Author: mad reaper

Hey, dude, I gotta ask ya… (Part Two…)

Remember, there are no dumb questions.
Oh, how many times we’ve heard this! This, of course is offered to folks attending a class, seminar or anything else offered to educate, train, or expand their knowledge. You don’t want anybody to feel inhibited whilst striving to improve themselves. It puts us at ease knowing that whatever pops from our mouths at such times isn’t opening the door for ridicule. I reckon it’s an attitude that should be held by all, regardless of the setting or situation, that some inquisitive soul should feel safe approaching you with a query without fear of being scoffed, dismissed, scolded or kicked in the groin. With the exception of children and the intellectually challenged- either by genetics or brain injury- this is bullshit. Idiots abound, and not just a few of them have PhDs.

You don’t have to be stupid to ask a stupid question. I see “stupid” as transient, something that can overtake a capable thinker at any given moment. It’s not conscious, it just happens. It can be fleeting, or persistent. It can be caused by extraneous factors like stress, shock, exhaustion or just a plain old bad day. Even laziness will trigger it, like somebody just doesn’t feel like spending the time or energy to figure something out on their own, though they’re utterly capable. “Why doesn’t this lawnmower start?”
“Maybe you should check the gas.”
Or, “This plant looks like it’s dying, should I water it?”

Those aren’t the dumb questions I’m talking about. It’s the ones I get that are related to my job and asked by people who do it just for the sake of asking. “You ever seen a dead guy sit up?”
“No.”
“‘Cause I’ve heard they do.”
“They don’t.”
“I heard it was from rigor mortis.”
“It doesn’t work that way.”
“Well, a buddy o’ mine’s dad worked in funeral home, and he said…”
“He’s either full of shit or yankin’ your chain.”
On that subject I’ll add: fingernails don’t keep growing, and neither does hair. A corpse will, on rare occasions, sigh, belch or fart when you roll them over. Air or gas sometimes is trapped in their belly or bowels, especially if CPR was performed on them. First time that happened to me I almost hit the ceiling. The “old wives tales” aren’t so bad, but it’s the crap based on “psuedo-science” that’s annoying and, quite frankly, stupid.
“If you jump off a building or bridge high enough, aren’t you usually dead before you hit the ground?”
“Huh?”
“Yeah. I heard the air pressure combined with fear and knowing you’re gonna die will stop your heart.”
I imagine that would make hitting the ground a lot more comfortable, but I don’t buy it. I’ve also been asked: “Is it true people hear beautiful music and feel euphoric just before they drown?”
Having never drowned, I replied I wasn’t qualified to answer. I will say, however, the basis of sexual asphyxia is grounded in oxygen deprivation, so the above tidbit could have some merit.
“If you get in a really bad car accident and hit the steering wheel hard enough, will your eyes fly out of your head and hit the windshield?”
No.
“Will it make you puke your guts up? Like out of your mouth?”
Never seen it. (You can “shit your guts out” though, and live to tell about it. Check out some power lifting videos on YouTube. Knee-buckling stuff.)
“What’s worse, getting shot or stabbed?”
A subjective question, I’ll wager. I’d have to guess as to where on your person you’d been shot/stabbed, how many times, and the size of the knife or caliber of the weapon employed to even attempt to offer an opinion. I can say this, though: I’ve never had a guy who’d died of a gunshot wound say to me, “Well, at least I wasn’t stabbed.” So, if death is the ultimate outcome, I’d say the question is moot.
And this from cop as we stood over a guy who’d plummeted about ninety feet from a bridge onto an asphalt bike path: “Do these guys bounce?”
Truthful answer: It depends on two things: how they land, and what they land on. If the person lands fairly flat they may take a single, very low- an inch or so- hop off brick, concrete, asphalt, hard packed gravel, stone or even thick ice. A steel deck or platform may even act something like a trampoline, but you’ll still only get one bounce. Not so with plain soil or sand. Our gentleman did not make such a landing. He hit heels first, straight up and down. In fact, for all practical purposes, he was still standing, albeit about two or three feet shorter than he was at his pre-plunge height. The long bones in his legs, femurs, tibiae (shin bones, people) and fibulae (the other one in your lower leg) acted as shock absorbing crumple zones. Though not designed for such a purpose they performed astonishingly well, shattering- exploding perhaps a more accurate description, with several chunks of bone that had blown through his skin scattered around him- and leaving him resting upright on his pelvis, which hadn’t fared much better than his legs. It didn’t take a degree in physics or serious study of kinetic effect on the human body to see there hadn’t been any bouncing going on here. In this case I’ll grant the Officer a little slack. I make an allowance considering that, even in his world, this was a sight that was appropriately jarring. Coupled with that, and certain to have added to his distress, the moron he was stuck with- me- found this sight from his perspective as “one of the coolest fucking things” he’d ever seen.

The above questions may be stupid, in my opinion anyway, yet they have an element of innocence to them. A person can’t expect anybody that doesn’t do the same type of work to have any glimmer of what’s fact and what’s nonsense. “Ya don’t know if ya don’t ask.” And one of my core beliefs is that to discourage curiosity is the gravest of sins. Therefore I meet them without succumbing to derision. I make every effort to correct and clarify. Sometimes an inquiry is prefaced by: “This is probably a stupid question, but…” And if it truly is, I will heartily agree- then answer it.

(Okaaay… Off for a long weekend! I thank all who check this out. Most grateful. Would love it if you’d drop a line or two. Have a great Labor Day weekend…. Wear your seatbelts.)

Hey, dude, I gotta ask ya… (part One…)

Switching from the psych ward to the morgue. I didn’t want to get into another history lesson right away, so I’m starting with this.

I’ve alluded before to the “What’s the weirdest/hardest thing you’ve ever done/seen?” I’m going to add “worst” because it also is asked, and seems to make a nice bridge between weirdest and hardest. Three different questions, yes, but I lump them together because it generally comes out to mean the same thing to the person asking. Experience lends one a certain prescience, and depending who’s posing the question you almost always know what sort of answer they’re looking for. If it’s “weird” they’re after, it’s most likely seeking an account of somebody hopping off a building and getting impaled on a fence or a flagpole. Weird seems to get tied in with suicide for some reason. They want an ending with a “twist.” Something cringeworthy. If it’s “worst” it could be the same thing, though with a more empathy inspired motivation in the asking, or it’s a brutal murder or some poor bastard who’s been rotting on his kitchen floor for six weeks. Then they’re after shock or disgust. “Hardest” without fail is related to children, and it’s the question most often qualified with the trailer “it’s got to be kids.” I’ll go with “weirdest” first.

The twist at the end. Rare, and often amusing, but nothing I’d call weird. A leap off a bridge or lunging from a sidewalk into traffic usually never goes totally according to plan. These are often acts of impulse. If jumping, you’ve got to factor in windage, the site of the jump and the landing area, which is not what people often consider when making such a decision, and hurling yourself into traffic is dependent on the reaction speed of the poor sod chosen to put an end to your worldly suffering. (The only suicide-by-getting-in-the-way-of-a-moving-vehicle that I’ve found foolproof is putting yourself in the path of something traveling on rails.) I could go on and on, but I won’t. So, for the first time in my history I will give you the weirdest thing I’ve encountered firsthand: A guy was found dead in his bed, lying with his head in a pool of congealed blood as big around as a hubcap and thick as a pork chop. For all its appearance, it looked as if somebody had snuck into this guy’s bedroom and planted a bullet in his skull. Crime lab, sealed residence and the whole works were put into action and his residence was held pending the results of our exam. The final determination: Exsanguination (he bled out.) Why? He’d incurred a rather deep cut on his forehead less than an inch long. No bullets, no knives, no shady crime whatsoever. It was an innocuous accident that killed this guy. Making a long story short, he’d been chipping shale to line the floor of a fish tank. In the process a shard flew up and struck him in the forehead at the hairline. His liver was shot from many years of alcohol abuse and could produce no clotting agents. At a work table a rock hammer was found next to a small stack of shale, and a razor sharp piece the size of a dime was on the floor with a teeny, tiny smear of blood on it. (If you want further details, and it is pretty cool- actual CSI stuff!- ask me in the comment section and I’ll oblige.) A twist ending, yes, but hardly spectacular. Knowing my audience at the time of the inquiry, I usually give them what they want and toss off a particularly gruesome event (if I like the person), or if I’m not feeling amiable at the moment I just give them a knowing look and say, “You really don’t want to know.”

Okay, time for “worst.” Again, it’s typically fishing for a toe-curling, jaw dropping tale of horror or a stomach churning oratory concerning maggots or spatter. My stomach hasn’t churned since my early teens. Disembowelment and putrefaction are just run-of-the-mill and all in a day’s work. Nothing interesting. Apply the responses cited at the end of the above paragraph. Once more I’ll open up and give you my version of “worst.” One winter’s eve I was summoned to assess a man found in the middle of a corn field at the rural edges of our Office’s jurisdiction. Apparently he’d been harvesting the back forty, a corn crop he couldn’t pull in during the fall due to heavy rain and soft field conditions. Learning something new, I was told a corn crop could stand all winter and it was not that unusual for a farmer to pull in a crop when the ground was frozen. When I got there it was dark. The temp was sub-zero, as it had been for several days. I went down a field road to a place where the fire dept. had set up klieg lights. Centered in the harsh light was the “Subject.” He was on his feet and dressed for the weather. What kept him upright was a farm apparatus described to me as a “corn picker.” It was a towed apparatus and explained to me as an “old school” implement, not often used these days. A deputy familiar with such things explained this was the reason I was there. It was a rather hazardous contraption, one that was capable of harvesting more than just corn if you weren’t careful. I saw this for myself. This guy had both of his hands trapped in the machine, under a set of rollers, to be precise. He was in just past his wrists with his body pulled tight against the tailgate. That’s why he was on his feet. The tractor, running this machine with its power take-off, was out of fuel. The injuries to the man’s hands and arms were nasty, but by no means fatal. He was frozen solid, despite his appropriate attire. His eyes were open. He was found as a result of a call made by a man who spotted him from a county road about a mile away. The caller had seen this man that morning while he was driving to work. He said he was in the same place, and when he saw him in the morning he believed there was exhaust coming from the tractor. Viewing the same sight that evening, he thought it strange and called it in. We learned the “Subject” was a bachelor farmer who’d inherited the old homestead when his parents died. He had no one at home to wonder where he’d been all day. He had a cell phone in his pocket with no way to reach it. One shoulder of his heavy, insulated overalls looked freshly chewed, as if in an attempt to gnaw his arm off. I don’t think I need to elaborate any further. Grim- ghastly in my opinion- but once again, not spectacular. I can see where this may indeed be… appreciated… at its face value, but it’s a case where I refuse to relate this story just to appease a little curiosity. The prime reason is that I can’t bring myself to enable or gratify their voyeurism. I won’t participate in the puerile when it comes to a life that ended so miserably. It hit me in a way I wasn’t prepared for, and up to this point I’ve felt a genuine need to keep it to myself. (Arrogance? It may well be I’m hesitant to concede there may be people not in this business that “get it.”)

Which brings us to “hard.” I had a whole, nicely thought out narrative planned out, but when I got to this part, writing it down, it all went to shit. It’s because this question, while it may not seem so on the surface, is the nastiest of the three. It’s the “sincerest”, which makes it more difficult to dismiss. It usually isn’t motivated by the desire for a “gross out” story or simple nosiness. It doesn’t center on what I do, but on what I do does to me. I imagine some of my colleagues have no problems with this question- maybe even welcome it. I hate it. And, yes… when it comes to “hard,” it’s usually kids. Anything associated with the loss of a child carries all the weight of societal mores; future promise, vulnerability, innocence, and I’ll not ignore “cute”, “sweet” and “adorable.” Hopes and dreams… You’ve been immersed in this from the moment you’ve developed cognizance of anything outside of yourself. Say, ten years old or so. You won’t get any Awwws… if somebody posted a video on the ‘net of a middle aged guy falling asleep on his dog. You’d just assume he was drunk. By the same token, you wouldn’t feel devastated if you found out the same guy was killed in a fiery, single vehicle wreck. Again, you’d probably assume he was drunk. Got what he asked for, thank God he didn’t take anybody with him. Any grief belongs to friends and family. If that happens to a child, when you see a picture of a toddler dressed in a Disney outfit via the media (I’ll be enthusiastically ripping that mob a new one in the future) who’d suffered the same fate, you can’t help but feel a pang of grief and despair. You’re conditioned to feel this. Loosely following the same path, I’ll bet when you hear of a thug or a career criminal getting murdered in the street, you ain’t sheddin’ a tear. If a child is murdered, the rage switch is flipped. Whoever committed such an act is instantly reviled, no punishment is too severe, no suffering this animal is to endure as a consequence is never enough. You not only feel for the child, but his parents, grandparents, friends of the family and anyone else who may have had even the slightest connection. This is normal. This is right. For you, anyway, and anybody who asks me what’s “hard.”

Most people never see a dead kid. I’ll wager ninety per cent of the people you know have never seen a dead child, and probably never will. Fewer yet, a murdered one. I’ve seen dozens. SIDS (Sudden Infant Death Syndrome), or, as it’s called now- SUIDS (Sudden Unexpected Infant Death Syndrome), overlays, accidents, homicides. I’ve seen infants and children, shot, stabbed, strangled, kicked, shaken, smothered… raped. I’ve autopsied them, in my early days at the morgue, and in my current position have literally pried them from their mother’s arms. I’ve removed them from bloodied cartoon character pajamas, picked the plastic barrettes from the hair of a five year old girl before the pathologist took pictures of the bullet hole in her head. Another day at the office? Yes. It has to be. To succumb to the social mores at these times is to open the door you’ll run screaming through. You wouldn’t be able to do your job. There’s not a person I’ve worked with that wouldn’t rather fish a body out of the river it’s been in for two weeks than deal with a dead child, but it’s not like you have a choice. This is when the “beasties” hatch behind your eyeballs. This is when the ones that are already there gain a little muscle. This is when I bring up the three “D’s”: Disconnect, Disengage, Detach. This is when dead is just dead. Birthdates are incidental. Take the case info, take your pictures, write it, forget about it. Please let the next one be an old guy found kacked in his bed. Don’t go home and kick the dog, snarl at your wife, bark at your kids, if you have them. Don’t even think about your kids until the critters in your noggin finally take a nap. When they’re little, don’t think about them when they’re riding their bikes, or waiting for the school bus, or at the playground with their friends. When older, smile when you hand them the car keys. Say “behave yourself, but have fun” when they’re off to a party. Don’t give the vaguest hint at what you know. And know firsthand.

“What’s the hardest thing?”

Shrug.

“It’s got to be kids.”

“Yep.”

‘Nuff said.

In the beginning… (Part Three)

The one thing stressed above all else when I transitioned from the medical to the psychiatric was consistency. The pajama thingy, time allowed for use of the patient phone (ten minutes per call, once an hour,tops), no profanity, food was allowed only at scheduled times, the television was on only at certain times and only programming considered appropriate was allowed- no slasher flicks, risque’ content, violent or disturbing themes (you could watch footage of a plane crash, suicide bombings or the latest updates on a serial killer at large on the news, but fictional representations of such were taboo.) Deviating from unit policy resulted in anything from a fifteen minute “time out” in your room, to winding up in restraints if your objection to taking staff direction was too rigorous. This made perfect sense. “Consistency minimizes the chances of ‘staff splitting’ by the patient.” In other words, if all patient requests, behavior, etc., are addressed in the same manner, meet the same response, they won’t go running around asking each nurse or aide for the same thing until they get the answer they want. Not adhering to this plan is a sure recipe for chaos. If I tell a patient “no” and they turn around and say- or shout- “Day shift let me do it, why are you being such a prick?” I’m going to be pissed off at the day shift, who just set me up to be a prick. See? Staff splitting. You can’t give the patients proper care and maintain a therapeutic milieu when the folks in charge are all pissed at each other. So I have to explain that, “I’m not being a prick, it shouldn’t have been allowed, and I’m sorry to let this lack of communication between shifts set you up for such disappointment… Your really shouldn’t say ‘prick.'” When I really want to say is: “That lazy-ass dipshit on days let you do it because you drive him up the wall. You intimidate that weasel, and he’d do anything to avoid anything that might lead to confrontation.” This brings me to the “discrete” approach taken with Calvin.

He was tacitly granted a free pass from consistency the first couple days he was on the unit. I may have felt comfortable making an issue of it with my peers on the non-professional level, but I also had a few years of hospital experience under my belt. When the nurses gave the word not to push policy up Calvin’s ass like I would have been expected to with other patients, I knew enough to keep my mouth shut. I really wished Calvin had felt the same. Aside from him running around in his street clothes, Calvin had no problem ignoring the phone policy. There was one patient access phone in the middle of the hall with the above described restrictions: Ten minutes an hour. We had about twelve patients on the unit at the time. Do the math. When Calvin didn’t have the phone in his hand, he’d hover around the apparatus while another patient was using it, shifting his weight from one foot to the other, muttering his displeasure and glaring at them. He was never overtly threatening, but he made damn sure the tenor of his presence was enough to make you want to drop what you were doing and just get the hell away. Some gave in, but others would cut into their phone time screeching at the well-dressed-but-rumpled manic barrister to “get the fuck away!” from them. Once he had the receiver in his hand you had to pry it away from him- literally, which I had to do several times. He wouldn’t let go, even when it was switched off from inside the nursing station. He did not waste the time he had on the phone. In between the haranguing calls he subjected his family to, he regularly contacted the police department, the courts, the bar association and the ombudsman. This is not unusual behavior for a manic patient. What set Calvin apart was that those he pestered actually responded. He wasn’t blown off as a raving nut, the usual response as these agencies were pretty well conditioned to such calls. Nope. They got back to the hospital, demanding to know what the hell was going on and what action to take. Discretion required indeed!

When Calvin wasn’t on the telephone berating his wife and grown children, or complaining to a former colleague about the abuse he was being subjected to in this “so-called hospital” and when were they going to do something about it, he would glom on to a staff member. This was almost always an aide, as we spent all of our time out on the floor. He’d position himself about half a step behind you and just off your shoulder and shadow your every move. With two aides on the floor you’d expect to be free of him at least half the time. I really wish that had been the case. One problem was the guy I worked with on evenings had been at this for several years. On top of that, he’d spent time in the “big leagues”- a State Hospital. You could duct tape a rabid skunk to his face and he’d ignore it if it suited him to. I hadn’t had enough time to develop this invaluable skill. And Calvin would not be ignored, yet knew he would be wasting his time trying to get under my co-workers skin. That made me his preferred target. The first couple days of Calvin’s admission I figured I spent, deducting the times he commandeered the telephone, ragging the shit out of the poor sod on the other end of the line, at least six hours. Six hours of him dogging my every step up and down the hall, wandering into the “day room”, handing out dinner trays (the man probably ate three bites a day the first week he was there) or standing an inch away from me when I planted myself against a wall and pretended to be taking keen interest in the activities of the other patients. Also, keep in mind, this guy hadn’t showered or brushed his teeth in at least a week. He was enveloped by an odious fog only a vulture could tolerate. It would have been only mildly irritating if he’d kept quiet. People in a manic phase won’t keep quiet any more than a fish won’t swim. His incessant verbal stream primarily consisted of insult and invective, delivered in an urgent but low monotone. For example: “Are you a sadist? Your presence here would suggest as much, though I’ve no more evidence other than your presence, and whatever circumstance that could have led to your finding work in such a place is unknown to me, but as a sadist you would find employment in such a place very gratifying….” or “Do you find satisfaction in your work? Impossible as it may seem to a normal human being, you must. I hazard to guess employment in a slaughterhouse or some other similar occupation where torment and destruction of the innocent is a prime factor would suit you as well…” or “Working here must be the culmination of many personal shortcomings you’ve neither the desire or will to either confront or correct…” and on, and on, and on. Now, Calvin was not the first patient that bombarded me with insults, but it’s one thing to get slammed by a guy who got his last pair of shoes out of a dumpster and another to be vilified by a man who made his living on elocution and logic. Calvin saved his most caustic barbs for the nursing staff, thank Christ. When he could catch one out of the nursing station he’d pounce: “I’m made to understand you are professional staff. Professional… Professional cunt perhaps.” (Odd as it may seem, the “C” word was the only profanity I ever heard him say. Must be some sort of repressed misogyny that never reared its ugly head when he was taking his meds.) There was a male nurse he particularly despised. “How sad for you,” he’d sneer, “to have to succumb to your limited intellectual capabilities which denied you the entrance to medical school, compelling you to make your way in the world forcing that pharmaceutical poison you call medication on the unfortunates you hold prisoner. Doesn’t it chagrin you? Taking orders from your betters, those quacks you refer to as psychiatrists?”

I couldn’t even hope he’d give me a break for a minute or two by switching his attention to a fellow patient. They all hated him. I first found this odd, as, despite any differences they may have had with each other, they always had a certain corps d’esprit. But Calvin wasn’t “one of them.” He hadn’t borne lifelong the consequences of their illness the way they had. He’d also established that he indeed was not “of their ilk” and expected to be treated otherwise. He couldn’t get within two steps of another patient without being told in no uncertain terms they weren’t going to put up with one second of his crap. They could threaten him with any sort of retribution they felt like. We had to intervene. Oh, I admit, I envied them. Alas, Calvin’s reign of terror was brief, his downfall began after about three days. The principal orchestrator of his ultimate undoing was his wife.

She’d not seen him since the day she called an ambulance-and the cops- and had him shipped to the ER, where a 72 hour hold was placed on him. (A word to the public: A 72 hour hold does not mean you stick it out for three days and scoot. The 72 hours -not including weekends and holidays- is the time allowed for the powers that be to initiate the commitment hearing process. After the papers were in, you had to sit and wait for the “system” to do its work. That, my friends, could last weeks.) Calvin’s wife showed up the same day Calvin got his papers, and I’ve no question it was not a coincidence. I wasn’t there to witness it firsthand, but I was given a pretty good rundown that evening. She showed up right on the heels of the serving deputy. Calvin was to have a hearing, at which it was to be decided whether to pursue more stringent intervention pertaining to his current situation, i.e., declaring a psychiatric emergency. This could include forcing medication, prolonged stay at his current location, or moving forward with commitment to the State Hospital. Calvin did not take this well. He leveled a round of insults and threats at his wife that put anything he’d said to us in the category of “warm fuzzies.” She took it without a blink. Calvin also got his first enforced “time-out”. She then turned on the staff. “Why isn’t he in pajamas? Why hasn’t he bathed? Why hasn’t he been held into account when it comes to the use of the telephone?” and any other questions she had as to why Calvin hasn’t been forced to comply with the rules the other patients had to live under. She was coming back tomorrow, and she expected to see her husband in hospital attire, clean, his hair washed and his teeth brushed. I heard her interaction with the staff was no less compromising than Calvin’s was. The gloves were off, so t’speak.

At the change of shift that day and during the quiet of Rest Hour, all members of the staff equipped with testicles were summoned to the nursing station. The order was we were to relieve Calvin of his suit, get him into the shower, scrub off what layers we could, and only turn him loose once he was clothed in hospital issue. This was his doctor’s order, no doubt made at the insistence of his wife. It took five of us. Calvin was subsequently taken from his room- where he’d retired immediately after his papers had been served and had torn his missus a new one, the only time since his arrival he’d spent a minute in there in daylight hours- and frog-marched down to one of the shower rooms. With no witnesses, Calvin was forcefully stripped bare-assed right there in the hallway (not enough space in the room itself to accommodate all that had to participate.) Cramming him into the shower room was about as easy as stuffing an angry cat into a vet-carrier. But, despite his shrieked and repeated accusations of “Faggotry! Faggotry! Faggotry!…”, he was forced into the streaming water, scrubbed down with three bars of soap and three washcloths (two of us stood guard outside), tossed a towel, which he threw back, and handed those stupid pajamas. Dripping wet, he dressed himself. Silent, he marched back to his room, his only statement was slamming the door. He spent the entire evening shift secluded. He did not come out once. He spent the whole time, which I learned doing compulsory room checks, poring over the court papers, no doubt looking for loop holes. When I popped my head inside his room, he did not even raise his head or offer a biting comment. It was a pleasant shift. As fate would have it I picked up a double shift that day. Night duty meant sitting at a table in the hallway and performing the room checks and assisting patients with whatever they needed, mostly unlocking their bathrooms or getting them an extra blanket. At three A.M. Calvin’s door swung open. He stormed down the hall to my table. He stopped, staring down at me for a few moments. I didn’t ask what he needed. He offered a severe smile, rapped the table once with his knuckles, and bestowed upon me the greatest line I would ever hear uttered in my entire time in the business of mental health: “Sir, know this: I hate you, it’s a cordial hatred, but hatred nonetheless.” He turned and stalked back to his room, not to emerge for the rest of the shift.

From that day on, Calvin was not the ever present agitator he’d been. He was still a pain in the ass, but it wasn’t with the same alacrity- or persistence- he had before. His court papers kept him busy in his room, studying them and writing refutations and arguments citing the injustice they represented. It took a lot of his time, and he amassed an impressive pile of handwritten documents. As it turned out, Calvin never went to court. His wife, tough lady, arranged a private consult with the psychiatrist, in an office,  with her husband present. This was remarkable considering his condition, but she was having it no other way. The doctor complied, as long as there was someone available to intervene in case Calvin abandoned verbal abuse for the physical. Arrangements were made. Calvin was reported to have regained a little of the irrepressible spunk he displayed when he first arrived, and the session did not go well. He returned to the unit as fired up as ever and, I heard, it was not a pleasant shift. Bad idea on the wife’s part? Don’t sell the woman short. She’d videotaped that session, though as how she got the Doc to go along with this I never heard. She then arranged that Calvin view this the day before he was to go to court. It must have had the desired effect, because he requested his status be changed to “voluntary”, which dropped the court involvement and was at least a show of his intentions to comply with taking medication and such, which he had up until that point refused to do. There were a few bumps in the road, and sometimes Calvin needed a little “encouragement” to start taking meds in the beginning, but overall he slowly cleared up and was gone in a few weeks.

Calvin was not unique in diagnosis, behavior or outcome. He was, in fact, quite unremarkable in those aspects. He was by no means the most difficult patient I’d ever encountered. By no means. There would be dozens of people I’d encounter over the next seven-plus years that would make Calvin seem like a mischievous kitten. What made him stand out to me was one factor that set him apart from most patients I’d met, and would meet, and that was his family. They dealt with him directly, firmly and, for lack of a better term, urgently. His wife and children were leaving nothing to chance regarding the outcome, and were not ready to just stand aside and let the “system” deal with him. They did not let his professional and social status play any part in how he was treated, and they did not cede control to his psychiatrist alone. They were not about to let him get sucked into the usual cycle, they were not about to let him, propelled by his illness, wear them down enough for them throw up their hands believe “they did all they could for him.” I would later learn that Calvin had experienced a few “bumps in the road” related to his disorder, but had managed to avoid a full blown manic break that forced hospitalization. He’d had the encouragement from his loved ones. He also had insight, self-awareness and the discipline to accept his illness and deal with it accordingly. This was what set him apart. Somebody had his back throughout, and they pushed for the best outcome they could no matter what they had to put up with. The vast majority of people I’ve known with chronic mental health issues don’t have this. Some have family that at one time may have been equally supportive, but over many years of dealing with the illness and the related complications, both personal and bureaucratic, simply could not sustain it. Other cases it may be the patients inability or unwillingness to accept the support necessary to keep them off the treadmill. Often times it became easy to let go once the pattern took hold. Mental illness is insidious in the effect it has not just on the person afflicted, but on everyone who cares about them. As one patient told me, “When you have cancer, everybody around you at least knows there’s an end in sight.”

(Whew! So much for a thousand words… just wanted to get through it, finish  what I started but not take a freaking month. That’s enough “lunacy” for now. Next time…. DEATH. See you soon.)

In the beginning… (pt. Two)

There were two units in the hospital. An “open” unit, and a “locked” unit. The “open” unit was for patients that were “functional”, could manage their day-to-day needs, attend group sessions, participate in their own care plan and were on the way to resuming life outside of the hospital. The “locked” unit was for patients that couldn’t- or wouldn’t— control their behavior. These folks were either actively delusional, seriously suicidal to a degree that required close monitoring, or were prone to impulses that could result in serious problems. The blanket phrase applied to them was “posing a danger to themselves or others.” That’s where they put me. I settled in and found I actually enjoyed the switch. Change is as good as a holiday. I’d learned a lot in a short time, the difference between schizophrenia and bi-polar disorder, and that there were such things as disabling personality disorders. I’d learned to shrug off insults, to differentiate between behavior driven purely by illness and what was behavioral bullshit. To evaluate what was a valid threat and what was posturing. To learn to speak with some one in crisis without provoking further escalation. Expect the unexpected, take nothing for granted, never turn your back on a psych patient. Most importantly, I learned to take whatever preconceptions I’d developed over my life about mental illness and flush them down the toilet. I’d been given an opportunity to actually see a part of me that was completely misinformed- uninformed- accept it and acquire some real knowledge and insight into a subject most people understood nothing about. Cool. After a month, I’d actually gotten to the point where I believed I’d acquired a real grasp of what this mental health thing was all about and I take anything it threw at me. Then I met “Calvin.”

The majority of the patients I’d met on the locked unit were “chronics,” people afflicted with an acuity of mental illness high enough to preclude any chance of integration into “normal” society. They were trapped in a never ending routine of moving from group home, to hospital, to state hospital, back to group home, to hospital, state hospital, to group home, ad infinitum, with little hope escaping the pattern. They were indigent and resigned to a future that was never going to deviate from their past. They were indeed individuals, unique in their way as all people are, but were trapped in a system that treated them all exactly the same. They had no choice, and as a manner of survival, accepted their choices were all going to be made for them. It was one of those things that once I understood it, I looked at the patients as small components making up a large but singular entity. They were like concrete blocks in a bland, gray, featureless structure. “Calvin” did not fit into this category.

One of the first things to be done upon admission was to relieve the patient of his clothing, replacing it with the ubiquitous backless hospital gown, a green seersucker robe with the belt cut off, and pale yellow hospital pajama bottoms, modified by removing the drawstring and replacing it with Velcro tabs. After a few washings the tabs became nothing more than useless, scratchy little squares. We rectified this problem with improvised belts of masking tape, wrapped around the patient three or four times. (This was back in the eighties. This ridiculous garb has long since been tossed in favor of a modified “scrub suit”. The wretched pj bottoms have been improved. The Velcro is long gone, replaced with the miracle product known as the elastic waistband.) A patient could “earn” his or her duds back after a few days of good behavior and compliance with taking their meds. Conditioned as they were, the patients usually submitted to this without a squawk. Calvin had been admitted to the locked unit on my day off. I was soon to learn it was a good day not to be there. When I arrived for an evening shift it was obvious we had a new patient. He was stalking up and down the hall, muttering to himself- as manic patients often do- and wearing a Brooks Brothers suit. This was my first clue that Calvin was not like the “others.” He should have been sporting the same awful pajamas all new patients were compelled to wear. He also should have been in his room. It was “Rest Hour.” (You’ll hear more about that, down the road.) Those were two hard and fast rules, no exceptions. The last half hour of the day shift and the first half hour of the evening shift patients were to stay in their rooms. No exceptions! The guys minding the store on the day shift were sitting in the hall, and obviously making a solid effort to let this guy know they were ignoring him. I’d been there long enough to believe I’d earned the right to make a stink. I jabbed a thumb toward our new addition as he blew past me and asked what was the deal. They both told me I was more than welcome to do something about it. A moment later, after about his fifth pass up and down the otherwise deserted hallway, our well dressed new admit noticed me. He pulled up short and positioned himself square in front me.

The top of his head was about two inches below my chin. As he glared up at me, I was able to appraise his non-regulation attire. The suit was definitely well made, and fit him perfectly and in no way came out of a donation pile. It was, however, badly in need of a pressing, and after a second or two I realized it was in more dire need of a laundering. The man stunk to high heaven. The buttons were missing from the vest. The shirt hung open to the middle of his chest. It was then I noticed the lack of a necktie. I also noticed he clutched the waistband of his pants, so he’d also been relieved of a belt or, as I sensed, suspenders. At least they’d gotten that much done. The frames of his eyeglasses were bent. “You appear to be a young man of some intelligence,” he snapped at me. His teeth needed a brushing as badly as his suit needed a dry cleaning. “But appearances being just that, appearances, I’m afraid I’m left no choice but to leave it at that.” And off he went again. Thus we made our acquaintance.

Shortly after our meeting, his nurse filled in a few blanks. Calvin had never before been admitted to this facility. In fact, he’d not been admitted to a facility of any kind for psychiatric reasons for decades. He’d been diagnosed as “manic depressive” as a young man in the forties, when the term was acceptable, and apparently had been managing it quite well since. Without being too specific, Calvin had gone to college, earned a high degree and had spent his entire life earning a living, as well as a stellar reputation, in the courtrooms of our community. He was well known and well connected with the upper levels of our society. Calvin had influence. Calvin had pull. Calvin had friends in high places. As this was being related to me I watched, through the shatter-proof glass of the nursing station, Calvin marching up and down the hallways, weaving in and out of the other patients, clutching the waistband of his expensive pants with one hand while gesticulating with the other, his lips in constant motion. His doctor, I was told, as well as administration and most likely the hospital attorney, that we were to manage his care with… “discretion.” Whatever the hell that meant. Her word(?) or orders from above (?) was never explained to me. So be it. It was “discretion” with which we were to handle Calvin, accomplished, erudite, articulate, and batshit crazy.

(Next post: The exciting conclusion! See you in a few days.)

 

In the beginning… (Pt. One)

Neither of these jobs was the culmination of a life dream. I fell into one, got shoved into the other. This isn’t a complaint. There are lots of folks out there who ascribe to the concept that you don’t pick your life’s vocation, it picks you. Or, “God sometimes puts you into the right place, at the right time.” Destiny. Kismet. Luck o’ the Draw… If you stand in the street long enough you might get hit by the right bus. There were times I wondered whether the hours I was spending on the psychiatric unit put me in greater need of intervention than the folks I was ostensibly there to help, and taking the report of a guy who quietly passed into the arms of his Redeemer while seated in the La-Z-Boy with a remote in his hand triggered a pang of jealousy, overall I consider my self blessed by the time I’ve spent in both places. These blessings were neither sought, nor anticipated. Of course, someone else may experience the exact same things and stagger away wondering what they did to make God angry. More on that in a bit.

In my late teens and early twenties I was an aimless lad working as a house orderly in a private hospital. I’d essentially been hired off the street for the job, back in the days when those things were possible, and it was something I’d gotten into when a year in college wasn’t providing the direction I thought it would in deciding what to do with my life. As things often go, marriage to a high school sweetheart and a couple of kids, kept me there longer than I’d planned. “Aimless” caught up with me as well, and the marriage fell apart (my fault!). When it rains, it pours. At the same time my matrimonial union crumbled, the hospital announced it was entering a bold new era- the exciting and previously thought-to-be- inconceivable realm of Corporate Healthcare. This great venture, which at the time promised to provide the nation with the most progressive, comprehensive and, without a doubt, the most affordable medical care that world had ever known, was to be achieved with the merger of several hospitals in the metro area. By uniting, these facilities would provide the cutting edge and quality of care at a level that no single, independent hospital could even dream of providing. Progress! It also meant the place that had been paying my bills would be shutting its doors. All was not lost, however. While I no longer had a job as a house orderly, a position at the bottom of the heap in patient care, the possibility of plugging in at the same skill/wage level job may be available at one of the facilities they’d merged with. As it turned out, I was presented with three options: 1) I could be employed in the kitchen as a “food service aide”, taking about a ten percent wage cut, or: 2) join the “housekeeping” crew, abandoning my catheter insertion skills and picking up a mop for a slightly less percentage of pay lost, or, as I was informed by a “Human Resources Facilitator” that was easing us soon-to-be-jobless folk through this transition: 3) there was a part-time slot open for a “Psychiatric Aide.” There was no such unit at the hospital I was working at. I honestly had no idea such things existed in private hospitals. “You’ll be making the same money.” I was told. “At the moment, it’s listed as part-time, but, believe me, you won’t be lacking for hours. Between you and me, I can almost promise you’ll be able to work as much as you want.” There were five other guys in the same situation. Three of them were in school. (One of them a third generation med-student and was only working in the hospital because his dad, footing the bills, made him do it. He was happy as could be the place was closing.) They had other, more palatable options, and not-too-far-in-the-future brighter prospects. One of the remaining two opted for the mop. The last shrugged his shoulders and took a lay-off, saying by the time his unemployment checks ran out he’d surely have another job. As for myself, quitting- though it really would have made more sense as far as my “life direction” was concerned- was not an option. I was facing child support and finding a place to live. I told my soon-to-be-former colleagues I was considering the psych job. “No fuckin’ way,” was the general response. Only the spoiled med-student approved, though he qualified his endorsement by warning me, “You better make sure you’ve got your head on straight, and keep it that way. Otherwise it’s gonna eat you alive. Good luck.” Sage counsel. At that point I’d only had three references in my life to rely on as to what it was like on a mental health unit, and it was three movies: “The Snake Pit”, “Shock Treatment”, and an old Boris Karloff flick, “Bedlam.” I can state with the utmost conviction that you will never find three lousier sources for research material. Despite that fact, I felt I had no other choice. I found nothing wrong with toiling in a kitchen or swinging a mop, but after working directly with patients and medical staff, I couldn’t do it. Though as an orderly I was on the bottom rung of the ladder of patient care, it was still “medical.” I liked the patients. I liked doing CPR, which was a total rush, successful or not. (This set the orderlies apart from the nursing assistants, who had to take a course at a vo-tech school- which we sassily referred to as “graduate school for ass wiping”- before they were deemed fit to do vital signs and give bed baths. They of course had to be trained in basic life support, but were not called upon to do chest compressions when such emergencies arose. It was because the orderlies were guys. In those days the nursing assistants, predominantly young women assigned to specific floors, were deemed too weak to do chest compressions for extended periods. How times have changed.) If I was to continue working in a hospital, a choice that had become no choice, it couldn’t be dumping trash or washing dishes. I took a job I was shoved into. Psych Ward, here I come…

(This wasn’t supposed to be this long. I set a limit of 1000 words as some sort of target for consistency. I figured it was about as long as I could test anyone’s attention span. So, I put the brakes on. I’ll continue shortly- including a war story!- and promise this straight up biography will not go on forever. See you again in a couple of days.)

What this is about… I think…

The header says it all, but perhaps some elaboration is in order. For the past twenty-eight-plus years of my life I’ve worked as a behavioral tech in a mental health facility (eight years, full time) and twenty as a medico-legal death investigator. As life would have it, a couple years ago I returned to the psych ward on a part-time basis. It wasn’t because I missed it. With two kids still in college, it became a logical means of supplementing a bank account that had become not much more than a filter between my paycheck and a couple of universities. So… as I am still employed at both places, I’m compelled to do this anonymously. It’s not that I’ve anything to hide, but as to protect those who may or may not be innocent. However(!), with the exception of names, dates and locations, all incidents related on this site will be true and without embellishment, either witnessed firsthand by this writer or related to me by a trusted colleague. Word of honor.

Embarking on this venture has been something I’ve considered doing for some time, have even been encouraged to do so, even. What initially made me reluctant was not being clear on what purpose it could serve. I’ve no desire to educate or inform on matters of mental health or forensics on the internet. That’d be “Bringing coals to Newcastle” as they used to say. Besides, I’m neither psychiatrist nor pathologist. My role in the care of the mentally ill is as what’s known these days as a Behavioral Tech. Got no shingle to hang on the wall. No fancy degree. My place in the battle against mental illness is in the trenches, with the primary job description being “Interact with the patient population, monitoring and maintaining the therapeutic milieu.” In other words, hang out on the floors and keep your eyes peeled for problems. This can range from politely reminding a patient to refrain from seasoning casual conversation with “F-bombs”, to jumping in to physically control a psychotic hell-bent on rejecting the therapeutic milieu for the freedom of the streets. I’ve earned my share of rug burns. The environment of the morgue is quite different. It’s quieter, for one thing; the “client”, so to speak, has no capacity for endless delusional rambling or spontaneous violence. And they all have the same diagnosis. On the other hand, I’ve never had to deal with maggots on a psych ward, and hauling a three hundred pound corpse up two flights of stairs is just as exhausting- if not more so- than wrestling an out-of-control manic into locked restraints. And in those cases you’re usually only responsible for one limb. But! there are skills developed in one trade that transfer well and serve beautifully to the other. Eight years of learning to communicate patiently, calmly, clearly and effectively with psychotics proved invaluable when having to relate to people who are suddenly forced to deal with the unexpected and tragic loss of a loved one. Instant and overwhelming shock and grief isn’t so far removed from debilitating mental illness as you would think. Maybe conveying that nuance to a few people is purpose enough.

While employed in either job, the most commonly asked question ever put to me is: “What’s the weirdest/hardest thing you’ve ever had to deal with?” Not an unfair question, and not unreasonable either, I guess. The thing is, what was weird to me a few years ago has long lost its eerie mystique… and what’s hard has become what I now accept as ho-hum, normal even. Working in either place does nothing less than rob one’s susceptibility to shock. And oftentimes when I do provide an answer to that question, it either disappoints the questioner- because what I now find odd or unsettling doesn’t fit in to what the average person considers thus- or they end up regretting asking me in the first place when I give an answer they can’t, as an average Joe, help but be horrified by. It’s doesn’t make it any better when I express my disbelief at how appalled they are by something I found hilarious. Which brings me to my next point. Neither occupation is one you can simply “leave on the job.” It doesn’t stay there. It doesn’t disappear from your head the instant you cross the threshold to your happy home, your safe haven. It plants little beasties in your psyche that love nothing more than to dart out from the holes they’ve bored into your brain, race around inside your skull, flipping switches, overturning tables, and playing the stereo way too fucking loud, all the while asking you the questions you can’t answer, and really aren’t sure if you want the answers… if they indeed exist. Even when they’re quiet, well behaved even, they whisper in the dark, commenting in the subtlest tones, on everything you see, hear, do and care about. You learn to chase them back into their corners, find a way to co-exist and ultimately keep them from letting their existence be known to others. But, them that knows you, sees ’em too… And those that know you really well sometimes have the audacity to inquire as to whether they’re out and about at any particular time you- well, ME, anyway- are behaving like a total asshole.

As I mentioned above, people around me have suggested I bring this stuff to the keyboard, crack my skull open and let whatever spills out be displayed to anyone who wants to have a look. It’s probably just a means of getting me to spew my bullshit in any direction I can as long as it’s not theirs. Fair enough. I’ve rented this space on the ‘net for at least three years. So, being the cheap-ass that I am, I’ll be dropping in once or twice a week to turn the beasties loose without restraint and hope to sustain it for at least that long. There will be war stories from both fronts. There will be divergences into what may be mundane or matter-of-fact to the nicely well-adjusted but drive me straight up a wall, through the roof and into unstable, decaying orbit. Hope I can make it an entertaining ride… And, hey, look at the state of our lovely planet in what is now our time in history. Lunacy and Death sorta fits.