The First Time I Flew Over The Cuckoo’s Nest

It was a Saturday in May, 1978.  I was alone.  I was young–twenty-one.  My parents were gone.  The previous night had been a nightmare; it was full of panic attacks.  My heart continued to race.  Thought I was going crazy.  I was thoroughly convinced that I was going to kill myself.  These thoughts were continuous.  I called my psychiatrist at least a couple of dozen times.  I would sit by the phone hoping that he would call back.  When he did, he said that I had a choice of finding some company, getting busy doing something, or going to the hospital.  The distress was too much.  Finally, I think he was so exasperated that he said I needed to go to the hospital.  I was not sure I could even drive myself there–the obsessions and the anxiety were that bad.

When I arrived at the hospital, I remember getting lost.  Really, I was in a state of panic.  I was referred to a section of Abbott called the Bushnell Unit.  It was a separate three-story building on the hospital campus.  Scenes from “One Flew Over the Cuckoo’s Nest” were running through my mind–I was concerned.  First, there was a lot of paperwork to get through.  The psychiatric charge nurse, a heavy smoker, emphatically told me that my psychiatrist felt that I needed to stay for a few days.,  I was not sure what to do.  I signed myself in, and then this stay turned out to be a lot longer than a few days.  It ended up being a month stay.  I later found that my departure after a month was conveniently timed with my insurance coverage limitations.  My parents’ insurance policy allowed for thirty days of chemical dependency or mental health in-patient treatment.

The first couple of days, I was literally shadowed by a psychiatric technician.  Frankly, this was irritating.  It seemed as if all he was good for was asking how i felt about certain things.  I quickly found out that there were four levels of independence.  The first level, no one really had any privileges.  If you achieved the fourth level, you were allowed to go home for a day or a weekend.  So everyone had to formulate a treatment plan, and the staff used behavioral modification principles to accord privileges to the patients. (I almost wrote “inmates.” I could easily equate to prison life.) Drugs were used for sedation.  When we went to bed, the staff checked in every fifteen minutes.  To my surprise, there were no ECT rooms.  I was having thoughts that I was certainly a candidate.  By visiting with other patients who came down from the upper floors, I found out that it was used when it was needed.

Immediately, a lot of bloodwork was taken.  There were  more of the same psychological tests that I had already taken before.  These include the MMPI, Rosrshach, and others.  It was two days before I got to visit a psychiatrist.  The psychiatric visits were three times a week.  These visits did not take more than fifteen minutes.  I was immediately prescribed Elavil, a tricyclic antidepressant, along with a light dosage of Trilofan, a major tranquilizer.  That was a very common prescription on the floor for those who were depressed.  I was in a ward for young adults.  It was an open ward, which meant that you walk out.  This was the “Depression Ward.” We also had patients who manic-depressed and chemically dependent.  While I was there, there were two serious suicide attempts.  Attempting suicide provide you with a trip upstairs to the lock-up floors.

Abbott was nothing like the psychiatric ward portrayed in the Jack Nicholson movie.  Actually, everybody, including staff, was dressed in street attire.  People actually looked rather normal.  Other than many of them wanting to sleep a lot, things seemed rather normal.  Allegedly, everybody had a program.  Everybody met in the morning to check in.  This was gathering in the round where everybody, including the staff, would say how the felt at that moment.  I thought this was completely silly.  I did not see any crazy psychotic breaches.  Here, in my ward, everybody knew the doors were open and you could walk out, unless there was a court hold.  Security was present, however, and I suspect that if I had tried walking out, I probably would have been grabbed, sedated, and sent to an upper floor.  Therefore, I did not test trying to walk out until I reached level three.

While I was there, the agenda was therapy, therapy, and more therapy.  That included group therapy, art therapy, music therapy, movement therapy, psychodrama –and the list went on.  There was occupational therapy.  Of course, there was a television and a lot of cigarette smoking–at the time, they allowed smoking in the ward.  The staff wanted you to write, and the staff would write.  This was your journal.  And it was reviewed by psychologists, social workers, and psychiatrists.  It was all open.  While a lot of the staff cared and had good intentions, at the same time, many of them had their own issues–and I noted when those issues came out.  It is very difficult to listen to someone whom you do not respect–that being for me someone who has never been in a state of depression.  Having someone who’s “never been there” dealing with you about depression is not helpful.

Oftentimes, there is a sense of shame that accompanies being depressed, which really is not necessary.  In the ward, there was a lot of pain.  The only real fix seemed to be talking with someone else who was either in pain or in recovery.  Most everybody in that unit–but not all–self-medicated.  Whether it was with alcohol or drugs, that seemed to be the case.  Sometime, talking was fine.  However, there were a lot of “repeat visitors” who seemed to just say suck.  I was afraid that I would be one of them.  It really did not help talking with them.  I think there is a time and place where talk must end and action must begin.  It was no secret that some of these “repeat visitors” would eventually be sent to a long term facility or a state hospital.  Sometimes, perhaps even with good intentions, the helping profession seemed to keep a lot of people stuck.

Throughout that month’s stay, I never felt at ease.  A lot of patients were dealing with both chemical dependency and emotional problems.  I was not comfortable because I felt different.  I did not trust those individuals who were giving out therapy.  I had an intuitive sense that they were no different, and that there was some narcissistic value for them being there “treating” others.  What I really resented were those who inflected their voices to make you feel that they “got it” and that they were emoting through that inflection.  It was just pure nauseating.  There were numerous twelve-step types of agendas going on.  A lot of those agenda were for emotional problems.  In my opinion, there was not a very clear distinction as to what starts what.  Is it the emotional problem that starts the self-medication issue, or is it vice versa?

Despite having family members with both sets of problems, my parents had a hard time “getting their arms around this.”  I think the general attitude from my parents and others was that one should “snap out of it.”  If you simply cannot do that, then these silver bullets called antidepressants were supposed to help.  Almost everybody at the ward was expecting some kind of fix; and when that did not happen, it only led to more shame and misery.  Most definitely, Abbott was about using antidepressants and other psychotropic drugs as an ancillary support system to talk therapy and other means.  At that time, the only antidepressants available were tricyclic and MAOI inhibitors. While the can be effective, they had side effects—some of them rather negative side effects.  A lot of times, you felt out of it, as if you were in a never-ending fog.

My father was always concerned that I would be like his younger brother, Charles.  Charles had been labeled a paranoid schizophrenic and then termed manic-depressed./  Prior to his first breakdown, Charles was very fastidious.  In other words, he was kind of OCD.  He joined the Army and had a breakdown.  He was medically discharged, went back to college, got his degree, worked as an accountant, and then got a job with the post office.  For the most part, he was functional.  When he went off his medications, which he did on occasion, he would lose his job and end up back in the VA hospital.  When he was stabilized, he would find another position, and my father would wait for the next round of paranoia.

In addition to wondering why I was at Abbott, I often wonder why others were there, since most of the patients seemed rather normal.  There were no wild rantings and ravings.  Actually, the place was rather quiet.  Some of the psychiatric technicians and nurses could easily have been confused with being patients.  In fact, my father thought the one who was working with me was a patient.  It was interesting that even some of the technicians were in some kind of recovery programs themselves.  I will say that some of them were as crazy if not more so than the patients.  I will always remember one psychiatric technician suggesting to an attractive woman patient that she should consider becoming a stripper because they made good money.

The facility was not in a desirable location.  It was in the Stevens area of Minneapolis where there was a lot of drug dealing and undesirable behavior going on.  After about a week at the facility, I managed to “graduate” to that level of privilege where I could actually go out for a walk for a hour.  There was a notorious strip joint on the corner of Nicollet and Eighteenth or Nineteenth Street called “Chicken Wings,” or something like that.  As I jogged by there, I remember being propositioned by prostitutes wondering if I would want to party.  Coming back to the hospital, I would check in and tell the nurse about my experiences, and it was a chuckle.

After being there a month, I did not feel any better than when I arrived.  I had not been fixed.  But, in their eyes, I was fixed and could be released.  The only thing that really changed was that I could sleep at night.  Therefore, I was only miserable during the day.  Really, I felt no different.  Nothing seemed to change.  In some ways, I might have been worse.  I was still looking, in vain, for something to take this away.  I was still in my own world and having suicidal ideation.  That summer, there was a point in time when I consider and was even accepted in a half-way house next to Hamline University.  One of the cute woman patients decided to check herself in there.  The place was called Hewitt House.  Today, I think Hamline University has a fraternity there.  This was a place where people went to transition after their in-patient experience.  I applied and was also accepted for county benefits that would pay for this.

In the end, I did not go to the half-way house.  One weekend, I went up to St. Cloud.  I do not know why.  But my cousin suggested that we take his car and head out to Lake Tahoe and go camping.  We did that and actually had some fun.  When I got back, I felt enough energy to get a job and hooked up with a psychologist that utilized rational emotive therapy.  That seemed to help, and I did get off the antidepressants.  I learned how to say busy.  I joined a health club.  I start running.  I lost weight.  Physically, I was moving, and that seemed to help stabilize me–for awhile

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