72-Hour Hold: Part 2

December 16, 2010

Today's post is number two of a five-part series running every Thursday until Jan 6. First installment here.

In related news, the AAMMS Resource Guide has been updated, thanks to input from our readers. The list now includes organizations in Hawaii, Illinois, Texas, and Washington states. Therapists recommended by email will be listed at Kabuuan Koaching; those submitted using the comment form will be posted to the comment thread.

Keep the suggestions coming, good people.


Part 2

Marin General Hospital is a collection of bungalows in the nook of a wooded hill. Deer wander by the windows here. By now it is about 5 pm. The cop takes me to a heavy gate and buzzes up. We are greeted by a tall older white man in a suit, with white hair pulled back in a pony tail. I take a dislike to his walk, which looks to me like clinical judgment and not sympathy. As we stand in the courtyard reviewing the terms of the 5150, another man passes through, this one African from his accent; he consults with a nurse and glances at me with curiosity, does not smile. Inside I am uncuffed and a new waiting begins. A nurse takes me through the paperwork, asking questions one word at a time. When she's done I join the couple with the baby in front of the TV. He holds his head in his hands as if it is too full, she cups his shoulders with her arm, they watch the baby sleep.

I can't see a reason for the delay; I'm not sure what the doctors are waiting for. Hungry, I microwave a corn dog TV dinner for myself, from the self-serve fridge, and eat all but the goop which is said to have bubbled itself into a brownie. As soon as I've thrown out the tray, though, the African man motions to me, and it is time for the interview. I follow him to a room with a door (closed), a low sofa (which I sit on), a chair (he sits on), and probably other pieces of furniture, but the world is narrowed to those three items. He leans back, legs crossed at the knees; I sit forward, plucking at my socks or tugging at my pant cuff. I must convince this man. I cannot stay this night. 

He asks me broadly to tell him why I am here, and I begin my new spiel. It's still rough, but that can lend authenticity. I tell him I take stupid risks, and that when the cop asked me what other kinds of risks I've taken, I was stumped, sure that I had, but unsure what in my very ordered existence they would be. But then I'd realized that where I habitually engage in reckless behavior is in my sexual activity: full well knowing the proper protocol, but at the last moment casting it aside, proving to myself my independence, my carefree autonomy, my control over something which I do not, in fact, control. I proceeded to explain my dissertation, my family life -- this being the context without which no risk-taking makes sense: that I follow rules so much of the time, strive to meet so many expectations, am always so good -- that I've developed a taste for the euphoria of playing with danger, breaking the rules of basic self-preservation. 

But he keeps bringing the line of discussion back to sexual activity -- why do I bring sexuality up with him? Why as an Asian woman am I so uncommonly outspoken with my sexuality? He remarks that I am the daughter of immigrants, that I come from an "upper middle class" family, and bonds with me as a "foreigner" who knows how difficult it is to work and succeed in this society. And then, putting down his legal pad, laments to me that I have done something so stupid that I may have thrown away all my hard work! That I have jeopardized my future -- don't I know that I have a record now, and that with "homeland security" going the way it is, potential employers can have my past dug up and it can incriminate me, make me unhireable? I am less alarmed than I appear, but I am alarmed. He keeps repeating, "I wish I could help you. I wish there was a way I could keep this between the two of us. Otherwise I will have to hospitalize you."

He goes back and forth between saying that given what I have done they will have to keep me, and saying that, yes, it is possible for me to be released that night and that his fellow counselors will abide by his recommendation following this interview. He throws in that it is possible to have a 5150 removed from my record (amazed I ask him how; "There is always a way," he says, "there is always someone with enough authority"), and that he is trying to think of a way to make that happen. Then he says, "Time you do some creative thinking. Throw out ideas, maybe it will help me think of some way to help you." I keep saying I don’t know how this system works. How can I demonstrate that I am not a danger to myself? What if I have someone come pick me up and vouch for me? He shakes his head, but keeps urging me to come up with more suggestions though he rejects every one, and makes none of his own.

It takes me a long time to realize that he has not tried to test the truth behind the story that I was never really trying to hurt myself. That the interview has stalled: 10 or 15 minutes of a circular standoff where he insists that he wants to help me and waits, and I insist on a naïve ignorance and helplessness. No clear objectives are being pursued, no questions asked or answered, no advice given, no plans made. I find it surreal that he is waiting for me to offer him a sexual favor -- that I could have fallen into this cliché -- but there is by now no doubt in my mind what this is. Making not the slightest acknowledgment that I know what he is waiting for, lest threatened by possible exposure he lock me up to the full extent of his power, I pitch each plea to appeal to conscience or some shadow of good intent. But I am by no means so stupid that I think a man like this would keep his word; to give in to his game would only make me more powerless, and more of a danger to him. 

 .  .  .

My bed looks small in the room, mattress set on a boxy wooden frame and yet if a bed can look frail… There is so much space to either side. Wooden nightstand on the right, two white folding partitions on each side that give some privacy to the beds against the far walls. The pillow is only just big enough for a head, the sheets and single blanket all cut to this sub-standard size, muted patterns of a pastel turquoise, and they smell clean with an infusion of cheap detergent I will learn to hate. I am given two sets of light blue pajamas, cotton pants and short-sleeve shirt with snap buttons, and except for the Marin General Hospital printed on the pocket, they’re not unattractive, functional and even comfortable. People wear them, together or mixed with other tops and bottoms, during the day too -- but I am strict with myself not to; they make you look like you belong here. Two pairs of baby blue hospital socks, the kind with treads on the bottom, complete my outfit. A disposable toothbrush, toothpaste, bottle of hair/body cleaning solution, lotion, a disposable comb and brush, and two sets of scratchy towels (also undersized), are provided to me. I arrange these things on my nightstand, the toothbrush and toothpaste neat in a paper cup, and I am reminded of my grandma, who in the convalescent home didn’t want to leave her things in the bathroom either, wary of germs her roommates might leave to roam. 

I had spent five hours at the Crisis Center before being walked over to Psych Ward A for the night. During that time the suspense about whether or not I'd be released gave way to suspense about whether I'd be transferred to the psych ward here or to a different hospital entirely, and so my hopes shifted from going home for the night to staying here for the night, because the patients and facilities in other county hospitals can be far more harrowing than the minimum-security bungalows of Marin. Whenever I needed to inquire about my status, I waited until the African doctor left the room and approached the white man I'd initially taken such a dislike to. He was not to be swayed into letting me go, but during our multi-phase conversation, tried earnestly to understand my situation, and to impress upon me the gravity of my actions. He insisted that underlying my impulse to take such foolhardy risks are subconscious impulses toward self-destruction, which I need to come to terms with, and that these few days can be a very good time to start doing so. Unable to deny subconscious impulses with any plausibility or effectiveness, I soon gave up. But his concern did seem to me genuine; he wanted to help me.

In between these periods of conversation and waiting I called my brother, who wanted to come take me home, but instead moved my car so that it would not be towed from Vista Point. I tell him I was at the bridge, and he understands right away without judgment; tell him I am at Marin General and he says, "5150?" He moves mountains while I am in here, and makes it in to see me as I am being checked into the Ward. Though it is long after visiting hours have ended, the night nurse Sara is kind and lets him stay. This is the first time I cry. Tomorrow he will get on a plane to Shanghai, and deputizes his assistant to watch out for me while he's gone. I also call my sister, who is flying out to Hawaii for the week tomorrow. Tomorrow, I realize with a mix of self-pity and self-beratement, they will both be far away, but my guilt would be overwhelming were they to cancel their trips for me.

Among the supplies Sara gave me after check-in is a blue folder for my paperwork (the kind you expect to find social studies reports in), including a bright yellow, stapled booklet with the words 'My Journal' in large black type on the cover. Inside the cardstock cover are pre-fab pages for journal entries: guidance for a patient’s priorities and meditations. The first page is topped by the header ‘Goals,’ and subdivided into 'During Hospital Stay' and 'After Discharge.'  Most of the other pages are divided into such guiding daily categories as 'Successes/Victories,' 'Tomorrow I Will Focus On,' 'Sleep Patterns and Dreams,' and 'Things I Should Tell My Doctor.' I flip through it, insulted by its transparency, and put it away from me.

Sure that I will have trouble sleeping, I ask for a sleeping pill and, after brushing my teeth, spend the next 20 minutes or half hour on the phone. I have called the boy to tell him what I meant to tell him earlier, that I have been undergoing stress I wasn't even aware of, and being very hard on him as a result. He is worried that I can get so angry, that I have a bad relationship with my parents. I reassure him, all the while with the traffic of voices calling good night and doors unlocking and closing behind me, the sounds of a shift changing. It is 11:30, and the night crew has come in. The people who have indulgently admitted me are leaving and I am too-sweetly admonished to go to bed. I am somewhere convinced that he will figure out I am in a psych ward, (how could he not see through the vagueness of being "not at home," "my friend's phone"), and the madness of trying to do dating-maintenance work while under suicide watch is not lost on me. I hang up hopeful that I have done well enough and, mindful of the nurse’s advisement that the staff keeps track of how many hours each patient sleeps, head off for my eight. 

* * *

Ask a Model Minority Suicide is
a series on mental health. Introductory post
Resource Guide here.
Next installment of this story here. Go here
to see all posts in this series.



Ask a Model Minority Suicide


at aamms[at]hyphenmagazine[dot]com.




Wow, these pieces are really well written, and I don't think a lot of writing is good... makes me want to know your life story. I mean, what did you major in? Was it English, like me? What are you doing now? How did you get out of the place you were in? I've tried a lot of things... medication, therapy...I'm in this weird place where I have essentially given up, but can't ever wholly give up. I don't think seriously about suicide, but sometimes I really believe that I will be in this holding pattern until death, that I am just enduring until I die. Of course, there is always the hope that things will get better, but it's hard to think of it as probable.. just possible.  

It's true that the medications or the therapy aren't the answer; they're just tools, some better than others.  But stuck now doesn't mean stuck forever; hang on til you're ready to try finding your answers again, my friend.

And yes, English, like you.  Pulling for you, with assurances that -- while there's no silver bullet -- it can be done.

I am so glad you're writing this.

Knowing it's not for nothing means a lot.

I have been hospitalized for a 5150 three times in my life, most recently around Thanksgiving of last year.  Luckily the last time they only let me stay less than 24 hours.  I told my boyfriend and he said he was disappointed in me, citing that I was much stronger than that (and it's true).  We're still going on strong though, approaching 2 years in May 2011. I'm really glad I have a boyfriend who really understands me (he's also bipolar and a former addict).  He even encouraged me to get off medication (which was not working for me and doing MORE damage to my body) and exercise more. Medication isn't for everyone.  There are alternatives, like orthomolecular therapy and yoga if you think Big Pharma doesn't give two sh!ts about our community.   http://www.orthomolecular.org/

You're right, there are alternatives to medication. Also alternatives to psychotherapy. I've heard of people who get involved in community support groups and the doing good does them good, too. Thanks for two more suggestions worth exploring.

Having support -- and someone with whom you can talk openly about a 5150 and everything attendant to it -- is huge. I figure every 5150 is different, but am somehow comforted that there are some common threads between ours.

Take good care. Hope 2011 is good to you, and that you are stronger and stronger.


This isn't cleared up in the article but I thought it would be important to pop in and just say, about the skeevy doctor who was trying to pressure AAMMS into a "sex bribe" during her intake... I don't want anyone to get any false misconceptions about mental health hospitalizations, history, and it's impact on your future job prospects, etc. This is something that seemed to come up a lot when I was a student government rep at UCLA for the Student Health program. The Health Insurance Portability and Accountability Act (HIPAA) holds health care professionals accountable to very strict privacy rules. It is the policy of most clinics to present their privacy policies when you come in. In therapy, it is usually one of the first formalities to get out of the way. Mental health status is not something Homeland Security takes into account. The number of people who have mental illness is incredibly high (49% of college students have some sort of treatable behavioral health problem, even if it isn't serious, for starters.) Your employer would not be able to look up your mental health status or any other medical record. (Health insurers might, but that's another story.) Do records get leaked? I'm not going to say they don't, but if someone "you don't want to know" finds out about your sordid mental health history it's more likely going to be from a non professional source (like an asshole ex). Yes, nurses at Britney Spears's hospital were paid thousands of dollars by tabloid magazines. This shouldn't happen to the average person. The average employer is going to care more about your sex offender status, criminal record, and drug tests. In fact, it is illegal for an employer to discriminate against any employee or potential employee solely on the basis of a mental illness, whether or not you disclose this to them (If they are even going to find out that you have one, which they likely will not given the privacy laws.) And no, if you're over 18 (or even under 18 but over 12 in California, in most situations) they can't tell your parents. To anyone who is weighing privacy as part of their decision as to whether or not to seek help for any emotional or mental health issues, please do some research. You will be surprised by what you learn. The truth is, many Asian Americans go to therapy, many of them are hospitalized, and these privacy protections work just fine for them. Student Rights (including privacy rights) and Mental Health http://www.bazelon.org/Who-We-Are/Leadership-21/Campus-Rights-Guide.aspx

This is awesome, jedifreac. Thank you.