E14. More Docs and Psych Ward

Pam and Sadie dig into hospital records written when Sadie was 14, reading what doctors and psychiatrists recorded and what they only hinted at. Medical notes describe red scaly skin and scratched extremities. Psyche notes flag learned isolation rather than psychosis. They describe a small, quiet girl who avoids eye contact and seems on the verge of tears. They ask what the body can reveal about exposure, neglect, and the system’s impulse to give adults the benefit of the doubt. 
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Transcript

Welcome And The Story’s Frame

Speaker 1 0:03

Welcome to the Sadie Green Story about an older adult looking back on her abusive childhood. It's a conversation between Sadie and myself, Pam Colby, her longtime friend. We are exploring how early trauma can affect a lifetime. Thanks for joining us. Hi, Sadie. Hey there, Pam. What do we got going this episode?

First Hospital Notes On Rejection

Medical Terms Hint At Neglect

Speaker 2 0:30

Well, we're going to share more records in this episode, but we won't go on and on. Lots of people took notes when I first came into the hospital at the age of 14. Med student, intern, supervisory staff. Much of it was repetitive. But the narrative within them all consists of what they saw in me and what they read about in my old charts, in the social worker report, the psych report from Brainerd State Hospital, and the court record, which did indeed give them lots of information. I won't go through every page. I won't do that. I won't go through most pages, but I will try and pull out parts that stand out as abnormal or worth mentioning, especially in the context of abuse. So without further ado, let's first review notes from what the medical doctors wrote when I first arrived on the pediatric floor. Girl of short stature for stated age with depressed expression. Sixth university hospital admission brought here against her family's wishes by the local welfare department. Susan is the third oldest sibling in a family of eight children. It seems her family has suffered financially on her account, and over the years they have rejected her. Rejected is underlined. Not only because she looks different, but because she is, quote, stubborn, unquote, and does only what she wants. The welfare department wrote telling us about her case without telling the parents they were doing so, and subsequently the parents found out and have now refused to come down and have left everything to the welfare department. Has a very wan smile, which she rarely uses, has many scratches on face. There is a very comprehensive summary in her old chart that shows her cognitive ability to be in the top 1% of the population. Small girl who talks in a very soft voice, does not look at you when you speak to her, is quiet, and looks as though she is about to weep. Bone age, reported to be 10 years, height age, 10 years, seems non-contributary, as not answering important questions, does not think she is either happy or sad, cries sometimes, does not know why. Does not really know why she misses school. Her biggest problem will be disposition after she leaves the hospital and or getting her parents to cooperate with her therapy. Placement has been mentioned to them, but they do not apparently want that. Possibly out of some nebulous sort of spite. Then it goes into all these medical things, vitals, description of eyes, ears, neck, no breast development, abdomen, tenderness, and then genitalia, no pubic hair, limbs, hands, legs, and feet, plethoric and cyanodic, skin over lower extremity, dry and scaly. So we looked up those two words plethoric and cyanodic. The medical term for plethoric means the red flushed complexion marked by plethora, a morbid condition due to an excess of red blood cells. The other word is cyanotic, and in medical terms, it is marked by or causing a bluish or purplish discoloration of the skin, peripheral cyanosis, when hands, fingers, feet, and or toes turn blue. This can happen in very cold weather if your skin is not protected. I just think I my extremities were red and because you were living outside.

Speaker 1 5:04

But what occurs to me is that they didn't want to go there. Do you know what I'm saying? Um they didn't want to believe that you had been living outside. Because they were looking for alternative answers to all your problems from your physical appearance being too small for your age to the fact that your skin showed signs of living outdoors. But they it seems like there was a medical reason to give your parents the benefit of the doubt.

Speaker 2 5:37

Yeah, and maybe they really didn't know. Later in conversations with the psychiatrist, I think, it is in the record that my grandmother and relatives state that I was living outside.

Speaker 1 5:51

So So these were the initial analysis of you first came in. And later as they got the story, they may have learned more, and then they could see that this was a result of child abuse neglect.

The Move To The Psych Ward

Speaker 2 6:04

Yeah.

Speaker 1 6:05

So what do we got now, Sadie?

Speaker 2 6:08

Now I would like to move on to how I ended up on the psych ward instead of the regular pediatric floor. And let me just read something from what I wrote almost forty years ago now. One week after landing in the hospital, I was being moved. They probably were more specific, but what I heard was you'll get more of what you need upstairs. So I packed my things in the same paper grocery bag I brought from home, and I followed the man to the elevator. This man had been to visit me before. He sat us both in straight back chairs that faced each other, with nothing in between us but his notebook. He asked me nosy questions like if you could have anything in the world you wanted, what would that be? I didn't answer. Stupid question. What does it have to do with me? He doesn't know my life. Leave me alone. Get out of here, just stop. I wouldn't lift my head to meet his eye, and I wouldn't say anything. Instead I huddled around my bald-up fists and waited for him to finish. But the next day he came again. Are you afraid of me? he asked. Are you angry with me? And I felt so confused and anxious, I wanted him to drop dead, disappear, but I knew that wasn't how I should be, so I answered no to both his questions. He was a small man in glasses, quiet and polite. I didn't have anything against him. But why couldn't he mind his own business? I raged, and leave my life alone. What made him think I could have anything to do with him? But when they said I had to move upstairs, of course I did. I followed him down hallways, turning corners that looked all alike. He tried to make a conversation, but I walked two steps behind him with my head down, no matter how slow he tried to go. No one else was in the elevator. He punched button number six, and I made sure my back was against the wall as far away from him as possible. He said, I think you'll like it here. Well he glanced at the ceiling, acting casual, and I thought, How the hell do you know? But I nodded my head politely, without looking at him, and I hung on tight to the silver railing that went all around the elevator. After five blinked red on the panel, and then six came on and stayed there, he rang a doorbell. A side panel on the elevator slid open, but there was a metal gate between us and a corridor. A woman walking toward us had a jangle of keys strung onto a plastic rope around her neck. He said, This person will take care of you. And as soon as she unlocked the bars and led us through, he disappeared, like he had done his part. I was delivered. Are you Susan? The woman asked me with a smile. My name is Jean. I'll show you to your room and help you settle in. If you need anything, you just let me know, okay? I followed her obediently. She showed me to a bedroom, unoccupied, with two beds and matching nightstands, two simple bookshelves, one dresser and a window. Dinner's in an hour. You'll meet the other kids then. We like to eat our meals together here. I stood in awkward silence. Well, I'll leave you alone for a while so you can get used to your surroundings. She plumped up the pillow on her way to the door, still smiling, and then she was gone, leaving the door wide open. I sat on my bed and wondered if it would be wrong to shut the door, so I could really be alone. Otherwise, I needed to stay sitting up straight in case anyone might enter. Keep my hands folded, alert to everything. It wouldn't hurt to lie down, but then I'd have to take my shoes off so they won't get on the bed spread. And what if somebody walked in and saw my ugly feet first thing? No, I won't do that. What if I went to look out the window? Oh no, too show off yet. If I just hunch up here close to the wall, they can't see me from the doorway and they'll forget about me. I'll just sit and wait. An hour won't be long.

Speaker 2 10:48

Station sixty four was a locked psych ward for children. Adults, sixteen years and older, were in a unit across the hall. The children's ward was shaped like a big letter T, with the front door opening into a long hall that connected the rec room, the stereo room, and the quiet rooms. The inner office sat at the intersection of the T, with bedrooms branching off in each direction, the boys' room on one end, and the girls' room on the other. An extended hallway held the galley kitchen, the dining room, the school room, tiny square conference rooms, and the occupational therapy room. On the very end of the ward was a fenced-in rooftop porch, where later I would learn we could have water balloon fights. I loved the fact that station 64 was locked. It felt like I was hiding, like I used to do back home, but now I was so far away, they might not ever find me. It was not possible for Ma and Pa to climb a bare brick building, six flights high, to get me. The glass walled office was just kitty corner across the hall from my room, and I was glad. I had a real bed here all to myself, with sheets and blankets, and it remained my bed from mid-March through September. Sometimes I had the whole room to myself, other times I had a roommate. While the roommates came and went, passing through to other places, or getting stabilized on meds. I stayed on, not sure what I was doing here or who was making the decisions. But there was solidness around it, a security. Rules had reasons that made sense to me, and were consistent, day by day. I wanted to do everything right. I wanted to know all there was to know before I might be tested, so I didn't look stupid. I wanted them to like me. The girls' bathroom down the hall had things I'd never lived with, like hot and cold running water, and loud flush toilets. Tall mirrors hung on walls above the porcelain sinks, where secretly, I checked on my appearance several times a day. In the glass, a reflection of my anxious face peered back at me, revealing secret painful shame. I saw colorless, thin, straight hair that even Bobby Pins slid out of. A crooked lip that showed off the wide gap between my teeth. And of course those obvious red scars right there in the middle of my face. My ugliness hurt so bad sometimes. All I could do was sidle back inside my room and hide under the blankets so that nobody would have to look at me and pretend their friendliness.

Speaker 1 13:54

Okay, well, we're gonna interrupt the story here just to debrief a little bit. When you're in the elevator going up to the psych ward, and we get into the psych ward and we realize you're gonna be locked in there. Now that's something that we all stereotype as a a scary thing.

Speaker 2 14:14

Yeah, it was not bad.

Speaker 1 14:15

And for you it was liberation.

Psych Notes That Signal Abuse

Speaker 2 14:18

It was so great. That psych ward was the best thing that could have happened to me. When I first got there, I'm shy and embarrassed and all that, but I definitely remember being grateful that it was locked. Next I want to share some early psych notes written soon after my arrival on the unit. And again, there is some redundancy, some repetition, but it's important to me, especially to me, that I showcase what is not just in my own mind. This is what a complete stranger, albeit a professional, wrote about the situation. Again, I invite Jacob and his lovely voice.

Speaker 15:02

Parents did not accompany the child to hospital. Alert girl with cleft lip repair and wideset eyes, appeared small in stature, did not look at me when I spoke with her, appeared on the verge of tears, skin red and inflamed with excorciations and scratches over the lower extremities. Depression. She has apparently had problems at home for many years. She attended a country school until two years ago, and then went to a school in Brainerd. School officials became concerned because she was withdrawn, missed school without excuses. Approximately one year ago, the school recommended to the parents that Susan have a complete psychological evaluation. The substance of his findings are as follows. She is happier by herself than in a group. Shows lack of concern about others, not so extreme as to be considered psychopathy, preference for solitude, not due to schizophrenic withdrawal, but is a learned attitude. This need not be due entirely to unusual physical appearance. In view of high level of abilities, it would seem justified to go to considerable length in repairing impediments to function, such as improving facial appearance and giving appropriate hormone treatment. Director of Guidance at Brainerd Junior High delineates in the referral other attempts to have parents follow through with recommendations of psychologists. Difficulties were encountered, and note is made of reported hostility and resentment directed toward Mr. Renshaw by Mrs. Lasnick. The welfare department subsequently arranged for admission to the University of Minnesota Hospital. The social worker was informed by parents as they took Susan for a trip to Minneapolis that they would not give consent for surgical procedures, since the welfare department, not they, were arranging the admission. The social worker tells me the Lasniks live on a farm in a shabby house, but have a great deal of pride. They are not affluent, but paid for all of Susan's previous surgeries without assistance. They resent the intrusion of the welfare department in their affairs, and harbor considerable hostility toward a paternal grandmother and other relatives who were responsible for calling Susan's situation to the attention of the authorities. There are seven other children in the home, all in good health and all cared for and loved by the parents. They apparently resent Susan, who takes a great deal of their time, money, and effort. The home is apparently dominated by the mother. Rejection, withdrawal dynamics in the home, doubt psychosis.

Speaker 2 18:32

Thank you, Doctor.

Speaker 1 18:34

Unusual physical appearance. Do you think that would encompass both the birth defect and the small stature and the weird clothes?

Speaker 2 18:43

I think it's putting what they need to into the notes, and clearly I am in trouble. But my preference to be alone and my introversion seen in only one to two percent of people is not necessarily related to how I look. Not underlined due to schizophrenic withdrawal, but is a learned attitude.

Speaker 1 19:10

Oh. So what do you think they're trying to say?

Speaker 2 19:14

The fact that they've underlined certain words, I think they know it's abuse and what they're signaling it.

Speaker 1 19:22

Yes. Wow. And the interesting thing to me is the introversion because to me you're a really you have an extroverted personality in a lot of ways.

Speaker 2 19:34

I think I am quite outgoing now. And they do track this. I'm I live here for six months in the hospital. And they track through the notes. And I start out being very solitary and isolating and not engaging. But within weeks that changes. And it really starts changing rapidly as time goes on.

Speaker 1 19:57

As they started feeding you kindness. Yeah. Like your eyedropper from the very beginning. I had a bed to sleep in. I had food three times a day.

Speaker 2 20:07

I knew what the rules were. Yeah.

Speaker 1 20:10

Back to the psych ward.

Public Stares And Kids’ Questions

Allowance Points And Solo Drugstore Trips

Speaker 2 20:12

Yes, back to the psych ward, the happy psych ward. All of us on station 64 went on group outings. One day, while standing in line for ice cream at Como Park, I noticed a small boy hovering at his mother's legs, staring at me. By now my birth defect had risen to the top in my list of major problems, causing me to cover my face in public when I thought that people noticed. But this boy was so little. With one finger in his mouth, he pulled on his mother's blouse and leaned into her body, whispering. She glanced in my direction, then straight ahead at the Ferris wheel, pretending for my sake that she didn't hear him. She patted his shoulder absently. Later, I'll discover it's much better when they talk to me directly. Innocent. Did you get in an accident? What's the matter with your nose? Then I can tell them how we're not all born the same. I can have some pride in explanation. Unless the parent interrupts, grabbing the child away while smiling thin apologies to me. Then all of us remain in shame. At the hospital, they give me an allowance of $1.25 per week. When I earned enough good behavior points, I could go outside the ward, first with a staff person, and eventually alone. When that glorious day arrives, I sign my name on the required sheet of paper. Timeout, one hour. Destination, drugstore. All my first solo trips. We're to the drugstore. Fondling the precious money in my pockets, I wandered down each drugstore aisle, scanning all those wide bright shelves of pretty products. One week, I'd chop for toothpaste. Another week, shampoo. Carefully comparing prices and colors, reading all the fine print on each item. I'd use up 50 of my 60 minutes, just deciding on my weekly choice. Standing on air at the cashier counter, I waited for the clerk to package my crowning selection. When the receipt was stapled to the bag, I walked politely out the door, out of sight, and then ran flying down the street for several blocks. Gripping my new package, I high jumped over sidewalks so as not to step on cracks. Then, while catching my breath, rode the elevator up until I finally arrived in my own room. Carefully, in reverence to my good fortune, I found a spot among the growing toiletry collection on the nightstand. This was my altar. Here my most personal possessions stood arrayed in all their glory. Deodorant, a hairbrush, sale-priced shoe polish, and always in the center was the short round jar of Amway lotion that Ma stuffed into my hand that final morning, that fat glass jewel of a jar I never opened.

Speaker 1 23:36

One thing I really got out of this, and I think is a moment to educate people, is the kids looking at you, that one child at Como Park and talking to their mother, and you feeling that strain of her trying to redirect. Yeah. And that for you you feel like it would have just been easier for them to ask.

Speaker 2 24:00

I don't remember much of ever being picked on or being mean to me about it. I I really don't have memories of that, but I do have memories of kids asking and the difference that I would feel between a parent that would try and silence them or pretend it wasn't happening, or somebody who was just direct. They just wanted to know I did look different, and they just they were innocent. It wasn't they didn't know that it was something to be ashamed of. So I did recognize the difference in those two responses.

Gratitude And What Comes Next

Speaker 1 24:37

Mm-hmm. Well no, I think that's a important lesson for all of us to think about because things like that happen all the time. I I appreciate you being so honest about it and telling your story. For sharing all your stories in this podcast with me and with our listeners. It's really been an enlightening experience thus far, and we hope people will continue to listen because we have more to say. Thank you, Sadie.

Speaker 2 25:06

Thank you. Thank you for listening and for being here. Bye for now. Bye for now.