The Mind-Body Problem
By Dennis J. Darland
July 15, 2007
Copyright © 2007 Dennis J. Darland
[This is a work of fiction.
All the characters, organizations, and events
portrayed in this work are either
products of the author's imagination or are
used fictitiously.]
I went back to Lincoln April 1998, after eight and a half months of research at NIMH. My diagnosis had been changed from paranoid schizophrenia to schizoaffective disorder bipolar type. I had approved SSDI. I got along pretty well for several years; I was taking quite a bit of medicine, and had a lot of side effects. I also only attended a couple David Hume Society meetings, which I had almost always attended before. But I did not have as much money and I was afraid of travel. I worked steadily at a differential equation program, but I found it *VERY* difficult. I read very slowly, but understood what I read. .
About this time Dr Notten noticed my BUN & Creatnine high. This can be caused by Lithium Carbonate, which I had been taking since at NIMH, for bipolar. He took me off Lithium carbonate. I had been taking 1800 mg/day. I switched about this time to seeing Sally Adler, a nurse practitioner. She worked with a psychiatrist, Terry Holmes, I had known as an undergraduate at Wartburg, in Waverly, Iowa. He was a philosophy, religion major and had gone on to medical school. I had known him, but not well. It was a surprise that he worked with Sally. Sally started me on Seroquel. I was all zonked out. I didn’t hear voices, but about all I could do was watch the NBA playoffs. I tried to go for a walk every day. I struggled to keep up with the David Hume Society Business. I tried to do programming, but the project I had been working on basically stopped. I had read that Seroquel often sedated people a lot at first, but that often they got used to it after a while. I wanted badly for it to work. I tried to be patient. I missed the annual David Hume Society Meeting, even though it was held in nearby Omaha. I wasn’t in condition to travel that far, even by bus. Sally and I discussed antidepressants. Sally added Provigil. She said it would make me more alert. I supposed it was an antidepressant. I also saw a psychologist, Dr Clark, who was more someone to talk to. Usually the talks with Dr Notten were pretty brief. I saw Sally longer, but continued to see Dr Clark. He told me Provigil was a anphetimine. I didn’t know anything about that, but supposed it was OK if Sally prescribed it. Also about this time she gave me a prescription for Omeprazole. To replace Previcid. It would only cost $3 a month compared to $50 a month.
In July, my parents, who I lived with since getting out of NIMH, were out of town, which was very unusual . That day, I had a root canal done. After getting home from the root canal I had extreme feelings of pleasure in abdomen. (Totally unlike anything I had ever felt before). I masturbated about 12 hours, unable to stop. Then, feeling sick, called an ambulance. This was July 16. I thought the dentist had given me heroin or something. I also thought I might be going through adolescence late. Hospital said I did not meet admission criteria. I heard one person ask another – what would happen if he stopped his medicine? The other answered “he would have a heart attack.” I took a taxi home. I had to tell Taxi every turn on the way home. For 2 weeks tried calling Sally Adler.[I think I was trying to reach her even before seeing the dentist.] She did not return calls. I was not sure she was getting the messages. I also tried Dr. Seeth and Dr Clark. Then I called the Police. Within about 10 minutes (before police arrived) I got calls from all doctors. Seeth said see Adler. Adler said see Seeth. Clark said see Seeth. I made appointment the next week with Seeth. – that was the first opening.
On July 23, desperate, I again called the police. I had the policeman take me to the hospital East General. The policeman tried to get me admitted; the policeman and doctor had a very long argument; many people were standing around; my parents also came separately and were arguing; later my mom told me they were trying to get me admitted. I would not say I intended to hurt myself or others so the doctor said I did not meet admission criteria. But I was afraid food and water were poisoned; I was afraid to eat or drink. I knew I couldn’t live without eating or drinking, but nothing was safe. I refused to sign the discharge papers. I asked for a second opinion. The doctor said he didn’t know if I was entitled to one; I told him I thought he should know. Eventually we left. Toward the end I tried to call Sally repeatedly, begging the receptionist to put me though to Sally or Terry; she said she couldn’t. I talked to my pharmacist, I thought the Provigil might be the problem, the pharmacist said it would be OK to stop it. I stopped the Provigil. It seemed I went through a terrible withdrawal. I listened to music and lay in a basic yoga like position in my recliner for about 16 hours as relaxed as possible. I was having continuous delusional thoughts. I had thoughts that Dr. Richard was behind everything, even though he had not been my doctor for years. I thought he thought he could save the world by programming people to be non-violent through hypnosis. The hypnosis was done by television. I thought that Dr. Richard had hypnotized me when I saw him, and that he got his ideas from me, mostly about Artificial Intelligence. I had told him it would not work. He could not see why, and was actually trying to do it. I had never imagined him that stupid! He thought he could create rules for what people should do in each situation. It was really a *HUGE* finite state machine. People were being programmed by TV to follow it. The only catch was that Dr Richard knew it might not work. He left a way to stop it. To stop it he had to thrust a blade through his own heart. But he thought if this happened it was my fault, because he got the idea from me, even though I warned him it would not work. So he made it so that if this happened, I would morph into his body, and the whole world would blame me. I would be hated more than Hitler.
The next day, very weak, I could hardly walk, I went upstairs, I thought the food was probably poisoned, but ate anyway. Somehow Mom had arranged for us to see Sally on a Saturday. I remember taking a medicine from her. Later Mom told me it had been Zyprexa. But I stopped eating & drinking (except diet 7-up). The next day, I was afraid of my mother. I ran away (only shorts & t shirt and no id) . My mother caught me in the van. I wouldn't go with her. Then Adler came trying to get me to drink something. (But I was suspicious - Why was she finding me on the street when she hadn't returned my calls?). Went a few blocks away & lay down on sidewalk. Adler came again, but I still would not drink. She left. I knew the couple who lived there, I thought they were undercover police and would help. I had the Idea that once I had helped them save the presidents life when he was secretly in town. I had somehow accidently created a diversion. There had been a terror plot. I had also thought cable TV was hypnotizing people and was yelling this.) I lay down on the sidewalk and lost consciousness. Later, I had a mild sunburn. A policeman came. My heart was beating very rapidly. I told him I thought I might have a heart attack. I asked him what I had done wrong. He said loitering. Next thing I knew I was on the ground with him on top of me. I mouthed “faking” to him. I thoughtthat we should make THEM think he was really arresting me. I seemed stronger than him, but relaxed, and let him handcuff me. I went peaceably and got in the back of the police car. Again I lost consciousness.
Then I remember being on a gurney, it seemed in a tunnel. Someone asked me for urine. I gave it. A woman asked me if I knew where I was. I said, “Where they would take the president.” She said, “That’s right – you’re safe now.” Some one asked me for urine again. I said I had already done that. They seemed surprised. The records show this was July 23.
Then I remember waiting. I heard a man say, “He won’t live long – he has a ruptured spleen.” I wasn’t sure if he was talking about me.
Then I remember being on a bed next to a curtain. A man asked me to sign a “power of attorney.” He didn’t even say who got the power. I refused. He then asked me to sign a voluntary admit. I knew that I had, when I had been first diagnosed in 1978 , and Mom had told me that was the right thing to do. I knew I needed help, and they couldn’t give it to me if I didn’t sign. I looked it over the headings and it seemed OK, so I signed.
Then I remember a man rubbing something on my eyelids – kind of rough.
Then I remember coming to on a bed surrounded by several people. They asked me if I knew where I was. I started to say “East General”, but recognized someone – James who ran the PET scan at NIMH. I said “NIMH”.
Then I remember various delusions of NIMH - that I was lost there.- that there were underground tunnels to Nazi horrors.- that these had been discovered.-that I heard peoples reactions as they saw the horrors, but that they did not know where I was - that there were even living brains of Jews in jars – being experimented on.
Later my mother told me I had been in intensive care for dehydration.
The records show I was moved from intensive care to the psychiatric unit July 25.
Then I seem to remember being thrown on a bed. Someone said “meeting in the community room.” I didn’t know where that was. I was afraid. I didn’t go.
Them I remember waking with my body across my left arm. My arm was numb. I got some circulation back into it.
I was in the mental part of East General – or so they said. I thought it might be somewhere that just looked the same.
I was at times on two different floors – I could tell from looking at a basketball hoop out the window.
I was on new medicines and asked why. Some they told me were heart medicines, but they didn’t know why.
I sometimes refused the nitro patches as I didn’t know what they did, and I was afraid they were addictive.
I remember seeing my Doctor the first time [at least the first time I remember]. I asked his name. He wouldn’t say. He said I knew. Later a nurse told me it was on my wristband. It was Ryan. He was from India. Later I asked him where he studied medicine. He said somewhere in India and Yale medical school. He said very little. Mostly he tried to talk me into being discharged, but I did not think I was ready. I sometimes wondered how well he knew English.
I almost did not sleep at all. They made me lay in bed at night even thought I could not sleep. I lay quietly most of the time. I couple times they gave me shots of Ativan (anti-anxiety).The first time I let them. The second time I fought, but they overpowered me. If I remember right most of this time the only psychiatric medicine I was on was Zyprexa. (and maybe Ativan by pill, also I think maybe a small amount of Haldol and cogentin ). I suggested depakote for bipolar. I hadn’t taken anything for bipolar since Notten had stopped the Lithium. He wouldn’t give me depakote, because he guaranteed I would gain fifty pounds. The night nurses seemed busy copying and changing records or something. It didn’t make sense.
They let me have a radio, which was wonderful.
I tried calling 911 a few times. I thought something was wrong. They changed 911 to call Hospital Security and I gave up.
Some friends visited me. Some I hadn’t seen for years. I also talked to others on the phone.
The therapy in the daytime was *VERY* good, but I thought they should do more. We would learn a game or something, but hardly be able to learn the rules before quitting, so there was little chance to use much strategy. However I did think they were oversimplifying human behavior. I had my parents bring Wittgenstein’s Big Typescript, and some books of Erich Fromm. I would read aloud in my room, imagining I was teaching them psychiatry. I had the Idea Bush had not won the election. I talked to my nurse about it. How could you get the results on the 10 o’clock news the same day as the election, but not have time for a recount? I had at one time, as a County Data Processing Director, and sworn in as a Deputy County Clerk, run the election computers. I had also done it for a gubernatorial recount. I knew it was a lot of work. It was my job. I sometimes worked as much as forty hours straight[including time for meals – this was for a huge printing job before an election – mainly the paper needed changed every hour, so eating didn’t slow anything down - I didn’t have overtime authorized for anyone else – and couldn’t get it when I asked for it in my budget. Someone else did it in the daytime, but there were other things for me in the daytime]. I did not get overtime. It was my job. I recommended the Rolling Stones’ Sweet Neocon to the Nurse, on A Bigger Bang.
I got to know some of the other patients. They were nice people, with problems. We played some of the games on our own.
My doctor went on vacation, I talked his substitute into letting me try depakote. I was soon sleeping, and home in two or three days, after three and a half weeks in the hospital. I have gained about twenty pounds since then. I was discharged August 16.
I recently obtained the medical records for my visit. When first admitted I was treated for Hypokalemia, which is low potassium. I think I can see indication of this in my visit July 16 when I was refused admission. I was again refused admission on the 20th and refused to sign the discharge form. Hypokalemia can cause heart problems. There were a few pages of EKG's indicating I have such problems – but no one has told me what they really mean.
July 20 14:48:14 PM [I was refused admission]
Vent Rate 91
PR interval 146 ms
QRS duration 82 ms
QT/QTc 348/428 ms
P-R-T axes 81 29 -2
Normal sinus rhythm
Normal ECG
When compared with ECG of Mar 16 21:08
T wave inversion now evident in Inferior leads
July 23 14:59
Vent Rate 104
PR interval 132 ms
QRS duration 84 ms
QT/QTc 384/504 ms
P-R-T axes 35 35 43
Sinus tachycardia
ST abnormality, possible digitalus effect
Abnormal ECG
When compared with ECG of Jul 20 14:48
QT has lengthened
July 23 17:12
Vent rate 83
PR interval 152 ms
QRS duration 78 ms
QT/QTc 424/498 ms
P-R-T axes 108 49 33
Normal sinus rhythm
Prolonged QT
Abnormal ECG
When compared with ECG of July 23 14:59
Heart rate down 21 bpm
July 24 6:40
Vent rate 70
PR interval 146 ms
QRS duration 78 ms
QT/QTc 410/442 ms
P-R-T axes 99 55 64
Normal sinus rhythm
Nonspecific T wave abnormality
Abnormal ECG
When compared with ECG of July 23 17:12
QT has shortened
On July 20
Lab normal except
Na 132
K 3.4
The records say I was offered left heart catheterization on July 25, before being moved to the psychiatric unit, but refused. I have no memory of this. I see Dr Seeth, who was copied on this, every three months for my diabetes, but he has never discussed it with me. The record also states I was found in acute renal insufficiency and dehydration. I improved with IV fluids. In about March, I had had a stress test, and a angiogram had been recommended, and they would have done angioplasty if needed at the same time. But at the time I was not doing well on the Seroquel. The literature on the angiogram said I would have to be conscious through the process which I think it said lasted 15-20 minutes, and have to lie quietly several hours afterwards. My doctor tried to tell me it only took 5 minutes. I was afraid I would panic. I wanted to wait till I was better. I am still afraid of my doctors.
Since this hospitalization, I have been suffering from numbness of both legs and left arm. I have tried to find the cause. I saw a neurologist who did tests, including two MRI’s. I couple days ago I looked up Omeprazole on the web and found:
http://mb.rxlist.com/rxboard/prilosec.pl?noframes;read=214
http://www.askapatient.com/viewrating.asp?drug=19810&name=PRILOSEC
I discontinued the Omeprazole a couple days ago, and my legs and arm seem a little better. I am sleeping *much* better!
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