Emergency Service

By Jess Kung Editor-in-Chief

I’ve internalized the fact that I am ill again, and I’ve convinced myself to not commit suicide, but I can’t help but still want to die. I’m staring at the linoleum of the hallway, the central nerve of this wing of the psychiatric hospital. While I wait to read and sign papers, two more patients arrive. Later, I overhear that they’re taking more than twice as many people as anticipated today.

My clothes are in a bag and all I’m wearing is a gown; I had to hold the back in place so my bare ass wouldn’t hang out when I walked. They give me another gown for my back. Somebody walks in with street clothes. I feel stupid. I could’ve just come straight here, avoided the emergency room charge.

The tag from the last hospital says things about me I never wear on my sleeve. It adds to the unreality. Maybe I’m just not here, alive when I don’t want to be, being addressed by a name I don’t use.

A nurse aid takes my paperwork and goes through it with me. This time, I’ve put myself on a voluntary hold. The first time, I was 15.

The first time, it was an involuntary hold. The official term is a 50150. They put me in a room with five other patients. The adolescent ward is a continuous teen movie: moment after moment of solidarity between kids from completely different worlds and completely different circumstances.

The morning I wake up there, after an early morning blood drawing, I hear my new roommates. I had been sleeping on my stomach and my haircut led someone to believe I was in the wrong room. It’s why I cut my hair that way, but I start to worry that it’s going to cause trouble.

One of them reassures me that my face gave me away. I don’t know how to feel about that because on one hand, I’m safe. On the other, I have to pretend to be something I’m not.

Six years later, I have the same problem. This time, I’m half a year into hormonal transition. I don’t know if my face is going to save me this time. I’m non-binary and I can’t read gender when I look in the mirror anymore. I have to hope for the opposite of normal — that people read me as the gender on my ID. As the nurse aid processes my paperwork, I know I’m going to be placed in a room where I will stick out.

“I’m transgender. Is that going to be OK?”

The nurse aid looks at me, calm but slightly dead-eyed. It’s probably long into his shift. He tells me that they’ve had transgender patients before, then leads me through a room to a shared bathroom with the stuff I’m allowed to keep. My clothes but not my belt, and five dollars and some change from my wallet, stuffed into a tube meant for urine samples.

In the bathroom, I have to prove to the nurse I’m not hiding anything. Embarrassed, I flash my front, then my back. The nurse leaves.

I look in the mirror. This is going to suck, but at least I can put pants on.

I spend a lot of time in the common room. One of my roommates is in a bad way like, “refuses to leave the room, having full conversations with the voices in their head” bad. They demand for the lights to always be low (ideally off) and they’re alternately respectful and belligerent towards the staff.

They have an awful relationship with my other roommate, who needs a wheelchair and a full-time nurse assistant and likes having the lights on. My first night, I am warned of how bad their behaviour is and how they torment everyone in the room with them. The nurse nods along.

The first time I am alone with them, I’m just trying to take a nap. It’s already tough to sleep in the incredibly cold room, but I end up listening to one side of the dialogue my roommate is having with their voices.

“Drop dead now,” they intone regularly. “D. D. N.”

It’s a lot of rage and betrayal. I hope that they are caught up enough in their voices that I can be overlooked but at some point, I have to adjust my back on the thin mattress.

They start talking about how there’s an interloper in the room, probably a lazy staff member taking a nap.

“What are you doing here?” they ask, and then ask again. I’m pretty sure they’re actually talking to me now.

“Look,” I say. “I was placed in this room, and if you don’t like it you can tell them to move me.”

“Shut up,” they say. “Oh, stuff it. Drop dead now. D. D. N.”

Their conversation continues and I leave the room. I can’t sleep.

Later, when nurses bring our meds for the night, my roommate sits up from bed to ask why someone from the wrong gender is in the room. This nurse seems a little bit over it, probably because they just threw a tantrum over taking their medication.

“Look. Why would we put someone in the other gender’s room?”

My roommates thinks about it. “A transgender?”

The nurse shrugs, “That’s not for me to say.”

I don’t know what you think happens in a psychiatric facility, but it’s mostly stuff to prevent the patients from hurting themselves or others while they prepare for the next step. It’s purgatory.

There were two group therapy sessions a day, mostly lead by a tall islander dude with a huge grin and a ukulele. He leads us through super basic self-care tips. He’s very well-meaning. He repeats the same instructions before every session: Respect each other and don’t interrupt.

One day, a difficult patient interrupts him. He tells him to raise his hand, and when the patient doesn’t — he’s trying to understand why he needs to raise his hand — he sends him back to his room. The group therapist loses his composure and he turns away from the group to take deep breaths. Someone giggles. He’s not much better off than us.

Having previously been in an adolescent ward, I find the experience here relatively similar. A lot of younger people are generally in for suicide attempts and a kind of gallows humor underlies our interactions.

In the adult ward, however, there are many more people who’ve been in and out of this system for years. They’re between here and other hospitals, group homes, their parent’s place, board and cares and parole.

I befriend a woman who’s 86, 87 at the end of July. I help her with the puzzles and games they give out at activity time because she’s never had to do a puzzle as busywork. She tells me about her life and I hold her hand as she worries about her uncertain future. When I meet her she’s in a wheelchair, but she tells me that she’s never needed one before — at this facility they just wanted her to use it.

The staff make no illusions to care about anyone’s individual problem, which is unfortunate in an environment where most people are experiencing some of the most intense problems in their lives. Personally, I just needed them to keep me from trying to crush my skull against every medium-hard surface. It was enough that they made me promise to not hurt myself and that they had to check in on everybody every half hour.

But I had things like health insurance, an education and a future. You can’t leave without planning your next steps, but your actual long-term solution is up to chance. Will you be able to maintain going to therapy? Will your next board and care treat you well?

The psychiatric ward isn’t a place to get better; it’s a place to get stable. A nurse told me as much. It’s no more disruptive to put a trans person in a room than it is someone who needs full time care, someone who can’t escape the voices in their head.

The nurses are already stretched thin, the doctors and therapists and social workers are almost literally juggling people. The system didn’t fit me, but then again, it doesn’t fit anyone. Unless you build a community with other patients, you’ll be left alone with your thoughts. And your thoughts are what probably got you here in the first place.

One evening, I go in to grab something from my bed. A light is on, the switch out of reach of someone who hates to get out of bed.

“Here, let me get this light,” I say quietly.

As I look to the figure, hiding under the thin blankets, I turn the light off and head out the door.

I think I hear a thank you.

 

If you think you are at risk of harming yourself (but not immediately), you don’t have to go through extravagant emergency room services like I did - you can check into a mental or behavioral health urgent care. There are two in Long Beach at these addresses:

 

The Behavioral Health Urgent Care Center, Long Beach

3210 Long Beach Blvd., Long Beach, CA 90807

 

Telecare Mental Health Urgent Care Center

6060 Paramount Boulevard, Long Beach, California  90805