Sunday, September 30, 2012

Good Form

"Your call is very important to us."

This is not a good approach to emergency psychiatric care.  In fact, this approach to anything, ever, is a loser.  I feel certain that if my call were important to anyone, I would be talking to the person to whom my call is so very important. 

Do not pat my hand. Love and care has never been convincingly transmitted via hand pat. Hand patting is a corporate training modality and I wont stand for it.  Not in my condition.

Oh, Medical treatment, what has happened to you? You were once so homey and ramshackle. So based in trust and knowledge.

I have a medical problem, I want to see my doctor. But my doctor doesn't want to see me, not for six to eight weeks. In six to eight weeks I will no longer have a medical problem. I will have self-healed, like a polymer cutting board, or I will have developed a morgue problem. 

"If this is an emergency, please hang up and dial 911."

It's an emergency of sorts, but not one that requires an ambulance ride. It requires the urgent answering of a telephone. I call again. I reach the on-call nurse. This is not an on-call nurse situation. And really is there an on-call nurse scenario that doesn't result in a visit to urgent care?  Because, though there seem to be no doctors available at this medical facility, I feel sure there is a twenty-four hour legal department who has made clear that nurses are not to give medical advice over the phone.  I ponder questions she might be able to answer. Her preference for light or dark meat, perhaps, or the name of a good hair stylist, locally.

I ask her simply, "Can you tell me if Doctor Yunis is working in the urgent care this morning?" This is a thing I've learned; that if I want to see my doctor, during this or the next lunar cycle, I can sometimes catch her doing her part with the unwashed masses in the clinic. I wait. 

"May I have your name and address?"

"My name is Jessica, but I just need to know if Doctor Yunis is working in the clinic today." 

"Your last name, Jessica? And your address."

"Look, I don't need a pen pal, I just need to know if Dr. Yunis is scheduled today in the clinic."

"I'm the nurse on call, is there something I can help you with?"

"Yes, definitely. You could help me so very much by telling me if Dr. Yunis is going to be in the clinic today."

My eyeballs are starting to click with rage and desperation. 

"I'm going to put you on hold."

She returns.

"No one is answering in the clinic right now..."

"Yes, right, because I dialed that number and I was connected to you. Is there no way to find the answer to this question? No printed schedule of who will be on-call in the Urgent Care facility? No screen we can tap with the on-call docs listed?"

"Let me put you on hold..."

She returns after I, and the Girl from Ipanema, have gone walking for a bit.

"Dr. Yunis is off today."

I am driving through a maze of flattened, baled cardboard and loading docks behind the supermarket. There is no doctor's office here. There is an uninspiring day spa and a pet groomer, but no one with a medical degree. If I need my toenails clipped or a spray tan, I know which building to park behind. My husband is not answering his phone, and he's the one who set this appointment up for me.  I leave escalating messages for him that I know will be played back for me, one day soon, when I've regained my sense of humor.

"It's not here, BABE, where the FUCK is this place?!" Click. "Really, this is the day you decide not to answer your phone?!!" Click. "JESUS FUCKING FUCK! ARE YOU FUCKING KIDDING ME? WHERE THE FUCK IS THIS FUCKING FUCK ?  FUCK!!!!"

I call the Doctor himself. It goes straight to voice mail. I'm doing a three point turn, cell phone to ear, in the dead end that leads to the day care playground. Tears of homicidal frustration collect in the collar of my shirt. I feel sure that I'm committing an arrestable offense. This is what they mean by a danger to to yourself and others.

My iPhone is giving me two different addresses that are maddeningly close to one another. Which is it? Over here, or over there? I cannot get through to a person to save my life.

Having crookedly parked and found the relevant suite number, I finally push through the office door which is hydraulically cushioned to be intensely more heavy and cumbersome than the organic weight of the door.  It feels like the door is shushing me with its revolutionary and patented mechanism.  I don't want to be shushed. This moment calls for saloon doors.

I get to the reception desk,  my eyes are swollen nearly shut and I am belching sobs. I croak out something that sounds like this:

"Thirty minutes...find...voice mail...crazy...driveway...late..."

I am handed tissues as I paddle to the waiting room, afloat on my mucus raft, eyelids inflated floatation devices.

"I have a little paperwork I need you to fill out."

I am handed not a clipboard with a Pharma ballpoint pen but rather a digital tablet whose heft and girth is that of a Speak and Spell. It's a plastic briefcase with a stylus dangling from a plastic cord and a credit card reader slot so the doctor can relieve my bank account of its $225 burden,  before my tears have dried.

There are a lot of questions. They are to be answered on a scale of 1-4, based on intensity. Poke the bubbles with the stylus. Except the stylus is sadistically insensitive. Only one out of every four pokes registers.

Do you feel anxious 1-2 days a week, 3-4 days a week, 5-7 days a week. Poke. Nothing. Poke...poke. Still nothing. POKE. POKE! 3-4 days per week. But now I've added this, a 5th day.

On a scale from 1-4, rate the truth of this statement, "I feel sad and isolated." Poke. Poke. "I'm poking the three, but this thing is making me want to poke all the fours!" I sort of loud talk/yell to the receptionist.  I am stabbing the Speak and Spell to death.

As I'm sitting there, three patients have come in, met with the psychiatrist and left with their scripts. All white. All female. Assuming they are returning customers, at $125 a pop, this guy has made $500 in the fifteen minutes I've been here hosing down his upholstery with my grief. 

"Just one more form, if you can, hon." Sure sure, I'm a pleaser, I will do the form. This one is paper, attached to a clipboard, in a way I recognize. It's an ADHD survey. But ironically they've chosen to lay out the form in a way that actually induces Attention Deficit and hyperactivity. Front and back in maybe a 3 point font. It's like trying to read the ingredients on a Ho-Ho wrapper. Lining your answers up with the questions is a physical impossibility. Especially while your eyes are blurred with tears.

Zero. zero. Zero. I'm trying to line up the the relevant zeros. I don't have ADHD, I have clinical depression that requires medication. I don't feel unable to concentrate, I feel unable to experience joy. It's not that I can't stay in my seat, it's that I can't stay in my skin. No, I don't have trouble completing tasks, I have trouble not wanting to beat the shit out people who don't understand depression. I am having trouble not leaping over the desk and shoving the clipboard sideways into the kind receptionist's smiling mouth. I abort the ADHD form in an enlightened moment of self-preservation. I don't have to do this. I put the clip board down on her desk and say definitively, "This is NOT me. I'm not doing this."

Deep breaths. This is chemical. Treatable. Temporary. I say it again. Chemical. Treatable. Temporary. I am my own best friend. I have to look into the future. In a few hours I will be back on anti-depressants. In two weeks I will be feeling much better. My colon will be shot to shit, but my mood will improve. Nothing will be this hairball and scary.  When the meds finally grab the reins on the bucking colt in my noggin, I will trot along the path like a faithful steed, gait steady. I've been here before, and I will probably be here again, but there will be joy in between. Somewhere between the valleys, peaks rise. Voices call to me from future heights, yodeling down to me as I begin the trek back up to meet them. The sound is sweet and beckoning with calm, centered promises. Their call is very important to me. 


  1. Ummmm, Ho Hos. Hey Jessica, anything we can do? Let us know...
    meeting for lunch or a mid day visit, Tuesday, Thursday, Wednesday, Friday? Love ya...hang in there.

  2. Julie said it perfectly.
    Also: You are a beautiful person Schickel.

  3. I know how it is Jessie!

  4. I don't know you, but can I tell you that when the pharmacy at Walgreens neglected to inform me that they were completely out of my anti-depressant until I arrived, toddlers in tow, to pick up my refill and I had taken the last one the previous day, I threw the box of super-plus tampons I was buying at the same time directly across the counter at the pharmacy technician who delivered the news? Completely lost my shit, right in Walgreens. That was 5 years ago and I'll be damned if I'll ever set foot in any Walgreens, ever. Those bastards nearly sent me over the edge. I was on auto-refill for god's sake! Do they not plan ahead?