DAYS 59- 69 Introducing Dr. Shore and 2 East

One very tragic consequence of Lee’s Normandy escapade was his acquiring the label of being an “IV Drug Abuser”. This was never true, but on Nov. 12, 1995 based on information received over the phone from Normandy, the On Call physician Dr. Brian J. Woodfall, in absentia, certified Lee on Form 4, M.H.A. citing "destructive behavior, including injection drug use". This first statement might be forgivable given the chaotic events and circumstances at the time, What was not forgivable, was the way that a succession of medical and psychiatric and social work professionals accepted the label without question. Again and again Lee is referred to as an IV drug abuser in his record from St. Paul's Hospital, and I know that this labeling had detrimental effects on his treatment.

During Lee's stay I had occasion to consult with Police Officers, Ambulance Personnel and others who had frequent contact with Drug Abusers and witnessed their treatment after admission to the Hospital. St. Paul's denies the fact, but to be identified as an IV drug abuser within the St. Paul's catchment area of downtown Vancouver is to be virtually guaranteed the revolving door treatment when taken to the Hospital, and the same applies to Mental Health patients unless they are suicidal or in Medical crisis. Police officers complained that they brought people that, in their assessment needed hospitalization, to the Emergency Department only to see the same individuals released before the officers had had a chance to write up their reports. Several Ambulance attendants reported the same practice, and others told me that they many times had lied on their reports about the pickup location of patients, so that they could take them to Vancouver General where they stood a much better chance of being attended to in a proper fashion.

Dr. Sheldon Zipurski, who first saw Lee on his return to St. Paul’s, accepted Dr. Woodfalls' assertion verbatim and repeated the calumny on Lee's second Certification, but he displayed a remarkable lack of curiosity when it came to any questions as to how, why, or what he had taken. Lee had no prior history of drug use, his left arm was in a splint from his elbow to his knuckles, and he was right handed. How had he injected himself? Did anyone see him do it? What did he inject? Was whatever he had taken compatible with the witch’s brew of semi-toxic drugs, eleven all told, that he was taking daily?

The answers are simple: 1. Don’t know 2. No-one and 3. Impossible to say because Dr. Zipurski and the other admitting staff accepted that he was just another junkie and never ordered any toxological scan. Dr. Rhesa Shore, Chief Psychiatrist on 2E, who had him in her care for two weeks previously, who knew his prior history, accepted the label and displayed a total lack of interest as to what he might have taken and how it might have mixed with all the other drugs he was taking on her orders.

What is possibly the most troubling aspect of the matter to me, was the failure of Dr. Joss De Wet, Lee’s personal physician, to scotch the damned lie as soon as it began to appear in hospital records. Lee was his patient for 5 years and Joss knew he was not a drug abuser. Why he did nothing to correct the record as soon as he noticed the error is a mystery. Was it was beneath his notice? Did he ever bother to read Lee’s file? Only he has the answers and he’s never volunteered them. I had a higher opinion of him than apparently was warranted.

On November 15, 1995 Lee managed to escape from the Hospital, this time from the locked Ward on 2 East. The ward phoned and advised us of his escape, and later phoned to advise us that Lee had returned of his own volition.

Lee's Journal Entry: Nov. 15, 1995

here i sit across from st. paul’s hospital.

i actually managed to get out. someone was coming through the door and i just booked out of it. i don’t think anybody noticed. so now i’m trying to relax over a coffee & cig. i’ve already been to the bank, now i just have to go to this liquor and grocery stores. i’ve got to take a cab because i risk any cops seeing me

i’ll be relieved once i’m in a hotel. i still haven’t decided what hotel to go to. the hospital had all my clothes (and everybody else’s locked up). they wouldn’t give me anything. so i wore a hospital gown tucked into my pants and these cloth slippers. I leave and it’s pouring rain outside. i just pray that the tylenol and drano work.

i’m jut afraid the cops will get me.

***

it’s always my luck.

i went to about 6 hotels and they all were full. i’m drinking 4 beer i bought earlier. i’m at the same cafe i was earlier.

i just don’t know what to do now. if i should get really drunk off of the rum i bought and jump in front of a train, or if i go back to the hospital, drinking rum and swallow tylenol and drano.

if i knew for sure that the pills and drano work i’d do the without hesitation.

i wish i had a pill to take and it would kill.

the skytrain would be instantaneous. it’s just getting up the courage to do it. so i think i ought to try the tylenol first. you’d think 6-7 bottles of it would be lethal.

perhaps i’m not completely ready to suicide. perhaps it’s just not the time yet. perhaps i ought to just toss a coin as to do the train thing or the tylenol/drano thing.

i know what i’m going to do- the tylenol & drano thing first.

***

i think for now i will go out for tempura lunch and then i know i’ll probably wind up at the hospital. the only other place is the train station.

***

so here i am in the japan restaurant and i’m pretty wasted- not knowing where to go. one thing in my mind tells me to go back to the hospital- yet another tells me to go to the train station ....

The writing in Lee’s journal scribbles out at this point. He passed out in his favorite Japanese restaurant and was returned unconscious by ambulance. We were made aware of the lie about returning of his own volition when we were sent a bill for the Ambulance ride.

From his escape attempt on Nov. 15 until his discharge from the Ward on Dec, 22, Lee was held in close confinement on 2 East. This was the most stress laden period of Lee’s stay at St. Paul’s. It was filled with escapes and recaptures, misinformation and no information, Certifications and Decertifications, and by what I perceived to be an assumption of a garb of infallibility and omnipotent power on the part of Dr. Rhesa Shore and the other Psychiatric staff on 2 East. There was an assessment of Patti and myself as nuisance factors with a litigious bent:, our input was to be ignored and we were to be given as little information as possible.

On November 17 the stress of dealing with the all the successive crises finally got to Patti and she just ran down. We had now been on a wild roller coaster ride of total unpredictability for two months and the constant uncertainty with which we were trying to cope had finally caught up. Patti's weight had dropped from 123 to 102 lbs, she wasn't able to sleep, and the constant strain of daily travel down to the Hospital with no certainty of finding Lee there finally took its toll. She developed a nasty case of shingles over her back and stomach and her doctor attributed it to the stress she had been under and advised her to rest. She badly needed a break, but there was no way she would be able to rest if she stayed in the middle of all the confusion, doubt, and uncertainty that our home life had become. She had to be removed from the situation, so I made arrangements, packed her up and delivered her into the care of her good friend Allene in Kelowna for a two week rest. She had explicit instructions to rest, recuperate, laugh, play cards, go out to eat and enjoy yourself as best you can. Try and forget for a while. Lee’s locked up and he’s safe. If anything happens you need to know about, I will call you.

On Nov. 21 there was another Family Meeting scheduled with Dr. Shore and her staff to discuss Lee. Patti and I desperately needed some answers to a variety of questions. In an attempt to get some and to try to defuse what was becoming an extremely frustrating and increasingly hostile relationship with the Hospital, the night before the meeting I stayed up very late and crafted a 3 page document that addressed:

1. My concerns related to bad communication with St. Paul’s staff, and a brief summary of the previous two meetings.

2. The matter of “confidentiality” and our right to know what was going on. If there was a problem then let’s get Lee in here right now and sort the matter out.

3. Lee’s mental status and ability to manage on his own, and what were his wishes re: Living Will, should his condition deteriorate further.

4. His “Code” status

5. His suicidal ideation.

6. Options available

7. Lee’s perceived alcoholism

8. What, if anything could be done to ease his mental pain and anguish given that his death was inevitable? Was there any equivalent to a “Brompton’s” cocktail that would give him any degree of tranquillity for the time that he had left to him?

At the start of the meeting I distributed my document to the participants and as everyone was reading it, Lee attempted to join the meeting. In marked contrast to previous meetings where his presence was essential if not mandatory. he was firmly refused entry by Dr. Shore. A brief period of discussion of Lee in very general details followed and then Dr. Shore proceeded to deal with my concerns and questions.

1. It was extremely regrettable about the previous bad relations with the Hospital

and she certainly didn’t want a continuance of what had become a somewhat adversarial relationship. She had no problems discussing matters openly with us and we can only see what the future holds.

2 & 3 Lee was not competent to handle his own affairs and this had been dealt with by his “Committal”. His financial affairs had been referred to the Public Trustee and we would be advised by them in due course. With regard to a Waiver of Confidentiality, or Lee’s wishes, i.e. Living Will, Lee was not competent to consent to anything since he has been “Certified”. As I interpreted it, Patti & I, as Parents and Next-of-Kin had no right to any information that could be deemed “Confidential” by the Staff of the Hospital and neither Lee, nor ourselves, had any control over his treatment should he have a physical relapse.

Lee is “Full Code” since he is not sick enough to warrant otherwise. Even though he suffers from a disease that will eventually be terminal, any deterioration in his condition that is life threatening will be accorded "heroic" measures. His previous chagrine at having survived whatever agent brought him into the Hospital was irrelevant. He was incompetent to judge such matters and he would be "saved" whether he wished it or not.

4& 6. Lee is suicidal and that is what got him committed. At this time there is no option but institutionalization in a locked facility. This was regrettable, and given the limited facilities available, regardless of his placement, Lee was not going to be a “Happy Camper.”

7. Regarding the possibility that Lee might not be an alcoholic but was correct in his belief that alcohol did help his depression, Lee was deluded in his belief and is an alcoholic.

She was sorry but there is nothing equivalent to a Brompton’s cocktail for mental anguish.

It took Dr. Shore less than 10 min to deal with all my concerns and questions. I asked at its’ conclusion whether there was any previous history we could provide and was told that they had all the information they needed. The meeting might as well have never taken place. It accomplished absolutely nothing. I was where I was before the meeting, perceived as a potentially litigious nuisance who was to be given as little damaging information as possible.