Patient Health Questionnaire – 9
1. Little interest or pleasure in doing things?
Have you ever been caught in a sudden rainstorm where you’ve had to run from doorway to doorway to get home and you walk in the house with your shoulders soaked, feeling something close to joy? Am I supposed to answer these questions with a yes or no? There’s just never enough rain.
2. Feeling down, depressed, or hopeless?
I am more or less sad all the time.
3. Trouble falling or staying asleep, or sleeping too much?
Sometimes when I can’t sleep I think about what I’ve lost on airplanes. Once I left a book at the airport before we boarded but I don’t know if that counts. I still think about the main character, how her life was about to unravel, like when you pull on a loose thread and now there’s a hole in your sweater. Did you know a placebo can work even if the patient knows it’s a placebo? If I think about that too much, I have trouble getting out of bed in the morning.
4. Feeling tired or having little energy?
Remember standardized tests, when the proctor would say, Time’s up, please put down your pencil. I spend whole days waiting for somebody to take the pencil from my hand.
5. Poor appetite or overeating?
I drink coffee in the morning, a glass of wine in the evening. Sometimes I stand at the open refrigerator door and drink milk straight from the carton.
6. Feeling bad about yourself — or that you are a failure or have let yourself or your family down?
I remember being small and crouching at the top of the stairs listening to the grown-ups’ laughter long after I was supposed to be asleep. Sometimes I still forget to come downstairs.
7. Trouble concentrating on things, such as reading the newspaper or watching television?
Do you know the difference between a pebble and a rock? A pebble is just a smaller version of a rock. Nobody would say, A pebble rolled down the mountainside and crushed my house. If I throw a rock at your window, the window might break. If I throw a pebble at your window, you might look outside and see me under the grainy streetlight. Maybe you would invite me in, offer me a cup of tea, ask if I wanted to sit next to you on the couch and watch a television show.
8. Moving or speaking so slowly that other people could have noticed? Or so fidgety or restless that you have been moving a lot more than usual?
Last week at my book group while everybody was ping-ponging clever comments, I closed my eyes and counted to ten, but I don’t think anybody noticed.
9. Thoughts that you would be better off dead, or thoughts of hurting yourself in some way?
Are you still listening? Shouldn’t you be jotting down some notes? How will you remember what I’ve said? Have you ever taken a CPR class? We had one at work today. The EMT started by saying, Once you’re dead, you can’t be more dead. He meant to encourage: even if we forget to lock our elbows or tilt the head back or apply compressions at the proper rate, the worst has already happened. Mostly I think the opposite is true.
Editor’s Statement (written by Associate Poetry Editor Mark Robinson)
In Patient Health Questionnaire – 9, Michelle Matz provides a brilliant antidote to the countless number of forms one must complete in order to get healthcare. The imagination runs away from the speaker in the very first response, where the answer becomes a question and ends in the blunt declaration: “There’s just never enough rain.” The responses continue throughout to appear random, though gain a subtle necessity as we go—with topics ranging from items lost on airplanes, beverages, eavesdropping on adults as a child, the difference between a pebble and a rock. I love how the poem displays the wanderings of the speaker’s mind, and how at the slightest prodding Matz’ associative skills emerge in language.
I often find questionnaires difficult to complete. Even when the answer is seemingly a simple yes or no, I want to answer with “maybe” or “sometimes” or “it depends.” I came across the PHQ-9, a tool for diagnosing depression, when researching something else entirely, and after reading through it, knew I would never be able to answer the questions as intended. I started playing around with it and answering from a place of poetry.