My apologies for going off the grid. Sometimes life veers off best-laid plans and takes one in a different direction. September has been such a time. In fact, the last six months have been such a time. For a self-described homebody, I’ve spent more time away from home during the last six months than at home.
September was a lesson in being at home with self no matter the circumstances. Earlier this month, my husband and I were driving back to Erie from my niece’s wedding in Vermont when I received a call from someone very dear to me asking if I could help her. She had just revealed to her psychiatrist of four years that since June she had begun abusing the Xanax he has been prescribing her for sleep. Weeping, she described his response, which led to feeling abandoned and out of options.
According to my friend, his response to the revelation, which she had outlined in writing in detail (I know because she showed me), was to tell her that she needed to “be locked up,” and that he couldn’t help her. Prior to this when she had broached with him her desire to be tapered from the drugs he had indicated that since she was not “a drug seeker,” he did not see the point despite her history as a recovering alcoholic.
In my humble clinical social worker opinion, this is a psychiatrist who should leave the profession. He abandoned her at the moment she became difficult to him. He failed in the practice of due diligence, sitting in judgmental silence staring at her until she left his office without so much as a referral to another-more-qualified-in-treating-addictions doctor. Instead, he shamed her when he should feel ashamed. For four years he took the path of least resistance, continuing to prescribe a highly addictive and dangerous drug (Look it up. Xanax, the most addictive of the benzodiazepines, should not be taken longer than 6 months.) rather than help her in the more difficult process to get off of the Xanax in favor of healthier alternatives in sleep hygiene.
Suddenly my plans for “Cooking Therapy” as a prevention program turned into an actual practice of combining my profession as a clinical social worker with my newly honed skills as a chef. I left for Pittsburgh immediately to help my friend navigate the mental health system while providing her with home cooked meals.
Fortunately, I have a sister who also lives in Pittsburgh with whom I could stay, but as luck would have it, she was also having health issues and in need of comfort food and tender loving care. I guess that is lesson one on the cooking therapy front. When the chips are down we crave comfort food. Simple, delicious, remind-us-of-love, food. Lesson two for me was I am capable of working as a personal chef. I turned out chicken and dumplings X 2, meatloaf X 2, mashed potatoes X 2, muffins X 2, pancakes to order, my date/dark chocolate brownies divided in two, and apple crisp divided by two, pasta sauce, tempeh ruebens when my “clients” were feeling better and their stomachs could entertain the idea of fermentation to the extreme, and at least four loaves of sourdough bread.
The real reason I wanted to write about this ordeal, however, is to praise the mental health services we interfaced with in Pittsburgh despite the unfortunate experience with her psychiatrist that ushered my friend into available services. I understand the frustrations of working with addicts, but how does a psychiatrist fail to make a referral when one of the best detox programs in the nation was in his own backyard? My friend is well educated and articulate yet felt completely defeated and hopeless against his rejection and judgment. I can’t help but wonder what a person without loads of education or supports would do in the face of his callousness.
All is well that ends well though our trip was a bit rocky. We began our search with my friend’s PCP, who also wasn’t much help, but did give us information about Pittsburgh’s Crisis Services. I had commented during our discussion with her PCP that as a social worker in Erie I always had good experiences with Erie County’s Crisis Services. My friend felt that her PCP took my comments as an easy out to decline to assist her in the tapering from the meds as she had researched. He ushered us out of his office without so much as checking her heart, but armed with directions to RESOLVE Crisis Services.
She and I are very interested in cultivating and preserving our relationship. She is a very nice and generous person typically, but as you can guess, not at her best emotionally or physically when trying to withdraw from a potent and highly addictive drug. I told myself not to take anything she might say personally. She is also very quick to apologize when she steps over a line.
Off we went to Pittsburgh’s RESOLVE Crisis Services http://www.upmc.com/services/…/resolve-crisis-net. I can’t speak highly enough of our experience there. We interfaced with the intake social worker and a nurse. Both women were kind, non-judgmental, knowledgeable, and patient with our questions. They made easy what just minutes before felt insurmountable.
I will skip some of our missteps, which actually injected some humor into the situation, on the way to UPMC’s Mercy Hospital, but we ended up at another Crisis Services in Pittsburgh where another social worker facilitated our journey to the right place. Though I do not quite understand the protocol, in order to gain access to Western Psych’s www.upmc.com/Western Psychiatric ambulatory detox one has to be assessed through UPMC Mercy’s emergency room first, so that’s where we went. I have gone through this many times over the last ten years with students requiring emergency mental health services, so I was up for a long wait. Thank God, in this case we received attention relatively quickly. Still the day was long. She was assessed and given enough medication to get her through the night then released and told to be at Western Psych’s Ambulatory Detox Center the next morning at 7:30 a.m.
The hopefulness of Day 1 vanished with the morning light of Day 2 as my friend had not slept for two nights due to the withdrawal from the Xanax. To say she was distraught is an understatement. She was that the only way she could leave her house was by ambulance to a hospital. I cannot imagine going through the difficult night she described fraught with brain tremors that rocked her every time she tried to close her eyes. I was in a bit of a panic myself unsure of how to proceed, but also knowing she had to be medically supervised. I felt I was in way over my head. Even though I’ve worked with addicts I have not seen a person withdraw from drugs or alcohol up close and personal. We were also battling preconceived ideas about what it meant to go to Western Psych. I think most of us conjure images of One Flew Over the Cuckoo’s Nest, when we imagine what mental health services are like whether inpatient or outpatient. Again I called RESOLVE and asked them to speak to her.
Somehow we made it there. Here’s what I love about Crisis Services. They facilitate one’s entry into appropriate services. We were assured that even though we would arrive late we could still be seen. Crisis Services had called ahead and Western Psych was expecting us.
The care she received through Western Psych’s Ambulatory Detox was outstanding in my estimation. Again we were treated with professionalism, kindness, respect, and care. We were informed about the side effects to expect and for how long. The nurse and resident “normalized” the symptoms so she knew she was not alone and would survive. She was set up with day-to-day services and follow-up. She did not require “lock-up” for thirty days or even a day. With medical supervision, the detox itself was finished within a week. I was left with the question: Why doesn’t a Pittsburgh psychiatrist know about these services?
The spirit works in mysterious ways. If the psychiatrist hadn’t behaved badly, my friend would not have been pushed to find other answers. At no other time since having children have I been available to drop everything and go. As a clinical social worker in Erie, I was aware of Western Psych, certainly, but I had not interfaced with them in such a personal way. I would not hesitate to refer to them now.
I also learned that some people really are cut out for this type of work. The intake worker, Rachel, at RESOLVE, and the nurse (whose name I do not remember I’m sorry to say) were exceptional getting us where we needed to go. The nurse, Danielle, at the ambulatory detox was phenomenal. She spent a lot of time with us gathering information and explaining information in order to provide the best services.
As I mentioned, I learned a few things about myself as well. Foremost, I learned that sometimes you just set aside your own agenda or plans to respond to the needs of others. Rather than worry about what I wasn’t getting done, I allowed myself the space to be with my friend and my sister albeit with self-care breaks to escape to the gorgeous Frick Park for long walks on wooded trails. What could be more important? And while I put cooking therapy on the back burner, I found a new way to do cooking therapy.
By the way, we often do not get immediately rewarded for such things, but how fun it is when we do. I had to send out an SOS to my sister’s neighbors for a KitchenAid mixer (and a potato masher if you can believe it. Who doesn’t have a potato masher in their kitchen? My sister that’s who). My sister’s neighbors responded with a KitchenAid still in the box and told me I could have it. Say What??!! Of course, one of my sourdoughs went to them but neither words nor loaves can suffice to express my gratitude.
All told, I was in Pittsburgh for almost two weeks. By the time I left, both my friend and my sister were on the mend and armed with new recipes (the meatloaf was a hit with my sister’s twenty year old dog), and better health care. I learned yet another lesson on being present and accepting what is. I’m trying to sustain this attitude now that I’m back to my “real” life.
Finally, though I was making comfort food, I cannot but help to make my dishes healthy. Since you hung there with the long and short of my tale, here are my recipes for sourdough dumplings and Kombucha zucchini muffins.
Sourdough Dumplings to make with Chicken and Dumplings
1 Cup Sourdough Starter (I have extra for my Erie friends)
1/2 C leftover mashed potato (that you made to go with your roast chicken that was turned into stock for chicken and dumplings:)
1 C sprouted whole wheat flour
2 t baking powder
1/4 t baking soda
2 T olive oil
1 t or more to taste chopped parsley or chopped summer savory or 1/2 t dried
Drop by tablespoon on top of soup or stew then cover, simmer, and don’t look for 15 -20 minutes.
Kombucha Apple Zucchini Muffins
1/3 C coconut oil
1/2 C maple syrup or alternative sugar such as coconut or date sugar
1/2 C plain Kombucha homemade or store bought
2 t vanilla extract
1 T ground flaxseed
1 3/4 C sprouted whole wheat flour
1 t cinnamon
1 t baking soda
1/2 t sea salt
1/8 t ground nutmeg (optional)
1 & 1/2 C grated zucchini or yellow summer squash
1 apple grated
Preheat oven to 350 F/ 180 C
In a large bowl combine the coconut oil through vanilla stirring to combine. In another bowl combine the dry ingredients then add to wet ingredients until just combined. Stir in zucchini and grated apple. Spray cupcake tin with cooking spray or use papers. Divide batter evenly.
I topped mine with a mixture of 1/2 cup chopped walnuts, 2 T brown sugar, and 1/2 c almond meal. Bake for 20-25 minutes or until an inserted toothpick comes out clean.