Tuesday, August 30, 2011

Say “person with schizophrenia”, not schizophrenic!

                When someone is called a schizophrenic, the word tends to describe them as a mass of symptoms that defines them.  Saying a person has schizophrenia better describes a complex person who is diagnosed with a disease. I have met thousands of people with schizophrenia. They are brothers, sisters, sons and daughters, mothers and fathers. They are liberal and conservative, Jewish, Catholic Protestant, Hindu and Buddhist. They are smart and stupid, interesting and dull. They are never the same although they often have symptoms that are similar.  They have hobbies and interests, hopes and dreams.  Most importantly they love and are loved.
The Story
Her young son stood behind her when she opened the door. He was 9 or 10, with jet black hair and big brown eyes. “I.D,” she demanded.  When I handed it over, she looked closely at the picture and at me, and then examined the lamination to make sure it had not been tampered with.  “We’ll talk outside.  You stay here and lock the door,” she said to the boy. She was a tall white woman 5’9” or 10”, with long brown hair.  Her face was thin, pinched and with a small mouth.  “I don’t know why the cops came, I wasn’t bothering anyone.  I was just talking to my son.”  “I guess the neighbors thought maybe somebody was bothering you or hurting you or your son,” I said.  “Also, you gave the police a false name and your son hasn’t been to school.”  “I told them that I had to escape my ex-husband who is trying to kill me. He has access to all FBI and CIA records and if I use my real name he can easily find me.  He’s found us in Flagstaff, Arizona, Rockford, Illinois and last month in Charleston, South Carolina.  He even had me raped in Charleston,” she replied.
The officer, who alerted me to Kristen and her son Adam, had contacted the Charleston police for information. They’d had a dozen difficult contacts with Kristen in the six months she lived there and confirmed the sexual assault had taken place about a month earlier.  They had a suspect in the case, who was also being investigated for other rapes, but they did not have enough for an arrest. 
Kristen claimed her husband was a member of the Noriega family and had been working as a CIA informant and as a drug runner and was part of the “Miami Mafia”.  “He has a long reach! People think I’m lying or crazy, but I know it’s true.  Look at the things that happen to me. How else can I be followed all over the country?  There are things that go on that we can see that are on the surface, and there are things that go on under the surface.  The things on top are controlled by the people underneath. I’ve been working for a number of years on a book that will expose the connections between corporations and the mafia.  There are great libraries here at Cornell and I’m going to spend time doing research so I can expose the system that nobody sees.  I hope I can hide out long enough to do my work.”
 “It sounds like you have really been through a lot,” I said.  “We keep our information strictly confidential.  The records we keep are only paper records.  We don’t keep any computer records at all. We won’t for at least a few years.  There is a woman I work with named Anne who specializes in helping women who have been oppressed by the men in their lives.  She also helps women who have been sexually assaulted. I’d love for you to meet her.  Would you do that?  And your son has to go to school. I’ll talk to them about securing his records.”
The psychiatrist who presented her case at our intake meeting was not optimistic. “This 36 year old woman had an onset of symptoms of paranoid schizophrenia at about age 22, shortly after her college graduation. We have received hospital records from her home town, Baltimore.  She was reluctant at first to sign a release, but after much discussion and prompting, she agreed that it would be helpful for us to confirm facts as she states them.  She is a traveller.  The only region she hasn’t been in is the Pacific Northwest and not for want of trying. She says that she was in Salt Lake City at the bus station with a ticket to Seattle when she saw her husband at the ticket office talking to the agent. Kristen says that she is happy to talk to Anne, but is unwilling to take medication.  I also saw her son and spoke to him with her present and by himself.  He is a nice young boy.  Mostly, he’s worried about his mom, who can go on rants about various delusions she has.  That was what the original call was about.  As far as the ex is concerned, I don’t know if he’s a good guy or a bad guy.  At the moment, we have no reason to look for him.  What I do know is that she has had some very bad things happen to her and for the sake of her son; it would be nice to try to engage her and have her want to stay here so her son can have a life.  But if she’s still here six months from now I’d be surprised.”
I heard the piano when I came down the stairs. Anne had called me and asked that I come down to the day treatment program.  It was late in the afternoon, the program was over and when she said it wasn’t a crisis, I’d been relieved.  The old upright was in a corner and usually it was subjected to unending versions of “Chopsticks”.  The sounds that came from it now were melodic and sweet. I recognized the song as an old standard, What a Difference a Day Makes.  When I was able to look over the top of the piano I was shocked to find a little boy with ink black hair and brown eyes.  His small hands moved easily over the keys, his gaze intent on the sheet music in front of him.  He picked up the tempo and the song took on a different flavor.  “I heard it played faster once,” he said, looking up at me.  An hour later, after preforming songs from West Side Story, some ragtime, and then Bach and Chopin, Kristen came in to get him.  “He’s good, isn’t he?”
Anne told me that Kristen recognized Adam’s talent early on.  In each community they had lived, Kristen had arranged piano lessons.  She’d scrimped and saved and traded labor and bartered belongings for the lessons.  What was clear was that this very charming and pleasant young boy had exceptional talent that needed to be developed.
Kristen’s agitation, including yelling, continued to cause problems.  The psychiatrist had given her a prescription for anti-psychotic medication that he said would “calm her”.  He told her that she was in charge of her treatment and she should take the medication if she felt an episode coming on or if the neighbors complained or the police showed up.  “It does take the edge off,” she told him at their next meeting.
After about eighteen months passed, Adam was nearing the completion of his first entire year in one school.  Kristen had joined our day treatment program and was a regular, cooking and serving lunch to some severely disabled clients.  She came to my office one day in April to brainstorm about ways to finance a summer arts camp for Adam in a nearby city.  I directed her to some local charities that I knew could help.  When she came up a few hundred dollars short, we took up a collection and I told her it was from a special charity.  It took three buses and a mile walk for her to take him there.  She’d spent the night on a bench in the bus station before returning the next day.
The regional orchestra that Adam performs with now is a five hour drive away.  I saw him just after he graduated from college.  “My mom’s crazy, but she loves me,” he said.
The Stories
The stories are my remembrances. Each of them is based on a true event in my work for Tompkins County Mental Health. I have changed the names and identifying information of every client, patient and co-worker except for Beau Saul, of the Ithaca Police Department, who I was fortunate enough to have as a partner. When confidentiality demanded it, I have changed details. The dialogue is my reconstruction of what was said at the time.   I have felt honored to be let into the lives of so many individuals over the years. Their stories are a gift I have been given.  Please enjoy them in the spirit with which they were written; to educate and inform.

1 comment:

  1. There are lots of people with schizophrenia who function really well. I'm glad you showed that we can be good Moms too.