I went to the VA hospital today, to get checked for some recurring depression. I just wanted to talk to someone and have a medicine change, but because I said I was a little more suicidal than usual, they had me change into psych unit pajamas and gave me a quiet room with a bed covered with anti-suffocation bed sheets.

Terminator played quietly in the hallway behind plexiglass.

To be clear, I wasn’t going to commit suicide. Very simply put, I live with a severe disability that needs to be closely monitored; I monitor my feelings like a diabetic manages their sugar. When my “levels” are low, I check in, well before there is a crisis. 

I want to write about my experience in the ER psych unit, because even if it’s a short 2-3 hour stay, there’s always a lot to say. 

Hospitals are prisons. French philosopher and sociologist Michel Foucault made that claim a few decades ago. He is one of the most revered contemporary philosophers. He said medical professionals “treat” you the same way a prison guard or police officer gains compliance.

Some of the ways Foucault points out hospitals, specifically ER psych units, are like prisons: They have authoritarian structures, dress codes, emphasis on silence and order, negative reinforcement, loss of individual autonomy, abridged freedoms, and minimal input in decision making. 

This was supremely evident during my stay in the psych unit. 

As I settled into my room in my uniform pajamas, I heard another patient say loudly, but not in a shouting voice, “I’m agitated because there’s seven of you around me trying to force me to take medicine! I don’t want antipsychotics!” 

“We are just trying to calm you down,” a nurse said. I couldn’t see directly into the space, but from what I know about psych units, they hire some buff people to control people. I imagined at least two or three strong men standing near the patient.

“I’m not calm because you are surrounding me and forcing me to take medicine!”

“If you’ll just calm down…” While they all stood around him.

He said the psychotics made him feel like shit, and he has his own body. He came in voluntarily, after all.

My head was abuzz. The nurses and doctors kept insisting that the problem of his agitation was him, not the circumstance of being force-fed medicine. A mix of benzos and an antipsychotic, would solve this man’s issue, they argued.

Unsuccessful in their bid, the nurses and staff retreated to outside the patient psych unit area. 

I looked into the hallway and finally caught a glimpse of the man. He carried the saddest and most distressed expression I’ve ever seen—like a child pouting when they’re being hit by a parent. From what I gathered, he voluntarily checked himself into the unit for 72 hour observation so he could get away from everything. Clearly, he was agitated, but not aggressive. I wish I could’ve just gone over to him and asked him about his day.

But because he was formerly an infantry sergeant, he was also rough around the edges. 

The nurses asked/demanded he stopped talking so aggressively. They threatened him and ordered him around the room so he would behave — like a prison. He retorted that’s just the way he talks. I kept thinking, if they just stopped ordering him around, and acknowledged his agitation and how their behavior is making him feel uneasy, the man would calm down. 

What the medical staff saw as aggression was, on the outside, just a person who is crusty and salty. A former infantry sergeant with a tough demeanor would be celebrated as a paragon of masculine strength. But in the ER psych unit… it’s aggression. And under Foucault’s theory, if a patient is perceived as aggressive, real or not, they are to be disciplined.

That’s exactly what eventually happened. 

After the nurses left the patient area, and a few minutes later, the patient rasped on the window seperating patients from the medical staff. They asked what he needed, and he said he wanted to talk to the doctor. This went back and forth a few times, with no one really understanding each other, until the nurse on the other side just started ignoring him.

After being ignored for a little while, he rasped on the window again. Eventually, the nurse came back to him. If he went to his room, the doctor would come.

“Why do I need to go to my room?” he said.

“For the patient’s safety,” the nurse replied.

“What do you mean for the patient’s safety?”

“For the patient’s safety,” the nurse repeated.

I should pause here really quick and mention that the nurse couldn’t use the second-person pronoun “you” because according to the theory hospitals are prisons, his agency was so far removed that he became an object to himself. In other words, he was just a patient, not a person with a set of individual desires and needs.

Eventually, the elderly man went to his room. Shortly after, the nurses rushed and locked him in. 

A gaggle of burly nurses gathered outside his door. I looked at him again through the door’s window, with a huge disappointed frown, as the situation made itself evident — the nursing staff manipulated him.

“What’s going on?” he asked.

“You were slamming on the window, and that’s being disruptive,” a male nurse told him. 

“I was just knocking on the window!” I was there, I saw it, he was indeed just knocking on the window. Annoyingly, certainly, but not aggressively or with malice. 

“You were slamming on the window,” the nurse repeated himself, ignoring the patient’s argument.

“I just want to talk to the doctor.”

“We’re past that point,” said the nurse.

In my mind, I’m thinking, are we really past the point of talking to the doctor? The man complied with what the nursing staff asked. Let him chat with the doctor, maybe it’ll actually calm him down and feel like he’s being heard and his agency is intact.

I took a close look at the elderly man through the window. His eyes were crying tearless tears. The nurse said he had to sit on the bed, and he looked back with fear, as if to say, “Is this really happening?”

The buff nurses bum rushed his room, and he said, “I’m not resisting.” In less than thirty seconds, he was restrained in the bed. He kept asking for the doctor. “Doctor, let me talk to you” “Before they give me medicine, let’s talk.” “I want to talk to the doctor before the medicine.”

Meanwhile, the nurses prepared a syringe and prepped the injection site. The doctor stood behind the commotion, observing, not doing anything. The patient looked directly at her and said, “Is this what you want? Why won’t you talk?”

The nurses gave him an anti-psychotic, and he writhed and shouted for over thirty minutes.

While I was there, he never did get a chance to talk to the doctor. He was just an agitated, rough-around-the-edges, sad guy who needed to be heard… and because he didn’t act right, he was punished. 

==

We often wonder why veterans distrust the VA. 

I’m fine, by the way. When the doctor came to me, I smiled politely and was effusively grateful.