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head, and wore coke-bottle glasses that made his eyes protrude like a frog’s. I could relate; my glasses were just as outdated.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.
   

ParanoidPrank

     “I want to show you something,” the twelve year-old girl said.
     Lizzie was smiling, but it was more of a smirk. There was no warmth behind it, only a mischievous undertone. She had a secret, and I was the benefactor. Lizzie’s grins always seemed half-frown to me, as if the disapproving lines were carved into her skin and she had to put all her effort into rearranging them. Her eyes betrayed her true feelings, always gleaming with some dark, primal deception.
     It hadn’t been a good day for me. I was starting to hear schizophrenic voices whispering on the periphery, demanding my attention. When I tried to listen, they either receded into the background or shouted something unintelligible. Most of the messages revolved around my co-workers talking behind my back. I knew this was nonsense, but when you hear a lie enough times, you start to believe it.
     Lizzie tugged at my hand. She had straight, honey-blonde hair that hung down to her shoulders. Her cheeks were ruddy, as if basted with fever. Her smile was stiff, insincere; wooden. A smile chiseled into a totem pole.
     “Come on,” she urged.
     “Where are you taking me?”
     “Into the bathroom.”
     I immediately grew suspicious. Kids could lure you into a private place, then claim that you had touched them inappropriately. “Why?”
     “There’s a bug in the shower. I want you to get it out.”
     “Tell Julie. She’ll help you.”
     “No! She’s afraid of bugs.”
     I didn’t feel like arguing. “Okay. But let’s make it quick. And I want you to stay by your bed.”
     She nodded, still grinning.
     Lizzie led me into her bathroom. I could feel my gut grow queasy when she pointed at a cockroach scuttling in the shower stall. The strange thing was, Lizzie showed no fear of the scavenger. She pointed at it with no change in expression. I wondered why she hadn’t stomped it already. She would probably take a perverse joy in crushing the filthy pest.
     I was about to approach the shower when the lights went out. I was surrounded by utter blackness. My chest constricted and my heart pounded. Lizzie had flicked off the light switch, playing a joke on me. She still held my hand, and I could feel her grip tightening. Slowly her fingers curled inward until her sharp nails gouged my palm. They felt like miniature talons.
     I had always been afraid of the dark. Now the bathroom was a fathomless abyss. Childhood fears clawed their way into my mind, hissing that there were monsters lurking in the shadows. Disembodied voices snarled that a demon stood beside me now, and would hurt me if I didn’t defend myself. Before I could even think, I tore myself loose of Lizzie’s grip. I rammed her away and groped across the wall. When I found the switch, I wrenched it up. Yellow light exploded in the bathroom, blinding me.
     Lizzie crouched in a corner, her smile gone. She was used to being the predator, but now she was the prey. She clutched her shoulder, which throbbed from the intensity of my attack. Her face was twisted with fear. This young girl, who terrorized the other kids on the unit and was unaffected by large doses of Haldol (a major tranquilizer), gazed at me as if I would dismember her with my hands.
     I moved forward slowly. The voices were still muttering, but I could push them away.
     For now.
     “Lizzie,” I said. “I’m sorry.”
     She edged away from me.
     “It was an accident. I don’t know what happened.”
     “You hurt me.”
     “Not on purpose.”
     “It doesn’t matter. My arm HURTS!”
     I held up my bleeding hand. “What about this? All fun and games?”
     Lizzie scowled. “You’re a psycho.”
     Something inside snapped. “You know what? It takes one to know one. And you can run out and tell every staff member that I pushed you, but no one will believe it because you're a chronic liar who cries wolf three times a day.”
     She bolted from the room. I could hear her yelling for Mrs. Comston, and I knew I would be reprimanded later. Not for shoving Lizzie, but for being in the bathroom alone with her. That story I could alter to suit my needs. All I cared about now was hushing the voices that were slowly turning me against myself.
     I wasn’t a violent person, but the relentless, accusatory voices were making me see dangerous, conspiring imps when I looked at the children.
     It wouldn’t be long before I injured one of them badly.

SlinkySidewinder

     Julio’s homelife was a mystery.
     It was rumored his mother was a prostitute, and that’s why he ran away from home and sought refuge with strange men in downtown Sacramento. Maybe she pimped him; I’m not sure. It absolutely blew my mind to discover that an eleven year-old boy spent most of the day looking after his four year-old brother (Manuel), acting as his surrogate parent while his mother disappeared for days at a time. Then, at night, when Manuel was asleep, Julio would lock the apartment and pull on his hoodie, wandering the city streets in search of adult male company.
     How did he learn this behavior? Was his mother an inadvertent tutor, schooling him in the dubious art of seduction? Did he watch her every night, selling herself inside a cramped bedroom, trading integrity for cash? After a few weeks did he strike out on his own, soliciting dirtbags for physical attention, his innocence chiseled away by father-figures whose intentions were corrupt?
     Julio was a lean kid with close-cropped black hair, a mischievous smile, and intense brown eyes. In the psychiatric center, he either wore a Raiders jersey or a plaid shirt that he kept unbuttoned to his stomach, showing off his gold chain and six-pack. He did crunches every night, saying that he had to stay “strong and smooth”. When I asked him what he wanted to be for a living, he said, “A pimp. With a crib full of hos. And when they act up, I can bitch-slap them.”
     I replied that he was too intelligent for that profession. He smiled slyly and said he was kidding, he really wanted to be a pro football player. But something in his tone made me realize that being a teenage gigolo was a much more realistic goal for him. He knew nothing about sports, except that staying muscular and athletic (and acting like an All-American kid) made him more attractive to predators.
     Julio vacillated between childish innocence and wanton maturity. One morning a phlebotomist had to draw his blood and he refused. I coaxed him into cooperating, and when the needle entered his vein, he let out a heavy sigh and rested his head on my shoulder, as if a lifetime of stress was being sucked out of him with his blood sample.
     My saddest memory of Julio came one night when three kids were in the dayroom, watching a movie. It was 8 p.m., and we were watching Spy Kids. Julio frowned when the young sister and brother argued with each other. “She wants to screw him,” he said matter-of-factly. “Everyone wants to do it. So they should just get in bed.”
     Mark, a totally humorless, militant staff worker told him to watch his mouth or he would go to the Quiet Room.
     Julio shrugged. “I’m just sayin’. They want to have sex, so why are they hiding it?” A faint smile touched his lips.
     Mark tried to distract him. “Button your shirt, Julio.”
     “Why? You afraid you might see something you like?”
     Mark’s face turned purple. “Just do it. No one wants to see your skinny body.”
     “Plenty people like my body. Like you. I seen you looking at it.”
     “That’s it.” Mark got up, towering over Julio. He was a beanpole, but stood 6’5”. “Get up. You’re taking a time-out.”
     Julio smiled at him. “Make me, stud guy.”
     “If you don’t get up on your own, we’ll escort you into the Quiet Room by the arms.”
     “You wanna touch me, huh? Feel if my skin is silky muscles.”
     “Five seconds, Julio. One…two…three…”
     Julio lunged at Mark’s leg. He wrapped his arms around Mark’s thigh, giving it a passionate embrace.
     “Get off, Julio.”
     “Ten dollars, Mark. That’s how much I charge. You get full night of pleasure, I get two boxes of cereal.”
     Mark tried to wrestle him away. Julio grappled tighter, his smile provocative, his torso squeezed against Mark’s leg.
     Mark pried him loose and Julio bit his hand. Mark recoiled, then shoved Julio flat. He climbed on top of him, giving in to his anger, performing a function that Julio craved. He flipped Julio onto his back and tried to pin his arms down. Julio flailed about, brushing his wrists and forearms against Mark’s mouth, yelling, “See? I knew you wanted to kiss me.”
     Even as Mark pinned Julio’s limbs to the floor, Julio heaved his waist upward, grinding his buttocks against Mark’s groin, simulating something dark and terrible. When a worker appeared in the doorway, Julio bucked for a few more seconds; then his defenses crumbled and he began crying, sobbing that Mark was violating him and “didn’t have the right kind of love”.
     Mark straightened up, shell-shocked. His expression was both appalled and somehow guilty. When Julio saw the fear inscribed on his face, his tears gave way to anger and he scowled as if Mark had delivered an insult that could never be forgiven.

LabileLobotomy

     Elaine was an elderly woman who still worked on the adult inpatient psychiatric unit. I admired her fortitude; most women in their late sixties would have retired years ago. The problem was, Elaine didn’t feel productive outside the mental ward. She had worked there as an LPT (licensed psychiatric technician) for thirty-five years, and it had consumed her life. Her husband had died ten year ago, and she tolerated his absence by surrounding herself with patients, both lucid and acutely psychotic.
     Elaine shouldn’t have worked in the potentially-dangerous psych ward. She hobbled along with a limp, and was useless during a crisis situation. She had auburn-colored hair that was so poorly-dyed it looked pink. She wore thick bifocals and had a shriveled, red-lipsticked mouth. Often she would grunt when waddling from one end of the unit to the other, her hips waggling, her spine warped with scoliosis from trying to support her obese frame. I also suspected she suffered mild dementia. She forgot simple instructions and asked you to repeat yourself several times, as if her hearing aid had malfunctioned. Honestly, she was a threat to the well-being of her fellow employees. If Elaine was alone on the unit with another nurse, she would not only be helpless during a violent attack, but would also be fair game for several of the sociopath men wandering the halls in search of lambs to fleece and slaughter.
     Still, even though Elaine was a liability, she didn’t deserve what happened to her one terrible night in August.
     Cholo was a 21 year-old paranoid schizophrenic who felt he was always in the FBI’s crosshairs. He saw the world through the distorted lenses of cracked binoculars. He felt helicopters were flying overhead, agents watching him and charting his every move. He also believed nurses would sneak up on him while he showered, injecting sterilizing drugs into his penis with a hypodermic needle so he couldn’t have children. Haldol and Risperdal (anti-psychotic medications) took the edge off his delusions, but he was still labile and occasionally hostile. He couldn’t stand Elaine, who pestered him like a disapproving grandmother.
     Cholo was scheduled for ECT in the morning. ECT (electroconvulsive or shock therapy) was a procedure reserved for severely depressed or catatonic patients. Voltage was applied to the brain with the intent of inducing seizures that would re-align its waves. It was a controversial treatment, and seemed barbaric. The hulking technician who applied the electrodes told me that it was completely safe; the amount of voltage discharged was less than a Duracell AA battery. Unfortunately, even if ECT was successful, it usually wore off in a few months. I had seen patients return from electroshock with artificial smiles, their faces twisted with confusion. They seemed synthetically happy, as if their emotions were manufactured. I often wondered if short-term memory loss took away their depression by making them forget the tragedies that caused their overwhelming sadness.
     One night at 2 a.m., Cholo wandered outside for a drink of water. He wore a white tank-top, a gold cross on a chain, and had a blue/green tattoo of the Virgin Mary inscribed on his shoulder. His lean body rippled with muscle. His head was shaved and he had black stubble on his jaws. Even as he approached the fountain, Elaine tried to intercept him.
     “Mr. Ramirez you can’t have any water,” she scolded. “You have your ECT treatment tomorrow and are nothing-by-mouth.”
     Cholo ignored her, yawning into his palm. The medications left him sedated and mind-numbed.
     “Mr. Ramirez, you can’t have no water,” she repeated, moving out of the nurses’ station through a swinging door. “If you do your ECT will be cancelled and Dr. Drenan will not be happy.”
     “Yeah, yeah, whatever,” Cholo mumbled. He grabbed a Dixie cup from the dispenser and rubbed his chin.
     “MR. RAMIREZ.” Elaine’s voice rose an octave. “YOU CAN’T DRINK ANY WATER. IT IS AGAINST PROTOCOL.”
     “You better back off,” Cholo mumbled, flashing her an irritated glance. “You ain’t my moms and you sure as hell ain’t got my respect. Geritol-snorting, hip-replacement bitch.”
     Elaine grew distraught. She hobbled toward Cholo, her eyes panicked. She believed that if Cholo drank the water, it would be her fault if his ECT was delayed. She was an old-school nurse who stood up and offered her chair when a doctor entered the room, even though her joints were rusty with arthritis.
     Cholo’s face twitched. His lethargy washed away and he became stiff with annoyance. He almost crushed the Dixie cup in his fist as he placed it under the spout.
     “MR. RAMIREZ. YOU ARE NOT LISTENING. YOU ARE GOING AGAINST PROTOCOL. THE DOCTOR WILL NOT BE PLEASED. YOU CAN’T HAVE THE WATER BECAUSE YOUR STOMACH MUST BE EMPTY FOR THE ECT. OTHERWISE YOU MIGHT CHOKE DURING ANESTHESIA.”
     Elaine grabbed his forearm. He jerked away and water splashed his tank-top. His gold crucifix was drenched. Cholo stared at the damp spot and his face flushed with rage.
     “WHAT THE HELL,” he snarled, stalking toward her. “YOU MADE ME WET MYSELF. I DON’T CARE IF YOU IS SOME DINOSAUR WITH A CANE, YOU CAN’T TOUCH ME. BITCH, YOU JUST SPIT ON MY CROSS. NO ONE DOES THAT TO THE SAINTS.”
     Cholo grabbed her hair and wrenched it to the side. A wig popped off, showing milk-white scalp beneath. Later I would wonder if Elaine’s dementia was so prevalent she forgot her hair was fake when dying the auburn strands.
     Elaine scrabbled away. Cholo flung aside the wig and loomed over her. He grabbed a potted plant off the counter and smashed it against Elaine’s head. The pot cracked and wet soil dribbled down her face, blinding her. She wailed, then fell silent. Cholo took a sharp fragment of the pottery and slashed her face from eye to jaw line. Then he tried to stuff the plant’s roots into her mouth.
     A nurse emerged from the break room, yanking the emergency cord. Alarms screamed and the unit was flooded with workers, mostly male. Cholo stooped over Elaine for a moment, mumbling incoherently, then dried off his cross with a napkin. He wandered away, holding his hands up and flattening himself against the wall when he saw the workers swarming around him. He smiled and told the “FBI spooks” he knew they were spying on him, because he had seen the camera they installed in the ceiling behind the light bulb.
     Elaine lay motionless on the floor. Blood trickled from her nose. Her pupils looked fixed and dilated. She didn’t respond to urgent hands shaking her. She was suffering from an intracranial hemorrhage (brain bleed) that would leave her with partial paralysis.
     Elaine loved being in the psychiatric center. She had 30 years of experience working with volatile patients. There had been talk for months about whether she should be coaxed to resign because she was “unfit for duty”. Managers thought they would be doing her a disservice by firing her. They didn’t have any evidence to support her dismissal. Now a paranoid, delusional man who confused her for a nagging parole officer had forced an early retirement in which she would lay in bed most of the day, half her body erased, her mind plagued by seizures, her eyes staring at a dingy grey wall that was as bleak as her future.

Toke*Anhedonia

The teenage boy despised me.

     You could see it in his scowl every time he confronted an authority figure on the inpatient psych unit. He had scraggly blonde hair, glasses, and a perpetual sneer that exuded contempt for anyone who tried to help him.

     Antony was here because he had an unhealthy addiction to smoking pot. His father had practically disowned him, saying that Antony had thrown away his future for a few cannabis leaves. His grades had dropped, his school performance was lackluster, and (once a promising athlete) he had lost interest in sports.

     According to Antony, he didn’t have a problem. He maintained control over his recreational use of marijuana. He could stop at any time. Besides, his father was a f-ing hypocrite. He condemned marijuana to hell but used it himself. The only reason he disapproved of Antony smoking joints was because he was a kid and couldn’t handle drugs like an adult.

     So Antony got thrown into the psychiatric center. For what? Substance abuse? Oppositional defiant disorder? Depression masked by the mellow euphoria of smoldering THC? What would the doctor prescribe for him? Prozac? Mellaril to tame his raging pubescent hormones? Counseling sessions that would probably leave Antony with an even more intense suspicion of adults?

     I was the only aide on the adolescent unit that morning. There were three boys and one girl. The census was uncharacteristically low for spring break. I went from room to room, reminding the teenagers that breakfast was at eight, and if they chose to hibernate they wouldn’t get a meal until lunch. They scowled at me and pulled blankets over their heads, preferring to sleep until noon. I reminded them that part of gaining privileges on the unit involved cooperating with staff and participating in activities. This earned me a few derisive snorts. My last caveat: I knew the boys liked sports, so I told them that if they chose to sleep, we wouldn’t go to the gym later. They responded by cursing under their breath and stumbling into the bathrooms to take a quick shower.

     When they were ready, we had community meeting. This allowed them to voice pent-up grievances and discuss their progress in the psychiatric center. The conversation went like this:

Me: “How are you feeling today, Antony ?”

Antony : “Like shit.”

“Why?”

“Because I didn’t get any sleep. One of the kids was yelling in the Quiet Room all night. What a joke. It’s more like the Screaming Room.”

“What’s your number today?”

“Four.”

“Well, that’s one better than yesterday. Or are you just saying that to get discharged faster?”

     “Nah, I feel better, dude. Really really great. I think the evil cannabis has been cleansed from my system.”

     All this was generic psych center bantering. I decided to press the issue a bit further.

     “Your dad says he doesn’t want you back home unless you agree to stop smoking pot.”

     “Dude, I get the pot from his stash.”

     “We’re talking about you, not him.”

     “The pot isn’t taking over my life. I just use it to chill a little. Is that a crime?”

     “Yes, according to your probation officer.”

     “Screw him. You can’t tell me he never smoked weed.”

     “Antony, look at yourself. You do everything you can to defend your habit. That’s addictive behavior. If it’s so easy to quit, why don’t you?”

     “Because I like it. It serves a purpose. If I didn’t have pot to help me relax, I would probably strangle my dad.”

     “Then we need to work on your dad’s attitude as well.”

     He laughed. “You guys are so full of it. It’s always the kid’s fault. My dad could be beating me with a club, and the psychiatrist would say, ‘ Antony , what could you do to stop stressing out your dad’?”

     “Well, you could stop smoking pot. That drives him crazy, right?”

     “A few joints aren’t the problem.”

     “I disagree. Marijuana has screwed up your life. It’s the root of all your troubles. You defend a drug that takes away your motivation, makes you eat junk food all day, and precipitates arguments with your dad. Seems like a high price to pay.”

     He responded by yelling, “You don’t understand. Pot should be legal. It’s legalized by the government for some people. It doesn’t hurt me. My father hurts me. He’s the one that should go away.”

     “You’d choose pot over him?”

     “Hell, yes. And over jerks like you, too.”

     My session was a complete and resounding failure. But what did I expect? I wasn’t a board-certified counselor. I was a college student earning minimum wage while taking classes. I had no training in the psych field. I cared deeply about the patients, but could easily say or do something that traumatized them for life.

      We went to the cafeteria and the teens ate together while I remained on the periphery, an outsider. They whispered to each other and chortled when glancing in my direction. I decided to take them to the gym afterward. We all liked basketball, so we decided to play 2-on-2. I had been playing since second grade, so had a firm command of the fundamentals. I chose a goofy kid named Mike to be on my team. He was obviously uncomfortable holding the ball, passing it back to me like a live grenade every time it dropped into his hands.

     Antony was a surprisingly agile player. He drove to the basket well, had a nice pull-up jump shot, and could dribble with both hands. The games were intense and hard-fought. I guarded Antony , and he scored despite my smothering presence. I didn’t back down, playing tough defense and often blocking his shot. To my delight, he didn’t give up, but played harder than ever, gleaning joy from competition itself. He truly seemed to enjoy the sport and smiled when I patted his shoulder and told him he was the next Stephen Curry.

     After an hour of sweat and hyperventilation, we returned to the adolescent unit. I asked the teens to get ready for lunch, and they mumbled “okay”. As Antony drifted toward his room, I stopped him in the hall. I told him he was a talented player and he could be a starting point guard on his high school team if he practiced hard enough. I expressed admiration for his skills and was glad he had given me an offensive whipping on the court.

     He returned to his room without comment. Maybe my words seemed manipulative. It’s possible he had been screwed over by adults so many times he viewed me as a smooth deceiver. Behind my compliments lay some underlying moral or self-righteous sermon.

     At lunch, one of the teens was effusive. He boasted about his skills and how he had kicked me and Mike’s asses. Mike was too shy to argue. I simply ignored the braggart.

     Antony shocked me. He told the kid to shut up, that he was a ball-hog, and that I could shut him down with one arm tied behind my back. Antony politely asked me if I wanted dessert, then gave me his pumpkin pie. He didn’t bring up the subject of marijuana, but he was kind and treated me with respect.

     That day changed my perspective forever. Forget medications and counseling sessions. Being good at a sport was what made me an equal in Antony ’s eyes. He may keep smoking joints, but at least he was more receptive to my opinion. And who knows, if his dad took an interest in what he liked and spent quality time with him, maybe Antony would realize that drugs were not a substitute for human emotion, and a natural high was more satisfying and enduring than the artificial stimulation of pleasure centers in an undernourished brain.