Who is Deborah Schwartz?
The experiences of Deborah Schwartz
The persistance of Deborah Schwartz.
The relations of Deborah Schwartz



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Pride

09.30.05
The weather was simply gorgeous today.
Clear sky, bright sunlight, cool light breeze, high of 68. I decided to spend my Friday off traveling down to the Lower East Side. I visited Gertel's Bakery on Hester Street and Essex and purchased four pounds of heavy Jewish baked goods. Then I meandered up the small dirty streets to Orchard, just south of Delancy. There I found the legendary Gus's Pickles, where they scoop your pickles out of the barrel. So I purchased a quart of sour pickles, and I bought a half-pint of marinated mushrooms just for good measure.

I continued my walk up to 14th Street along 1st Avenue, where I planned to pick up the M15 bus. But then I thought: I'm just a couple more blocks from Ess-a-Bagel, which is supposed to have some really fine bagelage. So I walked up to 21st Street. I got an everything with cream cheese to go. They boil the bagels right in front of you, and they give you a nice amount of cream cheese too. I had a couple of bites, then put the bagel back in the bag to finish it later. I was very happy with my Jewish gastronomic heritage day.

Then I saw a bus a 23rd and began to book it.

I was already sailing through the air when I realized what must have happened. My sneaker must have hit an uneven place in the sidewalk. I must have been leaning too far forward, running with too much momentum, to have caught my footing. Through the air I flew, arms outstretched, my many bags of Jewish goodies hanging off me like the billowing pillowy plumage of an awkward low-flying bird. As I prepared for my fall in the moment that seemed to last a life time, I had two thoughts. One was: I must look like a total asshole right now. The other was: Jesus Christ! I hope I don't lose this bagel.

I stayed face down on the sidewalk for sometime. This is an old ninja tactic I like to call my "possum move". If I were to try to jump up and pretend like nothing happened, I might all-of-a sudden become painfully aware that I had broken something, or that something was bent back in at unnatural angle. So I just lay there and tried to take stock of what was around me. My left index finger was skinned and bleeding. My right palm had been roughed up. My left knee hurt like heck, but I was still able to bend it.

I stayed sprawled out prostrate on the sidewalk for so long, even hard-bitten New Yorkers began to stop and ask if I were okay. That's when I noticed why my index finger had made contact with the sidewalk. It had been clutching the bagel, protecting it from the harsh fall. And though some of the cream cheese had squirted out on contact, my bagel was still in very good shape. My bagel was safe. My four pounds of sundry pastries were safe. My container of pickles was still sealed. As I pulled myself off the ground, I looked around at the crowd that had formed around me. I tried to say as casually as possible, "I just wanted to make sure my food was alright."

Then I hobbled a half block to the bus stop and caught a Limited back home.

09.28.05
More stories from my sister:

I guess there had been a drought of individual therapy patients on my ward, and I suppose that my supervisor was nervous that I was not getting enough therapy cases, so you know what that translates to: I get the dregs. Use that as a bit of foreshadowing for this story:

Last week in morning rounds, the treatment team was discussing a new admission. The 1st shift RN announced the patient's name, and the entire treatment team, seemingly in unison, sighed in exasperation, "Not him again." Being the inquisitive intern that I am, I inquired about this patient. The social worker explained, "I hate those dependent types. He's only here because he keeps having fights with his girlfriend. He comes to the hospital when they are fighting, and then they get back together when he is discharged." Personally, I hate those dependent types, too. He sounded like an awful candidate for individual therapy, so I giggled along with the rest of the treatment team, confident that I would have no interaction with this patient myself. How wrong I was!

It was during supervision the next day when my supervisor announced she had a new case for me. Usually, I gleefully accept any challenge she presents me with. But she told me she thought this individual, Mr. Dependent, would be a good case for me. I paused for a moment, trying to decipher if she was joking, and was going to crack a smile. I mean, it was just the day before that she was saying what a terrible and annoying patient this man is. And now, to assign him to me for individual therapy- surely she was pulling my leg. I waited the allowable 5 seconds and was able to determine that she was not, in fact, joking. She explained that this man has had several hospitalization and is "not the smartest." Point of clarity: Smart in N.C. means that you graduated high school. Not the smartest is Mild Mentally Retardation at best. Eager to please, I told her I would see him next week, as my schedule was pretty full for the rest of the week. Secretly, I hoped this patient would get discharged in the interim, and I would never have to see him. But I should know better. The ward psychiatrist is very conservative in discharges and has a tendency to keep patients too long. "Dr. I" as he is often called, likes to make sure the patients are nice and stable before discharge. Honorable as this may be, it would take several miracles to see any change in this patient. But I digress.

So here I was, last week, confronted with the reality that I would have to see this patient. Then I told myself, "It may not be that bad. I never met this patient before." Anyway, I was used to "not so smart" patients. I had tested 3 people for Mental Retardation last week alone. I can deal with it. I read through his chart to get some background information before seeing him. At the hospital where I work, the patient's picture is taken at admission and placed in their chart, group notes, RN notes, etc. This is very helpful to ensure that you are always documenting about the right patient. I get quite a kick out of seeing the patient pictures, personally. Especially if they are really hostile and active and get a shot in the butt with a major tranquilizer. Then they are all passed out in their picture. It's all good fun. However, if the patient is smiling in their admission picture, you know something is wrong, even for a mental hospital. I mean, come on, who smiles when they are getting admitted to a mental hospital? Well, Mr. Dependent does. You can see where I am going with this: Bad sign, bad sign.

After reviewing his chart, I met with Mr. Dependent (note: his name has been changed for confidentiality reasons). He was a pleasant enough man who was enthusiastic to meet with a therapist one on one. He handed me several wrinkled pieces of paper at the beginning of session, and explained that he wrote out the reasons why he was admitted to the hospital. It read something like this, "depression and sad feeling. End of relationship for 6 years, don't know where to go. I wanted it to die on me..." Die on me? What the hell was this guy saying? I had to stop reading at that point so that I didn't crack up laughing in his face. Talking to him would be better, I was sure. We tried to stick to simple topics, such as his goals post-discharge. He often stopped and said, "Ma'am?" That meant, "I don't understand what you said, could you re-explain that to me, please?" Come to find out, his girlfriend and her son were going to the mall and wouldn't take Mr. Dependent. Oh, the horror! He warned her that if she didn't take him, he would kill himself. Then she left, so naturally he tried to take his life. Clearly this man is thinking straight. Yet, he did not see too much wrong with that, insisting that it was her fault. Whatever, I have no patience for this sort of ridiculousness.

So we discussed where he wanted to live, because according to him, his girlfriend and parents were the source of his problems. He described a place, "where there are people all around, and staff all the time. You attend groups during the day, and social workers there. And have an individual therapist..." Not a huge jump, this man was describing the hospital. Then he showed me another page that he had scribbled in group. Under the "Goal" section, he wrote something like, "Maybe I can stay in the P Division." The P division is short for Psych Rehab, the long term unit. Obviously, he just wants to live at the hospital, being the dependent, sorry, soul that he is. The big haha in this story is that he was discharged 2 days later. Dr. I got on board and I didn't have to see him again! I become revitalized by these small triumphs!

09.27.05
Last week, before I traveled back to Florida, I stopped by Zabar's to pick up some goodies.
I wanted a loaf of pumpernickel bread, so I got on line at the bakery. In front of me was a frumpy middle-aged woman. She was wearing what appeared to be house clothes, and had her hair tied back in a low careless ponytail. A small, gray-haired older woman with her clothes exactingly pressed walked in front of us and began to order.

"Hey, lady," the middle-aged woman said, "Can't you see the line starts here?" The older woman paid her no mind, so the younger woman continued. "The line starts HERE. You just cut me in line." Then she turned to the person behind the counter. "That lady just cut me in line. Don't take her order."

The little old woman turned and, speaking with a thick Easter European accent, said, "Why don't you shut up already. Nobody cares about what you have to say?"

"You want me to shut up, do you?" the younger woman said, "You're the cheater. You cut in line." "Shut up, shut up," said the old woman.

"Hey," the younger woman called to the person behind the counter, "Why don't you give that lady something real sweet. She OBVIOUSLY needs it. Because she's so BITTER."

The old woman narrowed her eyes and said, "YOU AMERICAN BITCH!"

And then there was a lot of screaming and we almost had to pull them apart. Everyone on line and behind the bakery counter just started dumbly at the spectacle.

I am heading back to Florida again this weekend. My New York goodies were a big hit. So I went back to the Zabars yesterday. This time, I did not go to the bakery for pumpernickel bread. I mostly stocked up on coffee and babka. Then I went to check out. As we were waiting for my credit card to go though, one of the stores male works came up and started speaking very closely with my cashier. The receipt was then printed out, but the guy stayed, distracting my cashier. The fellow behind me in line was an older gentleman, maybe early 70s, white hair maybe a tiny bit too long, professorial looking. He called out jovially, "Okay, okay. No more having sex behind the counter!"

The cashier and the male worker, embarrassed, began to laugh. As did the other cashiers nearby. And everyone in line behind me. Everyone has laughing, enjoying a communal moment. There would be no more having sex behind the counter. Someone shouted, "That old dude's a trip!" And we all laughed harder. Then the cashier finally gave me my receipt and I left the store.

09.19.05
More from my sister, the sassy psych intern of Appalachia:

I thought I would pass along another story to distract you a bit.

About 4 weeks ago, my supervisor gave me a new case to see for individual therapy. She told me that this individual was just discharged from the hospital and re-admitted within 1 or 2 weeks (a rapid re-admission). Being that this is his 4th hospitalization this calendar year, the psychiatrist put his name on the waiting list for the Psych Rebah (long term) division, as he thinks that this patient has difficulty functioning outside of the hospital. She passed along his name and said he would be a good long term case because he will be here a while, and off I went to provide him with some therapy.

This patient is in his early 20's and has a diagnosis of schizophrenia. The perplexing thing about him is that he completely denies experiencing symptoms of schizophrenia, which makes you wonder how he could have such a diagnosis. In our first session, we talked a little about his diagnosis and he admitted that he was "hearing crickets" prior to this hospitalization "but only for five minutes and never before." I felt confused. He talked pretty easily when prompted, but his facial expressions were notably limited and he rarely smiled. He also seemed to be intentionally leaving out information, although I could not prove this. It was more a sense that I had. But in therapy, you work with what they give you, so I was going to give it a shot anyway.

In general, a good starting place for me is to discuss the patient's goals. One thing that the patient mentioned several times is that he wants to learn karate. This seems like a reasonable goal, however, he amended it by saying that he wants to "learn karate all over the world." It is at this point that his whole story unraveled. I asked him if he is able to learn Karate locally, here in North Carolina, and he insisted that he could not. Upon further query, he said to me, "You know this word: Chinese?" I affirmed that I did, and he nodded his head and said, "That's what I want to be." Come to find out, all this patient really wants out of life is to be a Chinese person. Please note that many people in the hospital (and in general here in N.C.) are quite unattractive, but surprisingly, that is not the case with this patient. This patient is a good looking, athletic individual, which confuses me all the more why he wants to look so dramatically different. For the next 3 sessions we discussed in depth his plan to become a Chinese person and why has has chosen it.

This patient said, "I think it would be great to be walking down the street to get a bowl of rice and bust out some karate moves." He explained that he wants to be Chinese because Chinese people "look real sharp." He believes that he can go to "a real hospital" and get a medical procedure that will turn him into a Chinese person overnight. With this procedure he will also gain the ability to speak fluent Chinese and obtain a new name. He did mention that he had never told anyone else of these plans, but to me, his diagnosis was very clear now. And the problem with delusions is that they are very difficult to challenge. Every which way I turned, I was confronted with more talk about Chinese people ( e.g. "Where would you like to get a job?" "At a Chinese restaurant.").

To tell you the truth, as amusing as this may be for a couple weeks, it does get kind of old and I felt like we were getting nowhere. At that moment, the patient seemed willing to talk about something else. During our last session, he laughed and smiled the entire time, which was in stark contrast to previous sessions. Don't ask me what he was laughing at, though. He wouldn't tell me. Apparently, there was a dialogue occurring in his head (the voices, I guess), to which he was responding. Surprisingly, as the patient's psychosis was becoming more and more obvious, he was more willing to talk about more tangible, attainable topics ("I would like to have a friend. How can I go about starting a conversation with someone?"). Seems like I hit paydirt with my ChinaMan. And yes, he is still planning on changing ethnicities upon discharge.

My only wish with this patient would be to have a videotape of his conversation with a plastic surgeon, proposing the idea of becoming Chinese. I just want to see the doctor's face.

09.17.05
What is appropriate to talk about on one's personal website, and what is not? I often struggle with this question.

About three and a half years ago, Brian's mother was diagnosed with ovarian cancer. She has been vehemently fighting it ever since. Following the initial surgery, in which they removed everything they could, she was put on chemotherapy. When one chemotherapy failed, she would demand to be switched to another. She spent almost three and a half years like this, until recently, when the chemotherapy treatments just stopped working.

This past Tuesday, hospice care was called in. Brian, Jessie, and Eddie are all with her now. I am still here in New York, feeling horrible and useless.

Because I can not bear to talk about this anymore, yet can think about nothing else, I will post a story my sister sent me about the crazies she looks after at a mental hospital in rural North Carolina:

I know that you have been feeling down lately, but I thought I would try to lift your spirits with a short story about a patient that I currently have in group. From the moment the patient entered the room, I knew that something was up. There are times when I encounter patients who look fairly "normal" and might blend in until they open their mouths (which is often the kiss of death for them, because they don't make any sense.) But by no means would this patient fit in. He is a slender middle aged black man who was wearing a long heavy winter coat. Granted, it has been a bit chilly in the mornings here, but realize that it is September in North Carolina, not an arctic blast! He was clearly seasonally inappropriate.

He sat down in a chair, and moved it so that he was facing the wall. He then proceeded to have a quiet banter with himself, which resulted in uncontrollable, unprovoked, and inappropriate laughter. Other than this, he was rather pleasant (unlike the woman sitting next to him who had a conversation with herself in which she continuously mumbled curse words--she would look ahead and just say, "bitch" and "fuck you." At first I thought she was talking to me, but then I realized she was just responding to her auditory hallucinations).

The next day in group he kept asking us (the facilitators) to read things to him and "help" him out. He really wasn't making any sense, so we started ignoring him after a while. He proclaimed to the group that this was his first hospitalization and that he really wasn't experiencing symptoms before he was committed. Just one reminder: I run groups in the Disturbed Thought Low Process Track, very few of those patients are there for the first time, ESPECIALLY if they are middle aged. Still, I was curious. I read his psychiatric admission report after group so I could clarify a few things. And then it all came together: Apparently, he is a 19 year old man and is pregnant with 7 babies. That explains everything! Glad I got that cleared up!

Incidentally, the one patient that I had told you about previously who reminds me of Uncle Ira (with the 3 pyramids) was readmitted to the hospital. In the short time he was out (about 2-3 weeks), he managed to get some new jewelry and a different, although unattractive, haircut. He kept shouting that he was re-committed because his family "lied." I was given the opportunity to work with him again in individual therapy, and as tempting an offer as it is, I think I will decline.

09.08.05
My grandmother visited the Museum (where I work) today.
We had a very nice lunch together. But before that, she had run upstairs and presented one of my coworkers with a three inch high stack of papers.

"Here!" she told the woman, "They're JOKES!"

The woman asked where she had gotten them, and my grandmother responded, "From the COMPUTER, of course!" Then she threw back her head and laughed.

I could never have made something like this up. And whether I like it or not, she's a constant source of material.

09.07.05
On my way to work, I saw the words "Pride Destroys Most Relationships" scrawled in chalk on the sidewalk. It had been written by the street artist DeLaVega, and he had attributed the quote to himself.

I severally dislike when people quote themselves. I think it is silly at best, and at worst, pompous, grandiose, and delusional. This was my first response to seeing this self-attributed quote. But then I thought about it some more, and I didn't mind it as much.

Later, I was on a crowded rush hour train heading downtown. A young man was sitting and I was standing near him. He produced a kind, knowing smile, stood up, and offered me his seat. I was taken aback by his kindness, but did not hesitate to show my appreciation by pushing people aside and sitting down. I wondered why he had done this. I considered for a moment that he might be flirting with me. But then I noticed he had made his way towards the other end of the train. Why would anyone ever give up a seat to a stranger for no good reason? And during rush hour? And why me? There were plenty of other women and old feeble people around.

Finally, I came to the only plausible conclusion: He thought I was pregnant. This made me feel sad and rather lousy about my physical appearance.

09.05.05
Wow.

I am so horrified and embarrassing about the US government's slack-jawed response to what is going on in New Orleans. Brian and I are pretty lazy, but we finally got it together to donate money to the Red Cross. Even my grandmother donated $200 to the relief effort. We were a bit shocked. This is the same woman who, when I told her about a chronically ill cousin who had attempted suicide, said, "Well, we've all got problems."

Our friend, Tyler, who lives in Houston, has been passing out diapers in the Astrodome. Kristin moved from Metairie, Louisiana less than a year ago and saw her neighborhood underwater on TV. She reminds us:

You probably slept in a bed last night. You probably slept last night.
You probably have not been without a shower since last Sunday.
You have probably eaten today. And probably multiple times since last Sunday.
You have probably had water since last Sunday as well.
You are not currently wading around in a sea of salt, raw sewage, bacteria, oil, gas, rodents, snakes, human feces, and dead bodies, that has surrounded your home, and your city, up to 20 feet.
You have not watched your friends, neighbors, or family members die this week. You have not had to leave them to rot on the interstate.
You have not been living outside in one of Americas hottest and muggiest cities.
You do not feel like your government is leaving you, and America is waiting for you to die.
If you aren't depressed enough yet, you can read about why Living Paycheck to Paycheck Made Leaving Impossible from the Washington Post by way of Heck's Kitchen.

I've been feeling pretty low about it all. But I suppose I shouldn't sit around feeling too guilty, because eventually, something really lousy will happen to me. And it's not like I can cash in those hours of guilty feelings for credit in heaven. Did I mention that I donated money to the Red Cross?


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