Raymond Abbott

Be a little patient with people, and the rewards can be significant

April 11, 2020Apr 11, 2020

Correna is full of simplistic Henny Youngman-type one-liners (many of you readers, I understand, may never have heard of the comic, Henny Youngman, but no matter). But her one-liners are not particularly funny. She might say as we drive along,…

She might say as we drive along, “I am SOB,” (Stuck or broke) or “CRS,” (can’t remember shit), or “SOS,” Stuck on Stupid, and her favorite one, which has no initials is “The world is full of idiots, …

The aftermath of a suicide attempt

March 25, 2020Mar 25, 2020

In November each year, I usually attend an all-day conference in Louisville on the subject of depression. Some of it can become a little grim, but there is an especially tasty free box-lunch that I appreciate. Suicide is a big…

Suicide is a big subject at depression conferences. One might expect this to be true. The focus is on suicide prevention, which is as it should be.

The discussion is usually led by university professors, and …

The aftermath of a suicide attempt

An interruption from an evangelist

March 21, 2020Mar 21, 2020

Charles looks older than his sixty-one years; he is very thin and quite stooped, and his eyes are what I guess are described as "lazy." One goes one way, and one another. He is badly in need of dental work.…

Charles looks older than his sixty-one years; he is very thin and quite stooped, and his eyes are what I guess are described as “lazy.” One goes one way, and one another. He is badly in need of dental work. He has emphysema, though he continues to smoke heavily. His coloring is not right, and overall, he looks unwell.

But for the almost ten years I’ve known him, he has never …

An interruption from an evangelist

This patient is more than just a street person

March 11, 2020Mar 11, 2020

When I first landed this job as a case manager (social worker), I was given Robert R. as a client. He was at his worst then, soiling himself virtually every day, with no change of clothing available. I remember him…

When he would come in in such a condition, sometimes even tracking in feces on his shoes, …

Patient voices

Can a rehabilitated sex-offender make positive change?

March 7, 2020Mar 7, 2020

Ed is not from Kentucky. I believe he told me he is from West Virginia and from a very low-income family. At about 15, he was hit by a car and paralyzed from the waist down. He's now about 30.…

Ed is not from Kentucky. I believe he told me he is from West Virginia and from a very low-income family. At about 15, he was hit by a car and paralyzed from the waist down. He’s now about 30.

But for a guy in a wheelchair, he is nothing short of remarkable for what he gets done. He goes everywhere, either by his own strength or by bus, even on …

When a patient planned to kill a social worker

February 29, 2020Feb 29, 2020

It all began on Valentine's Day when I arrived at my office and listened to my messages from the afternoon before. There was only one from a nurse at the state mental hospital. She had just seen, she said, a…

It all began on Valentine’s Day when I arrived at my office and listened to my messages from the afternoon before. There was only one from a nurse at the state mental hospital. She had just seen, she said, a Mr. Lonnie M. and was calling to alert me (there is a law to this effect) that Lonnie had expressed very hostile feelings toward me, quite specific in nature.

He planned …

My patient isn’t doing well. Is it my fault?

February 18, 2020Feb 18, 2020

The front-desk clerk, Ruth, comes to me and says Rose Henderson wants a cab voucher signed — which guaranteed payment. Rose could not be made to understand, Ruth tells me, that we are not permitted to sign vouchers when the person, the client, comes to our offices solely for the purpose of picking up cash … which is Rose’s purpose.

We are Rose’s payee, which means we handle her money. I …

Physician voices

Everyone has their moments. Even doctors.

February 9, 2020Feb 9, 2020

I sit in Dr. Victor's small crowded waiting room, awaiting my turn. I am seated between two women, the one on my left probably 45, and the one on my right, somewhat older, both though younger than me. The lady…

I sit in Dr. Victor’s small crowded waiting room, awaiting my turn. I am seated between two women, the one on my left probably 45, and the one on my right, somewhat older, both though younger than me.

The lady on my right doesn’t have much to say beyond telling me where she is from, and she is seeing Dr. Victor for the second time. The woman to my left is …

Could this patient have been saved?

January 31, 2020Jan 31, 2020

Wiley Boynton is dead. I first heard the news when Katie, a colleague, called me on my cell phone. Wiley had been taken to the hospital with a knife wound. I asked her right away: "Self-inflicted?" "I think so," she…

Wiley Boynton is dead. I first heard the news when Katie, a colleague, called me on my cell phone. Wiley had been taken to the hospital with a knife wound.

I asked her right away: “Self-inflicted?”

“I think so,” she said.

A self-inflicted knife wound might be possible, I figure with someone like Wiley, considering the violent world he came out of. I know quite a lot about him.

Wiley is around 40 years …

Could this patient have been saved?

Preceding traumas lead to current ones

January 22, 2020Jan 22, 2020

Anita is 37 with blonde, wild, disheveled hair. She is overweight, has bad teeth, wears too much make-up, and is severely depressed — sometimes psychotic. She tells me she often hears voices. And she constantly complains that the medicine she…

She has severe anger and is in an anger-management group at our offices. Each …

Preceding traumas lead to current ones

Can a unique boarding home save my patient?

January 18, 2020Jan 18, 2020

James is a tall, lanky Caucasian man, well into his 40s. He has brown curly hair and is not a bad looking fellow except for the vacant look in his large brown eyes. He is a pacer, which is a…

James is a tall, lanky Caucasian man, well into his 40s. He has brown curly hair and is not a bad looking fellow except for the vacant look in his large brown eyes. He is a pacer, which is a manifestation of his illness, and a consumer of excessive amounts of water.

You have to talk right at James to be understood. I try to make eye contact. Sometimes he doesn’t …

Patient voices

The suicidal patient who couldn’t be placed

January 13, 2020Jan 13, 2020

Mr. Fine is in for the eleventh time in less than a week. I work as a social worker in a hospital emergency psych unit. Mr. Fine is suicidal again. It is kind of late in the evening when I…

Mr. Fine is in for the eleventh time in less than a week. I work as a social worker in a hospital emergency psych unit. Mr. Fine is suicidal again. It is kind of late in the evening when I see him, although it is my first time, I am the only social worker on tonight.

This is the usual situation, one social worker per shift.

The psychiatrist takes me aside, quietly …

Speaking to cancer as if it were a person

January 2, 2020Jan 2, 2020

I'd known Ellis for years — he once hired me for a social work job. Yet when I think of Ellis Ledger, I remember him best the night I encountered him outside of his apartment building. I was out late…

I’d known Ellis for years — he once hired me for a social work job. Yet when I think of Ellis Ledger, I remember him best the night I encountered him outside of his apartment building. I was out late walking my dog. Ellis stopped to talk. He clearly was drunk, not falling-down-drunk (he never was), but feeling no pain, as they say, and he was upset about something important …

Getting pregnant may have saved her life

December 25, 2019Dec 25, 2019

Mary Beth is a female in her early 30s, quite obese and mildly mentally repaired, as well as suffering from schizophrenia. She lives in a housing authority apartment, which is not a great place. But being highly subsidized, it is cheap! Her apartment is in a perfectly dismal condition. She lives in absolute squalor with garbage strewn around, and I am unable to figure out what to do about it. …

The indignity of a cancer that takes away bowel functions

December 12, 2019Dec 12, 2019

I first became John Dolan’s social worker following his colon surgery, surgery for removal of a very large cancerous tumor, the largest the experienced surgeon said he had ever seen. John was told he had about three months to live.…

To the chagrin of his very large Catholic family, he was one of thirteen children; he was all the time rejecting their …

Patient voices

What will happen when the mentally ill get older?

November 27, 2019Nov 27, 2019

Jacob is just past 30 by a year or two. He is, as I like to describe him, a little boy trapped inside a man's body and very much mentally ill. He started off with fetal alcohol syndrome, which means…

Jacob is just past 30 by a year or two. He is, as I like to describe him, a little boy trapped inside a man’s body and very much mentally ill. He started off with fetal alcohol syndrome, which means his mother drank heavily when she was pregnant. I am not sure I believe that diagnosis is correct, by the way. Fetal alcohol syndrome is a much more complicated condition …

Is your doctor a marijuana user? Maybe you should ask.

December 31, 2015Dec 31, 201518

Marijuana use today is not limited to the poor, the marginalized among us; nor is it kept in the inner city, as it pretty much was when I was a kid. Now it is widespread, even legal in some states. One might even make the argument it has become a substantial part of the life of the elite, the affluent of America. And when we think of elite and powerful …

Drugs and prescribing

Would heroin addiction be the price of legalizing marijuana?

December 11, 2015Dec 11, 201522

I am a bit of a coin collector, and recently I visited my favorite coin shop in downtown Louisville. I was met with this news: A coin dealer I know in Austin, Indiana had been killed recently, murdered in his own coin shop, shot in the head by robbers. Four persons were later arrested when coins belonging to this elderly man were found in their possession. Austin, Indiana is, by …

Who’s to blame for this psychiatric failure?