WHAT’S IT LIKE TO FEEL CRAZY? by Art Smukler, author & psychiatrist

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?

LOOKIN’ COOL, BUT A FOOL: THE MYSTERY OF SCHIZOPHRENIA, by Art Smukler MD

I looked in the mirror and nodded. Yeah, I really liked my jacket and wool cap. It was chilly this morning, but with the new additions to my wardrobe, I’d be warm and look good.

Minutes later, I was browsing the window of Barnes & Noble when a homeless man, pushing his cart filled with plastic bags, announced to the street, “Lookin’ cool, but a fool”.

Shocked, I stepped away from the window and watched as the man shuffled past. “Jesus”, he was talking about me! I glanced at my reflection in the store window and shuddered. How did he know? I was feeling so full of myself this morning, and the old guy picked right up on it. It was brilliant.

It’s uncanny how some untreated schizophrenics have the intuitive skill to read our minds. Like a psychiatrist uses his “third ear” to pick up hidden nuances in psychotherapy, the schizophrenic can be even more acutely in tune to another’s inner workings.

To me it is absolutely amazing and mysterious. Sadly or happily or whatever one’s perspective, when treatment is successful, the magic fades — as do the voices and paranoid ideas.

How do they do it?

Maybe being paranoid, with all senses on alert, allows the primitive part of the brain to pick up and decipher the hidden thoughts of all potential attackers?  The biochemicals align just so and magic happens.

I loved my first year of psychiatric residency when I was surrounded by untreated schizophrenics. I loved the mystery and the magic.

I still do…