Invisible

Don't start here. Go back to the beginning and work your way back up to here. The first post in this way-too-long series is called "How I became Invisible," posted four or five posts back on 11-29-07.

Martinez escorted me into the ER. I scanned the full waiting area, desperate to make sure there was nobody there I knew. I don’t know what I would have done if there had been. I immediately felt a huge rush of guilt and embarrassment. Here were actual sick, uncomfortable people who were in need of medical attention, and I felt awful that I was going to be there taking up a space I didn’t deserve and delaying care for someone who actually needed it.

While I was taking in the realities of the waiting room—easily 50 or 60 people there—#1 was speaking with the nurse over at the desk. He called me over and the nurse handed me a clipboard with a form to fill out. I got only as far as my name and reason for coming in when I puzzled over the question. I wrote, “I am here because I am forced to be. Someone I don’t even know says I am suicidal, but I’m not.” I looked up because #1 was standing next to me. He said, “Come with me, May. You aren’t going to wait out here.” This was not an act of being considerate, as I suspected immediately.

I went through the security door to the intake room. The damn cop followed me in. I was beginning to wonder if he would be spending the entire evening with me. It didn’t seem like a good use of taxpayer money or law enforcement resources, yet there he was, hovering at my shoulder. It was getting old.

I sat down and was asked to produce my medical insurance card. Up until this moment, it hadn’t occurred to me that I would be held financially responsible for something I had objected to so adamantly. This was almost too much to bear, yet in my own self-interest, I couldn’t say anything. The nurse took my information sheet and went on to take my blood pressure, put a pulse-ox meter on my finger, took my temperature and entered my personal information into the computer. The entire time this was going on, the other nurse was chatting up #1. They apparently knew a lot of the same people and had lots to laugh about. She started telling him how she got a ticket and it was her second one and she asked, “So, can ya fix it for me? Make it go away? I was trying to get to work, ya know?” The other nurse was on the phone. Nobody was paying any attention to me whatsoever. I had officially disappeared in plain sight. I was absolutely invisible.

The intake nurse handed me a bunch of HIPPA forms to sign, and while I was scanning them, she picked up the phone and said something about a suicidal patient. I dropped the pen and said through my teeth, “I am NOT suicidal. He said I’m suicidal.” and I gestured toward the cop. He put his hand on my shoulder and said, “That’s enough.” I didn’t know how I was going to get through this. I knew it was so, so important for me to stay calm and remain pleasant, to show no fear or anxiety, but it was almost too hard. I couldn’t bear to hear anyone talk about me as if I weren’t there, but even worse, I hated that no matter what I said, it was just disregarded as probable nonsense. I had a mental illness. Apparently, anything I had to say was going to be considered a manipulative lie.

After just a few minutes, I was taken back to an exam room and told I had to sit on the exam table, not in the chair. I got up on the table, and #1 was right there standing next to me. Never in my life have I wished so much for someone to go away. I felt that as long as he was there, I would never get to convince anyone of my innocence. The embarrassment was killing me, I was sure of it. I tried not to make eye contact with anyone who came in the room.

Eventually, a doctor showed up and asked me how I felt and why I was there. It was just humiliating to have to say it again and again. Didn’t these people know how to read? It was on my chart. I took a deep breath, let out a sigh and said, “How do I feel? MORTIFIED. I want to crawl under the floor tiles, if you must know. This is a big misunderstanding. I said a bad word to the man on the phone from Diners Club, and now I’m being punished for it. I tried to say I was very, very sorry, but apparently, my punishment requires that I come here. The officer here says I’m suicidal, but I am not suicidal. Ask my doctor. Ask my therapist. Their contact numbers are on the chart there. Please, please call and they’ll tell you I am not suicidal, no matter what the officer says.”

I was trying not to be sarcastic, but being cheery and polite hadn’t done much in my favor, so I was willing to give up on that. The doctor left and I looked at #1 and said, “How long did you say this will this take? I really need to get out of here.”

“Now, May, it depends on how busy things are in the ER. It’s up to the doctor. I can see you’re getting defensive. You’re here for a reason and your defensive attitude isn’t going to help you.”

ARGH!!!!! I wanted to smack him hard, upside the head. Except since I was the one being admitted for the psych eval, smacking anyone probably would have been a bad move on my part. It was really tweaking my nerves that he kept using my name every single time he spoke to me, like this personal form of address was somehow supposed to make me feel better.

At this point, I hoped that whatever conclusion the doctor was going to reach, it would happen soon so I could home. It had to be obvious that I was OK. I had tried so hard to be pleasant, maintain eye contact with everyone (especially the cops--I heard somewhere that cops like eye contact), relax my shoulders and keep an open posture, smile, answer questions directly, not fidget, and maintain a friendly and confident behavior. I was honest. I was calm but engaged. I was charming and a little bit funny. Why wasn’t it working? Why didn’t anyone believe me?

The doctor came back, said something to a nurse near the door, entered something on a laptop, and walked out. A guy came in with a gurney and #1 said, “Are you taking her back now?”

“Yeah. She’s going back for evaluation.” Evaluation? What the hell had the last 40 minutes with the nurses and drive-by chat with the doctor been? I was sitting there, well behaved and cooperative. What was left to evaluate???

The cop turned around and left. (I later found out that per police department protocol, the cop has to stay with the accused until that person is officially turned over to hospital custody. He wasn't just keeping me company out of any actual concern for my well-being.) I jumped off the table and said, “OK, where are we going now? Show me the way.” Gurney guy looked at me and said, “I’ll take you.” I just stood there. I didn’t get it. Finally he said, "I have to take you back on the bed. It’s hospital rules.”

I wondered just how many blows of humiliation my soul could endure in one day. I had been stripped of all personal life control as I knew it, or so I thought, and now I wasn’t even going to be allowed to walk wherever it was we were going? Mortified. There is no other word. I thought surely I would soon be so belittled by the experience I could easily slip down in between those floor tiles.

I desperately wanted to cry, but I didn’t dare for fear of appearing agitated and not in control of my emotional state. I was angry, I was scared, and I was finally aware that there was definitely not going to be any “in-and-out.”

After a short trip down the winding halls of the ER wing, we stopped at the door of a small exam room. The halls were lined with gurneys, all of them filled with people suffering the effects of actual emergencies. Here I was, healthy and uninjured, being brought to a private room. It seemed ridiculous beyond comprehension. Gurney guy told me to get on the bed, which I did.

I waited about 15 minutes and a nurse came in. She didn’t even say hello. She took my blood pressure, wrote something down, and left. Eventually, the doctor came in—the same one as before. He looked on the laptop and asked why I was there. I said, “Not suicidal but here anyway. Remember me? I’m still here, still fine, still want to go home. Did you call my doctor yet?”

He typed something else in the computer, but didn’t say anything. Apparently, I was not only invisible, but even though my mouth was moving, I wasn’t speaking on a frequency available to humans. I tried again. “The police said I’d be in and out of here in an hour. I have a huge presentation to do for work tomorrow. Our funding depends on it. I need to run through the PowerPoint. When can I leave?”

He kept typing and said, “It depends on when the psych counselor gets here. He’s pretty busy (this turned out to be a lie. The guy wasn’t even in the hospital yet because his shift wouldn’t start for a few hours. Why this was kept from me still baffles me). “As soon as he’s available, he’ll be in to do your evaluation.” The doctor left, and I glanced around the room. I desperately needed some water, but there were no cups. A guy in the hall was explaining how he had been sliced all over by large shards of glass that had fallen from an atrium ceiling. Traffic moved up and down the hallway almost nonstop. I sat on the bed and waited for psych evaluation guy.

That’s when I noticed I was being watched. I don’t know why it didn’t register right away. There was an armed guard stationed just outside my door, and he alternated between looking in at me and at whoever was in the room next door. Every once in awhile, he looked in and did a visual sweep of the room. OK, May, that’s one more shove deeper into the humiliation hole. I tried to read my book, but I kept glancing over the top of my glasses to see if Mr. Safe Perimeter was still peeking in at me.

The nurse came back, opened a metal cabinet near the wall, reached in and handed me a gown. I just looked at it. “You can’t keep your clothes on. You have to put on a gown.” I was baffled. “What? Why?” If I thought I had felt panic before, it was nothing compared to this. My clothes? They were taking my clothes away from me? What was that all about? Obviously I wasn’t to be trusted. But why and trusted to do or not do…what, exactly? Not my clothes. My clothes. What was their concern? Why couldn’t I be in on it? The knot in my gut pulled itself even tighter.

I changed in the restroom, but honestly, I had a really, really hard time with all of the ties and the way the gown criss-crossed. Was this some kind of mental competency test? I was shaking so badly from anxiety, I ended up laying the gown on the floor, fastening up all of the ties, and then slipping it over my head. Apparently, I couldn’t be trusted to have shoes, either. I shoved everything in the white plastic bag the nurse had given me. PATIENT BELONGINGS was printed in big blue letters on the front, with a line below to write in the patient’s name. What’s the point of filling in the name? I am nobody. Nobody.

I put the bag on the visitor chair and covered it with my winter coat. I got back up on the bed and stared at the ceiling, regretting every word I had said to the Diner’s Club guy and any other customer service moron at CitiBank. I tried to imagine them being stricken with bleeding cancers, boils, and incurable nerve damage that guaranteed constant incontinence. I slumped my shoulders and looked down at my hands. The feeling of utter defeat put me beyond tears; I just felt sad and stigmatized, labeled and processed, no different than a hallucinating, babbling drunk picked up on the bike path.

The guard came in and I visibly jumped. I wasn’t startled so much as reacting to an armed man coming toward me. He was in his early 50s, medium height, with a round, friendly face. He looked at me and his expression was soft and sympathetic. “Would you like a blanket? It will cover your toes and stop your gown from showing your knees. The blankets are heated.”

I smiled and nodded. He got the blanket (toasty, as promised) and arranged it over my legs. Then he reached back into the cabinet and pulled out a pillow with a crisp, white cover. “You’ll be a lot more comfortable with one of these. Here, lean forward. How does that feel? Comfortable?”

Never in my life have I been so grateful for a tiny bit of consideration. Maybe I wasn’t invisible, after all. Not only could he see me, he actually spoke to me as if I were a rational human being. The guard then took the additional step of saying, “It will be easier for you to read if we adjust the back of this bed, I think. Hang on—we’re going for a ride. How’s that? Now you can lean back when you read.”

I thanked him profusely and sincerely. He stepped back in the hall and continued scanning what was apparently the “interesting” end of the hall. I had my purse under the blanket so nobody could take it away. I pulled out my cell phone and started to dial the number for the one friend I knew would stick it out with me until I was released or the phone battery died. A nurse walked by the door, stopped and barked, “You can’t use that in here. You have to put it away.” She was gone before I had even completely looked up. I snapped the phone shut and put it back in my purse.

The first nurse came back in. She got something from a cabinet behind me and said, “We need to do a tox screen. Leave the sample cup on the back of the toilet when you’re done.” She handed me the cup. Christ. Doesn’t this woman ever say ‘hello’ or ‘please’ or anything human? “Why do you need a tox screen?” Why didn’t you order this like an hour ago? “I already told everybody I haven’t had anything to drink, and I don’t do drugs. I obviously am not presenting any signs of impairment. All you’re going to find are things that are supposed to be there and nothing more. Is this expensive?”

“We need to make sure.”

Considering how dehydrated I was, it was amazing I could pee in a cup at all.

I couldn’t concentrate enough to read. There was a flat-screen monitor on a swing-arm bracket next to the bed. I saw a small sign taped to the table saying that this was a TV and Internet portal, free for patients. There were supposed to be games, too, but they didn’t work. The TV wouldn’t work either, but the Internet was OK. My salvation. I had been a member of an online bipolar forum for about two years, and these people were my last chance of getting through the surreal experience of being taken into custody. I logged on.

Within seconds, I was online. All email was disabled, but the forum was still there. I posted to the group with a title sure to get immediate attention. People started posting back immediately, so messages were coming and going almost in real time. I was hoping my forum friend, Jolie, was online as she always had something soothing to say. No such luck. I also opened a second browser window and logged onto the online dog show sponsored by Animal Planet. I pulled up the picture of my own dog and smiled at her goofy face. My forum friends kept me company until it just got too late in time zone after time zone.

The guards had changed shifts, and the new guy wasn’t all that friendly. Finally, he came in to see what I was doing on the computer. I pulled up the picture of the dog and swung the screen toward the guard. “It’s my dog. She has a couple of hundred votes so far. I’ve just been tracking the voting.” If I wasn’t allowed to use a phone—mine or theirs—I assumed I was in a communications lockdown, so it seemed prudent not to let on that I was having conversations online. Why I wasn’t allowed to talk to anyone still doesn’t make sense to me.

The guard softened at the sight of the dog, and I talked a lot about dogs, border collies, mountain bikes, skiing, and every other topic I thought 20-something guys would discuss under the circumstances. He had to keep checking in elsewhere, so in between conversations, mostly I checked online for new forum posts, or I stared at the ceiling. I tried not to look out at the hallway because my door was always open, and people stared at me unabashedly as they passed by. I was embarrassed and still filled with knots of anxiety worrying that I might be seen by someone I knew.

I spent most of my time staring at the ceiling or at the clock. I desperately wanted to go home. I could have put my clothes back on—who would have known? Nobody remembered to take them away from me (they should have been in a cabinet in the hall at the security desk). Time crawled by.

I was so scared, so invisible, alone, alone, alone, and I felt small. Just really, really small. Frightened. Confused. Disregarded, dismissed. Absolutely powerless as a human being. Nobody trusted me. Nobody saw me as a person. I was just the psych hold in Room 4. Being in psych hold means you have no credibility, no rights, no control of any decision that affects your own life, no access to friends or family when you need them most. Invisible because you are not worth seeing. I had done nothing to deserve this.

Three hours into being held in captivity, custody, whatever, the doctor came back. I could see he couldn’t remember who I was, so I repeated what I had said before: “Still here. Still not suicidal. Still want to go home. Still have a big presentation with unfinished PowerPoint tomorrow. Did you call my doctor yet? Can I please, please call him?”

The doctor once again tapped something into the laptop. He looked at me over his glasses and said, “The counselor is still running behind. He should be here soon.”

That was it. Nothing more. He was gone and I was left alone with no answers and no idea what was going on or what else to expect, really. Around 11:00, my meds started to wear off, and I felt nauseated by the drop in chemicals in my system. I was wired, even though normally I would have been in bed, sound asleep at this hour. In and out. Fuck you, Martinez.
At about 12:30 a.m., a guy showed up at the door. I was staring at the ceiling, having lost interest in the Internet hours ago. I said hello and asked if he was there to prove I was not a threat to society. Nobody in this place had a sense of humor. Nobody. The guy sat down and I got off the bed. I moved my things off the chair and sat down as an equal. I don’t know why, but right at that moment, it mattered. It was show time. I was on.

Counselor man (not even a psych social worker or MSW; just a guy with a clipboard and a certification in who-knows-what) did the standard background check, asking me all of the same questions I had been asked before. I knew much more about the technical aspects, facts, and practicalities of BP than he did, and it worried me. He asked a lot of questions, all of them on the form. I was crisp, I was intelligent, I was direct and to the point (seriously). I just wanted to go home, and I would perform in any horse-and-pony show I had to if it would get me out of the ER. Tap dancing: My specialty.

The interview was about 20 minutes long. When we got to the part about medication, I listed everything I was taking, what I had stopped taking, and how I had made appropriate adjustments elsewhere. I said, “It’s hard, this medication thing. I do everything I’m supposed to, but I’m medication resistant.” The guy looked at me and said, “What do you mean? You’re not medication resistant. You take your meds.” Sigh. Idiot.

“No, I don’t mean I’m treatment resistant; I mean, I take the meds but they don’t work like they should.” I wanted to thwack him hard on the forehead. People who are treatment resistant won’t get treatment or stay on their medication voluntarily. People who are medication resistant take medication but without successful therapeutic benefits. But what do I know? I’m not the shuffling professional with the counselor tag on his name tag who speaks to the mentally ill. I suffer from a brain-based illness, therefore, I must be a moron. But an articulate and well-read moron, anyway.

When we got to the last part of the interview, the guy looked up at me, shook his head in confusion, and said, “Why are you here? I don’t understand why you weren’t cleared after the tox screen.” He looked genuinely puzzled.

“Yeah, why indeed. Nobody believed me, but I tried to explain there was no problem, just an over-zealous officer. So, how was that tox screen result? Sordid and unsavory? A tale of bad behavior?”

Finally, he laughed. “Clean as a whistle.”

I thought that was it, but it wasn’t. Without even missing a beat, the guy said, “Count backwards from one hundred by sevens.” I looked at him and I’m sure my mouth came open. “I can’t. I mean, it has nothing to do with my mental state. I just can’t do math under the best of circumstances. I haven’t eaten in 12 hours, now it’s late, I’m tired, and frankly, I’m a mathematical retard.”

“Count backwards from 100 by sevens.”

I actually had to use my fingers. I got as far as 65 and was allowed to stop. There were three more mental puzzles and memory games to get through, which I tried to do without appearing slow or stupid. The cherry on the cupcake. Despite my articulate conversation and obvious lucidity, mental acuity evaluations were that one last opportunity to feel stupid and small. Stupid and small. Go ahead, laugh. At least it would mean you’re paying attention and I’m actually three-dimensional. Not just a diagnosis or potential legal liability.

An hour later, I was allowed to go home, a mere five hours after walking in the door. I went to bed at 2:00, but never fell asleep. My mind was racing. I was angry. I was still scared. I was indignant. I was hungry but unable to swallow food. The events of the night kept crashing into every part of my mind, and not even a double-dose of Xanax made it stop. It was too late to take Ambien, so sleep was out of the question.

My stomach hurt. I was still shivering, although I wasn’t cold. I wanted to cry, but I couldn’t even manage to do that. At 5:30, I got out of bed and made some coffee. After my shower, I sat on the couch, dejectedly. I didn’t want to go to work. The PowerPoint never got its final touches, and I doubted I could deliver the salient points competently.

Competent. Wasn’t that what the whole thing had been about—to determine whether or not I was competent and socially acceptable enough to live freely among the rest of mankind? And why wouldn’t I be? I didn’t live under a bridge or cause road rage incidents or harm people’s pets or get drunk or scream at trees or hallucinate or live in filth or hoard or pee on the sidewalk. No, what I did was piss off a telephone clerk at Diner’s Club who didn’t seem to be especially intelligent, but who definitely turned out to be mean-spirited and vindictive. He made one phone call and from that point forward, I was nobody. Nothing. Invisible. Not to be trusted, certainly not to be believed. The clerk was some almighty authority on my mental health, and on his say-so, I was reduced to being perceived as just another crazy woman to be dealt with on a cold November night. Nothing special. More work. Whatever. Get ‘em in, get ‘em out. Assume anything she says is manipulative, babbling nonsense—a lie.

I was angry. I was angry that based on the word of someone I had never met, never seen, didn’t know, there was nothing I could do to speak on my own behalf. Nothing. I was screwed. Screwed by the Diner’s Club guy, really screwed by the cops, screwed by my own brain, screwed by my inability to play along. There are at least ten things I should have done differently, but paramount among them, I should have lied about my mental health diagnosis and my deeply-held beliefs about right-to-die issues (which have nothing to do with my mental health at all). Had I lied and saved candor for some other time, then I wouldn’t have been lied to. In the end, I really was stupid, not so clever. Had I possessed any real intelligence, I would have lied since everyone assumed I already was.

To this day, I don’t really know what I did that was so heinous, such a perilous threat to the world that it required that I be taken into custody and stripped of all of my most basic freedoms. Apparently, though, I was so dangerous that I couldn’t even keep my own clothes, lest I run off into the streets of suburbia threatening to pay yet another bill as promised and on time.

As far as I can tell, I committed a crime of thinking and planning responsibly for my future. I was punished for committing a thought crime. I didn’t think it was possible in this country. George Orwell would have shuddered.

You know, they never did call my doctor.