Текст книги "Woman on the Edge of Time"

Автор книги: Marge Piercy

Соавторы: Marge Piercy
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Текущая страница: 26 (всего у книги 26 страниц)

TWENTY

Excerpts from the Official History of

Consuelo Camacho Ramos

State of New York–Department of Mental Hygiene

Bellevue Hospital

CLINICAL SUMMARY

IDENTIFICATION: This 35‑year‑old Mexican‑American Catholic woman separated from her husband Edward for the past three years has one child, Angelina, aged 4. The patient has been on Aid to Dependent Children since last May.

PRESENTING PROBLEM: This patient brought her child into emergency at N.Y.U., stating that she had accidentally broken her wrist. The child was bruised. When questioned by caseworker, the patient readily admitted beating her daughter, while drunk or drugged. The patient was incoherent, weeping, and exhibited bizarre behavior.

PAST HISTORY: This socially disorganized individual has been in an increasingly deteriorating state since the breakup of her marriage. Whereabouts of husband unknown. This patient has been in conflict with the law for two years. Convicted of aiding and abetting a pickpocket and given a suspended sentence and a year’s probation last April. The patient refers to an illegal abortion, followed by severe hemorrhaging and complications, for which a hysterectomy was performed at Metropolitan. The patient has recent alcohol and barbiturate problems. Seems hostile and suspicious toward authority. Lack of control and frustration tolerance. The patient has a tendency to act out problems with violent expression and hostile and extrapunitive tendencies.

MENTAL STATUS: This patient is disheveled and appears to be older than her stated age. She readily admits needing help. She is cooperative but confused and occasionally suspicious. Has not demonstrated assaultive behavior on the ward.

STREAM OF MENTAL ACTIVITY: The patient is incoherent. The patient’s thinking is extremely concrete.

EMOTIONAL REACTIONS: The patient’s general mood is anxious and exhibits extreme guilt. The patient’s affect is inappropriate, marked by crying without cause.

CONTENT OF THOUGHTS: Denies suicidal ideation. Denies delusions or hallucinations.

SENSORIUM, MENTAL GRASP AND CAPACITY: Sensorium clear. Oriented times three. Recent and remote memory appear weak. The patient has somewhat slow intelligence and answers questions poorly.

DIAGNOSIS: Schizophrenia, undiff. type 295.90.

State of New York–Department of Mental Hygiene

Rockover State Psychiatric Hospital

DISCHARGE NOTE

Dr. Messinger

HISTORY: This 35‑year‑old Mexican‑American woman, Catholic mother of one daughter, was hospitalized at Bellevue because of child abuse, alcohol problems, confusion, and bizarre behavior, and admitted here February 8.

HOSPITAL COURSE: The pt. responded well to medication, although with pronounced side effects, swollen tongue, etc. Her behavior slowly normalized and the pt. exhibited decreased psychiatric signs and symptoms.

PRESENT MENTAL STATUS: Alert, cooperative, coherent, relevant, with no abnormalities of stream of thought or content of thought. Acceptable insight. Oriented times three.

PHYSICAL CONDITION: Ambulatory–no physical abnormalities. Can care for self.

TREATMENT PLAN: Pt. discharged to welfare hotel until welfare finds her an apartment. She will report to Aftercare Clinic at Bellevue weekly.

MEDICATION: 1. Thorazine 200 mg. o.d. at 5 P.M.

                2. Prolixin 1 cc IM every 2 weeks.

                3. Artane 2 mg t.i.d.

CONDITION: Improved

DIAGNOSIS: Paranoid Schizophrenia, type 295.3.

From Bellevue Admission Notes:This evening this 37‑year‑old obese Puerto Rican woman allegedly attacked a relative and a relative’s fiancй with a bottle. Upon examination she was found lying on the floor, groaning incoherently, and proved disoriented as to time and place. She was hostile, uncooperative, and threatening. She was abusive to relative and relative’s fiancй. Admit. Thorazine 1000 mg by injection. Restraint.

From Rockover State Admission Notes:This patient is a 37‑year‑old Mexican‑American Catholic mother, separated from her husband Edward, whose child has been put out for adoption through the state agency. Has a history of violent psychotic episodes, including robbery, assault, and child abuse. Eleven days ago this patient attacked her niece Dolores Campos and her niece’s fiancй. This patient is known to us and has been previously hospitalized in Rockover. After ten days at Bellevue, transferred here. Remained acutely psychotic. During hospitalization, she has been mute and withdrawn with occasional violent outbursts. She has been uncooperative, attempting to refuse medication, and has no insight into her illness. Has delusions of persecution by niece’s fiancй and speaks of the State of New York as “murdering” a Negro boyfriend. This patient also constantly complains about the child put out for adoption. The patient has no consistent notions of right or wrong. She said that for the last two years she didn’t drink at all. She smokes about a pkg. a day. She denies any drug addiction, although she admits use of barbiturates in the past. She claims not to have had any relations with men in the past three years. She doesn’t admit any attachments to women either. This patient is a socially maladjusted individual subject to periodic dysphorias accompanied by fear, leading to violent episodes and aggressions. Admit to Ward L‑6. Restrict to ward. Violence precautions.

Escape Report:After a fight with another patient on the ward, causing mild concussion, this patient wandered out of the hospital and was lost in the woods for two whole nights and days. She was recovered in a bus station in Fairview very confused and uncertain where she was trying to go. She was covered with mosquito bites. It was decided to place her on close supervision … .

From New York Neuro‑Psychiatric Institute Notes:This 37‑year‑old female did not appear to have any motor difficulties. The patient appears to have learned to walk and talk at the normal time. Sent to Texas for birth records. Patient was delivered by midwife. No definite documentation of premature birth or birth traumas. History of blackouts and violent episodes in which patient felt as if she couldn’t control herself.

… Mr. Camacho is a well‑dressed man (gray business suit) who appears to be in his 40’s. He operates a wholesale‑retail nursery and has a confident, expansive manner. I would consider him to be a reliable informant who expresses genuine concern for his sister … .