Monday, December 6, 2010
What I can do. Monday, December 6, 2010.
“Act as if what you do makes a difference. It does.” ~William James
There’s so many things I can’t do. There are a few things that I can.
Yesterday my friend came to me. She was sick, she said, and she needed help. Tearfully, shaking, she asked me to accompany her to the ER.
Ella has dealt with paralyzing depression, anxiety, and sometimes psychosis for years. Unable to work, she depends on Disability, which offers minimal health insurance. Before she got Disability, she lived for a time in her car.
An intelligent woman, my friend recognizes she’s functioning at a low level; this knowledge makes her feel frustrated and ashamed. Raised in a home where she was taught to be subservient, lacking in any occupational skills, and having survived severe abuse, Ella barely talks above a whisper and breaks into tears every few minutes. She is filled with grief, regrets, and unresolved anger.
A few years ago Ella became suicidal and delusional. Her family and I felt she was a danger to herself, and we cooperated to get her placed in an inpatient facility for one week to get her past the immediate crisis. I’d be lying if I said she wasn’t angry at the time, but, she says to me now, “I know your heart is in the right place.”
In the months following her inpatient stay, Ella did very well. But like so many people in our society, she was teetering alongside cracks. And eventually, she fell into one. The community center where she was supposed to be receiving counseling did not provide her with a particular therapist; instead, they rotated, so she saw a different person each time.
Ella has led a difficult life, suffering multiple traumas over many years. She is a person in need of intensive, ongoing support. Instead, she found herself trying to explain her complex situation to one therapist and then to another (on the infrequent occasions she was actually able to get an appointment). No one had the big picture of her life. Who could make any progress in a situation like that?
After just a few sessions, she quit going. She didn’t like talking about her problems anyway. Ella took her pills sometimes, and got a couple of refills from a GP. But no psychiatrist was assigned to oversee her care. Her medication was as useless to her as her “therapy.”
At the moment, Ella is not suicidal, thank God. She’s not hallucinating, and she is not delusional. Last night, after nine hours in the ER, the doctor released her with a cheerful reminder take her medication and call a social service agency. She already has the number.
Ella has no voice. There’s so many things I can’t do. I can’t take away the traumas from Ella’s past. I can’t give her the occupational training she needs to find a job that might raise her self-esteem. I can’t make sure she takes her meds properly. I can’t change the social services system to give her continuity of care.
What I can do is hold her hand as she cries. So that’s what I did.