220px-Chestnut-breasted_Malkoha2First, let me say that the term “cuckoo’s nest” is a bit of an odd one, as, to my knowledge, cuckoo’s don’t build nests—they lay their eggs in other nests for other birds to raise (how smart is THAT?). But I am in the cuckoo’s nest, nonetheless. The one Ken Kesey made famous. The proverbial cuckoo’s nest.

I use this term fondly and with no derision. It was a struggle for me to get in here, and I’m proud to have made it into these mythical halls.

Yes, really and truly. I am writing you from an anonymous inpatient psychiatric ward in an anonymous city. And I’m writing you because too many people won’t speak of such things, and such things simply must be spoken of in polite company. Mental illness is a topic too depressing to be oft discussed, and to make this worse, I am a chronically depressed person writing to you about a depressing subject, but someone has to do it. Mental illness is far too marginalized in this country, and we all ought to be speaking about it more openly. Perhaps, then, we might start caring for the mentally ill with greater clarity and kindness.

I checked myself into this facility by way of the hospital emergency room. It seems to be the most direct—and perhaps one of the only—routes left to safe care for the mentally ill since the Reagan years. I showed up at the emergency room desk on Monday morning. I was checked into the cuckoo’s nest at 9:30 that night after an exhausting day I’ll elaborate on more later.

What put me over this edge? The psychiatrist in residence here—I’ll call him Bob because he looks like a Bob to me and because I’m embarrassed to say don’t remember his name, although I meet with him each morning. Anyhow, Bob explained to me that treatment-resistant depression, which is what I have, combines poorly with stress. Which I have had in spades. Sunday night, at a time when most of the stresses had rather suddenly been removed from my plate, I started feeling shaky. By Monday morning, I was in deep trouble. If asked if I were a danger to myself or others, I would have had to reply, “Any minute now…”

Bob likened my situation to a person with a backpack, trooping up a mountain. Someone keeps adding rocks, one or two at a time, to the backpack. At a certain point, you stagger. Then, with that last rock, you fall. Then Bob changed metaphors and shifted over the image of a turtle on its back. I liked that turtle image—squat, fat, and flailing helplessly. I liked it better than the hiker in the backpack, so I’ve stuck with that turtle. It feels just about right.

Bob said often when we are holding up a huge load and it suddenly falls away, we often collapse, because—for the first time—we can. I believe many people push themselves beyond their health limits. I know I do. This time, I pushed myself beyond my mental health limit. The weight came off, and I fell over.

There are a lot of things I want to say about this little side-journey in my life, but I can’t say it all in one night. If you are interested in the view from the cuckoo’s nest, I invite you to follow the next few blog posts. If this stuff depresses you and you’d rather have some lighter reading, I fully understand and I encourage you to push the “delete” button now.

The first thing I want to say is that I can now tell you from the inside what I have always suspected from the outside: The mental health treatment system in this country is appalling. I say this unequivocally. Access to care for the mentally ill is abysmal. It is demeaning, it is exhausting, and it is near comical in a twisted sort of way. Please note that I am saying nothing of the sort concerning the people who are delivering mental health care. So far, from my experience, everyone—from doctors to nurses, social workers, security guards, and janitors—has been kind and gentle. Well, maybe one guy is a bit of a jerk, but really, everyone else has been splendid.

I’ve been battling depression for 25 years now. This is the first time I’ve ended up in an institution, and this is how I came to be here: There was nowhere else for me to go. My previous doctor, a psychiatric technician under the oversight of a psychiatrist, had left her practice. I had felt that my anti-depressants were failing me for weeks. And I’d been calling around to other psychiatrists in my area, looking for someone who would take on a new Medicare patient. No one wants Medicare patients. At least, psychiatrists don’t want them.

And all the time I was calling around and searching, my depression was sinking its teeth deeper into me. In desperation, I called the number of an inpatient treatment center. They could only see me if I came in through the door of the emergency room. They hinted that it could take many hours before they would determine if I qualified for inpatient care. So, I had Carter drop me off at the emergency room with a small stack of magazines. He went off for sandwiches.

When you walk up to the emergency room counter and say, “I think I may be a danger to myself or others,” they get you into a room really fast. Like, warp-speed fast. Then, they leave you there. It is a locked room, bare, no windows, and nothing you can hurt yourself with. It was a long time before I saw anyone, and the day was interspersed with fairly brief visits by a variety of folks, followed by hours of alone time. Everyone asked, over and over, “Have you been thinking of hurting yourself?”

This was a dilemma. If I said “no,” I’d be essentially cutting myself off from the only source of help I felt I could get quickly. If I said “yes,” I was honestly not sure if such a thing was something I was prepared to tackle outright in the next few hours, so would I be lying? So I said “I will be shortly.” And by the time they asked me for the sixth time, I said, “Yup, you betcha.” Whatever it takes, I thought. I’m not enduring this marathon ER blitz for nothing.

I asked questions of the people who came in to talk to me, and they told me very little. I’m someone who needs information to feel safe and secure, and there was little of that forthcoming. I did not know what I was committing myself to, nor really for how long. I just knew that if I got checked in, I would be able to see a psychiatrist and get my medications reviewed and revised. And that I would be safe and secure and tucked away from a world and a life that had suddenly, overnight, become far too big to handle. At that point, nothing else much mattered to me, so I breathed a small sigh of relief when a nice nurse came in and said to me at 9pm, “An ambulance will take you to the facility. They are coming now.” When I asked if I should have my husband bring me some things—clothes, medications, anything—the nurse told me to ask about all of that after I got to the center.

So, off I went in the ambulance, thankfully, and with no sirens blazing.

No one should have to go through such a gauntlet for help. Most especially, people who are struggling to keep their minds together. At a time when I was least able to string two sentences together, I had to make a complex plan to get the help I needed, and then I needed to endure hours of frustration before I had any idea if I’d qualify for any help at all. Since coming here, I find myself surrounded by mentally ill comrades far, far more fragile and far more desperate than myself, people who are forced to cycle in and out of these places because there is nowhere else for them to go. My heart aches for these people. This is nuts.

So, I am writing you from my private, dorm-like room here on the upper floors of wherever it is I am. I am allowed plastic forks and spoons, but no knives, except at meals, so go figure. I may have my computer, but no container of dental floss, but I can tear off a length for my use providing it does not seem suspiciously long. I have had my medications altered by Bob, and we are hoping they work. The rest of my focus while I am here is to find a source of continued medical help when I leave. Where will I find a Medicare Friendly Psychiatrist? Does such a person exist? We’ll see…

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12 Responses to FROM THE CUCKOO’S NEST

  1. Megan says:

    love love love to you and what an amazing act of self love to go through such an experience to take a stand for your happiness and sanity in a system that does not have common sense. And what an eyeful you are learning about!!!

  2. Richard says:

    I am so sorry to hear of the challenges that you are facing especially when you were just beginning to once again build a nature haven in your new abode – something that I am sure serves to sooth the savage beast within you. I can hear in your description the fear and uncertainty of how to ask for help and the concern over what still lies ahead. Having lived for 3 years with someone who was diagnosed with PTSD and depression and also struggled with alcoholism I can understand how scary it is. Dealing with any form of mental challenge is extremely difficult since every person’s situation is different and how you react to medications prescribed only adds another unknown element to what you are so desperately seeking – peace and tranquility in life. My thoughts and concerns are there for you and I will continue to follow your journey through this – my hope is for a speedy resolution to some stabilizing solution. Somehow I feel your strength of character will support you through this and serve as a foundation for healing. How is Carter handling and dealing with this difficulty??

  3. Laura says:

    I’ll be pulling for you. You are a very brave and wise person. I just hope I could be that brave if I ever get in your position. You’re blog has meant a lot to me in the past year, and I look forward to many more posts! Love to you—-

  4. Susan, darling friend, I am honoured to read your account and deeply relieved that you are now in a Bob-enhanced sheltering facility. Hug-ful hurray to you for your gumption, for pushing on through a vale of raw challenges to reach your goal of safety and care.

    What you endured to get there still happens here, north of the border sometimes, but generally, our venerable provincial (ie ‘state’) universal healthcare systems make it easier to get help fast.

    Thanks so much for sharing on behalf of all of us with depressive illness. Your candid clarity does much to sweep away stigmatizing notions of us as somehow deficient and scary.

    Lately, in moving stress, I have been fantasizing a bit about the instant total relief brought by an IV line to one dehydrated after childbirth or food poisoning or a suicide attempt, etc.. It’s even more life-affirming than sips of water when thirst is dire. Reading your Cuckoo’s Nest dispatch leaves me with that kind of immense feeling: “This is Susan tapping into health again. ‘All shall be well. All shall be well. All manner of thing shall be well’.” Much love to you, dear lady, friend, co-traveller, and brilliant voice, Gentle Mighty Warrior Susan!

  5. Ann Patton says:

    A couple of things you CAN have there, and 24/7: Love from thousands of us, wishing you well, God Speed, best wishes for a return to whole health soon. And…an angel. Or several angels. I’m asking for some to come be with you now and I know others will, too. Thank you for sharing, so sorry, sorry for your pain, your desperation, but so very proud of you for being so brave and (hopefully) finding help at last. Thank you for all the joy and enlightenment you have given us over the years in your writing. Perhaps this particular article will help others find that door to help with mental health problems. Love you, Susan.


  6. Lisa Schmidt says:

    Thank you for sharing what desperately needs to be shared. I’m a RN on a Surgical/Orthopedic Unit and I know first hand how little mental health care is offered. We used to have an Emotional Care Unit at our hospital but it closed due to lack of funds. People are shuffled around and it seems to me lost in our system. It makes me cry sometimes after I get off work. I love your writings and it has been a blessing to my life. Your one of my favorite authors. Love and prayers to you. You are surrounded by love and good energy from all of your grateful followers.

    • Susan McElroy says:

      Lisa, thank you for your input. I was so hoping that my words would reach ears that needed them. What’s the point of living through such craziness if it is not of some use to someone? Richard, thank you for asking about my husband. Carter is carrying on at home, and is quietly supportive. He even brought Mazel Tov, our dog, to visit today! I can only imagine how difficult this challenge is from his perspective. Often, I think it is the support person—not the “sufferer” or the sick one—who suffers the most. I always felt it must be more painful to love someone with cancer than to be someone with cancer.
      And all the rest of you—thank you thank you thank you for your kind and uplifting words! They are so appreciated!

  7. Colleen Boe says:

    Wow Susan!! For a few minutes there I thought you’d been reading my diary. But then I remembered I’ve never kept one. If I had one tho’ it would read very close to your blog today. My turtle flipped over on March 15 this year….. beware the Ides. The event that upended my turtle was so relatively minute in the grand scheme of things that it doesn’t bear mentioning. The kicker is that I had gone off my anti-depressants (with my M.D.’s approval) in August of 2012 because I didn’t think I needed them anymore after 20+ years… life had more or less settled into a routine just this side of boring. So for 7 months I was coping just fine without the meds and then suddenly ‘Bingo’! While you were trying to find a Psychiatrist who would take you on as a patient I was trying to find someone who would fly to Arizona and drive me, my dog and my travel trailer back home to Canada because I didn’t think I could do it. Even though I had been RVing on my own for the past 3 years after my husband died. I had become a ‘snowbird’ and had driven down there with no incidents in November. Well actually my van had a major meltdown to the tune of $1500 but I didn’t. Life was good….I could handle unexpected dilemas!
    An angel in the form of an almost forgotten friend arrived shortly after my email reached her. Coincidently she had just quit her job and she sensed that I was in need ….more than I’d let on, and caught the first plane to where I was. The trip home for me was a 4 day blur….but I couldn’t have had a more competent driver/nursemaid. Of course I saw my Dr.immediately upon arrival home and went back on the Prozac plus something to help me sleep. I knew that the med. was going to take at least a month to start working and as you know a month is a long time. At some point in those dark days I stumbled across you and your writings cheered me. I truly believe in Animals as Healers….(my dog is a Blue Heeler.)
    I booked myself in to see a couple of psychologists…..hoping one of them could hypnotize me back to ‘before’ but neither of them had the right words. And finally one day I walked into my Dr.’s office and told him I was feeling suicidal. That word as you say, works magic; but you’d best be prepared for the consequences. The mental health person was there within half an hr and I was escorted to the hospital. Within 24 hrs. I was in a psych ward and like you I saw people much worse off. I met with a Psychiatrist the next day. A wonderful eccentric woman with many letters behind her name and a genuine desire to improve the mental health system in this province. Within half an hr. she had assessed me, changed my meds and given me a ticket out of there with a follow-up appt. 2 wks later. Of course things didn’t just become wonderful overnight….but I knew what the options were now. I had been to the Cuckoo’s Nest .
    My meds were tweaked and twisted until they finally worked, I saw my M.D. once a week, and my Psychiatrist once a month. I was referred to a CBT (cognitive behavioural therapy) program and I went every week. I took vitamins that are known to relieve stress, cut out caffiene and I walked the dog first thing every morning. I stopped reading the paper, watching the news and at one point I had a hard time listening to the radio. I lived on the couch many days.
    It’s been 7 months now and in 3 days I will head south again….back to where my turtle flipped.This time my daughter will drive down with me and fly back. It’s a long way and the dog is a lousy conversationalist. My Psychiatrist has asked me to keep in touch while I’m away because she’s intrigued by my trip. I’m looking forward to the sunshine again.
    This morning as I sat down at my laptop with coffee in hand and yours was the first email I opened it all came back to me. The Mental Health system here is stretched to it’s limits as well….who knew there would be so many of us to care for… and about. They and the SPCA are my charities of choice to donate to now. I consider myself lucky and I feel that you will be too Susan. My very best wishes for your speedy recovery. This was my mantra…..say it out loud and often and believe it..
    “Day by day in every way I’m getting better and better”!

  8. Bett Weston says:

    Blessings dear Susan, for this most sincere and honest sharing. I have often thought about how we fail those most frail among us. My prayers are with you on this journey. Namaste.

  9. Nancy Fuller says:

    I am a licensed Marriage, Family, Child therapist in the state of California. I am currently not practicing. Since Regan California has absolutely no idea how to handle any mental health crisis unless the patient has funds. Therapists routinely charge $100 – $150 an hour. Insurance must pay, but only up to a certain number of visits. Most physicians prefer medication. In the few remaining facilities overcrowding is the norm, as it is in our most celebrated facility – Los Angeles County Jail. Couple this with lack of adequate gun control and ease of obtaining prescription medication through the black market – well….. Susan, you are intelligent and brave to recognize that you required help. Especially brave to write about your experience. You are in my thoughts. Mental health is precious. It is little understood (probably in most cultures). Nuance is overlooked. Hang tough and know you are loved by your friends and family as well as the universal presence. Bob probably thinks kindly of you as well.

  10. Susan, this is perhaps (no, I think really) the most powerful piece I have ever read. And you not only wrote about it, but you had to orchestrate it—–and all done in extreme pain. I know you will be well; and I know you can move mountains with just a foot of dental floss. Much love to you, from a very long-time reader, Pat LeVesque

  11. Nancy says:

    Oh my gosh! Is there something challenging in the stars right now? I had a massive anxiety attack meltdown on October 30, decided that my drinking was not helping me at all, went to check in at detox on November 1 (but decided I was not that bad off).

    And I know November in Washington does not help…I used to live in Everett…

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