My P-Doc is such a piece of shit. Well, technically she’s not a doctor, she’s a registered nurse. ARNP. But she keeps trying to pin me with schizoaffective disorder, which is a combination of schizophrenia and bipolar. I had basically one psychotic break over the past five years. The symptoms have recurred, but never to the degree that they manifested themselves when I was under the effects of marijuana and Effexor. And I’ve been completely symptom-free for over two years. In all the biographies of schizophrenics I’ve read, the victims have suffered extreme symptoms for most of their lives. I believe I could go off my medication completely without a relapse, and in fact have done so for a period of about six months. But in the back of my mind lurks a constant fear that there really is something permanently wrong with me.
One of the hallmark symptoms of schizophrenia is hearing voices which aren’t there. I’ve never heard voices, I’ve never once even mentioned voices to her, yet every time I meet with her she asks me if I’m still hearing voices. She can’t even keep my symptoms straight! I doubt she even remembers what’s in my file, and heaven forbid she actually look over it occasionally. Today she told me that if I went even one day without my medication I would get sick and then I’d be Eastern State bound. That’s a load of scaremongering horseshit. To be involuntarily committed, you have to be a manifest danger to yourself or others.
Besides, Eastern State is for people without money or with Medicaid. If I were ever admitted to a hospital again it would be voluntarily, and it would be a place like UK since now I have Medicare. I think its preposterous to assume that the people of Advantage Clinical Services meet on a regular basis
in some back room, cackling and wringing their hands and talking about the best ways to make patients feel helpless and completely dependent upon them, but sometimes it feels like that’s what they are doing.
Perhaps its just the accepted wisdom of a lot of mental health professionals, but not only do they not want me to branch out on my own (even suggesting I live in an Advantage-controlled facility) but they actively discourage me from doing so. I really would like to find a better doctor / therapist. One who actually combines medication with a bit of cognitive-behavioral therapy, which I’ve read is the most effective treatment. It would be nice to find out once and for all what my problem is, but I’ve read enough of the literature to know that mental health diagnoses are very flexible and difficult to pin down. I suppose I’m lucky that I have a provider that will work with me at all.
All this trouble arose because I missed my last two doctor’s appointments and didn’t call to reschedule. The reason was simple enough, I had enough sample medication from a previous visit to last me for awhile, and I didn’t want to bother making an appointment with them if I’d just be in Lexington by the time the date rolled around. If I were truly on the verge of running out of medication I would schedule an appointment as soon as possible. That’s what prompted her Eastern State comment, that she was worrying that I had run out of medication.
Eastern State is the State-controlled mental health facility in Lexington that everyone goes to as a last resort. All the worst chronic cases, those with absolutely no income and no prospects, end up going there. It’s a very bleak place, with old 1970’s brick buildings interspersed among overgrown yards and sidewalks where weeds grow in the cracks. The worst possible place I could end up would be Eastern State. And to threaten me, even indirectly, with such a fate! It makes me angry.
That would be a side benefit of moving to Lexington, I could possibly get some competent therapists. Despite what I may think of my condition, I’ve realized over time that I’m not the best judge of my own mental health, and that I should probably submit to a professional’s judgment to maintain the low level of functioning that I currently have. However, I feel that the Doctors (Nurses) I have could be doing a better job, could take more of an interest in my case — and even more so, could try to assist me in becoming a productive member of society once again. I may never be able to contribute what I was able to before I became ill, but By God, I could contribute something. As it is I’m a drain on everyone’s resources — my friends, my family . . . . There has to be a better situation for me!
I figured if I had Medicare, I could find some kind of psychiatrist in Lexington who accepts it and I could schedule a therapeutic review. He could look over my file, then interview me in detail about the symptoms I have experienced over the past half-decade, as well as talk to family members to get a more unbiased version of events that occurred. Then he could make a more accurate diagnosis and prescribe accordingly. At the same time, he could refer me to a Medicare psychologist, Therapist, or Social Worker (I don’t care which so long as they are capable). That way I could be getting both components of what the literature says is effective mental health treatment: medication and talk therapy. Through a combination of these two elements along with a little vocational rehabilitation, I could conceivably be up and working in a few months.
Most of me though, just wants to sit on my ass here in BFE and do nothing. I’ve been good about it the past couple of days, but I know the lethargy will overcome me again eventually. Life is such a majestic thing, yet for me it seems I am performing the most rote repetition of daily tasks. I guess that’s just an aspect of the human mind: you become used to whatever conditions you’re currently in. That’s why we always want something more, something different. Perhaps I should take Al DeLarge’s advice and try to reach some type of Zen-like contentment. For me, though, it seems more likely that I would claim to have such a thing, but really be completely apathetic. I don’t know what I should do.
I spoke with Dobson (the landlord) today. He told me that he would be happy to lower the rent to $250, but he doesn’t know if his mother-in-law would accept a month-to-month lease. He and his wife are going to try to convince her of it this weekend, and after that will call me back. His mother-in-law is named Peanut, and she is the widow mentioned in previous entries. She has long since abandoned her husband’s original mission of rehabilitating young women and / or couples, and prefers to have somebody living in her apartment out back merely to make her feel safer. She has told me that seeing my light on late at night brings her a great deal of comfort, to know that somebody is awake and aware while she is in her house, vulnerable and asleep. I guess we have a few things in common.
But she’s the type of person who spends most of her time reading Christian romance novels, so I don’t think we could talk very effectively about many subjects. I’ve gotten to where I leave the kitchen light on all night for her now, whether I’m asleep or not. My Brother seems impatient to know whether I’m moving up there or not. I call him every so often to keep him updated. Surprisingly, he seems to want me to move up there. He said it would be cool to “hang out and watch movies and play games and stuff” which Delbert would say is code for “use all your cool toys” but with him I don’t really mind. I know he cares for me because he’s willing to sacrifice some of his privacy to give me a place to live.
I suppose I will wait and see what Dobson says about his mother-in-law and then decide. Even if she asks for a year’s lease, I’m considering staying anyway, because I really do prefer the slower pace of a small town. I’ll write more later.