Decisive/Delirium

     The new kid looked wacked-out.
     Whether you wanted to call him retarded, cognitively-challenged, or the more politically-correct “developmentally-delayed”, you could tell something was wrong with him. I didn’t find out until later that his teenage mother had sniffed model glue and abused narcotics in her second trimester. The fetus’s cerebrum suffered profound insults in utero. A grade-four stroke would have seemed mild in comparison.
     Dennis squatted on the hallway floor playing Leggos. Occasionally he would glance up at me and mutter something under his breath, like, “YOU BETTER STOP STARIN’ CUZ I DON’T WANNA LIKE IT AND IF YOU DON’T STOP THEN FREDDIE KRUGER WILL COME AND CHOP YOU UP AND HIDE YOUR BODY UNDER THE SAND IN THE PLAYGROUND CUZ HE WEARS RED AND WHEN I WAS A BABY RED JUICE SPILLED ON MY SHIRT AND THE STAIN WOULDN’T COME OUT AND…”
     You get the picture. His speech was a stream-of consciousness that spilled into an ocean of verbal sewage. When ranting about something, he wouldn’t even stop for apostrophes or commas. The jeering singsong would continue for hours if you didn’t put a cork in his mouth or excise his vocal chords with a putty knife. I was assigned to be his one-on-one supervisor for the day. That meant I got to follow him everywhere and try to curb his unpredictable behavior, which included smearing feces on the wall and trying to cut himself with the sharp edges of Leggo blocks.
     Dennis didn’t like to be watched. He was skinny, had a shaved head, and wore coke-bottle glasses that made his eyes protrude like a frog’s. I could relate; my glasses were just as outdated. I sat on a chair trying not to watch Dennis. He sat for a few minutes building a Leggo house, which he would then smash under his foot. He would laugh hysterically, his attention zooming in opposite directions like a homicidal mosquito. Eventually he would sit down cross-legged and start erecting a house again. This bizarre mind-loop could grind on ad infinitum.
     I read a newspaper, watching Dennis out of the corner of my eye. If he saw me staring, he would jump up and threaten me. “DON’T YOU BE STARIN’” he would shout, assuming a pugilist’s stance. He would raise one fist and scowl, making me smile. “DON’T YOU BE SMILIN’ OR I KNOCK THAT SMILE CLEAN OFF YOUR FACE AND YOU WILL NOT BE ABLE TO SMILE ANYMORE BECAUSE YOUR LIPS WILL BE ON THE GROUND AND SOMEONE WILL STEP ON THEM AND YOU WILL NOT BE ABLE TO EAT THAT FOOD IN THE CAFETERIA WHICH IS NOT GOOD BECAUSE MY GRANDMA BURNT IT ONE DAY AT THE PICNIC…”
     I said, “Sorry, Dennis. I’m not watching.”
     “WHAT?”
     “Go ahead and play with the Leggos. I’m not watching you.”
     “YOU BEST NOT BE.”
     I decided to test him. “Why? What are you gonna do?”
     “I WILL PUNCH YOU IN YOUR FACE AND YOU WILL NOT BOTHER ME EVER AGAIN.”
     “Really? You shouldn’t threaten me, Dennis. All I’m doing is making sure you’re safe.”
     “I DON’T CARE NONE ABOUT WHAT YOU SAY.”
     “Well, you need to be less rude. I don’t exactly enjoy following you around all day, like a stalker.”
     “THEN DON’T. I DON’T WANT YOUR UGLY FACE IN MY EYES EVERY TIME I TURN AROUND.”
      With this, Dennis kicked some Leggos across the hallway.
     “Don’t do that,” I said.
     “I DO WHAT I WANT AND YOU CAN’T SAY WHAT YOU WANT BECAUSE MY EARS WON’T LISTEN.”
     “Do you want a time-out?” I asked.
     This was my first mistake. He didn’t care about time-out, and probably couldn’t process why I would give him one. His mind was locked on auto-pilot, obsessing over my intruding vigilance.
     “TIME-OUTS WON’T MATTER BECAUSE I DON’T DO THEM AND I DON’T KNOW WHAT THEY ARE BECAUSE THEY DON’T CARE ABOUT ME.”
     “Forget it. Just sit down and relax.”
     “YOU SIT DOWN AND RELAX. YOU IS THE ONE WHO ARE BOTHERING ME.”
     Now I felt a need to assert my role as disciplinarian. Like giving him a consequence for his defiance would actually change his future behavior. This was my second mistake. If I had ignored Dennis, he would have ignored me. But I had to prove my authority over him under the guise of “not letting him get away with his rudeness”.
     “Sit down or you’re going in the Quiet Room,” I said.
     ‘MAKE ME PISS OFF FACE AND UGLY HAIR.” He grabbed a fistful of Leggos and flung them at me.
     “Okay, that’s it.” I got up and stalked down the hall. I towered over him and he cowered. But just as I leaned over, he swung his fist in a roundhouse blow and knocked my glasses from my face. I stared at the floor, shocked. The wire frame was bent, one lens popped loose. Dennis stomped on it gleefully.
     “THIS IS WHAT I DONE WHEN THAT MAN TRIED TO TAKE ME IN THAT FUNNY. ROOM. HE TRIED TO TOUCH ME DOWN THERE AND I WON’T LET HIM THAT IS WRONG AND I TOLD FREDDY KRUGER AND HE WILL CUT THE MAN’S LITTLE ARM OFF…”
     I took a deep breath. “What did you say?”
     “YOU HEARD ME AND I WON’T REPEAT IT JUST BE GLAD I DIDN’T KNOCK YOUR TEETH OUT BECAUSE THEN YOU CAN BRUSH THEM WITH THAT TOOTHPASTE WHICH I DON’T LIKE IT TASTE LIKE THAT GUM WHICH I HATE--”
     I didn’t hear the rest. My mind was reeling, my attention locking on the only words that seemed important.
     “HE TRIED TO TOUCH ME DOWN THERE”
     and
     “HE WILL CUT THE MAN’S LITTLE ARM OFF”
     This admission sent my obsessive tendencies into overdrive, and I went to write it down on paper, leaving Dennis alone in the hallway, staring after me with wild eyes, his fist raised against imaginary enemies.

                                           
   
   
   

Quack/Attack Part 2

     Gottswin angered me again today.
     I was with Mrs. Frumberg and her son Erik. Erik had been in the psychiatric center for a week. He was stabilized on medication for his oppositional defiant disorder and was ready to go home. All he needed was a discharge order. Unfortunately the physician on call for the weekend was Dr. Asshole. Psychiatrists rotate being on call to give each other a break, and today the chief quack in-house was Gottswin.
     Mrs. Frumberg had already waited two hours for Gottswin to show up. He had been playing golf all afternoon, pretending he knew a nine-iron from the flagpole, and he arrived buzzed from too many Rolling Rocks stuffed into the tee pocket of his golf bag. His curly brown hair looked dirty and his face was cooked red from the sun. He stumbled onto the adolescent unit with a goofy smile. I started to explain that Erik needed to be discharged, but he held up a finger and ambled into the bathroom. After twenty minutes, the toilet flushed and he staggered outside, wiping what looked like vomit from his mouth.
     Mrs. Frumberg was very nice. She spoke with a slight German accent, and didn't want to offend the all-powerful doctor. I wanted to tell her that Gottswin was a fraud, that she shouldn't respect a man who tried to give a thrashing boy a shot in the butt and ended up piercing his sciatic nerve, but I couldn't. I might lose my job, or at least bolster my reputation as a slowly-declining nutjob.
     So I tried patience. I walked Mrs. Frumberg and Erik around the psychiatric center, giving her a tour. To my dismay, everywhere we went, Gottswin lurked like a drunken apparition playing hide-and-seek with us. When we went to the cafeteria, he was there eating french fries. He smiled at us, pretending he was getting a quick meal on the run, then dunked a french fry into his ketchup and stuffed it in his mouth. When we went into the day room, we found him talking on the phone with his current whore-of-the-month. When we wandered into the hallway, we saw him through the window of his office, drinking coffee and playing a game on his cell phone.
     I wanted to pummel him. Mrs. Frumberg and Erik had been waiting four hours for a simple discharge order so they could drive home (three hours away) in the waning light instead of total darkness. Mrs. Frumberg's vision wasn't very good and she preferred to drive during the day.
     "It's quite okay," she told me. "We can always stay the night and I will rent a motel until the morn."
     I gritted my teeth and knocked on Gottswin's door. He frowned at me, annoyed. When I yelled through the closed door that Mrs. Frumberg was waiting for a discharge order, he scowled and held up a dictation note and prescription slip with Erik's name on it. Then he shooed me away and continued writing his clueless evaluation of Erik, gleaned entirely from other staff's observations. If Erik had a third eye on his neck, Gottswin wouldn't have noticed.
     Half an hour later, I was able to escort Mrs. Frumberg to her car. I apologized, but she claimed this wasn't necessary. "I understand the doctor is busy," she said. "His time is worth valuables."
     When they were gone, driving to the nearest Holiday Inn, I re-entered the psych ward. Gottswin was sauntering into the bathroom again, as if he were the very definition of "cool". I glanced behind the nurses' station. The LVN in charge was outside on the patio, giving a boy his insulin shot. I hurried into the medication room, grabbing a bottle of liquid Haldol and stuffing it in my pocket.
     Gottswin's office reeked of exhaled booze. I unscrewed the cap and poured half the bottle into Gottswin's coffee. Probably about 50 mg. Because he would be gulping it without Cogentin, the side-effects would be...considerable.
     I rushed back to the nurses' station and replaced the bottle. Gottswin trudged into his office a few minutes later, plopping down and draining the Styrofoam cup. He grimaced sourly and tossed it in the garbage.
     I hoped to God he would get into his car and drive home. The Haldol was a major tranquilizer and he would be near-comatose in half an hour. He would fall asleep at the wheel and drive his car over the bridge. Or plow into a tree and smash through the windshield, too sedated to remember his safety belt.
     My fantasy didn't come true. Instead, Gottswin suffered a severe EPS reaction where his eyeballs rolled back in his skull and his neck became so rigid he couldn't unglue his head from his shoulder. He lurched out of his office, moaning and gibbering like a zombie, groping at the walls. I wanted to trip him, to make him fall on his face and then kick him in the head.
     But I couldn't laugh at his misery. I had to act innocent. So I took him by the arm and guided him toward the bathroom, whispering that it would be all right, that I would get him medicine to unlock his neck muscles and tug his eyes back down so he wasn't blind for the next 12 hours. I lay him down on the floor, where he sprawled like a drooling idiot, teetering between awareness and unconsciousness. Then I patted his head, exited the bathroom, and locked the door.
     He would stay there for the next four hours.
     Exactly the amount of time it took for him to write Erik's discharge summary note.
   

Quack Attack

     Dr. Gottswin is a bastard.
     He is incompetent, arrogant, and negligent. There have been many times I have seen him talking about me and laughing behind my back. He doesn’t even hide it. I can hear his voice even when he isn’t at the hospital, mocking and ridiculing me. I am a lowly psych aide and he is Doc Hollywood with a medical license he probably purchased online or in a backward third-world clinic.
     But I ignore him. I know it might be my paranoid schizophrenia, my brain supplanting paranoid delusions that are a product of excess serotonin. Or maybe my ventricles are too big. I don’t really care, Gottswin can be as cruel as he wants to me. But I draw the line when he messes with the children in the psychiatric center.
     There have been many complaints about him. One night he was on vacation and didn’t see his patients all weekend. It is required that a patient’s primary psychiatrist see him at least once a day. Gottswin was in Monterey hitting golf balls onto Highway 99 and adding fat to his saggy belly by drinking beer in the golf cart. He arrived at the hospital at 11 p.m., sun-tanned and drunk. Despite his slushed brain cells, his superiority complex was intact.
    He lurched down the hallway toward the latency unit. Me and Charlie were sitting there, finishing our charting and making rounds in the childrens’ rooms every half hour to make sure they were safe. Gottswin staggered down the hall and Charlie asked him what he was doing.
     “Going to see my patients.”
     Charlie: “Not at eleven at night you aren’t.”
     “I’m their doctor. I can see them when I want.”
     “Nope. They’re asleep. Do you have any idea how hard it was to put twelve belligerent kids to sleep? Damn near impossible. You’re not going to reverse all the work we did.”
     “Don’t give me this bullshit, Charlie. Get out of my way.”
     I got angry. “There’s kids over here.”
     Gottswin glared at me. “No shit, Sherlock. Who clued you in?”
     Me: “Don’t cuss. It’s a bad influence.”
     “Tough fucking crapping shit.”
     Charlie stepped between us. “Assess the kids in the morning or I’ll write an incident report.”
     Gottswin cursed under his breath, then stumbled away. “I’m their doctor,” he yelled over his shoulder, loud enough to wake the entire unit. “I decide if they’re dangerous or labile. I prescribe the medications that stabilize them. If one of them commits suicide or jams a salad fork into your kidney, it will be your fault. The family will sue you and so will I.”
     This wasn’t the only time Gottswin upset me. Once he was taunting a kid named Kyle. Kyle was ten and I liked him. He was admitted to the psych center for Tourette’s syndrome, ADHD, and depression. Kyle wanted to go home, but Gottswin wouldn’t let him. He kept insulting Kyle, saying, “Your mother says you throw tantrums. Big, violent, craaaazzzy tantrums. Here you’ve been an angel. You’ve been honeymooning. But you know what? I’m on to you. I know what you’re capable of. And you’re not leaving this hospital until I see one of your huge, epic tantrums. Understand?”
     Kyle understood. So he reared back and kicked Gottswin in the groin.
     I almost laughed. Gottswin fell down, moaning and clutching his scrotum. When the pain subsided, he demanded I put Kyle in restraints.
     “I can’t do that,” I said.
     “What? I am his doctor and I am telling you to restrain him!”
     “Why? He’s perfectly calm.”
     “He just kicked my nuts in!”
    “He’s not out of control, so I can’t restrain him.”
     “You’re an idiot.” Gottswin went to get the leather straps so he could pin Kyle down in the Quiet Room. When he asked for help, no one moved. He stood in the nurses’ station, staring at Kyle with buckled leather restraints dangling from his hands. Kyle stared back at him. After a moment, Gottswin flung the straps on the floor and stormed toward his office.
     “Major infraction, Kyle,” he shouted. “Your true personality is coming out. I see the little monster behind your eyes. And guess what? You just earned yourself another week here.”
     A cowardly parting shot.
     Like I said, Gottswin is a bastard.
     But bastards get knocked down eventually. At the time I didn’t realize it was me who would sucker punch him.