artsmuklermd

Author: artsmuklermd

Art Smukler, MD was born and raised in Philadelphia, went to college and medical school in Pennsylvania, and completed his psychiatric training at UCLA. He is a board-certified psychiatrist, specializing in the treatment of adults with a subspecialty in adolescents. As a member of the UCLA faculty, he ran an award-winning psychotherapy conference for psychiatric residents and received the coveted “Golden Ear” award. He has published in psychiatric journals, and won the award for excellence in creative writing at The Santa Barbara Writers Conference. Now a full-time author, he applies his deep understanding of the human psyche to the motivations of his fictional characters.

A number of years ago, I was post surgery for a sports related injury. Woozy, they rolled me back to my hospital room and hooked me up to an IV drip, an EKG monitor, and a machine to give me morphine if the pain got too bad. As soon as the nurse left the room I needed to get up.

“What are you doing?” my wife said, startled that I was trying to stand.

“I have to get up,” I said.

“Stop it you’re being crazy. You’re going to pull the IV out.”

I ignored her, pulled off the EKG wires, pulled out the morphine drip, and started rolling the IV bottle towards the bathroom. I knew I was being crazy, but couldn’t stop it.

“Going to the bathroom,” I said, lying because I knew she was right, but I just had to get up and move around .

I stood in the bathroom and looked at my diaphoretic, unshaven face. I couldn’t just lay there. Something weird was happening to me. I waited 5 maybe 10 minutes and got back in bed.

“Are you okay?” my wife asked’

“I’m fine.”

Ten minutes later the same thing happened again, and ten minutes after that again, and again… It was a nightmare. It felt like I had lost my mind, and like a dog with a ball on the other side of a very high fence would never retrieve it. I begged my wife to go home. She wouldn’t leave. I didn’t want her to see me this way. The nurses didn’t know what was happening and kept suggesting that I take more morphine. Four long hours later, when the surgeon finally finished his next two operations and came in to see me, I was finally back to normal.

The next day I figured out what happened. The anesthetic, Droperidol, triggered an akithesia, an abnormal, uncontrollable movement disorder that originated in the extrapyramidal part of my brain. Droperidol is from the same family as Haloperidol, a major tranquilizer to treat schizophrenia, bipolar disorders etc. Haloperidol can cause the same symptoms that I experienced. Until this happened, I never imagined the hell my poor patients were going through when they had side effects from the medication I was giving them.

Not being able to control oneself is a horrible experience. Imagine having voices that try to control you, or a delusion that people are trying to kill you, or panic attacks so bad that you’re sweating, your heart’s pounding, you can’t think straight, and you’ll do almost ANYTHING to get it to stop.

For anyone to ever minimize the pain of mental illness is a travesty, yet insurance companies almost always separate treatment for “medical” problems with treatment for “psychological” problems. For the millionth time, let me remind them that the brain is connected to the rest of our bodies.

Any thoughts about being out of control or how our medical care system works or doesn’t work?

What does crazy really mean? Dying your hair green? Spending thousands when you don’t have it? Dropping out of school to become a rock star?

Nope. Any of the above may be construed to be poor judgment, an adventuresome spirit or just silly, but not specifically crazy. In psychiatry, we define crazy in 2 ways — the existence of delusions and/or hallucinations.

A delusion is a fixed, false belief that is unshakeable by logic and not shared by most of society. “An alien is my best friend,” might fit into this category. BUT, in ET, Elliott, the meek little boy-hero, was contacted by a cute friendly, extraterrestrial who did become his best friend. Setting that example aside, if you believe you’re being contacted and possibly controlled by aliens, YOU are delusional, have lost touch with reality, and should seek treatment.

A hallucination, most commonly auditory, but also visual or tactile, is perceiving something that doesn’t really exist, except in your own mind. In the old testament, god commanded Abraham to sacrifice his son Isaac. All 3 religions, Jewish, Christian and Muslim agree that this really happened, but disagree whether the son was Isaac or Ishmael. So when Abraham heard god speak to him, was this an auditory hallucination? Not in this world. Too many religious scholars and believers are in agreement that it actually happened. But, if YOU believe that god’s voice is directing you to kill your son, you are hallucinating and should get immediate help.

Any thought or ideas about being crazy?

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