Friday, January 26, 2007

My Planned Nervous Breakdown

Now I'm done thinking about the whole issue of who should get care, how, where, and by whom. Tired of ranting.

Okay, so I got this e-mail from ClinkShrink. She says that if I need to be psychiatrically hospitalized, The Retreat is out for me, apparently Rock Climbing is part of the package. As part of my blurred blog/real life dimensional problems, I tried wall climbing a few months back after Shiny Happy Person (of Trick-Cycling for Beginners) posted about the wonder of it. I couldn't get to the first foot-hold. I stood there, unable to lift myself, wondering why I'd want to do this anyway. My twelve-year-old daughter, who was kind enough to accompany me, scrambled to the top. Repeatedly. Clink ended her email by offering to be my roommate if I needed inpatient care. How sweet to have such a devoted friend. And if that doesn't make me feel fuzzy enough, Roy sent me Frank Zappa and Captain Beefheart performing Muffin Man. How good does life get?

So, I wasn't planning on The Retreat, at $1700/day, or any other inpatient psychiatric facility, for that matter. I realize, of course, that there are some aspects of life that one doesn't plan and that aren't under our control, but there are a limited number of things I can worry about, so I was going to leave this off the list. ClinkShrink got me thinking though: If I do ever need an intensive level of psychiatric care, what am I going to do.

I've decided to plan my own, luxury-laden, cost effective nervous breakdown:

I'd much sooner check into a nice hotel at $?400/day (+room service, with chocolate turndown service) and have daily outpatient sessions with a psychiatrist, thereby wasting resources by using a psychiatrist when a cheaper psychotherapist might do or, if I needed meds, efficiently combining my psychotherapy with med management which actually would be saving resources.

Financially, if we could keep me from shopping during this endeavor, it could be both more luxurious and much cheaper than The Retreat, figure roughly $550/day-- not bad for a feather bed, color tv, private bath, feather bed, turn down chocolates, and daily 50 minute sessions with a psychiatrist rather then a fresh-out-of-school social worker or any other mental health care professional assigned to me by a hospital unit in a setting where I wouldn't have any choice to have a shrink with a certain type of training (I want a blogging one who can identify...) or worry about things such as patient-doctor chemistry-- a doc I'd like and feel comfortable talking to.

Okay, okay, my $550/day rate doesn't count food, but:
I could probably be happy even with much cheaper Chinese delivery as opposed to expensive room service menu and many nice hotels are less than $40/day, the Ritz Carlton in Philly has (I think) a $200/night for the weekend special rate, (though the eggs benedict via room service is hefty) and for an extra fee, they'll come draw you a bubble bath with candles and champagne. We won't talk about how I know these things, but trust me, there are better places to hang out if you're looking for R & R and getting away from it all, then in a psychiatric hospital.

It might be hard to pair the hotel setting with the top-notch shrink physically, especially since I was thinking of having my breakdown at the Eastern Shore Marriott resort (good rates, beautiful rooms & setting, but no psychiatrists out there), or to find someone with 5 open hours a week waiting to be filled.

I once knew someone who called me because his wife was in the midst of a horrible, clearly in need of hospitalization, depressive episode, and I arranged for her to talk with and be admitted to Top Mood Doc's Unit in Great Hospital in Baltimore (Thanks to Fat Doctor for teaching me how to name people & places). They were even going to meet her at her car and walk her up. Ah, instead the couple hired a private duty round-the-clock nurse and took her to a private psychiatrist.

Wonder if I throw the private duty nurse into the hotel scenario, if that would still exceed the $1700/day cost?

Okay, tongue-in-cheek, of course. People in need of hospitalization for a mood disorder are not able to enjoy or benefit from eggs benedict, bubble baths, or feather beds, and my post here isn't meant to demean anyone's suffering. If, however, you're overwhelmed, stressed out, on the edge, but not actually in the midst of a major depressive episode, there are better and cheaper places to regain your composure then on a psychiatric unit, any psychiatric unit. But if I do go, I want Clink to be my roommate. Hoping that sharing a room with husband, children and Max doesn't bother her.


sophizo said...

LOOOVE IT!!!! This is an awesome post! I really don't understand why ANYONE would want to go to a psych unit to "get away from it all". That's the last place I would ever want a vacation. From the stories I've heard from people who have been inpatient....not fun! Heck...if I was ever in a position that I really needed inpatient care, I would probably lie to stay out of the hospital. My behaviors would have to be what gives away the need for hospitalization.

I vote for the beach and having sessions outside. The sound of the waves, smell of the salt, and cool breeze would calm anyone down. Ha!

ClinkShrink said...

You forgot to mention the nice hotel health club---I know how important the treadmill is going to be to you. And I don't know about the "keep you from shopping" part---I still think that may require a locked unit. I will, however, be happy to share a room with all and I'll throw in the Tai Chi lessons for free.

Dinah said...

Believe it or not-- and I may not do 9 minute miles-- but I did go to the gym when I was at the Marriott resort.

Midwife with a Knife said...

sophizo: I agree. The only thing I remember about psychiatry from medical school, really, is that psych units are not fun places to be for the patients (who admitedly are not there to have fun)

You know, I understand that a good nervous breakdown takes about two weeks (a week of nervous breaking down and a week of recovery from said nervous breakdown). Even if the shopping upped the bill to the $1700/day range, a 2 week breakdown is still cheaper than the 20 day evaluation period at the retreat.

Fat Doctor said...

I wholeheartedly recommend the Ritz Carlton at Lake Las Vegas, where I was for a recent conference. The place is amaaaaaazing. They have a spa that offers all sorts of happy treatments. The fire pit in the common yard area is uber-restful at night and beautiful men will bring drinks to the fire until you say enough!

You can get some great plane fares to LV, and the hotel rates ain't bad during the off season.

Oh, hell, now I wanna go back there!

alwaysthegoodgirl said...

I have a question that has nothing to do with this post, but it is about psychiatry. Are there any books, fiction or non-fiction, that any of the 3 of you would recommend? I really think I want to be a psychiatrist, and I was just wondering what you'd suggest to give me some insight into the profession.

Dinah said...

Let's see, there's this great (I may be biased here) novel out there called Monday at The Charm about a community mental health center.....see our sidebar.

Best realistic TV depiction of a shrink goes to Dr. Melfi of The Sopranos, I've told residents to watch this...

Interesting, but old, book on psychoanalysis by Janet Malcolm called Psychoanalysis The Impossible Profession, but very few psychiatrists become psychoanalysts; there are still psychoanalytic institutes, but it's a long, expensive path to a career with little demand (except maybe still in New York City :)

There's a How-To Guide on psychotherapy by Susan Bender called Becoming A Therapist (I may have slaughtered both her name and the book's).

There are shrinks every where in the movies, see my post on Shrinks on the Screen (not sure when, you can search it in the blogger search box), but mostly they are used as a tool to gain insight into a character's motives, rather than as a realistic portrayal.

The scope of psychiatry...maybe my next post?

ClinkShrink said...

This probably would have been a good topic for one of our three-part blog posts. Boy, are we going to have some different choices. My favorite/most recommended (not necessarily for psychiatry as a career, but for practice of psychiatry):

1. Kaplan & Sadock Textbook of Psychiatry
A classic reference.

2. Lishman's Organic Psychiatry
Neuroanatomy was my favorite class, and this book helped make the jump between brain disorder and clinical syndromes.

3. Frank's Persuasion and Healing
I wish I had read this as an intern. Wonderful description of the essence of a therapeutic relationship, regardless of your particular psychotherapeutic slant.

4. Andreason's The Broken Brain
I read this as a medical student and it's still a good overview of the history of psychiatry.

5. Gould's The Mismeasurement of Man
Social policies come and go, but science will always be twisted to support the latest theory. Stephen Jay Gould shows how this has happened in the past.

There should also be a good psychopharmacology reference on this list, but I can't think of any that are particularly distinguished or definitive. I may leave that up to Roy.

Mother Jones RN said...

Wow, I want to contact their nurse recruiter. I need a new job.


Mother Jones RN said...

Oh yes, and by the way, if you ever need a private duty nurse, let me know:-)


Steve & Barb said...

Here's a good one... Of Two Minds. An anthropologist follows around Hopkins psychiatry residents and discusses the split between mind and body (Descarte's dualism) that continues to plague, if not define, the medical subspecialty called Psychiatry (that's my bit of editorializing).

Dinah said...

Never heard of that book, but I just ordered it.

Patient Anonymous said...

I find that over my course of hospitalizations things really changed. Early on, they were great.

I actually once, just waltzed right in and said "Take me, my meds aren't working," or something to that effect and it was the most relaxing week I had experienced in a long time. It really was like a vacation! I know, sounds a little odd and maybe I just happened to luck out but I did catch myself before things got out of control and I "did something stupid."

Actually, I kind of had to "fight" my way in because I didn't appear to be in bad shape but once I started to make a fuss and started to look like I might "do something"...I guess that got their attention.

I've got to get around to posting about hospitalization...


I'm not a professional of any kind, but for enlightening reads I second Gould's The Mismeasure of Man. One doesn't need to be a psychiatrist to benefit from it. It's brilliantly written, and it changed my whole perspective on science and intelligence. And while we're on the subject, Koestler's Ghost in the Machine also contains some pretty neat ideas about human behaviour.

I know, nobody asked me. :D

DrivingMissMolly said...

How about Viktor Frankl's Man's Search for Meaning? It's the tale of a psychiatrist in the concentration camps and his observations on fellow man.

Important for me was his views on the "existential void."


Anonymous said...

EEK, I love you and eggs benedict. I don't think you are ranting. Tell clink I love her too. abf