You Can Have a Good Life

(Milwaukee, WI, October, 1988) I’d begged Charlie, my outpatient therapist to get me into a hospital, any hospital. He’d explained, almost apologized, that a psychiatric diagnosis was the only way he could justify getting me in anywhere. It still amazes me that I didn’t have enough or the right criteria to get me onto a medical floor. But I’d been persistent and had good insurance which probably helped. So, in September, 1988, I was admitted to the psychiatric ward at Good Samaritan Hospital.

The irony of this, and even possibly the humor, would hit me much later. Me. A mental patient? I was a social worker, had been for over ten years and was now employed at an acute carte psychiatric hospital. I knew only too well the world I was being pushed into.

My admitting diagnosis was conversion reaction. The DSM-III, the Diagnostic and Statistical Manual of Mental Disorders, defined it as “a disturbance of or loss of physical functioning that suggests physical disorder but which instead is apparently an expression of a psychological conflict or need.”

What that meant was that these strange and persistent physical symptoms, numbness in my arms and legs, blurred vision, loss of balance, general fatigue and weakness were thought to be caused by some deep and hidden psychic fear or unresolved conflict.

I’d certainly had enough changes and stress in the years leading to today. After living for fifteen years on the UP of Michigan with my husband, we’d divorced and I’d moved. Now, full time work, graduate school, a complete change in location and leaving an entire life behind, I guess that could be stress producing. But I was sure I didn’t have some unknown psychic fear or dilemma.

Prior to this day, I’d been popping Ativan like it was candy. The anxiety attacks had been coming with increasing frequency, with no warning at all times of the day and night. By the time I was admitted, I have to say I probably looked like a first class nut case. My psychiatrist, Dr. R, had been adamant about getting to the bottom of this.

“I’m going to order every test there is,” he’d said. “We’re going to rule out everything so you can finally face your fear, whatever it is.”

Next the social worker showed up, equally puzzled. At the time of our initial meeting she’d spoken to me as though consulting with a colleague.

“The diagnosis doesn’t make sense. It can’t be conversion reaction. You have insight.” Oh. Good to know, I’d thought. So began the array of medical tests and an ever changing round of truly woeful roommates both in and out of daily group therapy. The only thing I knew for sure was that I wasn’t crazy.

Mental hospitals which used to be places where people got lost for unknown periods of time are now little more than stabilizing, short term holding tanks used until more appropriate, “lower level of care” alternatives could be found. So, from the hyper-vigilant, anxious, drug addicted young girl to the nearly comatose, severely depressed middle aged woman being carted off to daily shock therapy (I didn’t think that was done anymore), every day was new and different. And also the same.

Nearly three weeks into my stay, after being in and out of a wheel chair, hauling myself to daily group therapy, I was told a doctor was coming to see me. Finally, I heard the message blasted over the intercom, telling me to report to the nursing station.

Dr. P, a quiet, impeccably dressed, Asian man introduced himself. We walked down the hall toward a small conference room. I noticed he was doing that same thing the two neurologists I’d seen earlier had done. Looking. Observing my gait and movements. I had to touch the wall to keep my balance. As he closed the door, the busy noise of the unit was shut out for a while and we chatted a little before getting down to business.

He began with the same routine questions. Only this man had a peaceful attitude and a mystifying calmness about him. Not like the other two, one who’d talked to me like I was learning disabled and the other who had the demeanor of a cold fish. Dr. P. asked if we could walk as we talked. So, we rose and headed out into the hall. As he observed me, he began asking questions about my medical past.

“When was the first time you recall experiencing this kind of numbness?” Though this was the third neurologist I’d seen in this hospital and probably the fourth or fifth physician in the last few years, he was the first to ask this question. It prompted a memory long forgotten of an incident I didn’t realize could be connected.

“I remember about eight years ago, right after my divorce, I would wake up in the morning, feeling fine and then my feet would begin to tingle; by noon I had numbness from the waist down. I had trouble walking but managed to get to work every day. I went to my doctor who said it was stress and depression and he prescribed an anti-depressant. The numbing lasted a few weeks and then it went away.”

“How and when did it start this time?” he probed.

“I got this numbing in my right hand, around the thumb and forefinger,” I began as I showed him my fingers. “That started about two years ago. I’d go to the doctor each time it got worse and I’ve had several tests. I even went to a chiropractor once. They always ended up saying it was depression and stress. It started getting worse this summer and now I’m finally here.”

With the words “finally here” I waved my hand through the air to emphasize what he couldn’t help but notice: I had to hang onto the wall to keep my balance and my feet dragged as I slowly moved along. He directed us back to the conference room and closed the door. “Well,” he said, “I feel that I can make a diagnosis with the results of the MRI, your history and what I see today. We will do one more test (an evoked response imagery exam, I would later find out), just to be sure. But the information I already have is quite conclusive. It is multiple sclerosis.” Then he stopped. He sat calmly and waited for my reaction.

After a few tears, I began to ask questions. He answered each one, slowly and precisely and then just sat there, waiting.    When I had nothing more to ask, he told me I would surely have more questions as time passed and that we would discuss them as they came up. He was getting ready to leave. Then he reached out, gently touched my hand and spoke.

“You can have a good life,” he said. “With MS, the patient has a lot of control over the progress and management of the disease. And MS is different with each person. You must learn how to adjust your life and find out what works for you. I am very busy unfortunately, so you will have to educate yourself. There are many resources out there to help you and I’ll make a referral so you can get started.”

It would take many months and years for me to realize the true impact his words would have on me. This quiet man, who had just delivered the worst news of my life, also gave me something that would stay with me probably forever.

I was upset, mostly by what I didn’t know. Who finds out the particulars of a disease unless you really have to? With the end of our conference, the next stage began. I was out of the “what is it” phase and into the “how do I handle this” phase.

I was moved to a medical floor and the prednisone injections began that very day. A nurse showed up first thing each morning for the next seven days. I was on the IV all day, every day pumping 500 to 1000mg. of this terrible but miraculous drug into my system.

And now that there was a name for what was wrong with me, I was referred to physical therapy. Bob, who worked with me every day, was a jewel, so patient and hopeful, encouraging every small move I made. When I first visited his gym, I was hardly walking. In fact, literally, I could not walk and talk at the same time. No joke. If I didn’t concentrate fully, looking down at each step I took, I’d fall.

Physical therapy gave me real hope. When I could accomplish little else, I could at least go down to the gym and perform a simple task such as walking up and down three stairs and feel absolutely wonderful about it.

The nurses and other hospital staff were always cheerful. They listened to what I was feeling but never let me play poor me. The social worker came to visit every day, just to say hello and push me on.

As soon as the needle was taken out that seventh day, hospitalization was no longer justified. I was released home to recover on my own. The oral medication for five days kept me weaker before I got stronger.

I’d found a study that said it’d been proven the course of a person’s illness and how they adjust can depend on the manner in which they’re told of their disease and in how they’re treated immediately following diagnosis. I believe that’s true.

I came in contact with all the right people at just the right time. I was treated, from the beginning, as a person with a future, as a person who could and would recover, as someone who could have a good life. And Dr. P. was only the beginning. When I called Charlie, to tell him my diagnosis, he confessed the confusion he’d been feeling.

“That really makes sense,” he said. “To tell you the truth, I was running out of ideas about what could be the underlying cause of your symptoms. I looked at every possibility and there didn’t seem to be an answer. Isn’t that great that now you know what it is, so now you can attack it. I’ve treated MS patients a few times before and it seems attitude has a lot to do with how things work out. And on that, I know you’ll do just fine.” There it was again: that “you can do it” message.

On discharge day, Dr. R, the psychiatrist, made his last visit. I think he’d been more disappointed than me when the diagnosis was finally made. He admitted later, “though you weren’t the typical conversation reaction, I really thought your symptoms were psychosomatic.” When he discharged me it was in the best possible way, with humor.

“Get out of here,” he said. “You’re so mentally healthy, you’re boring.”

Around noon my sister picked me up and drove me back to my apartment. After a month cooped up inside a hospital, the fresh air and sunshine on my face felt strange. We drove through the city and then up Lake Drive and I looked out the window to the expanse of Lake Michigan.

I knew from my long ago days living near Lake Superior that nothing can be more calming than taking in the majesty of a large body of water. It just puts everything in perspective. I wasn’t aware that day just how much my life had changed but I’d soon find out. And I was thankful I’d heard Dr. P.’s words. Don’t get me wrong; I’m not saying he performed a miracle. I still had this disease and I’d have to deal with it daily. But he gave me hope when I most needed it and I was determined to have a good life.

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