Sunday, June 10, 2007

Oh, you know, you win a few, you lose a few

I feel like I just got the everloving crap kicked out of me.

I just got home from the hospital. My father is down. He feels like he's not welcome at home. Despite my assurances that we love him, and the issue is that we're terrified of losing him, he feels unwanted.

And so he said, "Maybe I should just go stay in a shelter. I can't stay here indefinitely, and I can't come home."

Now, on the one hand, I know his perception of not being wanted at home right now is somewhat accurate - we're so scared that he'll come home and try again. I'm so sad he feels unwanted rather than getting that it's precisely because we love him so much. But on the other, my father is a huge manipulator. And he's Catholic; he works the guilt like nobody's business. Is this manipulation?

Whatever it is, it makes me feel terrible. He said so many awful things. I left the hospital crying, devastated, exhausted and despondent.

What I want, what I really, really want, is someone in a position of authority - like, oh, a doctor, you know, like a psychiatrist, perhaps - to tell me that he is mentally in a position to come home.

And truthfully, I don't believe a fucking one of his doctors. I believe, on the whole, that their agenda, over patient care, is to get him out. I can't get this assurance anywhere.

We have another family meeting at the hospital this coming Tuesday. So just prior to my delight of a hospital visit, my brother, Betty, and I met to talk about it. To get on the same page and figure out the questions we want answered.

The last meeting at the hospital was brutal. And really, I believe the meeting was only called because we wrote a letter with offers of cooperation accompanied by very thinly veiled assurances of litigation, should they discharge him prematurely.

During the meeting, my father said, among other things and in three different breaths, that 1. he has everything to live for, and has no reason to kill himself; 2. that of course he'd lie to my mother - otherwise she'd try to stop him from killing himself; and 3. that it might just be easier to end it all.

This gem of a meeting would have ended with the psychiatrist saying he was out of time - busy, busy, had to get to the next patient. He'd already given us an hour. Except that my brother insisted we determine a next step before ending the meeting. And the guy responded that he'd recommend a discharge in the next three days.

My brother said no way, and we would escalate this. So the meeting continued on in a businesslike but acrimonious fashion, which then began to worry my dad. He reminded us that this man was his caregiver, and he didn't want us to anger him. We all assured him that this was nothing personal; it was pure business.

And then the psychiatrist, on his way out the door, said the following. And I quote practically verbatim.

"Your family has a much lower risk tolerance in this situation than I do. And they should, they're your family."

When my dad asked what he meant, the man continued.

"I've discharged plenty of quasi-suicidal people. It's a risk I'm willing to live with. Your family is not willing to live with this level of risk."

None of us recovered from our shock fast enough to ask if the hospital did any follow up, or had stats on how many of those "quasi-suicidal" people went on to actually commit suicide after being discharged.

And then the case worker called Betty last week and said that at the point of our next meeting, my dad will have been in the psych ward four weeks. She said "You said you wanted him in here four weeks in the last meeting." (Truthfully, we were guessing at a number.)

"So," she continued, "you've gotten what you wanted."

Right, you absolutely worthless bitch. We got what we wanted. We have a patient advocate who has done nothing for us, a psychiatrist who comes across as cavalier about my dad's life. And oh, yeah, my dad, who still, after weeks of care, might or might not want to live, depending on the day.

And nobody to fucking trust about where he is or should be.

Yeah. We have exactly what we want. Don't you think?


  1. I am so sorry to hear that things are going this way. As always, I'm thinking of you, and am here if you need an ear/shoulder.


  2. Oh, for fuck's sake.

    Sounds like the doctor's quote would be great in court if it gets to that, though.

  3. Um. Er. Holy crap.

    Someone needs to explain to me what the precise definition of "quasi-suicidal" is. I've always looked at that as an either-or kind of thing. But then, I'm no doctor. Of course, this guy doesn't sound like much of one, either. Do you suppose that "douchebaggery" is a legally-defensible term?

    So sorry about this. Good thoughts and vibes coming your way.

  4. Dagny - Thank you thank you. You are always so supportive. I hope to stop needing it soon.

    LMNt - Yeah, I know. My brother asked if we could quote him on that and he said yes.

    WiB - A good friend whose parents are doctors pointed out that there is a level of risk doctors have to go with. And that nobody, unfortunately, can guarantee us he'll be OK. It sucks, but it makes sense to me, too. I hate it I hate it I hate it.

  5. Sorry the doctor(s) is(are) being such an ass. Kind of makes you wonder what the guy wrote on his medical school application essay (the one where they're supposed to feign in order to gain acceptance) Maybe you should ask him during his next eval. Better yet, if your dad's case ever gets to be part of rounds, ask him in front of the interns, quoting what he'd said previously.

  6. Snappy comeback I wish I was there with:

    "You, doctor, have a much lower risk tolerance for medical negligence and malpractice suits than we do. And you should; you're the doctor in charge of Michael's care. Abandon that care, and the risk will become reality."

    Keep up the pressure. That money street runs both ways: make them see how expensive it will be if they release him prematurely.

    Primum non nocere, not primum illae premiums, Goddamn them.

  7. Anon - We have a meeting tomorrow. I'm going to bring it up then.

    G - We didn't threaten litigation outright, but we had a lot of lawyers involved in the crafting of the last letter, and it was very clear what we would be willing to do if necessary. We have a LOT of questions for them for tomorrow.


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