Pscyh Clinical: Week Five

My fifth week of Psych clinical ended yesterday and, for the second time, my preceptor asked me, "Are you sure you don't want to go into Psych?" Followed with, "You'd be perfect for it." I kindly told her I was sure and we laughed, but later my groupmates said that I made this terrible face when she said it and that's what all the laughter was about. I really gotta work on my facial expressions! It's not that I can't see myself as a Psych APRN, it's just that I can't see myself as NOT being a midwife. This conversation happened after my conversation with a patient (another black woman on the unit who, like my last patient, is also addicted to cocaine) lasted an hour long - significant because she had refused to talk to staff and other students on the unit. This woman had had an "outburst" earlier in the week; she had called the social worker on staff a "racist bitch" and was screaming at her uncontrollably. Of course the staff just considered her to be very angry about something else, and requested that she apologize to the social worker after speaking to her about her feelings. Which is all fine and good (and necessary) but I also wanted to validate her feelings about the social worker, because angry or not, drug addicted or not, right now this patient is techinically clean (albeit only a month's worth, but still clean) and so she knows what she's saying and my guess was that she had a reason for saying it, so I asked her about it. Sure enough, the patient had an altercation with the social worker earlier in the month in which the social worker decided to interview another patient (a white patient) who had just got admitted that morning instead of her, despite the fact that she had been there 3 days already. I asked her why would the social worker do that...what would she get out of it? She said that she and the other black patients on the unit have all had negative experiences with the SW and the patient herself had had some negative experiences with the SW on her last stay on the unit some months ago, and that she felt like she just didn't like or wasn't comfortable interacting with them, and that maybe she was intimidated. So we talked for a while about all of that, and how to get what you came to get despite her or anyone else and then we moved on to other things. But later I followed up with other patients about their experiences on the unit, specifically as they pertained to racism (or not) and the same sentiments were expressed without my mentioning the SW or anyone else specifically. So it made for an interesting day, and when I questioned my preceptor about the SW, she said she thinks it has less to with race and more to do with the fact that the SW isn't very good at what she does, and some patients (I add: "especially the black patients who proabably have more experience because of socioeconomic differences on the unit") know more about the system than she does, which really irritates the patients. That sounds like it could be true. Anyway, I also spent a long time talking to this patient about books (she was thumbing through O mag while we were talking) and she happens to be very well read and *almost* (LOL) put me to shame! (now isn't that snobbish...elitist...ohhhh, someone like *her* could not possobly be more well read than *I*...mhmh) What a great Friday at clinical.

*The photo above is of Africans Americans at Spring Grove Hospital Center. When (if) you go the page to read about this place, look in the right hand column of topics and you'll find "African American Patients at Spring Grove." It's probably the first Psych hospital to accept free or enslaved African Americans.

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

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.

Transcending Race

I keep forgetting to talk about this, so now it’s like a nagging email that I keep forgetting to respond to. Since I’m trying to clear my inbox/mental space, I’m doing it now. A few posts ago…ok, a lot of posts ago…I mentioned that one of my friends told me that she had “stopped seeing color” and had “gotten over it.”

I don’t know what to say to that, except for “good for you…I guess.” I can understand one transcending, or rising above, their own negative, stress-inducing response to racial inequality. I can understand not limiting one’s friends based on some perceived notion of racial solidarity. I can even intellectually understand the “it doesn’t matter because it doesn’t really physically exist” theory (aka: the “there are more differences between two people of the same race than there are between two people of different races” theory). And if that were all she was talking about, this post would not exist. But her comment was in response to my excitement about the presence of minorities in my class, and my even greater excitement that we actually speak to each other.

I haven’t gotten over race, and I don’t know that I want to. Does getting over it mean that I no longer have to pay attention to it? Does it mean that, because my socioeconomic status will probably approach the upper-middle class mark, I no longer have to worry about or think about what it is like for poor people? Yep, I know that poor people ≠ black people, but we cannot separate race and class in this country, so just follow me. If I’ve transcended race, does that mean that I am no longer impacted by the reality and gravity of the issue for everyone else? In all fairness to her, I’m sure she’d say “No, of course not. It just means that you don’t spend every waking moment of your life thinking about it anymore.” I can dig that. I mean, really, when I wake up I’m usually thinking “for real?” anyway. But, what I cannot imagine is not evaluating my life, thinking critically about the state of this country, or trying to explain to my family what college is like for me, without the lens of race. So many of my everyday experiences are influenced by race. Maybe people will ask, “Why is that the case for you, but not your friend (or anyone else for that matter)?” I don’t know exactly. Maybe she evaluates her life through the lens of “woman” and while she has somehow transcended race, she still wonders if she would make more if she were a man, or if she would have been invited to speak at that conference or have a better chance at being dean of the professional school. Maybe she has so many other “desirable” characteristics (long straight hair, thinness, light skin) that she hasn’t felt the full effect of what it is to be defined by her blackness. Or, maybe she has, and just doesn’t give a damn.

But here’s one thing that does matter:

There is a grave inequality in level of, expectation for, and success in EDUCATION. This inequality leads to a disproportionately high number of poor minorities in this country. (duh) But it also negatively impacts my experiences (and non minority students) while earning my education.

What she actually said was “You’ll learn to get over it.” I hope not. And if I do, may it only be because racial diversity in programs like mine has increased so much that we are no longer surprised to see one another.