Quiet Room - Lori Schiller [107]
Looking over the chart, I could see how much effort had been expended on her. Everything that anyone had known how to do they had done, from shock treatments to talk therapy. Practically every known drug had been tried. No effort had been spared, and nothing had worked. No wonder people were on the verge of giving up hope.
Her history didn't scare us here on the long-term unit, though. We didn't see patients like Lori as hopeless. We saw them as a challenge. We felt that we were a different unit, we were a special unit. Part of the esprit of our long-term unit was that we could do things nobody else could do. Just because nothing had worked didn't mean nothing could work. We could take people like Lori whom everyone else had given up on and help make them better.
We didn't believe that medicine was the key. Of course we still kept trying everything in our power to find a drug or combination of drugs that would make sense. Drugs could and did alleviate psychotic symptoms in about two thirds of all schizophrenic patients. But most of the patients who came to us had arrived on a long-term unit precisely because medication hadn't worked. Like Lori, these patients had already been subjected to a bewildering variety of drugs, none of which seemed to do much for them in the long run.
Instead, we concentrated our efforts on getting inside the heads of our patients. Many other treatments focused on using medication to alleviate the psychotic symptoms. These treatments were considered a failure if the patient was still hallucinating. We felt otherwise. We felt that, hallucinations or not, there was a person inside there—and that we could reach that person if we tried.
We spent a lot of time on the unit talking about how to reach our patients. It took a talent, a certain chemistry between two people—and it wasn't always the doctors who had it. Sometimes it was the nurses. Sometimes it was someone completely unexpected like a volunteer, or a cook. It was very much our sense that we could create a bond between our patients and someone who could be their bridge from inside their craziness back to the outside world.
My desire to put my beliefs in this kind of treatment into practice was one of the reasons I chose to come to New York Hospital in the first place. It was one of the few hospitals that had a long-term unit that used these kinds of techniques.
I hadn't always wanted to be a psychiatrist. I had come to psychiatry by a roundabout route. In college I had been an artsy type, interested in cinema, literature and poetry. I saw them all as opening windows into the hidden side of people. In college, too, I had been fascinated with the literature of psychosis. One book in particular, called Two Accounts of a Journey Through Madness, intrigued me with its description of a patient's attempts to understand her own illness.
It wasn't until my third year of medical school, though, when we began rotating through different specialties, that I noticed a difference between myself and my classmates. They either liked to run around and do research, or treat sick people. What I liked to do was talk to the people I was treating. I wanted to know what they felt like, what their illness was like for them, and what it was like for them to be in the hospital. I also found out then that people responded well to me. They seemed to want to talk to me.
I decided to become a psychiatrist. And when I arrived at New York Hospital, I asked to be assigned to the long-term unit. I liked the idea of being somewhere where patients were given the time to work through and understand their own illnesses.
My emphasis on psychology, though, didn't mean I was going back to the old days of blaming schizophrenia on flawed parenting—the old model of the schizophrenogenic mother. We weren't looking for