SPAZ
SPAZ
By Peter Tannenbaum
2007
“….But I, being poor, have only my dreams;
I have spread my dreams under your feet;
Tread softly because you tread on my dreams.”
William Butler Yeats.
skew@clear.net
1 UNIVERSITY ……………………………………………….. 5
The road to hell is paved with good intentions.
2 SEATTLE …………………………………………………… 14
From the frying pan into the fire.
3 YARD WORK …………………………………………………. 18
Anyone can be tripped by a small
pebble.
4 SLEEPLESS ……………………………………………….. 22
“There is a pleasure sure in being mad, which none but mad men know.” John Dryden (17th Century).
5 DREAM ………………………………………………… 27
While the brain sleeps, the mind dreams.
6 PRAGUE ………………………………………………….. 32
Don’t curse the darkness light a candle.
7 STODDARD’S CAFÉ …………………………………………. 38
Psychiatry is not science.
8 THE LAKE REFLECTS THE MOON ……………………………. 44
Many miles to go before we sleep.
9 SHIP OF FOOLS ………………………………………………… 50
A fish out of water.
10 TRUTH NO JUSTICE ……………………………………………. 57
“And your brothers shall return you sword to you.”
Aleksandr Pushkin (1827) Message to Siberia
11 SLEEP IN THE STARS ………………………………………… 62
-1-
UNIVERSITY
“Whom the gods would destroy, they first make mad.”
Euripides; Greek tragic dramatist (484 – 406 BC)
Peter Trees grew up in Michigan, just down the road from the University. He was a shoo into college. Peter found college confusing; he did not remember much of what he read. He got financial aid, worked part time, and got help from his parents. During his junior he spent a semester in DC as an intern in the Senators Office. As a student intern Peter was assigned to write a short paper about Public Inebriates. After the internship ended Peter returned to college. During summer recess, his senior year he needed a job to make money. Peter looked in the news paper; nothing at all. He went to the student center and looked on the job board: “Night Security Guard wanted for Art Fair. Friday and Saturday. Cash. Call number.” Peter called from a pay phone. He met the artist; a friendly person with a big mustache.
“I am a student,” Peter said, “on summer break; a U of M senior.”
“I can use you to guard my tent at the Art Fair; Friday and Saturday nights, while the fair is closed.” the artist said.
“OK,” Peter said. “I’ll meet you in the evening when the f air is closing.”
Peter lay awake in his tent on State Street most of Friday night; guarding art work. He dossed down and remembered the previous month:
Peter drove alone in his used convertible MGB to visit Washington DC. On route he camped out in Virginia; he did not sleep very well. The next day he arrived in DC. There he met someone he knew from college and spent the night in her laundry room. Peter was out of money. The following day; a construction company allowed him to work for cash for the day to buy gas for his car. That evening he headed for the highway, he was very tired. He drove to Ocean Shores Maryland, parked his car on sand next to the highway to rest; he was stuck. A bunch of roughnecks driving around drunk in a pick up truck stopped and helped him push his car out of the sand. Peter took a ride with them to drink beer; they stopped near the beach; one swung at Peter, he ducked and ran, then hitchhiked to find his car.
The next morning Peter drove west; half way through Virginia he pulled on to an off ramp and slept with his head resting on the steering wheel. He awoke to the sound of a cop pounding his billy club on the side of his car door; “Can’t sleep here,” cop said. Peter continued on the highway, praying his car would not breakdown. He was almost out of gas; he picked up a hitchhiker named Strawberry. They rattled along the highway, he asked her for gas money; she opened a switch blade, then put it away and agreed to help pay for gas. A few hours later he dropped her off at a truck stop near St Louis.
In St Louis he called some friends he made during college; they invited him to sleep in there attic. It was hot in Saint Louis and he wondered if he had slept at all. The next day Peter got a job fundraising, door to door for Acorn Citizens Lobby; he made five dollars. Peter did not consider the pay good enough to keep the job. It was a short drive north to Michigan; his old car rattled on the highway. Peter landed at his parent’s house.
Peter was glad he had a job sleeping in a tent at the fair. He wondered if the paintings on the wall swayed with the wind. There was no wind. Peter spent the next morning wondering about the art fair; in the afternoon he went to his second job painting a hallway for a friendly medical student.
That night he returned to his tent on State Street. The next day he knew enough to collect his forty dollars; a job well done deserves honest pay. Peter was sleep deprived and could not function. He walked around the art fair watching the world tumble around; he felt like he was doing summer salts. (Sleep deprivation was causing insanity and delirium.) He walked to the hospital that afternoon; they gave him some drugs (mellaril), called his parents, and let him go. He left the hospital and hailed a cab; he wrote the address of his parent’s on a piece of paper and handed it to the cab driver. (The mellaril was bad for Peter, it made his body foreign to him, it made him tired, and tightened his muscles making him think he was being twisted.)
That evening Peter was in the Nero Psychiatric Institute at the University of Michigan (University Asylum) drugged by doctors with stelazine (to end thoughts) and Cogentin (to prevent the stelazine from causing muscle spasms). Diagnosis: paranoid schizophrenia, (DSM III 295.31) a brain chemical imbalance. Hospital admissions report states that Peter “…was suffering from numerous somatic delusions, including that he had worms in his body and a bat in his stomach….” The asylum hoped to save Peter from insanity. The antipsychotic drug Stelazine caused permanent brain damage.
The university psychiatric Tower of Babel in 1983 used the DSM III (1980) definition of Schizophrenia:
A) Diagnostic criteria for a Schizophrenic Disorder: At least one of the following during a phase of the illness:
(1) Bizarre delusions (content is patently absurd and has no possible basis in fact), such as delusions of being controlled, thought broadcasting, thought insertion, or thought withdrawal
(2) Somatic, grandiose, religious, nihilistic, or other delusions without persecutory or jealous content.
(3) Delusions with persecutory or jealous content if accompanied by hallucinations of any type
(4) Auditory hallucinations in which either a voice keeps up a running commentary on the individual’s behavior or thoughts, or two or more voices converse with each other
(5) Auditory hallucinations on several occasions with content of more than one or two words, having no apparent relation to depression or elation
(6) Incoherence, marked loosening of associations, markedly illogical thinking, or marked poverty of content of speech if associated with at least one of the following: (a) blunted, flat, or inappropriate affect (b) delusions or hallucinations (c) catatonic or other grossly disorganized behavior.
B. Deterioration from a previous level of functioning in such, areas as work, social relations, and self-care.
C. Duration: Continuous signs of the illness for at least six months at some time during the person’s life, with some signs of the illness at present. The six-month period must include an active phase during which there were symptoms from A, with or without a prodromal or residual phase, as defined below.
Prodromal phase: A clear deterioration in functioning before the active phase of the illness not due to a disturbance in mood or to a Substance Use Disorder and involving at least two of the symptoms noted below.
Residual phase: Persistence, following the active phase of the illness, of at least two of the symptoms noted below, not due to a disturbance in mood or a Substance Use Disorder.
(1) Social isolation or withdrawal
(2) marked impairment in role functioning as wage-earner, student, or homemaker
(3) markedly peculiar behavior (e.g., collecting garbage, talking to self in public, or hoarding food)
(4) marked impairment in personal hygiene and grooming
(5) blunted, flat, or inappropriate affect
(6) digressive, vague, over elaborate, circumstantial, or metaphorical speech
(7) odd or bizarre ideation, or magical thinking, e.g., superstitious-ness, clairvoyance, telepathy, “sixth sense,” “others can feel his feelings,” overvalued ideas, ideas of reference
(8) unusual perceptual experiences, e.g., recurrent illusions, sensing the presence of a force or person not actually present.
Examples: Six months of prodromal symptoms with one week of symptoms from A; no prodromal symptoms with six months of symptoms from A; no prodromal symptoms with two weeks of symptoms from A and six months of residual symptoms; six months of symptoms from A, apparently followed by several years of complete remission, with one week of symptoms in A in current episode.
D. The full depressive or manic syndrome (criteria A and B of major depressive or manic episode), if present, developed after any psychotic symptoms, or was brief in duration relative to the duration of the psychotic symptoms in A.
E. Onset of prodromal or active phase of the illness before age 45.
F. Not due to any Organic Mental Disorder or Mental Retardation.
The DSM III definition of schizophrenia, had duped the University Asylum which doped Peter. Really Peter had severe sleep deprivation. The prevalent philosophy of the University Asylum in 1983 was to label lots of people schizophrenic and give them drugs. Peter was drugged to “sleep,” with stelazine, yet the REM he needed to recover his sanity was inhibited by that antipsychotic. In the asylum Peter hallucinated (hypnopompic) cats crawling out of windows and getting into fights. After one week of rest, food, and drugs, Peter was interviewed by a panel of doctors then released. Peter left the asylum a changed man; brainwashed to believe he was a schizophrenic. Peter did not know what that meant.
Freedom: Peter walked out of the asylum with a bottle of pills and found his car parked where he left it. That evening Peter met a college co-ed; he drove her to the gravel pit, they went skinny dipping and made love in the twilight.
Peter was not a very good student, he was not good at spelling, his grade point average hovered just below a C. Peter needed three courses to complete his Bachelor in General Studies.
If he had DSM III schizophrenia, a brain chemical imbalance, the University Asylum had 1952 DSM Paranoia:
This type of psychotic disorder is extremely rare. It is characterized by an intricate, complex, and slowly developing paranoid system, often logically elaborated after a false interpretation of an actual occurrence. Frequently, the patient considers himself endowed with superior or unique ability. The paranoid system is particularly isolated from much of the normal stream of consciousness, without hallucinations and with relative intactness and preservation of the remainder of the personality, in spite of a chronic and prolonged course.
Peter saw a psychiatrist at the University every week for several months. His, “chronic brain chemical imbalance, schizophrenia,” was treated with antipsychotic medication. “Don’t forget to take your meds every day.” his psychiatrist told him. Her prescription for stelazine, later changed to mellaril, put Peter in a state of unknowing. She told Peter it was important to take the drug every day. She explained to Peter that he was a schizophrenic. With antipsychotics exacerbating sleep deprivation, Peter’s psychiatrist brainwashed him to believe he was a schizophrenic.
The Handicapped Act of 1976 was there to protect him. It required all schools receiving any state money to educate all their students (including the handicapped). Peter was found to have a brain chemical imbalance. He did not apply for special education; instead he was interviewed by the Social Security Administration and given SSI (crazy pay). Five hundred dollars per month seemed like a lot of money. His social worker explained to him, that it is important to understand that you are insane.
With help from his parents, a psychiatrist, and some medication; Peter rented a room in a college co-op. The co-op was good, friendly, well intentioned people. Peter was given a triple shared with two room mates. One of his room mates attempted to teach him how to do a roundhouse karate kick. His bed was a mattress on the floor. While he lived there in 1985, he published a few short articles in the student news paper. One night he took all the fruit and flowers from the kitchen and put them around his bed and lay down and dreamt that he died. ((The antipsychotic medication had caused a sleep breathing disorder. Strange complex, central and muscle obstructed sleep apnea, created by prescription drugs, plagued Peter most of his adult life. That night time nightmare of death, gifted to Peter by the DSM and EliLilly, Peter might have though was the schizophrenia that he had been told he had. So he took more pills to mask the nightmare of death.))
Peter was not a very popular student. The antipsychotic pills that treated his “schizophrenia,” ostensibly eliminating “hallucinations and voices,” caused cognitive impairment. The University was a very competitive place and people who did not know “what’s up” did not get very far. Peter missed graduating by three courses; he had learning and memory difficulties. His college girlfriend was an art student. While he was living in the co-op on antipsychotics (meds), she graduated and moved to New York City; he never saw her again. The most difficult part of “schizophrenia” was feeling social isolated. Graduation from college seemed unimportant and impossible. Ignorance was not bliss. Peter dropped out.
Peter took a job as a bus driver for University Transportation, he drove the 6:00 AM student shuttle bus, around the university campus in circles. One morning while driving the bus, he clipped a sign post and shattered a side view mirror: “…eight years of bad luck….” (The antipsychotic drugs created muscle movement difficulties as soon as he started taking them.)
Peter quit his job driving the bus, and flew west.
-2-
SEATTLE
“The fish are the last to discover water.”
When Peter arrived in Seattle ((he visited several friends he grew up with in from Michigan;)) he had his antipsychotic pills with him. He was a guest of Matt P for a while and a guest of Rick B, both from Peter’s home town. After a few weeks in Seattle, he rendezvoused with Aaron, whom he had met during college. Aaron liked to take LSD and walk in the park. Aaron told him about a room for rent in a house in the Capitol Hill neighborhood, in the house lived Lance and Linda. Peter rented it. Asleep in his room, Peter had nightmares about being hit by golf clubs at four in the morning. He took his meds to help him sleep.
Peter got a job life guarding at a city swimming pool. Peter had several flings with young beautiful women on Capitol Hill. The pool re-tested lifeguards at two week intervals; Peter was fired in a fortnight. A few days later he was thrown out of his house by his house mates Lance and Linda. Lance and Linda thought he was too straight; they did recreational drugs, he did prescription drugs. After Peter was thrown out of his house; Aaron let Peter store his belongings in the basement of the house where he was renting a room. Aaron’s house had a basement fire and Peter’s belongings were burnt and soaked with water.
Peter rented another room and found a job, life guarding at the Mercer Island Jewish Community Center. He was fired the next day for being too tired. He went to a doctor and got a script for more antipsychotic drugs (meds) for schizophrenia; so he would not get fired again. A few days later Peter was hired by the YWCA to teach swimming; and fired for confused thinking; he almost fell asleep in the pool. Three strikes and he was out of the lifeguard chair.
Within three years Peter had rented rooms in five different houses. Peter had nightmares of being crushed and smitten during the night. “Did ‘they’ kill me during the night?” he wrote in his note book, “Was I crushed by forces?” Peter had a sleep disorder, ((to ameliorate it he took antipsychotic drugs which made it much worse. Antipsychotic drugs inhibit REM causing madness.))
Peter finally rented a room in an old rooming house in the residential Roosevelt neighborhood; he kept the same address for seven years. ((He spent about 12 years in the Roosevelt neighborhood?)) He was hired at a Residential Youth Shelter, located the downtown YMCA. At the orphanage they said, “Take yo meds.” The job lasted one year then the shelter was closed. The first weekend off from his job, just after he cashed his pay check he was mugged by “white trash” just off Broadway on Capital Hill. One punched him the other grabbed his wallet and stole his money.(Peter liked the staff he worked with at the shelter.)
Peter’s Roosevelt neighborhood rooming house had wild parties. One night after he got drunk with his girlfriend, Firefly, a student of massage, they went to his room and made love. He awoke with her yelling at him; “You had a seizure, you were shaking all over.” “Where was I?” he asked his thin blond Firefly. That morning he got out of bed and went to the hospital for an EEG (brain wave scan). The results were normal; doctor said there was nothing wrong with his brain waves. He thought Firefly had caused the seizure. ((Probably it was a reaction to antipsychotic drugs that had a cumulative effect on Peter.)) Firefly moved to Arizona, Peter stayed in Seattle.
Peter enjoyed: music jam sessions, camping trips, smoking cigarettes, gardening, drinking beer, and taking antipsychotic pills. He was hired as a helper at the University of Washington Physics Department. Two months later he was fired for being too “slow.” He got another job at U of W Oceanography doing data entry; a few months later he was fired for pressing the wrong button on a computer. He worked telephone sales and was fired. He did volunteer work at Greenpeace, and made friends.
Peter did yard work and weeding part time to make money. He often felt alone; he figured he would die young. He was convinced his crazy pay (SSI) was hexed, so he spent a couple of years with no crazy pay, hoping that if he really needed money he could dream up a way to make it. (Really the prescription meds he was addicted to were poisoning his mind unto stupidity and disabling his brain and inhibiting his REM sleep.) He was getting hungry, going to the free food church, and relying on handouts form his parents. He kept applying for jobs, going to work, and getting fired. Some nights he could not sleep, in bed he often imagined a fish flopping out of water, he did not know what that meant. He took his sleeping bag to the park and attempted to curl up under a tree; he could not sleep and walked home. He was forced to get more crazy pay.
Peter went to the local 45th Street Medical Clinic and told the clinic Doctor Alison Fitzgerald, what the University Asylum had told him years ago in Michigan; he had schizophrenia. Peter’s father called Dr. Fitzgerald to tell her what the University Asylum had told him; that Peter had schizophrenia. The doctor agreed it was schizophrenia; she prescribed more antipsychotic pills to end his nightmares before they ended him. Peter used them as sleeping pills. He considered the pills a curmudgeon to hit demons in a nightly crusade to be free of evil persecutors that were attempting to kill him in nightmares. Peter saw the clinic counselor several times who conferred with the doctor; their conclusion: more pills for schizophrenia. ((His nightmares were caused by sleep apnea exacerbated by antipsychotic.))
Aaron rented a room in a house in the Roosevelt neighborhood. They met for beer occasionally. Aaron used to say, “Profigleane,” “Youz pays your money and you takes your chances.” ; “Sleep with your finger up your nose.” ; “feckless”; “Fuck em if they can’t take a joke.”; “Go get lost on a golf course.” ; and “Never drink beer with anyone unless you can fuck his sister.” “I’m serious as a heart attack.” and “My mother takes foot long shits.”; “Whip you with a wet noodle.”; You cant be serious.”
Aaron invited Peter to several music parties at Aaron’s house, Peter met some friendly people. Aaron drove and they camped next to the ocean at an International Rainbow Gathering in Vancouver Canada. Peter watched Rainbow People swimming naked in the ocean. That evening they sat next to a crackly beach fire and ate seaweed soup and giant Vancouver Island mussels. A few years later Peter and Aaron played in the same volunteer orchestra. After several concerts, Aaron quit the orchestra and relocated to Montana, to do environmental work. A month later Aaron visited Peter in Seattle and gave Peter a ride to Montana. Peter was too doped up on meds to know what was going on. In Montana Aaron lent Peter his studio and Aaron slept at his new girlfriends house. A few days later sleep deprived and doped up on poisonous antipsychotic medication; Peter took the Greyhound to Seattle. In Seattle and continued playing in the orchestra.
Peter also went camping in the Olympics and Cascades with his friend Robert. Robert lived in an art studio in Pioneer Square; he was good at reading and auto mechanics. Robert built bicycles from scrap abandoned bike parts and sold them for hundreds of dollars. Robert was a vegan. A few years later Robert relocated to California.
Peter liked nature a lot. Peter and Peter's friends, camped, backpacked, hiked, cross country ski-ed, hot tub-ed, fished, and even climbed a couple of mountains with his friends. Usually Peter brought his antipsychotic pills to the mountains they made it was easier to sleep in his tent at night.
In the city Peter played music in an “open mike” band, Lightning and the Thunderheads; they preformed in bars. Peter played trombone; Chuck S played accordion; and Lightning JD played guitar and vocals. They drank beer and played, On the Streets of Bakersfield.
-3-
YARD WORK
“The blind leading the blind.”
Peter worked yard work and interior painting for five years. He and his friends drank beer in the bars around town. He took pills so he could get sleep and go to work. In the morning; he’d smell the coffee and go to work, painting, or digging ditches. Two shovels to the right, two shovels to the left. He did yard work at a church on weekends for ten dollars per hour: he pruned bushes, raked leaves, scraped the grass out of cracks between sidewalks, picked up trash, shoveled dog shit off the grass and buried it in flower beds.
Legally, in the State of Washington, fewer than nine thousand dollars per year for one person was poverty. Peter had lived at about the poverty level for seven years. One evening Peter imagined that someone put a giant jar of honey on his head and bees crawled all over his face; he considered it a schizophrenic hallucination. Antipsychotic drugs had inhibited his dopamine and serotonin neurotransmitters. Insect hallucinations, similar to coke bugs, according to the Merck Medical Manuel Home Edition 2003, indicate neurological damage caused by drugs. Peter was too sleep deprived and doped up to know what that meant. The doctor recommended antipsychotics so Peter took them; they seemed to help him stay in bed at night and rest and be unaware of his nightmares.
In a tuxedo Peter bought at a thrift store, he played his trombone in a concert with his volunteer orchestra at Benaroya Hall. They played, Rimsky Korsakov’s Scheherazade. After the Benaroya Concert Peter quit the orchestra.
A few months later Peter could not figure out the difference between brain and mind; he vomited several times in the street. He returned to the 45th Street Clinic and explained to Doctor Fitzgerald that he had nausea and terrible nightmares. She prescribed more antipsychotic drugs for schizophrenia. Peter was addicted to antipsychotics. Peter explained to the doctor his body twisted when he relaxed, and he was nauseous, he did not know why. Doctor wrote Peter a three month prescription for antipsychotic drugs; he took the script, got the drugs, and never saw her again.
Peter switched to the Country Doctor Medical Clinic. They allowed him to see counselor Jay and Dr Brad Roter. After several sessions with counselor Jay, the doctor and counselor conferred; then Dr Roter wrote Peter a script for more antipsychotic medication for schizophrenia (zyprexa). Zyprerxa inhibits dopamine; Peter did not know what that meant.
There are eight dopaminergic pathways in the brain, the four major ones are (for 17 years antipsychotic inhibited all eight?):
mesolimbic pathway: influences feelings of pleasure.
mesocortical pathway: is essential to the normal cognitive function of the dorsolateral prefrontal cortex (part of the frontal lobe; affects memory), and is thought to be involved in motivation and emotional response.
nigrostriatal pathway: involved in the production of movement.
tuberoinfundibular pathway: refers to a population of dopamine neurons in the arcuate nucleus of the mediobasal hypothalamus…. Dopamine released at this site regulates the secretion of prolactin from the anterior pituitary gland. Affects growth hormones.
(Antipsychotic drugs inhibit all of these pathways. Inhibiting these pathways turned Peter into a sociopath. Peter’s social skills were inhibited. The depth and understandings of human relations were inhibited. He had difficulties keeping friends and relations. Inhibiting these pathways (about fifteen years) created memory loose and caused stupidity and blunted Peters brain. Permanent damage to all dopamine pathways?)
His ability to do arithmetic, balance his check book, was inhibited and he was some how unaware of the permanent damage to his brain. Peter and his doctors somehow misinterpreted the drug inhibited dopamine affect as schizophrenia and prescribed more drugs. The sicker the drugs made Peter the more antipsychotic drugs he was told to take)
To make money, Peter attempted to learn some trades: carpentry, landscaping, cooking, and painting. He had some friends and they helped him. He did not learn the trades fast enough to make money. He learned how to paint apartments.
In 1997 Peter drove a friend, Rebecca F, to the National Rainbow Gathering to camp out. Walking past the medical tent in the Rainbow Gathering Peter noticed Doctor Brad Roter volunteering there.
When Peter returned to Seattle he decided to take some courses at the Community College. Peter’s grades at the community college were no better than his grades at the University. Peter did not learn much, he could not remember. Peter dropped all his courses except jazz band.
Peter looked in the newspaper want adds and found a job painting apartment interiors. Peter was still playing in his bar band and had a girlfriend, Laurie, to sleep with on the weekends. Life was improving; after work one sunny afternoon he was driving south in his car towards town. Simultaneously an eighteen year old yuppie from California was driving north at sixty miles per hour. The yuppie crossed the center line and crashed head on into Peter’s 95 Toyota. Peter did not have his seat belt on and was going about thirty mph. For a moment he could not breathe; he struggled for his life.
Medics pulled him from his car, put him on a stretcher and drove him to the emergency room. Peter thought he was paralyzed; he lay motionless on his back unable to move, waiting for x-rays. “Are you on drugs?” the doctor asked him. “Zyprexa,” Peter responded. At 6:00 p.m. the x-ray results: not paralyzed. He lay on a stretcher waiting for more tests results; at 10:00 p.m.: no concussion. One more test, for internal bleeding; “We will have to operate tonight,” said the doctor. At 2:00 a.m. they slit Peter open, searched his guts, found a small tear in his mesentery, repaired it, then stitched him shut.
Peter spent one week in the hospital, he could not walk for three days. He spent one month at home on his couch recovering; his friends and his cat Tiger kept him company. He took opiate prescription pain pills instead of antipsychotic. They helped him quit smoking and relieved pain. He liked them much more than the antipsychotic drugs. Doctor would only allow one months supply of pills, they were like heroin, highly addictive. Peter recovered from his car wreck and thanked his lucky stars he was still alive.
Peter consulted an old friend from Michigan, Matt Perkins, who used to say, “I’d rather have a bottle in front of me than a frontal lobotomy.” He was a lawyer. They sued the yuppie who crashed into Peter and won seventy five thousand dollars in an out of court settlement. Peter paid his hospital bills, credit card bills, and repaid his parents some of the money they had lent him.
Peter flew to Hawaii and snorkeled with green sea turtles. He brought his antipsychotic pills with him to help him sleep and control nightmares.
A few months later he went to Europe. He brought a small bottle of antipsychotic pills to help him sleep. He spent a week in Amsterdam drinking beer and getting blow jobs from whores in the Red Light District. He also went to the Anne Frank House, Van Gogh Museum, and Rembrandt Museum. Then he flew to Athens Greece; he stayed near the Acropolis for a week. Peter read a little about Hippocrates, the father of western medicine. While walking alone on the Acropolis Peter felt like he was going to fall to the ground. He wondered if his vertigo was caused by bed bugs in his mattress or the Greek liquor Ouzo.
-4-
SLEEPLESS
“While the brain sleeps the mind dreams.”
Upon retuning to Seattle Peter surfed the internet and found an article about nightmares associated with “sleep paralysis.” It sounded like his mind. He called the hospital and made an appointment with Sleep Medicine. The following is Dr. Loube’s report on his condition after their first meeting:
Re: 2002 sleep lab consultation
CHIEF COMPLAINT: Going to bed feeling that he will die by the end of the morning.
HISTORY OF PRESENT ILLNESS: Mr. Tree is a 44-year-old gentleman with untreated schizophrenia and bipolar affective disorder. He has been largely noncompliant with Zyprexa and in the past he discontinued Haldol, Cogentin, Stelazine, and Mellaril, because of concerns for dyskinesia and also a concern for progressive “brain death.” …He is in bed from about 23:00 until 07:00 in the morning and sleeps fairly solidly, but when he wakes up at 07:00 he fears that his brain has stopped and that he has been crushed by some type of forces during his sleep. This type of sensation has been present for many years. These symptoms are somewhat improved by sleeping in different locations such as sleeping in a youth hostel in another city or sleeping on the couch rather than sleeping in his bed. He is concerned that he has sleep paralysis ….
PAST MEDICAL HISTORY: Bipolar affective disorder, schizophrenia, and status post-abdominal trauma in December of 2000.
MEDICATIONS: Zyprexa 25 mg on a p.r.n. basis.
REVIEW OF SYSTEMS: ….He feels panicked and has anxiety throughout the day, as well as difficulties throughout the day with the sensation that there is screaming and crying occurring in his mind, which he cannot suppress. This could also be a problem at night.…
FAMILY HISTORY: Negative for known sleep disorders….
SOCIAL HISTORY: He is a chef who is currently not working. He smokes tobacco through a pipe and has occasional marijuana use and he does not drink. There is no recent illicit drug use.
PHYSICAL EXAMINATION: Height 70 inches. Weight 201 lbs. BMI 28.84. Vitals: Blood pressure 128/68….
ASSESSMENT/PLAN:
Sleep-related anxiety: I would like to see him started back on
antipsychotic medicati
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