The Mental Health Registry Is Coming


They say it will be like the Cancer Registry: a tool for data gathering, to assist in developing and evaluating and improving treatment strategies and outcomes.

All well and good, but mental health/mental illness information is a little bit different than cancer information.  A little bit more sensitive.

Let’s take one example that’s close to my heart.

Every year when I renew my physician’s license to practice, I must answer a question regarding my mental fitness to practice.

Now we all know that I am disabled, so of course I don’t formally practice medicine.  I keep my license in case I am called upon in an emergency, like Dr. Watson, Sherlock Holmes’s esteemed companion.  

I have never had a single complaint, lawsuit, or bad outcome.  I am very careful to keep up my continuing education.

And yet, the one time I openly disclosed my psychiatric diagnoses when applying for a license in a new state, I was immediately bundled off to the “Physicians Health Program,” where I was forced to be drug tested weekly and attend a three month sham “behavioral health” program, aka “drug rehab,” even though I have never had any substance abuse issues and was not at the time using any drugs at all.  Then I was put on “probation” for a year, even though I hold unrestricted licenses in good standing in four other states.

After putting up with this garbage for several months I withdrew, chalking this one up to a very expensive experiment.  I paid the Honesty Tax.  How degrading!

I will be very much heartened if I find that this registry is exactly what it purports to be: an instrument to better coordinate the search for better treatments.

But I doubt it.  How could a centralized registry of psychiatric patients go untapped?

Let’s say I want to take a break from retirement and teach high school biology.  They do a background check (I hope), and as of now, they don’t find anything, because I have no criminal record.

But if there is such a thing as this “Mental Health Registry,” who’s to say that in five years Homeland Security doesn’t find itself good reason to insist on the identities of the patients listed–oh, it says the data is anonymous, doesn’t it?  But it also says that the registry will be a good source of patients for clinical trials.

Yes indeed, the Cancer Registry is a good place to find patients with specific cell types of specific cancers, to recruit for clinical trials of regimens for that specific cancer type.

Well and good!  But mental illness is a bit more tricky.

Once we have names and diagnoses, we have information that can be subpoenaed.  Patient information does require a subpoena.

But under the Patriot Act, will that rule of law stand?  Or will the Registry database be…leaked, perhaps?  Or simply mined by Big Brother?

Call me paranoid, but I am not at all comfortable with any computer mainframe having my psychiatric details.  Even the Pentagon gets regularly hacked by high schoolers.  

I Am Alien

 

alien woman head

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. Then I found that I could wriggle one hand free, and soothe myself by sucking the largest one of the digits.  This took away some of the fear.

After the half-light memories, I remember no more until much time had passed.

They had told me that I would not remember them, when they dropped my astral body into this receptacle, this mobile vessel that the natives here call “human.”  But I do have faint recollections of my real people, mostly in the form of feelings of kinship, and an understanding that surpasses words.

Although my memories of what happened after I left the box have been erased, I have seen a home movie of my first steps at the age of nine months post-emergence.  The movie shows a small native female running away down a sidewalk, falling, picking herself up, and running further away, until the large native identified as “my mother” runs and picks up the small one, carries it back to the starting point, and sets it down; whereupon the small female commences running away again.  The natives surrounding the movie camera are heard “laughing.”  The small female was me: trying, as soon as I attained locomotion, to run home.

Several years later they took me to a building full of native children, and a large female overseer gave each one a paper covered with shapes, and color sticks, and commanded all to fill the shapes with color.  I saw no point in this meaningless exercise and turned the paper over, so that I could draw a picture of my real parents.  The overseer objected strongly to this, and made me stand in a corner; this was a relief, as that way I did not have to participate in their ridiculous activities.  From then on I learned the ways of achieving the corner, and did spend most of my time there, dreaming of home.

At night I sat by my window for hours, pleading with my parents to come and get me, explaining to them that they had left me on the wrong planet for too long.  I heard them from afar:  Not yet, not yet.  Your job is not finished.  Not yet.

My native “parents” did not know what to do with me, since I refused to associate with the native children, whose language was simple and crude, whose games ridiculous, and who, at the age of six, could read nothing more complicated than “Dick and Jane.”  By that time I had read a good deal of my parents’ library:  Herman Hesse, Gunter Grass, Franz Kafka, which was my favorite, especially Metamorphosis.  This was by far the best thing about this world: books, because they took me away, for a time.

The animals were a relief from loneliness. They have great wisdom and do not require speech to explain their thoughts and wishes, which are many and subtle.  The natives have terrible misconceptions regarding the animals: they think that because the animals cannot speak as they do, that they must be an inferior race.  This is wrong.

In my readings I discovered that there are special doctors for people whose minds work differently from those of the rest of the natives.  In these times they are called “Psychiatrists,” but in earlier times they were called “Alienists,” because those who do not conform to the norms of this world are considered “strange,” or “alien.”  I also learned that beings originating from other planets, like myself, are called “Aliens” as well, because we are strangers in this world.

Upon a time, there were great houses called “Alien Asylums,” where Aliens were sent for safety.  I thought, perhaps, that in an Alien Asylum I might find some one like myself, from my own planet.  I wanted to learn all I could about these places, and to see if there was one nearby.  So I got out the great book called “Encyclopedia” and looked up “Alien Asylum,” and was shocked at what I found there.

The Aliens were tortured in a ghastly fashion, with straitjackets and cold sheet wrappings and electric shocks.  I decided that I would not go there; in fact I decided to try to mimic the natives so that they would not know that I am an Alien.

I did so by spending all of my time at my studies, or in reading famous books, or in working with the animals, so that they could see that I was a very good native.

Many years passed in this fashion, but then something—I do not know what–happened that damaged my gyroscope, and I found myself one moment flying toward the sky and my home planet, and the next moment crashing to the ground.  I was unable to right this malfunction, and soon it became known to the natives, who carried me against my will to an Alien Asylum.

Fortunately the Asylum was not like the ones in the Encyclopedia.

In fact, it reminded me markedly of my first days at school, where I was given the papers with shapes and the color sticks, and told to color inside the lines, if I wanted to get out.  I refused to participate in this absurd activity, and they gave a bad report of me to the Alienist.  He ordered them to make me swallow pills, many pills every day, that made me feel weak and dizzy.  But then I was no longer expected to color either inside or outside of lines.

When they released me from the Asylum, the Alienist sent me to be “Tested.”  A kind native woman asked me many questions and gave me puzzles to solve.  I solved many puzzles, until there were no more left.  Then she asked me to look at pictures of native faces, and tell her what the people in the pictures were feeling.  This I could not do, because I am not a native and I do not use their modes of communication.

After we finished all the tests, I returned to the Alienist for his report on their outcome.  He told me that I had Asperger Syndrome and Bipolar Disorder.  He explained to me what those things mean; but it was nothing that I did not already know.

I am Alien.

Alien spaceship

Well, That Was Fun…Wasn’t It?

Look, I love my psychiatrist.  I think he’s a genius.  He thinks he’s a magician, so he’s all right by me.  In my opinion, you have to be crazy to be a psychiatrist in the first place–a good one, that is.

We’ve been riding this boat called my brain in more or less rough waters for, oh, twelve years now, with a few breaks for me to galavant across the country or the world.  So he knows my inner clockwork pretty well, and I know his pretty well, and most of the time it works out.

See, I have always lived an inner life, and never much paid attention to my environment.  I chalk that up to my considerable Aspergerian tendencies, and unless someone comes to visit and I am painfully reminded that I haven’t cleaned in years (you think I’m kidding?), I don’t even notice it.

My shrink thinks my essential disorganization is due to inattention.  He thinks that stimulants will fix it.  He’s had me try dexadrine in almost every form there is.  In fact, he just mailed me an Rx for Dexadrine Spansules, which is what you give kids mixed in apple sauce.

So I have this whole amphetamine pharmacy that I can’t quite bring myself to take to the “medication recycling day” at the drug store.  Hmph.  I know what THEY do with it anyway.  They get ripped, is what.

So last time he gave me the long-acting dexadrine I thought it worked pretty well, but never remembered to take it after that.  You must know that I am the mother who had to give the school nurse my son’s bottle of Ritalin because I could never remember to give it to him and the phone would ring reliably at 10 am:  “Doctor, did you forget to give your son his Ritalin again?”  Because without it, he was just like a top bouncing off of everything in the room and crying at the same time.  Five milligrams of Ritalin, and the sun came out all smiles.  So I had his doctor write the prescription for the school nurse to give, and life was good.

Ooooh-kaaaay, back to my story.  Yeah.  So I saw my magician on Thursday, and he encouraged me to try the stuff again, and he also prescribed a light box, 10,000 lux, for my persistent depression.  All good so far.

Yeah.  So yesterday I took a long-acting dexadrine 10 mg in the morning, which is what he said to do.  Only, you gotta understand, my mornings start at around 11 am because my night-time meds take so long to wear off.  So I took it as soon as the coffee kicked in, which might have been noon by that time.

About four o’clock I was sailing.  I was literally cookin’ along, because I prepare a big family dinner every Friday night and so I was choppin’ and marinatin’ and having a general good ol’ time.

Eight o’clock and I was still buzzed.  I started feeling a little cranky so I took an Ativan.  No dice, did nothing.  Ten o’clock, I took my usual night-time sledgehammer dose of Ativan, Clonipine, Zolpidem and Seraquel.  That usually results in unconsciousness within half an hour.

Nope, not last night.  Instead, I went into a state of half-wake, half-dreaming.  I think that’s what vampires must do.  It’s certainly not anything I would call sleeping.  I lay on my pillow, eyes lightly closed, alternately shivering and drawing the blankets up to my chin, and breaking out in sweats and throwing the covers off.  Haven’t had anything like that since I laid off menopause.

Finally at seven (seven!) I turned over and said to the dog, “This ain’t goin’ nowhere.  I’m gettin’ up.”  She opened one eye and shut it again.  She’s a late sleeper too.

Noga, my Lhasa Apso PSD, getting her beauty sleep

Noga, my Lhasa Apso PSD, getting her beauty sleep

I made coffee, drank it, and went to work deleting emails.  If you knew how many thousands of unread emails I have in my many email accounts, I’m sure you’d think less of me.  But anyway, that’s what I did.

Long about 11 o’clock, the sun came up over the mountain like it usually does.  The dog stretched and yawned and demanded her morning petting session (kisses and hugs too) before she went outside to take care of business.

After she came in, I fed her, and then we both went back to bed and slept till it got dark.  Now it’s 11 pm, and I’m waiting for the nighttime meds to kick in.  I might try that stimulant shit again, at seven in the morning like you’re supposed to.  Then again, I might not.

Mass Murder and Psychiatry – Psychiatric Times

Mass Murder and Psychiatry – Psychiatric Times

I read this article three times over, and I’m still reeling from what I think it said.

I think this article said that:

1)  People with psychiatric illnesses should be considered at risk for committing mass murders should they chance to get their hands on automatic weapons, and know how to use them;

2)  People with psychiatric disorders don’t really have disorders, but diseases;

3) People with “psychiatric diseases” are potentially vessels of evil, as the author experienced in the prison population.

I think this article itself is a vessel of evil.  Please correct me if this is just me being my usual paranoid self.  I admit to being particularly paranoid since the latest mass killing was attributed to a person on the Spectrum.  As a person on the Spectrum myself, this type of finger-pointing that stigmatizes all of us makes me want to hide even more than I customarily do.  I don’t know how that would be possible, since I only go out in public once a week, for my therapy session; but there you go.

Please help me out, Dear Readers.  Am I just being hyper-paranoid here, or has this guy really stamped the Mark of Cain on the forehead of everyone already branded with a DSM diagnosis?  Help me out here.

Mass Murder and Psychiatry – Psychiatric Times

The Psychiatrist and the Lightbulb

The husband and wife sat stiffly, as far apart on the stiff divan as the laws of physics would allow. The intervening silence froze the air.

“Well?” the cordial voice of the psychiatrist punched through the waiting silence, and it shattered and fell tinkling to the office floor. The man glared at him malevolently. The woman raised her eyebrows and nodded to the psychiatrist knowingly, while making a barely perceptible motion with her chin in her husband’s direction.

“I SAW that, Gladys!” the man accused angrily, rising slightly from the couch and shifting to face his wife. Gladys sat up primly, pursed her lips and folded her hands, gazing straight ahead beneath hooded eyes, her blue permanent curls trembling slightly.

“Now,” said the psychiatrist soothingly, “why don’t we start at the beginning?” And as there was no offer of a beginning, he took the more direct approach and asked the man:

“What brings us in here, today?”

“What brings US in here today,” snarled the husband, “is my WIFE! If you want to know why we’re here, ask HER, since she knows so much.” And he shut his mouth with a snap that could be heard all across the office.

Even I heard it, and I was just a second year medical student. This was my first time observing a psychiatric office visit, and it was turning out to be much more interesting than I had expected.

The psychiatrist sighed and tried again.

“Well, Mrs. Jones, why did you accompany your husband here today?”

“Thank you, Dr. Smedley. As you know, I had to lie to get him here, and he’s awful mad about that.” Mr. Jones snorted like a bull. “You can say THAT again. That’s the last time I fall for THAT line of__”

“Mr. Jones,” purred Dr. Smedley, “Your wife is only concerned for your well being.” Mr. Jones fell into a seething silence and glared at the doctor from behind thick black-rimmed glasses that made his eyes look twice as big as they actually were.

“Now, Mrs. Jones, if you would like to tell us all here what you told me on the telephone, I think that might be a good way to begin.”

“Well,” began Mrs. Jones uncertainly, darting anxious glances in the direction of her husband, who seemed to be occupying himself by entraining a psychic death-ray in her general direction, “It all began a few months ago when Gerald here started talking to the light bulbs.”

“I wasn’t talking to the lightbulbs, you little idiot, I was talking to the ALIENS who use the lightbulbs as an instrument of communication!” Gerald exploded, spraying saliva all over everything in his immediate vicinity. I had instinctively jumped back, but Dr. Smedley was wiping his eyeglasses with his pocket handkerchief.

Mrs. Jones simply nodded, shrugged her shoulders a bit and raised her palm as if to say, you see? This is what I’m talking about. Dr. Smedley frowned, scribbling furiously on his steno pad.

“Mr. Jones, may I call you Gerald? Thank you. Gerald, how long have you had this delusion that aliens are communicating with you through the light bulbs?”

“Delusion? DELUSION? What kind of an idiot do you think I am? Better yet, what kind of an idiot are YOU? HAH! YOU’RE the kind that they would NEVER speak to, so of course you don’t know. Of course you think it’s a delusion, because you’re a petty, ignorant little pissant that aliens wouldn’t waste their precious time on. And their time IS precious, too.”

Gerald climbed up and stood on the arm of the divan, directly beneath the ceiling light fixture, and cocked his head to bring his ear closer to the bulb. He closed his eyes and listened, nodding his head vigorously from time to time. His wife wept silently at the other end of the divan.

Here I got a little excited, hoping that he would go on and tell us more about the lives of aliens and their experience of time, but my hopes were dashed.

“Gerald. Please sit down. Now, I am about to demonstrate something about the nature of light bulbs, and I hope that after I show you this, you will be able to understand that light bulbs do nothing more than convert electricity into light. They are not capable of transmitting sound or any other kind of means of communication.” Dr. Smedley opened his desk drawer and produced a light bulb and a hammer.

Gerald’s eyes grew large with fear. “No. Doc, please. Please don’t do it. Those are very important. They contain essential classified secret emissions.” Dr. Smedley wrapped the bulb carefully in a tea towel. “No, Doc, you don’t understand. Once you bust those things, it’s all over. All is lost. You can’t go back—” CRUNCH! With a satisfied smile, Dr. Smedley carefully unwrapped the tea towel to reveal the shards of the light bulb, its now naked element quivering in shame.

“Do you see now, Gerald? This is nothing more than a piece of tungsten metal attached to a special piece of glass. No one could possibly use this as a communication device, even if there WERE aliens,” he said kindly.

“Gladys, get up. We’re going. This man is dangerously insane.” Gerald collected his wife and hustled her out the door. She kept her eyes down, this time, no longer seeking the eyes of Dr. Smedley. He had discredited himself a little, I think.

“Well now, what did you think of THAT for your first outpatient psychiatry case?” Dr. Smedley turned his high beams on me.

“Well,” I began carefully, “personally, I really wanted to hear more about the aliens in the lightbulbs. Like, what did they say to him, and how often did he talk to them, that sort of thing.”

“Ms. L_,” Dr. Smedley glared at me. “Aliens do NOT talk to people through light bulbs!”

I knew I was pushing it but I had to advance my case. “Dr. Smedley, isn’t it true that each person experiences reality in his own unique way?”

He nodded, “Of course.”

“In that case, is it not possible that this man’s reality happens to be that aliens communicate with him through the lightbulbs? I mean, whether or not this is the objective truth, it’s still his reality, right? So who are we to argue with him about what is real or not real for HIM?”

As I delivered my speech, I observed Dr. Smedley becoming redder and redder in the face, but somehow I could not stop myself. All of the outrage that had been building pressure during the absurd and degrading occurrences of the interview with the Joneses came pouring out all at once. I felt suddenly, triumphantly, at peace.

But oh, no! What’s this? Dr. Smedley climbing upon his desk–where just five minutes before Gerald had stood upon the divan—and Dr. Smedley is jabbing his forefinger at me, for emphasis, and shouting “WE—ARE—THE–AGENTS–OF–REALITY!” Over and over, again and again. WE. ARE. THE. AGENTS. OF. REALITY!

Aghast, I backed slowly out of the room and closed the door, never to return. Just like Gerald and Gladys Jones.

THE END

Postscript~with very little poetic license, this is a true chronicle of the first day of my psychiatry rotation in medical school, in 1983.  Proving, once again, that truth IS stranger than fiction.

 

ⓒ 2012 Laura P. Schulman, all rights reserved. All reproduction without express written permission of the author is prohibited.

 

Nature News Special : The Autism Enigma

http://www.nature.com/news/specials/autism/index.html?WT.ec_id=NEWS-20111108

Here is a wonderful collection of cutting-edge articles on autism research.