Psych ER

I sit here contemplating the design of this psychiatric emergency unit. The psychiatrist has told me he won’t be admitting me. He said I have a history of being resistant to treatment, and that for people with Borderline Personality Disorder (like me), admission often fails. He’s not the first psychiatrist I’ve heard this from. Stigma still flourishes even among mental health professionals (sometimes most among the professionals). He tells me this while I am literally begging for help. My wife, in tears next to me, voices her own deep fears of the possibilities that come with the depth of this illness anytime I’m alone, while she is at work or sleeping.

He can’t send me home because I’ve stated I’m acutely suicidal. Perhaps, by leaving me to wait for long hours at a time, he is hoping that the design of this place will drive me to claim ‘sanity’ so that I will ask to go home. That way he can be rid of me, with a pat on his back for helping the hospital avoid a costly admission. I recognize this is likely not a conscious plan in his mind, but still am not convinced he hasn’t been trained to respond in such a manner as ‘best approach.’

So I sit here while other patients pace the halls screaming in their own terror and delusions; every footstep, every voice, every set of keys echoing through the empty rooms and hallways. The smell of piss saturates the poorly circulated air. There are no windows, only dingy beige walls marked by the aggressions of others, and heavy doors, almost all of which are locked. I lay on a mat on the floor of an almost empty room (if you have a family member with you, they will give you a chair). The sheets are often stained with what looks like blood and the flourescent lights blare unkindly.

A doctor comes sometime between four and ten hours later to see if anything has changed, if I now want to go home. And damnit, I want to go home so badly – to my own bed, to a clean toilet, to a place with hand soap and towels. Apparently even hospital grade non-alcoholic foaming hand sanitizer is to big of a risk for patients like us. So we take our chances with C-difficle, MRSA, and whatever else others bring in with them. Germaphobia does not combine itself well with other forms of panic.

Yes, I desperately want to leave this place. But I remember my promise to Kathryn, my desperate need for help and my inability to manage the fireball of emotions on my own. In one of my most vulnerable moments, I must find within myself strength to stay when my mind is screaming to flee.

So I tell them I’m not safe. I tell them about the racing thoughts and crushing pain. When asked if I will hurt myself if I am discharged, I answer with an honest yes.

The doctor leaves and says someone will come back “soon” to reassess me. I lay back down not knowing if my wish is for sleep or death. In the room next to me someone starts screaming again and inside, I start screaming too.

This must be hell, coming here is its own form of suicide.

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