor on December 3, 2012

http://bipolarforlife.me/2012/12/03/tomorrow-i-will-lie-to-my-doctor/

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Bipolar For Life

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