“You gotta help me, Dr. Freedman. They’re gonna keep me here forever!”

Ahrele was a young man from a chassidishe family who’d suffered abuse at the hands of a relative, dropped out of the frum world, stumbled on the idea of psychedelic drugs to self-medicate, and ended up in a psychiatric hospital. Part II

Less than three weeks after Ahrele had been to my office, threatening to trip out with his friend Tamir if I didn’t provide him with hallucinogens, he wound up in the locked ward of a psychiatric facility at the edge of Jerusalem. I heard about it from his father, Reb Leibush, who begged me to come visit and see what I could do. I’d visited this particular hospital a number of times to do second opinion consultations; it was clean, well-staffed, and respectful of frum Yidden (there were several Orthodox psychiatrists and nurses on staff).

I was greeted at the door of the ward by a nice fellow named Effy, who introduced himself as Ahrele’s nurse and brought me into the common area where Reb Leibush was sitting.

“Dr. Freedman, baruch Hashem you came! They’re treating him like an animal, you have to help him!” he said as he stood up to greet me and glared at Effy.

Effy, to his credit, didn’t take it personally. “What he means is that we have had to keep him in restraints because he keeps lunging at the staff and even managed to bite a doctor during his admission to the unit.”

Effy walked back to the nurses’ station and left me with Ahrele’s father, who proceeded to tell me his version of the story.

Apparently Ahrele had arrived at the house late Motzaei Shabbos screaming unintelligibly, accompanied by a friend — that same no-goodnik named Tamir who had recommended psychedelic drugs to him in the first place. Neither Reb Leibush nor Tamir were able to calm Ahrele down as he began frantically taking off his clothes and sprinted out of the building. It wasn’t long before he was tackled by the police and brought to the psychiatric hospital in a severely disturbed state.

It wasn’t a rational Ahrele who had refused to cooperate with the staff since he arrived, it was a suffering young man in a different world. One could only imagine what his brain was experiencing as he felt compelled to dress like Adam Harishon before the Eitz Hadaas and spring through the streets screaming. One could only guess what he was trying to communicate even now, 24 hours later, as he struggled in the leather straps that bound him to a bed in the “Quiet Room.”

To Reb Leibush’s dismay, Ahrele was clearly unable to engage in any meaningful discussion with me at the current time.

“But can’t you get him out of this state?” he implored.

I explained to Reb Leibush that Ahrele had most likely taken psychedelic mushrooms and had a bad trip. The same chemicals that this young man hoped would wash away his pain had triggered psychotic symptoms that, given their severity, were unlikely to simply disappear.

It wasn’t the time to scare him with research suggesting that up to a third of individuals experiencing psychosis due to hallucinogenic medications would end up progressing to serious, chronic mental illness. There was no need to frighten him with the word “schizophrenia” and all of the stigma that goes with it. Rather, I sought to reassure Reb Leibush that while being held in a locked psychiatric unit wasn’t the most pleasant experience, it was what Ahrele needed now. It was the safest place for a young man suffering from a drug-induced psychosis.

Reb Leibush thanked me for my time and asked if I would come back to consult on the case the following day. I reassured him that Ahrele was at a fine facility and that it wouldn’t be of much help to anyone until Ahrele had calmed down and was able to engage in a more meaningful conversation. At the very least, he needed to be out of restraints and be able to demonstrate enough interpersonal safety in order to avoid going back into the Quiet Room.

And in fact, two days later I received a call from Ahrele himself, asking if I could meet with him.

“Dr. Freedman, you gotta get me out of here!” he pleaded.

“I’ll come tonight,” I told Ahrele, explaining that I needed to finish up my work at the clinic and say goodnight to my kids first, even as he begged me to drop everything I was doing and rescue him from the hospital.

It was close to 9 p.m. when Effy opened the door to the psychiatric ward, where I found Ahrele pacing anxiously.

He ran toward me and squeezed my hand hysterically as soon as he saw me. “You gotta help me, Dr. Freedman. They’re gonna keep me here forever!”

Effy had updated me that Ahrele’s agitation was much better controlled with the antipsychotic medication he was being given. But apparently, he remained paranoid and still had some time to go before he’d be ready for discharge.

“Dr. Freedman, this is a prison! They tied me up and forced me to take medicines!”

“Ahrele, this is the right spot for you right now,” I urged him.

“Dr. Freedman, I think I broke my brain when I took those magic mushrooms. I think Tamir broke my brain and now I’m going to be crazy forever.” He began sobbing hysterically as he lay down on the floor. “I’ll kill him when I get out of here for breaking my brain!”

There was a chance that his mind would never rebound from the drugs, but the odds were that he’d recover, and that was certainly what I was davening for. I sat with Ahrele on the hallway floor for a few more moments and calmed him until Effy helped him into his room and offered him a sedative to sleep through the night.

“If you can’t get me out of here, Dr. Freedman, will you at least visit me again tomorrow?”

“Just give me a call, Ahrele,” I told him. I imagined we’d need a few more days before we could talk about his plan after discharge. He definitely wasn’t prepared to leave any time soon.

As I walked toward the exit, I reminded myself that while a mental hospital wasn’t a hotel, it beat a jail any day. And for someone who needed acute psychiatric treatment like Ahrele, it was the safest and best place in the world.

As Effy unlocked the door for me and I wished him a good night, he hit the nail on the head: “This kid may think our hospital is torture, but the only prison he’s trapped in is his own tortured head.”

To be continued…

(Originally featured in Mishpacha, Issue 825)