District of Columbia Government Bureaucracy: A Nameless Number on a List that Later Got Mislaid

In Boris Pasternak's novel Doctor Zhivago, the author poignantly describes a character whose existence in the Soviet State was reduced to veritable dust:

"One day, Lara went out and did not come back. She must have been arrested in the street at that time. She vanished without a trace . . . forgotten as a nameless number on a list that afterwards got mislaid, in one of the innumerable mixed or women's concentration camps in the north."

I have often thought of those words when dealing with the D.C. Department of Mental Health.   Kenneth Smothers, M.D., a psychiatrist with a private practice, has been associated with the D.C. Department of Mental Health for many years.  Dr. Smothers rents an office in my apartment building. 

On June 22, 2005 I wrote Dr. Smothers the following email message out of desperation.  I have never spoken to Dr. Smothers.  I do not know if he read this email.  Perhaps he knew nothing of it.

And the U.S. Marshal wants to know why I write a blog?  Isn't writing a blog preferable to alternative choices made by other people in my situation?

Dr. Smothers:

I am a patient with the DC Department of Mental Health. I have a case manager and a psychiatrist. I have been a patient with the Department since July 1996, nearly 9 years. 

My situation has only worsened over the years. I have no family or friends. I am totally socially isolated. I experience my situation as very painful. I am writing to you because no one will listen to me. My psychiatrist treats me like an object to be pumped full of medication. He shows no evidence whatsoever that he is aware that I'm a human being. My therapist doesn't listen to me. She only offers advice, exhortations, and repeated recommendations that I attend my local synagogue (I'm not even Jewish, technically speaking). 

It's totally bizarre. Last year, 10 Metro DC police plus FBI backup (four special agents) came calling at my door. A letter I had written had alarmed law enforcement. I said to one of the officers: "This situation needs to be resolved." I was told in the most vehement voice, "Oh, this is going to be resolved. Believe me, this is going to be resolved TODAY. We're going to see to that." That was October 12, 2004. What did the police do? NOTHING. They transported me to DC General. I had a forensic psych exam. I was then sent home. The psychiatrist simply recommended that I speak to my therapist. 

But as I say, my therapist doesn't listen to a thing I tell her. She simply cajoles me and recommends that I attend my local synagogue. "What do you think I am?" she says. "Someone who you can chat with as you would a friend over a cup of coffee?" Well, the fact -- the reality -- is I have no friends. No one. NO ONE NO ONE NO ONE NO ONE. I may as well be the only human on the moon. In a case like mine, to fail to empathize with my desperate situation is an act of cruelty. 

In my situation, I need someone to listen--as a friend would over a cup of coffee. I know you are a very intelligent man, a graduate of the Georgetown University Medical School, one of the country's premiere medical institutions. I reside at 3801 Connecticut Avenue, where you have a private office. You do not know who I am, but I know who you are. 

I've decided to write to you periodically. What do I do in a case like mine? My situation came crashing down on me today. I had an appointment with Gail Newman, an employee with Supported Employment (room 464, around the corner from your office at Spring Road). She missed my last two appointments. Last week I waited two hours for her. She never showed up at the appointed hour. 

You are familiar with Supported Employment? "More walk, less talk?" "A Unique job for a unique person?" Well, Ms. Newman -- I don't blame her personally -- it's the system -- but she works in an office in which the computer doesn't work, and her telephone doesn't even work. She said basically that she couldn't help me. She could have told me that over the phone. Why did I have to wait two hours to finally be told that she couldn't help me? She told me to call the Rehabilitation Services Administration. Great. She said all she does basically is help people write a resume, and she helps with job applications. Well, I already have a resume. And I think I know how to fill out a job application. I have two law degrees. I passed the bar exam in Pennsylvania. I think I can fill out a job application. 

My reality has hit me that things will never change for me. Month after month my psychiatrist will hand out pills, and my therapist will tell me to attend my synagogue. I will spend the remainder of the week laying on my couch and staring into space, watching Woodie Allen in the movie "Deconstructing Harry." -- "Mr. Farber, will you excuse me for just one moment?" (That's a line from the movie, a line that has a special resonance for me.) 

Yes, that's my entire life. I might add, like Woody Allen, my one regret in life is that I'm not someone else. My life is odious. Do you ever hear patients say that? Do you help people? Can't something be done for me? Can't someone just listen --"like a friend over a cup of coffee?" I know I can do something. "Something." 

I am reminded of the battle cry of the Third Estate in France in 18th-century revolutionary France. "What is the Third Estate?" -- "Everything." "What has the Third Estate been until now?" -- "Nothing." "What does the Third Estate wish to become?" -- "Something." I would just like to become something or even just "Something." 

Do you know what it's like to be a "Black Man" in America? That is my plight. Marginalized and hopeless. I'm not suicidal. But I sometimes wonder, purely hypothetically, what would the Powers do if they were to get a phone call some day. "Mr. Freedman was found dead in his apartment today. An apparent overdose of diphenhydramine, which he purchased because his psychiatrist refused to prescribe Ativan, a medication of proven effectiveness for Mr. Freedman's insomnia." What will they do? They will think of all the things I -- yes, I -- failed to do. "Well, he never told me he was so anguished. He never tried to tell me how despondent he was. He never seemed to seek help for his problems. He could have talked to me at the clinic, but he never bothered to do that. It's all his fault. He should have called me and asked for an appointment." 

Self-destruction. "A Unique Outcome for a Unique Individual," if you catch my drift. Listen, Doctor, what I've decided to do is to chat with you regularly. It's purely anonymous. You have no idea who I am, of course. You don't know who my psychiatrist is, or who my therapist is. It will be like an anonymous confessional. All I request is that you listen LISTEN LISTEN LISTEN LISTEN LISTEN to me, screaming, screaming in the darkness. I'll write again tomorrow. Maybe you could take this letter up with the senior people at the DC Department of Mental Health. 

Your friend.

P.S. I miss Mardi. Why did they let her go?

I wish I could be friends with Dr. Dolinsky, a tenant in apartment 600. He's a cool guy.