24 January 2009

Healing Dialogue

This is a very close rewrite of the conversation I had this afternoon with my new caseworker. It was the second time I'd seen him. I'm just going to let the dialogue, which is foreshortened but remains representative and is in many parts verbatim, speak for itself, as it were.

I have changed the names.

Scene: a rabbit's warren like office building containing dark, narrow corridors set at illogical angles, dark amber glass, industrial carpet. Inside are three different mental health agencies, a pharmacy service and the office of the local congressional representative. Enter a young woman (that is, me) tired and a bit harassed looking.

Receptionist slides open glass panel
Me: Hi, I’m here to see Owen.
Receptionist slides closed the glass panel and nods dismissively
The young woman sits down on the plastic covered lobby couch and picks up one of the medication leaflets and starts reading it. Five minutes goes by.

A man in his approximate forties opens the door to the sanctum sanctorum of mental healing, revealing employees indulging in what can only be described as loud yakking and ferrying reams of paper from one closet-like room to another.

Owen: Hi, there. Not late this time!
Me: No. Hello.
thinks: wasn’t late last time, either

They walk around the corridors for a minute trying to find an unoccupied office. One is located and several foot high stacks of papers are rearranged to make enough room for two people to sit down.

Owen: How are you today? [shuffles papers]
Me: Doing well, doing well. A little stressed out. A little tired.
Owen: Well what’s up that you’re tired and stressed?
Me: It’s been a long week. The semester started last week. . .
Owen: Semester? But I thought Local County Tech started this week?
Me: They may have. I’m up at the state university, though, and we started last Wednesday. We talked about this last Friday.
Owen: Ah, that’s right. Philosophy. I took a philosophy class in college. That was when I didn’t know what I was doing with my life. You don’t need to know what you’re doing with your life yet when you’re still in college, as you know. My professor, oh man, he was a character. You know those people who always answer all the questions, with their little hands up in the air?
Me: Yes. I am one of those people. But I try to have a sense of humor about it.
Owen: Oh.
Me: It’s okay. Don’t worry, it’s not like I don’t know what . . .
Owen: Well one day the professor said “Whoever answers this next question will get a jawbreaker.” Like a candy, you know. So this guy raises his hand and answers the question and the professor like, you know, just slugs this piece of candy at him and it hits the wall, and oh man, it just like breaks into a bunch of pieces and I mean just like this huge thwack, BAM! Yeah, I still don’t know what that was about.
Me: Hmm. Neither do I.
Owen: So let’s see. [shuffles papers] And you’re graduating when?
Me: Well, that’s part of why I’m so exhausted this week. I’ll be graduating…
Owen: It’s not a race, you know. You’ll get there when you get there.
Me: I know. But I’m going to graduate this spring. I just got the registration worked out yesterday morning. And I think that having borne with all the stress of it this week and still sleeping and going to class and getting my work done, I really think that I’m going to be able to get through the semester.
Owen: That’s great. And you’ve been doing the mantras like we talked about last week?
Me: Well, no, because like I told you last week, that doesn’t really help me very much. But I have been doing other things to relax.
Owen: The great thing about mantras is that they center your breathing which is at the core of the way you feel. You have to say them breathing in and breathing out and it just takes you out of yourself. In fact, I spent about ten minutes doing that this morning and it was amazing. I was kinda still half asleep, kinda drifting in and out of being awake, you know, and it was like I just left myself, I really got outside of myself. And that’s all related to what this guy I know’s brother in law who was in a monastery in Vermont, real religious guy but he died real young, like fifty-two or something. Anyhow, he said in a poem that I can’t really remember how it goes, but it’s about how the core of everything is love. That that’s the real truth about everything. With your philosophy, I guess, you’d call that the meaning of life, right?
Me: Well, the idea that love is at the center of everything is certainly a very religious idea about the essential nature of the world.
Owen: Yeah, yeah. Well, that’s why the mantras are so important because they take you out of yourself. And this guy, this monk guy, said that hell is full of all the boring people, the people who never get outside of themselves and what they’re thinking and that’s why they go to hell.
Me: Hmm.
Owen: But you don’t use the mantras. What do you do?
Me: Taking baths, reading. . .walking, when it’s a bit warmer, or sitting in the sun. Sometimes I… Owen: And you take [peering down at file] klonopin?
Me: Yes.
Owen: How often do you take that?
Me: [sighing internally] Not very often.
Owen: Once a week, or?
Me: Well, it depends on the week. This last week, I’ve taken it pretty often. But when things are less stressful, maybe once a month or something.
Owen: You have to be careful with that. Those pills can be addictive. But you’re only taking half a milligram?
Me: That’s right. And I really don’t take it often enough to get dependent on it, though I realize, believe me, that that’s something to worry about.
Owen: I was talking to my officemate, you met her, Rachel, and we’re not sure that you need to be on CST. In fact, another of my colleagues overheard us talking last week and asked me whether you really needed to be on CST. Do you think about stepping down to med management?
Me: I have been, but with school starting and having had to change agencies, I thought it would be best to get to know things here before stepping down to med management.
Owen: I can see that. But what with all the restructuring we’re doing, I’m not sure that we’ll be able to keep you as a CST client. And they’re talking about doing away with the med management program because we can’t get any money from the state for it.
Me: What?
Owen: Yeah, well, I guess they expect you to get your own doctor.
Me: Well…I can’t afford that. That’s why I’m here. Psychiatrists are expensive. I have no health insurance. What am I supposed to do if that happens.
Owen: Oh, don’t get stressed about this. I didn’t mean to stress you out.
Me: Well, it’s a little late now.
Owen: Nah, they’ll never do away with it. I’m going to go ask Beth. [stands up, sticks head out of the door and shouts] Hey Beth? They’re not going to stop the med management program are they?
Beth: [offstage] No. I mean, they want to and they’re going to review it in February but we’ve got 112 clients in it and I don’t think they’ll be able to get rid of it.
Owen: [to Beth] Thanks! [to me] See, they’re not going to do away with it. So don’t stress.
Me: Well, with all due respect, I have heard that before. It was the same at the last agency and then they went out of business and gave us only two weeks’ notice and then it took me eight weeks to get in over here after they told me that they would take care of the transition work for me. It was eight weeks of people not returning my phone calls or saying that they will call me and then not calling me and being given misleading information. Even if you’re going to find a private doctor it can take a couple of months and for me to find someone I could afford to go to would take at least that long. So if they’re even thinking about stopping that, I have to wonder whether I should go ahead and start looking around now.
Owen: Well, that might not be a bad idea. But they’re not going to stop the program. But people do go through a lot to find a doctor. When I was first out of college, a friend of mine got me a job in a mental institution and, I was telling you about this last week, about how everyone was being involuntarily committed and I got to see all kinds of crazy diagnosisses [sic], man it was crazy out there. [laughs ruefully] Well, there was this pregnant girl, pregnant and fourteen, fifteen and psychotic and they had her on all kinds, just all kinds of different drugs – thorazine and neurontin and all that – and none of it was working so her parents just took her out and said they were going to take her to the root doctor. You know what a root doctor is? Like, there was a band called the Root Doctors? You must have heard of them.
Me: No, I haven’t, I don’t really know all that…
Owen: Man, why am I even telling you about this? This is your time, you should be doing most of the talking. But you don’t know what one is?
Me: No.
Owen: Never heard of a root doctor? It’s funny who does and who doesn’t. Well, they’re like witch doctors, like voodoo doctors. And they put these things in like cheesecloth, well I don’t know if they really use cheesecloth, but they put these things in and her parents took her out and said that if it worked, they’d bring her back and if it didn’t work, they’d bring her back. So after a like long weekend, they brought her back and she was fine. No problems anymore. I’m not saying it worked but it did have an effect and I guess you with your philosophy would say that it was about belief.
Me: Well, the placebo effect has been very well-documented in a number of well run drug studies over the past century, so yes, I suppose that could have been about…
Owen: Now when are you seeing Dr. Perry?
Me: I think it’s the 16th.
Owen: I have, let’s see, the 19th.
Me: I’m willing to bet you’re right. I have it in my planner but I don’t know it off the top of my head.
Owen: I’ll just look it up. [taps at the computer] The 19th. Well, that philosophy’s great stuff. One of the most interesting classes I took, although I thought it was a whole lot of bull at the time you know. See you next week. Good to talk to you.
Me: Yes. Next week, then.

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