8:00 a.m. – Breakfast
8:45 a.m. – Community Meeting
10:30 a.m. – Snack
11:00 a.m. – Group Therapy
11:45 a.m. – Lunch
1:00 p.m. – Visiting
2:00 p.m. – Activity Group
3:00 p.m. – Snack
4:30 p.m. – Walk (if approved by insurance and doctor)
5:45 p.m. – Dinner
7:00 p.m. – Visiting
8:30 p.m. – Snack
Every day in inpatient has the exact same schedule. And yet we get it explained to us every morning anyway, as if we should expecting a radical change (to be fair, once a week, there are supposedly puppies). I figure the daily loop is because, while the rhythm of life doesn’t change, the people in the ward are constantly rotating, so it’s almost always fresh for someone.
By day two, as my brain rebooted, I decided that the schedule reminded me of the ‘Rules for the House of young prisoners’ in Paris that Foucault cites at the beginning of Discipline and Punish. The days are planned out to the minute: Rising; Prayers; Work; Meal; School; Recreation; Work; Wash; Work; Inspection; Sleep.
We were not prisoners, of course—even an involuntary hospitalization is a far cry from being in jail—but there was something about the rhythm that seemed vaguely similar. There’s an aspiration in each to show that the institution is not merely a quarantine, but a complex machine constantly pushing us towards self-improvement.
I wonder how busy those young prisoners actually were, though, because in inpatient, at least, you mostly don’t do shit.
I don’t blame the people behind the programming. Our animators were indefatigably positive, even when three-quarters of the unit would stay in bed around group time. And while eating six times a day might seem to fill the time, meals go fast when you’re sitting around a table with fifteen people in complete silence. In truth, our days hinge on the unpredictable arrival of our psychiatrists and the anxious waiting for meds to kick in.
My five days spent reading Calvin and Hobbes and eating snacks cost the taxpayers of California—obliquely, by way of my student health plan—$40,000. Although my insurance company sent me several e-mails encouraging me to “manage my health care expenditures” (which is hard given that I didn’t have e-mail), it’s a pretty meaningless number. It’s so unfathomably large, and so out of sync with how little seemed to happen while I was there.
It really is pretty hard to figure out why psychiatric hospitals cost so much. There are none of the accouterments of a ‘real’ hospital; no MRI machines, no patients walking around with IVs, no doctors in white coats hustling down the corridor. You could put us all in the fanciest hotel in Berkeley, hire us each a personal nurse, art therapist, and security guard, and switch us from generic to name-brand medication, and you still wouldn’t come close. It’s easy to see why, around the world, governments are shuttering the asylums. It seems silly to pay so much for a place that almost no one wants to be.
But I, at least, am grateful for my hospitalization. I’m grateful for being safe; I’m grateful for a few days to rest; I’m grateful for the therapists who came every day with a smile that seemed terribly out of place. But I’m also just grateful for the hospitalization itself—that I can tell people “I was in the hospital” and they suddenly realize that what happened was serious, that I didn’t just have a case of the blues or a panic attack; that I wasn’t going to climb out of the hole I had dug with a standard dose of Prozac and weekly talk therapy; that I was in a condition every bit as scary and life-threatening as the conditions that filled up the “regular” hospital wards downstairs.
And maybe that’s the point. Something around 1% of the population will ever be in a psychiatric hospital; of those, 20% are back in a month, and once you’ve been back twice, it’s a long shot to avoid a third. I didn’t learn much in the hospital, and it certainly didn’t turn me into a self-governing Foucaultian subject. But it’s still a big moment, one I can put on the calendar and say, “That was the big break. That was when I finally changed.”
That’s a lot of snacks! Are you familiar with Camille Robcis’s work? http://history.cornell.edu/camille-robcis You probably are, but I just thought I’d mention as what you say about Foucault here really reminded me of a talk I saw her give recently about institutional psychotherapy in postwar France.
This is a really helpful lead. Thank you, Emily!