At the end of last year, I was deteriorating quickly.
My psychiatrist said he wanted a second opinion, which was how I ended up in IOP at La Amistad for a while. However, the medical team there wasn’t great, so it was decided that I would be seen at the Mayo Clinic in Rochester, MN.
Mom and I arrived on Sunday, explored on Monday, and my appointments at the Clinic were all done today. It is usually less than 10 degrees here, and there are heaps of snow on the ground. I hate being cold; it reminds me of the abuse I went through in various relationships in winters past.
However, being the artist and aspiring optimist that I am, I’m trying to make the best of the situation by taking photos of all the things I wouldn’t see at home in Florida. At home, photographers make a big deal out of “golden hour,” the time of day when the light is thick as honey and the shadows seem to recline on the ground. Here in the icy north, “blue hour” is what it’s all about. On our second night here, I stood outside and watched the sky fade to a bruised cerulean, the rooftops blushing pink and sweet, and the lights from passing cars were like flames.
There is beauty everywhere. Even in unlikely times and unlikely places.
My first appointment at the Mayo Clinic was a psychiatric evaluation, which I have been dreading for days. I honestly did not believe that anything would come of this adventure. My meds seem to be working better than any other combination I’ve tried, I’m functioning well in society, haven’t missed work lately, and my therapist says she can tell I’m doing very well.
As I’ve mentioned, the idea of me possibly having borderline personality disorder has been thrown around a few times, and I am adamantly against it. Not only is there a massive stigma against BPD, but there is also no medication that can treat it–only DBT (dialectical behavioral therapy), which I have dabbled in and did not like.
First, I met with a young Dr. Evans, who looked like she was about 16 years old. She asked me lots of questions, screening for things such as disordered eating, OCD, PTSD, BPD, and psychosis. I found it difficult to answer her in much detail because I did not know her, and these were very personal questions. She asked me the standard borderline stuff, “Do you feel empty inside?” “Do you fear being abandoned by your family or friends?”
And lastly, “Who are you?” I wanted to snap at her, “I’m Katherine Orfinger, it says so right there on my chart.” One of the main components of BPD is a shifting sense of identity. I went round and round with the therapist at La Amistad about my identity, trying to prove to her that my personality was simply evolving, not disordered. I said to Dr. Evans, “Look, I’m 24 years old. Who am I is a big, philosophical question, and there are tons of different ways to define that. I am a cashier, but I am also a college graduate. I am an observant Jew, and I am a member of the LGBT+ community. I am a mental patient, and I am a published author. You’re going to have to get a little more specific if you’re trying to get a different answer.”
“Mm-hmm, mm-hmm,” Dr. Evans said, scribbling in minuscule handwriting on my chart. She asked me several more rounds of questions, gave me a few forms to fill out, and then left. She came back with another doctor and my mom.
The basic end result of the psych evaluation was that I probably have schizoaffective disorder, PTSD, and maybe BPD. The symptoms for these illnesses all overlap, so it’s very hard to tell what symptom is coming from where. The doctors who spoke to my mom and me were very vague, and didn’t give us much of an answer, at least nothing we hadn’t already heard.
Next up was a blood test, and then we had some downtime. My final appointment was with an internist, Dr. G. I do not like doctors. Whenever I have to visit a doctor for a physical issue, I feel like I’m in trouble, like the doctor is going to scold me for not taking good care of myself, or I’m going to fail a test.
Dr. G. asked surprisingly good questions for a doctor, especially one whose main focus is not psychiatry. I talked to him about feeling like I am not connected to reality and showed him something that I had written to summarize where my reality does not line up with that of others. I was afraid that it would be “too weird,” that they’d stick me in a padded room against my will or something. But this doctor was very friendly. He joked around with my mom and me, told us a little bit about himself, and then asked me to step into the next room for a brief physical exam.
My other least favorite thing about doctors is that they usually have to touch me to do their jobs. I am not much of a hugger, I hate a friendly pat on the shoulder, and I will jump six feet high if someone comes up behind me without warning. Personal space is my best friend. Besides that, I was a little on edge being in a small, windowless room, alone with a man I did not know. I tried to remind myself that to a doctor, bodies are just part of the job, and he’s seen just about everything. Still, I began to feel paranoid. “Are you okay?” Dr. G. asked me. I nodded. “Are you sure?” I nodded again. He did all the necessary poking and prodding and I took the hospital gown off and got back into my warm winter clothes.
“I don’t think it’s schizophrenia,” he told us. “I think that you’re a very healthy young woman, and that it’s probably schizoaffective like you thought. You’re going to be fine. You’re going to be a little odd, but you’ll have a good life.”
My experience at Mayo Clinic was by far the best psychiatric experience I’ve had. Although there were no major breakthroughs or miracle cures, I feel better knowing we left no stone unturned. So many other doctors have treated me like a problem to be solved, a mere diagnosis on a piece of paper, or a list of symptoms. I’ve had doctors who overmedicated me to the point where I was sleeping so much I had to set multiple alarms to be at work at 5:00 PM. One doctor put me on lithium at age 15. One doctor would accuse me of using illicit drugs or not taking my medication. I’ve had them dismiss symptoms, nearly give me serotonin syndrome when I was on painkillers after surgery, and on and on.
Today’s appointments were not about fixing a broken brain. They were about getting a comprehensive view of everything that’s going on with me, how past trauma influences today’s challenges, and how I can better face said challenges. I was treated like a whole person, not just a mental patient. Although not much has changed, perhaps I have reached the finish line. Perhaps this really is as good as it gets. As I told one of the doctors with whom I spoke today, I am satisfied with my life. I am so much better than I was at the end of last year. I know that some people stay on the same medication for years and years, rather than constantly switching things up, hoping for incremental improvements. I am hoping that this is the golden ticket, the right medication combo unique to my body, and that this will enable me to stop thinking so much about what I can’t do because of my illness and focus on what I can do despite it.