1. During my second hospitalization, which occurred in the same location as my first, I passed a nurse.
"How are you doing?" she asked.
"Okay," I said, which was true. My mania and subsequent depression seemed to have been exorcised by the overdose I'd taken immediately prior to being hospitalized, and other than being frustrated by my return to the WS2 ward, life no longer felt like an intolerable sentence.
The nurse smiled. "But how are you really doing?"
The notes I've acquired from Yale Psychiatric Institute read, among other things, "Patient shows a lack of insight."
2. "[The patients] were being driven to a prison, through no fault of their own, in all probability for life. In comparison, how much easier it would be to walk to the gallows than to this tomb of living humans!" writes investigative journalist Nellie Bly in her 1887 exposé, Ten Days in a Mad-House, which gives reader a revelatory view into a New York City "lunatic asylum." Bly gained access to the hospital by pretending to be insane herself.
After her admittance, Bly recounts asking for her notebook and pencil. The attending nurse, Miss Grady, tells her that she brought only a book, and no pencil. "I was provoked," Bly says, "and insisted that I had, whereupon I was advised to fight against the imaginations of my brain."
In another part of Ten Days, she says, "I always made a point of telling the doctors I was sane and asking to be released but the more I endeavored to assure them of my sanity the more they doubted it."
3. The doctor told me in one of our rare meetings that I'd said, upon emergency room intake, that I believed in a "conspiracy of people" who were determined to hurt me.
"I didn't say that," I said. "I said that I was feeling unsafe." But "feeling unsafe"—as in, feeling terror about everything and nothing in particular—was an unfortunate phrase for me to use during the intake. "Unsafe" is a psychiatric code word for "suicidal," which I was not, although I was many other things. "Unsafe" might have triggered the hospital's belief—its own delusion—that I felt unsafe due to a paranoid belief: a conspiracy of people out to do me harm.
The hospital maintained for the remainder of my stay that I had come in feeling "unsafe," with delusions of persecution. Because "unsafe" doubled as "suicidal," I was considered a danger to myself. Even though I had voluntarily walked into the ER for help, "unsafe" meant that I was considered to be "involuntarily hospitalized," which also meant that I was locked down in the rural Louisiana hospital, on the north shore of Lake Pontchartrain, until the doctors gave me permission to leave. I did not know how long that would be.