“A patient man is better than a warrior, and he who rules his temper, than he who takes a city –Proverbs 16:32
I take a medicine that helps with anxiety, an SSRI called Celexa. I’ve been taking it, or another version of it, for several years. It keeps me on an even keel. It helps me to ride the wave of life stresses without being smashed by the wave and dragged across the rough sea floor. It’s important to take the medicine on a regular schedule, to maintain an even level in the body, And some research suggests that to suddenly stop taking an SSRI can have serious psychological side effects.
Last week I went to pill line to get my medicine. Some medicines, like Celexa, are apparently in high demand in prison because people crush them and snort them into their nasal passages to get high. So while I can keep my blood pressure and cholesterol meds in my cell with me, I have to walk to the dispensary to get my Celexa. I do this every morning along with scores of other inmates who take medicines for anxiety, depression, schizophrenia, aggression, bipolar disorder, chronic pain and sinus problems. The sinus problem people have to get their nasal spray daily at pill line, although I’m not sure why. None of the addicts here have ever mentioned trying to get hold of nasal spray.
There are two windows at pill line. One window is for last names beginning with the letters A-L. The second window is for letters M-Z. Apparently there used to be just one window for A-Z, but the lines were too long. When I first came here both windows were in operation and the line was never long. Then after a few weeks they went back to using only one window, A-L, for all inmates. Now the line extends past the metal slalom and results in inmates milling about in a disorganized mass, trying to figure out who is next to enter the metal slalom. Plus you have inmates who have received their meds trying to exit through the crowd. It’s obviously a security risk with so many inmates and so much medication in one place. So they used to have a CO standing in the dispensary room. But since it’s gotten so crowded, the CO has elected to stand outside.
Anyway, I went to pill line on a Thursday morning to get my Celexa. After waiting in line I got to the one open window, and the nurse behind the safety glass scanned my ID bar code. (We’re really high tech here, don’t you know.)
“You’re expired,” she said as she passed my crushed up Celexa through the metal slot. Actually it’s more like a small metal revolving door, or a small rusted steel merry-go-round. It’s rusted because after so much use the paint has worn off, and the crushed meds are placed in cups of water that we drink. The water spills when the meds spin around on the metal merry-go-round, which causes the metal to rust. They crush the meds and put the crushed powder in water so you can’t give your meds to anyone else.
The only problem is that most of these meds are not supposed to be crushed. They are designed to absorb slowly into your system. When they are crushed, they hit you like a ton of bricks. So for about 30 minutes after gulping down my horrible tasting crushed up Celexa in water, I’m buzzing like a bumble bee and grinning like I just found out a pardon came through from the governor. But then it equalizes in my system and does what it’s supposed to do the rest of the day, which is preventing anxiety. In addition to my half hour of happy smiling time, I’m also unable to read for those 30 minutes. My eyes jump all over a page, and I have to read the same sentence over and over to make sense of it. That wears off after 30 minutes, too.
A few months ago I had to meet with the psychiatrist who prescribes my Celexa. “Any problems with your medication?” he asked. I told him that it made me loopy because they were crushing it.” “They are not supposed to crush it.” “but they’re crushing it.” I said.
He said to wait while he checked on why they were crushing it and dialed the phone. He asked the person on the other end of the phone if the Celexa had to be crushed. He ended the call and told me that the Celexa did not have to be crushed. “So why are they crushing it?” I asked. He typed some things into the computer and said, ”I’m adding a note to not crush your Celexa.” The next day at pill line I was given my usual crushed Celexa in water. I told the nurse, “The psychiatrist said to not crush it.” “We crush everything.” she said. “He said he put a note in the computer,” I said. She looked at the computer screen, “There’s nothing here,” she said. “Take your meds and move along.” The 38 inmates in line growled in agreement with the nurse.
So anyway, back to last Thursday morning. “You’re expired,” the nurse said. “What does that mean?” I asked. She said, “You need to put in a sick call.” She meant getting a sick call form from my block officer, filling it out, and dropping it in the sick call box. The form would then come to the nurses who would mark in their computer system that my medicine needed to be renewed. “Can’t you just mark in your computer system that my medicine needs to be renewed?” She pretended she couldn’t hear me through the safety glass. “Look,” I said, “why not have a little box beside the place on your screen where it says the medicine is expired? A little box beside the place on your screen where it says the medicine is expired? A little box that says inmate requests renewal or something like that?” She still pretended she couldn’t hear me. “Take your meds and move along,” she said. The line growled. So I went back to my cell block and asked the block officer for a sick cell form.
There are about 20 different forms inmates request, and the CO’s throw them all in a desk drawer. It takes forever to dig through the drawer and locate the right form. So the CO’s end up getting annoyed at having to find a form for you. If they can’t find it within a few seconds searching, they tell you they are out of them. “We are out of them,” the CO told me. “Check back this afternoon.” What he meant was to wait and bother the CO who comes in to replace him at 2pm. So I waited. The afternoon CO checked the desk drawer and found a sick call form. I filled it out with the instructions “Please renew my expired Celexa” and placed it in the sick call box around 4pm.
The next morning I was back at the A-L pill window and the nurse was glaring at me. “Did you do what I told you to do?” she barked. “Yes, ma’am,” I said. “I put in a sick call form.” “You’re still expired,” she said and took hold of her computer mouse. After lots of scrolls and clicks she looked at me with accusing eyes. “You put the slip in in the afternoon,” she snarled. “I’ll give you your meds today, but that’s it until you’re renewed.” I asked when that would be. She glared. It’s Friday, she said. I agreed that it was Friday. “Move along,” she said.
Friday meant the weekend. Policy DC-ADM 820 1.6 states: “To access medical services, you must place your completed sick call slip in the sick call box before 8am. Nurses will pick up the sick call slips on your block and you will be placed on Sick Call line the next day.” However DC-ADM 820 states that “sick call for population will be conducted Monday through Friday.” That meant that no one would approve my medicine renewal until Monday. I also made a note to always get sick before Thursday at 8am.
Saturday morning came and I went to the pill line. It was a different nurse. I held up my ID and greeted her with a smile. “I’m expired, “ I told her. “Yes you are,” she said and gave me my Celexa. “You need to put a slip in, “ she said “Yes, ma’am.” I replied.
Sunday morning had yet another nurse. “I’m expired, and I put a slip in.” I told her. She stared at her computer screen. “There’s nothing here,” she said. Apparently the ”expired” message lasts 48-72 hours, and then it vanishes, along with the name and dose of the medication you were taking. “I put a slip in on Thursday.” I told her. She stared at the screen and at the line of inmates behind me. “What do you take?” she asked.
Now at this point, I thought that it was a good thing I was not a criminal thinker. When I told my cellie about this he said, “You could have asked for anything!!!!!!” I told him to cut out the thinking errors or he was going to end up right back here in prison. He asked, “You only got your Celexa, didn’t you?” “I did.” I said. And he shook his head like I’d just missed a great opportunity.
Monday morning saw the return of the original nurse. Her screen was blank, too. “I have nothing for you,” she said. “ It’s celexa.” I reminded her. She shook her head. I leaned down to the steel medicine merry go round to speak so she could hear me clearly.
“You’re not supposed to suddenly stop taking Celexa. The directions warn you against that.” I said. “I still have nothing for you.” she replied.
I went back to the cell block and asked the CO for a sick call slip. “We’re out of them.” he said. One of the block workers was at the desk and told me he had a sick call slip in his cell. I followed him to his cell. He opened a file box with folders neatly bagged and alphabetized. He flipped to S for sick call and pulled out a folder. “How many do you need?” he asked.
My cellie was excited as I filled out the sick call form. “Make sure you use lots of your big words,” he said. “You mean like this?” I said. “Receiving one’s medication should be a relatively carefree, automated process, and not plagued with bureaucratic obstacles.” “Yah,” he said, “ Just like that!” I wrote a very long paragraph, filling every available line on the form.
On Tuesday morning the nurse presented me with my Celexa in pill line. “So it’s renewed?” I asked. She gave me a look and said, “Obviously.”
On Wednesday morning I was ready to go to the library – we get to go once a week – when the CO told me I had to go to medical for a sick call. So off I went to medical to sit for an hour, waiting to see the doctor. I knew this had to be about my Celexa renewal and that it was an unnecessary visit. But try and convince a CO that you’re right and they’re wrong!
After waiting for an hour, I was called in to see the doctor. He was an older Korean man, staring at the sick call form I had filled out – the form with all the big words. “So what’s this about?” he asked with a heavy Korean accent. “It was to get my Celexa renewed.” I said. But before I could explain that it had obviously been renewed according to the nurse, he said, “You in wrong place. You need psych.” I tried to explain that it was all taken care of, but he had me follow him down the hall to the psych office and pointed for me to sit on a bench in the hall. After a minute he came out of the psych office and said, “Wait here. She take care of you.” He disappeared down the hall.
I waited. And waited. Inmates move in and out of the psych doctor’s office while I sat in the hall. Eventually the Korean doctor came back down the hall. “You still here?” he said, “Still here.” I said, suppressing the urge to add “obviously.” He went into the psych office and returned in less than a minute. “It’s all set.” he said. “You go away now.”
So now my cellie and I have a new favorite line – “You in wrong place.” And we remind each other of that daily.
All of us will face the challenges of bureaucracies, whether it’s dealing with a doctor’s office, an insurance company, or technical support for a malfunctioning electronic device. And if you can ride the insanity of it like a wave, watching in amazed wonder as the events carry you along, and even smiling at the depth of the folly, then you will have done well. For not only will you have demonstrated patience and controlled your temper, but you’ll have a great story to share. But if you don’t take well to being misdirected and mistreated by the exasperating nitwit servants of the system that is supposed to be helping you, then at least you can blow your top without the threat of being dragged off to the hole. And you can be thankful for that!