Saturday, August 20, 2005

A Beautiful Mind

One thing I am regularly faced with in my job is the face of madness. We get regular visits by attempted suicides, and most of those are not so much attempted as practiced.....they know exactly how much of what to take to get a free ticket to the Critical Care Unit via the Rescue Express, without to much chance of actually dying. Quite a few we call our "frequent flyers", and they tend to be the nastiest personality wise. While in the throws of their drug-induced delirium, they bite, they kick, they spit, they scream obscenities, you name it, it's the best of Inappropriate Behavior, the mini-series. We pump their stomaches, fill their guts with liquified charcoal to absorb the bad stuff, shove a tube down their throats to get them breathing, then tie them down with restraints and enjoy their pleasant company for a few days. You might consider it a cry for help, but with these girls, and it's mostly girls, it's a profession, one they have gotten good at, at least so far. The odds are they are going to screw up and pass out before they dial 911, or they manage the wrong combination of drugs and then no amount of rescue can help them. Aside from the cost that the hospital must swallow to save these rebels without a clue, they tend not to realize the damaging effect some of these drugs can have on their organs, even though we manage to stabilize them, they end up becoming candidates for an organ transplant they have no hope of getting, due to their habit of bodily abuse. We don't give precious organs to people who will only turn around and keep drinking or taking drugs.
You might imagine by now that I and my fellow care givers are cold, heartless people to be discounting people so easily. Nothing could be further from the truth. Yes, in many cases an emotional trauma or mental illness has a role in these unfortunate events, in which case we truly hope they can get the help they need to get their lives back. If they have loving, caring spouses or families, AND they have decent insurance, chances are they will get the help they need. Problem is, many more are outcasts for one reason or another, no support systems, no insurance, no one to truly care what happens to them. These people are by now totally embittered to society as a whole, and the resources available to them are pathetic to say the least. Many would require the toughest of love, if it was even available to them, to straighten them out, to provide some sense of purpose and belonging to them, as well as a sense of responsibility to themselves and the people around them. They are damaged goods, a product of a society that cares more about shoving democracy down the throats of strangers thousands of miles away than the well being of it's own citizens.
Can we as caregivers do much more than we already do, bringing them back from deaths' door and sending them back to the world that encouraged them to behave so? You tell me. I dodge their swings, I ignore their curses, I clean their butts when they crap their beds, I feed them when I have to keep their hands tied down, and I never take it personally. Sometimes when they laugh and brag about how they are going to take another stab at it as soon as the county mental health clinic cuts them loose, I just smile and keep my mouth shut. Because I know they are right. The so called shrinks there will ask them if they intend to do it again, they will smile most angelic and insist they never would, and the ass hole will sign them out and let them go, because they need the bed for the next one on their way. There's no funding for long term, legally enforced psychiatric care, because the money is better spent by us good citizens on football stadiums and other much needed social programs. The kindest thing we could do for them is to hand them a pamphlet entitled "How to do it right, the proper way to commit suicide". But, we can't do that, that would be crass and heartless. But at least it would be honest.
I do not fear death. I fear madness. I fear despair. I fear a stroke or some other debilitating occurrence which would place me at the good mercies of a health care system that tends to bottom line rather than any quality of life it might could retrieve for me in the hour of my greatest need. But, in the meantime, if you come to me, and do not attempt to bite me or hit me or sicken me with your lame brand of kill yourself humor, I will hold your hand, I will talk with you, I will do everything a man in my position can do to make you comfortable and help get you well again, and if nothing else, I will care about you. Because you, but for the grace of Bob, are I. And a beautiful mind is a terrible thing to waste.

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