In Africa, orphaned elephant babies were taken to a particular preserve. As the bulls reached adolescence, they began to harass the rare white rhinos in the preserve, starting with throwing sticks at them and escalating to murderous attacks that left white rhinos dead on the plains. Park rangers kept rap sheets on the young bulls, cataloguing their offenses against the community. Finally, someone had a good idea about how to solve the problem.
A specially built truck was sent out into greater parts of the continent and massive mature bull elephants standing eleven feet tall at the shoulder were darted with tranquilizers and sent for rides aboard the truck. The truck carried a sign essentially saying, “Gone to kick butt.” Unloaded at the preserve, the old bulls ambled around, minding their own business. When one of the adolescent’s would run at a newcomer, the old bull would flare its ears, snort, and send clearly understood signals of power, turf and authority. Peace returned to the preserve.
In CPEP, we have Eddie: six-foot-six-inches tall, 420 pounds, twenty years old, and of limited intelligence. His mother is white, his father is not, and it appears that neither parent ever taught Eddie the meaning of the word “No.” Now, it’s a little late. Eddie does what Eddie wants to do—who’s to stop him? If he wants to lumber into the nursing station or any other place that’s off-limits, he does it. The staff follow behind mewling, “No, Eddie, you can’t go there. Stop, Eddie; don’t do that.” When the staff become too annoying, Eddie flares with a little anger: the marauding elephant throws sticks at the white rhino. Eddie has trained the staff to be very compliant.
Eddie hurts himself by bashing his head against things. When he’s admitted to psychiatric care—which is frequent, and usually to CPEP—he has a large fresh wound in the middle of his forehead. He pleasures himself by showing off the scars on his arms where he has bitten himself.
(On inpatient in 3-6, Eddie was locked in solitary confinement in the back. Slowly and tediously, he learned some manners. By the time they let him out, he behaved himself—sometimes. Other times, he would backslide.
(James, a security guard posted to keep Eddie in his room, was given strict orders that he could not lay a hand on Eddie. Eddie decided he was going to come out of his room. James’ considered it his business to protect the staff and other patients. Having a strong commitment to duty—and his hands tied by the staff—James stood his ground in the doorway as Eddie charged. James was consequently trucked off to the Emergency Room for evaluation of injuries sustained.)
Friday and Saturday were quiet in CPEP. One man, two white women and five black women rested quietly in the eight rooms lining the left side of the hall.
(The women included Cindy, Anne and Kathy. “Are you scared?”
(“Yes, I’m scared.”
(“I’m scared, too. You wanna be scared together?”)
It was quiet, very quiet, when Eddie arrived with three security guards. Sleeping women, already frightened by the system they found themselves in, were awakened to the rambunctious sounds of Eddie rearranging the furniture and everything else. One of the security guards went away and came back with a plastic bag holding the leather cuffs that are used to tie patients to the bed in four-point. He stood in the doorway to Eddie’s room, gesturing. Eddie, like any other animal subjected to repeated behavior management, reacted like Pavlov’s dogs and settled down. He was not put in restraint.
Eddie can have all the winsomeness of a small child—indeed, some staff members excuse his behavior on the grounds that “he’s just a six-year-old.” And when was the last time you watched a six-year-old when he didn’t get his own way? (To be continued)