Psych Clinical

I realize I haven't said much about my psych rotation. Last night I talked to my friend and I realized that this is because I don't have the language for what is happening on the unit at this facility. In my "Psych Clinical Orientation" post (just look down a few posts) I talked about how glad I was that the unit is a voluntary research unit. I am still glad to be on the unit because 1)I think it's better than the alternative, which would be inpatient involuntary, which isn't really my speed, and 2)Because I think I needed to see what I'm seeing...even though I don't quite know why.

What I am seeing is a disproportionate number of black people involved in clinical trials for drugs that both have and have not been tested before, including pharmaceutical-grade cocaine (which is a drug that "has" been tested, vs drugs that are not yet FDA approved), and patients in experimental treatments that involve brain manipulation and a form of electric shock therapy. YES, there is "informed consent" on the unit - meaning the patients signed that they agree to participate. But repeatedly I am hearing from patients that they really didn't understand what they were signing (and the staff/researchers on the unit consider this to be a delusional moment related to their illness, ie: they understood, but they just don't remember that they understood!) Now, I am questioning exactly what informed consent really means...especially when someone is going through withdrawal or has an 8th grade level of education...according to Wikipedia, "The individual needs to be in possession of all of his faculties, such as not being mentally retarded or mentally ill and without an impairment of judgment at the time of consenting. Such impairments might include illness, intoxication, drunkenness, using drugs, insufficient sleep, and other health problems." A lot of what I see is troubling...

My friend asked me something about processing it all or coping or something (I don't remember what the exact question was) but now I'm thinking about it...

I know what I feel and why I feel it, but I have yet been able to articulate it, meaning I don't have the academic language for the problem that I am seeing. I have put up my reading list for 2007 and includes the book "Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present." I think this book will help give me the language and a way to process this BS in a way that allows me to recover mentally and spiritually from what I am witnessing, especially in the absence of some much needed ongoing conversation about it.

In the mean time, when talking to my husband about my theory of not having the academic language to express my psych experience, he, with his knack for bringing me back to reality, asked me "why do you have to explain it in academic language, what's wrong with regular ol' language?!" I laughed so hard! But it's true. What's wrong the way I've been explaining it to him? Or the way I (half) explained to it to my friend? Really there's nothing wrong with it...and if I could get away with it - using an unimaginable number expletives (as I do with him) and my animated way of talking fast in half sentences, all breathless and sometimes hopeless (as I do with my friends)- the truth is, I would. But that just doesn't cut it in the classroom. After all, their is that pesky double consciousness to deal with; I rarely speak in class unless I have completely formulated the thought and have the appropriate (ie, acceptable) language to present my comment. Fair? NO. Necessary? ABSOLUTELY.

So, I am going to dive into "Medical Apartheid" slowly, and I hope that the history presented is accurate and that the language of the author gives me a way to voice what I'm feeling and recover from the trauma caused to my psyche from this rotation.

Papaya Uteri, Race & Media Invasion

A great workshop was ruined by the media. It started very slowly, as people introduced themselves (mostly medicine and nursing - all grad level) the occasional undergrad would introduce him or herself and they would be journalism or political science majors. At first we were glad to have the diversity; I think these folks belong at the abortion discussion table. But then their questions and incessant scribbling started the buzz, and when we began to actually do the hands-on portion of the workshop, the cameras came flying out - including video cameras! I did get to practice once, but this pretty much ended the workshop for me. I can't stand to have strangers taking my picture without my permission, and I definitely do not consent to being videotaped by someone with their own video camera.


And, I've reached my limit with the university, in general, trying to sneak pictures of me and my friends for their diversity campaigns! Did I mention this in another post? I can't remember, but at any rate it's happened quite a few times. I really do leave as soon as people bring the cameras out - especially as the number of instances that make me feel like I'm an impostor on this campus increase...Did I mention the case of mistaken identity that happened a few weeks ago? Well, while at the nursing school - in my school sweatshirt - with my school ID hanging around my neck - with my bookbag on my back - leaving the computer lab...I was somehow mistaken for a member of the cleaning crew. Yep, for real. There was some internal struggle as I wanted to correct this person without giving the impression that I don't respect the cleaning crew or other "blue collar" workers, especially since on some days it is their faces, their smiles and laughter, and their speaking to me that makes my day. But at the same time I want people to have to face their issue about me being here to study just like Suzy...

And yet another incident just yesterday: I went to one of many libraries on campus that has like a million very important, one of a kind texts that are under heavy security and for the use of students and faculty only. I walked into this library (for the first time) and asked about the current exhibit (which is open to the public) and also about seeing, touching, admiring the first edition Morrison's The Bluest Eye. This man looked me in my face and said that although I could walk around and look at the exhibit, it would be "impossible" for me to see the text or enter the research basement because that area was for "scholars only." I said to myself, "THAT is what it felt like to hear "Whites Only." I was taken aback, yet again. (It surprises me when I am surprised because one would think I'd get used to it) I said to him "Oh, and I am not a scholar?" He backtracked quickly of course, but "And aren't I a woman?" replayed in my head a million times.

When is it going to end? Or when will I be blind, mute, and deaf to it? Curse you - thou who held my hand and walked me into knowing awakefulness...Geesh, I didn't ask for it! By the way, how do I turn it off? LOL

No Providers, No Choice

I saw a bumper sticker Wednesday that said "No Provider, No Choice." It came right on the heels of a conversation with my good friend N where I said I find conflict with being pro-choice and not willing to be a practitioner who provides abortions. I do not mean that I think every practitioner who is pro choice should have to perform abortions, but that I, personally, find it hard to claim that I am pro choice if I am not willing to be the one to provide/perform the abortion. We also talked about whether I would perform an abortion all the way through the law's determination of how far along a woman can be and still have access, or if I would have my own moral "number line" that I would not be willing to cross. It turns out that I also have a problem with determining what the number should be...meaning that if 16 weeks is what is determined to be the latest an abortion is available, that would probably be my cut off as well. Then we talked about safety of providers and about being stuck doing abortions forever once you start because there will be so few providers.

I will be going to a workshop next week to learn how to perform a Manual Vacuum Aspiration (MVA) The workshop will provide a hands-on learning opportunity using papayas as the uterine model.

Here is a link to statistics about abortion providers in the US.

I also recently watched the movie "The Cider House Rules" which deals with this issue, and it was great! This is an older movie that a lot of people have already seen, but I had somehow missed it.

I never really thought about whether or not I would be an abortion provider because it's not something that CNMs typically do. In most states, 44 to be exact, only physicians can provide abortions. However, if I end up in one of the 6 states where midwives are the providers, or as the law expands or changes, I will be a provider, and I know that scares some people. For a quick history of the role of CNMs in abortion, click here.

New Applicants

New applicants to the nursing program started interviewing yesterday. Wednesday night me, M, and U, took the student M was hosting out to happy hour and gave her the low down because she had to leave the next day right after her interview and so she wasn't going to be able to go to a potluck. Then, Thursday (after my 7:30am - 4 pm clinical) I participated in the diversity session for applicants from 4-5:15 (which only had only one racial minority at it!) and then went to the potluck for new applicants at 5:30 and talked till 8. My voice hurt, my feet hurt, and I was exhausted. But I really do believe that people should know the truth about whatever program they apply to. This school is not a good fit for everybody and, just like every other institution, there are things that they claim they do, that they don't - and those are the things I want people to be aware of.

The diversity session was irritating at first because staff and faculty were present and wanted to (of course) present the school as a diverse and welcoming institution. I have no problem with this, but I do believe that the numbers should be mentioned! And I think "diversity" should be explained further, as in..."we're referring to diversity of sexual orientation rather than race." And think you can say, "our racial diversity this past year was X%, and although that's not necessarily a high percentage, it's more than last year's Y%" Those are the kinds of things I would say if I were from the diversity committee! But anyway, after they left, we had a real conversation about what the school really offers/doesn't offer and how it does or does not affect students. Basically, there is a committee, and so far I have known of one event they hosted (and it was a good event) but not much else. We also talked about the lack of conversation about diversity in the classroom and it's absence from the first-year curriculum all together. I think the student's got much more out of it after the faculty and staff left, and I think it was even more helpful because the three different students had very different experiences at the school.

I made a point of hugging and talking to the 2 black women applicants at the potluck. I don't think it was something many people noticed (I simply hugged them and said "special welcome, nice to see you" in their ear while I did it) and they were grateful. There were two other current students who are black women there, but one did not speak and the other did, but passes so it was lost on them. The first one said "I'm glad you came over" and the other said "it's nice to be seen." One of my friends who did see it all questioned me about it. At the time I just said "because" and smiled. I didn't feel like explaining. But now I do:

I don't think people get how isolated one can feel, even in a room full of people. You're standing there with your gold and tattoos, in urban hip hop wear, with a body frame that takes up a different kind of space than anyone else (woman number 1) or you have a great big afro with hoop earrings and are openly lesbian (woman 2) and you're nervous as hell. You gotta get over so many extra anxieties before the interview even starts! No matter how confident you were before you got off the plane and arrived at the school for your interview, when you step into the room this sea of whiteness blinds you until you see at least one person who looks like you, and when you find her you only hope she's as happy to see you as you are to see her! I recognized it in our new applicants, and I was proud to see that they found each other.

I'm so happy that I decided to go, despite my exhaustion.

Post -It Note

Today is one of those days where I actually finished every single thing on my Post-It Note, and it feels so good. When I looked at the list, I realized that it is also a good mini-glimpse of an ordinary off-day of a nursing student:

Study Lecture 3 of Psych, before 10 am!
Study Pharm Anti-Infectives, before lunch!
Turn in work forms to Human Resources
Get final Hep B shot and take release form back to school
Reply to the dean's email
RSVP for tomorrow's potluck with new applicants
Fax forms to social services office
Mail letter to my mother

Now I'm work.

Psych Clinical Orientation

I oriented to my new Psych clinical rotation on Friday. I wondered why my clinical group only had 3 people in it, including myself. (That's less than half the normal size of a group) Turns out my placement is on a very small unit - only about 8 patients - inpatient, locked unit. The patients have severe OCD, Schizophrenia, and substance addictions. The best thing about our unit is that it's a research unit, which means that the patients are inpatient voluntarily and that they get paid to participate. The worst is that facility is state funded, which we all know means that they're broke. The facilty has inpatient, outpatient, and walk-up services.

I was the first one there for the orientation and had to sit in the lobby by myself for 30 minutes because everyone else was late. It was...interesting. Many, many black folks, and consequently many, many young men trying to "get to know me." I met two black men who rapped out loud to themselves the whole time. They weren't paying any attention to me, but I was listening to them. I have always been fascinated by what I presume to be a very thin line between psychosis and sanity. Everything they said made sense, and that was my worse fear for this rotation. What does it mean if psychotic people make perfectly good sense to me? There was a lot of conspiracy theory in their rhymes, but I believe in a few so-called conspiracy theories myself. I'm not saying that I can't recognize the difference between me, a non-psychotic person, and them. However, I think we have gravely underestimated the psychological trauma related to racism in this country and so I can't help but wonder how many of these people used to be just fine (or borderline, like we all are) and then they just snapped under the reality of this life?

Our professor gave an example of an African American married man who had to work two full time jobs to make ends meet for his family; one day he woke up and decided that he just couldn't do it anymore and he went into a severely depressive & suicidal state and had to be instituionalized. I must say I CAN imagine. The goal is to get the person to remove their stressor, to put things into perspective, to change. How do you tell someone not to work as much? Are you going to supplement his income? How does a person without very many marketable skills find a job that pays so well that he will be able to work one job? If he could find it, wouldn't he already have it? Who chooses to work two full time jobs for their entire life? The point is, what if the event that leads to psychosis is just life. What if you are being crushed under the weight of a circumstance that isn't going to change?

There were many other examples, and a good friend of mine asked about the intersection of race and mental health. (We're getting much better at taking turns!) The professor referred anyone who was interested to the works of another person. Now, I am all for providing students with the resources that allow them to investigate something for themselves, but why is it that the impact of race on the psyche is not also a topic that up for discussion in the classroom? If we aren't going to discuss it, then what is the relevance of including the race of the person in the case study examples? And I find it wholly inappropriate to spout statistics that help to set up the minority/unhealthy vs. non-minority/healthy/normal dichotomy without dicussing race at all.

I realize I'm ranting at 2 am Eastern and no one's listening. But the other day I realized that I pay over $1,000 PER WEEK to this place! I refuse to pay AND be invisible. We are reading a novel for this course in order to write a paper on mental health. We write all about the character's mental disease, so it's stuff like The Bell Jar (Plath)(deals with depression) and She's Come Undone (Lamb)(deals with Obesity, PTSD, and depression). I submitted a proposal to read a novel by a black woman because I have reached the point where I refuse to pay and not get what I want. I learned this from my colleagues. These people are vicious climbers, demanders of what they came for - and the only way to not fall victim to getting what's left over because they didn't want it, is to be right there fighting for what you want. It's the game in every sense of the word. I chose 72 Hour Hold by Bebe Moore Campbell (Bipolar mania). What does this have to do with the whole "grad school is a game" theory? It occured to me that the only reason they get what they want is because they have the audacity to demand it.

New Job

Um yeah, ok. I said a friend had a great post up about midwives and fear, and then didn't give you the link! Well it is from Bellytales: Student Midwife, and you can see it here. She really is an excellent writer.

In other news, I got the library job, and I start Tuesday. My main requirement when searching for a job was that I be able to do my homework while at work. The library is perfect for that.

I have a Psych clinical site orientation today, then a trip to human resources to fill out some paperwork, then Student Health for my last Hep B shot, and finally to the library to study for my Pharm exam this upcoming Tuesday. I'm not ready for Pharm, it's been 4 weeks since I looked at a page of Pharm notes. I have a lot of memorizing to do.

Apparently school is in full swing.

Semester 2, Spring 2007

Man I didn't want to come back. My body still isn't used to getting up at 6:15. My mind is still racing at 2 am as I lay in bed trying to fall asleep.

MedSurg ended as you all know, and it has been replaced by Psych on the calender. I have class on Mondays and Tuesdays from 8am to 3pm, and clinical rotations for 8 hours on Thursdays and Fridays.

8 friggin AM: PHARM
10 (Mondays only) BIOMED
(Tuesdays only) PATHOPHYSIOLOGY
1 PM: PSYCH

I have a job interview tomorrow to work at a university library for a few hours a week. Work study at the school isn't very good because it's only 4 hours a week and those 4 hours are so hard to schedule with faculty that it's frustrating. I'm looking for a straight forward schedule of 10-15 hours a week. I don't want to work because I don't think it will be good for me in this program, but what other option do I have? I need money and I need it now. <>

A friend has an interesting post up about the fear of the practitioner (specifically midwives) that is really excellent, check it out.

On a positive note, I read an entire collection of Aaron McGruder's The Boondocks last week, and revisted it this week, and it was PHENOMENAL. I laughed so hard my stomach hurt! And then I watched a Katt Williams stand up special from HBO and again, laughed so hard I cried. His Michael Jackson commentary was on point and brutally honest and funny! Evenif you don't usually like our self-degrading style of black comedy (sometimes it does hurt my heart) I think you'll enjoy Katt's special. And if you are one of those black folks who read, please check out any collection of the Boondocks, it has really cheered me up recently!

Never Drank the Kool-Aid

Finally.

I really enjoyed this collection, which is not suprising because I enjoyed his first collection (short stories) when it came out, too. Never Drank the Kool-Aid is a collection of essays written by Toure. Most of the essays were previously published in magazines like Rolling Stones, The Village Voice, or The New Yorker. Most are interviews with hip hop artists, a few are sports figures and one or two are personal essays.

First, the introduction is a great because 1)It's in list form, and I love lists and 2)It includes a brief, brief history of hip hop section (I'm talking less than one page!) which really summarizes it well! The grouping of essays falls under such headings as "Sensitive Thugs" (including Eminem), "Big Willies" (including Russell Simmons) and "Get Up, Get Out and Get Involved" (including JayZ and Kanye) and many others, 12 sections in all.

Since I'm a nursing student in every sense of the word, I don't have time to give the most in depth review. Therefore, I'm giving you the best three things about the collection, and the one thing I hated:

Top 3:

#3. In the "Big Willies" section, the essay "Ships Passing in the Night" (Barak Obama and Colin Powell) printed in Suede. I love it - not just because it's a good essay (it's a basic 4 page overview of how either man could be the first black president) but because it's political commentary in the middle of a collection of black hip hop stars. It's one of those moments when we showcase that "yes we can drop it like it's hot" but we also care who's in office, who might be in office, and who we might not want in office - even if he is a black man. The last paragraph is the best, go read it.

#2. "Jay-Z Has Got Guts" printed in Rolling Stone because I am a Jay-Z fan, as is my husband, and this piece allowed me to be more than a fan. With most rappers, I like what they have to say (Kanye), or I respect the lyricism (Luda and Em), or their struggle (Pac). With Jay-Z I respected the history. The number of albums he has produced is amazing, and I loved him more as he started to get his grown and sexy on with Beyonce (who is also interviewed). He also spoke about giving back and an internal conflict related to giving back that I could relate to (you'll have to read it!) I liked the piece because he lived up to my expectations. Who I imagined him to be is who he is, and that's always great. Then I read this : "In the sixth grade, a test showed he was reading at a twelfth grade level." And he addressed that with this: "I always liked to read. I still do." I fell in love.

And #1. (hands down) A section ("Microphone Fiend") that has only one essay...Crack is Responsible for Hip Hop (this was an an interview with ?uestlove) I don't know why, but this one just got me. Maybe the title. Maybe the little moment of intellectual orgasm I got out of the political + musical commentary, I don't know why, but I loved it most. A lot of the essay was also about D'Angelo. I *so* enjoyed this essay.

Until the last page, when the thing I most disliked about the collection really messed me up:

Question to ?uestlove: "Is there any female MC that you'd F***?"

And *THAT* is what I emailed him about. The only female MC in the collection is Lauryn Hill, so I was really disappointed that he would ask this - especially in the absence of any interviews with Lil Kim, Foxy, Rah Digga, Da Brat, etc. And it just really messed me up because it didn't flow, it was so abrupt! I emailed him about it (kept it light and funny), and he emailed me back immediately (cool points for that, and for being equally personable) and said that he was "sorry it offended" and admitted that it might be "juvenile" but he still thought it was "interesting" and "reasonable."

So there's my little review. (Honorable mentions for the Eminem interview, the Mary J Blige letters, and the Love Your Niggas essay) It's all good, go read it.

Next book review will be "Sister Outsider" by Audre Lorde, but it won't be until this weekend...school has offically started.