I believe that everyone deserves a chance – simply for being human and imperfect. As a psychiatric nurse practitioner I see the depths of struggle that people can become mired in. I see the folks who have no insurance, no job, and little chance of “pulling themselves up by their bootstraps.” They have usually been through multiple providers before they sit in my chair, in my office. They tell me of endless nights spent in tears, afraid of their own shadows – even those imagined. They tell me of the months they are forced to wait to get an appointment at the local community mental health clinic-those clinics that were established under the Kennedy administration to help depopulate our state hospitals. They tell me of the hurried 10 minute visits that result in medication after medication being piled upon them – all without time enough to really talk, and tell the prescriber what is really going on in their heads, and souls. Who do they turn to? Who do they rush toward in this technological age of enlightened healthcare?
I recently was asked, by a colleague, to see a 24 year old woman who had been growing increasingly bizarre. She lived with her parents, and had been fairly gainfully employed until she began having volatile arguments with herself in the parking lot of her local Wal-Mart; until she began arguing with customers in the check-out lane about unusual ideas laced with paranoia and suspicion. Her parents had been excessively troubled by her sleeplessness – up all night, talking to and arguing with herself, in the absence of anyone else. Could I see her? They had no insurance as her Father drove a school bus for the local school district, and her Mother was disabled from a stroke at a young age. They had received the run around from the local community mental health center – insurance, informed consent (which she was unwilling to give – she didn’t have a problem after all), privacy/confidentiality, etc.
Yes, I’ll see her. Extremely bright, extremely articulate, but so impaired in the areas of relating, reality perception, and coherent thought. “Pay me what and when you can” I told the Father. Did I really say that? I have a family to feed too! Wow….what a sap.
It is important in this life, of frequent turmoil and strife, to have someone come along beside you – to encourage you – to say “ok. I may not have all the answers, but I’ll walk with you for a while, and we’ll figure out the answers together.” It’s in the shadow of each other that we all must live. A little support and reprieve never hurts. Maybe one day those dispossessed, impoverished struggling folks will be able to look at us and say “thanks – you held me up when there was no support left.” After all, at the end of our trials we must all decide if there is something left where the dark begins that we may stand on, or we must learn to fly.
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