The only entertainment, therefore, consisted of the “dinner show.” Three times a day the staff and patients would gather in the area between the elevator and the cafeteria and wait for the meal to be served. This was the dinner show–the ragged and fractious interactions of human beings waiting to be fed.
Tempers would flare and we, the captive audience, would cheer the actors on. One day Leslie and an especially disagreeable patient named Janet were verbally pushing and shoving each other. Leslie had her fill of it and abruptly peeled off her key chain and beeper and threw them on the table. This was understood to be Leslie’s declaration of war: she shed the role of staff and was prepared to do battle with Janet on a woman-to-woman basis. Alas, Janet–being a head shorter and fifty pounds lighter–backed down.
It was an interesting environment in which to study the staff and their reaction to stress. One man, Ron, would stay in the middle of the melee but as the action increased his respiration rate increased. It was somehow comforting to watch his self-control.
And then there was Joe. Ah, yes, Joe, a therapy aide. A short, fat Italian who espoused the philosophy that being a patient at Hutchings was punishment for having done some wrong thing. That’s all there was to it in his simple philosophy. We weren’t sick people needing treatment; we were bad people needing punishment. Being in Hutchings was doing jail time, and he was the jailor. I often wondered how many times Joe had, with a single severe punitive statement, undone the work on which therapists had spent weeks. Joe functioned with all the petulant tyranny of a five-year-old.
Patients and staff alike would rise to attention at the sound of screaming but I came to understand that often it was Joe screaming, not a patient. He simply was overmatched in intellect and emotional maturity by many of the patients. Joe was particularly bad at working with women. The psychiatrist would roll his eyes and shrug–what could he do, Joe was Civil Service?–and go on with business.
I always went out of my way to avoid Joe because his attacks were so random and irrational that you couldn’t effectively defend against them. One slow Saturday night the patients got up a petition to have Joe removed; the petition precipitated an investigation, the results of which probably never will be known by the patients. There is a system for dealing with bad staff members but it is cumbersome and moves with ponderous slowness.
Sharon is manic. The first thing you have to understand about persons suffering from mania is that they will drive you crazier faster than anyone with any other illness will. They talk nonstop. “Pressured speech” it’s called. They leap racingly from one subject to another like a skier being pursued downhill by an avalanche.
Sharon is forty-ish, chain smokes, and gathers up odd bits of everything and stashes them in a big handbag that she periodically loses and claims has been stolen. She is a big woman with frowzy black hair. Her mouth smiles readily but her eyes blink in confusion, trying to track all her thoughts in her merry-go-round world. Manic people, I have learned, are resilient. There is no such thing as hurting their feelings, so I clearly and precisely ask her to be quiet.
Gradually we work out the terms of our friendship. She is together enough to have some control over her speech, as well as an awareness that she’s kind of hard to take, so when she gets to be too much for me I silently raise one finger to my lips and murmur “sh.” She shushes if she can and, if she can’t, she takes off and aggravates someone else.
Polly tells me that she suffers from four different psychiatric illnesses. One of the reason’s people end up in state hospitals is because they suffer from more than one illness. Most hospitals reject persons with dual diagnoses. They will, for example, agree to treat a person with bulimia but only after the drug addiction has been treated. No facility can be found that will treat the drug addiction until the bulimia has been treated, so the person ends up in the state hospital being treated for nothing.
Polly is being treated randomly, incoherently and ineffectually for anorexia and depression. She is five-foot-two and weighs ninety-eight pounds. She spends the day curled up in a chair, apparently drifting in and out of sleep. When they take vital signs, they cannot find her pulse. State psychiatric hospitals are not medical facilities; they do not provide comprehensive medical care so Polly is taken to the emergency room of a medical hospital. There she is found to have a blood pressure of 70 over 60 and is given priority treatment. After two intravenous feedings and two injections of potassium, she is returned to the psychiatric hospital. She says she feels better. She is put on a new medication and in two weeks she has enough strength to bitch about the hospital. In another two weeks she is discharged, unhappy but reasonably healthy. (To be continued)