Seriously, where has Kenny been?

Disclaimer

• First and foremost: some of the names and events in this post have been slightly obfuscated so as to not unintentionally violate any HIPAA regulations. If you are reading this and feel that something in here is personally identifiable and you are not comfortable with it, email me at kennyfranks3+blog@gmail.com with [Privacy] in the subject line and I will address it as soon as possible. Please let me know what specifically you want to have changed and how it violates HIPAA regulations, other regulations in your jurisdiction, or most importantly, your privacy.
• Absolutely none of the information below has been endorsed, approved, or reviewed by my employer, the institutions referenced, or anyone besides me and possibly a very small group of people that I trust. These thoughts are mine and mine alone.
• Some of you may wish to follow up with me anonymously, but aren’t sure how to do that. That’s okay. I’d like to provide a guide for you to do so. In the meantime, the most I can do is assure you that anything you email to me will be protected to the best of my ability.
• If you are wondering why in the world I’m posting this so publicly, I explain that in the section below.
• Throughout this post I am simply trying to document my experience and offer suggestions, not to place blame. I truly believe that every person I interacted with, or who made decisions about what my next steps would be, was doing the best they could to help me.

Introduction

Me in the Zuckerberg Hospital Emergency Room
Photo Credit: Someone I trust, taken on an iPhone

Since my last post on Facebook, I’ve had more texts / messages / IMs of encouragement than I could have ever imagined. Some of them were of the nature of concern, and others were of the nature of gratitude. Some of them were from people I knew, others were from people I’ve never met. But the words of encouragement were so valuable.

Unfortunately I’ve been completely unavailable to respond to those for the past few days, and I’d like to explain why. As I hinted in my last post, I’m not always going to be there when people need me. But I need you to know I’m there.

I took my own advice last week by doing the following:

• Do what’s best for YOU.
• Be honest with yourself and with the people who care about you. (I choose to believe that everyone cares about me, at least a little.)
• Think about what makes you happy. Both the people, and the places. Keep those in mind.
• Find someone you care about, and ask, “How are you doing?”

I’m so glad I took my own advice. Just minutes after hitting the “Post” button I would be the beginning of what I hope will be the worst, yet perhaps most rewarding, experiences of my life.

Just minutes after I hit the “Post” button, some people who were close to me felt that I needed mental help, for various understandable reasons. I could have fought them harder on this, but I didn’t. They were on my list of people who make me happy, and who I could trust. I needed to listen to them for once, as I’m normally the one to try to make those calls.

In fairness, I was having some pretty existential thoughts that weren’t flowing together very well, and I was having trouble sharing those thoughts with them. I was telling them about how I think it’s possible for humans to never die, and how if everyone in the world worked together instead of fighting each other, we could make the world a better place. I was saying things that, in the current setting, didn’t make a lot of sense. I wasn’t communicating my “big ideas” very well. Yet at the same time, I was very happy; perhaps deliriously so. I was thinking beautiful thoughts, but was having a tough time communicating them. My sleep patterns were irregular, but despite getting a small amount of sleep (3-5 hours per day between Sunday and Thursday), I felt as though I was waking up rested. I was drinking lots of caffeine and sometimes using medication to help me get “in the zone,” be that the “work” zone or the “personal” zone, but I didn’t identify this as a bad thing.

Was I going crazy? Was my sleep deprivation causing me to have delusions? The funny thing about those questions is that there’s no way for me to know the answer to them. How do you tell someone who is delusional that they are wrong when they feel so strongly otherwise? 

To answer this question, I had to defer to the people I trust, and who make me happy, to help me make that call. And that’s exactly what I did.

I was taken to Zuckerberg Hospital Emergency Room. Aside from the ER, where would one go if there was immediate concern of mental instability? I still felt strongly that there was nothing wrong with me, and that I should be honest with everyone when they asked me a question. Maybe something was wrong with me, and that my happiness in feeling that I could make the world a better place, was based on a delusion. If I’m not honest with the people who are trying to help me, and if I don’t genuinely believe that everyone is truly looking out for my best interest, how will I ever know if I’m going crazy?

Zuckerberg Emergency Room Entrance
Photo Credit: UCSF

Entering the Zuckerberg Hospital Emergency Room

As I entered the Emergency Room, I asked each person I interacted with: How are you doing? I got a mixture of answers. Since many of the people I worked with were hourly workers, I couldn’t help but to notice that the answers seemed to correlate with where they were in their shift. Those just coming in for the day were complaining about the parking lots being full, about beds being full, about being overwhelmed. Those getting ready to leave for the day were excited about being “home,” and being able to relax and be with the people they cared about and trusted the most.

I had my vital signs checked. All good.

I went through security and chatted with some of the security guards.

I remember as I passed by the SFPD stations. Normally I have somewhat of a distaste for police officers, with all the recent news, but I refused to let this burden me. I chose to believe that those police officers were people, just like me, with all of my best interests in mind. I asked a simple, “How are you doing?”

Based on their answer, in my own way I tried to assure them that with time, everything will be better.

I don’t know if it helped, but I like to think it did.

Throughout the process I decided to go against my usual routine of jumping in to answer questions. When asked what my mental emergency was, I answered with “I’m not sure.” I let my friends answer for me.

As I was being taken through the intake process, and I couldn’t help but to feel that each step of the way, I sensed the same common themes: nobody knew what to do with me, there was no space for anyone, and everyone was overwhelmed.

I was honest with everyone. When asked the question “Do you feel as though you are a harm to yourself or others,” I would answer with something along the lines of “Absolutely not. I don’t want anyone in the world to be harmed.” And that was the truth.

I was acting happy, perhaps deliriously so, but I was happy. What do you do with someone who is so happy, whose friends think something is wrong?

Me in the Emergency Room

With time being a factor, someone had to make the call about something at some point. Despite everyone being overwhelmed, and despite the fact that there wasn’t a good place to put someone like me for further review, in that moment, a decision had to be made.

The decision was made to place me on a 5150: an involuntary, psychiatric hold, for 72 hours. The fact was, space was limited in the ER, I didn’t belong there, and something had to be done with me. They could either let me go, or decide that something more had to be done. Looking out for my best interest, they chose the latter. I didn’t agree, but I needed to listen. I think they probably knew what kind of environment they were about to put me in, and they didn’t want to put me there. Putting myself in their shoes, I really can’t say I blame them.

Preparing for the 5150 Hold

In my work life, and often in my personal life, I’m often one to stand up and say “Guys - wait a minute. This is silly. Let’s stop this right now.” But I had to accept the possibility that I was delusional. I needed psychiatric evaluation to prove otherwise. I needed someone I trust to tell me if I was insane or not. If I can’t trust the doctors to evaluate me, who can I trust? I realized that I can’t make this call by myself, and I shouldn’t. So instead, I decided to observe as I’m being placed through this process. Maybe a little time away wouldn’t hurt. Maybe I could do as I normally suggest to others, and provide feedback later to the people who can influence change. If I don’t reward the good behavior and point out the behavior I don’t think is helpful, how will I ever expect things to get better?

Some people I trust did their best to prepare me for what was in store for me while being on a 5150. Some things I heard were:

• The food you have access to will likely be bland and gross. You better eat up while you still can.
• They won’t let you have anything with you. Your phone, your laptop, anything other than a writing utensil.
• You’ll have the choice of which Benzos to take, and when.

Overall, the image painted of the 5150 hold was not a positive one, but I decided that I was not going to allow that to interrupt my happiness. I wanted to enter this with a clear mind. A happy mind.

My friends set me up for a ridiculous photo op, complete with my “cape”.

For some reason, in advance of being placed on the hold I feared that I would eventually forget who I was, and who my friends were. So I wrote down on the front of my notebook all of my “identities.”

My name is Kenny Franks.

I am a Googler; someone who trusts their company to do the right thing.

I have a personal life, where I interact with people digitally via Facebook or on my personal GMail account.

If I were in the movie Inception, I would consider this notebook my personal “totem”. Without it I am truly lost. Everything else has been taken from me. My clothes. My phone. My laptop. Everything that existed that helped me prove that there are people out there who care about me, would be taken from me. I’m so glad I braced myself for this.

My notebook, my personal totem

Transferring to the Psychiatric Emergency Room

To transfer me from the General Emergency Room into the Psychiatric Emergency Room, I was asked to remain in my bed and I would be wheeled to my destination. In addition to the person who was physically transferring me, I was provided with two lovely SFPD officers. For one of them, it was their first assignment ever. I hope I made their first assignment a pleasant one! (This kind of reminded me of that special feeling I get when I find out I’m someone’s first Lyft or Uber ride. I have the opportunity to make or break their first “experience.”)

While being transferred, I continued to feel that everyone, every step of the way, was confused about what to do with me. What exactly was the psychiatric emergency? Why does this kid need a police escort exactly? Everyone was simply doing as they were told, and I understood why they were doing it.

As I was being transferred to the psych emergency room, I had no control over the physical direction I was taking. I was being escorted in my bed by someone I had never met, alongside some police officers. I was in a very vulnerable state of not knowing if I was crazy or not. And at one point through the process, I remember being at a crossroad of some sort that said “Male dressing/undressing” and “Female dressing/undressing,” pointing in separate directions. In this vulnerable state, I had no choice but to accept decision given to me by this person I had never met, who is escorting me through the hallways. My heart sank. For some reason, in that moment, I felt as though I could truly start to understood what it must be like to be a transgendered person. The transgender community can call me naive for that statement if they’d like, but that thought will forever be engraved in my mind. I am so fortunate that my gender identity is that of which I was given at birth, and that the “choice” wasn’t being made for me by someone I don’t know. This is something that transgendered people have to deal with every single day of their lives. Unfortunately, it didn’t surprise me a lot that there seemed to be a high percentage of transgendered people in the psych emergency room. They were confused about who they were, and then were placed in an environment that simply added to that confusion.

In the Psychiatric Emergency Room

Once I entered the Psychiatric Emergency room, I felt as though the staff knew there was something different about me. I seemed just fine. I had a positive outlook on life, a bubbly, happy attitude; an attitude like I would normally have during a good day at work, or at home when socializing with friends. The physical barrier between me and the staff seemed to be simply a precaution; I understood the staff and they seemed to understand me. At the same time, I was also a patient. A coherent, cooperative patient.

Zuckerberg Hospital Psychiatric Emergency Room
Photo Credit: SF Chronicle

New patients who came in, and the patients who were already being admitted, were all over the place. They were of varying levels of cooperativeness, and coherency. But something I did notice was:

• Most people coming in were brought in by police. Often, police would convey the behavior of the detainee to the staff. (As far as I know, however, this was not logged anywhere.)
• Many of the people there were drug users. And they were what I would consider responsible drug users; they had a ritual of drug use that they believe allowed them to be the best possible version of themselves. They knew the drugs they were taking, and probably knew them better than the staff.
• Most patients there reported irregular sleep, but they did not at all identify this as a bad thing. This irregular sleep was not due to any specific drug. Those who hadn’t slept in a while reported being happy, but assumed that something was wrong due to the people around them saying something was wrong.

I, too, was apparently having trouble sleeping. That was a big reason why I was there in the first place. However, I was taken away from my normal environment and ritual of falling asleep. I’m the type of person who normally likes to listen to a show on TV before bed. This was no longer an option for me.

I could write an entire novel about my experience there and the people I met, and I may provide some stories of that later. But in particular I had some interactions that I want to share now.

I remember having a nurse ask me some questions in the interview room. I did not initiate the conversation; I allowed the nurse to ask me the questions she wanted to have answered, and I would answer them honestly.

Nurse: “Have you been here before?”
Me: (Tempted to answer “yes”, but I should clarify) “I have been to the SF General Emergency Room before, yes.”
Nurse: “Oh, by ‘here’ I mean the Psychiatric Emergency Room. The other emergency room is on a different system.”

This interaction made me wonder… what if I had just said “yes” like other patients in my situation might have been tempted to do? Would they look me up and think I was delusional for thinking I had been there before, simply because of a misunderstanding?

I remember another interaction that one of the therapists was having with a patient during a group session. Obviously part of this is paraphrased.

Therapist: “So tell us, why are you here?”
Patient: “I’m not sure. My husband is in jail, I guess.”
Therapist: “I see. Where do you live?”
Patient: “Nowhere.”
Therapist: “Ah, okay. And for how long have you been homeless?”
Patient: “About a year or so, I guess.”
I thought about the list I made with all of the places and people who make me happy, who make me feel at home. It may have been unwelcome, but I interjected.
Me: “Do you consider yourself homeless when you are with your husband?”
Patient: “No, not really.”

This hit me pretty hard. Just because you don’t have a place that you can call home, a place that makes you happy, doesn’t mean that you’re homeless. The patient didn’t use that term, the therapist did.

As time passed, the staff began to rotate. The people who were there upon my entry, who were introduced to me as happy, bubbly Kenny, were no longer there. I started to become Kenneth: a psychiatric emergency patient.

There are so many other interactions that I could write here, but another recurring question I kept hearing from the staff was, “do you want to get out of here today?”

Of course everyone wants to “get out of here today.” I assure you, I don’t want to be here any longer than you want me here. But asking me leading questions, with the (perhaps unintentional) implication that if I answer in a certain way I’ll be able to leave sooner, is not a great way of dealing with someone who is deeply confused. I refused to give the answer that “they” wanted me to give. “They” can’t help me unless I’m honest.

I started to lose track of time. What day was it?

I had no idea if anyone was looking at my case. If I asked for my doctor or nurse I would get a response like “The doctor knows you’re waiting to see them.” Or even worse, I’d be asked who my doctor or nurse was - and I had no idea. 

I was never offered an opportunity to take the medication I brought in with me. I forgot if I had even asked for it.

I was told not to talk to other patients.

I was only referred to as my legal name, “Kenneth”. Any attempts for me to make corrections to this, even politely, seemed completely futile. This was also true for the transgendered patients. It’s Kenneth in the computer, and that’s what my name was now. Your name is Kenneth.

I was in this place from Thursday afternoon all the way through to Saturday morning. I was restricted to the confines of the Psych Emergency room, devoid of any way to communicate with “the outside world” aside from a standard, shared telephone.

Thank goodness I had a list of names and phone numbers in my notebook. Some were on sticky notes, some were in the notebook. Honestly, I started to lose my sense of who these people were. Would they pick up the phone if I called, from an unknown number? Would I be bothering them if I called? I had no idea. As more time passed, it truly took a lot of mental effort to remember who my friends were, and when I spoke to them last.

At one point I started forgetting who I was. Literally.

I had to look at the front of my notebook to remember my name.

I remember doing a lot of things that confused the staff, and that frustrated them. I couldn’t sleep. I didn’t want to frustrate anyone, but I felt like I needed to talk to someone about how scared and alone I was feeling, but there was nobody there to listen.

I remember asking for a benzo to help me sleep. I remember asking a couple of times, or at least being tempted to ask a couple of times, but I knew the staff was so overwhelmed.

I remember seeing a pill on the ground near my bed. I knew it wasn’t mine, I knew I had to sleep or I wouldn’t be getting out of that place, and I knew that if I wanted help, I needed to stop this “observing” business. Nobody was going to help me but me.

I took the pill I found on the ground. I didn’t know what it was, but I didn’t care. I knew that if I didn’t do something, I was going to die in this place. Whether or not that was true became irrelevant. The old Kenny had died anyway. You’re Kenneth now, and Kenneth, you’re crazy. That’s why you’re here.

I remember reaching what I hope is the lowest point in my life. I now know that this conversation occurred late on Friday night, but when I placed the call I had truly lost all sense of what time it was or how long I had been there. I picked up the phone to call one of the numbers in my list. I told them that I couldn’t handle where I was anymore; I was so hopeless. If I didn’t get out the next morning, that I would have to take matters into my own hands. I’ll let you use your imagination on what I meant by that.

There had to be a time limit on this feeling. I had to have a time to look forward to. Regardless of if it were true or not, in that moment, I knew in all of my being that my options were that I would be getting help from these people soon, or that I would die here.

The only way I knew that anybody was even looking at my case was through my friends. I didn’t know that people were trying to transfer me to Herrick hospital, only to find yet again that they were full, and I had no idea that doctors and nurses were trying to care for me. Quite frankly, they had very little time for me anyway; they had real emergencies to deal with.

Finally, I remember an angel coming to me and waking me up at what I now know was Saturday morning at roughly 6 am. They told me that I was being transferred in a few hours. Words can’t describe the feelings that overcame me. I was finally going to get someone to talk to. I was going to a place where someone had the time to care about me.

The Transfer to Fremont Hospital

Finally, after some amount of time that I wasn’t quite able to fathom, whatever paperwork was necessary was completed, and I had been cleared to be transferred to Fremont Hospital.

I was transported by two lovely paramedics. Despite the hellish nightmare I had been through, I started our interaction with, “How are you?”

We chatted a bit as I was snugly strapped into my gurney, like Hannibal Lecter. I think they, too, were confused about why I was there, but they were doing their job and following protocol. I thought this was unnecessary but I didn’t fight them on it.

It was Saturday, October 8 2016 at 8 am; the first time since Thursday morning at 10 am that I got to experience fresh air. Sure, I didn’t get to stand up and walk around since I was strapped in, but for a few brief moments as I was being wheeled between the exit of the Psychiatric Emergency Room and the ambulance, I got to feel the warmth of the sun, to hear birds chirping… to remember that there is a world out there.

I kept my journal close to me. I refused to let it go.

Arrival at Fremont Hospital

Once I arrived at Fremont Hospital, I had an amazing turnaround. I was able to smile again finally. I was around people who cared about me, and who had the time to show it.

Fremont Hospital Main Lobby
Photo Credit: Fremont Hospital

I felt as though it had been weeks since I had seen my friends. I now realize this was only a matter of days, but it felt like so much longer.

I was greeted by a nurse who was just as pleasant as they could be. Once we got into a private room to discuss my situation, they (perhaps jokingly) asked, “so tell me the truth - you’re just here for a place to sleep for the night aren’t ya?”

Again, they seemed to be unclear as to what to do with me. I didn’t know either. But I knew that at this point, I definitely had some issues. But I was so confused about what they were.

When I met with the doctor through the intake process, I finally got to see my actual 5150 form. On the form there are four options, at least one of which must be selected:

• Danger to himself/herself
• Danger to others
• Gravely disabled adult
• Gravely disabled minor

On the form it was indicated that I was a danger to myself, and that I was gravely disabled.

The doctor at Fremont asked me, “I’m told that you recently had some feelings of hopelessness, which is why you were put on the 5150. Can you tell me more about that?”

I had to clarify that in fact, I had not been placed on a 5150 because of my hopelessness; I felt hopeless after being put on the hold.

I was also quite confused about the assessment of being gravely disabled. I remembered my previous Facebook post where I indicated how privileged I felt that I lived such a beautiful life, in an apartment that I loved, surrounding myself with people who meant so much to me. What part of that made me gravely disabled?

But alas, to put someone on a 5150, a doctor has to select something. And this checkbox, which could have originated from a “not sure,” is what would define you through the rest of your journey.

I don't blame the doctor one bit. They did what they thought was best for me, and I want to thank them for that.

In the Fremont Hospital Psych Department

The hospital was beautiful compared to what I had experienced before. But the aesthetics were only a part of it. The staff there had the time to care. That was the most important part to me.

I was provided with a schedule for the day. I had plenty of time to myself to write in my journal and reflect on my experiences, while also participating in group sessions. I chose to not feel as though I was “above” the other patients, as one might be tempted to do if they were put in a situation like that. I was surrounded by people who had some really interesting stories about why they were there - many of them had been transferred from jails, some of them had histories of physical violence or of harming themselves. I felt somewhat out of place here; when asked “why are you here,” the best answers I had were “my friends were concerned about my mental well-being” or “my friends were concerned about my sleep patterns.” The response from the other patients was often along the lines of “it’s really great that you have so many people who care about you.” I couldn’t help but to smile. They were right.

At all times, I knew what was next for me. I learned the names of the nurses. They called me by my preferred name after I asked them politely to do so. I was trying to help them, and they were trying to help me.

There was a board that had my current nurse’s name and current doctor’s name. It stayed updated so I didn’t need to try to guess or remember it myself.

I met so many amazing people during my stay there, all of whom deserve a blog post on their own. I remember all of their names and where they came from. Of course it’s not my place to reference that in this public setting, but I encouraged all of them to write about their experiences when they “got out.” I hope they’ll take my advice.

One particular moment that stuck out to me was a dialog I had with one of the patients, who for this example, I’ll call Fred. (Somewhat paraphrased)

Kenny: “How are you?”
Fred: “I’m not sure man. These pills they keep giving us… they’re messing with me. They’re giving me bad dreams.”
Kenny: “Can I offer a suggestion? You don’t have to take it if you don’t like it.”
Fred: “Sure.”
Kenny: “I might recommend you speak with your doctor about that today. Write it down so you don’t forget, if you need to. Remember, they’re just here to help. Maybe if they knew that you were getting bad dreams, they can make some adjustments so you don’t feel that way.”
Fred: “That’s a good idea. I might just do that. I like your suggestions. You make good suggestions.”

Now, I have no idea if he took my advice, but I like to think he did.

And with this simple suggestion, which I could probably only make if I were a patient like “one of them,” I like to think that I made an improvement to someone’s life.

Leaving Fremont Hospital Psych Department

Finally, about an hour and a half before the time expired on my involuntary hold, I was being released on my own recognizance. I made an agreement with the staff that I would be seeing a therapist; something I already planned to do prior to the hold, and something I recommend for everyone. I recognize that I am privileged enough to be able to pay for a therapist without having to worry too much about financial implications; I hope those without my privilege have somewhere to go, too. If not a therapist, just to someone they can trust.

I couldn’t be let go without there being some sort of diagnosis. I was unwilling to take the easy way out by admitting that I had been diagnosed with any of the common disorders such as bipolar disorder, schizophrenia, depression, or anxiety disorder. Depending on the day, you could say I have any of the above!

I finally got a diagnosis that I was somewhat comfortable with: “Brief Psychotic Episode.” I was okay with this. I don’t think there’s any particular reason for my “psychotic episode,” but at least I could let the record show that whatever was going on was brief, and that I could return to my normal life without being hung up on this detail.

I remember being so excited when I was told that at 3 PM, I would be released. I got that information in the morning, but I decided to attend group sessions in the meantime anyway. There were people that I had met there that, quite frankly, I didn’t want to just “leave,” but I knew it was time for me to get back to my usual life. Their time would come too, and then they could get back to their lives, and to making the world a better place.

I planned the remainder of my downtime accordingly, and ensured that I made time to write notes about the things that each of the staff members did that I thought were good things. I wanted to reward the good behavior I saw. I had already thanked those staff members in person; but could I do more?

I asked for some printer paper and a marker. I wrote 5-6 notes, one for each staff member that I felt did an awesome job looking after me or the other patients, and folded them up individually. I wrote why I thought they did a great thing, citing specific examples when I could, even if those specific examples didn’t involve me. On my way out, I dropped them into the “Superstar Employee” bin; a collection box that’s read by the CEO. I don’t know what the CEO does with them after that, but based on what I’ve heard of that person, I think they will take that feedback into serious consideration next time they think about raises or other ways to reward their employees for a “job well done.”

Personal Reflection

I learned so much from this experience, but came out with so many more questions and other thoughts.

• It’s a travesty that people who need mental help in the bay area have so much trouble finding it. Instead of having a fear of being placed on a 5150, people should be able to embrace it, and cherish the fact that they’re about to spend 72 hours with people who care about them, and who want to help.
• It’s so unfortunate that we have to wait until something bad happens for people to get help that they need. Had I been more combative, or had I been willing to admit that I was contemplating suicide or that I was bipolar, I probably could have gotten out of there a lot faster.
• While “in there,” I met so many brilliant people. Throughout my time at Zuckerberg Psych Emergency Room and Fremont Hospital, there was one theme that occurred among everyone: They all just wanted to be heard. Listening to someone doesn’t require a medical degree. Just asking someone “How are you doing?” can go so far.

As for me, I’m just ready to get back to my normal life. I’m ready to get back to work, I’m ready to be able to spend time with my friends like I used to. I feel as though I have a bit of PTSD from the experience, but writing helps. And I know that, with time, my friends and family will start to recognize me for the person I was before all of this happened.

I don’t blame my friends for taking me to the ER. Regardless of your religious beliefs, if you’re like me, you believe that some things happen for a reason. Maybe I was put through this process because I was in a position where I could do something about it.

Why did I write this? Why am I providing this information so publicly?

I have always been a strong advocate in providing feedback, both good and bad, to the people who can do something about the problems you see. I simply can’t do that unless I’m honest and upfront about who I am, and what I’ve been through. If I hide the fact that I was on a 5150, how would I be able to leverage any of my existing credibility to influence positive change?

Furthermore, while I was going through the process and what I hope will be the darkest hours of my life, one thing that got me through it was knowing that, with time, I would be able to get my message out. I knew that I was in a unique situation compared to most of the patients. I am privileged enough to work for a great company who cares about the wellbeing of its employees. I have great insurance coverage through them, and with time I would be put somewhere where doctors could focus on me. I also feel that I’ve historically had an ability to “level” with people, to understand how they feel and where they are coming from. The first step in doing this was to listen.

I am uninterested in being a part of the “rumor mill,” either at work or in my personal life. If you want to know where I’ve been for the past week, I have your answer above. If you want to talk to me about it sometime, schedule some time with me. I’m more than happy to discuss it with you.

No matter how you look at it, I was put on a 5150. I still believe this was a bit extreme, but that everyone did what they thought was best for me. In retrospect, I learned a lot from the experience. But I refuse to let the 5150 define me, much like how I refuse to let my sexual orientation define me. I think people should be open and honest about their mental health concerns, and me trying to hide my history is not setting a good example.

I’m not worried about losing my job. I work for a great company. Despite my searching I’ve yet to find any indication that I have violated any policies with them, as I’ve clearly indicated these thoughts are my own and not of my employer’s.

Unlike many of the patients, I spent most of my time in my 5150 understanding that the staff are trying to help. I assured patients of this myself. I assured patients like I assured myself that each of us could do our own little part to help make the world a better place. If I don’t write about my experience, I lied to those patients. I lied to myself. And I don’t think that’s acceptable.

The people who worked with me, or who are reading this post, might assume that I was putting myself through this process to take a “privileged tour” of the experience, and that I was taking up a bed in ERs and hospitals just for the sake gaining popularity by blogging about it. To be clear, I was not a “blogger” before today. Frankly, I didn’t realize how broken our medical health care system is in this area, nor did I enter this process with the intent of “exposing” it. But, regardless of your feelings toward my intent, I hope you’ll understand that I wrote this post because I feel like I needed to; I think we can all learn from the experience I had, and nobody will know about it unless I write about it.

I wrote this for me.

I wrote this for YOU.

Because I care about you. I know you are trying to make the world a better place.

One step at a time.

My Suggested Call(s) to Action

I don’t know if anyone will read this, and in fact, I know that due to certain regulations, it’s possible that some people reading this aren’t allowed to admit that they did it! But still, I want to offer my suggestions to everyone I worked with.

Suggestions for the staff at Zuckerberg Psych Emergency Room

1. For the love of <whatever higher power you believe in>, who in the world has the key to the bathrooms? Don’t just say that someone out there in the hallway has the key. Tell me who that person is, and I’ll ask them. This will result in me asking you less questions, not to mention me being less confused.
2. Communication with the outside world is extremely vital. Please prioritize giving patients the means to communicate with people. Who would you call if you suddenly were held against your will? Tell me right now - what’s their phone number? Who will you call if they don’t answer, and what’s their number?
3. Put a notepad and paper next to the phone. Sometimes people who are in various mental states have problems with tasks like remembering a phone number when they’re trying to type it into the phone, but if they can write it down, they can remember it.
4. If you’re tired of being asked the same question over and over again (“how do I dial out”, “where’s the bathroom”, “when can I take a shower”, “can I use the phone”), then write the answer down somewhere and post it. Remember, these people are completely lost. They need you to answer these questions for them.
5. Put a label on all of the rooms. What is the waiting room? What is the hallway? Find the terminology that all of your staff can agree on and remove the ambiguity. I’m not entirely certain that even all of your staff agrees on all of the labels, though I might be confused or misremembering certain things.
6. Everyone should have their nametags visible. Everyone. This is more important than you know. Encourage patients to do the same. NOT LEGAL NAME. Preferred name.
7. Do you have a few minutes of downtime? Don’t wait for someone to explode. Don’t stop and play Words with Friends. Get up, find a patient, and ask: How are you doing? Really listen. Hear what they have to say. Encourage them to write their thoughts down and to talk to the doctor about them when it’s time. Assure them that everyone is trying to help.
1. This might be “against the rules.” Well, it was probably against the rules for me too, but me doing this one simple task with the patients seemed to give them hope. And if it was against the rules, there’s so much chaos going on that you didn’t stop me. What’s the worst that can happen if you tried this, just once, to see if it worked? I don’t think they’re going to fire you. They need you.
8. Make sure there is a clock with the date and time in every room. Make sure it stays correct.
9. As shifts rotate, ensure that there is a board or something somewhere for patients to know who their current nurse and doctor is. Your patients have no visibility into that, yet it seems to be an important detail for them to know.
10. Remember, nobody is going to do any of this for you. You have to do this yourself. You’ve tried to communicate with the “higher ups” through your protests, your petitions to the mayor, your attempts to declare a state of emergency - yet as of the end of September, there still seems to be a problem. Enough is enough.

And by the way - THANK YOU for doing everything you can to make the Zuckerberg Psychiatric Emergency Room, and really the world, a better place.

Ideas that I think could help, but probably can't be done alone by the medical staff I worked with at Zuckerberg

1. Whatever is requiring you to use legal names on nametags for patients, I’d encourage you to try to fix it. Is it because you need to look them up in a database? If so, maybe a system change could be made that allows the staff to use numbers instead, and pair that with a preferred name. Let the nametags of patients reflect who they want to be identified as. I do not go by Kenneth, I go by Kenny. Calling me Kenny goes a long way in my recovery.
2. Do you really need to have the bathrooms locked at all times, regardless of if someone’s in there? What is it that you’re trying to accomplish with this? Do you not trust patients to know if they need to use the bathroom? You might have a good answer to this already, but be aware that the current state of never knowing if the bathroom is use or not is a perpetual Schroedinger’s Cat question, and if you don’t know what that is, I’ll summarize by saying that this isn’t something that you want to be experiencing as a person undergoing a psychiatric emergency.
3. What is the policy on personal clothing? Why is that policy there? Define this so there is no longer any ambiguity. Remember, that jacket that you feel the need to take away from a patient being admitted “just to be safe,” might be a very important totem for someone. It could be a reminder of a loved one that they hope will still be waiting for them on “the other side,” or a reminder of a loved one that they lost recently, who put them in such a severe mental state that they had to be admitted.
4. You can tell me all you want that the doctor knows that I want to see them, but I might forget by the time I get back to my bed or chair. If you can give me a time, that helps so much. Book the interview room for it. Give me a card with that time on it so I don’t forget. I have nothing else to do in my life right now; I assure you, I’ll be there in that interview room ready and waiting when my time is ready. And you know what? If that time ends up not working out due to another emergency, tell me that. I’ll probably understand. You can give me a new appointment card, and I’ll continue to write my thoughts.
5. When police are bringing in patients, they have valuable feedback to offer about the cooperativeness of the patient. Is this being taking this into consideration as you help this person through the process?

Big picture ideas that probably won't happen unless there's significant priority to be put on the mental health issue in the SF Bay Area

• I think those in the mental health profession should be required to experience being put on a 5150. Doctors, nurses, everyone. I went through it and learned so much from the experience. Putting yourself in your patient’s shoes will really go a long way.
• It's so unfortunate that we aren't using technology more to help people with mental health issues communicate more with the people that they trust, or organize their thoughts. Some of the people I met were engineers or computer enthusiasts who have a lot to offer for the world, yet we shut them out by reducing their means for communication to almost nothing.
• Mayor Ed Lee, Officer Manfredi: In late September, your police department shut down the entire area surrounding city hall to help a man who was undergoing mental crisis. I remember this well because I livestreamed the event. Congratulations to the city of San Francisco and to SFPD for a peaceful resolution. I know you care about mental health, so much so that you’re willing to shut down a critical part of downtown San Francisco for hours, for one man undergoing a crisis. Are you aware of the type of environment you may have put that man in afterward?
• Mark Zuckerburg: Are you aware that a hospital with your name on it is having a crisis with mental health? Are you aware that brilliant minds in the SF Bay Area that you call home, including perhaps even some minds belonging to people who work for you, are being sent to a place like this? I want to believe that the city of San Francisco is doing all they can financially to prioritize this. Do you think mental health of people in the tech hub of the world is important? If so, can you assign someone to investigate this further?

One last thing

Don't forget -- find someone you care about, and ask them, "How are you doing?"

Listen. And be honest.