One of the things that happens when your immediate family member is manic, and you are trying to get him hospitalized, is that the nurses, psychiatrists and social workers who are evaluating him will also sort-of evaluate you. They’ll listen for signs of family discord, or for hints that you might be exaggerating things. Why? Because maybe you are crazy yourself. Or malicious. Or maybe you just like attention. Who knows. People are nuts.
Why this sucks for you: even if you are the calmest, sanest, most rational person, and also the most compassionate, loving, well-intentioned daughter (or sister or whatever), navigating our mental health system with a fully manic loved one in tow will make you bat-shit crazy. By the time you actually get said loved one into a facility, you will be just as much of a hair-sticking out, clothes-a-wrinkled-mess, eyes-sagging-with fatigue, disaster as the person you are trying and failing to care for.
It’s at this stage that words become land mines. If you tell the wrong person at the wrong time, or in the wrong context that he is drinking, they will refer him to AA, and you will be fucked (you have to say “self-medicating with alcohol”). If you tell them at the wrong time or in the wrong context that he hit your mother, they will refer her to a battered women’s group, and you will be fucked (you have to make it absolutely clear that he is delusional and this is abnormal for him). If you lose your cool and start yelling or making threats, they will write the whole thing off as ‘family discord’ and you will be fucked.
The last time, after weeks of trying to keep him from taking the car or burning the house down in the middle of the night, my mother found herself at the local hospital, begging a psychiatrist to commit him, while he sat placidly in the next room trading jokes with the security guard.
The psychiatrist said: He is actually much calmer and more pleasant than you are right now.
Not everyone who gets through medical school is a genius.
But this time, so far, we’ve been lucky.
My sister, mother and I marched into the social worker’s office like we were marching into the debate of the century. We had coached our mother beforehand: Just stick to the facts, mama. Stay focused on your main concerns – his health and safety, your safety and peace of mind. Tell them about what he did to the house. But don’t get into a long-winded story about what the neighbors think. Or about how he needs a colonoscopy.
I had a notebook, and questions, and a coherent argument. Because I was prepared to argue. Because that’s how it’s gone in the past: He needs to stay in here because we can not protect him from himself out there. Here is the list of crazy shit he’s done. Here is the pile of police reports. Here is our trembling mother.
But they were two steps ahead of us. They had already scheduled a commitment hearing. They had already switched him from the one drug that gives him tremors, to another that hopefully would not. They had already noted his quick metamorphosis – from the sweet old man they admitted a week ago into that other not-so-nice guy. When my sister described the way his eyes sort of glaze over during his rages, the social worker nodded emphatic recognition.
Yes, she said. Exactly.
In short, they – social worker, psychiatrist, etc. – were on top of shit. And when professional people are on top of their professional shit, they don’t really need you, frightened and protective family member, to tell them what’s what. They don’t need you spouting off things you learned on Google or asking churlish questions. What they do need is for you to trust them and give them space.
So. Instead of knowledgable and prepared, I probably came off as anxious and a bit overzealous.
And which of you is the one that keeps calling and emailing me, the doctor asked when the social worker introduced us to him.
I raised my hand. I wanted to explain: Last time, we had to beg them to go to commitment hearing. And then the doctor didn’t even show up and it was a total disaster. And then they discharged him, to a taxi cab driver, when he was fully out of his mind. So, you see …
But then I remembered what we had told our mother: stick to the essential facts. Don’t stray into long-winded accounts.
So. We think he’s in a good facility this time. A facility where the social worker listens to the family and really actually seems to give a shit about our concerns. A facility where the doctor not only prescribes medication, but also pays attention to how he is responding to it, and makes adjustments accordingly. A facility where he is not left to sit in bed or nod off in a corner all day. And, this above all else: a facility that we are assured WILL NOT DISCHARGE him until he is, at the very least, stable.