Does She
Have a Plan?
At the front desk of the emergency room, Jeff says, "My wife has bipolar," and immediately they press the button to open the door and Jeff ushers me in. Here's a trick: if you ever want to get into the emergency room fast, tell them you're bipolar or schizophrenic. Works every time. They take my vitals --- my pulse is racing, my blood pressure is about twenty points higher than it usually is --- and show us to a room, assuring us that the doctor will be there soon.

We're sitting in the triage room --- well, Jeff is sitting, and I'm in the corner, having crawled on top of a cabinet behind a tangle of medical equipment, agitated and talking a mile a minute until the doctor comes in, at which point I snap my mouth shut and become mute.

"Why are you up there?'' the doctor asks me, baffled. Jeff and I stare at him. Finally Jeff says, "Because she's crazy."

The doctor raises his eyebrows. "Ah," he says, still not quite getting it. He asks me a series of questions --- what brings me in here today, am I suicidal, do I have a plan. With every question, I look at Jeff. He repeats the question to me, and I nod or shake my head. In this way, we establish for the doctor that I'm nuts and need to be hospitalized. The doctor disappears and is replaced by someone from the psychiatric staff. The man walks in, takes one look at me, and says, "Would you feel better if the lights were off?"

"Yes!" I shout, then shut up again. He switches off the lights and takes a seat.

"Tell me what's going on," he says, and Jeff does.

"This happens every summer," he says. "Around June, she gets hypomanic, in July she's manic, and by August she's gone completely around the bend. It happened again this year. It started with her working around the clock and not sleeping. Then the anxiety set in, about a month ago. She's seen her doctor a bunch of times, and he's been trying to switch her meds fast enough to keep up with the episode, but obviously it hasn't worked. In the last week, she's been afraid to leave the house, just running around being compulsive for days, talking constantly, and then today I came home and she'd been cutting."

The man is writing on his clipboard. "Is she suicidal?"


"Does she have a plan?"

"She says she doesn't, but she's lying."

The man looks at me. "Does all this sound about right?"

"I don't have a plan," I say.

"She's lying," Jeff says.

"The point is that you're not safe to be at home, is that right?"

I nod. By the time we get to the hospital, I'm no longer under the impression that I'm sane. Once I've started cutting, I know I'm not likely to stop until I've done some serious damage, and I don't want that any more than anyone else does. The last place I want to be is the hospital, but I'm not stupid. I know when it's time to go in. I am so terrified of myself and of the vast, frightening world, that the psych ward, with its safe locked doors, sounds like a relief.

"All right," the man says, and then suddenly we're interrupted by another doctor, who walks in the room and switches on the lights. I flinch and shade my eyes. The second doctor goes through the same questions as the first doctor --- what brings me here today, am I suicidal, do I have a plan --- and Jeff goes through the same answers --- she's having an episode, she's suicidal, she has a plan. Satisfied that the psych staff has it under control, the doctor leaves, and the first doctor switches off the lights again.

"Sorry about that," he says. "Well, listen. You've obviously done everything you can at home, and we don't want to make you wait when you've already made a serious effort to stay out of the hospital. Give me a minute and I'll get you upstairs." Soon he comes back to get us and escorts us up to Unit 47, where they know me well.

--- From Madness: A Bipolar Life
Marya Hornbacher
©2009 Mariner Books
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