Monday, September 17, 2012

Chapter 20 The politics of Q tips

So at the appointed time I arrived in the activity room at take my place at the council table.
Rose is more or less in charge, something between a moderator and secretary.  Diane is there, she is a very quiet Asian woman who drools, one of the side effects of her medication.  Seems terrible unfair, there she is a nice polite woman drooling all over the place.  It is considered a minor side effect.
Carl is a thin scruffy man who has the distinction of having the most annoying human voice I have ever heard, a high buzz saw nasal whine that just cuts right through your skull.  First time I saw him was shortly after arriving in the mad house.  He was in the day room trying to learn Spanish by memorizing the dictionary.   Fork cucheria, fork, cucheria,.  As it seems that people with truly annoying voices are attracted to politics he is there.
Bob is there playing with his dolls.  Bob is exactly what one would imagine a mad house patient to look like, a fifty year old man who looks like a toothless beardless bald garden gnome with a four year olds dress sense.  Today pink tights, purple tutte and star spangled sneakers.  He thinks he is the Lindbergh baby.
Other then that the event is atteneded by people who were just hanging out in the activity room so were drafted.
And let the games begin.  First the reading of the notes of last week.  Which is of no interest to me.  Then the floor opens to new business.
Carl takes the floor.
It is a well known political tactic to allow the biggest blow hard in the room to go first, let him suck all the air out of the room so when you finally get there with your proposal people are so tired and ready to leave that they will happily agree to just about anything.
Carl is perfect, he has a file folder stuffed with charts legal paperwork forms and all.  He wants the MHRF to become a patient run co op with an open door policy were they could come and go as they like, get jobs, have control of their medications ect ect ect.  His buzz saw whine goes on and on.  Till finally Rose steps in with the time nearly up.  She says she will take all this down and send it on to the hospital administers,, or ,, somebody.
“Is there anything else?”  She looks around the table.
"Well, yes.” I speak up.  “I would like soy sauce and Tabasco sauce added to the table condiments. The meals are, to say the least, bland and the soy sauce and Tabasco would be a help.  Also salads, I must say that six ounces of salad divided up between an averages of six to ten residents, can’t really be called salad.  It barley qualifies as garnish. So more salad please.” 
She says she will speak to the dietitian as she is in control of the kitchen menus.
This is of course code, for ‘I will forget this and hope you do to.”
So next week a repeat of the first.  Carl goes on and on till the time is nearly done. Then I ask Rose has spoken with the dietitian yet.
She hasn’t gotten a chance to see her yet but will this week.
Next week.  “Have you spoken with the dietitian yet?”
The next stall will be the pick some small part of the over all proposal as a reason to reject the entire thing.
“Yes, well, the dietitian feels that soy sauce will be too high in salt for the sodium restrictedpatients.”
I smile, (wonderful if the objection had been money that would have taken months of work to get around. This was easy.
“Soy sauce while high in sodium is certainly no higher in sodium then the table salt already provided, and Tobasco is a low sodium product that is often recommended to people with sodium restricted diets.  Now as to the salad.  Due to the medications you all hand out, most of your residents have constipation not to mention weight gain, so I would expect that you would be encouraging the consumption of salads as much as possible.
Now is the time to add something to the proposal that the powers that be can reject so they feel they have some control over it all.  It makes them feel good.
“I would also like to see more than just lettuce and shredded carrots in the salad, tomatoes would be nice, the occasional cucumber, some sprouts.”
“Ohh  and one more thing about the soy sauce.  You know over half the residents of the MHRF are Asian.  It would seem to me that not providing soy sauce is pretty culturally  insensitive.”
This was San Francisco after all, I figured I had them with that one.  Then Diane, who has never said a word for weeks, peeps up.
“I’m Asian and I don’t care if we have soy sauce or not.”
(Ohh lord there is always one)
Diane is one who just cant handle any sort of confrontation.  I guess she felt that I was putting her in the middle of an argument.  Knowing her fear of confrontation I knew exactly what to do.
I kicked her under the table.  Then I leaned over and hissed into her ear.
“Hush up you. You may not care if we have soy sauce or not but I do.. and I’m just a white girl from the backwoods of Maine I can’t exactly claim soy sauce as part of my cultural heritage now can I?  So don’t screw this up for me.”
She ducked her head and slunk down in her seat.
The motion passed and next week I sat down and put Tabasco sauce on my omelet at breakfast and for lunch I put soy sauce on some chicken mess And crunched into a nice pile of salad, no tomatoes, but hell I never thought I would get that.
Having achieved my goals I promptly retired from politics.
After a couple of weeks without my attendance at the council meetings Burt pops into the library.  He is wearing his ‘I’m concerned for you and reaching out face.’ 
“I notice you haven’t been to  the consul meetings.”
“Nope.”  I prop my feet up on the desk leaning back comfortable in my chair.  “I achieved what I set out to do so I have now retired from politics.” 
 Brave words too soon spoken as it turned out.
“I’m sure you have other issues you could address.”
I thought briefly of q-tips.  It is an odd thing to me that one can get a razor but not a q-tip.  When you take a shower you can get a plastic safety razor from the staff nurse.  You have to sign for it and turn it back in when done with your shower.  I can understand wanting some controls when handing mad people razors.  What confuses me is that while one may have a razor one may not have a q-tip.  Why is a mad person trusted with a razor but not a q-tip?  I run the mental calculations in my head.  Mad person + razor+ a half hour alone in the shower= potential trouble factor X.  Then I run the calculation Mad person + q-tip. I just couldn’t see a q-tip resulting in a higher potential trouble factor than a razor.
Not having a q-tip, it’s a small irritation.  You don’t notice not having a q-tip at first.  Maybe it was just my obsession with clean ears, but it was really starting to bug me.  So one day when the nurses back was turned I swiped a bunch of throat swabs, thus solving my q-tip dilemma.
So when Burt mentioned other issues and I naturally thought of q-tips.  Who would I have to take on in order to get q-tips?  That would be the nursing staff and possibly housekeeping.  I did a quick cost benefit analyses, the amount of effort I would have to expand in order to get the q-tip reward.
“No, sorry Burt, there isn’t anything else I can think of that the consul can address.”
“But I’m certain you have other issues you could address, you have some ideas about the way the hospital is run.”  Poor Burt is confused and a bit worried, to find me suddenly a woman without issues.
“Issues?  Ideas? “  I let out a tea pot hiss and roll my eyes.  “Where do I begin?  Ok the two biggest issues for the patients is they all want more input and more control over their medications.  A pretty sane thing to want in my opinion.  They also want more freedom, more passes to the outside.  Again a very sane thing to want and one I think should be encouraged with added guided field trips to encourage and facilitate interaction with the outside world.
One of the mission statements of the MHRF is ‘to help the patients acquire independent living skill sets.’  What you have is supervised patients running the cash register at your little playtime convenience store and a once a month ‘how to cook spaghetti’ class.
The activity room. Rose is a sweet person but has no ability to organize activity.  On the other hand that she is given only ten bucks a month to buy art supplies with could be a reason she is so loath to do anything.  That just boggles me, I mean really? Ten bucks a month?  Here we are in San Francisco and buying crayons for mad people is something you can only get ten bucks a month for?”
Your patients need physical activity.  You have a gym that is locked and completely empty of any equipment and there is no physical therapist on staff.
Other than the anti drug and alcohol group meeting sing alongs, there is no attempt at therapy of any other sort.  Having mad people chant just say no while you hand them their daily meds is the sort of heavy hand irony that would be considered over the top in a student movie.
So yes Burt I have issues and ideas, but none of them that the patient council would have any power to address.”
“You don’t know that, after all you got soy sauce and more salad.”
“I got Tabasco sauce too Burt.”
"Exactly, then why not come back to the council and put your ideas forward.?”
I sigh and do the eye roll.
“Because Burt trying to dig the Holland tunnel with a tooth pick is not my idea of a good time.”
“I don’t understand.”  
“Yes you do.  Look the council is set us to give the patients the feeling that they have impute into their treatment.  Some illusion of control over their lives. And to ‘ facilitate their integration into the larger society by giving them the experience of working together’.  It however has exactly no actual power and is in no way set up to be an instrument of change.”
“But you effected changes through the council.”
“Yes Burt, I got what I wanted.  I chose a small and inconsequential issue that would only be an inconvenience to the food service workers.    And lab rats have more political pull then the food service workers union.  It was perfect, an issue you could give on and then say in  your annual reports how the council actually has some impute in the running of the hospital.  Win, win, everybody is happy and I get to put Tabasco sauce on my omelet.”
“Think of how much more you could accomplish.”
“It is believed that Archimedes once said, something along the lines of “give me a fulcrum and lever large enough and I can move the world”   Well without leverage your not Archimedes your sis aphis. “
Burt gets that slightly embarrassed, slightly bemused look on his face that he gets when I make some classical reference he totally doesn’t get.  To be honest it bugs me.  How can one go all the way through all those years of advanced education and not brush shoulders with at least one illustrated classic comic book?
“Burt, everything I just mentioned involves movement of money, changes in regulations in rules in procedures even in laws.  To believe that a bunch of mad people sitting around a table playing with dolls would have any power to accomplish anything I just spoke about is, delusional”
Burt finally gives up and leaves looking a bit crest fallen.  Reality is always such an unpleasant surprise for Burt.

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