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Years ago I wrote a story for the Los Angeles Times about a nurse I had met at Northern Nevada Adult Mental Health Services. It’s a free government clinic and I felt like a total loser. I had bipolar disorder. I was afraid, desperate, embarrassed and broke.
Inside, I was assigned to the nurse, Jeff, and explained that I attended a fancy university, fluently spoke Russian and Spanish, had written for Newsweek magazine and traveled the world.
Jeff didn’t care what language I spoke, or what — if anything — I did for a living, what my bank account looked like or how I got to his desk. He was happy and smiling, and quickly soothed my fears about being his client. He cracked jokes.
He also spent a lot of time with me. I never had a regular psychiatrist. In government-funded mental health clinics nationwide and especially in Nevada, a state short on psychiatrists, “traveling” doctors come and go between these clinics, often “borrowed” for a few days from California clinics. I’ve had these kinds of doctors, and I never liked them. It wasn’t that they didn’t know their medications; they just didn’t know me, and knowing the client is important in the field of mental health. I usually saw them once and then they’d be gone by my next appointment. They only knew my name by looking at my chart.
In the state system, patients are not allowed to talk to doctors over the phone. But year after year Jeff was always there, always returning my calls the same day. He knew more about my medical issues then anyone. Continuity is important in the lives of people with a mental illness, given that so much of our lives can be unpredictable. Moreover, medications are serious narcotics, often sedating, with many possible side-effects. It’s important to have someone around for the long run familiar with my medical history. In this case, it was my nurse, not a doctor.
For my story I wrote about how much Jeff loved his job and how he was adept at treating and soothing impoverished mentally ill patients who might not have a place to spend the night.
The folks at the clinic waited for the story to come out, and when it did, I was devastated. The content itself was cheery and paid tribute to Jeff and Nevada’s nurses, but the newspaper published a dismal, black-and-white, stereotypical photo of what I guess was supposed to be a dilapidated mental hospital, a la the movie “One Flew Over the Cuckoo’s Nest.” It didn’t reflect the story at all.
Jeff and the others didn’t care. They were just happy to have their efforts finally noticed by the public. Rebecca the pharmacist taped it on a hallway wall for all the patients to see before administrators took it down.
I always thought it would be much cheaper and more effective for the state to recruit psychiatric nurses through the University of Nevada, by offering nursing degree candidates full-ride scholarships in exchange for a several-year commitment to work for the state as a psychiatric nurse in low-income areas, kind of like the “Teach For America” program.
I left Reno for a job in Washington, D.C. It was hard to say goodbye to Jeff, but the job allowed me to afford a doctor in the private sector who, like most psychiatrists in our nation’s capital, charged $300 an hour, cash only. At first I was excited to have a Harvard-trained psychiatrist, thinking that an expensive doctor would provide better care. But Washington was too hectic and stressful for me, and my head was constantly spinning. No medication helped. After three years I returned to Nevada to live quietly with family members, having learned a big lesson: It’s not a doctor’s pedigree that makes a difference. It’s more about the other people in my life. And it’s about getting help before my problems balloon to what some call “mental health stage four.”
Though he’s no longer my nurse, I recently stopped by the clinic say hello to Jeff. It was great to see him, and we chatted amicably until he apologized and said that even though it was his break, he had another patient who needed help.
Kim Palchikoff is studying social work at UNR and writes about mental health.
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