Intermountain Health

Jacks

Two years ago today, I came out of my medication-induced blackout at the inpatient psychiatric unit and began working on an elaborate origami project that involved making the Sydney Opera House with a theater and stage inside it. I used paper placemats and pages from a colorful book for this purpose. I was given a copy of the Book of Mormon by the staff, but I didn’t use its pages in my project. It sat in my room idle as I worked.

I wrote and performed rap songs with another patient named H— to the delight of other manic patients on the unit. Those with severe depression were not moved by our artistry. We were good at the rapping, and our antics provided a counterpoint to the aimlessness, the hall-wandering, and the five-minute interfaces with the psychiatrist each day in which he blamed us for having depression or bipolar.

I used a deck of cards to map out human networks that are responsible for abusing and trafficking others. The kings and jacks were big players in those networks, and they were also stand-ins for my father and his best friend. The networks were very organized and knew how to hide other cards, and themselves, as needed. My father’s name was Jack. He was a jack of all trades, even ones that weren’t legal.

I wrote short poems and made notes about my stay using a tiny pen that only sporadically worked. Pencils, Intermountain. Give patients on B-Ward pencils.

In my chart, the staff noted that I was well-behaved and posed no threat to anyone. I did throw paper at one point, down a long hall, overcome suddenly by how dehumanizing psychiatric care is. Nobody noted that in my chart, but one tech did scream, If you do that again … without completing the threat.

I declare today, September 10, the Day of Origami and Rapping forevermore. Long live folded paper and battled song.

Black Box

I had an exciting thought about a poem at the tail end of a dream, and now I can’t go back to sleep. The fact that poems thrill me after three decades says a lot about poems. Perhaps it’s not just the Earth and sky that last forever, as the band Kansas asserts. It’s also the verse, the line.

I will never remember what happened to me two years ago today because I was overmedicated in the emergency room at Intermountain Health after being turned away when I went to the mental-health access center there for help the day before, but not before the access center kept me in a loud, brightly lit room for 24 hours with no bed, where I was left alone with two male nurses. What a terrifying thing for someone with a history of abuse at the hands of men to endure while in a state of trauma about her childhood abuse. Also, sleep deprivation and exposure to lights and noise, including music, day and night are more in keeping with prison torture tactics than with mental-health care, but sadly, the two are often one in the same. Shame on Intermountain for engaging in such practices.

To top it off, they failed to give me my thyroid-replacement medicine for hours, thereby exacerbating the state I was in by disrupting my endocrine system, which in turn negatively affected my HPA axis. That axis is key to emotional regulation. I don’t have a thyroid thanks to thyrotoxicosis and cancer, so my thyroid-replacement medication is critical. My TSH was already 11mIU/L when I got to the access center. It should have been less than 1mIU/L. The access center made my hypothyroid state even worse by not administering my medicine in a timely fashion.

The ER overmedicated me after I said Joseph Smith was delusional. What I actually said was, Sure. It’s fine when Joseph Smith does it, but not me. I wasn’t being hyperreligious. I was deconstructing religion, in that moment Mormonism, as well as the unwritten social rules that appear to govern when someone is seen as insane, divine, or both. Crazywise, as some call the latter. But not, largely, Southern Utahns, and certainly not ER workers at Intermountain.

That’s the last thing I remember. I blacked out for more than a day, this one: September 9, 2023. It’s a dark, rough-hewn box I can’t open, but I think Sharon Olds’ devil from her collection Satan Says might be inside it. By that, I mean my father.

Folding

This is the two-year anniversary of my stay at the local inpatient psychiatric hospital where the psychiatrist described me as being involved in sex trafficking, as if I was trafficking others as an adult as opposed to having been trafficked as a child. The psychiatrist also said my trauma had nothing to do with my mania, told me in so many words to be a better wife when I expressed my concerns to him about my husband’s behavior, refused to help me get services from the local organization that helps people who’ve survived sexual abuse, and wrote in my chart that I had a poor prognosis because I have no insight into having bipolar.

And he was supposed to be one of the better psychiatrists at that hospital.

This is also the day I briefly saw Utah poet laureate Lisa Bickmore and thought she was some kind of healing Earth goddess, which I still think is the case. When I’m manic, I see essences. Lisa is a lot more than a healing Earth goddess, but she also has the essence of a healing Earth goddess.

These are the final days of my hegira, the one I declared over before it was over. Over the next few days, I’ll be sitting with everything that happened two years ago in a process that’s like folding now and then together the way two ingredients are combined in baking. Not that I bake. I prefer folding time to folding things like whipped eggs and melted chocolate. When I need to eat something, I just eat it. I rarely mix it with something else.

Weaponing Healthcare

Today, my primary care doctor opened my appointment by telling me that he believes I’m a hypochondriac. I’ve survived and/or live with multiple illnesses, including cancer. I live with more than one rare disease, including common variable immunodeficiency, which is serious and life-threatening. I have autoimmune diseases, renal insufficiency, postural orthostatic tachycardia, and arrhythmias. I’ve been treated for atrial fibrillation. I have aortic root and ascending aortic dilations. And I have PTSD and serious, life-threatening, bipolar.

All of this is documented in my medical record at Intermountain, where my primary care doctor works. It’s not in my head. It’s not me imagining health issues that don’t exist. They exist, and I’m attempting to address them. I worked as a medical writer and editor at some of the best institutions in the country for years. When I get a diagnosis or face a health challenge, I do research and have the determination to address the situation however I can.

Today, I was asking about my fasting blood glucose being over 100 for the past two years. That’s diagnostic for prediabetes, but none of my doctors brought the high results to my attention. High blood sugar seems like something I should be able to discuss without being called a hypochondriac. It’s especially important given that my chances of developing diabetes are 3 to 4 times higher because I have bipolar disorder.

I was also at the appointment to discuss my BUN level and (BUN/creatinine ratio). My BUN has doubled in the past 5 months and is above the normal range. Perhaps that’s not an issue, but given my history of renal insufficiency and the fact that lithium, which I started taking at a higher dose 5 months ago, causes kidney disease in about 26 percent of patients, the higher BUN level seems like a valid issue to raise.

Healthcare systems don’t seem to welcome the type of patient I am—one who’s female, has chronic health issues, and has a mental health diagnosis. We wait years or decades before our issues are taken seriously and addressed. By that time, we often have medical trauma because of how the healthcare system has treated us or our conditions have progressed, often irreversibly, because we were gaslit into thinking it must all be in our heads, a point our doctors belabor.

If I can’t approach my doctor for routine care, explanation of test results, or to discuss a health concern—the very things primary care providers are supposed to do with their patients—without the entire encounter being dismissed as evidence of a mental health problem, then why am I even trying so hard.

This isn’t the first time this has happened here in Southern Utah. Another doctor at Intermountain denied the fact that I had atrial fibrillation despite a preponderance of evidence that I had the condition. I was denied the medication I needed because of his insistence that I didn’t have afib. Yet another doctor at Intermountain tried to tell me my diagnosis of common variable immunodeficiency was unfounded despite the fact that I have extensive documentation of that disease from accomplished immunologists who know how to diagnose and treat immune system dysregulation.

I’m tired. I’m tired of this treatment. I’m tired of this sexism, this ableism, this dehumanization. I’m just tired. These attitudes and behaviors on the part of doctors cause unnecessary and severe iatrogenic illness for those of us who are subjected to them. I can’t carry that burden on top of my actual health and mental health issues. I’m tired.