Level Numbers
Remember on the first day of school when your teacher would say, “Everyone starts with an A”? Here on the mental ward, everyone starts with a zero. When you first enter the unit, you are assigned a privilege level that starts at Level 0 (a staff member checks on you every five minutes to make sure you have not killed yourself, and you are not allowed off the locked unit for any reason). The highest level is 5, which means you can travel unaccompanied outside the hospital for up to four hours. The dry-erase board on the wall by the nurses’ station will list your privilege level next to your name, in addition to the name of your attending doctor.
Being a Level 0 isn’t easy. It can be downright frustrating at times. As a Level 0, you will not have a phone in your room because cords are dangerous. Because you can’t talk on the phone, you might feel frustrated and caged in, so you may wish to venture into the hall to let out steam by playing pool or Ping-Pong. Unfortunately, there will be no balls, pool sticks, or paddles on either table, so you can’t play. You have to earn your way toward using them again—you are a zero.
As you become more sane, you will be granted more privileges. At Level 1 you may use the phone at the nurses’ station for quick five-minute calls, and they’ll only check on you every half hour. When you move up to a Level 2, you may use balls, sticks, and paddles. At Level 3 you may use a blow dryer and curling iron on your hair and go on afternoon and evening nurse-facilitated smoke breaks. During these outdoor smoke breaks, you will walk along the side of the hospital in your open-back gown with your smoking-patient friends and pray no one you know sees you. A Level 4 means you may leave the unit for an hour at a time unaccompanied as long as your doctor writes you an authorization to leave on pass (LOP). Level 5, the “I’m almost free” level, means you can walk around wherever you want for four hours.
No matter what your level, a nurse will come around every half hour at night with a flashlight to make sure you’re okay. When you see the flashlight in your room, please raise your hand if you’re awake. If you don’t see the light, see a nurse.
Medications
Everyone receives medications at the same time. When you hear the speaker voice announce “medication time,” report to the nurses’ station. Some patients will stare at you when you are given your pills. Don’t worry, there is nothing on your face; they are looking at your meds. If you are being given a strong psychotropic or painkiller, some patients may ask you what you told the doctor to get that “good stuff.” Don’t tell them. Don’t even think of trying to trade your pills. The nurse will check under your tongue to make sure you have swallowed them.
Group Activities
Another way to earn a higher privilege level is to participate fully in group activities; they are the heart and soul of your stay. Socialization via group activities is important to get you ready to go back to the biggest group of all: the outside world. For this reason, at Crazy Spa your meals are your first group activity. You will have all meals in the cafeteria across from the nurses’ station.
Another group is Medication Education Therapy, where you sit in a circle with a nurse-practitioner and discuss your drugs and their side effects with other patients. It can be scary, wondering if it’s worth it to trade your mental disorder for “brain shivers, loss of libido, and recurrent cystic acne,” but in the group you’ll also trade sex and makeup tips to help you deal with the horrible side effects. (Don’t borrow anyone’s lingerie; it’s unsanitary.)
“Fuck you! I’m the son of God and I don’t need any of your damned medication!”
— Jeff Smith, Level 0
“I love this place.”
—Homeless guy
“I’m going to run away on my next smoke break.”
— Lisa Lee, Level 4
Another exciting group you’ll not want to miss is Occupational Therapy. Occupational Therapy sounds like someone will be helping you find a job, but that’s not at all what it’s about. (Actually, if you have a job, keep your mouth shut about your mental illness when you go back to it so your boss won’t try to find ways to fire you.)
Occupational Therapy is a sort of arts and crafts. You cut out photos from magazines and make collages to describe your emotions. If you’re not allowed scissors yet (Level 2), you have to rip the magazine photos out with your hands. How you went from being CFO of a Fortune 500 company to ripping up magazines with your hands like a savage may frustrate you. You know this collage won’t help deal with your overflowing in-box when you get back to your office, but just go with it; that’s the only way you’ll ever leave Crazy Spa. If you feel you can’t deal with it, see a nurse.
Thank you for choosing (being forced to choose) Crazy Spa. Remember: This is your time. Our primary focus is you, as long as your insurance doesn’t run out. If it does, we’ll let you know. And we’ll probably ask for this pamphlet back.
You Can’t Do a Drive-by from a Wheelchair
A new study that involved surveying 90,000 adolescent U.S. students showed that those who considered themselves to be of mixed race were more likely than others to suffer from depression, substance abuse, sleep problems, and various aches and pains.
—UNC News Services, October 10, 2003
I spent eight hours in the Emergency Room or, to be more specific, eight hours in the Seclusion Room, which is the ER’s “safe” room, which means it’s free of anything a mentally ill person could use as a weapon. It’s painted bright white and furnished with only a mattress and a sheet that smells faintly of bleach. The sheet is so thin it’s see-through, so you couldn’t possibly smother yourself with it, and if you tried to hang yourself it would just collapse into a pile of white dust under the strain of your body weight.
Eight hours in that all-white room gave me a lot of time to think. Mostly I thought about being black and crazy, how I’d let the whole race down by losing my mind. Maybe I should just hand in my Black Pass now and go back to being mixed.
When my mother, my brother, and I lived with my grandmother, she didn’t allow any woman younger than herself to complain about anything. Getting down and depressed was just something black women had to deal with, something to push through, not something to roll over and let crush you. Right before she ate dinner, my nana would say, “I’m sick and tired of being sick and tired,” like a sort of grace. I thought she invented the saying until I was grown and went to the African American History Museum and learned it was Fannie Lou Hamer, a black civil rights activist, who first spoke those words. When Hamer was jailed following a nonviolent protest, white cops forced black prisoners to pummel her with a blackjack. Even then she didn’t get depressed: just “sick and tired.”
My grandmother’s predinner sighs, coupled with the understanding nods and umm-hmms of her church friends, seemed to be her antidepressant. With that and her Personal Lord and Savior on Sundays, she’d be just fine, thank you. In her house, the popular phrase “Black don’t crack” meant black women didn’t get wrinkles and they didn’t have nervous breakdowns.
Of course, if my grandmother didn’t allow grown women to complain, we little kids couldn’t do it either. If my brother and I even sang a stanza of “It’s the Hard Knock Life” we would be sat down and forced to listen to an audio tour of the white homes she cleaned when she was our age. “Aren’t you glad you don’t have to scrub white women’s floors?” “Yes, Nana,” we knew to reply in unison.
How could I get so low? I’d never had to scrub a white chick’s floor. I was attending a posh Ivy League school with rich white girls who grew up having their floors cleaned, and still somehow my body and mind had given up on me. Congratulations, Angela. This is what your mom marched on Washington for: so you could vote and have a mental breakdown right with the white crazy people. Let freedom ring!
Oh, my God, my mother. What if she gets nervous when she calls my apartment and I don’t answer? I knew her, she’d start calling hospitals. There was no way I was going to let my mother find out I was hospitalized. No sense both o
f us being disappointed in me. I rang the bell for the nurse.
“Did the cops tell you my name? I can’t have my mother knowing I’m in here,” I explained when the nurse rushed in. “What can I do?” I pleaded. I thought the nurse would be annoyed with my request and would reply with “What can you do? You can try being sane,” but she nodded knowingly and took my ID bracelet off. A few minutes later, she came back with a reprinted one. My new name was Jane Doe.
Maybe I shouldn’t be hiding from my mother, I thought. Maybe she has information about my father’s side of the family that will help my diagnosis. That has to be where this weakness originated. Maybe Milani’s new religion is right: It’s my weak white genes that have me doomed. I wonder if I can go to her Hebrew Israelite meeting with a bottle of Prozac and a PowerPoint presentation detailing the mental inferiority of mulattoes with a white father. Would they accept me like I accepted the white man who said all white people are evil because their ancestors lived in the snow?
The weird part about being depressed (at least for me) was that a tiny part of my brain was still seeing things as I used to see things predepression. When I was with Mah, even if I didn’t question all the race rules out loud, I always questioned them internally. When he told me that the saying A dog is man’s best friend meant that white men liked to sleep with dogs, I thought, That’s the dumbest thing I ever heard. I grew up with a white man, and he didn’t fondle our dogs!
“Black women should always cover three-fourths of their body,” he’d admonish me, adding that this kept us from unwanted male attention: namely, rape.
Why don’t men learn to control their dicks? I’d think.
With depression, my internal questioning voice morphed from a sarcastic shout to a scared muffled whisper. Perhaps, maybe, could it be that depression has nothing to do with race? Maybe? the small sane part in my brain asked.
With 99 percent of my brain screaming that, no, it was all me and my weaknesses that caused me to be in an emergency room with a panic button, it was really hard to hear one lone dissenter.
After a spell of fighting to pay more attention to that tiny internal voice, I started tuning it out because it became more of a torturous tease. Psssst. . . . This is what a normal brain used to feel like, and you’re never getting back there.
Thankfully, both the small sane part of me and the depressed part wanted to go to sleep (thin mattress and bleachy sheet be damned; I was bored), so I closed my eyes. I dreamed I had completed college and was at an all-white resort spa getting weight-loss treatments.
Lord, get me through this so I can know if a seaweed wrap really does help you lose inches, I thought, when I woke up. Maybe that’s it. Maybe I just need to lose weight to be happier. No, I thought. Only white girls care about weight.
Tuesday, 6 P.M. Pt slept. Burn on neck.
An orderly came to roll me up to the Psychiatry Unit.
“Insurance reasons?” I asked, getting strapped onto the gurney.
“No, it’s so you won’t try to run away before we get upstairs,” he said.
At first, I laughed. I had on foam slippers with no grip on the bottom; how was I going to run anywhere? As we rolled through the halls, I got nervous. Did the orderly think I would run because I’m crazy or because the psychiatric unit is full of freaks? Would I see the homeless guy from the subway who thought nothing of breaking into casual masturbation? I imagined some crazy chick who wanted to feel all over my face like blind people do in movies when they fall in love with a sighted person. By the time the orderly pressed the button to have us buzzed through the locked doors, I had convinced myself that I was going to have to fight all the other patients one by one. I fixed my face to look as rough as my insides felt.
When I was wheeled to the nurses’ station, my face relaxed. If I had to fight, I would easily win. Sitting on the couches around the nurses’ station was a bunch of frail-looking old white ladies, two of them so old their skin was see-through. The old white women gave me a quick nonjudgmental once-over.
“Shit, I thought you were Food Services. I’m hungry,” one said, and went back to watching television.
A nurse walked over to me.
“Welcome,” she said. I stared at her.
She approached one of the old ladies and asked if she could make room on the couch for me.
“Rose, just scoot over a bit so our new patient can take her MMPI test,” the nurse said.
“I want to go home! You will not touch me!” Rose snapped. The women looking at the television laughed.
“Rose, please slide over and make room,” the nurse said again.
“I want to go home! You will not touch me! I want to go home!” Rose repeated, digging her nails into the couch cushions.
Rose wasn’t budging from her seat; I had to respect that. I have a thing in my heart for crotchety old ladies, the ones who know they are going to pass away any day now so they talk to anyone anyway they damn well please. I would find out later that Rose was suffering from combination Alzheimer’s and dementia, and “You will not touch me! I want to go home!” is pretty much all she said.
“I can take the test here,” I volunteered from my wheelchair. The nurse handed me the MMPI and I started filling out the 500-plus questions, using my lap as a desk.
True-or-false question number 41 of the MMPI: “At times I think I am no good at all.” This question seemed just a slight variation of MMPI true-or-false question number 35: “I certainly feel useless at times.” Hmmm. Were they trying to confuse me? Is this a trick question? What would a real crazy person answer so I can be sure to answer the opposite way? What answers did I put on the Penn psych test that got me here in the first place?
A Food Services worker buzzed through the bulletproof doors, pushing a metal cart stacked with food trays. The old women rose from their seats, searched through the trays, and then sat down together in the cafeteria and began eating in silence. Soon after, while I was answering False to question number 87, “I was suspended from school one or more times for bad behavior,” an announcement crackled through a loudspeaker above my head. Dinner has arrived in the cafeteria.
As soon as that announcement was made, a rainbow coalition of crazy people came around the corner and descended on the tray cart. Soon there were about twenty-five people eating dinner and, out of that number, ten were black. To be exact, there were eight black females and two black males. Damn, about the same skewed percentage as my dorm. All the good black men must really be gay or in prison.
Just as soon as I got a little happy that I wasn’t the only crazy black in the world, I decided to withdraw that emotion. I didn’t want to be down with crazy people, no matter what race they were. I can’t accept being labeled crazy for the rest of my life. It’s going to be harder for me to get life insurance and health insurance, and antidepressants are very expensive.
Most of the patients had finished their dinner when I was still working on my last set of MMPI questions. I was tired, and I really wanted to start a random selection of true and false answers without reading the corresponding questions, but I figured that, with my luck, my random answers would score out to NO HOPE FOR REHABILITATION and they’d ship me off to a lab where I would share space with a monkey and pray for PETA to rescue me.
I was almost on my last question when a young woman who appeared to be around my age sat across from my wheelchair. She had flawless cocoa skin, her face was perfectly made up, and she must have been at least a Level 3 because her hair was so straight there was no way she didn’t have curling iron privileges. I could tell she wanted to talk, but I really just wanted to get to my room, so after I glanced up at her I rolled myself into a corner and held the MMPI test an inch from my face, like I couldn’t read the print.
Despite my wheelchair moves, the woman walked in front of me and introduced herself as Ally. She asked me if it was my first time in. I pulled the paper a little bit back from my head and nodded yes, thinking that she’d at least take my lack of words as an
indication that I didn’t want to talk.
“Did you come in through the Emergency Room?” Ally continued.
I nodded again.
“I bet you got stuck in the Seclusion Room, didn’t you?”
Nod.
She laughed and pulled a pack of Marlboro Lights from her pocket. A sister smoking Marlboro Lights? That almost always means she went to a predominantly white college. Suddenly, I became a little more interested in Ally—Did she go to Penn, too?— but I was still too tired to care much.
“I hate that Seclusion Room. It’s so boring,” Ally continued. “Next time they try to stick you in there, tell them you’re claustrophobic. They’ll put you in a regular room. It’s worked every time for me.”
Next time? Did I look that crazy?
“There won’t be a next time,” I said, laughing a little, trying to sound confident, even though I was in a wheelchair with a stack of psychosis forms in my lap. “I’m getting out of here in three days,” I added. I’d read on one of the forms that they could keep me involuntarily for only seventy-two hours.
Ally’s lips curled up in a slightly condescending smile. “Well, good luck with that. I’m going on a smoke break.”
Who did she think she was laughing at? Was Ally going to be the first chick I had to fight in here? I didn’t say ’bye to her, so I guess she took my silence as her cue to stand up and leave. Before getting buzzed through the double doors, she looked back at me and said, “Just get through it. Do everything they say to do, exactly how they say to do it.”
In hindsight, had I listened to her, things would have been much easier. It seemed so weird for someone to be so confident about surviving the mental health system. What a horrible thing even to admit having knowledge about, especially for a black woman, I thought.
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