After a while of seeing the same people in the hospital day after day, they began to trust me more and more. I did what I could to earn that trust, being a patient advocate whenever I could, listening when I could and never being argumentative. When I occasionally did have to restrain a patient (usually because they were in a violent altercation with another patient, or much more rarely, another Mental Health Assistant/MHA) I did so as gently as I could, trying to calm things down, rather than add fuel to the fire.
Nearly every possible psychiatric diagnosis was represented in our ward. The majority were schizophrenic — which, for the layman, is not the same as a “multiple personality disorder” which is actually extremely rare. Schizophrenia is simply a collection of dysfunctional symptoms that include delusions, hallucinations (mostly auditory), and incomprehensible thought, speech, and behavior. Some patients could be quite lucid when taking their anti-psychotic medications, usually only for a few weeks at a time. Others made no sense ever, but still seemed to appreciate somebody to talk to.
One older gentleman, “Bill,” who had been in the ward for more than fifty years, was often lucid enough to work in a program outside the ward. For much of the day, he’d be gone, but he’d always greet me cheerily with, “I’m an ugly man, Jimmy.” (Jimmy isn’t my name, but he always called me Jimmy.) “I’m an ugly son of a bitch.” One day, he came back from “work” early, clearly frightened.
“What’s wrong?” I asked.
“Well, I was working, and then I saw Jesus outside, following me in his black limousines. That bastard has it in for me, Jimmy.” He paused, and explained, “that’s really why I’m here. You see, when I was a young man, a witch turned to smoke, and flew up my butt. She made me say ‘bugger off!’ to God.”
I’m not quite following this, of course.
“God forgave me, he’s a pretty good guy, but Jesus didn’t. So now he follows me around in his black limousines. So when I see him, I know it’s time to hide out here until he gives up for a while.” Then, with a wink, “I’m an ugly man, Jimmy. An ugly man.”
“I’m here,” piped up “Terrence,” from the day hall, tapping his empty pipe on the chair, “because I spent far too much time in the orient languishing about in opium dens. I fear it has affected my cognition. So my advice to you, Jimmy, is that if an oriental sorceress speaks to you through your teeth and tells you to smoke opium, try to ignore her! I wish I had.” He continued speaking, but his words sounded less and less like English (or any language.)
“Sarah” called me over to where she was sitting in the day hall. She had also been there for the better part of 50 years. “Do you think,” she said, in a low voice, “they put Spanish Fly in the Kool-Aid to make us horny?”
“I don’t think so,” I mused. “Seems like that would be an expensive thing to do. Want me to try the Kool-Aid?”
“Yes I do,” she said enthusiastically. “you should probably stay right here, just in case it works.”
“Gary” was diagnosed with schizophrenia as well as extreme borderline personality disorder. Borderline personality disorder, is not somebody “on the borderline of having a personality disorder or not,” it’s actually a personality disorder that involves borderlines — often perceiving things in black and white, all or nothing. It was colloquially referred to as “AD,” or “asshole disorder,” because they were some of the most difficult patients to relate to.
I’d often find Gary sweeping, and make an effort to talk to him. “How are you doing, Gary?”
“I don’t think anybody likes me,” Gary answered. “I think they hate me. You like me, don’t you? You probably hate me. Why do you always leave me? Why can’t you just stay here and talk to me all day? I hate you.”
“Well, you’re doing a pretty good job with the sweeping, there, Gary.”
“Yeah, I like to sweep because it’s the only thing I’m good at. Sweeping. I suck at everything else. That’s why everybody hates me. Except you. You like me. Because I sweep. Except I suck at sweeping. That’s why you hate me.” Gary continued sweeping, not looking at me once.
“Right, well, I’ll see you later, Gary.” We had a lot of similar conversations.
“Male help!” was called, so I ran back out to the day hall. Everybody was leaving the porch area, and my supervisor explained what was going on.
“Eugene” was a 350 pound, six foot six Vietnam veteran. Although huge, my general impression of him was as a nice, gentle man, although I never actually heard him say anything coherent. When he spoke, his words were hopelessly jumbled, but he’d speak as if you understood, then fold his hands together, and stare for hours at a time. At the moment, he had barricaded himself behind an upturned table and a few couches, and would occasionally shout something. I think I could make out “Viet Cong,” but not much else. Eugene had a pile of chairs, and when somebody peeked through the doorway, he’d throw them with devastating force.
Five MHA’s gathered, including my supervisor. “One thing we could do, is keep peeking in until he runs out of chairs, or tires himself out, and then we all charge him, and take him down. He’s very strong, so we’ll have to hold his arms and legs and head, as hard as we can, and drag him out.”
“I don’t think we want to be perceived as the enemy,” I pointed out.
“Fine,” he said, “you figure out how to get him out of there. But do it fast, before he hurts himself.”
“Eugene?” I called from around the corner.
He answered with some incomprehensible shouting.
“I’m coming in! COVER ME!” I shouted, and ran onto the porch. As I ran toward him, I saw his head pop up, and he made a frantic “come here” gesture. I vaulted the pile of tables and chairs and landed beside him in the makeshift fort. He wrapped his huge arm around me, then gave me a hug. Another string of incomprehensible words, but he seemed relieved, and peeked out of the fort.
“I didn’t see any more out there,” I said, “I think they may have moved off to the north.”
Eugene thought about this, and nodded, his eyes still on the length of the porch. He stood up slowly, and helped me to my feet. He spoke again, and I could barely decipher the words, “I took way too much acid.”
Together, we walked off the porch and into the day hall as calmly as could be. The other MHA’s had retreated to the far end of the day hall, and I waved as Eugene and I walked to the dorms. I dropped him off at his bed, and walked back.
“We should probably go and restrain him,” said one of the MHA’s. “He’s just had an episode.”
“You go ahead and try that,” said my supervisor. “And Jimmy” (pointing at me) “and Eugene will both beat you to death with chairs.”