Institutionalized by Choice: My Thoughts on Life In The Cuckoo's Nest

February 2, 2026 

Michael Cline, Author

Tom O'Connor, Publisher

There was a time in my life when I was a bit out of my mind. I didn't exactly know it, but the signs were there. Still, I made the best of my time in the loony bin and learned that I wasn't all that crazy, and that my mental health issues were partly self-inflicted and partly made up.

Sure, I was crazy. That came from my childhood, which was unfair, cruel, and chaotic. By age 7, I learned to stuff my feelings and, like a light switch, turn off my emotions. It was easy to do so in my early youth, but after years and years of bottling up all that harmed me, eventually I sought out other means to keep things deep down in that internal, dark place where I kept my demons.

By age 23, I had left my hometown, hoping that I could leave my trauma there, and moved to New York City. My new chosen home was downtown in the East Village. This was long before gentrification killed the neighborhood's seedy yet creative soul. That part of town had a reputation for crime, punk rock, graffiti, trash, and my eventual demise, heroin.

I quickly learned that this particular, easy-to-get narcotic, which seemed to be used and abused by half of my neighborhood, was an excellent product for quieting my pain and trauma. Unfortunately, it's also quite good at destroying lives, mine included. Quickly hooked, I stupidly strolled into oblivion for five years, losing everything.

Eventually, I found myself hopeless and helpless, and left the city. Both of my parents had died by the time I turned 13, and I returned to the home of my grandparents, the ones who raised me. I was still hooked to the gills, and after some rather unpleasant days, I reached out for help.

They had fifty years on me and hadn't a clue how to help. My grandmother called her doctor, explained my situation, and asked for advice. The good doctor mentioned getting me into rehab. Still, without health insurance and having already signed myself out of several programs AMA (Against Medical Advice), that was out of the question.

He suggested that they bring me to the emergency room of a nearby public hospital. I was deep into a painful withdrawal, and he believed they could help me or send me to a place that could. Not having any other options, and my grandparents absolutely refused to allow me to buy the drugs that would immediately make me temporarily well, I reluctantly agreed to go.

We took our place in the long line at our local public hospital, located in a not-so-nice part of town. I was so dope sick that I could hardly stand. For a person with an addiction who is hopelessly hooked, heroin is like oxygen. Without it, we panic as if we are drowning. From my prior experience, I knew I wasn't even experiencing the worst of what was surely to come.

Once it was my turn to be seen, a jaded admissions clerk rolled her eyes when I approached the window. She already knew what was coming.

"Why are you here?" she barked at me. "What's your medical emergency?"

I was sweating and shaking, and I knew I looked bad. Through a half-smile, I quietly whispered, "I'm dope sick. I'm a heroin addict. I need help." I was not prepared for her response.

"We ain't no rehab," she said with an annoyed tone. "Next!"

I told my grandparents the news. They were obviously disappointed. My grandmother walked away from my grandfather and me, over to a pay phone near the Emergency Room's door, picked up the receiver, and dialed a number. After a very brief conversation, she returned to where we were standing.

Her doctor explained that if I tell the admissions clerk that SHE's feeling suicidal, they'll legally be forced to admit me to the hospital's psychiatric ward and hold me for a minimum of three days. This strategy seemed deceitful, but this wouldn't be the first time that I had manipulated someone to get what I wanted.

Ignoring the line at the admissions window, I went to the front and stood next to the person being helped. "I'm going to kill myself," I blurted out matter-of-factly. The woman who had just told me the hospital wasn't a rehab rolled her eyes and said someone would speak to me soon, and to have a seat. It was apparent she didn't believe me, but rules are rules.

Within minutes, I was greeted by a young woman who asked me to follow her into an office. She introduced herself as a mental health counselor, and while she wasn't what I would call friendly, she did treat me with far more respect than the jaded clerk had. She asked me to sit down and fill out a questionnaire.

"So, you have a heroin addiction, I see," she said while flipping through the papers on her clipboard. "And you want to harm yourself. Is that correct?"

Sensing that she may doubt my threat of self-harm, I doubled down. "Yes, that's correct. I'm in withdrawal, and I'd rather slit my wrists than endure another second of living. Either you help me, or I'll leave this hospital in a body bag."

"There's no need for that," she said. "Please remove your shoelaces and belt, and place them on the table." I did as instructed. A nurse arrived, took my blood pressure and temperature, and weighed me. I was a haunting 109 pounds, far below the 135 I had weighed prior to heroin taking over my life.

With that business taken care of, the counselor had me sign a form that stated I was voluntarily admitting myself to the psychiatric ward. "Follow me, please. Catholic Charities will pay for your stay here since you do not have medical insurance."

I entered a small room that contained only a hospital gurney. Its cement-gray walls were devoid of anything interesting, save the occasional hairline crack or cobweb. Sitting down on the gurney, I was told that someone would see me shortly. The door shut with a loud clank, and I could hear her lock it from the outside. Locked in, all I could do was wait.

I've no real idea how long they left me in that locked and empty room, but it seemed like an eternity. With each passing moment, the absence of heroin in my body caused me more and more pain. Dropping my laceless shoes to the floor, my body collapsed on the weathered gurney. My mind raced, but at least I knew that even if I had the money and the means to score a bag, I was safely locked up in a hospital observation room.

Oddly, the thought of being held captive was comforting. Quickly, the thoughts of buying dope to fix what ailed me left my mind. Lying prone on the gurney, I absently stared at the small CC camera that was bolted high up on the wall in a corner. I was being watched.

I woke to the sound of jangling keys as the large metal door opened. Two men appeared wearing white lab coats. One introduced himself as a psychologist, but the other one remained silent. The head shrink asked me a series of questions.

1. What's your name?

2. Do you know what year it is?

3. Who is the President of the United States?

4. Do you know where you are?

5. Do you ever hear voices?

Although weak, I pushed myself up into a sitting position and answered his questions. Fearing they were looking for an excuse to get me out of there, I told him that I did hear voices, but I knew they weren't real. And to add a bit of flair to my fabricated story, I threw in that I sometimes saw orange fireballs glide by me, close to my temples.

He nodded and wrote some things down on his clipboard. "Grab your shoes, Michael, and follow us." Without further conversation, they led me into the hallway and into an elevator. We exited on the third floor, and I was escorted into a sally port. The first door read in large black block letters: 3 EAST, PSYCHIATRIC WARD.

We were buzzed in, and the second sally door opened after the first closed. The shrink and I entered the locked-down unit affectionately known as Three East, or as I called it, the Loony Bin.

The psychiatrist introduced me to the head nurse and then abruptly left the unit. Again, my vitals were taken, and the nurse looked over my chart. With a friendly smile, she looked at me. "You're lucky. The unit has thirty beds, and one had just opened up an hour ago. How are you feeling? How's the withdrawal?"

I felt that her smile was genuine. To be honest, I didn't know what to expect. A part of me figured the nurses would be Nurse Ratched types—cold-hearted and emotionless—but I couldn't have been more wrong. Throughout my withdrawal and afterward, I received a more than acceptable level of care.

The first order of business was to get me started on medication. The psychiatrist prescribed me Haldol. My best guess is that I was given this antipsychotic medication due to my lies about hearing voices. As a drug addict who couldn't get his drug of choice, I was completely okay with whatever they forced me to take. The second medication was Clonidine, which the nurse told me would help lessen the severity of my opioid withdrawal symptoms.

After I had swallowed both pills and proved that I had done so, they brought me to my room. I was pleasantly surprised upon entering the room, as it wasn't what I expected. From the carpeted floor to the tasteful framed artwork on the walls, it looked more like a budget hotel room than a psych ward.

The room had two beds, and one was occupied by a guy about my age, completely covered in blankets. "He's going through withdrawals like you," the nurse told me.

Exhausted and feeling rough, I crawled under the covers and tried to sleep.

I was rudely awakened the following morning by a woman yelling, "Vitals! Everybody up!" Somehow, I had slept for a solid twelve hours, something I had never been able to do when suffering through dope sickness. It could have been the medication, or perhaps the knowledge that I couldn't leave the locked-down unit unless I had Houdini-like skills. Either way, I felt a little better.

I crawled out of bed and joined the other sleepy patients in line. A nurse was taking our temperatures and blood pressure. She did so with a smile, and since it was 5 in the morning, the entire unit and the rest of the hospital had a calming stillness.

This was my first chance to look around. The common area consisted of a wall-mounted TV and several plastic chairs and tables. Meals were served here, and it also doubled as a hang-out area when patients weren't in mandatory group therapy sessions. The rooms were laid out on two different hallways. Between them was the nurses' station, where medication was dispensed. At the end of one of the hallways were men's and women's communal showers and two doors leading into what were referred to as "quiet rooms," or, as some of the patients called them, the "rubber rooms."

I quickly learned that half of the patients were in a similar experience to mine. Strung out and out of options, people with an addiction, both homeless and housed, signed themselves into the psych ward on phony suicide threats. Three East was a haven where they'd be able to ride out their withdrawals with no way of getting out, while also getting free medical attention and meals.

Our days were all the same. Once our vitals were taken, we got our meds and waited for breakfast. I had entered the unit at 109 pounds, far below my normal 135. Being so malnourished due to active addiction, I was allowed to have two trays of food for each of our three meals. While most abhor hospital food, after years of living off a slice of pizza or a candy bar every few days, to me, it tasted as if it came out of a five-star restaurant.

The people with an addiction had to attend daily Narcotics Anonymous meetings, and it was my first taste of "the rooms." A few of the patients balked at the mandatory meetings, grumbling, "I don't need this." Willy, the counselor who ran the groups, always kept things honest. "Oh really?" he'd mock. "Look where you are! People without drug and mental health issues don't voluntarily admit themselves to psych wards!"

My withdrawal wasn't too bad, and within five days, I was back to normal. Feeling human again, I fell into the daily routine and happily chatted with all the patients during our downtime. Time flew by, and before I knew it, I had been in the unit for 15 days. I was compliant with my medication, even though I knew I didn't need it, because I wasn't psychotic and didn't hear voices.

"Michael," said the head nurse. "I need to speak with you. Please come to my office." I had no idea why she wanted to see me.

Once in her office, she smiled and said:

Listen, I've been doing this for a long time. I know it's wild when I see it. You're a smart guy, and you don't belong here. You're probably afraid to leave, since you know that you can't get heroin here. However, this isn't the way to recovery. If you're held here for 21 days, your next stop will be the State Psychiatric Hospital, and it's nowhere as lovely as it is here, and once there, it's tough to get discharged. Is that what you want?

Her words hit me hard. Suddenly, I felt like McMurphy, the character in Ken Kesey's novel, One Flew Over the Cuckoo's Nest. He played crazy so he could go to a psychiatric hospital, naively thinking that he could avoid prison by doing so, when in fact, his prison sentence wouldn't begin until he actually went there.

Thinking fast, I admitted that I never heard voices and wasn't experiencing any mental health issues other than being a down-and-out junkie who had run out of options. She said she'd set up an appointment for later that afternoon for me to tell the same to the head psychiatrist. It would be his signature that would get me out of the unit before I hit day 21.

Two days later, I was released.

While I don't regret my time in the psych ward, I do feel as if I somewhat abused the system and took a bed away from someone with real mental health issues. I could relate to the other addicts there, but it was easy to spot the ones who truly needed to be there. They didn't have eyes like mine. Their eyes were soulless, like those of a doll.

If you enjoyed this, you should check out one of the two books I've written. My Adventures in Tuva covers a lifelong love of a place no one's ever heard of, and New York City Junky Days chronicles my life in Manhattan's East Village.

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Michael Cline can be reached at michaelcline2323@gmail.com

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