A Christmas Carol

When I first met thirty nine year old Roger on Christmas Day in the psychiatric hospital, he was crying.

Roger told me how much he hated Christmas. As our conversation went on, he shared that his mother had died when he was very young and his father was always distant.  Roger recalled being left alone at boarding school while his friends went home for the Christmas holiday.

Determined to make something of his life, Roger decided to put all his energies into being rich. And indeed, he was wildly successful. But ultimately his obsession with wealth prevented him from close friendships or ever getting married.  As the years went on, Roger preferred the ‘security’ of his money rather than the unpredictability of human relationships.

Now he was grieving, and utterly all alone. And suicidal.  

The next morning, I took a bit of a risk and told him that his journey made me think of Scrooge in “A Christmas Carol.”

Wrong thing to say - or maybe it was the right thing…?

Roger erupted: “Who the hell do you think you are, calling me Scrooge?”

I decided to not let up.  I told him that this is his moment, his watershed moment, and his anger toward me was not going to deflect the reality of his suffering.

Roger then started swearing at me. He raised his voice and threatened me.  I responded that he can choose to threaten all he wants but I’m not going anywhere;  I’m right here, every day, and I care.   I told him he could leave the hospital if he wishes and continue to ruin his life if he wants to…….

Now if I was a literary romantic, I’d like to say that Roger had a dream that night of “The Ghost of Christmas Yet to Come.”  And that the ghost showed him how relationships and giving are the key to happiness, and that in the end all his wealth would mean nothing.

But of course life doesn’t always go the way of novels and movies.  Unfortunately, Roger chose to sign himself out of the hospital.  Before he left, I told him that trying to make up for his past pain and neglect by beingself-contained will not bring him joy.  But Roger would hear none of that and told me to get lost.

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One of the beauties of life is that we humans have free will; we can make our life what we wish it to be.  And we have the blessing of repentance, that we can turn our past around.

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Two years later I was walking down the street and suddenly, there was Roger.  He appeared amazingly like a different person,  greeting me warmly and then introduced me to his wife and newborn daughter!  I must say it was all quite surprising and delightful.As we departed, Roger looked straight at me and, with a smile and a wink, he said quietly, “Call me Scrooge!”

Groundhog Day

Gene was 48 years old, divorced, an alcoholic.  He came into the psychiatric hospital after trying unsuccessfully to hang himself.  As I entered his room, he was crying:  “Doc, I’ve screwed up so many things.  I wish I could start over.”

But going back in time is simply not possible.

Nor should it be

Except!

Except in the epic 1993 film, “Groundhog Day”!

In this amazing movie, we watch Phil Connors (played by Bill Murray) living the same day, February 2nd, over and over again.  Phil starts off as a sarcastic and selfish man, ridiculing the people of Punksutawney, PA (where Groundhog Day takes place) as simpletons. But as the film progresses, as Phil Connors wakes up every morning and February 2nd is repeated over and over again, his selfishness ultimately changes and he refines his character. 

It is precisely then, when Phil uses the day February 2nd to the fullest and does acts of goodness, that he finally wakes up and, alas, it is February 3rd!

In life, time  moves on. We cannot stop it. It is our most valuable commodity.  To recognize and live with the preciousness of time is powerful - while also knowing that the clock will turn into the next day and again to the next. 

So, with Gene in mind, I arranged for the patients to watch “Groundhog Day” that night on the psych ward.  I was hoping the film would strike a chord inside Gene, that he would see that in each day lies opportunity for a new start.  That he would see the preciousness of time, that time moves inextricably forward, and that time allows us the chance to bring about radical change and transformation.

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Years after the movie version of “Groundhog Day”, it premiered as a Broadway musical.  One man who came to see it was Bill Murray. Almost comically, after seeing it, he came again the next night - to experience “Groundhog Day”, again!   The NY Times wrote that at one moment Murray was seen weeping. Why? The Times wrote that Murray’s tears reflected the very potent idea that in life “we just have to try again, we just have to try again.”

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The next morning, I asked Gene about his thoughts on “Groundhog Day”.  All he could talk about was how funny it was.  And how ridiculous it is to think that a little animal can predict the weather.

He then complained that no one in the hospital is helping him get better and that he’s shaking from coming off alcohol and there’s not enough food so could he please get double portions.

Oh well,… I thought to myself…

Time for me to keep trying, again, and again.

(My thanks to Rabbi Meir Soloveichik for his podcast which helped me with this blog.)

Lisa's Agenda

Different patients have different goals when they are admitted to a psychiatric hospital. They go like this:

(1) those who sincerely want to get better; (2) those who are persuaded by their family to come in - they often eventually gain insight and appreciation;

(3) those who can’t wait another second to get out; these patients are oftentimes admitted against their will.  They consistently have no desire to engage in meaningful treatment.

And then there is the unfortunate but inevitable 4th category:

(4) those who have a self-serving agenda, like economic gain or a desire for ‘disability’.

Enter Lisa….

Lisa was an attractive woman who dressed the part. She was a flirt.  It was easy to see that the male patients were highly distracted and couldn’t take their eyes off her.  She milked this, loved the attention.  When I made my room rounds and she asked me why a (female) nurse had to accompany me, I recognized that Betty was a probable danger zone.

The next day my suspicions were confirmed: Lisa reported that a particular male patient had entered her room during the night and had taken advantage of her sexually. She said that she would pursue legal counsel and sue the hospital for not protecting her. 

Certainly, it is always the hospital’s responsibility to protect each patient. And that’s why every psychiatric hospital has ‘mental health aides’ to watch over all that goes on, day and night.

There are also cameras throughout our particular psych ward and so, after hours of reviewing the video tape, Betty’s claims were deemed a total fabrication.

Amazingly but not surprisingly, the next day Lisa announced that she felt better and was no longer harboring “suicidal thoughts”.  We made sure this was consistent and so a couple of days later she was discharged.

In short, Lisa was what we call a malingerer, someone who pretends to be ill in order to achieve other gains.  In my mind, Lisa's malingering was a reflection of her own internal pain and needs, which led to navigating the world as her personal playground of manipulation and self-interest.

I tried to talk to Lisa about this, but she was not interested.  Sad.  She was simply unable to look at herself.  Diagnostically, this pattern falls into the categories of narcissism and sociopathy….almost impossible to cure.

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Two weeks later, a male patient, Jim, came to my office.  Jim had been in the psychiatric hospital while Lisa was there. He told me that he desired her and they had exchanged numbers: “She was so pretty, doctor”, Jim told me, “and she said she wanted to meet me at my place.  I couldn’t believe my luck!…”

But as fate would have it, Lisa came to Jim’s place and, within short order, she robbed him of a good sum of money. “What a fool I am”, Jim cried to me.

Lisa. 

Lisa’s agenda.

The truth is that Betty, like all of us, has a soul within her, a soul that is a piece of Divinity, a soul that is pure and good, a soul that is who she truly is.  But, sadly, her soul has been muffled and covered over.

To uncover that grime is the challenge, each on our own level, that we all face.