A homeless man sleeps in the Gaslamp Quarter of San Diego. Photo by Chris Stone
A homeless man sleeps in the Gaslamp Quarter of San Diego. Photo by Chris Stone

My maternal grandmother’s China closet holds my inheritance from her: her favorite art deco vase, one solitary ceramic swan, eight Desert Rose plates, cups and saucers. She probably had bipolar disorder like me, had episodes that left her raving about being sexually assaulted by her 10-year-old brother, or injected with drugs by strangers in the night who also poisoned her food.

Grandma was confined in a sanitarium in 1950, given the cold water treatment and who knows what else. I shudder at visions of her being swaddled with icy wet blankets, half-drowned, freezing water cascading down while she thrashed and cried out, begging, helpless to escape.

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Her husband put her there. Was it easy? Was it just on his word? Had she objected? What had she wanted? If I could, I would summon her ghost and ask about that.

Summoning the ghosts of those days stirs nightmares and dread in those of us with tendencies to peculiar thoughts, mania or obsessions, who watch the world through windows curtained with fear. I identify with the ardent desire to avoid involuntary treatment. But the shoe fits poorly, pinching my toes, rubbing my heel.

My own involuntary hospitalizations have been like wearing steel-toe boots without the right socks. They slid around a little, but my toes were protected from impulses best left unspecified.

As I responded to treatment, grew slowly sane, I bore witness to the journeys of my fellows,
bore witness sometimes to miracles I thought were akin to the raising of the dead.

The catatonic returned to life, the utterly fearful, restored to trust, the fearless saved from ruin and certain death — I witnessed these transformations in locked wards. I have seen sanity restored where there was only despair, delusion, rictus grins or silent stares.

Some were healed by the place itself. The unhoused sometimes recovered given a safe spot to sleep, three meals a day, structure, empathetic support and abstinence from the street drugs relied on to help them stay awake all night — the most dangerous part of their day.

But it appeared that for others it was the pills, shots or shock treatments, sometimes taken willingly — sometimes not — that produced the most profound changes.

Here in California, they can’t make you take meds without a court order, something reserved for only the sickest. So, many refuse. Some grow thin as a shadow because they will not eat. Others become insensate to all but hallucination and delusion.

A few minds contract until what is left resembles a wooden doll leaking urine. Some men and women grow so sick they require medical intervention to save their lives — dying with their rights on, it’s been called. Even then the advocates who guard the rights of everyone to refuse treatment argue for the bare minimum of intervention.

I think about them, the men and women whose lack of understanding endangers their lives. I was lucky, knew I was sick, knew I was where I needed to be. I understood my salvation came in a capsule. Medication isn’t perfect — I have the tremor to prove it — but the alternative would have been death at my own hands.

On a drive home in the rain, I passed an emaciated man wearing nothing but shorts standing on the edge of the freeway onramp. He rigidly rotated in space, arms outthrust — twisting down to the ground, up into space — an animated bird constructed of tinker toys. As I took out my phone to call for help, I pondered the need for shoes that fit and when coercion might become compassion.

No need to wonder, to summon my ghost to know what I would want in his shoes. I would want involuntary confinement and treatment. I embrace the imperfect steel-toe boots of the 21st century and feel grateful for them every single day.

Patricia Wentzel is a peer advocate and case manager for NAMI Sacramento and serves on the Sacramento County Mental Health Board. The author wrote this for CalMatters, a public interest journalism venture committed to explaining how California’s Capitol works and why it matters.