Abstract

Ronald Reagan once said, "The most terrifying words in the English language are: I'm from the government and I'm here to help." President Reagan's quip was intended to amuse, unlike the story I am about to share. With solemnity and with all seriousness, I will borrow from his remark and make a short list of a few more terrifying words in the English language. My list of terrifying words, after 25 years serving as a professional in the mental health and substance abuse service delivery system and currently as administrator of the federal Substance Abuse and Mental Health Services Administration (SAMHSA), would be seclusion, restraint, and "doctor's standing orders." Not long ago, I had several hours to think about this list. Toward the end of a recent hospital stay, a medical error was made that left me voiceless in my own recovery, alone in a hospital room, and immobilized by indescribable pain. I was admitted to a hospital to undergo surgery for a kidney stone. Less invasive procedures were not available to me, because the stone was too large. Throughout most of my hospital stay I received excellent care from the entire medical team assembled around me to