WRONG-DOING ACKNOWLEDGED BY THE ER

In November 2021, my file was closed by a mental health department at a local hospital after I had been a patient there for eight years. Treatment for my bipolar 1 disorder (first thought to be schizophrenia) began at Riverview Hospital in 1965 where I was a patient for ten months. Since that time, I had for the most part been followed by private psychiatrists.

Being shut out of the system happened shortly after an appointment I had with a psychiatrist was suddenly cancelled. No good reason given. This psychiatrist had treated me for years previously.

I was stunned. Felt abandoned. I had suspicions of why this had happened, but did not want to jump to conclusions.

The reason given was that they could no longer look after me because resources at the hospital were not meeting the demand and, since I had a private counselor and I was doing well, care by my general practitioner should be sufficient. The GP could refer me to a psychiatrist if I needed a 15 minute phone chat with a professional. (My GP was a person who was not at all familiar with the ins and outs mental health care and it showed.)

I now believe my suspicions for losing psychiatric care were well-founded. The psychiatrist who had cancelled my appointment had disagreements with me in the past about the validity of the borderline personality disorder diagnosis he had given me. And he would not  hear my reasons. He also refused to admit that BPD had stigma attached to it, greater stigma than any other mental illness.

This doctor could not bear to be proven wrong by a patient. And so, he caused her to be denied the care she needed.

In my work with him in the past, I had told him about the mistreatment that had caused traumatic memories every day or two, each time followed by suicidal depression. But he shrugged this off as over-sensitivity caused by the BPD.

I tried to describe complex PTSD as a more likely diagnosis, a condition resulting from ongoing emotional abuse. But he refused to listen or even to admit that such a condition existed.

On Sunday I went to emergency, feeling abandoned and needing care. Most importantly, I needed a psychiatrist to take me off Tegretol (carbamazepine) which I had been taking for many years. My neurologist blamed its long-term use for the physical disabilities I had developed—the strong hand tremors and unsteady walking. Two months ago, she had told me I had to come off or the condition could worsen. But the system had still not allowed me back in as a patient, though I had tried repeatedly.

At the ER I told my story about having my file closed by the hospital. When a psychiatric nurse who interviewed me heard, he willingly volunteered that the psychiatrist in question was, “a bad doctor,” and, he said, “I would tell him that to his face.” “Other nurses here would say the same thing,” he added.

The ER physician I saw recognized the wrong that had been done to me. He saw the need and showed much compassion. Later he came back, delighted, because he had found a psychiatrist who he thought would take me on as a patient. He would see me that very afternoon in the hospital. My case was not the kind of emergency that the ER is designed for, but he realized that for me to be without a psychiatrist since November was wrong. I needed care.

Unfortunately, when this psychiatrist arrived, he told us he could not have me as a patient. At the age of 76, I needed to be treated by an older adult team—a geriatric psychiatrist. Usually older patients need less medications. Such a doctor would know how my medications needed to be adjusted for a person my age. I was given a referral.

I came away from the hospital feeling relieved. My needs had been recognized. Wrong-doing acknowledged.

Now all I have to do is wait for a phone call from my new psychiatrist.

Marja