September 12, 2011

two flew over the cuckoo's nest part II

     I came home and in my best Southpark imitation, told my son, "don't do drugs.  Drugs are bad, umkay."

"Yes, dad.  I know," he responded with a sense of exasperation.

"No, you don't know.  I just came from a psych ward where I interviewed some poor guy who's entire future is now going to be spent cycling in between being homeless or institutionalized because he completely fried his brain.  Let me tell you what can happen..."

     It was sad, really.  Which is to say, a drastic understatement.  The interview was subdivided up between the various students.  By chance, I got the part that dealt with developmental history and substance abuse.  Essentially, my questions revolved around, "tell me about your childhood" or "tell me what you drink, smoke, snort or inject."  And given the case, those were the biggies.  A tragic case - a dual diagnosis of schizophrenia and substance abuse.  His demeanor was what is called a 'flat affect', probably from the medication working.  That means he used the same monotone voice to describe the grades he got as the same voice he used to tell about being sexually abused.  It was the same voice he used to tell me about the cocaine he used to make the pain go away.  It was also the same voice that he used to tell me of his plans to "hurt those who hurt me.  I didn't want to kill them.  I just wanted to make them feel the same pain as me."
     Up until the age of 12, he lived a normal suburban existence where he "didn't want for nothing.  I got A's and B's in school."  Then he moved from his caring aunt back to his abusive mother and step father.  Shortly after, substance abuse started as did the schizophrenia.  Which came first?  Chicken or the egg.  I wonder how much research has been done to show what impact substance abuse can have in creating mental illnesses.  And vice versa.  (And homelessness is clearly a mental health problem.  No amount of job training is going to change that fact.)  He still managed to complete high school and was on his way to becoming an engineer.  And I believed him.  He could rattle off dates and hospitals and diagnoses like they were written in front of him.  I couldn't tell you what I did last week but I'm the sane one.  Yet ask him to spell "world" backwards and he couldn't get past "w-o-r???".  It was like his brain worked right up to a certain point in his life and then just stopped.  No new information or thinking.  And when we began to exit the ward, we waited until an orderly could get a key to let us out.  I was at the back of the group and looked out at the ward.  I guess part of me said, 'don't turn your back on a potentially dangerous situation.'  My eyes panned across the room and saw him sitting on the couch.  Despite the lack of any emotion on his face whatsoever, he raised his hand in salute and waived goodbye to me.

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