I was trying to keep my mother alive when she didn’t want to be. Was I her greatest advocate or worst traitor? I still don’t know.
My Mom has tried to kill herself four times – five if you count that time she pulled staples out of pamphlets at the psych unit and took them to her wrists, though I think that was just to prove a point. Three times by swallowing bottles of prescription drugs, once by the drop of a running blowdryer in the bathtub. All four times she’s failed, been dragged out of her slow plummet by someone else, and woken up angry to be alive. I don’t know if she’ll ever stop trying, or if I’ll ever stop dragging her. It’s hard to keep her safe when the hole she keeps falling into is herself.
On the interior walls of the Payne Whitney Hospital, there are signs that describe the early history of psychiatric services in New York state. One sign reads, “Asylum: A place of refuge in which one may feel safe from imminent harm.”
When my Mom was a patient there this summer, she was assaulted and sedated by nurses after the stapler incident. She was coming down from a week-long drug binge and was in a heightened state of mania. The staff say they have only one way of reacting to suicide threats: “We have to take them seriously.” She called me afterwards in a fit of rage and humiliation, begging me to get her out of there, screaming that she just wanted to die.
Admittedly, it was both of our faults that she was there. My phone had rung in the middle of the night a few days before and I listened to her tell me again and again that she was not OK. She sounded worse than I’d ever heard her before, almost unrecognizable. I’ll come get you in the morning, I promised. “Just hang on. It’s gonna be OK.” I lied.
I spent the earlier hours of the next morning desperately calling friends and asking for help, trying to find solid recommendations for emergency mental health care from those who had experienced it firsthand. Almost everything came up empty.
Either friends or friends-of-friends told me horrific narratives of their mistreatment in various New York City psych wards, or gave recommendations for programs that ultimately lead nowhere. I call hotlines that ring endlessly with no answer. I call hospitals that say they have no space in their psychiatric inpatient programs; hospitals that have inpatient availability but no emergency care; hospitals that cannot tell me whether they accept her insurance or not; they will “have to get back to me” but never do. Those who navigate bureaucratic institutions know that it is a special kind of hell. Lines, waiting rooms, the sound of shitty hold-line jazz, being hung up on, being turned away, telling and retelling with as much patience and calmness as you can muster the story of your current emergency. You use their terms and diagnoses to be taken seriously. You choose the least of institutional evils, because you know that waiting any more is not an option.
I arrive at her place with a plan and she emerges from the doorway. I haven’t slept in a week, she tells me. I decide to bring her to a hospital in Manhattan. I’d been told that their inpatient program is good; that their staff is compassionate, but that they only have 30 beds total. No one will tell me if there is availability or not, so it’s a long shot. In the emergency room, I sit in the waiting area with the distinct feeling that I am handing her over. No one talks to me. I flip through a magazine from 2011 while a nearby group of nurses makes brunch plans for the weekend.
They admit her to the emergency psych unit and trade her clothes for hospital gowns. After a few hours pass, I’m anxious and attempt to check on her, but the psych unit is highly secured. Security guards stand by the entrance looking me up and down, asking me for ID, snickering at my ignorance of how things work here. By the time I am let in, she is fast asleep on the hospital bed. She looks so small, curled up with her knees to her chest. I sit with her under the fluorescent lights that never turn off until they tell me to leave.
The first time she was hospitalized I was 19. She had OD’ed on sleeping pills and my uncle, sensing something was wrong when she called and slurred her words, called 9-1-1. She had her 53rd birthday in the psych unit, so I brought balloons and cupcakes. I stood at the front desk of her unit after passing through three levels of security. The attendant untied each balloon string after searching my bag, looking at me with pity in her eyes. “Hanging hazard,” she said. She handed me back my bag, minus my pens and keys, and then passed me each balloon one by one until I had my arms full. I stuck an unlit candle in one of the cupcakes and forced a smile. It’s not so bad, I told her, and it wasn’t. Mom and I sat listening to the TV run in the background, sharing a tray of meatloaf for dinner.
This time, I visit her each of the three days that she is held at the emergency psych unit in Manhattan. I keep asking if a bed at inpatient has opened up, but no one gives me any answers. I give my phone number to the nurses and ask them to please call if anything changes. On Monday morning, I call the hospital on the way to work, and a voice on the other end tells me that no current patient with that name exists. My heart drops through my ass and I am washed over with panic. “What do you mean?” I ask, “SHE WAS JUST THERE.” Turns out they had transferred her to another facility outside of the city, overnight, without informing anyone.
I’m ashamed of it, but my advice to her on the phone after the assault was to cooperate. I was so scared of her disappearing in the system. The Mental Hygiene Laws of New York State provide certain protections for voluntary patients, a status she held because no one had forced her into admission. One of these protections is control of what medications one takes – as a voluntary patient she could say “no meds tonight please” and nurses would have to honor that. But when a voluntary patient threatens to harm themselves or another patient, this autonomy is legally, immediately waived. It was this idea that scared me: the minute her status changed, she would lose any remaining power over her own body and mobility. They could hold her there indefinitely, transfer her endlessly, and put her on a cocktail of benzos that could keep her in a state of oblivion for decades. Her threats of suicide qualified an exemption, so they sedated her with force. They pulled her clothes off her body and held her down, stabbing a needle full of tranquilizers into her right ass cheek.
She requested to be discharged. In response to her request, the hospital staff had three days to make a decision – they can either grant the discharge, or take her to court and apply for involuntary retention. At court, a judge would listen to testimonies from her and her doctors, and make a decision. If she lost, her status would be changed to involuntary, and she would concede whatever bodily autonomy she had left. The likelihood of them believing a “mad woman” with substance use issues over the authoritative position of the institution is slim.
I beg her to retract the request. She’s paranoid and thinks I have turned on her, asks me why I’m trying to “send her away.” I don’t know how to tell her that I can’t keep her alive by myself anymore. “I’m doing the best I can,” I tell her. “You selfish little bitch. You dumped me here. YOU DUMPED ME HERE!” she screams into the phone before hanging up. I drag myself into the shower, turn the water up to the highest heat, and sob. I don’t stop until I can’t distinguish my tears from the running water. I think of how she used to wrap me in a towel and sing lullabies after baths as a child. I miss my Mother.
Some days go by. I go to visit her in the hospital. A nurse dumps out the bag of things I brought for her and returns it half empty with the approved items. In the pile of rejected items, there’s a hairbrush, a robe, and a notebook she’d asked for. She approved a sweater, a soft hair brush I’d brought as backup, sweatpants without the drawstring, and a small bag of makeup. I put my belongings in a locker and am let into the residences. My Mom and I sit together for a while, she seems to be doing better. She tells me that art therapy sessions have been helping her and that she feels more grounded. There are post-it notes covering the back wall of her cell-like room; a bunch of ink cartridges that patients are given as pens lie scattered on the nightstand. Her notes are scribbled, illegible artifacts of her mania. I’m happy that only she understands them – some small refuge in this place of no privacy. I go from the bed to the window and lift the blinds to let some light in, sighing at the sight of parallel bars. We sit there watching the TV, encased in thick plexiglass, and I trace the lines of some previous patient’s engraving on the bedframe: “GET ME OUT OF THIS HELL,” it says. I smile thinking about the sign in the hallway. “A place of refuge in which one may feel safe from imminent harm.” Right.
Before I leave, my Mom sheepishly slips me her shit-stained underwear and jeans – the ones they tore off her during the assault – to take home and wash. “I’m so sorry,” she whispers. She looks like my mother for a second. “Its nothing. I got it, Mom.”
My life is tied to hers in so many ways that I have been forced to abandon all my desires for independence. Other young people in my life, especially in New York, are always grappling with questions of self-sufficiency. We grew up in neoliberalism’s heydey – often all we know is a society premised on personal responsibility, privacy, myths of individual success, meritocracy, and blame. But the multitude of my relations to her becomes a backbone for my belief in fundamental interdependence. She made my life, I save hers. When institutions fall short of sustaining us, as they always do, we need strong relationships to keep each other alive.
A few months have gone by since she was released from the hospital. I’ve been watching a lot of TV and eating much more than I’m hungry for. A few nights ago, after staying up particularly late, I had a nightmare. We were in the house I grew up in, sleeping, when doctors came upstairs, sedate her, and cut off all of her hair. She moaned but was secretly enjoying it when they held her down, watching the pieces scatter to her shoulders and the floor in a daze. She hadn’t been touched in a way that wasn’t violent in months, she whispered to me.
After they leave, she comes to and tells me we have to go to the basement. There she has built a Station of Forgiveness, and she starts to threaten me. She shows me that she’s buried everything and everyone I love under the concrete, and if I don’t play her Forgiveness game, she will bury me there too. I scream and we start fighting, but suddenly I see that she is armed with weapons strapped all over her body, and is pulling one out. I run to a payphone outside the house and call 9-1-1.
I start sobbing as I hold her down and pull each weapon off of her. Even in dream state, I know that if the police come and find her armed in a state of mania, they will kill her. I look at the window and see headlights turn on from the house next door. Were they always there, waiting? Didn’t they hear us screaming? The police arrive without EMTs. They are human in appearance but embody the physical behavior of pigs. They snort around the house, stomping heavily, disregarding me and my pleas for them to help her, looking for something to incriminate us. She lies on the cold basement floor shivering, defenseless, until they load her into a van and drive away.
I wake up sweating. I wake my partner up and tell her I had a nightmare. It was just a dream, she tells me. But I can’t help feeling like it was altogether too real. I am her greatest advocate and her worst traitor. I watch them take pieces of her, I witness the violence against her, I keep delivering her to their door. I want her to survive, but sometimes it feels like I’m just killing her slowly instead.