Wednesday, June 10, 2015

How Does a Padded Room Sound for a Change of Scenery?

       I was enjoying a good feeling for the first time in a long time after Aysa left. I was no longer alone in my struggle. Past experience should have tipped me off the good feeling was not going to last. Corporate/Oakhaven had a reliable habit of utilizing underhanded tactics to achieve their ends. Nefarious forces had been conspiring against me all day long. An emissary of those nefarious forces was about to strike.
       This emissary was Dr. Lilly, the attending physician in charge of my care. This was not his normal monthly visit. Those visit occurred usually in the middle of the month either shortly before or shortly after lunch. This was January 5th at 7:30 PM. He had made a special trip. He walked in, pulled up a chair, and asked me what was going on. At first, I was actually relieved to see him. If anyone was going to be an advocate for me, surely it wold e my attending physician. Mercy, was I about to e proven wrong.
       “We had an issue about allowing a visitor. It escalated. I am really not sure how it reached this point. No one has been very forthcoming,” I said.
       “I've had administrators and a corporate attorney in and out of my office all day long talking to me about you,” Lilly said. By the tone of his voice, he was clearly angry about being bothered y this as much as he had.
       While I took note of his irritated demeanor, the mentioned involvement of a corporate attorney took point in my mind. I had not yet learned Sonya had claimed the lawyers had interpreted my Facebook posts as a death threat against Brock . Even when I did learn it, I was skeptical. I still doubt professional legal counsel would make unfounded, fanciful claims. This was the first time I heard lawyers had become involved.
       “Lawyers are involved? Over Facebook posts?' I asked.
       “I don't think it's your Facebook itself so much as what the posts say.”
      “My Facebook is humorous. Funny photos. Funny status updates. They are jokes. There are 400 more just like them dating back to 2009,' I explained
       “We don't have time to determine they are jokes,” Lilly sad.
       “You apparently have time to look at them in the first place. I would hope you would take the time before declaring someone a threat.”
       Hindsight is 20/20. If I had taken time to think rather than immediately respond, I would have asked if Lilly had red the actual posts. They were a Garfield cartoon and a Farside comic about Humpty Dumpty. Both were completely unrelated to one another. Was he aware of this, or did he think I actually had made a comment in which I suggested killing Brock? It does not matter at this pint, but I have over analyzed my conversation with Lilly countless times over the last nine months. Pointless, but it was what I did.
      “It is not just Facebook, but your threatening behavior in general,” Lilly said.
       “What aggressive behavior?” I asked. This was the first time I had heard any accusations beyond Facebook posts.
       “Your emails and your contacting the ombudsman.”
     “My emails? The ombudsman directed me to write a letter to Brock explaining my position on the visitation issue. The social worker is the one who contacted the ombudsman on my behalf.”
       “Okay, Jamie.”
      His response betrayed a disbelief in my answer. What had corporate told him? Or more likely, had Paulette lied about her involvement in her to cover herself? She had a history of selling me out to save her own skin. I will never know the answer to this question, either.
      “I have a right to communicate with management and contact the ombudsman if I feel the need,' I said.
       Lilly did not address my statement. He went back to the question of guessing my state of mind based on scant evidence. “I asked them about why they had put you one on one. I asked 'Has anyone examined him?'”
       'No. I asked why they had not spoken to my counselor, Dr. Hiatt. He is the one person who would know more about my mental state than anyone else. I was told 'We don't do that.'”
       Lilly sat back in his chair. Dr. Hiatt had told me it was improper for him to not be notified of any evidence of mental disturbance. Lilly knew this was true, but was not going to admit it. So he changed the subject. We were going to have a man to man talk now.
       “No one is trying to stop you from having visitors. But this one you want to see has been discharged. We need rules in place to deal with that sort of thing. You're an educated man. You know why the rules are there.”
“Of course. The rule is meant to protect residents from reprisals or abuse by fired employes who might be out for revenge.'
       “Exactly.”
       “And I acknowledged that in my letter. But I am also smart enough to know the rules have to be compliant with federal law. This one is not.“
       “Again, these rules are in place for a reason. The rules are made with typical residents in mind.”
       “I am not a typical nursing home resident.”
       “No. the rules were not set up with you in mind, and I think you are at a point at which you need to consider if you're ready to leave.”
       “Because of the rules over my health? I do not think it works that way,” I said.
       I was now internally questioning the ethics of my physician taking such a stance. Surely he, of all people, would insist focus be shifted back to my health concerns. Whose best interest did Lilly believe he was ethically bound to advocate? He appeared to be tossing my medical concerns aside to appease corporate/Oakhaven.
       As if he was reading my mind, 'Lilly tried to explain how he had bent the rules for me in the past. “I’ve had a number of meetings regarding you over the months, particularly in terms of you feeling comfortable among residents. I've advised them to move you away from any roommate who makes you uncomfortable.”
       “Too bad you were not around for Caligula. He was a schizophrenic they forced on me,” I said.
       This marked the second time in our conversation I wish I had taken more time to think before I spoke. Not only had I never been moved from a room I had repeatedly requested to leave, but Lilly had advised Oakhaven to pay particular heed to any such requests? Was this true? Again, I will never know. I did not have time to think about it, either. The conversation was about to take a dark turn.
       “I know it can be disconcerting to have a roommate with mental issues that you can't talk to.'
       “Talking to him was not the issue. He tried to strangle me. Don't you think that is improper?”
       “Somewhat.”
       There were two times in my stay at Oakhaven in which I sat in dumbfounded silence over the incomprehensible behavior of someone associated with the nursing home. The first was the morning after Caligula attacked me when Paulette called me into her office, and then never even mentioned the incident. The second was Lilly suggesting I was only half right being forced in with a mentally ill resident who tried to smother his previous roommate was a bad thing.
       “Only 'somewhat?' Would you care to elaborate?” I asked.
       “Most residents have mental issues. Some things are unavoidable.'
       “DHEC fined them a $150 grand to encourage them to avoid it in the future. I still have not gotten an apology.”
       “I can't comment on whether anyone apologized.”
       “It' was not the first time they disregarded my rights, either. Dr. Hokanson threatened to up my Lexipro to 48 mg if I didn't straighten up. What would 48 mg of Lexipro do to me?”
         Lilly began to squirm in his chair. “i can't comment on that professionally.”
     “You don't have to. I looked myself. It would render me practically comatose.”
       This was true. There were any number of resident who were medicated out of their minds to make them easier to control. I switched physicians from Hokanson to Lilly after the threat. Lilly had never suggested increasing my dosage. He probably wished he had now, though. He was becoming testier at my responses. I needed to dial it back some. It was fine. Lilly wanted to lecture me. I would let him.
       “What I think we should do is stop your feeding, clamp off the tube, and watch your weight. If you maintain your weight, we'll pull the tube and see about getting you out of here.” Lilly engaged in a dramatic pause. “This is going to sound like a threat, but if you make anymore aggressive acts, you're going to e put in an ambulance and taken to the hospital for an evaluation with possible involuntary or voluntary commitment.”
       “You're right. That does sound like a threat," I sardonically replied. “What exactly is considered an aggressive act?”
       “Emails, internet posts...any actions deemed threatening by staff.''
       “Isn't everyone under a similar standard?”
       “No, I am adding this specifically to your orders.”
       “Ah, so I need to sit down and shut up,' I quipped.
       “No, that's not what this means.”
     “Yes, it really does. I am supposed to have a meeting with management Wednesday morning.”
       “You can have your meeting.'
       "As long as no one decides on a whim I needed to be committed to a mental institution in the interim.”
       “I'm going to go write the orders.” He stood up, took a step, and then paused. “Was this worth it?”
       “I am not the one causing problems, Dr. Lilly.”
       Without responding, he left for the West wing nurses' desk to write out the new orders. As the time passed, I grew angrier at the whole conversation. It particularly struck me when the time I would normally get my feeding passed. I was interpreting the conversation to mean the tube was coming out and if I had any thoughts of protesting, I was going to be involuntarily committed. For all I knew, I was being set up to miss the meeting Wednesday. I had not even given consent to stop the feeding. There was no way I was going to be able to sit still while all this happened. I decided to risk sending out another email explaining what had just happened in order to hopefully throw a wrench into the works. The email will be cut and pasted into the next post.

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