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Crazy Days at Metropolitan State Hospital — Walking the Line as Captain Kirk

On the ward, we had a color television that received a few broadcast channels, suspended from the ceiling in the day hall. On the CTG Wards (“Continued Treatment Group” — shorthand for “expected to be here forever”) very few patients actually paid attention to the television, though a handful of the more lucid ones would occasionally watch for a while. Almost nobody except visitors had the skills and inclination to actually watch it for an entire show, though occasionally, whatever happened to be on would feature prominently in somebody’s delusion.

I was in the day hall when Star Trek: The Next Generation came on, which I’d never seen before (not having a VCR, and always working when it aired.) I recognized the words in the introduction from the classic series… and pandemonium ensued. “Donna” ran to the television, screaming at the top of her lungs, “you’re not Captain Kirk!” over and over. She’s so agitated, I reach up and change the channel.

“Was that Star Trek?” yelled “Rob” from the porch.

“No!” shot back Donna, still shaking with rage. “The real Captain just turned it off!”

Uh oh.

She saluted me, adding, “Captain Kirk, you have the bridge. Shall I set a course, sir?”

Again, one walks a fine line between buying into a delusion, and denying it outright. Both paths are fraught with peril. But human interaction is a good thing, and generally people don’t like being ignored, and deflection isn’t always easy.

“Well, I don’t see a need to set a course right now,” I said, walking the line. “I think it’s best if we stay here for a while.”

“Understood,” she saluted, and marched off.

Rob sat on the porch with his new boom box and a pile of tapes, purchased with a social security check he got for disability benefits, listening to heavy metal at reasonably low volumes. Long-haired Rob looked like a heavy-metal weightlifter, and was usually lucid enough for conversations.

“Hey, Captain,” he greeted me with a smirk, having overheard Donna. “Have you seen my sweet boom box?”

“It’s great, Rob.” I was genuinely enthusiastic; it sounded great, and Rob didn’t insist on playing it too loudly or after hours. He’d bought some headphones, too, but during the day, he’d just play it quietly. He had decent taste in music, and the boom box was more expensive than any I’d ever own.

“I need you to get me something,” Rob said, in a conspiratorial aside. “It’s something I couldn’t get myself while I was out on my pass.”

At this point, I was rather assuming it would be drugs.

“I need you to get me a t-shirt. One with writing on it.” Well, that didn’t seem so bad after all.

“What writing?”

“It should say, ‘I murdered your children when you were at work,'” he said, “you know, something to wear around for my next day pass so nobody fucks with me.”

“Do they?” Rob was as big as I was, and heavily muscled. Aside from our giant hallucinating Vietnam veteran, he’s one I’d have concerns if I needed to take him down.

“Well, my dad fucked with me. ‘You need to feed the cat,’ he said. I said, ‘I’m not feeding the fucking cat.’ and a took a shotgun and BLEW IT ALL OVER THE FLOOR. ‘THERE, DAD, NOW NOBODY NEEDS TO FEED THE CAT.'”

“Uh. I’ll see what I can do, Rob,” I told him, walking the line again.

A commotion broke out; I hear female screaming in one of the dormitories, and I ran toward the sound. On the way, I passed Donna, standing at attention. “One of the crew has been possessed, Captain. There’s blood everywhere.” She salutes and steps aside.

I see the blood everywhere first, then I see one of the female patients, “Lanelle,” waving her bleeding wrists and chasing around everybody she sees. She is shouting, “I HAVE AIDS. I’M GOING TO DIE. WE’RE ALL GOING TO DIE.”

She very well could have AIDS, or it could be a delusion. Due to patient confidentiality, we wouldn’t routinely be told. I notice that the other MHA’s are nowhere to be found. Regardless, she needed to be calmed down and helped.

I grab Lanelle from behind and wrap my arms around her arms, being careful not to slip in the blood. The problem with our usual restraints is that they cover the whole arm, so I wrestle with her as I ponder what to do, talking calmly and keeping her off balance.

Donna appears before me. “Orders, Captain?”

“Go to the nurse’s station, tell him we need a gurney and we have a patient with bleeding wrists.”

“Aye, aye,” Donna salutes and runs off.

Moments later, two MHA’s arrive with a gurney. We strap down Lanelle while the nurse puts gauze over her wounds. “Does she really have AIDS?” one of the MHA’s asks the nurse, trying to avoid the blood Lanelle and I are covered in.

“I don’t know,” says the nurse. “Try not to drink any blood.”

The wounds don’t look too bad, but per procedure, the MHA’s take her away to be examined by a doctor, and the nurse follows. This leaves me alone in the ward. “Orders, Captain?” says Donna, standing at attention nearby.

Screaming breaks out in the day hall, male and female shouting. Oh, shit. There’s still blood all over the dormitory. “Well, Donna, maybe you could see what you can do about cleaning this up, I’ll be back,” as I run to the day hall.

One of the women on our ward, “Clara,” is a very large woman. By that, I mean she’s both quite tall (probably around 6″ 3″) and has a lot of non-fat bulk to her. She never says anything coherent, but generally lurches about the ward, swinging both arms together in unison.

I round the corner in time to see Rob punch her, hard, in the face, while she swings her arms, clubbing him in the head. “Don’t fucking touch me!” Rob yells, and she’s shrieking incoherently. I hope that if I restrain Rob, she’ll calm down, so I encircle him in our take-down hold, dragging him backwards, as fast as I can get him out of range of her fists. Rob struggles, hard, and we’re too close. ”

“Listen,” I said in Rob’s ear. “If you let me get you to the restraint room, I promise I’ll get you the shirt.”

“Really?” he says, relaxing in my grip. I pull backwards hard to get him out of Clara’s range. She’s still swinging, but not at anything in particular.

Rob walks with me back to the restraint room, and I’ve got him strapped down, sitting outside the room, filling out incident paperwork for Clara’s black eyes. Meanwhile, Donna has managed to clean up all the blood; the ward is spotless. When the nurse and MHA’s return about 10 minutes after they left, they are amazed.

“How the fuck did you restrain Rob by yourself?” asks one of the MHA’s.

“How did you manage to clean up all the blood?” asks the nurse, inspecting the dormitory. “I don’t think it’s ever been this clean in here.”

Donna gives them a smug look. “He did it because he’s the real Captain Kirk. There’s only one, and the sooner you understand that, the better off you’ll be.”


A week later, I handed Rob a paper bag containing a t-shirt silk-screened in capital letters, “I MURDERED YOUR CHILDREN WHILE YOU WERE AT WORK.” Despite the possibility of it being a terrific lapse in judgment, I keep my promises, and I printed it myself, in my apartment.

“Just promise me you won’t wear it around the ward, and especially not around the Christians,” I asked.

“No problem,” said Rob. “I’m going to visit my dad in a couple of weeks and I’m going to wear it. I can’t wait to see his face when he reads I’ve murdered his children while he was at work!”

He seemed so happy, I didn’t have the heart to point out that Rob is an only child. “Are you sure?” was all I could think of saying.

Rob seemed to have second thoughts, “Hmm, you’re right, he might think I meant his cat.” He thought a moment, then brightened. “I’ll wear it when I visit my mom.”

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Crazy Days at Metropolitan State Hospital — The Art of One on One

One gets used to patients thinking they have talents or pasts they don’t, so when “Mike” told me he wanted to play the piano, at first I wasn’t sure he actually meant it, or even meant it literally. I found out the hospital had a piano a few floors down, so I got permission to take him off the ward, down to the piano.

He sat at the piano wringing his hands for a few moments, and I was fully prepared for him to either suddenly realize he couldn’t play, plink out “Chopsticks,” or whale on the piano until I had to restrain him. I was pleasantly surprised when he launched into Bach’s Keyboard Concerto Number 1 in D Minor, beautifully. He then played a few classical pieces from Chopin and Mozart, and I was content to sit and listen for a while. In the middle of a piece, he stood up violently, flinging the bench backward, his fingers, clawlike, extended skyward. “Shit!” he yelled. “Shit is coming out of my fingers! Nothing but shit!”

I picked up the bench and hurried after him; he went straight up to the ward, and then back to the male dormitory to sit on his bed, gently rocking back and forth. I left him and walked back to the day hall, running into “Danny,” a schizophrenic hypochondriac. “I think I’m dying,” he said, which was his customary greeting.

As with any delusion, you neither want to feed it by agreeing, nor become argumentative by denying it, so I usually ignored or deflected. Danny continued, pointing to the center of his chest, “I think it’s my heart this time. I think it stopped.”

“Want me to check it?” I offered. One of our duties included taking vital signs — blood pressure and pulse, and sometimes temperature if it seemed necessary and it seemed likely the patient could handle a glass thermometer.

He held out his arm, looking the other way as if afraid to look. I didn’t have a pressure cuff or a thermometer, so I checked his pulse. His heart rate was a little high, probably from anxiety, but in the normal range.

“You have a pulse,” I told him.

“That’s terrible!” said Danny. “My heart stopped and I still have a pulse! It must be something really bad. I’d better go lie down. And maybe die.”

I left him to his room and was assigned to one-on-one duty with “Donna.” One-on-ones were patients at high risk of one sort or another, usually violent toward themselves or others. When on a one-on-one, you’re never supposed to be more than arm’s length away from a patient, for any reason. For example, if a fight started elsewhere, you’re supposed to let it go and call for help. This included the bathroom, which is why female MHA’s were normally assigned to female patients. Donna, however, was a big, strong woman. If she needed to use the facilities, I was supposed to either maintain the short distance, or temporarily hand her off to a female MHA (in short supply) and wait just outside.

Donna was on one-on-one due to “extreme suicide risk.” She was psychotically depressed, which is either terrible combination of schizophrenia and depression, or depression so severe it’s indistinguishable from schizophrenia. A few weeks earlier had managed to fashion a plastic utensil into a weapon, carving deep gashes along her veins in both arms, and bleeding enough that she had to be removed from the ward for surgery, and later, electroshock. Her arms and throat were criss-crossed with long white scars from previous attempts, and the stitches from her recent surgery were still visible down her forearms.

When Donna was handed off to me, she was examining her arms. “These stitches are so goddamned ugly,” she said. “It’s depressing.”

If there was a hint of irony in her voice, I didn’t detect it.

We talked pleasantly for a while, and in the middle of speaking, she suddenly launched herself at an end table, trying to pull out the drawers. I’m not sure what she had in mind, but I restrained her and tried unsuccessfully to calm her down, eventually having to strap her down in isolation, where she was sedated. This effectively ended her one-on-one, until she was released from the restraints.

One-on-ones were usually dreaded by MHA’s, as I’m sure they were dreaded by patients. A one-on-one was usually characterized by hours upon hours of doing absolutely nothing (one-on-ones actually sat by the patient’s bed while they sleep, if they sleep) punctuated by the occasional fierce battle with a patient, usually as soon as you looked away or let your guard down.

I was sent down to a different ward for a one-on-one with a schizophrenic patient with pica. Pica is an affliction where a person is compelled to eat things that aren’t food — like dirt. When coupled with schizophrenia, the compulsion was magnified and enhanced with irrational behavior and thinking patterns.

My patient was sitting at a table, his MHA carefully positioning himself between the patient and the day hall as he handed off responsibility to me. “Careful,” he warned me, “he eats cigarettes. Don’t give him any, or let him anywhere near ashtrays.”

The patient glanced up at me, and returned his attention to the blank sheet of paper in front of him. He had a ball point pen, and over the course of the next hour or so, sketched an elaborate scene of hell entirely in blue ball point, entirely with dark, cramped strokes. It was both gorgeous and horrifying, the work of a unique and talented artist, with an impossibly detailed and realistic scene of supernatural torture and suffering. He had worked slowly from one corner of the page to the other; rather than sketching complete figures or backgrounds, he worked his way in a narrow stripe across the page, and back again.

Another patient walked up behind me, looked at the drawing, and said in a low whisper, “watch out, man, you’re almost on deck.”

As the artist put the last stroke of blue ball point in the corner, he crumpled up his creation… and tried to eat it. I was quicker, and stopped his arm before it reached his mouth. The artist looked at me with a forlorn expression. “At least let me throw it away. It’s Hell. I need to destroy it.”

“Fine,” I said, with some empathy for the compulsion.

The artist lunged toward the day hall. “I’ll put it in the ashtray,” he said, reaching for it with both hands.

I blocked him gently and pulled him away from the ash tray. “There’s a trash can near the door,” I said.

The artist studied the ash tray behind me, shrugged, and said, “yeah, okay, you win.”

He accelerated toward the trash can, reaching it just before me, pulling out a paper bag that was on top. Again I caught his hands, and pulled him away from the can as gently as I could, taking away the bag and throwing it back in the can. With a sigh, he threw his drawing into the trash can, and sauntered back to the table.

He started another drawing on a new sheet of paper, again starting at the corner. He was halfway through an equally intricate, but quite different scene from Hell when I handed him off to another MHA. “Why doesn’t he eat the pen?” he asked me.

The artist stopped drawing, having overheard. “Because,” he said, waving the pen at us, “eating a pen would be nuts.” He pointed to the pen, and to his drawing. “There are demons in the ink, I’m trying to get them all out.”


When I returned to my own ward, Danny, the hypochondriac, was shuffling around, clutching his chest. As I watched, he lay down on the floor. He was right below a poster on administering CPR. and had managed to position himself just like the “victim” on the poster.

One of our quieter old ladies was walking by, and stopped at his prone body. She looked down at Danny, and up at the CPR poster with comic exaggeration several times. She bent down over his body, listening for a breath, listening for a heartbeat, and referring to a poster. When she got to the step on mouth-to-mouth, I thought perhaps I’d better intervene, but instead of starting mouth-to-mouth, she held up a carton of milk from the cafeteria and shouted, “WANT SOME MILK?!?”

“No,” said Danny, not moving. “Thank you.”

I left him to his own devices and went back to the male dormitory, where Mike was sitting on his bed, feet drawn up, a look of horror on his face.

“Mike, what’s wrong?” I asked.

“A tse tse fly appears to have invaded,” he said, pointing.

Near the bed was an enormous cockroach, the kind that lived in the tunnels. It was not making an effort to skitter away or hide, but instead was rearing up on its hindmost legs, waving its antennae. It was surprisingly creepy.

“I’ll choose you for it,” I said. “Evens or odds?”

Mike lost with evens, and grabbed a shoe. He danced over to the cockroach, then hammered it with the shoe repeatedly with a tremendous sound that echoed through the ward. A big cockroach makes a big mess.

“I’ll get some paper towels,” I said.

“Better get a bucket,” said Mike. “Cockroach shit is a lot worse than piano shit.”

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Crazy Days at Metropolitan State Hospital — Internal Stimuli

One day, a new patient was brought to our ward. This is unusual primarily in that most of our patients were long-term, and there wasn’t a whole lot of turnover. People didn’t often get out or leave, so seeing new faces was unusual unless it was for an extremely-rare family visit or new recruits joining the visiting Christians. The new guy was an older man, who looked like an old southern gentleman, with shoulder-length grey hair and a chin-puff beard. I don’t know if he had a southern accent, as he didn’t speak.

Paranoid schizophrenics don’t all appreciate or understand eye contact and a hearty handshake, so I left him alone. He didn’t speak, and mostly paced back and forth along the day hall, a ritual I wasn’t about to interrupt.

Our largely-Haitian custodial staff (and some MHA’s) were in the obnoxious and dangerous habit of speaking French to each other on the ward. A normal person not fluent in French might have suspicions that they are being talked about. To a paranoid schizophrenic, this is not only an absolute certainty, but it provides proof of a conspiracy against them, feeding into any number of delusions and agitating them beyond belief. For this reason, the hospital had a strict English-only policy. The policy was sometimes just ignored, with the predictable result that French-speaking Haitians tended to get attacked at an alarming rate.

On more than one occasion, I found myself rescuing one or more Haitian rejects. It pissed me off and I wrote them up. Knowing the patient was set off unnecessarily may have led me to be even more gentle when I restrained a patient, even though I might want to punch the jerk who should have known better. I never did, of course, though I’ll admit being pretty slow on the draw if the patient wasn’t in danger of getting hurt.

Sometimes, though, a patient would be set off by nothing in particular. More accurately, nothing external, as schizophrenics often had a disjointed internal dialog that could upset them or tell them to do things. This was referred to as “responding to internal stimuli,” and would appear on incident reports where a patient would appear to go off for no discernible reason. Even with medication, some patients were subject to bouts with their internal demons, so on the ward, one’s guard was never entirely down.

As I sat in the day hall chatting to a patient about one of their problems, the new guy walked back-and-forth, back-and-forth in front of us. Nobody paid much attention, though I tried to keep an eye on “the Colonel,” as I thought of him, without it seeming obvious that I was keeping an eye on him, which can be a trigger for an episode. So mostly, I listened to his feet, and didn’t look at all.

The footsteps halted abruptly near enough where I could see his feet, even looking down. A lot happened at once — he reared back, and his foot came up. With a small measure of pride, I can say that my first thought was how I could keep the Colonel from hurting himself. With a larger measure of embarrassment, my second thought was “here comes a foot right for my FACE,” and since I didn’t want to knock the guy onto the concrete, I decided to lean back to minimize the blow and get kicked in the face. Decided is probably far too strong a word, as ruling out more potentially-harmful-to-the-patient options as his leg was in motion left me with very few choices of action, most of which involved a facially-visible shoe print.

Agitation breeds agitation, so a lot of the patients started yelling and getting upset. The Colonel lost his balance with the initial blow, his fists balled with rage, body shaking, face strangely impassive. I grabbed him and we fell to the ground together. “It’s okay,” I said calmly, “I won’t hurt you.”

Other MHA’s showed up and they walked him down to the restraint room. Since I’d been kicked, I was instead sent to the nurse, who looked at the tread on my face and said, “those look like Converse All-Stars.”


As they struggled to restrain him, the MHA’s noticed dollar bills on the floor of the restraint room, which had fallen out of the Colonel’s many pockets as he tried to wrestle free. He’d apparently had nearly $500 in small denominations crumpled and stuffed all over his person, which was inventoried and placed in safekeeping to be returned to him upon his release.

I didn’t see him for a while after that, but while I was sitting on the day porch, he marched out and fixed me with a wild-eyed look. I was wary, but not openly defensive. After a moment, he sat down next to me.

“Sorry about kicking you,” he said with a sigh. “Money just makes me so crazy.”

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Crazy Days at Metropolitan State Hospital – Getting Out

We didn’t wear uniforms or special clothes as Mental Health Assistants — aside from a general guideline about wearing comfortable clothing without accessories that could be stolen or used to strangle somebody, we dressed however we liked — for me, this generally meant jeans and a shirt that wasn’t too loose — which is what most of the patients wore. Most MHA’s were indistinguishable from patients, except sometimes they did slightly more work, and always had keys attached to their belt loops.

Therefore, the general assumption when walking around the grounds is that the people you see are staff. As a huge hospital, there were always people outside on the grounds here and there, and little reason to pay attention to them.

As I parked my car in the lot, I noticed a large man on a Harley cruise by. I looked up to see his back as he thundered by. Nothing remarkable in that. However, as I walked from my car to the front door, there he was again, cruising along in the same direction. That struck me as slightly odd. Just as I got to the front door, I heard the familiar engine noise of an approaching Harley, and this time caught a glimpse of the driver as he sped by. It was “Eugene,” a patient on my ward — a 350 pound, 6 foot 6, hallucinating Vietnam veteran.

I hurried upstairs, and located the nurse in charge of the ward. “Hey, I just saw…” I started.

“Eugene?” he finished for me.

“Yeah. I just saw him go by on a motorcycle. Does he have a day pass?”

“Nah,” the nurse said prosaically. “One of the Christians let him out. Apparently he just scared the Hell out of her, and she held the door open for him.”

“The Christians” is how we referred to a church group who would visit the ward. Their hearts were certainly in the right place, and they offered company to any of the ward’s residents who were interested. They’d play games or read Bible verses, and were generally well received. On the other hand, they were often woefully unprepared to deal with our tougher cases, sometimes mistakenly fed delusions, and were often a focus of attacks. When they were around, I usually kept an eye on them, as there were at least a few patients they’d agitate. Occasionally, there would be a new face, and sometimes they’d simply freak out, and beg to be let out of the ward.

The week before, I’d been on duty when one of the Christians ventured from their usual table to offer to read the Bible with “Ed,” who was generally quiet on his daily dose of thorazine. She took his lack of response as assent, so she sat down and started reading. Ed listened for about five minutes before screaming “Jesus killed my parents!” and launching himself at the poor woman. I was nearby, and caught his elbow before he punched her in the face, taking him down; even immobile in my grip, he refused to calm down, so I tied him down to a restraint bed.

By the time I got back out to the Christian table, she was gone, but one of her friends thanked me on her behalf, and offered to pray for me. I hadn’t expected her to be back.

However, she had been back, and Eugene, a huge and gentle man, had startled and frightened her so much, she had let him out. He’d never shown any sign of wanting to get out, nor ever asked for a day pass, or to go out to work.

“So, where’d Eugene get the motorcycle?” I asked the nurse.

“As far as anybody can tell, he stole it. He was a mechanic in Vietnam, apparently,” explained the nurse.

“So… Are we supposed to go get him? Or call the police?” Nobody was chasing him when I saw him, or, for that matter, appeared to be paying attention at all.

The nurse shrugged. “Well, you know Eugene. Unless he’s having an episode, he won’t hurt anybody or himself, and he’s really not capable of living on his own. Besides, he’s a volunteer, and he’s on the DNR list.”

Surprisingly, most of our patients were technically volunteers. It was more rare to encounter a patient who had actually gone through the legal process of being committed. Being a volunteer didn’t mean you could come and go as you pleased — you could fill out some paperwork, and you’d be released in 48 hours if there were no objections. The trick was that an objection was automatic, and the process of commitment would begin — so there was a class of patients who would apply to get out, then withdraw their request when threatened with commitment, often assured that they’d be released when they were truly ready.

Another class of patient included people who didn’t seem very dangerous, and for whom the hospital was a sort of home — people who would otherwise be mildly deranged homeless, living on the streets. Many of these people were on a “do not report” list, which meant that if they escaped or left the hospital, nobody made a fuss. They’d be granted a day pass and wander off, and nobody would look for them or report their loss to the police. Usually they’d be back some time after their medication wore off, a week to six months later, usually on their own, and occasionally brought by the police.

The nurse continued, “he’ll probably put the motorcycle back and come in when he gets tired. Hopefully whoever owns it won’t call the police, that would just mean more paperwork for us. Hey, why don’t you take a patient outside who hasn’t been in a while, and you can kind of keep an eye on Eugene, just in case?”

“Sure,” I said, and got about ten feet from the nurse’s station before “Melvin” drew me aside. Melvin was shy and quiet, slight of build and older, and I hadn’t talked to him much before.

“Do you think I can go outside?” he said hopefully. “I haven’t been outside in fifteen years.”

“Really? Wow. Sure, of course,” I said. “Let’s go.”

Melvin and I walked out and sat on the lawn. We watched Eugene buzz by several times, while Melvin smiled contentedly and picked blades of grass.

“So, Melvin,” I said, conversationally. “How come you haven’t been outside in so long?”

“I can’t get a pass to go out by myself,” said Melvin sadly. “And nobody will ever take me.”

“That’s … well, that’s too bad,” I replied. “How come?”

“Well,” he began, and hesitated. “I killed an MHA. Buried him in the woods over there.”

“Uh. Really?” I was a little surprised that nobody had mentioned this to me, but then again, I didn’t tell the nurse who I was taking outside, and we did have a number of dangerous patients on the ward. It could be true.  It might be that the hospital never even found out what actually happened. It could also be a delusion, but even then, if he thought he’d done it before, he might try something “again.”

“Yeah,” he said, a trace of regret in his voice.

I briefly assessed his small stature and thorazine-dimmed reflexes, and decided I wasn’t any worse off with him one-on-one than I was when vastly outnumbered in the ward. Eugene buzzed by a few times before Melvin spoke again. “Don’t worry,” he said, “I like you.”

Eugene went by a few more times. “It’s good to be outside,” Melvin said, standing up. “Do you think you’ll ever take me out again?”

I thought for a moment. “I don’t see why not,” I said honestly, “I’ll check with the nurse next week to see if we can head outside for a while again.”

“Even five minutes would be great,” said Melvin, as we went inside.

About an hour later, I looked up to see Eugene looming through the glass on the other side of the door. I walked over and unlocked the door for him, and stepped aside as he came in.

“Ran out of gas,” said Eugene.

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Crazy Days at Metropolitan State Hospital — Meet the Neighbors

Work wasn’t the only crazy thing going on for me, living in Waltham, Massachusetts seemed no more sane than spending all day — sometimes two — inside the wards.

I lived in a three bedroom apartment with four roommates, two of whom worked at the same hospital. It was a cheap, relatively run-down 4-apartment building owned by a guy who managed properties for other people, and had scraped together the cash for this place. None of us had much money, and we managed to get the rent reduced even further by agreeing to paint the kitchen ourselves and accepting the fact that we had no refrigerator. We never ended up painting the walls, though we did think about it, and the five of us squeaked by on a little dorm fridge with a capacity under two cubic feet.

The apartment was infested in a way that I’ve never seen an apartment infested before or since. Roaches seemed to be everywhere, at all times. Although they mostly disappeared with a faintly horrifying clicking whenever the lights were turned on, there were always a healthy amount around and underfoot. Other insects abounded, and every shower was preceded by a ritual that involved trying to rinse down the drain the smattering of insects that managed to find their way inside the tub and onto the shower curtain. This was true even if only a few minutes elapsed between the last shower and your own.

It’s amazing what one can get used to. We simply kept all food items tightly sealed, and what couldn’t be thoroughly sealed got crammed in the little fridge whether it actually needed refrigeration or not. Early on, we made a few calls to the landlord, who promised to fumigate, but not much happened.

We met our downstairs neighbors first, which included “Rose,” who appeared to be a single mother in her 50s or 60s with a group of somewhere between 5 and 10 adult children, their spouses and/or girlfriends, all living in an apartment approximately the same size as ours, which was at capacity with 5. I first met her when returning from second shift, around eleven. She was in front of the apartment in a folding chair, drinking something out of a paper bag.

Across the street, her son emerged from underneath a 70’s-era rustbucket of a car holding a muffler with the entire 6-foot-long exhaust pipe attached, waving it over his head. “Hey, ma! I think I know what’s wrong with the car!” he yelled triumphantly, waving the exhaust assembly like a flag.

She looked at me, and said without irony, “that boy’s mechanically inclined.”

I ran into her again the next day when I went to a Shell station to put some gas in my car; she was sitting in the attendant booth, reading a magazine. I paid her, and she recognized me, and said hello, and confided that the Exxon a little down the street was a little cheaper, and they were having a special on oil. I needed oil, so I thanked her, and planned to pick some up.

After work, I headed to the Exxon to pick up the oil, and there she was, in the attendant booth. “Oh good,” she said, “I’m glad I told you about that.” It had been a long day, so instead of asking if she’d quit her job to join a different gas station, I headed home.

I had picked up an early shift the next day, so on the way to work, I stopped by a Texaco to get a convenience-store style lunch in a microwavable container, and there she was again. “Hi!” she said, as if I should expect her to be working in every gas station in the greater Waltham area.

“Wow,” I said, “in how many places do you work?”

“Five,” she said. “All part time. Takes all damned day, but I’ve got a family to feed.”


After a long double shift, I drove home. Not many people are out late at night, but there was a man walking his dog. Just as I was driving up, he pointed toward the street, saying something to the dog. The dog danced into the street, watching its owner excitedly, as if expecting something to be thrown.

I swerved to avoid hitting the dog; since a car was coming the other way, I had little choice but to swerve up on to the sidewalk, narrowly missing the man. Momentum carried my car up and onto the lawn of a corner house. I could feel the car sinking in the wet lawn and mud underneath; afraid of getting stuck, instead of stopping, I eased on the gas, moving off the lawn, over the sidewalk, and ultimately back onto the street where I was.

Checking my rear view mirror, I saw a house with splashes of mud and sod across its facade and big picture window, deep furrows where tires had torn across the lawn… and a man scolding his dog.

I didn’t stop, I’m sorry to say, but the next day, guilt got the better of me and I visited the house to apologize and see what I could do to fix the lawn. It was a little after noon, and a tired-looking man answered the door. As I launched into my explanation, he seemed to wake up a little, and said, “wait, what?”

I explained again about the dog, and how I’d trashed his lawn.

“Oh thank god,” he said. “I thought I’d done that and blacked it out.”


My roommates and I were invited over to meet our adjacent neighbors, whom we ran into out front while talking to Rose and a few of her clan over beers. They were a nice Indian couple. Only two of us could go, the other roommates having to work.

They opened their apartment door to one of the more amazing things I’ve ever seen. Their walls, floor, and ceiling were crawling with insects. It was a swirling, disorienting feeling, like all the surfaces were constructed entirely of roaches.

“Tom,” my roommate, simply said, “Oh. My. God.”

It was suddenly, horrifyingly obvious why our apartment was overrun, and why our best amateur efforts at eradicating our own insect scourge appeared to have no affect whatsoever.

“Please be careful not to step on them,” our neighbor said, using a broom to gently sweep us an insect-free path to the table. “We believe in the sanctity of all life.”

I couldn’t think of anything to say. Tom and I walked dumbly to the table. I brushed off my chair and sat down, fascinated as the bugs occasionally crawled over our hosts, who made every effort not to hurt them.

“Welp,” said Tom. “I gotta go. I … just have to. Nice meeting you!” and he bolted for the door.

“Would you like some tea?” the woman asked me.

“Well, I…” while I had gotten used to cleaning every cup before I used it in our own place, this was a bit much for me. It was like being inside the Smithsonian roach exhibit, intended to demonstrate what a roach population would look like in a typical kitchen if a few generations all survived to adulthood.

Tom leaned back in the door. “He has to go, too.”

And we still had one neighbor yet to meet.

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Crazy Days at Metropolitan State Hospital — How Did I Get Here?

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.”

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Crazy Days at Metropolitan State Hospital – The Intake Ward

Like most people subsisting on the lowest rung of the hospital ladder, I’d often try to pick up extra shifts in order to make more money. Interested people would head down to the assignment office, where they’d have lists of openings, and if you qualified, you could sign up and take the shift, subject to a few restrictions. You couldn’t take more than two extra in a row, that sort of thing. The choicest assignments went to those with seniority, preference was given to people actually assigned to the ward they were picking up an extra shift for, and so when I picked up extra shifts, they were often first or third shift on my own ward, or wards that were incredibly unpopular for some reason.

As it turns out, it may not have mattered whether I was given preferential treatment on my own ward; it was immensely unpopular due to the higher-than-usual number of violent patients. So I was pretty surprised when I got a second shift on an “intake ward.” For some reason, nearly everything else was chosen first.

There was a good reason for this. The intake ward was the first landing place for people who were picked up by the police and given to the hospital instead of running through the court systems because of some obvious reason that they belonged here. I had wrongly imagined that the intake ward would be populated by gently eccentric people brought in by concerned families — not so, those people went to private institutions. In our hospital, the two major paths in were being brought in by the police, or on a stretcher, often to go through the most brutal phases of substance withdrawal. Many were homeless, picked up by the police for something as minor as vagrancy, but managing to clearly demonstrate that they were “a danger to themselves or others.” More than a few homeless wanted to get in to the hospital, checking themselves in, and living out their days with food, shelter, and medical care.

Though the greatest reason for its unpopularity among the staff was the sheer unpredictability of the place. After settling in on a ward, you got to know the patients well — what might set them off, what they like, who needs company. While everybody has their good and bad days, they are within parameters well established by their particular afflictions and medications. Not so on the intake ward. Anything could happen, so you had to constantly keep on your toes, and since everybody is virtually unknown, you can’t tell the difference between the truly docile and those preparing to spring into violent action. To make things just a little worse, most of the people there are quite convinced they don’t belong there at all — and a few actually don’t.

Within a few minutes of my arrival on the ward, I was waved over by a patient sitting in the day hall. He looked around to make sure nobody was listening, and said, “hey, want to know how to make a silver watch out of a nickel?”

“Sure,” I said. While you never want to buy into anybody’s delusions, it never hurt just to listen to anybody.

“Do you have a nickel?”

I searched my pockets, and came up with a dime and a penny, and nothing else. We didn’t carry much, and our keys were required to be firmly attached to our belts. In many cases, the keys dangling from the belt were the only way you could tell staff from patients. “No,” I said, showing him the two coins.

“Well, those won’t work, but I’ll at least tell you how to do it. You’ll have to just imagine the nickel. Now pay close attention,” he said, holding his palm flat, and pointing to the center. “First, you put the nickel in the center of your palm. Right in the middle, right about here.” He traced a nickel-sized circle on his palm.

He paused, looking around to see if anybody was paying attention. They weren’t. “Okay, now make sure you get it in the exact center of your palm. Right in the middle. Have you got that so far?”

“Yes,” I said earnestly, holding out my palm and pointing. “Right here.”

“Exactly,” he said, triumphantly. “You get that just right, and the rest is easy.”

I waited.

“Okay, the next thing you do,” he glanced around again, as if he were about to divulge a tremendous secret. “Is you get some tools, you make all the parts, and you put them together.” He beamed, having conveyed his miracle system to somebody who understood. “Next time I see you, make sure you have a nickel, and I’ll make sure you do it right.”

There was no telling what might happen with an actual nickel. Would he be profoundly disappointed in our inability to make his technique work? Would he become violent, now viewing me as an enemy, unable to use his closely held secret? Or would his delusion simply shift, always chasing what wasn’t around?

A call for help left me for little time to contemplate, and I ran to the source of the call. Another MHA blithely watched me run by (as was the case, more often than not) either on an assignment that takes priority, or simply profoundly lazy or risk-averse. I usually made an effort to believe the former.

I got to a room where a patient was up on a desk, waving a lamp, still plugged in and brightly glowing, and yelling “I’m not crazy!” which was doing surprisingly little to convince anybody. A staff member — an MHA, by the looks of him — sat on the ground by the desk, bleeding from the head, and looking slightly dazed. I had a little more sympathy for the man on the desk than the man under it, for some reason.

“Hi,” I said, as brightly as I could.

“Don’t touch me,” he said, fairly calmly, still brandishing his lamp.

“No problem,” I said, stepping out of the doorway. “Mind if I touch him?” I pointed to the dazed MHA.

I walked over and got him to his feet. To the man with the lamp, I said, “I’m just going to get him out of here and hand him over to the nurse. He seems to be upsetting you.”

“Uh. Okay,” he relaxed a bit, finally seeming to notice that the lamp in his hand. And that he was on the desk. He climbed down sheepishly and set the lamp down as I dragged the MHA outside the room. Aside from being dazed, he seemed okay, so I dumped him in a chair by the door and went back in.

I was followed by something I hadn’t seen on any ward during my entire tenure at the hospital — a psychiatrist. He stepped in, looked at the man now sitting at the desk, and said, “are you more angry or frightened right now?”

He gave this some thought, and said slowly, “frightened.”

The psychiatrist turned to me and said, “I think we’re okay here, I don’t want you to frighten him.”

The MHA was still sitting outside the room. Still rather dazed. Maybe a concussion. I half led, half dragged him to the nurse’s station, where I left him.

I returned to the day hall to find a man with a white headband and wristbands, neatly groomed moustache, clean, expensive tennis shoes, and an incongrously ratty-looking oversized t-shirt and shorts. “You there,” he addressed me as if I were his waiter, “I could use a hand here.”

I walked over and asked what I could do. “Any chance I can make a phone call?”

“Sure,” I said, pointing him to the pay phone.

He looked dejected. “I don’t suppose you’d loan me a quarter, would you?”

Because I had checked earlier, I knew for a fact I had a grand total of eleven cents in my pockets. “Just a minute,” I told him.

I walked back to the nurse’s station, where the MHA with the head would was lying on a bed behind the nurse… snoring. The nurse sat by the window, reading a magazine, and looked up at me.

“Hey, does that guy have a quarter in his pocket?” I asked.

Without a word, the nurse walked over and fished around in the snoring man’s pockets. In a moment, he produced a quarter, and handed it to me without a word. He went back to reading his magazine.

I went back to find the guy with the headbands talking to the guy who knows how to make silver watches out of nickels, nodding absently as he explained that “apparently, the police don’t like it when you try to play tennis naked.” He brightened when I handed him a quarter.

“Thank god,” he said. “My wife is going to kill me.”

“Yeah,” his friend agreed. “It’s too bad you didn’t get a nickel.”


The man with the lamp found me in the day hall next. “I just wanted to say thanks,” he said awkwardly. “You know, for not punching me or anything.”

“No problem,” I said brightly. “Hey, how did it go with the psychiatrist?”

“Well,” he said sadly, “he’s kind of a dick. I think I’m going to be stuck here for a while.”


A couple of weeks later, I got another shift in the intake ward. All the faces were new, as I should have expected, every patient who was there before either discharged or moved to a more permanent ward. Lamp guy and naked tennis guy had been discharged; nickel guy was committed to one of the long term wards, and I did see him now and again. He’d recognize me right away.

“Hey!” he’d call as soon as he saw me. “Did you ever find a nickel?”

Once, I actually had a nickel, which I handed to him. He examined it carefully, shook his head, and handed it back. “This one won’t work,” he told me. “It’s the wrong year. Keep looking, though, chief, I know you’ll do it.”

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Crazy Days at Metropolitan State Hospital – The Tunnels

I moved to Waltham, Massachusetts a few days before my job started at Metropolitan State, and so I decided to look around Boston. Without a lot of cash, the best thing to do seemed to be to get on the T, pick a station, get out and wander around. I did precisely that, and as I got off the T at about 8:00 a.m., a guy with a shaved head walked up to me, looking rather lost, and perhaps a little jittery.

“Hey, uh,” he said sheepishly, “do you know the way to the train?”

“Do you mean the T?” I asked, unsure if he meant the same thing.

“Nah, I just came from the T,” he said in his thick Boston accent. “I mean the trains, like, to leave town.”

“Sorry, I have no idea, I just got here,” I explained. “I just got off the T, but that’s really the only thing that I know where it is.”

“That’s cool,” he said, and wandered off, presumably to ask somebody who knew what they were talking about.

He was quickly forgotten as I saw the sights in Boston, returning early in the afternoon. I got off the T and stood at the bus stop for one of the electric buses that passed near my Waltham apartment. As the bus came, a woman with a baby struggled with folding her stroller and asked if I would hold her baby for a moment.

“Sure,” I said, as the baby slept, and I was careful to support his neck.

She got on the bus with the stroller. The bus doors closed, and the bus drove away.

So I was alone, in a strange city, with a baby, and no earthly clue as to what exactly I should do next. I was going to get on that bus, obviously, so I at least had to wait for the next one, but if it came… should I get on? Would it be better to stay put, or go somewhere like a police station?

The thought occurred to me that this was my baby now, and I was picked, not to hold the baby for a moment, but to raise it as my own.

Another bus came by, and I decided not to get on. The most reasonable course of action seemed to be to just stay put, until the baby woke up. And then figure out what to do.

As I contemplated this, another bus stopped on the other side of the street (coming the other way) and the mother jumped out in a panicked run across traffic, yelling something along the lines of “OHMYGODMYBABYTHANKGODTHATFUCKINBUSDRIVER.” My ear had not quite attuned to the Boston accent, so I’m not entirely sure. At any rate, she gave me a hug, and took her baby. When the next bus came, I carried the stroller on board and got on first.

I hadn’t even begun work yet.


At the end of my first week of work, my supervisor assigned me to “take out the trash.” There was a big plastic-over canvas on a steel frame cart filled with trash bags and loose trash; “Dan” pointed out an old-style freight elevator in the middle of the ward with a steel door that required keys to open. “You can get down to the tunnels down through there, and then it’s a bit of a maze,” he explained, as I pushed the cart into the elevator. “Gordon will show you. He’s a patient, but he’s pretty trustworthy.”

With that endorsement, “Gordon” stepped onto the elevator as “Dan” walked away — he seemed awfully familiar, and we were descending to the tunnels as I suddenly realized where I’d seen him before — he was the person who had asked me for directions to the trains.

“Gordon,” who hadn’t said anything but had been staring at me since he got on, recognized me, too. “Heeeey,” he said, “you’re that guy I asked for directions.”

“Ah, I remember you as well,” I said. I couldn’t think of anything else to say, so to fill the uncomfortable silence, “did you ever find the trains?”

“What the hell do you think?” he said, becoming agitated. “Would I be back in this hospital if I’d found the goddamned trains?” He grabbed the trash cart, and started lifting it up and smashing it into the metal walls and steel gate of the elevator. The racket echoed up and down the shaft, and through the tunnels, and he was shouting now. “YOU KNEW WHERE THE TRAINS WERE, YOU JUST DIDN’T WANT TO TELL ME BECAUSE YOU KNEW I’D ESCAPED, YOU SON OF A BITCH” “Gordon punctuated this by slamming his body and the cart into the walls of the elevator as I backed into a corner, trying to be inconspicuous.

The elevator stopped. So did “Gordon.”

“Oh good, we’re here,” said Gordon cheerfully, as if nothing had happened. Seeing me frozen into my corner, he laughed and said, “just messin’ with you, man.” He started whistling and pushing the trash cart. “By the way, don’t tell anybody I escaped, they won’t let me do this any more.”


The tunnels at Metropolitan State were absolutely amazing. Under the buildings, miles and miles of tunnels criss-crossed the gigantic campus, leading to intersections, dead ends, sometimes entrances, and long-forgotten rooms and parts of buildings that hadn’t been used for years. Trash detail was an opportunity to explore that I thoroughly enjoyed — most of the time, “Gordon” and I would go together.

Most of the tunnels were long-ago painted concrete corridors lit with bare bulbs, in some cases so sparse that you could barely see the next lit one in the darkness ahead. A channel ran down the middle of the tunnel for drainage, and the floor gently sloped toward the channel. In the channel there was sometimes a trickle of water, but more often there would be some of the largest, most fearless cockroaches I’d ever seen in my life. Rather than hide, they had a tendency to stop and rear up as you walked by. It was like being threatened by a wallet with antennae.

A lot of rooms were empty and uninteresting, containing little but debris, but there was a room that contained an old-style dental chair with restraints with a few large splashes of brown stains on it; a few rooms just filled with little cages, about rabbit-sized; a room with one larger cage in the center, about human-sized; a room with a bed frame in the center of the room where the concrete walls had been chipped away nearly everywhere that a person could probably reach; a room where chains hung from the ceiling from a couple of high beams. Every new discovery was bizarre and creepy, yet stimulating. Most were probably arranged as we found them for much more mundane reasons than we could imagine.

As we explored further and further from the ward, we’d have to run in order to avoid being missing for too long — the loading dock entrance where we dumped the trash wasn’t very far away, and presumably either one of us would be missed — at least I thought so, until we got lost. So lost, in fact, that we had to leave the tunnels to get our bearings, and didn’t recognize the buildings around us — though it was an easy matter to walk back to our building by navigating by the bell tower. (We didn’t want to run, since that would probably raise questions, and possibly an alarm, so we settled for as casual-looking a power walk as we could manage.)

We slipped into the ward through the front door, then back down to the tunnels to retrieve the trash cart.
“Dan” saw us step off the elevator with the trash cart. “Where did you guys go? Did you guys get lost?”

“Gordon” answered before I could, “Yeah, nobody down there knew where the FUCKING TRAINS are.”

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Crazy Days at Metropolitan State Hospital – I Don’t Belong Here

My first day of actual work, after training, was in the ward that would be where I spent most of my time at Met State. On the sprawling, 400-acre complex, it was a wing of yet another giant building, designated by a floor and direction. Between the staff, it was known as “chronic, long term,” which I was never quite sure was an official description or not.

Wards operated under the nominal control of a nurse, who usually sat in the “infirmary,” a little room with a half-door where medication was handed out. Operational control of the ward was in the hands of my immediate supervisor “Dan,” an MHA-3 (the number indicated seniority and pay grade), a large, genial man who introduced me to many of the patients, and outlined the basics of the job. We parted so that he could take care of something, and one of the patients I had just met pulled me aside.

“Donna” looked like a mental patient. Older and somewhat scrawny, she had a tired and haunted look. “You’re new here,” she said in a low voice. “You’ve got to help me.”

“Certainly,” I said cheerfully. “Just tell me what I can do.” We walked into the day hall, a kind of semi-open porch where there were open windows covered with bars and chain link fence.

“I don’t belong here,” she sighed, “I’ve been here for thirty years, and nobody will listen to me.”

I sat down to listen. I was determined not to judge her by her appearance — 30 years of living in a mental hospital would surely make anybody look like they belonged there. It was also my first opportunity to do some good; I assured her I’d listen, and do what I could.

“When I was a girl,” she continued, “my mother had me committed. You see, I’m a …” she glanced around to see that nobody was listening, and whispered, “lesbian.”

“In those days it was considered a mental illness; it wasn’t normal, and my mother had no idea how to cope with it. So she committed me to this place, and at first, being a lesbian was enough to keep me here.” She looked defeated and sad as she went on. “But now I’ve been here so long, I can’t get anybody to review my case or listen to me, and I’ll be stuck here for the rest of my life. My mother died a few years ago. There’s no reason for me to be here.” She went on to provide details of her plight.

I told her I’d do what I could. There were procedures for these things, that had mostly been alluded to in training rather than detailed. There was paperwork to fill out to request a case review by a psychiatrist, which requires case histories to be reviewed by the person filling out the paperwork — me. I asked Dan the MHA-3 where to find what I needed. He helped me locate all of it. “You’ll learn,” he said, with a knowing smile that wasn’t quite a smirk.

I finally located her case history — all on paper of course, in those days — and I checked with Dan to make sure I had the right one, because it didn’t appear to match at all. “Donna” had been there about thirty years, but the case history said nothing about being a lesbian, and said she’d been brought in for “incoherence and confusion” by the police as a young woman. Her file was also marked “voluntary,” which meant that she had not actually been committed, but was there on a voluntary basis. I looked through all of it, but for thirty years of being institutionalized, her file was surprisingly thin.

I located “Donna” in the day hall to talk to her before I continued with the case review paperwork. When I sat down next to her, she asked anxiously, “did you read my case file?”

“Yes…” I started, not sure where to go from there.

“Well, it might not do me any good,” she said, handing me a postcard. The picture was of an electric bus outside a library in Waltham. It was crumpled and worn, postmarked from Waltham about a month ago, and addressed to Donna, care of Metropolitan State. The handwriting was cramped and artistic, in blue ball point pen.

It read, “Dear Donna, please do not leave the hospital, we will come for you soon. — The Aliens”

Donna took back the postcard and waved her arms in an expansive gesture, “So I can’t leave yet, the aliens won’t know where to find me.”

She looked at the postcard for a moment. “Ahhh, I forgot to put the date on here.” Taking a pen from her pocket, she crossed out “soon” and wrote “tomorrow” in the same handwriting.

“They’re coming tomorrow,” she whispered in a conspiratorial voice. “Don’t tell anybody.” She then shouted, “IT’S OKAY, EVERYBODY, THERE ARE NO ALIENS COMING TOMORROW.” She gave me a wink, and left the day hall.

Dan walked up and put his hand on my shoulder. “Don’t let that discourage you,” he said. “In a place this big, there’s bound to be people here who don’t belong here.”

That was to turn out to be true.

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