So I talked with the social worker in the ER and she informed me that my psychiatrist was out of town so she could not call him to discuss whether or not I needed to be admitted. She would have to talk with the psychiatrist on call, who had never met me. I had a bad feeling about that. I explained to her all the reasons why I thought it would actually be better for me not to be admitted: I had an appointment in three days with my therapist, and I would not get any therapist in the hospital; many of my coping skills, like taking walks, taking hot baths, and listening to music would not be available to me in the hospital; I had just received my service dog a week before and being away from him would be stressful for me; and so on. She acted like she understood all that and said she'd talk to the doctor on call about.
I also told her that my psychiatrist and I had previously agreed that my local hospital did not do a very good job of providing inpatient psychiatric care. He has privileges there and sees patients there because it's the hospital nearest his office, so the most convenient for him and most of his patients. But he told me that if he or a member of his family needed inpatient psychiatric care, he would not go there. He told me where he would go and agreed with me that I should seek inpatient care elsewhere if needed. The social worker said that if the doctor on call felt I needed to be admitted, she would see what she could do about arranging for me to be transferred elsewhere.
Well, I don't know what she actually told the doctor on call, but a couple hours later, the ER physician (not the psychiatrist on call, this was a medical doctor) came in and informed me I was going to be admitted. I was upset. I asked what about being transferred to another hospital and he said he didn't know anything about that, but that the psychiatrist on call, without ever actually speaking to me himself, had declared I was a danger to myself and was to be admitted for a 72 hour hold. I asked to speak to the social worker to find out why I was not being allowed to go to another hospital but was told she was not available and that maybe I could speak to her later. I never was able to speak to her later, though.
Now, I was in the ER for about eight hours altogether. It was very cold. I had to ask repeatedly for a blanket before someone finally got me one. Then the nurse came in to clean my wounds and she washed them, getting the blanket wet. So then I had a wet, cold blanket. It took a very long time to get another.
After I'd been there for several hours, I asked for something to eat. I can't eat that much at one time, since I had gastric bypass surgery, and it had been a long time since I'd eaten. I was told I could have some saltines or some graham crackers. Now, I have reactive hypoglycemia, and if I eat starchy carbs without any protein, it often makes my blood sugar drop very low and I feel like crap. Mind you, when I say my blood sugar drops very low, I mean it has been as low as 37 in the past when I've tested it. But they refused to bring me anything but crackers.
A couple hours later, after a lot more complaining, they finally agreed to order me a dinner tray. The dinner tray arrived at the same time the ER physician arrived to tell me I was being admitted and to treat my wounds. As you might imagine, that killed my appetite.
The most traumatic thing that occurred while I was in the hospital was the treatment I received from the ER physician. He announced that he was going to staple the wounds on my arms rather than suture them. I have no clue how one determines if staples or sutures are most appropriate and I did not care whether they were stapled or sutured. He said that two of the cuts on my left arm and one on my right arm needed stapled.
And then I realized he was getting ready to start stapling. I had not been given any lidocaine or anything to numb the area. I've had stitches in the past on two occasions, once when I fell and cut my lip and once when I cut my wrist (I was treated at a different hospital then, and the doctor there was extremely compassionate and gentle and caring; I remember he injected lidocaine before doing anything, including before he cleaned the cut, so that it would not hurt when he cleaned it), and both times I was injected with lidocaine and didn't have to ask for it.
Those of you that know me know I'm typically not shy about speaking up with health care providers. So I said, "Hey! Aren't I supposed to get some lidocaine or something?"
The doctor said, "It's not necessary," and started stapling.
Now, I've since been told that sometimes doctors feel it's more painful to inject the lidocaine than it is to just put in the staples, depending on how many staples are needed. I was told by the director of the emergency room that stapling wounds doesn't hurt that much (I'm not sure how many staples she's had put in her body, though). And I acknowledge that the perception of pain is sometimes not just a physical thing but that one's emotional state affects the degree of pain one feels and how well one copes with it. But I was depressed enough that I'd cut myself a bunch a few hours earlier, and then I was extremely anxious about the idea of being admitted to the hospital, and I'd been cold and hungry for several hours. How do you think my emotional state might affect my perception of pain or my ability to cope with it?
But also, keep in mind that, while the doctor had decided only three cuts needed to be stapled, there were significantly more cuts than that. The psychiatrist that treated me while I was in the hospital (the same one that admitted me over the phone, because mine was out of town) estimated that there were about 50 cuts on each arm. I guess he felt it would be too much work to count them to get an exact number. My point is, my arms were sore. They were swollen. If the tissue hadn't been so damaged, maybe the staples would not have been so painful.
It was painful. I said, "It hurts," more than once. I'm pretty sure I cried. I recall kicking one foot against the bed at one point.
But I didn't say no. I didn't say stop. I didn't say, "I don't consent to this." Because I was pretty sure I would not be allowed to refuse treatment. All patients should have the right to refuse treatment, including psychiatric patients. For the most part, the law even says so, although there are laws that allow patients deemed dangerous to themselves or others to be involuntarily committed to psychiatric hospitals. But I had already been told I could not refuse to put on a hospital gown, that I would be tied down and undressed if I tried to refuse. I figured the same thing would happen if I tried to refuse treatment of the cuts on my arms and I didn't want to do anything to make things even worse for myself.
I felt, and still feel, as if I had been assaulted. I was physically hurt, without my consent. People stood by and watched the assault. A friend was with me at the hospital and he sat right be that bed and didn't say a word. There were nurses around. Apparently no one thought there was anything wrong with what was happening.
And there was nothing I could do. I was helpless. Powerless.
As you might imagine, all of this reminds me very much of my childhood. I was abused. No one intervened. I'm not sure anyone knew what was happening when I was a child, but someone should have known. And some people probably did know. And no one did anything. And I was powerless.
After the ER physician was done, I had three staples in my left arm and four in my right arm. I asked for pain medication. He ignored me and left the room. I asked more than one nurse for pain medication and was told they would have to check with the doctor. I don't know if they ever did check with him, but I was not given anything for pain. It was nearly five hours later, after I'd been taken up to the psychiatrist unit, before I finally received oral pain meds.
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