It was 1968. The war in Vietnam was raging, the Beatles were making music for everyone to make love to, and my college peers were smoking pot, dropping acid and doing something with mushrooms to experience alternative realities and really find God. They were going to demonstrations and changing the world.
I was working full time in the local psychiatric hospital in Louisville, Kentucky while going to college part time. I looked like a college student of that time, only better dressed, when being better dressed was not the right thing. My fellow students thought I was an alien. I was part of the medical establishment. Young people then celebrated mental illness as a far out experience.
For those four years of college, I worked on the locked ward for women in a psychiatric hospital full time. It was a wonderful job for me. I had the 3-11 shift, my favorite work time, and had an opportunity to mean something to patients often forgotten by everyone.
Some of the patients who had attempted suicide due to depression or had recurrent severe depression requiring electroshock therapy and medicine with terrible side effects would come for a while and with good care and good luck move back out into the community to start over. Many of the women on my ward were schizophrenic and unable to function without hospitalization in spite of drugs that failed to control their paranoia, delusions, fear, rage, and hallucinations. Many were institutionalized for most of their adult lives.
The door of 3 North opened when I rang the bell every day at three p.m. The big double doors were unlocked from inside for everyone but those who had the authority to carry the big door keys. I can still hear the sound of that ring and the feel of the doors moving inward as I left the life of a college student and entered the surreal world of mental illness.
The patients of that locked ward all had stories and we spent years together. Certainly their stories have remained with me. Soon after I began my work there a young Vietnamese woman who spoke limited English was admitted. She had married a soldier and he had been transferred to Ft. Knox. Her break with the world was real and permanent. She had made multiple suicide attempts and had finally settled into a delusional state that she could change her face to the features and complexion of a Caucasian woman. Often she would cut out large pictures of beautiful women and try to push the image into her face. Her daily ritual with me involved placing her hands on my face and transferring the image over and over again to her face. Failure to change her appearance fueled constant episodes of rage.
This weekend I saw on its opening day a poignant and heartbreaking film: The Soloist, a chronicle of mental illness based on a series of 2005 articles by the 53-year-old Steve Lopez, a columnist for the Los Angeles Times. In the film, as in real life, Lopez —played by Robert Downey Jr., in the best performance of his career — accidentally meets a homeless schizophrenic man named Nathaniel Ayers. Jamie Foxx plays Ayers, who was a cello prodigy 30 years before his illness forced him into life on the streets. (You can see and hear the real-life Ayers, and Lopez, in this 60 Minutes segment.) Foxx and the other actors who give life to those who are mentally ill and homeless are astonishing.
The pivotal point in the film, and in this schizophrenic man’s life, comes when he becomes part of a mental health clinic on Skid Row — populated by the seriously ill and homeless of that community and cared for by understaffed, underpaid but dedicated mental health workers.
Lopez chronicles the story of Ayers’ life and the change in his life that occurs with a reconnection to the music that animates him, while he and Ayers form a unique friendship that transforms both of their lives. This true story of serious mental illness can have no happy ending, but Ayers did become a man no longer on the street, a man connected to his music and a man cared for by those who understood his suffering.
The treatment of mental illness has changed dramatically since that time in the late 1960’s, when institutionalization was often the only option. Now there are many community-centered models, but lack of funds has left millions who are ill untreated, abused, afraid and homeless. I cried through the last half of The Soloist, because I remembered how it felt to be so close to those who were suffering and to have so little to give them.
The Soloist broke my heart.
http://www.youtube.com/watch?v=q5GvsB3NfD0
Hi Dr. Allen,
Thank you!
Mental illness in a loved one is frustrating, sad and can bring out the worst and best in you. I have two brothers and one of them, my middle brother, Steve, was diagnosed schizophrenic in his late teens. I’m the youngest & only sister. It helped to bring my family closer together and gave me compassion for the mentally ill that I never would have otherwise had. It has made me exceptionally sensitive to thoughtless comments such as ‘Oh, she’s sooo schizophrenic’ made by naive people when making a derogatory comment about someone who is not afflicted with the illness. I recently told a naive, annoying friend, if you’re going to make fun of the mentally ill make sure you know what illness you mean to be making fun of…you’re talking about someone with multiple personalities which is not the same as schizophrenia. I was so angry, I wanted to make her feel bad and ashamed. I’m not proud of what I said – I do need to decide on what I will say in the future when it happens again…and I know it will. For some reason, schizophrenia is the mental illness du jour that is often used to describe someone, not mentally ill, in a derogatory manner. It’s a cheap shot and basically a replacement for the now non-politically correct derogatory comment to describe someone as a ‘retard.’ I look forward to the day when it will be considered unacceptable to describe anyone without a mental illness as someone with one. Mental illness is not something that you elect or choose to take on. We have no right to even assume what it’s like to be afflicted with a mental illness. Rest assured it’s not funny or taken lightly by those afflicted with one or their loved ones. Try to be grateful, informed, aware & sensitive, if you and your family, have not been afflicted.