A Bad Hair Crazy Day
Crazy does not mean anti-social. Crazy does not necessarily mean unkempt, unsanitary, offensive or mean-spirited. Crazy is not silly, laughable or entertainment. Crazy is definitely not stupid.
Ever since Ronald Reagan said, “We will no longer warehouse our mentally ill”, the pharmacy is the place where they get the gear needed to navigate in the world. We call it Clozaril, Seroquel, Abilify and Zyprexa… among others. The problem is that “chemical warehousing” with the best agents is ridiculously expensive. No insurance and the crazy person is hung out to dry.
I was called out front and this older woman introduced herself to me with these words, “I am just your neighborhood insane person.” She looked for a reaction and got nothing from me.
I nodded, “We’re all a little bit crazy.”
“I am talking insane,” she added. “There is no little bit about it.”
There is very little short of child abuse that can get a rise out of me. I didn’t
take the bait.
She gave me a winning smile and I thought, she’s flirting with me.
“All right, you feel crazy today.”
She frowned and went on, “I hope that you will be patient with me. I try really hard not to but I can get a little obsessive with my drugs. I ask lots of questions.”
I assured her that it was okay, that my job was to answer questions. There were plenty of questions. After awhile, she lightened up. Maybe she began to trust me. I treated her just as I would treat anyone else. No prejudice against the crazy. No snide remarks to the tech. No hidden laughter.
One day, I looked out and there she was. There was something not right.
I walked out front and sat beside her. “Are you okay?”
“I am crazier than Jack Nicholson today. I hate days like this.”
“Oh,” I said. What do you say to that?
“You can’t see him, but that dumb sunuvabitch keeps telling me to do stupid things.”
“Are you having a schizoid episode?” That response was weak, but this doesn’t happen every day. I have suspected other people at times, but this was the first time that a patient reported directly that she was having hallucinations.
“I am really crazy today.”
I didn’t know that crazy came like a bad hair day.
I asked her if she needed to discuss her medication with her psychiatrists.
“There is nothing they can do. I can’t afford the good medicine. I’m in the doughnut hole.”
The Part D shame. A right wing slanted committee in bed with Big Pharma and the insurance companies wrote the Part D bill.
She explained that her hallucinated person was forceful, clever and, get this, more real to her than I was. She had learned what was which and who was who.
What do we do as a culture, a society? What can we do as an individual practitioner? Will voting right help? Or do we just look away and think about the hard-to-get squash court reservation after work?