By the time I was assigned her case file, Melena Jones was coded SPMI. Severe persistant mental illness. The hardest to treat, the most resistant to treatment – most often through no fault of their own.
This Saturday night it was sheer chance that I was on the Crisis Team when she went in to the local community hospital. I had met with her once, at the tiny place she shared with her fiance, two dogs, a dairy goat, and several visiting adult kids. She was not far from the public persona that had made her an expert on the very tiny subculture of open and welcoming Baptist denominations. Her hands gave the only faint sign of her battle with Parkinsons.
The blind older woman she called Mom was in fact one of the many friends Melena had made over the years, as was the equally blind husband Melena called Dad. I knew from the file that her biological parents – indeed an entire extended biological family existed – but they were not involved in her life to any great extent.
It was an odd December, for New Hampshire had experienced the oddest warm weather, interrupted by the occaisional cold night with a dusting of snow.
I arrived at the ER, bustled against the cold. Joanne, the charge nurse, looked up from her screen.
“Bout time chickadee..how come you take so long down in Dover at St. Make a Buck? Don’t you love our local evals?”
“I do, but tonight they had 3 seperate slice and dice cases from the college, plus two o/d’s. What is it with 20 somethings these days? Why the long drawn out carving designs instead of the usual slashing?”
Joanne sighed “It is that Mexican weed they smoke. We had one last night. Wanted to ‘bleed beautifully’. Damn drugs.”
“Any tonight?” I asked, hoping that she would say no. “All my alert said was 2 cases complex”.
Joanne sobered and sighed. “One. The other guy died 45 minutes ago. Probably a massive coronary. Here is the woman. Room B.”
Melena had pressed her life alert button, and when EMT’s arrived, they found her sprawled on the floor on top of the victorian ivory wedding gown I had been shown two weeks before as it sat on a dress dummy. Treating it first as a fall, the young Explorer teen had obviously been thrown when in the midst of describing how she fell taking the dress off the dress form Melena suddenly said in a flat monotone voice “and so I decided to die. But it is taking rather too long, so I would like to go to the hospital please.”
According to the report, she had cooperated in turning over her medications, her contact info, and in going to the ambulance. Her only request had been that we wait until 10pm to call her fiance so “he will get to play 2 bingo games.”
Once having been brought to the psych eval room, all of her medical items – her cane, service dog Majestic, her medicines, and of course the pump that fed anti tremor medicine into her viens were taken away on the grounds she could self injure with them. That was 11 hours ago.
I took a deep breathe and stepped into the room. As I expected, she was in horrible shape, wracked with tremors, spittle sliding down the corners of her mouth.
“Melena” I spoke as softly as I could, “It is Sam. What happened Marlena?”
“Oh, posh..” she said weakly, in a quivering voice, “how did you get here so fast? Go see that other fellow first. Leave me be.”
“There’s no one else Marlena. Please, tell me what happened.”
“I was a fool, that’s what happened. I tried to invite the other family.”
“Your biological family? I am confused Marlena…you haven’t heard from most of them in over a year. Why now?”
“I don’t know…because I am an old fool? Because the one place you really want your family together is when you stand before God and say I do?” Melena started coughing, large wracking movements of her lungs trying to clear out the mucus that accumulated in those 11 hours.
“My parents said no.” A hollow laugh tried to escape her aching chest. “Apparently, the move to Florida made their health worse, not better. They are, in the words of my other life’s son “too frail” to travel.”
Surprised that she had even talked with one of her many children, I asked, “Did that conversation …was that just too much for you? I know your previous counselor worked with you on limiting contact with toxic relationships…”
“Actually, I saw him” Marlena stated flatly, in a monotone voice. “At a restaurant of course.”
Marlena’s file clearly outlined both the time her abusive first husband terrorized her by barging into a restaurant where she was eating and the psychiatric crisis she experienced when her biological parents unexpectedly told her they were leaving for Florida much earlier than planned. Virtually any person with even a basic knowledge of Post Traumatic Stress Disorder would have known that restaurants were, for her, akin to a Southeast Aisan jungle for a Vietnam Veteran.
Choosing my words carefully, “Marlena, how did you end up in a restaurant? When did this happen?”
She frowned, and snapped back angrily “I hadn’t seen him in over a year. What was I supposed to do, say no and maybe not see him ever again? I took my ativan, and sat near the door just like the doctor said! It was going fine until they came up.” She started to tear up and her voice became softer. “I would have made it ok, but ….you know, he didn’t even remember it was the baby’s anniversary? They are all the same. Once someone is dead, they forget them…”
I had to think for a minute, then remembered that December 5 was a trigger date in her file. She was almost 5 months pregnant when after a particularly brutal assault by her exhusband she miscarried. Less than a month later, she had made her one unsuccessful attempt to escape that …my thoughts were interrupted…
“…monster. He taught them that. It isn’t the boy’s fault. Still, you would think he would remember he has a couple sisters in heaven.” She crumpled the thin hospital sheet in her hand. “Enough. I just think I have had enough. Why should Gary have to deal with all this? I looked at the gown, sitting there, and realized I would never have the picture. You know, with his parents, my parents, our kids, our siblings. Hell, since he became a baptist, half of his relatives don’t talk to him. They will show up because his father will say so.”
Her eyes watered again. “No such luck on my side. No one gives a damn.”
In some respects, I was thrown a Hail Mary pass that night, one of those things that shake my agnostic foundations. Pastor Dave Billings was just leaving the ER’s family room, and as was his habit, glancing toward each psych eval bay to say a quick prayer. I knew not to close the curtain on a PTSD patient who had more than once been tied down and blindfolded by her abuser. Marlena looked up at the soft knock, and nodded him to come in.
“I’m no Papist” she said, “and not dead yet Pastor. Don’t believe in last rites. You are too early.”
“Or, maybe” he countered, “not too late.”
Within a few moments, I was able to step out, and had just finished my stale bottled water when the locusts descended in the form of the ER Administrator.
“What is happening in Psych B? Can we discharge her yet?”
Everyday, well almost everyday, the mental health workers in this state get a choice of doing the right thing, and possibly losing our job, or doing the expected thing. It colors every judgement call we make. Unlike many, I had paid for my schooling with beauty pagents, a stint in the national guard, and 3 sisters trolling fastweb.com for every scholarship they could enter me in. While it wasn’t easy, I still lived in the same tiny 10 x 10 room at my parent’s mobile home where I grew up. I had no debt except my car payment and the Sears card I had purchased my laptop and interview suit at. I had no little kids to support.
“Ok, so code her a 72 hour hold?”
Incredulous stares. “You actually found her a bed? She’s going to transfer?”
Taking a deep breath, I drew up straight, and squaring my shoulders, spoke in what I hoped was my best clinical authority voice. “My assesment is not completed yet, and the patient has invoked her right to religious support and counseling. Once that is completed, I will be continuing my assesment. However, my ability to do the assesment has been slowed because her medical, hydration, and nutritional needs have not been met. Also, she has a standing order for pain medication, and her tox screen is clear. Please have the attending order her medications including her pain med, water, and one can of ensure as soon as Pastor Dave is finished. Within 30 minutes of those three things being administered, I will be able to complete my assesment.”
I turned on my heels, and walked away.
The auditorium erupted with applause, and I slowly let go of the sides of the podium. As I looked around, it seemed the entire crowd was on their feet, and for a moment I was disoriented. Marelna…I had used her real name? Violated HIPPA? Suddenly, I felt movement on my right elbow…a shaking tremor, and there she was, her hair carefully styled, makeup on, and flowing white vestments with a large V shaped blue accent arount the neck. Behind her, similarly dressed, was a large chorus with people in wheelchairs, every color you could imagine, and every gender.
Using the wireless microphone she wore, Marelna spoke, and instantly the crowd fell silent.
“Amen! Amen! That my brothers and sisters is tes-ti-mon-ey! That is the scripture and the gospel for our times, living here in the combat zone on the mission frontier! That is the healing of Jesus, the feeding of the 5,000, and the story of the Good Samaritan all rolled into one! My life was so blessed by My Savior that day. My sickness that day wasn’t Parkinson’s, it wasn’t PTSD, it was abandonment. It was being once again orphaned. It was loneliness, despair, and sadness. Parkinson’s made it worse. PTSD and Depression made it worse. Laying in a psych ER bay with no water, food, or medicine for eleven hours made it worse!”
The applause thundered again, along with calls of “Amen!”, “Right on!”, and more. Everyone was on their feet, or leaning expectantly toward the stage.
Marlena continued “This is what we are meant to do! Just like that cold December night, we are called by Jesus, just like Lisa was to take up our cross, stand tall, and do what is right! Be…”
Drowned out by applause again, Marlena had to pause, but motioned with her hands, pushing down as if to lower the volume on some large invisible sound board.
“Listen…because of Lisa’s actions, that very night Pastor Dave called my birth parents in Florida. It was because of Lisa’s actions that he was able to mediate our firat honest conversation in years. As many of you know, it was then I was told of my mother’s battles with untreated depression that had caused the fracture of our close relationship. It was then that I learned how hard it was for her to overcome acraphobia to go out one day a week with my aunt to painting class. It was then I learned of my father’s stroke. And it was then that they truely saw that by hiding all of this, by never being photographed, by simply ignoring anything I said about my wedding they were just hurting me all over again.”
“Because of Lisa’s actions, Pastor Dave was able to set up family counseling via skype video, and a year later when I did get married, my Aunt brought my parents. During the counseling sessions, I got to know my aunt again. I also was able, with God’s help, to forgive another aunt and uncle who had directly benefitted from so many wrongs committed by AG Edwards and the other criminal enterprises that destroyed so much of this world in the early 2000’s. I was able to move past the callous disregard they had been taught by the 1% they worked for and emulated, to see the real people underneath. I was even allowed to talk to my 95 year old grandmother again…to have her phone number, and to have privacy when I spoke with her.”
“My birth family gained treasure also. They gained back a daughter, a new son in law, and a new granddaughter and grandson that today provide almost a third of the support to ensure that my brother, who never married or had children, has a comfortable old age in his home. They gained two great granddaughters that decorated the fridge with pictures, and understood that my mother’s dementia made it impossible for her to know who they were. They gained real friends in my adoptive parents, and enjoyed the winter trips we made to Florida each year. They gained visits from my daughter in South Carolina.”
“Pastor Dave found that night a new ministry, and to this day the first question a person is asked when they get placed in a psych eval bay at the ER is: “Would you like to have a visit from a spiritual support person?”
The crowd erupted again, hands clapping and waving, shouts of “Praise Jesus!” filling the air.
Marelna continued, “Today Psych Spiritual Support has trained over 5,000 lay and ordained ministers from every branch of the Abrahamic religions, from other faiths such as Hinduism, Taoism, and Wicca, and has provided services to over 100,000 people in the United States alone! “Because of Lisa’s actions, the United States has fully accepted the UN agreement for treatment of the psychiatricly ill, and all patients seeking a psych eval are offered clean drinking water every 2 hours and some kind of nutritional support every 5 hours! Praise God! Praise God from whom all blessings flow!”
I was blushing by now, even though this was the 16th city on our tour. I wondered why that was, but then felt Marelna’s hand on my shoulder. She looked at me, smiled, and spoke to the crowd again.
“Lisa, like Paul the Apostle, ran the race. Like the Apostle Mary Magdalene, she was silenced, villified, and had her reputation dragged through the mud. As many of you know, less than two months later the tables were turned when Lisa appeared at a taping of my first show at the Farmington Opera House. She had just been terminated by her employer, had just cleaned out her desk, and been escorted from the building. Her parents were furious that she was ruining a good career with these foolish God, bread, and water ideas. She was afraid to go home.
This time, I was in her shoes, and she was in mine. This time, God intervened not with Pastor Dave, but with a child…well a young lady. Many of you have seen our show from 2015 where Ashley Jones talks about the year she lost her mother, of how she got interested in what her Dad, who is our Producer, did for work and learned how to be a cameraman. That year, Ashley was a fifth grader, and she and our son Jamie were stagehands. Ashley saw right away that Lisa had been crying, and sat talking with her for almost an hour while her Dad and I finished taping one of those very first shows.”
I spoke up, finally finding my voice, “In that hour, Ashley gave me two most precious gifts…validation and hope. She talked about all the struggles her Dad and others at the Unitarian Universalist church fought everyday, about how they supported each other, and about how even when things are the saddest there is still stuff to look forward to. She talked to me with such an honest open way that it reached right through the fake “if there is a God, He sucks” barrier I had erected around my heart.”
The applause rang out again. “While to me, the divine isn’t a person or Trinity like what Marlena experiences, I have found a spiritual home in the UU church. It nurtures my work for social justice for all disabled. It strengthens my faith in humanity being able to choose what is right over what is easy or expected. It opened doors for me to find a mental health job where my principals didn’t have to be sacrificed to survive. It helped me heal from being fired.”
The applause rang out again, and I looked at Marlena. “I even got to be a bridesmaid in Steampunk goggles, and met my wife Luella!” The applause grew even wilder, cheering mixing with Amens and Alleluias.
Marlena spoke up, “Friends, now is the time…today is the day. You are each called by whatever you conceive of as a Higher Power…God, Yahweh, Allah…the Divine Spirit, or even Science or Philosophy’s nobelest goals. For me, it was God and taking Jesus as my personal Savior. For Lisa it was the perception of something Divine and unexplainable, and for each of you it may be different. However, each of you, each day, is given an opportunity to better this world, to relieve suffering, to clothe the naked, to feed the hungry. And, each of you will pay a price for making that choice because it is the most counter cultural action you can do. There will always be evil and it’s cousin apathy in our world. My question for you is: Will you join the battle for Good, and will you do it now?”
The applause and cheers rang out as the choir began to sing a triumphal march. The crowd started to move, a great movement of bodies toward the stage. As they formed into lines, I looked down at the ministry’s workers, already surrounding the stage with color coded action packs. Each had a large icon above them indicating if they represented a religious belief system, and as people made their way to the front they chose who to approach. Each person was escorted to the various exits in groups of two or three to a worker. I knew from past events that the confrence centers meeting rooms had been divided up into hundreds of small workspaces where attendees could talk about the paticular areas of their lives that troubled them, that they wanted to effect change, or just to pray for those who could do what they felt they couldn’t. I remembered how many had simply begged forgiveness of the Catholic priests in the first few events – even if they weren’t Catholic. We had changed our training then, getting help from theologians all over the world to create a healing or forgiveness ritual for each religion that was represented.
Marlena and I walked back to the chorus, and joined in the singing. By the third verse, as was her practice, Marlena had vanished deep into the choir, invisible to the few people remaining in line. She had fought with the producers about that. “I am not the star here. If anything it is Lisa who is the star. I am just a bag of quaking old bones God has seen fit to use. If it becomes all about me, the movement is doomed. I got my birth family back. That is all the reward I need.”
When the song finished, and the curtains closed, everyone got ready to take down the set. I helped for a while, with my wife, and then we headed out to the Director backstage. “Dave, does anyone need us?” I asked.
He shook his head, “No, you two lovebirds go get some rest. Marlena is going to be out in the audience seats praying with folks for a while. So far we have 1,143 new ministry members and 124 of them are mental health professionals that want to join the Psych Spiritual Support training program. More than enough for a class here in Toledo. Our next stop is going to be tough you know…some small white bread city north and west of Detroit. Lots of apathy. You should get some rest before we head out tomorrow night.”
Luella smiled and said “Boss, don’t worry. I already lined up a great place to eat, and a funny comedy to watch. Besides, I found out Toledo actually has some pretty nice art galleries and a cool museum. We can play tourist here and even hold hands!
Dave groaned “Don’t…just don’t remind me of Alabama….I still can’t believe they cuffed and mug shot the two of you….go…get out of here…I have work to do!” His pretend scowl dissolved into laughter. “Go on…!”
We laughed with him, and walked out into the night as Marlena took a seat in the auditorium and began to silently pray.
(C) 2013, Brenda Eckels Burrows, aMGC.
This is a work of fiction. Any relation to persons living or dead are either purely coincidental or the result of damage to my memory from multiple sclerosis.
The practice in New Hampshire and elsewhere of patients needing a psych evaluation due to a mental health crisis being left for hours or days, denied water, food, medical care, and spiritual support is unfortunately real. Also real is the tearing apart of families because of stigma about mental illness, poor communication, and resistance to use of tools like family therapy.