DSM IV for the Devout

I can’t help wondering, with so many Jewish people in the medical professions, if any one else has had a similar experience to mine. That is to say an experience, which closely aligns our traditions with mental illness.

Here is my tale…

A young, overzealous, lad in graduate school, I chose to spend some elective time studying mental illness in a psychiatric prison. My first day was a horror ripped straight form the pages of, “Silence of the Lambs.”

Crossing the threshold of that building I left the free and sane world behind. My first glance was of the dim gray walls, the heavy set guards in blue, the buzzer that coincided with the opening of a monstrous metal gate heavy enough to crush a man’s skull.
I tell you no lie; within minutes my damp, sweaty fingers were loath to let my ID card just hang on my jacket. I clutched it there firmly for fear that it’s loss would doom me to join the very populous I intended to study.
I could see them now, through the gloom of poor governmental lighting. These apathetic figures in their cells; moaning of miseries that only they could understand. They noticed me as well… some of them sitting up in cots, or walking over to rusting iron bars that separated their world from mine.

“Ben”

I jumped half out of my skin at the sound of another human being so close to my ear.

“Wha…”, I said, clumsily dropping my note pad and seriously considering making a run for the door.
As I bent to pick up my notebook my Yarmulke fell off too.

It was the security guard talking to me, and for my part, I was making another sterling silver first impression.

I collected myself as he informed me that he would always be watching me as I was interviewing patients. He put his hand on his nightstick and patted me on the back..

“You’ve done some stupid things in your life,” I thought to myself, “but this is the worst.”

I stood there in a moment of indecision as the reality of my new predicament rattled about my head like a bunch of old bones. I don’t know what to tell you, really, except perhaps that fear of a bad grade in grad school is more powerful than fear of death.

Stomach fluttering, anal sphincter clenching and unclenching to the beat of Tom Petty's American Girl, clutching my ID and note pad in a seismic, fucking, Kung fu death grip, I entered that first cell.

*******************************************************


Looking back, all theses years later, I need not have been as terrified as I was, the guards were top notch, “incidents” were rare to non-existent, and the short stretch of time I spent there studying schizophrenia, proved to be one of the most fascinating experiences of my life.

One of my first interviewees had been incarcerated for holding up a convenience store. Unfortunately for him, his weapon of choice was less then satisfactory.

There it was for all to see, written on his admission note in bold face type… “Two old socks in a plastic bag….”

Sitting there in his dingy cell, on a rickety metal chair with unbalanced legs, I remember clearing my throat and stifling a laugh before asking, “So…. you held them up with a bag that contained two of your socks.” I tried to imagine the scene at the store, how had the clerk responded?

He nodded affirmative and confided apologetically, “the devil made me do it.”

Such a fascination with good and evil, devil, and god, since my time at the prison I have not come across anything like it.
This patient had entire notebooks scribbled with words he had received from one or the other. His dementia had over flown his notebooks and spread to his walls, his covers, his floors and his body. Sitting in his room I was surrounded on all sides by his broken mind.

Yet another inmate had a sense of humor mired in word games.
“Date of birth”, I had asked him as a preliminary.
“I was born on a plane on July, 1947”
It wasn’t the birthday in his chart…
And then I got it…. 747. He played similar tricks with every opportunity.

The most horrifying story I heard was of a college student who had the onset of his schizophrenia in the dormitory and began to hear voices coming from the radiator next to his bed. Late at night an unknown child would call for help, insisting it was trapped in the boiler room.
This illusion became so powerful that this patient had called the police, insisting that they search the boiler room for the lost child.

But the reason I bring up this entire subject is to recount to you one particular episode that has stayed with me all this time.

It is the story of young girl, who, as it commonly happens, had her schizophrenia present in her college years. As she tells her story she was walking back to her dormitory on a sunny day in March when having just returned from class, she heard someone call her name.
"Sarah", the voice said behind her.
She turned around, looking for whoever might be calling her name.
She turned to see an open field.
Sarah scanned the windows of the nearby building and of the dormitory, but no one was evident.
Shaking her head and continuing her walk back to her dorm, her name was called again, this time louder and more insistent, not far behind her.
"Sarah"!
She spun on her heal, only to be confronted with the confounding emptiness that surrounded her.
She desperately wondered what type of college prank was being perpetrated on her and felt tears spring to her eyes. She decided to walk resolutely to her dorm regardless.

"Sarah", it was an unmistakable whisper…. directly in her ear.
Sarah fled to her dorm room in a panic, hands clenched over her ears, but nothing she did could stop the voice.

It was a matter of days before Sarah's disease was diagnosed, and a matter of months before she was instatutionalized due to its severity.

I went home that night after hearing Sarah's tale, and something was bothering me…. It reminded me of something that I couldn't quite put my finger on, like a movie star whose face you can see but whose name stays tantalizingly on the tip of your tongue, playfully avoiding your conscious mind.

Then it hit me…. In few seconds I had flipped to the appropriate page of the Jerusalem bible I had in my house….

Samuel I Perek 3 Posuk 4

And the Lord called Shemuel and he answered, here I am. And he Ran to Eli, and said, Here I am, for thou didst call me. And he said I called not, lie down again. And he went and lay down. And the lord called yet again. Shemuel. And Shemuel arose and went to Eli, and said, here I am for thou didst call me. And he answered, I called not my son, lie down again. Now Shemuel did not yet know the lord, neither the word of the lord yet revealed to him. And the lord called Shemuel again a third time. And her arose and went to Eli and said, here I am, for thou didst call me. And Eli understood that the lord had called the child.



Spooky isn't it.....