Memories of an Essence — Chapter 9

Chapter Nine

Miracles of Modern Medicine

arie lived to see this day only because children or subjecting them to sexual assault, since

M certain members of the medical profes- sion obeyed their vows. She almost did not live to see this day because certain other mem- they believed he would turn them over to the police. The days had not yet arrived when the physical signs of child abuse were advertised to all doctors bers of the medical profession violated their vows. and laws had been passed requiring them to report During her entire life, her physical and mental such cases to the local police. health was repeatedly reviewed by various mem- He delivered all three McKenzie children bers of the medical establishment, as it operated in and watched them grow up. He saw Shelly as a a major California city. Unfortunately, not all of loving, concerned mother. At least she was with the those standards were helpful to a patient suffering younger two children. When she brought in Marie, from the post-traumatic disorder known as MPD. the eldest daughter, he saw something different in Fortunately for her, her medical care her eyes, but he could never put his finger on what during her earliest days was in the hands of one of it was. those revered, but now rare medical professionals, Gerri, the younger daughter, was the the family doctor. Dr. David Frank's office was on outgoing one. Arthur was somewhat backward, the edge of the area where Marie and her family with an IQ lower than his sisters. Marie impressed lived, and he took care of many of the families in him as the reserved, quiet one, someone who her neighborhood. His nurse was a friendly neigh- always seemed afraid of something. He knew that bor who lived in back of the McKenzie home. Dr. eldest children often had to grow up faster than the Frank believed in being a part of his community younger ones, since they were expected to parent and treating his neighbors with dignity and honor. the babies and help their parents, if both were He had the old-fashioned idea that his professional working. reputation would allow him to make enough money Over time, Dr. Frank learned that the to pay his bills and raise his family. McKenzie family was not one of the more stable He owned his office building, so he owed ones in the neighborhood. They were divorced nothing to a corporation or a large group practice. before Marie suffered the terrible burns that re- He was one of those obsolescent private practitio- quired him to do extensive skin grafts. When Marie ners, one who knew how to take care of 90 percent was being prepared to have her skin grafts, Dr. of the ailments that his patients suffered from. He Frank knew she was taking ballet, as his own sent the other 10 percent to the specialists near one daughter was in her class. Marie had taken ballet of the big hospitals where he had admitting privi- lessons from the time she could walk. By the time leges. of the fire, she was in toe shoes. Her dream was to Dr. Frank thought he knew his patients be a great ballet star. Dr. Frank knew how much fairly well, and he did, to the degree they allowed Marie loved the ballet. So when it became time for him into their lives. Unfortunately, those who the skin grafts, he told the anesthesiologist about abused their children kept it within the family by Marie's love. The anesthesiologist and the surgical threats and intimidation. They would not tell an nurse told Marie a story of a great ballerina to honorable man like him regardless of what the law calm her while she waited for her surgery. said about confidentiality between doctor and After the surgery, Dr. Frank ordered patient. They would not admit to beating their Marie's father to come visit his eldest daughter in

her hospital room. He did what he could to raise treatment. the spirits of his young patient, but the mental The doctor suggested that if antibiotics collapse she suffered when she returned home didn't help, she might have "stomach epilepsy." He greatly upset and perplexed him. He referred her to explained this as a rare type of seizure disorder in the best child psychiatrist in the area, but he never which the paroxysmal spasms were in the gut, not really knew what happened inside the mind of his in the muscles of the limbs, because the part of the young patient. It was difficult enough taking care brain that was affected controlled the movements of her skin and bones, without deciphering what of the intestines. went on inside her head. This explanation was comforting to Dr. Frank's Essence was learning and Mother, but Marie didn't understand. She knew growing. Becky was blissful to know that her what was going on between her father and her, charge was being taken care of by a talented doctor horrors she couldn't tell anyone about it. The stress with a fantastic Essence. She was truly honored to of not being able to tell was just as bad as the know his Essence and to be in such company. abuse itself. If she didn't share it with someone, she Dr. Frank had previously experienced would explode. Because of her father's constant many trying moments with his young patient, threats, Marie was programmed to say not a word. Marie. When she was five years old, her mother Mother gave Marie the antibiotic Dr. had brought Marie to him because of intense Frank had prescribed. But the medicine relieved abdominal pain. He carefully followed his usual none of her symptoms, and Mother and Daughter procedure to investigate such a problem. She was returned to his office in despair. When he examined first unable to keep down her food or have regular Marie the next time, he found a walking corpse. He bowel movements. She had major bouts of diar- called for an ambulance and phoned the hospital to rhea. She clutched her abdomen and doubled over admit her to the pediatric ward. He ordered intrave- in pain much of the time, making it impossible for nous fluids to rehydrate her shrunken body and her to stand erect. She hurt all day, and she could ordered the nurses to feed her a liquid diet if she not sleep at night. For the first week, her parents could take anything by mouth. She couldn't, so he assumed that she had the flu and ignored her ordered a feeding tube inserted through her nose complaints. When she lost 20 pounds in a week, into her stomach through which the nurses pumped Mother decided to take her to the doctor. When he down liquids, proteins, and vitamins. saw her, she was so weak she couldn't walk with- The severe pain had started after her father out trembling and was totally helpless. had started ejaculating into her mouth. Before that, Marie was grateful her mother finally took his probing and stroking fingers were bad enough, her to see Dr. Frank. To her, he was a kindly gray but when he escalated his sexual abuse one step haired doctor who took time to talk to her. Marie further, she just could not bear it in silence. She truly loved Dr. Frank. He was patient and kind -- had to tell someone about it, and Becky hoped her nothing like her father. charge would tell Dr. Frank. Because her mother Dr. Frank's physical examination showed was there, Marie feared for her life if she told, so no localized area of pain where there might be an she dared not tell the doctor the truth. infection. She hurt all over her abdomen. The pain Becky hoped that, when her charge saw was both above and below the umbilicus, and it Dr. Frank, he would find out what was disturbing traveled to the right and left of the midline as well. her. Even though Becky knew that Marie's life plan Blood and urine tests were normal. Since an infec- was already in force, she was hoping Faith and the tion might be present in spite of normal lab tests, other CIE would change "The Creator's" plan for he decided on antibiotics as his first choice of Marie. But that was not to be. Becky's first duty

was to make sure her charge lived. her stool turned up nothing indicating infection. Becky was concerned about her charge's Her electroencephalogram (EEG) had shown only illness and communed with Faith. "nonspecific abnormalities with no localization." Becky: "What is happening to my charge? Dr. Frank had to consider emotional Is she going to cease to exist? Is this the end of her factors as a last option, but no one brought to his life cycle? What are we going to do? Has 'The attention anything that might explain what was Creator' decided that she will not meet Dr. Allison upsetting his young patient. During the last two and become one? Have my efforts in keeping her days in the hospital, he tried a therapeutic test by somewhat sane with the abuse been for naught? removing the stomach tube and giving her a muscle Please, Faith, let me know, as my charge is dying, relaxing tranquilizer an hour before each meal. On and I'm not sure how to stop it." his next visit to her, the nurses' notes recorded that Faith: "Nothing has changed, Beck. She she had accepted her offered meals without com- will continue to exist, and 'The Creator' still has the plaint and had consumed 80% of what was on the same plan in place for your charge. Your charge tray. He couldn't ask for more than that. At last he has to experience this, and there is nothing anyone felt he had come to a reasonable understanding her can do to change her life at this time. She has to problem, and he discharged her home. experience everything that is going to happen to her The only trouble was that the mild tran- because of 'The Creator's' plan. She will not cease quilizer pills he gave her kept her in a dreamy state, to exist, so take heart, Beck; it is not her time as with a feeling she was not totally there. yet. She has other duties to finish." When Marie was seven years old, she fell Becky was relieved but still concerned and hurt her elbow. Mother again took her daugh- because she knew what Marie had to face until the ter to the doctor. On the x-ray, he found no fracture right doctor was to come along. She was aware line. He put her arm in a sling to keep it immobile Faith knew it was going to be a rough road for her and told her she probably bruised her bone. He and her charge. Faith, Hope, and Charity had advised her to wait for it to heal, and Mother confidence in the extent of Becky's training. They should bring her back in a week for a recheck. knew Becky could do what was asked of her. Faith A week passed, and Marie returned to Dr. knew what Marie's life was going to be like when Frank's office. She still had the same amount and the plan had come full circle. Faith had done all type of pain whenever she tried to move her elbow. that was possible to prepare Becky to be the She hurt as much as ever. The doctor could find ISH/Essence of Marie. Faith was blissful to watch nothing more to explain her continued pain and was her student help such a mixed up human as Marie. bewildered as to why her elbow did not feel better. But they also knew what Marie's life was going to Dr. Frank had just completed a weekend be like when Dr. Allison finished his therapy. Faith course on hypnosis for general practitioners. Here knew Becky would be blissful with this lifetime of was a chance to try out his new skills and see if he bringing Marie back from the depths of hell. Hope could relieve the pain of his young patient. The and Charity were also blissful with their efforts, instructors had told him that children were easily since they had helped Faith in her tutoring of hypnotized, as they used their imaginations a great Becky. deal and had not yet gotten skeptical about going Gradually Marie's weight came back as her into trance. intestinal track calmed down and began to digest He told Marie he was going to hypnotize and process the food they fed her. her while she was sitting on his examining table. Still, Dr. Frank had not been able to isolate He asked her to focus her eyes on the corner of a any specific cause of the problem. The cultures of piece of paper stuck to his bulletin board. He told

her to look at it closely and relax. Marie did so and She had to hide the problems from anyone was GONE. who might be able to help her, or she would be After Marie went into trance, he moved her responsible for unspeakable harm coming to her arm around and determined there was no physical parents or to herself. If her father found out she reason why the joint should not move freely. He told anyone, he would kill her just like he had then brought her out of the trance, by counting beaten to death her beloved dog. No young girl backwards from three to one. could do that, and certainly not Marie. So the Becky was watching all this from the abuse kept coming, and her body kept changing in inside and was attentive. She knew what was going response. to happen, but she hoped she was not going to have Every human body is built to react in to manufacture another false-front alter-personal- specific ways to each change, such as infection, ity, as her supply of "spare parts" was getting slim. injury or pregnancy. That is the basis behind all When Dr. Frank put Marie into a trance, laboratory tests. The doctor expects to find a the presently operating false-front alter-personality certain laboratory test change in the case of each disappeared. She was gone. Becky had to work fast illness. Those tests may change soon after the to create another one who could take the body symptoms begin, and they tell the doctor what home. The new one had to know who she was and disease process is occurring. But what if the body what she was doing there. Becky fashioned together no longer can respond as it was designed to do, and a new Marie during the time Dr. Frank had her the doctor does not get the laboratory results he charge in trance. expects to find? By putting her into a trance for a humani- When Marie was 19 years old and preg- tarian cause, Dr. Frank had "dissolved the psychic nant with her son, she felt nauseous, so she knew glue" that had held all the alter-personalities to- she was pregnant. MediCal required proof by way gether in a "loose confederation." Now they found of a pregnancy test, and the one most frequently they could all declare their independence, and they used then involved a rabbit being injected in a vein were ready to go wild, each one on his or her own. with the woman's urine to see if it ovulated. In Dr. Frank had started a major change when he Marie's case, the rabbit did not. The doctor told her hypnotized Marie to help her move her arm without she was not pregnant, but Marie knew better. She pain. He thought he was helping Marie by doing waited for three weeks, while suffering through something simple and innocuous. He never knew he morning sickness, and then decided to see an had started a tidal wave. He had cracked the dam, obstetrician. He did a pelvic examination on her and the alter-personalities started running amuck. and congratulated her on being two and a half Becky knew she could not stop him, as this months pregnant. was all part of Marie's life plan, and neither Becky The doctor told her some women do not nor another human could change Marie's life. show signs of pregnancy with the rabbit test, so he Aside from the stress induced illnesses always did a pelvic examination as well. Marie Marie suffered from, her physical and emotional asked the doctor to do her a favor and do a rabbit reactions to the abuse wreaked havoc with her test every month to see when she would turn posi- bodily systems. She could not respond as her tive. He agreed. When she was seven months organism was designed to respond. She no longer pregnant, the rabbit finally ovulated. She was could have symptoms signaling something out of clearly showing the physical signs of pregnancy by balance. She could not attend to the problem the that time, so no one could tell her she was not symptoms pointed to and gain relief from the pregnant. problem. Her husband was beating her more rough-

ly, leaving bruises on her. He was sexually abu- fingers had made on her abdomen, and Sad Marie sive, as well, and anally raped her. shrieked in pain. He had his proof, with his demon- When she was 22 years old, Sad Marie's stration of "rebound tenderness." marriage was falling apart, and she was disinte- "You've got one hot appendix, Marie," he grated as well. Kelly was about to leave her, and said. "It's time to take it out. Have you eaten she started having intense abdominal pain. She had anything today?" already had the therapeutic abortion and Kelly had "No, I haven't," she answered. beaten her in the shower, triggering the loss of her "Then we will find out if an operating third pregnancy. room is available and get it out as soon as we can," She had pain on her right side every time he said. she ate or drank any food. Whether she laid down, An hour later the nurse wheeled her into sat upright, reclined, or stood up, she couldn't the operating room where the surgeon was waiting decrease the pain. She was doubled over with pain for her. He found her appendix to be infected and and couldn't stand up straight. Still, she was afraid swollen, thin enough to burst. Her right ovary was to go to doctors, as they usually doubted she was infected with a tumor attached, so he removed both physically ill. organs. Sad Marie was left with only one ovary. When she finally saw a doctor, her temper- During her second marriage, Devin Fields, ature was normal and her white blood count was the integrated Marie's new husband, was also not elevated. The doctor told her she might have abusive to her. She had integrated all her alter- too much gas. But that did not explain away the personalities, so she was better able to fight back. pain to her. He prescribed antacids to get rid of the Her pain came on about ten minutes again after she pain. ate anything, especially fatty foods. The pain She took the big white tablets every five started in the middle of her chest, then moved to minutes, but the pain continued as bad as ever. She her right side next to her arm, and then to her back, returned to the doctor with her complaints of still on the right side. excruciating pain. He told her that, with no fever She went to her doctor, and again all the and a normal WBC count, she did not have appen- routine laboratory tests were normal. She had no dicitis. The pain was too low for kidney trouble fever and both her red and white cell counts were and too high for appendicitis. But he would send within normal limits. She was physically drained her to a surgeon anyhow, even though he thought but not emotionally depressed, at least no more the referral a waste of time. than one would expect to be with a husband who Sad Marie saw the surgeon in the hospital always had to control her. emergency room. She described her pain as an After his examination, her doctor referred intense burning, stabbing one that became worse her to a radiologist for a set of x-rays of her gall- when she ate and prevented her from standing up bladder. The films showed no opaque stones. Marie straight. She was doubled over when he asked her had what seemed to him a classic case of gallblad- to walk around the examining room. der disease, and surgery was her only option. She The surgeon asked her to lie down on the agreed, and he scheduled her for surgery the next gurney, so he could examine her. He told her he day. would not touch her on the sore right side, as he When her surgeon came to her hospital wanted to examine the other side of her abdomen. room after surgery, he had a glass vial containing He slowly and carefully palpated the left side of her her four gallstones. He told her she had a classic abdomen. Slowly his fingers pushed deeply into her case of "hidden stones." He had successfully tissues. Then suddenly he released the pressure his removed her gallbladder. Unfortunately, since then

she has had chronic difficulty with diarrhea and constipation. While married to Fields, she started having cramps in her left leg. She was constantly in the bathtub trying to ease the cramps. Her doctor put her in the hospital for traction for a week, hoping the weights would help her feel better. When he added more weights, she hurt even more. She tried to explain to the doctor that the pain was more severe, but he explained that the weights would make her feel worse for two or three days, but then the pain would ease off. Marie tried not to let her doctor know how badly she felt, as she wanted to be the perfect patient. After a week of no improvement with traction, the doctor decided that a myelogram was needed.1 This test showed no obstruction in her spinal canal. The doctor sent Marie home, but she still had the leg cramps, but now it was in both legs. She found it increasingly difficult to walk, lift or move. Finally she went back to the doctor, who readmitted her to the hospital and repeated the myelogram. This time it showed a bulging disk at the L5-S1 level, so he scheduled surgery. He removed a herniated L5-S1 spinal disk, and, postoperatively, she felt much better. She experienced only the incisional pain from the operation. She was soon discharged home from the hospital. Two months after this surgery, she was admitted to the seclusion room of Yolo General Hospital by Dr. Dailey. Just before discharge, she fell off the bed and landed on her back on the floor. She knew she had jarred something in her back. She returne

nostic tool. resume torturing Sad Marie and making her life 2. Sedatives and stimulants: Before difficult. integration, sedatives used for "stomach epilepsy" Sad Marie spent only two days in that calmed down the pain, but put her on "cloud nine." ward. Kelly was so worried she might tell someone Caffeine makes her extremely exhausted. what he had been doing to her, he gave her an 3. Antibiotics: Before integration, penicil- ultimatum -- either she got out of there, or he lin was beneficial for infections, and it did not would take their son and leave her. Sad Marie was cause drowsiness. After integration, it put her to more afraid of Kelly than of being in the hospital. sleep. She had to do what Kelly wanted her to do. She 4. Analgesics: These medications allevi- persuaded the doctor she had recovered from ated pain normally before integration. After inte- getting angry at her husband and was perfectly able gration, aspirin made her active, but in a sluggish to go home now. way. Codeine, instead of making her sedated, now When Sad Marie had divorced Kelly and makes her hyper-alert and hyperactive. was living in Sacramento, Becky decided that Sad ***** Marie needed to start seeing a psychiatrist, because Between her first marriage and her psycho- the time was coming closer for Dr. Allison to come logical integration, Sad Marie spent half her days to meet her. The only one who would see her was in one psychiatric hospital or another. She first Dr. Harvey Masterson. Becky knew this doctor entered the psychiatric ward of a community was not going to listen to her or anyone else inside hospital in Benica. Her first husband, Kelly, beat Sad Marie. Becky had to keep her charge in a her severely, and Lynn finally had enough of it and somewhat sane condition, as the "hostile psychic tried to stab him with a knife. He called the police, sisters" were having a field day. Becky needed a who found a raving madwoman on their hands, so doctor who would let Sad Marie ask questions and they sent her to that hospital on a 72-hour hold. try to find some answers with her. Becky knew it The place looked more like a jail than a was impossible for any of these doctors ever to hospital, with bars on the windows, locks on all the accept that her charge had MPD. doors, lifeless colors on the walls, and drugged Dr. Masterson was an older man who wore patients sitting around doing little all day. The thick glasses and had a soft, calming voice. She lights were on all the time, so, if patients were not hoped he could find out what was happening to drugged, they could not sleep. make her life such hell. Sad Marie had high hopes During admission, the nurses examined her that Dr. Masterson could help her. He was the first inside and out to find out if she was carrying a of many doctors who looked only at the problems weapon or other contraband items. She always had superficially and did not try to get to the roots of to wear a hospital gown and robe with blue slip- them. Becky needed Dr. Masterson available to put pers. She and the other patients were so drugged Sad Marie into a psychiatric ward if one of the they were not allowed to go to the toilet alone. "hostile psychic sisters" tried to kill her. Attendants had to be with them whenever they took Becky and Faith decided that, because he showers or baths as well. was such an elderly gentleman and hard of hearing, While in that setting, the "hostile psychic it did not matter what Dr. Masterson did or did not sisters" learned some lessons. They knew they hear. He usually sat back in his chair behind his could not act out there and still be free to do what big desk and let his patient talk about anything on they wanted, which was to have fun with Sad her mind. This was difficult for Sad Marie to do. Marie's body. They kept inside so she would look She was programmed to be depressed and nothing well enough to be discharged. Then they could else. Dr. Masterson would ask questions and try to

help her find answers. But he never looked deeper any problems. But he would not stay around to for solutions. answer her questions. He then dismissed her and Becky was blissful that there was now a called in his next patient. doctor who could protect Sad Marie from Being on MediCal, she was only allowed self-destruction, as Becky's energy was being one month's hospital stay at a time. At the same depleted with the constant acting out by the various time, her doctor could not wean her off dependency alter-personalities. When Lisa Kay tried to kill Sad on the ward by giving her passes outside the hospi- Marie with an overdose, Becky called Dr. Master- tal. If he did, MediCal considered her not sick son and told him, "Marie just tried to kill herself. enough to need to be in the hospital at all. What should we do?" The day room doubled as a cafeteria, as Dr. Masterson, thinking he was talking to well as a multipurpose room where the patients Sad Marie, told her to go to the Emergency Room could read, play cards and socialize with other at American River Hospital (ARH) in Carmichael patients. To her, the other patients appeared sicker where he admitted her to the psychiatric ward. He than she was. After all, she knew what she was did not think much about the wording of that phone doing, at least some of the time. call from Becky. He just thought that his patient Drinks were always available in that room, had had a change of heart and wanted to live after including coffee, tea, hot chocolate, sodas and all. This was the first of several times he admitted juices. The soda cans had pull-tab rings, and no Sad Marie to ARH. staff members ever checked to see if they were The staff at ARH treated patients as discarded. Lisa Kay and Lynn kept several pull-tab persons to be respected and cared for. Sad Marie rings in their room so that they could use them on kept coming back so often that they finally began her, just as a bed inspection was starting. She treating her as a nonperson. Most of the time she would then be whisked away to be locked in the was drugged so heavily she could barely function, seclusion room, where she only had a toilet, bed, which was the goal of the staff. and mattress. Sleep was nearly impossible since the Since the staff wanted all patients to lights were on all the time so the staff could ob- participate in group and occupational therapy, they serve her. Someone was always stationed outside made sure all were out of bed by a certain time. the seclusion room door whenever a patient was in Patients were not allowed to return to their rooms there. Many times she was locked in there, not to hide out in bed the rest of the day. The staff knowing why. rewarded participation in the community meetings After a while, the staff hated to see Sad and activities. They had meetings every week to Marie coming through the front door, because they deal with problems on the ward and how to fix knew she would be a problem for them again. She them, but Sad Marie felt they were a waste of time. tried to follow their rules, but one of her "hostile She watched the staff members doing all the talk- psychic sisters" would then show her face, and then ing, while the patients just sat back and dozed. all the nurses' bad feelings would rise up in them The attending psychiatrists were expected again. They were human, too. to see their patients every day to evaluate how they During her admission physical examina- were doing and whether they deserved more privi- tion, she told one general practitioner that other leges. Eventually they had to decide when dis- people told her she suffered from blackouts, and he charge was feasible. Sad Marie's psychiatrist asked her if she had any knowledge of blackouts. usually spent five minutes with her, reviewed the How could she have knowledge of blackouts if she nurses' notes in the chart, told her to get more had them? She did know she was having periods of involved in the community, and asked if she had time she could not remember, but he didn't ask

about those. He didn't ask her if she ever found square hallways until she ended up at the front herself somewhere where she didn't remember door, where a staff person was always stationed. going to. He didn't ask her if she ever found some- With the "hostile psychic sisters" scream- one calling her by a different name. At the same ing at her, Sad Marie would run out the door, with time, she couldn't trust telling anyone these things the staff person frantically pushing the alarm were happening, for then someone might think she button and trying to catch her as she hurled by. was crazy and lock her up forever. She knew she After the first few hospitalizations there, the ward was going crazy. was always on lock-down status when Sad Marie When the staff took patients out for walks, was there. This infuriated the staff the most. Lisa Kay or Lynn would grab pieces of glass or After the allowed month in the ward, Sad other sharp objects they could use on Sad Marie. Marie's psychiatrist sent her home with a month's Once she was dead, they thought they could live supply of pills and an appointment to see him in their own lives. The staff never checked for such two weeks. He repeated this pattern over the next weapons when they came in from those walks. If two and a half years, but he could never figure out they thought she was so drugged all she could think why his patient was not getting better. about was walking, they were wrong. What neither Dr. Masterson nor Dr. In spite of these minor faults, the psychiat- Hazelton understood was that, if they did not probe ric ward at ARH was one of the best she was ever for answers, they could not open Sad Marie up and in. The shame is that they never knew what was see what was happening inside her. Becky knew really wrong with her. from her talks with Faith that neither Dr. Master- After she saw Dr. Masterson for a year, he son nor Dr. Hazelton would ever accept the idea retired and referred her to another psychiatrist, Dr. she had MPD. They knew most doctors didn't Arthur Hazelton. He was a bald, 45-year-old man believe in the diagnosis. Even if they had, they who worked alone, separating himself from his didn't know how to treat it. Anything they might do patients by sitting behind a big oak desk. He let his could hurt Becky's charge rather than help her. patients talk but seldom gave any feedback. When Becky knew her prime directive was to keep her Sad Marie asked, "Why am I depressed?" his charge alive and somewhat sane until the doctor answer would be another question. who had been picked for her could arrive on the "Tell me why you think you are de- scene. That doctor was Dr. Allison. pressed," he would say. This was at a time when When Dr. Hazelton became totally frus- the "hostile psychic sisters" were running amok. trated with his inability to help his patient improve, The first month she was seeing Dr. Hazelton, one and the nurses subtly gave him an ultimatum to of them tried to take an overdose, but Wendy keep her out of their ward, he wrote a transfer stopped her. Wendy went to the ARH Emergency order to Crestwood Manor in Sacramento. He Room, where Dr. Hazelton authorized her admis- encouraged her mother to become her probate sion. conservator, so she could take the necessary action Whenever Dr. Hazelton hospitalized Sad to keep her daughter from killing herself. Marie on that psychiatric ward, she would become Crestwood Manor was one of a large chain very agitated. At night, she would constantly walk of long-term psychiatric hospitals owned by a large the halls, which lay in a square pattern around the corporation. The buildings were originally conva- ward. As Sad Marie walked those halls, she would lescent hospitals, previously known as nursing stride faster and faster. All the while, Lisa Kay and homes. To house psychiatric patients, they added Lynn would be yelling at Sad Marie to get out of extra security to prevent runaways. The primary there. She then walked even faster around the purpose was to provide long term custodial care for

the chronically mentally ill patients whom no one Sad Marie found herself on the floor so expected to get well soon. Thus they were called many times staff members thought she was faking L-facilities, for Long term care. Each one was run to get attention. But no one tried to find out why by a head nurse, but the majority of staff members she fainted so often. When she fainted during were aides who had only minimal training. rounds by Dr. Hazelton, he told her she was going When Sad Marie was admitted to the one to be in there a long time if she didn't learn how to in Sacramento, she found herself in a room with behave herself. He told her she would end up in a two other patients. The place was so short staffed state hospital if she didn't start taking responsibility it seemed to her that the patients ran the hospital. for her own behavior. When Dr. Hazelton saw her At night, the patients played their radios loud, as if slump to the floor in a faint a second time, he told they were trying to outdo each other in achieving the staff to let her lie there. He thought she was just the highest noise level. In Sad Marie's room, the putting on a show. lights were on all the time, while the radios and The staff insisted that all the patients take TV's blared. The woman patient in the last bed in the medication that had been ordered for them. If her room kept inviting men into her bed for sex. they would not take it voluntarily by mouth, they Staff members kept catching her in the act, but forced them to take it. The patients had no right to never said anything about it to their supervisor. refuse. Often the patients would palm their pills Other patients came into the room dancing, smok- and save them up. Every couple of weeks, they ing and sneaking in liquor, all under the noses of would get together at night and have a big Pill the staff members. Party. Anyone could get whatever they wanted. Lisa Kay wanted desperately to join in the Marie has only bitter memories of that 30- fun, but Becky kept her under control most of the day stay at Crestwood Manor. The food was time. Becky didn't want Lisa Kay to get to like the horrible and had no taste. The walls and floors had place, or it might be difficult to extricate her from the smell of urine emanating from them. This was there when the right time came. Becky wanted her the lowest point in her life, because she had no to be eager to leave when Dr. Allison had come to freedom and no hope. town and was ready to start his brand of therapy. When Mother became Sad Marie's conser- She could only sleep during the day, vator, she signed her out of Crestwood Manor and because of the all-night parties that the patients moved her to Yolo County. This was one of the organized. Because Sad Marie stayed in her bed few times Mother and Daughter agreed on what during the day with the curtains drawn, the aides was best for Daughter. told her that she was never going to leave there. If After Sad Marie started in therapy in the she didn't participate in the "program," she would Yolo County MHS with me, she came within the never be considered well enough to go anywhere confines of that system. The only hospitals immedi- else. Sad Marie's curtain always stayed closed ately available to her were the Woodland Memorial around her, telling everyone to leave her alone. For Hospital (WMH) and Yolo General Hospital the most part, it worked. (YGH), which was across the street from the main To keep some semblance of order amidst MHS clinic building in Woodland. The psychiatric this chaos, Becky decided that, whenever one of the ward at WMH was designed for the private pa- hostile alter-personalities tried to come out, she tients of the psychiatrists of the Woodland Clinic, would have Sad Marie faint. Lisa Kay kept trying a multidisciplinary medical clinic that drew pa- to come out to play, but the fainting kept stopping tients from a wide area. The psychiatric department her from doing anything that would interfere in the consisted of two doctors when I came there, Drs. destiny of what was to happen. Luther Lucien and Barry Romero. They were also

the active psychiatric staff of YGH, as their con- working alongside the staff of the MHS. tract with the MHS gave them responsibility of Dr. Lucien was a total contrast. He was a caring for all hospitalized patients. Patients who tall hawkish looking balding man whose tone of came from the county jail were placed in YGH in voice indicated that he expected respect for his its locked seclusion rooms. MHS patients who exalted position, while he showed no respect for could be accommodated on an open ward were others. He wore a white waist-long lab coat while admitted to the homelike ward at WMH, where on duty, with his name embroidered over the left they mixed with the patients who were covered by breast pocket. I knew the customs of dress for private insurance. If someone at WMH misbehaved doctors and that psychiatrists routinely shed these beyond the tolerance of the nursing staff, that lab coats when they finished their internships. All patient would be transferred to a YGH seclusion psychiatrists I knew preferred to wear street clothes room under the care of the same psychiatrist. when they saw patients, as they felt that would put All psychiatrists working in the MHS them at ease. The lab coat represented BIG SCI- clinic had admitting and treatment privileges at ENCE, AUTHORITY, THE DOCTOR, and both YGH and WMH, but they seldom exercised created a distance between and psychiatrist. Only the admitting privileges, since that meant working a psychiatrist unsure of his professional identity after hours. There was no provision for overtime would wear such a lab coat. payment in their contracts. However, they were During these meetings, Dr. Lucien consis- free to see any of their patients during hospitaliza- tently put down everyone connected to the MHS, tions, and I did my best to visit any who were and most of his criticism fell on Morino, the liaison hospitalized at WMH so that I could collaborate between the hospital and clinic staffs. She was kind with the psychiatrist on the ward and help him and diplomatic and kept up with every case. Yet, arrive at a rational discharge decision. When a Dr. Lucien went out of his way to find error in her patient was admitted to YGH, it was usually for a management of each case, or, if he couldn't blame very short time, and often the patient was dis- her, he blamed the clinic therapist for failing to get charged before I had even heard about his or her the patient well and allowing him or her to go into admission the night before. the hospital in the first place. The first week I was employed at the As I watched this drama unfold, I saw MHS, I sat in on the meetings the MHS staff Morino trying hard to cover all her bases, to be members had with Drs. Lucien and Romero to alert to all problems that needed solutions, and to discuss the hospitalized patients. The primary document everything that went on with these MHS contact person was a psychiatric nurse, patients. No matter what she did, it was never good Charlene Morino. Morino immediately impressed enough for Dr. Lucien, and she would frequently me with both her personal and inner beauty, as she be near tears when the meeting ended. I wondered was a lovely person to be around. She was the kind what was going on here. I had never seen a psychi- of woman every male staff member wanted to sit atrist be so hard on a nurse, and she was doing a next to at lunchtime. She was intelligent, friendly, superb job, as far as I could tell. and outgoing, and devoted to the welfare of the Dr. Romero always treated the MHS staff patients. members with courtesy, and swallowed his com- Of these two psychiatrists, I felt comfort- plaints when Dr. Lucien went on one of his critical able only with Dr. Romero. He was a short, pleas- binges. I wondered how he could stand having Dr. ant man, dressed in a casual suit and tie, who Lucien as a partner, but I never saw Dr. Romero showed compassion for his patients. He was soft undercut Dr. Lucien's authority or criticize him in spoken, never lost his temper, and was flexible in front of the others. On the surface, at least, they

appeared to be at opposite poles from each other. But this woman just sat there and looked at I hospitalized Sad Marie for the first time him. When he started to question her reason for six weeks after we started therapy together. Lisa being there, Lisa Kay figured she might as well Kay attempted suicide by running in front of cars come out and give him the full story. "What do you driving by ARC, and I sent her in by ambulance want to know, you asshole?" she asked him. "Fuck from the Broderick clinic on a 72-hour hold. Dr. it. I got mad and took a walk in the street in front Lucien was on admitting duty and knew nothing of that place she calls a college, and the bitch about Sad Marie or the others that first time. But Wendy cut me down. She had the gall to drive over he got well acquainted with her over the next three to that damned Broderick clinic, and that damned years. asshole Dr. Allison got chicken and called the cops Yolo General Hospital had been built in on me. God, he couldn't take it, and so he had to the 1920's when there were no psychiatric wards call in the army. Who does he think he is, God outside of the state hospitals. The only rooms Almighty?" available had been built as substitutes for the Lisa Kay paced the room, spitting her county jail seclusion cells, since they were designed venom at Dr. Lucien. She was angry at being to hold inmates who had been transferred for thrown into this "shitplace," and she was furious evaluation after running amuck in the jail. The because of how Dr. Allison had treated her. She walls were thick concrete, and painted a dirty knew Dr. Allison was scared of her, but she was white. When Sad Marie was shoved into the seclu- going to get her revenge on him yet. Lisa Kay did sion room by the ambulance attendant that first not know what Dr. Lucien might do, but Becky did. time, all she could see was a steel framed cot bolted She kept telling Lisa Kay to shut her mouth, and to the floor and a glaring floodlight recessed in the Wendy and the others refused to come out to stop ceiling. That was it. There was no toilet, no sink, the insults Lisa Kay was heaping on Dr. Lucien. no chair or stool -- nothing else. When the ambu- Dr. Lucien was shocked, but only a mo- lance attendant left, he locked the big heavy steel ment. How can someone change so suddenly from door behind him, leaving her in there with no way being so quiet and sullen to being in a complete of calling for help, except by yelling through the rage? But he only thought about that for a moment. tiny grill window in the door. How dare a patient of his talk like that? She had During the next three years, Marie was in better learn to respect his position, if nothing else. and out of one of those seclusion rooms at least a And pretty damn quick, too. He wasn't going to dozen times. Sometimes the nurse would leave a take shit from her or any other no good MediCal big yellow plastic barrel in her room for her to patient. defecate into. Sometimes, the nurse would be kind "I don't know what Dr. Allison was think- enough to let her out so she could walk down the ing," he barked, "but I know what I'm going to do." hallway to the women's bathroom. Turning to the nurse behind him, he ordered, "Get When Dr. Lucien met Marie on his morn- those leather restraints in here and put them on her ing rounds that first time, he saw a quiet, reserved pronto, all five points." woman sitting on the cot, whose behavior gave no The nurse knew how Dr. Lucien was, but indication of mental illness. He was used to seeing she could not understand why he was so angry at patients who where there on 72-hour holds com- this patient. The nurse could see the patient was plaining they were unfairly incarcerated, and the upset, but that was not cause to tie her down. But voices they were hearing told them to kill them- the nurse knew better than to ever question Dr. selves as soon as they left. He knew how to deal Lucien on anything. Then he would come down on with those patients. her, and no nurse ever wanted that to happen.

She rushed to get the leather straps and charge's therapy, she appealed to her CIE to get proceeded to hook them around Marie's wrists and Dr. Lucien sick or called out of town. The CIE did ankles, strapping each one to a corner of the bed. what they could to answer her pleas. Lisa Kay screamed and started to fight with the In her subsequent admissions to that nurse and Dr. Lucien while they were putting the seclusion room, Sad Marie had to listen to Dr. straps on her. Dr. Lucien yelled for help, and a Lucien tell her Dr. Allison didn't know what he was male orderly came to hold her down while Dr. doing. He seemed determined to ruin Dr. Allison's Lucien injected her with a potent tranquilizer to reputation any way he could. Each time she came keep her quiet. Finally, the nurse strung the fifth in, he ordered five point restraints on her, to teach strap across her waist, and tied it to both side her that she had better follow his orders. Maybe beams of the bed. then she would learn some discipline. Dr. Lucien That accomplished, Dr. Lucien made it had to have order in his life and in his patient's clear to Sad Marie, who had returned as soon as lives. Because Sad Marie was not his patient, he Lisa Kay figured out this doctor could not take her was going to destroy Dr. Allison and show every- verbal swipes, that he would brook no insolence one what an imbecile doctor he was. Once he did from any patient of his. She could tell her precious that, he could then bring order into Sad Marie's life Dr. Allison that he, Dr. Lucien, was in charge as by making her obey him. long as she was in this building. Sad Marie got the Sad Marie never told me what Dr. Lucien clear impression that Dr. Lucien had no respect for was saying about me and what he was doing to her. her psychiatrist and would do whatever he could to The false-front alter-personality was made only to sabotage his therapy with her. She wondered why. bring the body in for therapy, and Becky knew Becky was watching the whole scene and when it was time for Sad Marie to enter the hospi- could see that Dr. Lucien had made up his mind tal again. She knew how long her charge was going that Sad Marie needed to get his power message. to stay, so the CIE assisted her with the times in He wanted her to know that she was not fooling the seclusion room. Becky had plenty to do dealing anyone and that Dr. Allison was a fool to believe with the helper alter-personalities who were afraid she had MPD. He thought she was just insane and of being in that room because of her charge's many needed to be committed forever to a state hospital, experiences of being locked in a closet by her where she could be locked away with no chance of father. I had not yet learned of that problem in escape. She saw he wanted and needed all patients therapy, and Becky had to keep therapy going one to respect him so that they would do anything for step at a time. She could not overload me with too him. Patients had to know he had the power of life many traumas at one time. or death over them. He had to let them know it was Dr. Lucien believed I had coached my his choice whether they lived or died, and they had patient how to act up when she was there, so I was better not forget that. making her worse, not better. It was therefore his Becky tried many times to talk to his mission to rescue her from this idiotic doctor. Essence, but she soon learned that his was one of I visited her there that first morning before those few who can change from a good and decent my clinic appointments. Sad Marie was out, and I Essence into one that is turned. Becky decided that asked the nurse to release her from the restraints. I Dr. Lucien was a dangerous man, but she also explained to her that, since I was leaving town the knew her charge would eventually be safe, if she next week, this was the only day I had to get this could stay out of his way when she needed to be mess straightened out so I could safely let her go hospitalized. At those times when Becky needed to home. I then left to see my clinic patients across the be sure Dr. Lucien would not interfere in her street.

When I returned several hours later, about how Lisa Kay was created, since she was the Wendy was in charge and told me that Sad Marie one who had precipitated this crisis. She described could not stand being closed in a room like that how her dog, Bonnie, had chewed up her father's because her father had locked her in a closet for flower beds in the back yard and how he had punishment so often. She had also been talking to rushed out yelling they had to get rid of Bonnie. Mary Lou, the child alter-personality, who now felt While I was trying to discuss what her that she could start growing up, as I felt that was father might have been going through emotionally important. Mary Lou wanted to come out and tell at that moment, Lisa Kay broke through and took me how Wendy had been started and about other over. In a mild manner, much calmer than she had important episodes before Lisa Kay had started at been the day before, she described how her father age eight. I sat back to listen to Mary Lou's stories. had been mad at Mother and took it out on Marie. "When Marie was seven and a half," Mary She then agreed to leave and let Mary Lou come Lou began, "she was lying in bed, late at night, back to talk to her doctor. while her parents were still arguing and fighting. When Mary Lou returned, I now had a She got up and went into her brother's room. There basic understanding of the dynamics of the scene in she saw a pair of white shoes walking on the bed which her dog had been killed. I needed to give that on top of him up to his head. She watched the feet understanding to Mary Lou so that she knew inside walk out the window, and a voice said to her, what had happened and didn't have to take the 'Everything is going to be all right, don't worry.' word of her doctor. I decided to use my "mind She recognized it as the voice of her doll, even reading" technique for that purpose. though her doll had been gone for many years. She I asked Mary Lou to see the scene of her woke up her brother right away and told him about father coming out the back door angry and freeze this, but he told her it couldn't have happened. She the scene in her mind. I asked her to read her told her minister about it many years later, and he father's thoughts and feel his emotions. She was said it couldn't have happened. That was the last able to understand that he was mad at Mother and time she told anyone about what she had seen that needed to get back at her. I let the subject drop night."2 with that new understanding. "That's very interesting," I said, "tell me Then I discussed my hope that Mary Lou more." would start growing up. This was at the phase of Mary Lou continued her story. "Later that therapy when I still had the mistaken belief that same year, she again heard her parents fighting late Mary Lou was the Original Personality and, if I at night. She went into her brother's bedroom to get could start her growing up, she could take charge some toys and blacked out on the floor. It was of the body full-time. So I kept the pressure on her during that time she just couldn't stand to hear any to "grow up, grow up." more of her parents' arguing all the time, and she Mary Lou wanted to please her doctor and must have made another Marie who could handle make him happy, but she didn't know how to grow it better." up. She asked me, "How do I do it?" I then asked her to tell me what she knew I answered, "Go up inside your mind and ask how you do it." She went to look for whomever had talked to her through Wendy the day before, and, when 2 What Mary Lou was describing was the her eyes opened, someone else was in charge of the time that Faith, Becky's Guardian, talked to her, to body, someone that I had not met before. let her know that "The Creator" sent her, an angel, She was a peaceful personality, quite calm as a sign that He cared about her.

and reassuring. I mistakenly assumed this was psychic sisters," I felt that Lisa Kay did pride Marie's Inner Self Helper (ISH), the helper I knew herself on keeping her word when she gave it. I had I had to find to get me successfully through ther- to be sure exactly what she agreed to, as that was apy. She told me she had been the one who had as far as I could trust her. talked to Mary Lou through Wendy yesterday, I decided there was enough control in the telling her to let out Lisa Kay. When I asked her system inside Sad Marie, and I could recommend for her name, she said she had none. "She is to take to Dr. Lucien that our patient could safely go home one step at a time," she said to me. She told me now. I thought I had showed Dr. Lucien I was in that she had been there since birth. good rapport with my patient and would be prompt She then asked me for a pen and paper and in caring for the problems she presented. I had wrote, "Listen to me and keep your heart in tune done my best, but my best was never good enough with my words. I am here to help you (Wendy, for Dr. Lucien. Marie, Mary Lou). Listen and learn, please. Each time Sad Marie was admitted to the [signed] Michelle." She told me that she had no YGH seclusion room, I promptly visited her as personal name, but she picked that name as one I soon as I could. I evaluated the reason for the latest could use when I needed to call for her. crisis and did what I could to create a new balance Michelle was Becky's tool for talking to of forces. I did all I could to prepare Sad Marie to me. As I had already panicked several times with be safely discharged as quickly as possible. her charge, Becky had communed with Faith, the On her fourth admission, I was shocked Guardian, about how to approach me. They de- when the nurse told me Dr. Lucien had left an cided to have Michelle be Becky's spokesperson order on her chart: "Dr. Allison is not to be allowed until they had complete trust in me. They wanted to to see this patient." Never in my career had I been be sure I did not panic when the other crises were refused the right to see my own patient when she scheduled to happen. I had to hang in there so that was in the hospital. Every other doctor I had Becky's charge would be able to fulfill her life worked with had appreciated my attempts and plan. Michelle was what I came to call an "ISH successes in finding answers for their common Personality." problems. Now Dr. Lucien was refusing to let me Then Michelle was replaced by Mary Lou. see her at all. What was going on here? I showed her the note, and she was upset to think I knew Dr. Lucien had been sniping about that there was another alter-personality in there. me behind my back ever since Sad Marie's first She already had enough of those. I tried to reassure admission, and something about her had "stuck in her that her assumption was untrue (although it his craw." Dr. Lucien had never told me what it was true), that this one was what I called the ISH was about her that galled him so much, or I might and was an integral part of herself. It was someone have been able to help him cope with it better. But she needed to listen to and who would be part of to pull a power play on me was going too far. her when she became well. I headed for Dr. McIver's office. When I During the rest of that visit, I visited with told my boss what Dr. Lucien had done, Dr. McIv- each of them several times, to check out what my er told me to relax and let him take care of it. He options might be. Michelle told me that, between immediately went over to the hospital to check the them all, they could keep Lisa Kay from acting out. chart, and then he called Dr. Lucien.3 Wendy told me she could get Sad Marie to school at ARC. Lisa Kay gave me her word that she would not come out during the time I was out of 3 Faith asked her supervisors, Hope and town. Even though she was one of the "hostile (continued...)

"Luther," Dr. McIver started, "I saw an as long as you let her out today. But remember, order on Marie Kelly's chart that says that Ralph your clinic has a contract with us to take care of Allison is not to see Marie while she is in the hospitalized patients. The contract includes a seclusion room. Can you explain that to me, clause that you agree to cooperate at all times with please?" His tone was soft and diplomatic, but the responsible staff members of the MHS in stern as steel. managing our patients. Do you hear what I'm "Well, Dennis, every time he comes in to saying?" He was not about to let Dr. Lucien brow- see that manipulating hysteric, he just makes her beat one of his psychiatrists, but he also had to worse. He plays into her delusion that she has these keep these Woodland Clinic psychiatrists handling other personalities, and you and I know that is just the hospital duty. The contract was coming up for a lot of damned foolishness. He's got it into his renegotiation in another couple of months, and he head that she has MPD, and we both know that's knew the Woodland Clinic needed the money. bunk. So I don't want him in there messing up what Dr. McIver continued. "Hereafter you will I'm trying to do." let Ralph, or any other member of my staff, have "Well, just what are you trying to do, full access to any patient of ours. Do you under- Luther?" Dr. McIver continued. stand me? I know this particular woman is one "I'm trying to show her that she is not hard-to-handle patient, but you have to give Ralph going to get away with this charade anymore. the leeway to do what he thinks best and see how it Someone has got to show her that she can't keep up goes. You have no valid reason to interfere with his this game she's playing and that someone seems to therapy. I think you know that, don't you?" be me. Everyone else is too chicken to do what "Okay, I get your point, Dennis," he needs to be done, which is to set firm limits on her answered. "I'll let her out today and not stop him acting out." talking to her in the future. But I still think he is "Is that why you always put her in five leading her on, and she is just acting out his fanta- point restraints and give her such large doses of IM sies." tranquilizers, Luther?" he asked. "That may be," Dr. McIver responded. "You bet, Dennis," Dr. Lucien bragged. "If "Only time will tell. In the meantime, you keep out I didn't, there's no telling what she might do to the of Ralph's way, and I am sure he will keep out of nurses or other staff members. I've got a responsi- yours." bility to them, too, you know." Dr. McIver then called me and told me that "When are you planning to discharge her, my patient would be discharged this afternoon and Luther?" Dr. McIver asked, seeking a compromise. I could see her in the outpatient office at her next "I guess I can let her out after rounds this appointment. He told me he had warned Dr. Lucien afternoon," he said, realizing that he had said too to not interfere in the future, but for today, I should much already. He really didn't have any grounds to just keep out of YGH and let him cool down. keep her after today, now that he knew Dr. McIver Three weeks later, I had to send Sad Marie would be watching his every move. to the psychiatric ward of WMH for the first of her "Well, I won't interfere this time, Luther, five admissions there. Dr. Romero was the psychia- trist on duty, and he listened carefully to her as she gave her long history of both medical and mental 3 (...continued) problems. He talked with me about what she had Charity, if she was permitted to listen in on what been doing and what I had found in my therapy. Drs. McIver and Lucien were saying. They gave her Wendy gave him most of the history he needed, so clearance, and this is her account of that he saw her most of the time during the admission conversation.

procedure. they could call me if they needed my advice. After The ward at WMH was small, with 12 seeing Dr. Lucien at work, I had no desire to beds, three to a room, and one seclusion room for invade into his territory and give orders that might an agitated patient. That room had the same bed conflict with his. and fixtures as the other patient room, except it Also, a patient locking herself in a closet only had room for one bed. The nurses liked Dr. was not what I considered a psychiatric emergency. Romero, but they did not care for Dr. Lucien. They I didn't remember that her father had punished her were afraid of him and did everything they could to by locking her in the closet, and I had little idea avoid calling him for emergencies. what I might do in such a situation. So, I played The most notable event during that hospi- the odds there was little likelihood of her hurting talization was when Mary Lou locked herself in the herself in the closet, and I expected a helper would laundry room. The nurses' notes describe the soon tire of this dilemma and take over to open the situation this way: "Agreed to go on walk with door. staff. Unable to be found when group was ready to The nurse on the phone did not have the leave on walk. Found in laundry room where she panic in her voice that might have alerted me to had chosen to seclude. Minimal verbal response. come out and rescue her from a serious problem. Angrily stated she would not come out when When I had worked on the psychiatric ward in another patient requested to be allowed to get his Santa Cruz, I knew all the nurses well, and I could clothes. Response to staff was, 'I can't come out till tell what they really wanted and needed from their Daddy Frances tells me I can.' Resisted persuasion tone of voice. I did not know these nurses, so I to come out of room. Remains in laundry room, could not determine whether they were reporting to physically preventing anyone from opening door." me to keep their records proper, or if they were A man visiting another patient looked like asking me to get over there and solve "my" prob- a twin of her father. Mary Lou thought it was her lem. father, and she was scared of him because she was I decided this was not an emergency and not in school. She knew her father would be angry stayed at home. Becky had asked Michael to make with her and beat her again. To hide from him, she sure I came to the hospital to deal with Mary Lou, locked herself in the laundry room, thinking it was and Michael had assured Becky that his charge the closet at home where her father had often would solve this problem. What Becky and Mi- locked her for punishment. chael failed to take into account was that this one The nurse called me, but I did not come time I decided to use the free will "The Creator" right over and talk to Mary Lou in the closet. I told had given me. the nurses that they should just wait, and eventu- When I decided not to come out, the nurses ally one of the other helper alter-personalities waited for Mary Lou to come out on her own, most would come out and open the door. I did not see it likely when she got hungry. She finally responded as such an emergency that I had to rush over and to her stomach grumbling, but went straight to her deal with it in person. My patient was primarily room, without eating, until the next morning. Mary under the care of the WMH psychiatrist, and that Lou never forgave me for not coming to rescue her doctor was the one who had primary responsibility from the closet. to deal with all that happened on the hospital ward. As a result of my not leaping to the rescue, I felt that the nurses worked all the time with those Mary Lou took longer to trust me than if I had two doctors but did not know me, as I was new in shown up at the laundry room door. It also took town. The two hospital psychiatrists should be able Becky, Faith, Hope, and Charity longer to feel to decide what to advise the nurses at that time, and right about coming out and meeting me, so we

could all work together toward my patient's inte- had to be worked through in therapy with me. gration. I had failed the first test when I went The nurse looked at the corner where Sad looking for my boss when Mary Lou first came Marie was pointing and could see only an empty out. That political decision put the Original Marie chair. She observed Sad Marie barely able to keep back into hiding. When Mary Lou hid in the laun- her eyes open, leaning against the wall. Since dry room thinking her father was going to hurt her psychiatric patients frequently hallucinated, she again, I didn't come to save her. I was being tested. was used to dealing with people who saw things The ISH and CIE had to be sure I was ready for that were not there. She calmly told Sad Marie that the big league playoffs. she saw no one there and asked Sad Marie to take After Lisa Kay tried to slash me at the her clothes off and get back into bed. She went to Satellite House, Sad Marie was admitted to WMH get Sad Marie some medicine to help her sleep. She for the third time. At 2:15 a.m. Sunday morning, told her that it would be better if she waited and she was awakened by a dream of her father yelling talked to Dr. Lucien when he made rounds in the at her. When she opened her eyes to escape the morning. dream, she saw the image of her dead father in the Sad Marie was too confused to know what chair in the corner of her room. She couldn't be- to do. But the nurse was kind and understanding lieve her eyes, but there he was! and seemed to know what was best for her. She "Hello," her "father" said to her. "I want decided she could go home right after breakfast and you to go home now. You are not supposed to stay doctor's rounds, so she stripped off her clothes and here. You must come home so I can show you how got back into her nightgown. When she got back much I love you. I cannot love you if you are in under the covers, she put on her tape player head- here." phones so she could listen to the relaxation tapes Sad Marie stared at her "father," under- she had brought with her to help calm her down. In stood his command, and started to put on her fifteen minutes, she was sleeping again. The nurse clothes. She must always obey her father; that is heaved a sigh of relief, grateful that she had not what he had taught her. When she had put her coat had to call Dr. Lucien out at this ungodly time of on, she walked to the door to tell the nurse she had night. No telling what he would have yelled at her to leave now. on the phone at that hour. The nurse who had "Where are you going?" the nurse asked. briefed her at shift change made it clear that he "My father says I have to go home," she could not stand this particular patient, and she answered. should try anything she could to keep from having "Where is your father?" the nurse asked. to call him for her. "He's in the corner," Sad Marie answered. After breakfast, Sad Marie asked the day Because of the dream, Lisa Kay had nurse to come into her room. "I want you to see decided to get back at her "psychic sister" by something," she told the nurse. "The other nurse showing Sad Marie that Father was still alive and said it's not there." She pointed to the chair in the someone to fear. This was not so. Father was dead. corner and asked, "Do you see my father sitting But, since Sad Marie had never seen her father in there?" his casket, she had never accepted the reality of his "No, I don't," answered the nurse, remem- death. She experienced feelings she would have had bering what the night nurse had told her in report if her father were alive. Lisa Kay took advantage that morning. of Sad Marie's failure to accept her father's death "Nobody believes me," Sad Marie said. "I and created an image of her father for Sad Marie to have to leave. My father is telling me to leave." see. Becky allowed it to happen, as this issue now The nurse sat down with her and tried to

change the subject, hoping to get her mind on the This time she went out into the day room where the "real" world she knew Sad Marie must be con- nurse was sitting and told her about it. The nurse cerned about facing upon discharge. She asked her again comforted her, told her to sit there and rest a how she was doing in school. She asked what she while, and maybe he would go away. Sad Marie felt about going back to the quarterway house, spent the rest of the night dozing on the couch or where she had come from. watching the early morning TV shows, waiting for Sad Marie was grateful someone cared breakfast. When daylight came, she called ARC to what was going to happen to her. She told the see if she was still eligible to go to classes there. nurse her fears of flunking out of college and losing She called me at the clinic to tell me what had her grant. She told of her bitterness with her two happened. I assured her she would be discharged roommates who were ganging up on her and mak- that day. ing her their patsy all the time. The nurse was During the three years Sad Marie was relieved that Sad Marie was willing to talk about repeatedly in and out of the seclusion rooms at the actual issues that needed solving instead of YGH, and during her four admissions to the WMH listening to her hallucinated dead father. psychiatric ward, Dr. Lucien kept up his constant When Dr. Lucien came to make Sunday barrage of verbal and medical abuse of her. Every morning rounds, he read the nurse's notes about time he saw her, he told her how worthless she Sad Marie's early morning apparition. He asked was, how little she deserved anything they were her what had gone on, and she explained. "Well, doing for her, and how he knew she was lying all you had better behave yourself on this ward, or I the time. He let her know repeatedly that she will have to ship you over to Yolo General Hospi- deserved to languish in a state hospital forever. Sad tal. Do you hear me?" he warned her. But he was Marie knew she was dependent on Dr. Lucien for glad the nurses had defused the situation without her medical and psychiatric needs when he was on calling him. He could never go back to sleep when duty. She did not want to do anything to harm him, he was awakened for a 2:00 a.m. emergency. or she might lose her contact with me. She even "But I have to leave if my daddy tells me had to endure the hours in five point restraints to," she pleaded. "I have to do whatever he wants." when she had to defecate in her own underclothes, Dr. Lucien had no patience for this non- because he had left orders for the nurse to ignore sense. "Just listen here, young lady. You didn't see her calls for help. He didn't believe her when she your father in there, so quit trying to pull that kind told him of her chronic back pain that made her of stuff on me. You will leave here when I am good hurt so badly whenever she stayed on her back for and ready to let you out. Do you understand me? long. He forced her to endure the unendurable, and Are you going to control yourself, or do I have to then gave her such large doses of tranquilizers into ship you over to that seclusion room again?" her buttocks when she was released, she could "I understand, doctor," Sad Marie re- barely walk to the clinic to see Dr. Allison. sponded, realizing that she was no match for the During her final WMH hospitalization, I powerful Dr. Lucien. "I will behave myself. You planned to bring all the alter-personalities who can be sure of that." were ready to give up their independent existence "I'm glad we understand each other, Ma- into the Original Marie. Dr. Fred Newbury had just rie," he answered. "Now go on back into the day joined the staff, and he agreed to be her attending room. I've spent enough time on your problems." psychiatrist. Dr. Newbury was a friendly, warm The following morning at 4:00 a.m., she young man, bright and compassionate. I felt com- again woke up in her hospital room and saw her fortable with him in charge for the most important father sitting in the chair, telling her to come home. hospitalization my patient would ever have.

But Dr. Lucien was on call during the weekend she was in the ward. During his Saturday morning rounds, he talked to her briefly and re- fused to give her the in-hospital pass she asked for, claiming that he could not do so as long as she had any suicidal thoughts. She couldn't argue with him, of course, but she saw other patients with the same privileges whom she knew were still talking about suicide to their doctors. She didn't think it was fair for him to refuse her the chance to walk around the hospital halls when she had nothing to do on the ward. On Sunday, she was baking cookies for the other patients when Dr. Lucien came for rounds, and she offered him one. He refused. When he asked her if she had any current problems, she told hi sa mees who m she knew

he handled Marie. He was very supportive of all was on the WMH ward last confronting Dr. Luci- we were doing." en. I asked her to use the "mind reading" technique, The next day, the partially integrated so that we could both learn why Dr. Lucien had Marie went to Stepping Stones Day Treatment treated her so badly for so long. Center, where Martinez encouraged her to slam the "Dr. Lucien is saying that he thinks I don't punching bag around as long and as hard as she need to be on this ward," she said. "But he is wanted to. He hoped this would "get her in touch thinking that he would like to get rid of me, to send with her angry feelings." Unfortunately, it didn't me back to Yolo General where he could work me help much as Jill could only see Dr. Lucien's face over and prove his power over me. He wants to in the bag, and his image made her anger only that show everyone that Dr. Allison and Dr. Newbury much stronger. It did not diminish but grew to are nothing but assholes. He can't stand it that their monumental proportions. patients like them and don't like him." When she saw me on the next visit, I tried With that explanation, Marie realized that to age regress Marie back to the time when she last she was not at fault by being a "bad patient," just felt insulted by Dr. Lucien on his rounds, but Jill as she had not been a "bad daughter" to her father came out to interfere. I decided she was not yet and stepfather. She realized that Dr. Lucien's battle ready to go through any resolution of her hatred of was with the two doctors she liked the most, and he the evil psychiatrist. She still had to have some couldn't stand any patient not bowing to his will. time to express and feel it physically. She had kept He needed power over his patients, and he was it buried down insider herself for almost three years willing to do anything to get that power. He had now, and she needed some time to "let it all hang long since given up obeying the Hippocratic oath. out." With that understanding now conscious, Finally, Becky felt sorry for all I was going Jill was willing to give up her anger towards through with the trauma of the session, so she came psychiatrists into a can of molding clay. Jill shoved out to replace the angry alter-personalities. She and pushed her anger from deep inside into the can, said to her favorite psychiatrist, "Dr. Allison, now and she squeezed it until it broke apart. When she you see what we have had to keep under wraps was done, Marie age progressed to the present while you took care of all the older personalities. time, and Jill appeared again. Jill tried to prove she could overdose Marie the "Why, hello, Dr. A," Jill smiled sweetly. other night, and she took three antidepressant pills "I'm so glad to meet you again. I'm truly sorry for after Marie had taken her regular dose. But Charity trying to hurt you after seeing Dr. Lucien's image took over and swallowed the Ipecac. Marie was up in your face. I hope you will accept my apology for vomiting the rest of the night. That showed her we such rude behavior. But you now understand what aren't going to let her get by with that kind of that man has been doing to us every time we had to behavior." go into the hospital." I thanked Becky for letting me in on this "I accept your apology, Jill," I said. "I'm "good news," and I mentally prepared myself for a glad you're feeling better now. I don't plan on therapeutic confrontation with Jill at our next having to force you to see that man ever again, so session. When it arrived, Marie did everything she that problem should be over." could to avoid letting me deal with Jill, but I was "We're glad for that," Jill answered. "I even more stubborn then usual in following my think we have had our fill of psychiatric hospitals. plan of therapy. Now it's time to go to Stepping Stones, so I will bid When I finally persuaded Marie to cooper- you goodbye for now." ate, I age regressed her back six weeks to when she With that final comment, she walked out

the door and went on to the Day Treatment Center. The undesirable psychiatrist would never **** get involved with a patient, meaning that he would During subsequent years, YGH had seri- only answer questions with other questions. He ous difficulty meeting state and national standards would sit back and appear utterly bored with with its outmoded hospital building. At first, Dr. whatever the patient talked about. McIver tried to remodel a medical ward into a 2. Alertness: The desirable psychiatrist small psychiatric ward. Finally the county officials would stay awake while the patient is in the office. decided to stop "spending good money after bad." If he found he could not, he would either send the Like other small counties, Yolo County closed its patient home or avoid scheduling patients when he hospital in 1992 and started contracting for all cannot stay awake. services to the private hospital, WMH. Now all the The undesirable psychiatrist looks at his psychiatric patients, good or bad, angry or pleas- watch during the session, rubs his eyes, stares out ant, have to be managed on the ward at WMH. the window and closes his eyes. Sometimes he falls At last report, Dr. Lucien was still on the asleep while the patient is talking. He will not staff at WMH. Dr. Newbury found that there were notice the patient tiptoeing out the office, shutting not enough children and adolescents in that practice the door behind her. When he wakes up and finds to suit his tastes. When, in 1988, a new private his patient gone, he is not curious enough to call hospital opened its doors in another county, he her at home to see if she made it safely. became a psychiatrist there. Dr. Romero left the 3. New methods: The desirable psychia- clinic after that to become medical director for a trist is willing to try new and improved methods of hospital in another city. treatment. He does not stick only with what was in Dr. Newbury has since seen several pa- the textbooks he studied in school. He will try tients who appeared to be multiples, and, with his whatever might conceivably help his patient, exposure to how I approached Marie and her warning her of potential dangers so that she can be psychic sisters, he was able to work out a treatment an informed, cooperative part of the system of plan for each of those patients and help them healing. toward integration. His hospital has avoided the The undesirable psychiatrist will not try pitfalls of a special ward for dissociators, so he has out anything he did not learn was proper to do in not been plagued with the problems so many other school. He values orthodoxy over results. He may specialized ward therapists have had to face in this be interested in curing his patients, but only if they past decade. will respond to the approved methods. He is not **** willing to be flagged by his peer reviewers by doing Over the years of going to these psychia- anything different from all the rest of them. He trists, Marie has come to some conclusions as to plays it safe. what makes a "Desirable Psychiatrist" versus an 4. Labeling: The desirable psychiatrist "Undesirable Psychiatrist." What characteristics remembers that each patient is a unique individual. and behavior of the psychiatrist can help the patient Because some procedure worked with another with MPD become healthier? (For clarity, the somewhat similar patient is no guarantee that it psychiatrist is called "he" and the patient "she.") will work with this new patient. He may make a 1. Personal interaction: The desirable label in the chart for reporting to the insurance psychiatrist interacts with his patients. He is not company or the referring doctor, but he does not afraid to sit close to them. He does not need a big consider the patient to "be the label." He realizes desk between them. He wants to be close to his there may be more differences between two patients patients, not on the other side of a huge void. in the same diagnostic category then there are

between two people in different diagnostic catego- is right again. ries. 6. Crises: A desirable psychiatrist sees a The undesirable psychiatrist feels his first crisis as a window of opportunity during which he duty is to apply a label to the patient. Then his can do therapy that the patient has been resisting behavior is based on what tradition tells him is the doing. Now that the crisis has made her hurt in proper way to treat everyone with that label. He some way, corrective therapy to prevent further does not feel he is doing his job unless he can label similar crises is a small price to pay to prevent what kind of person that patient is. Nothing the further major crises. He uses her pain and embar- patient then does or says can conflict with what he rassment as a needed prod to persuade her to look expects someone with that label to do or say. into areas she has been afraid to face before. He Anything else is malingering. It does not matter if keeps her in the hospital until she has faced and the label is incorrect. Once the psychiatrist assigns effectively dealt with those issues that brought her a label, the patient is thereafter "nothing but a there. He lets her go home when she has conquered [label]!" the mountain she has created for herself. 5. Ethics: The desirable psychiatrist will An undesirable psychiatrist takes a crisis not cross over the line that separates his patients personally, and gets angry at the patient for making from his family. The two are separate and equal, him look bad. In his opinion, a psychiatrist should and shall remain that way. He will not give his be able to prevent all acting out of his patients, and views of how the patient was in the past and will he wants all others to think of him in that way. not try to implant in the patient's mind ideas of Patients of undesirable psychiatrists soon learn that activities that did not happen. He will not try to they can have crises safely only if they are "man- seduce the patient, but will maintain a professional ageable crises," something that is intense enough to relationship. Only in this way can he help the get the doctor's juices flowing, to make him feel he patient become the best person she can be. is doing something useful. The patient must not The undesirable psychiatrist is more expect him to explore the cause of the crisis more interested in power and prestige than in the welfare than superficially, as then he might feel obligated of the patient. He may feel justified in seducing the to do something constructive for the patient. That patient because he thinks he is God's gift to women would put him in the position of being seen as and has a need to prove it (because he doesn't manipulated by the patients, a fate worse than really believe it). He puts his patients above his death for him. family members in value and makes one jealous of In addition, the patient of an undesirable his attention to the other. He assumes that only he psychiatrist must avoid what he calls "acting out," knows what the patient really experienced decades the most negative label possible. Such an additional ago, since he read about it in some trade book label would guarantee her becoming labeled a recently. He feels a need to convince the patient "troublemaker," and no one wants troublemakers in that it happened just the way he thinks it happened. their practice. That the patient has no memory of any such The basic plea that Marie makes at this event(s) is all the more proof to him that it hap- time is that new psychiatrists and other psychother- pened, because she "is in denial." To deny some- apists be trained to interact with their clients, thing he, the authority, knows happened is absolute realize they are human beings, and deal with them proof that he is right. He can never be wrong, with respect and dignity. regardless of what the patient remembers, with that kind of reasoning. If she remembers it, he is right; if she doesn't remember it, she is in denial, and he