I very nearly made it through college without ending up on the wrong end of a nurse-patient relationship. Then came finals week of my first semester of senior year. We were doing a radio play very late at night when the fear and hopelessness hit me. I stepped out of the station to try and get myself under control. And as I sat on the couch in the new union basement and tried not to cry, I had to face the fact that what I was doing was not working. And I started to look ahead at life. I saw no relief. I saw this monster just regrowing head after head after head and I felt desperate. There was an unused bathroom just feet away and a drawer full of box-cutters in the radio station. It would have been very easy. But, I was a student nurse, and it had been drilled into my head that people who are feeling suicidal need to go to the ER. So, I asked my boyfriend to drive me. At the ER, I tearfully admitted to the triage nurse that I was feeling suicidal. She asked about my insurance, took my purse (although thankfully not my clothes as I've seen done in other hospitals), and brought me to a room where I waited to be evaluated.
Typically, when one goes to the emergency room, one expects sooner or later to see a doctor, or a nurse practitioner; someone who is licensed to diagnose and treat illnesses. This is apparently not the case when you are a psych patient who shows up at five in the morning on a sunday. 24 hour emergency care by a physician is not deemed necessary for you. I saw a counselor. Her name was Jen. I told her my symptoms and she seemed decidedly unimpressed. She pushed, and pushed for some sort of circumstantial reason why I was feeling this bad, but nothing I told her seemed satisfactory. The tone of her questioning was almost skeptical, as if she suspected I was somehow faking. When she asked about my previous diagnoses and I told her that they didn't really know, she became irritated. I just wanted to be out of that room and away from that woman who made me feel so insignificant and so small. After demanding for forty-five minutes that I explain myself, as though I were a misbehaving child, she asked if I wanted to be admitted. The simple answer was "of course not". Of course I did not want to locked up with limited access to my support system, no control over what and when I ate, and strangers judging my every move. No, I did not WANT to be admitted. But I didn't want to be turned away without so much as an assessment by a doctor either. I didn't no what to say. I just sobbed. She stared at me for a while and then said "Why don't we talk to the psychiatrist and see what she says?" "We", she said, as if I'd be involved. "Yes", I said, "Please, I would love to see a psychiatrist." She left the room. She was gone for a long time. I waited. I thought when the psychiatrist came in, we would talk for a few minutes and she would give me some new medication and maybe a referral for a follow up appointment and I would assure her that I would call somebody before trying to kill myself and that would be that. Only, the psychiatrist never came in. Jen returned after about a half an hour and said "We're gonna go ahead and admit you." I was confused. "What happened to the psychiatrist?" I asked. "I just spoke to her on the phone." Jen said. So I was not to see a doctor after all. "Could we, actually not admit me?" I asked, beginning to feel that this had been a very, very, bad idea. She shook her head. "We already have the order to admit you." I thought, How could that be? This doctor hadn't seen me, hadn't asked me a single question, and had just taken away my freedom. She had made her assessment (and I use the term very loosely) solely based on the opinions of someone else. It's not as if Jen had had a set of medical facts to report to the doctor, like the size and drainage from a wound which would be the same observations no matter who was making them. I know from my experience on the other side of psychiatry that all the information she gave to the doctor would have been subjective observations that might have been interpreted very differently by a medical professional with supposedly more experience and training. "That's just the way we do things", she said. And that was it. Nothing I said after that point mattered, it was just a question of whether I was going to walk up to the unit or be physically forced. So I walked.