Situation Normal - All Fouled Up

I thought we had finally found a doctor, Dr. M., that would continue to see my son permanently. He was hospitalized twice during her three month vacation, and when she returned, she told him that he would have to find a new doctor*!

Our understanding of the reason he was told to find a new doctor was that Dr. M. would not have prescribed him the medication he was put on in the hospital while she was on vacation, and she would not prescribe it to him, as an outpatient, ever. This medication has brought him more sanity than he has had in four and a half years, so we were very alarmed. We talked to the secretary about transferring his care to the doctor in that practice who had seen him in the hospital and who was the one who put him on this medication, Dr. O.. The next week we were told that he had agreed to take my son as a patient. Well, things have been ducky for a few weeks, until this Thursday.

In the crowded waiting room, I was concentrating on my sudoku, trying to keep my focus off of the screaming torture taking place in a sadistic movie on the blaring television in the waiting room. My son was across the room with his head phones on. I was marveling that, though this was the movie channel the TV was always tuned to, the employees did not seem to be worried about it's effect on the mentally ill people in the waiting room; or me for that matter. I was debating about whether I was going to get up and change the channel, when noticed that my son was standing in front of me, holding out a fat envelope. I asked him what it was and he nodded toward the secretary, who was licking another envelope flap, and said, I think it's a bill. I took it and he went back to his seat.

A bill!!? A huge bill! He is on Medicare and has our state's insurance as his secondary coverage; his co-pay is zero and he is considered disabled by the government. Inside the envelope is a multi-page print-out of a predictably obtuse billing history for my son. He doesn't get billed, Medicare and the state insurance system do. I tell the secretary that they must have made a mistake and she tells me to talk to the billing person.

What ensued in his office was very disturbing to me. The man in billing, pulls out his stack of EOB's and points to each column; to the amount that was billed which was bigger than the amount allowed, which was bigger than the amount Medicare paid, which was bigger than the amount owed by the state insurance program..... and then that's when the shake-down started. He said that my son owed them that amount for every visit he had made to Dr. M. at their practice. I point out that is the column belonging to the state program. He said yes, but the state program had not paid them for ANY of their patients, so the patients must pay it!

I suddenly thought of all the schizophrenics trying to hold on to a shred of sanity, trying to survive in this world with severely faulty perceptions of reality, being handed a bill for something they would not know that they didn't owe. Most of these people don't have any money, or barely enough for subsistence living, and the clinic they are depending on, for their prescriptions, has the gall to trick them into thinking they must pay or lose their access to the clinic; or worse fear that they will be thrown into jail for not paying their bill.

I told the billing man that he had a problem with the state program that he needed to resolve, and that that he should not try to make the patients pay the state's portion. I told him that our son had full coverage, and that if he contacted the state program they would verify that. He then said, "Yes, they tell you that you are covered, but they haven't sent us any money." I pointed out, again, that it was a problem between him and the state, and that for them to expect the patients to pay that amount was wrong. Expecting their patients to be his liaison between their office and the state was absurd. Even if they had the clarity of mind to look into the problem, it was not their job! And, that some quantity of their patients would not know that the office had no right to make them pay it.

He then wanted to know if my son was the one who had to have the weekly blood tests. -Yes. (The blood tests are not done at their office, and we don't even know if they ever look at the results. The pharmacist where we get his medicine is the one who tells us the results.)

Were we happy with the doctor he was seeing? -Yes.

Was the medicine helping him? -Yes.

Do we want him to continue to see this doctor? -Yes.

Well then, why would we refuse to pay the bill? After all they filed the bills with the insurance company for us, as a favor. -Huh?!!

Once again, I say that my son's co-pay is zero, he does not owe them this money, the state does. And, was that a veiled threat about whether my son could continue to see his doctor? The billing guy's response is to show me a sentence on his print-out that says patients are responsible for the bill if their insurance does not pay it. I responded that the state has always paid in the past and that my son had been assigned to this practice based on the fact that they were one of the providers on the state's list. The doctors agree to accept the amount allowed for the service, as determined by medicare and the state's insurance program. And, again, it was not the responsibility of mentally ill patients to be his go-between with this problem he was having with the portion owed by the state insurance program.

This is not a verbatim transcript of what was said, but you probably get the idea. My son walked in after the billing guy and I had been arguing for quite a while, and he became upset that, by making the billing guy angry, I may have just gotten him kicked out of that psychiatrist's practice. I couldn't continue it any longer, and my son and I left the building. I collapsed into tears outside, thinking that by trying to stand up for not only my son's rights, but for the rights of all of their patients who could not stand up for themselves, that I may have just gotten my son booted out from the best psychiatrist we'd seen yet.

I don't know why they are having trouble getting their money from the state insurance program. The state should not be stiffing doctors when they submit bills to them. It will make the few doctors that participate in the program, want to leave it. We may have found the ONE good doctor that will participate. The state's negligence is hurting the people who need help the most.

I wonder if the non-payment by the state insurance was another reason the other doctor refused to see him any more. They might be trying to cull government insured patients from their patient list. They certainly wouldn't be the first ones to do it.

*[Here is where, if you are sick, you have no clue how to find a new doctor. This might be your seventeenth doctor in four years. Most of them were assigned to you when you were released from the hospital.

If you can remember that you might be able to get another doctor by calling the state insurance program's toll free number and call it, you will be confronted with an automated answering system that is confusing, convoluted, and even pressing zero won't get you a human. You might have a friend or relative call for you, but the answering system will be just as confusing and impenetrable for them. Some of their systems cut right to the part where, if you don't enter the extension for the person you wish to talk to, it ends the call automatically. How do you know whom you wish to talk to?

If you remembered to save your book that lists doctors who will accept your state medical insurance, medicaid or medicare, you will discover that many of them dropped out of the program after the directory was printed.

If you have access to a telephone during doctors' hours, you can leave messages on many answering machines. Odds are against any of them returning your call, but if one might, how do you get a returned call if you don't have a phone?

Let's say you are lucky enough to find a doctor who will see you, and their next available appointment is two months from now. How are you going to get your medication between now and then? What if the doctor will not see patients who take the medication you are on?

Next you'll realize that the doctor's office is so far away from where you live, that you have no way to get there. Never fear, they will tell you that there is a free service especially for taking people to their appointments. You are supposed to call the state insurance program's phone number (see above) a few days before your appointment so they will put you on their schedule. Just because you are on their schedule does not mean they drop you off just before your appointment and pick you up just after it. Partly because you can wait for hours beyond the time your appointment was for, to actually get in to see the doctor. Your time spent with the doctor will be about ten minutes.

We haven't used this service yet, partly because my son has frequently been terrified of strangers and would not have gone with them. But another big reason is that I talked to people and watched others, in doctor's waiting rooms, who depend on this service. I have seen people who wait in the waiting room all day. I have also seen some very rude drivers.]

The Weekend's Entertainment (schizophrenia in jail)

The Weekend's Entertainment
The weekend's entertainment has just been shoved inside the door.
His hands and feet are shackled as he stumbles to the floor.
Well now, what we got here?
When he talks it don't make no sense; why, is hard to tell.
We gonna do us some correctin' and some guardin'.
Throw him in a cell.

He yells gibberish at us all day long and won't shut up at night.
We strapped him to a chair and made sure that it was tight.
Defiant fucker pissed hisself, we love to watch him fight.
Got no respect for authority, man, we doin' some correctin' tonight!
He's loosing all his privileges, being such a prick.
The up-side is, he's so crazy, we can beat him all to shit,
we'll say he did it to hisself, the charges will never stick.

His upset Momma and his Daddy say their boy is sick;
Say call a doctor or ambulance, get him some help quick!
We tell them he's misbehaving and he's ours for a couple more days.
Judge don't work on weekends.
We ain't listenin' to you cry and yell.
So piss off now, we're busy correctin', or we'll put you in a cell.


"The Weekend's Entertainment" happened at the onset of my son's schizophrenia.
He was 18 and attending college about 30 miles from us. The week before, he totaled his car in a fender-bender and began sending us odd, difficult to understand emails. He called us with a tangled set of plans for a trip he wanted to take, and instructions for us to attend Thanksgiving dinner at his ex-girlfriend's parent's house, even though they had not invited any of us, not even him. His father and I were worried that he was messed up on drugs, so we planned to get to the bottom of it when I picked him up on Friday.

In the car, the radio was on and this normally inhibited kid was flinging his head, arms and body around to the music the whole way home. When we got to the house, I was relieved because his dad would be with us now. But when I parked next to my husband's truck, my son got out, opened the driver's side door on the truck and began loading everything he had brought with him into the truck. Then he took my gym bag that had some of my clothes in it and my boots and put those into the truck too. Then he got in the truck and drove away! I was stunned, wondering what just happened, why would he do that?

I rushed inside and told his father that he just left in the truck with his things and mine, and he seemed very wasted on something and definitely shouldn't be driving. We tried his cell phone, but he didn't answer. I decided to drive to his ex-girlfriend's apartment to see if that was where he went, but the truck wasn't there. I drove back to the house and my husband was waiting outside. He said the police just called and had him under arrest for trying to steal a truck! They wanted us to come right away. They said he had stopped at an oil change place and the guys inside saw him open the door to one of their trucks and he began loading all of the stuff he had with him into the truck. He was trying to start the truck with his father's key when the guys pulled him out and held him down until the police got there. The police thought, since he had so much stuff with him that he was packed for a trip, they didn't know that half of the stuff was mine.

Mental illness was not on our minds, and I think we both assumed he was high on something. The whole thing made no sense, he was already in a truck, why steal one? He was handcuffed and being put into the police car when we got there. We asked, Why?, but he had no answer. I angrily asked what drugs he was on, but he had no answer. He looked sick and confused. We felt sick and confused. They said that they had to question him at the police station before he would be put into the county jail and since it was about 5:00 PM, we wouldn't be able to see him until the next day. We were frightened; the charges against him were serious.

The next day his father went alone to see him. When he returned he was visibly shaken. He said that the things our son said to him made no sense. He could not explain why he was trying to take someones truck. If he had been high the day before, it would have worn off by now. He remembered him saying something about going to New York City to visit his ex-girl friend and her grandfather, because he was in the hospital. He also said he was taking on the sins of the world. A definite Christ reference. We had usually only attended church for weddings and funerals, so the hyper-religiosity was a surprise and a huge tip off that his mental state was not returning to normal. He also did not think our son had slept and he looked awful. My husband tried to get some answers from someone about how to get him out. He was told that the first chance our son could see a judge would be on Monday. We were both seriously alarmed and wondered how to go about finding a lawyer. Do they see people on weekends? I called his ex-girlfriend and she said her grandparents are all dead. She was at home, not in New York, and told me that he had been calling and sending odd emails to her the week before.

The next visiting time, they refused to let his father see him. He was told that our son was misbehaving and tried to flood his cell, so he wouldn't be allowed to see any visitors. He came home, picked me up and we both went back to the jail to get them to have a doctor see him. I was panicking at the thought that he was perhaps insane and that they wouldn't let anyone see him. The guard that came out to talk to us was a gigantic man with an attitude. He did not have any intention of calling a doctor or the Mobile Crisis team. We had never heard of the Mobile Crisis team, so I wrongly assumed it was part of the law enforcement system, like a SWAT team is. But I thought if they could help my son, then call them! He wouldn't and didn't. I was pleading with him that our son was exhibiting signs that he might be insane and he needed to be seen by a doctor. The guard kept loudly repeating, Mam, to me, becoming more angry each time he said it. It finally sunk in that Mam meant SHUT UP, when he said if I didn't shut up and leave, he was going to throw me in a cell! I was already crying and begged again, most obsequiously, asking if there was at least a nurse on their staff who could see him. The guard went through the mighty glass doors and came back a few minutes later and said that our son was with the nurse. That was all he could do and we needed to leave. I found out later from the staff nurse that she never saw him; no medical professional saw him.

We went home and my husband called lawyers until he found one who would meet with us immediately even though it was Sunday. He agreed to go with us to court the next day to try to get the judge to release our son to our custody, to take him to the hospital. The next day in the court room, we were horrified when the prisoners were brought into the room. Our son was shackled hands and feet, hair wild, dead eyes, head down, not walking, but being pushed each stumbling step by a guard. How? What? What had happened to our son? He didn't see us. He didn't look up. Once they were seated, a guard would periodical poke him to make him quit leaning toward the floor. When his turn came, the lawyer made the request to take him to the hospital and the judge agreed, though the charges would still be pending.

It took us three days to get him out of there and into the hospital. It was a total nightmare. His brain was on another planet and his body was bleeding, dehydrated, starved and bruised all over. What he was put through during his time in our county jail was torture. When he could speak a bit more clearly, many weeks later, he told of being tied or strapped to a chair that was then turned to face a wall. He was just left there; his pleas were ignored, they left him there to wet himself and rave in his madness.

I didn't know people were treated so badly in this country, until I saw what their combination of punishment and neglect had done to my son. There could not have been any doubt that there was something seriously wrong with him. They could have called for the mobile crisis team to medically evaluate him, but they never did.

Ironical, it has recently come to light, that our sheriff has been filling huge numbers of fake prescriptions for narcotics for himself, over at least the past few years, but he's still on the job because that's how our system works. He's the man I spoke to on the phone to report the deplorable treatment our son had received in his jail. He didn't know anything about it, but I had the feeling he also didn't care and nothing would be done about it.

I talked to one of the arresting officers while my son was in the hospital, to see if he knew what had happened to his glasses, because they were not returned to us at the jail. He didn't know, but he did solve one mystery for us, he said our son told them that he was trying to take the other truck because a child on the side of the road sent him a telepathic message, to change trucks, as he drove by.