Friday, November 21, 2008

Is It Checkout Time at Bellevue Hospital? -- New York Magazine:

There are countless ways to go crazy in New York City—permanently or briefly, bloodily or peacefully, comically or horribly—but those among us who have ever wondered if our own names might one day be called in that unlucky lottery are generally aware of a key distinction: You can lose it privately or you can lose it publicly. Losing it privately can be resolved by a call to your shrink, or the intervention of family, friends, and colleagues, or medication, or a stay in a private mental-health facility. But if you’re in Manhattan and you happen to be unfortunate enough to decompensate in a manner that involves an imminent threat to yourself or those around you, your day is probably going to end the way it ended for all three of the aforementioned gentlemen: You are going to Bellevue. Bellevue will almost certainly not be the last stop on your personal journey, but it is the single word that, for more than a century, has told the rest of New York City that there is now one less person on the streets about whom it has to worry.

“It takes a lot to get into Bellevue,” says Frederick Covan, who arrived at the hospital in 1980 and served as its chief psychologist until 1994. More accurate, it takes the absence of any alternatives. Bellevue is not for “some Upper East Side suicidal neurotic or whatever—they’d go to NYU Medical Center next door. Our patients were the ones with no money, no resources, and multiple stressors.”

That, or their behavior is so extreme—criminal or otherwise—that no other option presents itself. Merely wandering into the middle of Broadway while muttering incoherently? Probably not enough. “You know, the brilliance of the schizophrenics when they’re directing traffic,” says Covan, “is that they always direct it in the direction it’s already going, so their grandiosity is reinforced. But if they start to direct it in the opposite direction, or if they’re assaulting other people, or if you came in and said you really wanted to kill yourself, not just that you were thinking about it … You know, Bellevue is not the place for you if you’re just not feeling good today and you’re really worried about the stock market.”

5:36 PM