Part IV Fear and Loathing in the Department of Mental Health. Welcome to the Jungle

Alright, people, it's time to once again to gather 'round , fill your glasses and brace yourselves for another totally uncensored look at reality, as brutal as it may be, with no excuses and no turning back. If you have a need for your denial to remain intact, or if you have a weak stomach, then I suggest you turn back now. We deal with the truth here, in all its gory glory, and we don't let a little blood stop us. The combination of a scene involving treatment of the severely disturbed which was already unnaturally weird, the arrival of a school of sharks bent on preserving their political standing within the department at all costs and a total lack of leadership has reduced Metro to a primitive state. The meat-eaters are all around and there is less and less cover. No one is in charge and if you try and step in to help, you'll feel their long sharp teeth dig into your back and their razor-sharp claws begin to rip the flesh away, and soon you will be added to the mounting pile of bones gleaming white in the sun. Yes, welcome to the jungle. The question , then , becomes who is sane and who is insane?

"The keepers found themselves pinioned hand and foot and thrown into the cells as if they were the lunatics themselves by the lunatics who had usurped the offices or the keepers" Edgar Allan Poe

Indeed. Who should have the keys and who should be getting a PRN of about 5 of Haldol (IM of course) ? Can you imagine doing a takedown on Willie Weld? Can you picture the look of pure terror on his face when he realizes that he's going to get 4-points in locked door for a minimum of 3 hours? Even better, how about inducing EPS on Wee Willie and watching him flop around on the floor with his tongue sticking out of his mouth?

But enough of these fiendish fantasies. We have some ugly facts to deal with here and spinning tales about lashing Weld to a bed in a dark concrete room is not going to make the nut. Jesus, I've got to stop this late-night, half-ripped typewriter-humping bullshit. Fucking around with friends and hanging out until everyone crashes, and then sitting down with a head full of chemicals to pound out this gibberish is more than I can handle. It's all that keeps me from coming completely unhinged, though. I gave up trying to deal with the scene at Metro as thought it should be taken seriously months ago, and now it's all I can do to keep from loosing it completely right there in the Administration Building you know, waving a big marlin spike around while jabbering about reptiles and pools of blood and all the rest of it. How you people who actually have to work there take it I'll never know.

But we were just about to talk about ugly facts when I zapped off on that mindless tangent. Things have degenerated, somewhat predictably, to levels of hopeless madness in all corners. Everybody is working in isolation from everyone else, partly because you never know when the person next to you is going to be taken out by a transfer or just leave the system altogether. And you don't know when your turn will come. It's Vietnam all over again. Total chaos, sudden death, and the best you can hope for is to survive the carnage only to have nightmares and flashbacks for the rest of your life. The job was hard enough to begin with, and now the cage is being shaken every few days as the staff turns over and everybody feels lucky to be getting one more check. It's no wonder that everybody needs some nurturance these days. It's no wonder that everybody needs something.

"For People like us, In Places like this, We need all the hope that we can get" The Call

Is this any environment for the work we're suppose to be doing? And through it all comes this distinct, sickening, enraging feeling that there is no one at the helm.There is a total lack of leadership. No one is attempting to grab the wheel before we are smashed into a million pieces. No one is devising a realistic, coherent plan for what is going to happen which allows the workers to have some faint idea what may happen to them. You may get laid off. You may get transferred. We can't tell you. But you don't worry about it, you just keep pickin' cotton until we tell you to quit. Who do you think you are, anyway? A person? HA!

And of course, whenever you put these questions to anyone at nearly any level of the System; they will babble and gibberish like "Well we don't even know what's going to happen to us!" or "We're just going week by week or month by month by ourselves!" or some other equally chickenshit excuse. And I have chosen that word carefully, because chickenshit is just what it is. The whole point is that, in times of confusion and uncertainty, people have the choice of either passing the buck and bullshit onto the next level below them or refusing to let the shit go on and taking the heat for it. Leaders stand up and say "Okay, here's what we do know, and here's what we need to do." That means making some touch choices and biting the bullet. That means rolling up the sleeves and getting with it. And whether or not the leader's plan is good or successful, just , just having a real leader ( and gender does not matter here) making a stand and doing something makes all the difference for the people on the bottom of the stack and the whole system stands some remote chance of working. But it has to begin with some authority taking charge.

"The men who hold high places, must be the ones who start to mold a new reality" - Rush

Idealistic adolescent bullshit, you say? Pie-in-the-sky jabbering delivered from a safe distance? Perhaps. But the criticism doesn't change the truth of these mad ravings. Ass covering has reached an all time high while genuine clinical care has reached an all time low. And right there,dangling like Damocles sword is the state purpose of the 17-member committee appointed by Weld: to determine which (if any) DPH,DMH, and/or DMR facilities should be closed. Jesus. Talk about the hammer coming down! Nowadays whenever anyone is talking about their plans or the future of a group or a patient, there's always this ominous qualifying phrase: "Or, at least as long as the hospital is still here" Un-fucking-believable. And some people people wonder why there is a "morale problem." So shall we raise our hopes that this commission will come to our rescue, reporting to Gov. Weld that DMH has already been saddled with more cuts than it can reasonably handle and recommending that staffing patterns be returned to humane levels? Not likely kiddies. When all said and done, this commission will amount to a formalized execution procedure, in which our heartless governor will be handed the authority to do what he has to do to toss a few thousand of weak and defenseless out of the lifeboat. Sharkbait!

" The real problem lies with the ponderous bureaucracy of DMH which does not compare with anything I have seen..." - Dr. David Bulmer's letter of resignation as Medical Director of Northampton State Hospital 4/7/91

No shit, Dr. Dave! DMH has rotted from the inside becoming rife with parasites and evil bastards who like pilot fish attach themselves to the belly of sharks and the bigger shark, the better you eat. One look at the members of the commission will tell you that they are not going to change things. It is heavily stacked with the existing top level DMH people who have the most to lose in any significant tampering with the system which they have been carefully tinkering with for years so that it suits them best. Then come a few State Reps whose input will be determined entirely by which way the goddam wind is blowing when the report is drawn up. And who are these other losers? Do you see a single clinician, a single well known name from the ranks of Mclean or B.I or even Cambridge goddam Hospital? No, Hell no. No one who could give intelligent clinical insight into the state DMH plan.

And certainly no one who can tell how things really are.What are they going to do? Ask the Administration how things are going? Give me a fucking break! Those poor fools couldn't tell anyone how things are really going if they tried! All they see are numbers like total census and scheduled discharges. Or total seclusions and deaths. They don't see that some patients, inpatient stay is increased by months because of a senseless transfer to some other hospital. They don't see how some patients are falling apart because they're being rushed into poorly planned and poorly developed residences by order of the Administration. They don't see how the treatment of so many patients is being set back because of unprecedented shuffling of clinicians fleeing from the axe of layoffs. They don't see how "the 1991 downsizing of Met State" is going to become a very common phrase in the psychiatric histories of hundreds of patients, cited as a reason for another decompensation or otherwise senseless change in the course of treatment. And they don't seem to care that in some unwritten history, it will be evident that the blood is on their hands.

Whew! That was one killer paragraph that I wasn't sure I would get through without bursting a bloodvessel in one of my temporal lobes. But so far, so good. The going has been weird no doubt, but lately the emotional torque has been almost too much. When I sit down at the typewriter, the rage takes over, I begin frothing at the mouth and it's all I can do to keep from going into a grand mal seizure. But most of you know exactly what I'm talking about. Metro has always had a special place in mythology of most community mental health systems as a sort of brutal purgatory (this is common for state hospitals) but fantasy has become reality and it is (naturally) harder and harder to face the fact that our days may be numbered and the number may be few.

"Cryin' wont help, and prayin' won't do you no good"- Led Zeppelin

For most of us, this is a sad but all-too-evident fact. For some of the team players and Administration types, however, who think they have done tough job in difficult times but have come out smelling like a rose, the ugly truth awaits. Our acts will speak for us and winners will not be measured in terms of rank or privileged or prestige. For the jarheads and yahoos who don't realize this, I can only offer pity. The clock is ticking, people. Now's the time to kick out the jams and wind it out on some serious effort in the treatment of the severely disturbed. Who's really doomed? The heartless managers, that's who. So fuck the doomed eh?

To be continued

Part III Fear and Loathing in the Department of Mental Health. In the Belly of the Beast

Ah yes, boys and girls, welcome, once again to Dr. Phibes demented world of Brutal Truth, Mad Ravings and Final Wisdom. That's the ticket here, friends: reveal the lies, unmask the truth, and Face the Music as it were. We don't have much time as it seems that I'm cycling in and out of hopeless insanity much faster these days. The cycles get increasingly vicious as the scene gets weirder, and the scene has gotten very weird, of late. Staff are being shuffled around like so many cards, William Weld is sharpening his axe and familiar faces are disappearing as the life boats fills up.

No One Gets Out of Here Alive.The Doors

Indeed. I was pondering this evil idea as I looked out my grimy window at the lifeless grounds when I suddenly recalled something a colleague had asked me earlier that day. "Does this all really suck as bad I think it does?" he said dead serious. "Or am I just complaining too much?"He leaned forward across the desk, suddenly animated, and the way he was gripping his dagger-like letter opener was beginning to make me nervous. "I mean I can't go through the day without standing up in the middle of some meeting and saying that I've had enough of the lies and the BULLSHIT!" Abruptly, he froze, and in one instant I realized that he had just heard the rattling around behind him, which I knew to be a porter emptying the trash. But before I realized what would happen in the next instant, he had whirled and was upon the helpless porter, who never even screamed.... "Poor bastard," I said as were disposing of the body, "he was in the wrong place at the wrong time," and instantly I realized how true that was, for all of us, and even more so for the patients. The Wrong Place at the Wrong Time.

The New Dumb are in power and they fully intend to work out on those of us unlucky enough to be outside the power loop. The corruption and evil start at the top and pour down in crashing torrents far from a trickle. Weld clearly doesn't give a good goddam who gets hurt as long as his State's bond rating goes up, which makes for a perfect dovetail with the vicious slashing of the last months of the Dukakis term when managers hoping to hold onto their political power took out their axes and swung freely. Of 450 layoffs in DMH last fall, only 29 management slots were eliminated. And how many of the managers occupying those slots were protected by moving them elsewhere? Like at the Quincy Mental Health Center where managers were moved into positions like Director and Supervisor of Case Management and Human Rights Officer. No less mysterious is all the juggling which has gone on right here in our own newly formed Middlesex Area. And the evil just keeps coming down the pike. At each level, it's passed onto the next while everybody covers their ass.

Yeah, yeah , yeah. Tell me something new, will ya? The rich and powerful get where they are by stomping on the skulls of the weak and the doomed. So What? That's the way it's been since Egyptians thought that the Israelites would make fine slaves, and nothing has changed in thousands of years, plagues and files and angels of death notwithstanding.

So what are WE supposed to do about that? If we oppose it directly, we're shark bait. Shit, can you imagine what they'll do to me if they ever find out who I am? And what have I done? I've spoken the ugly truth and I have not been a team player. In some circles, that is enough to earn you a bullet in the brain and an unmarked grave.; But the real sin of the Disconnection is how it forces people to face that side of the ambivalence which they thought they had out to rest. "Maybe I should think for myself about every step of this wretched process."It's very upsetting to those who would prefer to just do their jobs and leave the ethics to the academic types , and it even pisses some off...

But for those still working in some relatively intact part of the hospital, the central question remains: faced with this unrelenting evil, what are we to do? How can we fight it? And how do we deal with the idea that we have worked side by side with people who, on the basis of ethical clinical practice, we should wrestle to the ground and squeeze until they scream uncle?

It is impossible to know virtue without vice...Good and Evil have always existed side by side. Fyodor Dostoyevsky

Czart! How's that for a grip on reality? A lot of sane people will move to the back of the bus to make room for the whatever epileptic/fanatic wrote that little gem. Truth rears its ugly head. Get used to the idea that even if you see yourself as standing for what is good and right in clinical practice, you must be able to deal smoothly with yahoos and waterheads who know no better. Even if you can't change the world and the Department of Mental Health, you will have plenty to small battles in which you can score victories for your principles. How should a transfer really be done? Should a clinician who is reassigned to another unit with barely ten days notice terminate with a client before he/she knows who the new clinician will be? Where should a given patient go? How much anxiety should a patient be expected to tolerate? In a pinch, should Psychologist be expected to do (shudder) social work? At what point are the clinical resources so stretched that treatment is no longer happening and one enters the nether world of custodial care? (Take a look at the staffing pattern for July 1991 as an example.) With all the changes happening is it worth the effort to do the routine bullshit of continuing to see patients and increase passes for people doing well and all of the rest of it?

Never forget that any simple clinically good act you do is a blow for the oppressed against the wolves in power. It doesn't matter what the Administration says. Our own clinical judgment is the final measuring stick because our alliance is first and foremost with the patients.

These too are human beings, they are your brothers. Vissarion Belinsky

Which inevitably, brings my admittedly warped train of thought back around to this one concept which, though theoretically substantial is meaningless horseshit to an audience of people about to lose their jobs, their purpose and their heart. That concept is the future of Met State. To the 100 or so employees who will almost certainly be dead meat come July 1st, the Met will be little more than a graveyard of lost dreams and doomed hopes. But, in fact, there will still be 220 (according to Marylou)patients here, and a few staff hanging around for some as-yet undetermined purpose. What will this latest incarnation of Met State look like, and what will be possible given the current projection of totally inadequate numbers of staff? And what can they be expected to attempt given the horror to which the survivors have been exposed over the past 6-8 months?

How are the dead raised? With what kind of body do they come? 1 Corinthians 15:35

The survivors in July of 1981 will have inherited one helluva legacy or kickass clinical treatment in the face of oppression and mismanagement perpetuated by the rednecks of L.B.J's era, the paranoid fascists of the Nixon years, the doomed goons of Carter's gallant attempt at principled gov't., the yuppie pigs of Reagan, and the new dumb of our man Bush. We're talking once again about the school of the gonzo psychotherapy, which says that true therapy is not for the faint of heart and that all those who believe either that one can remain intellectually or administratively distant from their work are full of shit. Although the foundation of gonzo therapy, (and gonzo journalism - see HST) is participation in the therapy, there is an underlying truth, which is that there is another reality beyond what you can see and touch. It is a reality of emotion in which the experiences of attachment, closeness and loss are considered far more real than the day and date and whether or not one in fact has heard the voice of Cleopatra saying that one should come to Egypt and be King. Sounds like a great gig to me, man! There's the Queen, there's being fed grapes by all those babes in the harem, cruising down the Nile in the moonlight, camel races...Fuck reality, man. But then, the gonzo psychotherapist knows that reality has less to do with whether or not one acknowledges having a mental illness than with how one deals with wishes to be close to other people and the pain of loss of significant others. Everybody has a life. Staff or patient, administrator or clinician. Everybody has a life. How you gonna live it? What's really important? Status? Power? Having a candy apple red 1991 Toyota Celica? How you treat other people , regardless of their mental status?

But all of that is for those who still have some room to maneuver. What about those who have been put in a no win situation clinically? Those who have screwed over on one unit only to be transferred to another where doing anything would amount to participation in the crime? Simple. Get yourself a letter of resignation, write "Fuck You and Die" on it, and get in the goddam lifeboat!

And what of Met State? What shall be the fate of the place that has come to stand for so much to those with and without a major mental illness? What of the place which has been our hope against despair and the vessel for our energy, our talent, our faith? Will it pass away into dust, done in by half-mad dimwit managers with bigger fish to fry? Will it pass forever from the consciousness of those who struggle for principles of the downtrodden over the oppressors and good and evil? Dream fucking on pigs. The writing may be on the wall for this place at this time, but we will ultimately be judged by how we fought and how we died, and whether we saved our necks by fucking over someone else. It takes courage to give up personal gain and security for the sake of higher principle, and we have balls galore! You are fucking with the wrong people, and when the great scorer comes to write against our names, it will not matter who won or lost, but how you played the game ( see Red Grange) And it wont matter what sort brutality you subject us to in this place at this time, because the forces of nature are good and cannot be denied. There will be another place and another time. Just wait.

To be continued.

Part II - Fear and Loathing in the Department of Mental Health. The Hammer Comes Down.

Yes, faithful fiends, there is no rest for the Doomed; the Dogs have been released, and if you stay in one place for too long, they'll rip your ass off. Their pursuit is relentless, and the evil is clearly spreading. Everyday, we come into work at the Met and are immediately hit by another wave of Weirdness. Someone else announces their imminent departure, or someone is heard whispering furtively about having heard from a "reliable source" that Weld is hell-bent on closing us down. Every scrap of hope you muster is soon stomped on, and if you relax for instant, WHAM! you get socked with another brutal dose of the reality that those in high places want our hides nailed to a tree for reasons which remain unclear. Hearing the plans for "downsizing" was an experience ugly enough to strike fear and loathing in the stoutest hearts. Seeing the plans take root and become reality is nothing short of major trauma. The hog is out of the tunnel, running free and the dogs are closing in.

Do not give dogs what is holy; and do not throw your pearls before swine, lest they trample then under foot and turn to attack you.... Matthew 7:6

Old proverbs just get proven over and over again, eh? Truth has a way of rearing its ugly head and laughing in your face at the worst goddam moments. When we last spoke, we were attempting to come to grips with the nightmares which lay before us. I wont even attempt to explain that last column (" To Live and Die in MA"), mostly because I still don't know exactly what happened. I started to write this analysis of our situation with an eye toward saying what everyone was feeling as a way of boosting morale, and then found myself in the grips of some horrible manic depressive psychosis from which I barely escaped with remnants of sanity. But that probably says a lot about the mood of the staff right there. So let it stand, for good or ill, and let there be no guarantees. I feel myself getting a little frayed around the edges even now, and who knows where this path will lead...

Since we last spoke, the hammer has come down almost everywhere in the hospital. The once thriving Admissions unit has now been reduced to a single ward of dazed and confused clinicians who stagger about, wondering how many more hits they can take. The Burke unit has been shelled in their first round of Westborough transfers, and huge black clouds of smoke have been seen curling up from the CTG building, signaling the slow death of the Semrad Unit. Damage Assessment?

I spoke with an informant from the Burke ward, and the scene is not pretty. She could speak very little at first, muttering the usual pleasantries of hello. Then, as we talked, her eyes began to glaze over and she wrung her hands and clenched her teeth. "It's unbelievable" she said, looking past me into nothing, "they're taking all our patients. Just like that. They're gone, and we're not doing treatment any more. We're just going day by day and looking around each morning to see who's left" She was talking faster and faster in loose, rambling fashion until foam began to appear in the corners of her mouth and I was forced to sedate her by ramming a handful of Seconal down her throat with a glass of gin. I removed all the sharps from her office and left her in a deep, fitful sleep.

I told this story to my contact on the Semrad unit, who snickered and said "Yeah, those poor bastards are going through what we went through back in December. I've seen the whole syndrome, shock, denial, and then anger, unless of course they have a total psychotic breakdown." I laughed uneasily at this last remark, but I could tell by the tone of his voice that he was dead serious. We had arranged to meet in the Crest after work one day, and he was already there when I arrived. I ordered a beer and he ordered another vodka tonic. His eyes shifted constantly throughout the interview, and his hands were noticeably trembling. He had obviously been drinking heavily for days which made him look even more haggard and haunted. "I've never seen anything like it." he mumbled into his drink. "It's a war zone. We all know we're going to die, we just don't know when or how. We were in this system treating these patients before most of the Cambridge Somerville staff were out of rompers." He finished his drink in one long gulp and looked straight at me. "They're screwing us every way they can. You work your ass off to move patients, and what do you get? Thirty days notice, that's what." At this point big tears began welling up in his eyes, and the waitress who had been approaching the table backed off with a look of fear on her face. My contact began to sob, pound the table, and scream "The fuckers won't get me! I'll gnaw on their goddam skulls!" and I was forced to mace him right there in the bar before he lost control. he went screaming to his knees and clutching his eyes and I was able to slip out in the confusion. The horror in his voice had been almost too much for me..

Worse and worse...Can't you stand it? Are you retreating? Is this hour with the living too dead for you? But there is one thing that belongs here...Shall I tell you what it is, gentlemen of Boston? -Walt Whitman Leaves of Grass

Such is the angst and anger that has gripped the front-line clinicians in the throes of downsizing. In every war there are casualties, eh? It's weird how even the lifers who have way too much seniority to worry about being bumped in the night are getting jumpy, never mind the new kids on the block. Let's face it. On this Valentine's Day, 1991 we find ourselves lined up on the razors edge. To stay or to go? For those who have an option elsewhere, they must choose between their loyalty to Met and getting out before the ship goes down. They have to either stay in the war zone and risk being left high and dry when the ship finally sinks, or leave friends and the cause behind, lying awake with traces of survivors guilt. of course it's easy to say that anyone should take any reasonable option, in part because it's true, but what of the guilt? Try and remember that your loyalty is to a set of principles about using your skill and training (whatever it may be) to do the right thing clinically, and not to the stone and mortar making up the Met. Always carry the Met with you in your heart, and it will always live..

And what of those that, for at least the time being, have no option? Will you be taken care of? Dream fucking on brother. The reality is quite grim, and the reaper's scythe is sharp as a motherfucker. Gut check time, people. Dig deep and don't forget why you're here. The game isn't over yet, and we truly don't know what the future holds. So stick to your guns, work your ass off for your patients, but take a little time to get on the phone and GET A JOB!!!! And of course keep smiling. As best as I can tell, we're suppose to be bustin' ass to close down the met for the pure satisfaction of it. We're talking total denial..

It's the end of the world as we know it and I feel fine- R.E.M

But then we must admit to our part of the whole scene, mustn't we? I mean, what possesses an otherwise rational and intelligent individual to dedicate their livelihood to working with people who are sick? Obviously a big soft heart which automatically aches at the sight of the doomed attempting to make their way in the world with a brain ravaged by major mental illness. The other quality is that taste for the edge. Come on , people. Ninety percent of the population goes through their day with no awareness that there are (were) four hundred people out in Waltham who experienced some of their feelings as audible voices driving them to do things like attempt to slice their dick off with a kitchen knife. And YOU deal with them each and every day.

So any claim you have to being a totally normal and well balanced person is right out the window. In fact, you are probably a very special person who has some sense that there are things more important than what kind of clothes you wear, what kind of car you drive or whether you have your own parking place.But there is (probably) also this very wide subversive streak in you which prefers the edge to any sort of safe middle-class life. Fuck beaver cleaver and the horse he rode in on. Give me real life. Give me someone who needs a self-inflicted cigarette burn to feel alive, and let me talk them out of it. Let me deal with someone who was found in a fetal position in the cabinet underneath the kitchen sink with piles of feces here and there throughout the apartment who is now in an argument with me about the rights of an individual to not to be fucked with by psychiatry ( arguing but alive) and I'm happier than a pig in shit. The edge. Only those who know it can really talk about it. And there are many ways to experience the edge. Any sort of suffering, really will do the trick. So here we are. All of us packed into one building, staff and patients, the only thing really separating us being the luck of the deal. We got good cards, they got shitty cards. And our job is to help them play their shitty cards the best as they can. We are a new school of thought. Gonzo Therapy! We are the new breed.

We are the children of concrete and steel.. Everything is possible, but nothing is real -Living Colour.

True enough, fellahs, but where will this dedication get us? Certainly not to a new life for the Met. This poor bastard has been hit as hard and directly by DMH as an Iraqi bunker by a laser-guided missile. But the spirit lives on eh? Spirit is something one cannot destroy. And if it is carried in the hearts of many, it will never die.

To be continued.

Part I - Fear and Loathing in the Department of Mental Health. To Live and Die in MA.

Well kiddies, as 1991 begins, we find ourselves in a situation so weird and evil that even your own Ultimately Twisted Doktor Phibes finds it hard to grasp the full evil and weirdness. But we shall try, presently, to come to full grips with the truth as we know it, and its various perverted implications. With any luck, we'll come up with a reliable count of how many dead and (what we'd all REALLY like to know) where the bodies are buried.

"...my brain reeled as I saw the mighty walls rushing asunder - there was a long tumultuous shouting...and the deep and dark tarn at my feet closed sullenly and silently over the fragments of the House of User." E.A Poe

Does the same fate await Met State? Will the CTG building collapse in a heap of rubble and sink into a slimy black pool? We can't say for sure, but if the mutant zombies from Central Office ( and Area Office?) have their way, the long life and illustrious history of the The Met will come to a sudden quiet end. What is the Plan? Downsizing? What does that mean? Well, fellow fiends, that's bureaucratic doublespeak bullshit;" they're cutting us off at the knees and hoping we don't take too long to bleed to death. And why you may ask, you poor, innocent, wide-eyed sheep. Dazed and confused by the onslaught of hungry, frothing wolves upon our Fair Flock, you do not realize that the rules have been changed. Or more rightly, we were never really playing by the rules that we all thought we were playing by. We thought we were here to help the disenfranchised, the weak, the poor; those who because of a Mental Illness were unable to exist in our competitive society- those who would be chewed up and spat out by the Real World if not adequately protected. The Doomed, as it were. But, in fact, we were the real Babes in the Woods. We did not have an adequate grasp of the Final Truth that our fates are and have been directly controlled by the people ( I use the term loosely) who are Politicians and not Clinicians. I don't mean the clowns at the State House who we keep on for the entertainment value, but the various Planners and the Bureaucrats right here in the Department of Mental Health. They look smooth and friendly on the outside, but they are a cruel and brutal breed who, if necessary, will eat their young to survive. Harsh words, I know. But I have seen them in action, and my blood ran cold at the shameless displays of power-hungry selfishness.

Several forces and Unnatural Cycles of Nature have, in fact, combined to create this weird and vicious scenario. Here we are in the last year of the lame duck Dukakis administration- Republicans come into power in January so for the grunts in state government, the Secretaries, the Department Heads, and their respective Staffs, there is no tomorrow. They have no problem with doomsday policies; when the ship goes under, they'll flee down the ratlines and resurface as parasites on the belly of some future state office. This atmosphere of impending doom is then combined with the state's well-publicized fiscal crisis resulting in a feeding frenzy of the powerful upon the weak. The middle-level people in the Central and Area Offices are taking Full Advantage to rearrange things to their advantage. They can establish a budget-cutting reputation and power base to carry them into the new administration, and settle a few old scores at the same time. Make no mistake. We've been set up. The Met has been systematically starved of resources over the years, and we have made no friends in the Department for some years. They swing a deal to pretend to lay off managers who then get promoted into positions where they are given an axe and allowed to swing freely. Then our name is trashed with a series of irresponsibly done investigations (which had been sparked by admittedly disgusting and evil acts) in a smear campaign the likes of which has not been seen since Nixon's scheme of dirty tricks and petty crime of the 1972 election. We've been set up and it was a damn good professional job, if you ask me. These friends know what their doing. Let's face it. We've seen similar cheap shots and immature game-playing by brain dead yahoos who made their lives by surviving in the state system without doing a shred of decent clinical work time after time.The only difference here is that the stakes have been raised considerably in these mean stupid times. Now the survivors have become full-blown predators. And what of the population we supposedly serve? What of the Doomed?

"Fuck the Doomed...." Richard M. Nixon

Yes the brutal fact is that the heartless paranoia of our 35th president is frighteningly similar to the mood of the current (and future) DMH administration. Rather than courageous and principled leaders, we're talking about the moral equivalent of alligators, sharks, and wolves. They are about looking good and making friends in high places, and accruing power. Some of the rules which we weren't told are simple Rule #1 is that the Big Dog will Eat. When times are good in the Commonwealth they can feed on the fat leaving us alone, basically. When times are lean, however, anyone and everyone becomes Fair Game. The sharks come up from the deep, the wolves down from the hills, and gators out of the swamps looking for easy meat and they will get it. They will pluck swimmers from the shallow water or children from the playground, and only a silent string of white bones on the shore will be left to tell the tale, because these bastards are experts at stripping the flesh away clean, and no one will hear the screams....

"Some things that fly there be Birds-Hours-Bumblebee...some things that stay there be Grief -Hills-Eternity" Emily Dickerson
"And then I realize with fright: Spiderman is having me for dinner tonight!" The Cure (Lullaby)

Met State, in its current incarnation, appears to have the same fate of birds, hours and bumblebees. It shall have its life sucked from it like the unfortunate fly caught helplessly in the web of the spider.The All Holy number of 220 is ruling our fate. The census will be 220 by June 30, clinical wisdom and simple compassion be damned. Even more grim is the number 440. The staff will Cut (think chain saw) from 700 to 440. Any doubts about reptilian nature of Our Masters? Look at how they work.Layoff notices come silently at 3:30 on Friday afternoon. Forms for requesting Lateral Transfer soon follow ("There's a nice sharp razor, now do the Honorable Thing")come the afternoon before Thanksgiving (from here on to be known as Bloodletting). And the first wave of transfers to Westborough State Hospital were planned for the first week of the year so the patients were being informed the week before Christmas. Merry Fucking Christmas to you too, pal. Yes it looks grim. What is an honorable and right-thinking employee to do?

Who lets these people live anyway? Yes, I too have visions of speeding past the Central and Area office in the back of a stripped-down Jeep Rambler with a Steyr SSG P-II sniper rifle and an Aerospatiale AACP short-range anti-tank rocket for a little old-fashioned justice ( the rifle has a 26-inch heavy barrel and Kahles steel tube scope, while the rocket is fully guidable with a 4-second quiet time ( they wont hear it coming) and the low muzzle velocity, for you weapons fans - we're talking kick ass justice) but this is not a Realistic Option. Instead, we must choose our battles and make our stand where we have a chance in hell of coming out alive. At this point, your Crazed Correspondent ( the Demented Doktor) would say that this time will come between February and May when the principle of Political Expediency (the 220 rule) goes head to head with compassionate Treatment and Clinical Wisdom. Las Vegas currently has Political Expediency as the 9 to 1 favorite. I advise you to wait until early February when the odds are surely to go to something more like 14 or 20 to 1 and then lay out some serious cash. Why? Because we have the Hidden Factor on our side. The Factor of Truth, a King Hell sense of drama and not a mild taste for the raw flesh of our Oppressors. The time will come, gentle readers, for throwing off these false sheepskins and baring our fangs- the fangs of truth, love and Clinical Wisdom, and All Things Good. I, for one, will be damned if the State Mutants get away with wholesale emotional abuse of My People with their so-called fiscally driven Plan. I will not be one of the Good Germans who contribute to a Grand Tragedy when I know good and goddam well that the whole thing is Horseshit.... but I seem to be preaching a bit here. Suffice it to say that there is blood in the water, and no one is safe, least of all our beloved patients. If you thought that the late 60's was the age of Paranoia, you ain't seen nothin' yet.

These bureaucratic fiends have it all figured out, you see. They say that times are tough and cuts are necessary. But instead of being laid off, these shameless warthogs get promoted and put in charge of deciding who gets screwed. Where are the nurses, social workers, psychologists and doctors that got laid off or bumped? Cast your eyes upon the shore, gentle readers and shudder at the bones gleaming white in the sun..

"The horror, the horror..." Jim Conrad from The Heart of Darkness

What can I tell you kiddies? The Final Truth is, I hope, not yet written, though the signs are very grim. Trust no one especially some half mad dimwit administrator who tells you with a straight face that primary concern through all of this is the Clinical Care of the patients. Every step from here out must be made with great care or your leg may be chomped off up to the knee. One moment you'll be asked to do something that is not only okay, but a rare chance to do a little good, and the next moment you'll be asked to quietly put a bullet in someone's brain for the good of the greater majority. You've just awakened to realize that you've been wandering aimlessly in a minefield and the next step may render you a helpless mutant, so consider each step carefully. Now we'll find out who really has the balls. The weak will be eaten up quickly, so arm yourself, walk tall, watch your back, and do your best to ignore the mounting piles of bones.....

To be continued.