When Dandelions Are Blooming

Looking out my back window, I notice that my backyard is turning yellow. Dandelions are blooming. Last year, I tried to dig them all out. This year I am going to let them take over the yard.

My husband, my psychiatrist, my former therapist, and I developed a shorthand to describe my spring elevation in mood--"when dandelions are blooming." The switch to and from daylight savings time seems the predictable time for an upsurge in energy. That is a nonjudgmental phrase. Dandelion time is often a prodictive, creative state; certainly it is good for my writing. I also exercise, lose weight, eat better, and reach out to people. I find comfort in God, go to church more and pray more. I wear my dad's miraculous medal with a pen attached. I have faith that if I walk into a church, any church, I will find nurturing. Black churches are particularly wonderful. People seem to grasp intuitively that here is a hurting soul needing loving rescue.

When people ask me what I do, I answer, "I am a writer." I have wanted to be a writer as long as I can remember. Since I wrote a prize-winning essay on fourth grade on why curiosity didn't kill the cat, but gave her nine lives, many teaches have urged me to submit things for publication. Dr. William Sadowsky, my shrink from 1987 to 1992, pointed out I didn't have a writer's bloc, but I had a submit to the publishers bloc. Sadowsky had the grandiose fantasy of turning me into a New Yorker writer. Blogs are a wonderful half way point.

I write when dandelions are blooming and trash my writings when they stop blooming. Gradually, from 1993 onward, I threw out about 70 notebooks and 250 tapes that I made from 1985 to 1992.I had planned to write a book on bipolar disorder and psychotherapy, based on my therapy with Bill. For a writer, that is a suicidal gesture, but no one was alarmed. Every spring I mourn their loss. The rest of the time, I console myself, "good riddance."

When dandelions are blooming (to my family , when I am getting manic), I reach out and share what's happening with my family, asking for suggestions and support. Here is a typical letter written to my daughters and brothers in November 2005, after I was fired from a library job just before the end of my probation period. No warning or reason was given:

My moods are fluid and labile. I am at risk. Andy started his new job today and desperately needs me to stay sane and centered. He can't concentrate on work if he is too anxious about me, and my anxiety about his anxiety is destabilizing. I would appreciate more support from the rest of you to relieve the burden on Andy. At least three times a week I will tell you my plans. I will giv you honest feedback on how well I followed my schedule and what things I have done that I might regret. Please feel free to give me honest feedback if you think I am getting into serious trouble , If I can listen to it, discuss it sensibly and learn from it, I am doing relatively well. If I become angry or argumentative, I better call my psychiatrist and adjust my meds.

I write no such letters when dandelions have blown away.

Losing the Charm Bracelet--June 1973

Sharing this is frightening.  Only my first postpartum episode in 1973 had definite psychotic features.When I am manic, I occasionally find it hard to distinguish among books I have read, movies and plays I have viewed, and what I have actually experienced.When hen I am manic, I remember hundreds of books I have read, movies I have seen. What fueled this episode, by far the worst one, was a pregnancy spent editing psychiatric books about schizophrenia. The most frightening fantasy/dream of that 1973 episode turned out to be straight from the surrealistic Fellini film, Juliet of the Spirits. Religious movies I had seen as a child, Song of Bernadette and The Miracle of Fatima.

I am not a jewelry person. Except for my ruby engagement ring that I never remove, good jewelry is wasted on me. I am careless, and I misplace it.

The charm bracelet was different. Uncle Frank, my favorite uncle, gave it to me in 1957 when I was a junior bridesmaid at his wedding. I was 12. 1957 was also the year my father molested me--French kissing and genital fondling. He did it three or four times, then stopped. My recollection was that my mom was pregnant. When we were going up the steps of our local Catholic Church, he told me: "What I did was wrong. If I ever try to do it again, you need to stop me. Say, no daddy, it is wrong." This admonition was  more traumatic than the molestations. I felt responsible; had I seduced my daddy against his will? Since I always resented sharing him with my mom, my fear seemed plausible. I never told anyone; who would believe me? Besides, what would happen to Daddy if people knew what he had done?

What Is Your Problem, Mr. Rashkolnikov?

My MLS in library science has enabled me to help more clients than my MSW in social work. Shrinks put diagnostic DSM numbers on people; librarians only label the books. Matching someone up with the perfect book for his present crisis can save years of meds and shrinkage.

A friend of mine, who is the psychiatric social worker at Montifore Hospital in the Bronx, has an office full of books. Chris says lots of patients unknowingly come to his ER for the best book for them in the present crisis in their lives. They don't need admission. I recommend a young Irish client struggling with his sexual identity read James Baldwin; Baldwin did most of the therapeutic work.

I do know there is some magic in making the client/book connection.; trusting one's intuition is key. One high school librarian characterizes librarians as the last alchemists. I talk to kids long enough to determine whom he/she reminds me of. Then I recommend their soulmates favorite books. It shouldn't work, but it frequently does. So does not thinking what I am doing..

Rarely explored is the role that a common literary experience plays in therapy. My best psychiatrists have been English majors. If a client refers to particular books, poems, songs, I would try to track them down. If I didn't have time to read them, I at least skim them long enough to understand the basic themes or characters..I answer immediately when clients ask about my favorite novel. Some analytically oriented shrinks might spend the whole session analyzing why a client wants the answer to that question.

Savior or Evil Enchanter

I am seeing a new therapist today. I am sure that's why I am reposting this.

My dad died May 11, 1987 of Alzheimer’s Disease. My mom, my Uncle Frank, and I went to Charleston the next weekend to attend my godchild's wedding. The night we arrived, I called the first of my many ex-psychiatrists to tell him I was manic and couldn't sleep. Horribly, he prescribed stelazine, a powerful and sedating anti-psychotic, When I got back from Charleston, things immediately deteriorated between my husband John and me, even though we hadn't seen each other for three days. I didn't even unpack my suitcase, which was full of my journals I had lugged to Charleston hoping to show my cousin, the writer.

I took the car out on an errand. I had asked John to do it, since I knew driving and stelazine were incompatible, but he was busy. I should have postponed the errand. The contrast between my Uncle Frank and my husband seemed unbearable. Admittedly, I didn't talk to Uncle Frank the way I talked to John.

I momentarily blacked out at the wheel and found myself on the wrong side of the road. Terrified, I made a desperate bargain with God. "I have struggled so hard with this disease; I am not going to kill myself by accident. I don’t believe in you, but I am giving you a chance. I am going to the local hospital ER and asking to see the psychiatrist on call. I will believe in you if the right doctor walks into the room." I drove to South Nassau Hospital, announced I was manic and needed to be hospitalized immediately. No questions asked, they put me into a private room and phoned the psychiatrist on call.

I carefully displayed my suitcase full of notebooks. I was reading Mary McCarthy's, How She Grew. She described how her editor husband locked her into a room until she started writing her first novel. As I was waiting for the shrink, I thought, "he is never going to forget this night. If there was a God, I would be meeting the co-author of my book." In retrospect, loony bins are not ideal places to shop for a co-author. From the very beginning, I intended to write a book about psychotherapy and manic depression. My longing for a co-author was a dangerous symptom. I have always imagined I need a man like me to be me.

Dr. William Sadowsky walked into the room. I handed him my resume. He delightedly took it-- “no one has ever done this before.” I blurted out: “Dr. Sadowsky, my father just died; he molested me when I was 12; and if I had a lover in New York, I wouldn’t be here.” Dr. Klein later marveled how I described the major themes of a twice-a-week, five-year therapy in the first sentence. Dr. Sadowsky read my resume, then studied the notebooks and the Mary McCarthy book. “I already know I am going to be a big disappointment to you. I can’t keep you here long enough to write your book."

Loony Bin Gulags, 1973, 1989-96

I have been jailed and tortured in five different loony bins in New York City and Long Island. I have never felt so hated. Psychiatric hospitals feel like gulags; I feel like a political prisoner. I practice my nonviolent passive resistance skills, going completely limp as the staff drags me to latest punishment for disobedience. Loony bins are not benign refuges for rebels. My tart, incisive tongue got me shot full of knockout drugs and locked in a padded empty room without food, water, or toilets for 9 hours at Hillside Hospital. As I was being dragged to the "quiet room," one aide said to watch my head; a nurse said, "don't bother." They were not very upset when a patient tried to choke me with a heavy metal phone wire; they subtly conveyed that I had it coming to me.

Roosevelt Hospital shackled my arms and legs to a bed all night (four point restraint) because a nurse snapped when I got my backpack from the nurse's station. I had established myself as a trouble-maker by refusing to wear a hospital gown. Every other hospital required the patient to wear her own clothes. Instead, I was wearing a red shirt: "Never Love a Man Who Doesn't Love Jane Austen, Doris Lessing, and Margaret Drabble." As a skirt, I wore a green shirt with manic on the front and witch on the back.

Wisely, I didn't hurt myself by struggling. My 8-hour restraint  proved I was not a danger to myself or others. I tormented the aide forced to watch me all night by subjecting him to my off-key singing of We Shall Overcome, The Times They Are a Changin all night. Aides have to watch shackled patients because people who die in four point restraint inconsiderately embarrass hospitals when newspapers outline their story. The aide knew very well that my incarceration was due to a tired nurse's snapping. But he told me to be a good girl and not cause any trouble; there was nothing he could do. Bullshit. I lose respect for people who cave in with that excuse. There is always something you can do if you are determined enough, ingenious enough, brave enough.

Nassau County Medical Center put me in four point restraint when I tried to make a phone call to my 14 year old daughter in 1996, to make sure my mother had picked her up from school. Once you are seen as a nutcase, you have no rights whatsoever.

I often capture the floor's music system and subject everyone to 60's protest songs. I also dance away my despair to the great amusement of many people since I suck as a dancer. Patients, families, and even psychiatrists often mistake me for a psychiatrist because I dress the part and project the requisite intellectual arrogance. I am often the only social worker who is not hiding beyond locked doors, so I get heavily involved with other patients. Psychiatrists often adore me; nurses and social workers often loathe me. I give my fellow victims lots of laughs.

But my ability to laugh my tears doesn't eradicate the agony of the loony bin or the lifelong trauma my captivity has inflicted. My shrink once told me he could have gotten me out in a day rather than ten days if he could have convinced a plastic surgeon to sew up my mouth. He complimented my uncanny ability to diagnose the incompetent staff members and then describe their problems to them in exquisite detail. Their unbalanced reactions to me confirmed the truth of my observations.

I have always been a nonviolent pacifist; my only weapons are my pen and my tongue. I have escaped loony bin torment since my first marriage ended in 1996. Many people, including psychiatrists and family members, view psych hospitals as refuges. They don't believe that a tart, incisive tongue got me shot full of knockout drugs and locked in a padded empty room without food, water, or toilets. They couldn't imagine themselves with both arms and both legs shackled to a bed all night because they asked a question that an out-of-control nurse interpreted as undermining her fragile authority.

I am deeply committed to family therapy approaches and replacement loony bins with creative, loving alternatives for people suffering from the spiritual emergency that is mania. Bed and Breakfasts for manics in Manhattan would seem ideal. Hotel rooms with high speed internet connections are another benign possibility. Alone, it is so much easier to distinguish what craziness is coming from me and what craziness is coming from the supposedly sane people interacting with me.

Jane Austen at Hillside Hospital

 In October 1994, I was in the middle of a painful manic episode. I hadn't slept for days. I needed an immediate adjustment in my meds and was unable to contact my psychiatrist. I went to Hillside Hospital, Long Island Jewish Medical Center. Impatient at the long wait and desperate for sleep, I joked, "I am Jane Austen and this is my husband Adolf Hitler, and we need a marital evaluation." Of course, Jane got locked up and haldolled in submission, and Adolf went home. This was not my brightest move. My former psychiatirst Bill Sadowsky had trained at Long Island Jewish, and I thought humor was an essential part of the curriculum.

I wrote my usual troublemaking letter to the head of the psychiatric department and the head of the hospital,  asking the following:

1. Are there any compassionate, competent psychiatrists on staff?
2. Is the patients bill of rights some kind of sick joke?
3. Should I insist that my lawyer accompany me to this thinly disguised jail? Is a manic depressive diagnosis a new way of taking people political prisoner?
4. Does LIJ investigate whether staff members, particularly the late night shift, have ever been reported for child abuse?
5. Was revealing my status as a social worker a suicidal gesture, given the level of hostility it would arouse in some insecure staff members. "Oh my God, one of us could be one of them?"
6. Have you ever considered hiring a former patient to evaluate and assess the psychiatric stability of staff members?
7. Is personal psychotherapy required of staff members or are patients expected to provide that gratis as part of their treatment plan? Do their insurance companies know of this arrangement?
8. Do staff members have any responsibility to deal with anguished patients in the middle of the night or are they entitled to react like those anguished patients' abusive parents?
9. Is LIJ psychodrama where you have the opportunity to re-experience all the traumas of your past life?
10.. In line with prevailing philosophy, why not drug all patients into total oblivion and hire computers to do the paperwork? Perhaps patients with insomnia would like to heal their peers? Perhaps some anesthesiologists would be interested in moonlighting? Or some great Danes?
11. Is desiring to listen to music and see bright lights after midnight bona fide proof of having lost control and being an acute danger to oneself and to the whole community?
12. Am I my sister's or brother's keeper if they are not paying me?
13. What should a patient who is also a professional do when she witnesses numerous instances of psychological abuse and harassment perpetrated against utterly vulnerable people? The abusers are primarily interested in catching up on their sleep, reading newspapers, watching television, acting out their own undealt with conflicts with God knows whom.  Does my promise to uphold the NASW code of professional ethics become void at LIJ?
14. Wouldn't I be better off in a friendly loving place like my old room in my mother's house with a radio, cd player, my Mac, where no one treats me like a bratty five year old and threatens quiet rooms and restraints for disobedience and talking back?

Descent Into Hell--St. Vincent's, NY, June 1973

The birth of my first daughter Emma in 1973 was my road to Damascus, my epiphany, my mystical experience, my utter bliss.  Despite 16 years of Catholic education, I had been an atheist for ten years. Looking at her incredibly eager bright eyes, I was certain she could not be the product of a chance collision of molecules. She was my miracle, and I suddenly believed in God, and for the first time since childhood found myself praying prayers of gratitude without forcing myself to do it.

 My faith has persisted for 36 years. When a friend once asked me shy I needed to believe in God. I told her, "because then I might have committed suicide." Emma's daughter looks amazingly like her with the same penetrating eyes that seem to be looking deep into my soul. For the first time I was confident enough to believe I could write a book about feminism and motherhood. Motherhood empowered women, not diminished them.

 My bliss turned into a nightmare as I became manic and my husband became anxious and depressed. Our reactions fed each other. That first episode was not just a hormonal, biochemical postpartum episode Although we both unquestionably needed psychiatric help and medication. I was tricked into going to St. Vincent's Hospital in Greenwich Village; I was told I was meeting my brother. I didn't want to leave Emma, who was entirely breastfed. I was assured my mother would bring her.

Drugging Kids Instead of Changing America

I  am the mother of 4 daughters; the grandma of five grandkids, 5 and under; the big sister of 5 younger brothers; the aunt of 11; the great aunt of 8; the oldest of 45 first cousins. I am a psychiatric social worker and children's and young adult librarian. As a therapist I have worked with clients with serious mental illness.  I have been involved with many  hundreds of kids  for all my 67 years.

 I am also a manic depressive, diagnosed at age 40 in 1985. My life was better before diagnosis and treatment, although I have taken meds for 26 years. Too often psychiatrist seem to want to drug away the radical feminist pacifist I have always been, who doesn't value obedience and always questions authority.  In my 20s I edited world famous psychiatrists, occasionally with a scissor (early  70s cut and paste). It took ten years to find a medication that helped more than it hurt. I read about it on the Internet and shopped for a psychiatrist that would partner with me to experiment. This year, I might have found one that actually worked at the smallest possible dose.  I will have much to say in this blog about  the challenge of therapy with bipolars, both as a patient and as a therapist.

Obviously, I am not denying a role for medication; I have swallowed my pills all this time. It is not clear if I should have. I am not denying a role for medication.  I am not talking about ADHD drugs like ritalin. However, childhood bipolar disorder has only been discovered in the last 15 years, mostly in America. Many discovers have close ties to Big Pharm. Until 1995 conventional psychiatric wisdom was that bipolar disorder could only be diagnosed in the late teens.  There is no conclusive study that proves childhood bipolar disorder leads to adult bipolar disorder.

Psychiatrists still debate whether it exists. I attended the 2010 meeting of the American Academy of Child and Adolescent Psychiatrists. Foreign psychiatrists were not true believers.  Some reacted as if a portal had opened over the Atlantic, and they had  fallen into a demon dimension with another species of children. "What is a bipolar child?" one Dutch psychiatrist ask.ed In 30 years of practice, I never met one."

Fearsome Foursome--My Undiagnosed Darlings

Strategist, Michelle; Adventurer, Emma; CEO, Molly; Writer, Jane

Writer, Strategist, CEO, Adventurer

My four daughters have turned out wonderfully--well educated, professionally successful, happily married. Three of them are wonderful mothers; the youngest is expecting a baby next May. Such a happy ending was not predictable during their childhood and teen years. I wonder what diagnosis they would earn now. Certainly, I worried at least three of them were bipolar, if not spawns of Satan, when they were younger.

Here were some diagnostic indicators. Obviously not all applied to all four daughters.

• They were chronically late. No one could get off to school in the morning without substantial maternal help, usually involving driving.
• They never picked up their toys. I have stepped on 20,000 lego pieces in the dark. To this day I cannot walk across a dark room without my toes' going on alert.
• Emma and a friend decorated their bedroom with a mixture of desitin and baby power while their grandpa benignly looked on.
• Emma painted her entire body purple when I was on the phone.
• Bedtime was a joke. A friend said you could call our house at any time of the night; someone would be sure to be awake and delighted to talk to you about anything for as long as you needed.
• They told their mommy " "I hate you" with not an ounce of guilt or remorse. When I asked Emma why she was acting like a devil child at age five, she explained "Mommy, I used all my goodness up in school." She now uses her goodness working for world peace.

Musical Chairs--a Game Any Shrink Can Play

As both a patient and a therapist, I have been struck by the perplexing reality that sometimes the patient becomes the therapist and the therapist becomes the patient.  At some level, I believe that all successful therapies are mutual referrals from God. Both people have a tremendous amount to learn from each other. Tragically, the patient is often the only one who realizes that. Humility is not on the curriculum in medical schools, clinical psychology programs, or social work schools.

I saw Bill Sadowsky for both psychiatry and therapy twice a week for 5 years. Our therapy was a transference-countertransference nightmare  by anyone's standards. In November 1987, after treating me for six months, Bill exploded:

"If I reacted to any of my other patients the way I reacted to you, I would know I needed years more therapy. But I don't and that is how I know the issues are coming from you."

 That was bullshit. He did need years more therapy, and I provided it too  much of it. But since I never paid him a cent and he was willing to endure upheaval for my sake, we could joke about the mutual training analysis sponsored by the state of New Jersey, my husband's employer. We both did get better. He remarried a psychiatric nurse. I earned a master's degree in library science and social work.

Looking back, I enabled him to be the therapist who treated me. Irresponsibly, he moved in North Carolina in 1992, giving me 7 weeks notice Much worse was his decision not to communicate with me, not to answer phone calls and letters ever again. I am sure Bill  lied to himself that he didn't want to sabotage my therapy with Dr. Gary S., whom Bill had referred me to. Painfully, over the years I have realized how hard I had to work to turn Bill into the kind of shrink I needed.

 In our last session in July 1992, Bill assured me that my view of our relationship was not nearly as distorted as I sometimes thought it was. He assured me I would be a distinguished therapist and writer.  I laughed, "that is high praise coming from my most difficult patient."

After I met Gary , I teased Bill: "He is so gentle. Is he my reward for putting up with your shit all these years?" Bill said I would be able to tell by what issues arose in my relationship withMichael what had been his problems and what had been mine. If my husband's insurance hadn't paid for my treatment, Bill would owe me a lot of money because so much of our therapy was driven by his issues..

I saw Gary twice a week for two years and intermittently for  15 more. Yet I have not done nearly as well under Gary's care.  Gary  is a clinical psychologist.I always needed a psychiatrist as well. Therapists and psychiatrist don't communicate adequately; I suspect it is almost always the psychiatrist's fault. David, briefly my psychiatrist in 1993 and 1994, had the audacity to say, "if Gary is telling me the truth," when their perceptions of me differed.

Gary often seems too controlled, too contained. He rarely reveals anything about himself. His apparent sanity has made me feel less sane. But I know I have been picking up his stuff all along; unlike Gary, he doesn't acknowledge it. He follows every rule of therapeutic correctness. He is primarily a child psychologist. He is much more comfortable with my depressed self; my manic side makes him too anxious. Bill was the reverse. But my manic side earned two master's degrees, embarked on a successful social work career.

For years with Bill I struggled with whether I was too crazy to be a social worker. Becoming a librarian was a consolation prize. Bill reminded me that "the staff has the keys, but the patients are expected to get better." He questioned the validity of the concept "too crazy to be a shrink." My social worker career faltered a year after I started to see Gary in 1993; I have been hiding out from my gifts in public libraries ever since.Gary   seems to think I am too crazy to be a shrink, althoughthe is far too professional actually to say it. If he said it, I could argue with him and build up my self-confidence. Instead, I agree with the unvoiced judgment. Things would have been different if Bill stayed. He couldn't stand to see me settling for less than I could accomplish.

Yet why am I so shaped by the expectations of the men I love? Wouldn't I have been better off seeing an experienced, motherly therapist like myself? My writing helps me more than therapy would. I am tired of playing invisible musical chairs. At a certain point, more therapy seems a counterproductive distraction from the real business of my life.

Is Your Kid Mentally Ill?

I am 67 years old, the oldest sisters of 5 brothers, the oldest of 45 first cousins, the mother of 4, the grandma of 5 1/2, the aunt of 11, the great aunt of 8.. I stayed home full-time  with my daughters for 14 years, took care of my grandson until he was 2.  I  have been an editor of psychiatry books, a childbirth, breastfeeding and parenthood educator,  a children's and teen librarian, and a social worker. Children and families have always been my passion. Two years ago I spent an entire week with thousands of child and teen psychiatrists at the annual meeting of the American Academy of Child and Adolescent Psychiatrist.. So I feel entitled to offer advice on kids and mental illness.

Parents of troubled kids should first discuss with their parents, grandparents, aunts and uncles whether their children are just displaying normal children brattiness and misbehavior. What were you like as a child?  They remember what you were like better than you do. Talk to friends with older children and with teachers you trust. Is the problem a mismatch between your temperament and your child's? It is far more challenging to parent a child who is nothing like you. What role does sibling rivalry play? Does you child have the right teacher? I had totally unrealistic expectations for my first child.

I was always seeking my mother's, grandma's, mother-in-law's reassurances that my kids' impossible acting out was within normal limits. Their father always reminded me that many of the qualities that were driving us round the twist would contribute greatly to their adult success. Some children are temperamentally unsuited for childhood. My oldest daughter should have been born with a printout: "You will win only 5 battles with this child. Choose them carefully." I was warned. She repeatedly stuck her tongue out on the delivery table.  Childhood was far too boring for Emma.

If experienced parents, teachers, grandparents express concern, I absolutely believe in family therapy (including sibs and grandparents if possible), no matter how young the child. Siblings are particularly important. As a social worker, I have tried to help far too many clients who were both identified patients and family therapists.

I am very troubled by imposing lifelong brain disease diagnoses on children and young teens and treating them with untested drugs with harmful side effects. Being told I had a broken brain at age 40 was devastating. I cannot imagine the reaction of a child who is 7 or 8 or 13 or 15.

60s Radical in the Loony Bin, 1989

This is the exact copy of a letter I wrote to my psychiatrist when I was hospitalized in November 1989. I am not editing it; I want you to understand how I am manic, how intellectually arrogant and obnoxious I am, and why I antagonize the staff. Other people are treated better than I was, but they are more humble, obedient, and appreciative. A year later, I was hospitalized for three days at South Nassau for depression and the experience was totally different. South Nassau was by far the best of the loony bins, but that was because my psychiatrist was on the staff.

November 1, 1989
Dear Dr.  William Sadowsky,

I petition to be released from South Nassau Hospital as soon as legally possible, preferably today. During the day, especially when students from local colleges visit, it appears to be a caring, enlightened therapeutic community. When the clock strikes 11, the psychiatrists have long disappeared, the regular staff goes home, and the ward is subtly transformed into a quiet nightmare where no sentient patient could possibly feel secure.

Fortunately, there are not too many sentient patients aware of what could potentially happen since virtually all are snug in their drugged little beds. But those of us strong enough to evade psycho-pharmacological lobotomies experience an entirely different horror behind the benignly cheerful facade.

Self-evidently I have no way of knowing whether the night of Oct. 31-Nov. 1 was representative or a particularly ghastly Halloween prank: the invasion of the body-snatchers so to speak. Looking back, I glimpsed faint foreshadowing earlier in the day. Item one, I was forbidden to keep my contact lens lotion because I might poison myself or the other patients with it. I informed the staff their chemistry was faulty. Poison control had once assured me the stuff was harmless after my three year old had taken a sip. I pointed out that it was more probable that I would break my leg feeling my way out to the front desk for the lotion when I couldn't see. You understand, Dr. Sadowsky, that the staff members in question were not in my league, intellectually or verbally. Continually I was assaulted by some mindless mumble-jumble about rules.

The rules about walkmen, radios, and tape recorders are equally arcane. Most people of my acquaintance on this planet use music as a way to wind down, process the confusing, frightening events of the day, pray, dream, meditate, masturbate, sleep. Given such highly personal goals, each person needs to choose her highly personal music. The helpless victims at South Nassau are robbed of their personal music because the clairvoyant staff can see they are all bound and determined to strangle themselves with the cords of their electronic coffins. How blessed you are to have a staff capable of piercing behind every calm exterior to the electronic suicide waiting to happen.

Here is how another hospital handled the dilemma. Sixteen years ago, when I requested a radio at St. Vincent's, in a state infinitely more distraught than the state I am experiencing now, my request received a careful individual evaluation. The hospital's need to protect its potentially suicidal patients from electric cords was soberly explained, but I was allowed to bring in my own radio. When I couldn't sleep in the middle of the night, when even their full arsenal of drugs couldn't dull the agony of my separation from my two-month-old, entirely breastfed daughter, I did not feel abandoned by the human race because I heard voices, warm, comforting voices, in the middle of the night on the radio.

Join Revolution for Family Friendly US

When I was a radical young feminist in the late 60s and early 70s, I was profoundly disturbed by the middle-class nature of New York feminism. Only a tiny minority of women could afford to become doctors, lawyers, college professors, corporate executives. The needs of women of color were ignored. African American women had always worked and taken care of their children. They were more dubious about abortion, since the babies of teen mothers were often cared for by relatives.

 Unlike many women with my intellect and education, I stayed home with my four children full-time for 14 years. I also cared for my mother in my home 24/7 during the last four years of my life. Both my husbands and I made career and financial sacrifices to make that possible. Certainly my career has not been the success I dreamed about. But I am not sorry. I involved myself in nonsexist childrearing, childbirth education, breastfeeding counseling, parent education, toddler playgroups, babysitting cooperatives, cooperative nursery schools, school libraries, a campaign to save the local public library, the nuclear freeze movement, mental illness support and advocacy, parent advocacy for playground upkeep and a preschool playroom, the War Resisters League, Pax Christi (Catholic anti-war group)--the list is endless.

When I made the mistake of attending library school and social work school, I naively assumed my qualifications would be obvious and no one would dare to treat me like a beginner. Instead, I was given the the salary, benefits, authority, and respect of a beginner and the responsibilities of a long-term employee. Several bosses seemed threatened I wanted their jobs. I recall one infuriating incident during my first social work placement; my childless supervisor earnestly instructed me how to interview a client with her two year old present. I had frequently run La Leche Meetings with 20 moms and 30 babies and toddlers. Women social workers who had taken very short maternity leaves and worked full-time during their children's childhood too often acted like all my knowledge and wisdom had been attained by cheating. I got more respect from male professors.

 The situation has worsened; women are terrified of taking only a few years off from work. And yet the men who fought World War II left their jobs for several years and did not suffer economic consequences. The government even paid for their college and grad school education. When my mom went back to college in 1963 and work in 1968, after having raised 6 children, she was accorded more respect and her experience was more honored than mine was 20 years later.

Full-time childrearing is frequently belittled as beneath the time and attention of intelligent, well-educated parents, who presumably should have exploited immigrant women of color to love and understand their children while they pursued their more important jobs. In the 70s parents were going to have flexible work schedules so both could raise their children. Instead , in New York City both child care and elder care are lovingly performed by women of color, mostly immigrants, some with irregular immigation status.. When I take care of my grandson in the same New York City playgrounds where his mother frolicked,. my companions are mostly nannies from all over the world. An older white woman with a toddler is assumed to be his grandma, not his nanny. I am often appalled how little highly successful two-career couples pay their nannies; many fail to provide the caregivers with any benefits, Social Security, least of all health care. They think nothing of calling the nanny on Sunday and telling her they don't need her that week or forever.. As one dedicated women from the Dominican Republic told me, "the more I love the children, the more it hurts my heart." Imagine loving a child as your own for three or four years and then never seeing them again when they go to school full-time or the family finds a cheaper nanny.

 The aides who helped us take care of my mother during the last years of her life had tragic stories. We paid the agencies about $18 an hour (2001-04); the aides got less than half of that. Most did not have cars and might have to take two buses and a subway to reach their client's homes. Many had left their children in the Caribbean with their families. I agree that most women with college degrees, graduate, or professional degrees have made enormous strides in most major professions and in the workplace generally. It is only when women have children or have to care for aging parents that they fully realize that women have mostly gained the right to follow the traditional male life style, emphasizing work over relationships, caregiving, community activism..

As women chose to have children at an older age, the realization is late in coming. At that point their lives tend too become too frenzied and exhausting to leave any time for political activism. Nothing has changed to make full-time or even part-time child care by fathers more financially possible. My four well-educated, successful daughters are only having their consciousness raised as they begin to have children. Before they became mothers, they believed feminism had won its battles. You might make over $100,000 a year, but you might still have to pump breastmilk for your infant in the toilet One daughter was told she could not store her pumped milk in a company refrigerator for a day because it was a biohazard. If you work at Walmart's or a department store, you won't be able to nurse at all, no matter how vehemently your doctor argues that breastfeeding is best for your babies.

A movement as sweeping as the civil rights movement is required to make America a child-friendly, elder-friendly, family-friendly, human-being friendly society. 

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How to Cheat on the Mental Mini-Status Exam

Given that researchers plan to diagnose Alzheimer's Disease ten or twenty years earlier, no one is too young to practice cheating on the Mini Mental Status Exam .

Make sure all the answers are on your smart phone before your neurologist visit. 

If the examiner asks you not to look at your smart phone, offer to teach him how to use it so he won't have to waste so much time "remembering" Smirking casts doubt on your sincerity.

Mini-Mental Status Examination

The Mini-Mental Status Examination offers a quick and simple way to quantify cognitive function and screen for cognitive loss. It tests the individual’s orientation, attention, calculation, recall, language and motor skills.

Each section of the test involves a related series of questions or commands. The individual receives one point for each correct answer.To give the examination, seat the individual in a quiet, well-lit room. Ask him/her to listen carefully and to answer each question as accurately as he/she can.

Don’t time the test but score it right away. To score, add the number of correct responses. The individual can receive a maximum score of 30 points.

A score below 20 usually indicates cognitive impairment. ___

What is today’s date?

 What is the month? 

What is the year?

 What is the day of the week today? 

What season is it?

Whose home is this? 

What room is this? 

What city are we in? 

What county are we in? 

What state are we in?

Examiner: Confiscate all smart phones and ipods before administering this part of the  test. Be aware your patient will be hiding them.

Ask if you may test his/her memory. Then say “ball”, “flag”, “tree” clearly and slowly, about 1 second for each. After you have said all 3 words, ask him/her to repeat them – the first repetition determines the score (0-3):

 Examiner: Suspect surreptitious text messaging to oneself.

Ask the individual to begin with 100 and count backwards by 7. Stop after 5 subtractions. Score the correct subtractions. 

Patient: Make sure to teach your child to count backwards first so they can ace this exam.

Ask the individual to spell the word ”WORLD” backwards. The score is the number of letters in correct position.

Patient: Silly you, learning to spell forwards. No wonder there are so many people with dementia.

Ask the individual to recall the 3 words you previously asked him/her to remember.

Ball  Flag Tree 

Examiner: Suspect his mental acuity if he isn't consulting his cell phone.

Show the individual a wristwatch and ask him/her what it is. Repeat for pencil.

Examiner: Don't award any points if patient says the wristwatch was  a primitive cell phone and a pencil was a primitive ipad.

Ask the individual to repeat the following: “No if, ands, or buts”

Examiner:  "No if, ands, and buts, this is the stupidest test I have ever taken" still earns full credit.

Give the individual a plain piece of paper and say, “Take the paper in your hand, fold it in half, and put it on the floor.” 

Examiner: Duck the paper airplane headed toward your eyes.

Hold up the card reading: “Close your eyes” so the individual can see it clearly. Ask him/her to read it and do what it says. Score correctly only if the individual actually closes his/her eyes. 

Examiner: Disobedience is unmistakable proof of dementia.

Give the individual a piece of paper and ask him/her to write a sentence. It is to be written spontaneously. It must contain a subject and verb and be sensible.

Examiner: "You are a fucking idiot" is an eminently sensible sentence.  Control your emotions.

Give the individual a piece of paper and ask him/her to copy a design of two intersecting shapes. One point is awarded for correctly copying the shapes. All angles on both figures must be present, and the figures must have one overlapping angle.

Patient: The examiner is testing your motor skills. Informing him you still skateboard will not improve  your score.

Total Score:_____

DISCLAIMER: ANYTHING WRITTEN  IN BOLDFACE IS NOT PART OF THE TEST. ANYTHING NOT WRITTEN IN BOLDFACE IS THE ACTUAL TEST.  

Ripples

"We drop like pebbles into the ponds of each other's souls, and the orbit of our ripples continues to expand, intersecting with countless others. " Ken Wilbur, No Boundaries
Children love throwing pebbles into the water and watching the ripples spread out. The ripple effect is how I conceive of my contribution everywhere on the Internet.

What I loved about being a public librarian was the opportunity to throw thousands of pebbles over the years. Handing the right book to a child going through a difficult time could be worth months of therapy. A ten -minute conversation with a distressed mom can help her reframe her problems with her children. Fifteen minutes coaxing  elders to try the internet can open up the world for them. Guiding  frightened new cancer patients to local support groups and the latest research might lessen their fear.

I preferred being a librarian to being a social worker. Insurance companies compel therapists to put numbers on people; librarians only number the books. So many public librarians considered being social workers, not realizing that they already are.

I once treated a young Irishman struggling with gay identity issues. Introducing him to James Baldwin was my crucial intervention. A late friend, a ER psychiatric social worker at a large municipal hospital, had an office filled with books that he gives away. Chris believed many people experiencing the spiritual emergency of acute mental distress need a good listener and the right book, not hospital admission and mind-dulling drugs.

Being a La Leche leader  (volunteer breastfeeding counselor)  in Manhattan, Bangor, Maine, and Baldwin, NY,  from 1977 to 1987 was  a deeply rewarding way to create ripples. My name and phone number were on posters all in doctors' offices and hospitals.  People were invited to call me 24/7 for breastfeeding advice.  No one ever abused that offer.  The few late nights calls I got were important. Many more  mothers  who should have called  didn't.In the days before cordless phones, I needed a phone cord that stretched anywhere downstairs, from the front to the back door. Otherwise, I would be giving advice on sore nipples and improper latching, and my kids would be painting themselves purple, making magic potions for their baby sister, or decorating the playroom with talcum power and destine.

 I counseled many hundreds of women in meetings and over the phone. Often I will meet someone who insists I look very familiar. After exchanging our life stories, we realize I was her La Leche League leader. Or I was the helpful librarian whose name she never knew. Public librarians tend to be anonymous handmaidens..

I believe it is our moral responsibility to make the world a better place. I have always wanted to change the world. As I age, I realize my legacy is to make ripples,  one pebble at a time. Each of us is doing that when we blog, and we will never know how far our ripples expand.Ratings and comments and editor's picks don't measure ripples.

Bobbot, a fellow blogger on Open Salon,  has kindly given me permission to include his comment, which expresses my ideas better than  Wilbur or I did.

The ripples are not affected by accolades. They spread even beyond our ability to see them still making minute changes as far as the body of water they are in goes then, even though no longer perceptible they return to where they came from. That is the legacy, change even imperceptible is still change and that will not be undone.