Out Cold ddm-3

by Tom Schreck

  I wanted to know the Karl back story and maybe get a better handle on the helmet, rubber gloves, and his hate for the New World Order. The package came with a form letter about confidentiality and the general phone number to call for veteran medical records.

  The first page of the file contained a discharge summary, which is kind of an executive summary of everything in the chart. It's kind of like Cliff Notes for the lazy counselor. This is how it read:

  DISCHARGE SUMMARY

  VETERAN'S ADMINISTRATION HOSPITAL

  ALBANY, NEW YORK

  Karl Greene

  Date of Evaluation: 1/8/08

  Case No.: 1667-9289-11A

  Date of Report: 1/10/08

  Unit 7

  Admission Date: 1/2/08

  PURPOSE OF EVALUATION

  This is the first psychiatric admission for this 28 year old, single, white male, who was referred through the office of Veteran Affairs following what was described by his commanding officer as 'Behavior consistent with PTSD'. Greene, a sergeant in the US Army Special Forces division was admitted to the VA following a brief stabilization admission in Germany.

  Sergeant Greene was receiving psychiatric services at this hospital until 1/7/08 when he assaulted a mental health worker, breaking the worker's nose, and causing facial bruises and lacerations. Greene refused to attend group therapy and objected when the mental health worker grabbed his elbow to escort him. Staff report that Greene claimed the mental health therapy aid was part of conspiratorial activities against him. Greene rendered the mental health worker unconscious with a martial arts style blow. It should be noted Greene did express remorse at assaulting the mental health worker and did seek out assistance in reviving the unconscious worker.

  BACKGROUND INFORMATION

  Sergeant Greene had been an active duty sergeant in Special Forces for the last four years. He enlisted during the Iraq conflict, verbalizing he wanted to be part of the nation's war against terror. Greene was cleared of any mental history and did not show any symptomatology consistent with mental illness at the time of enlistment until a series of trauma related events occurring within battle.

  The event that appears to have precipitated his current admission involved a raid on a suspected insurgent headquarters within the city of Baghdad. On December 25, 2007, Greene and 3 members of his team entered the house believed to hold the insurgent leaders. Sergeant Greene was the first soldier through the door. He immediately took on fire from two of the insurgents. Greene was not wounded and was able to neutralize his attackers with gunfire.

  As Greene and the three members of his team proceeded through the house, they were surprised by another Iraqi who emerged from a closet. Two of Greene's team members were shot, one fatally, before Greene fired upon the assailant. As Greene continued to fire on the Iraqi, he heard the shrieking of several children. When Greene stopped firing and looked into the closet where the Iraqi had emerged he found two young children, a brother and a sister, ages 5 and, 3 dead from his gunfire.

  Sergeant Greene had been cleared of any wrong doing in this situation, but the next morning following this incident he was found wandering outside the camp with his firearm. His fellow soldiers were concerned about his behavior and were concerned he might be suicidal. His commanding officer requested psychological services and he was immediately sent to Germany for observation.

  Tom Schreck

  Out Cold: Round Three of the Duffy Dombrowski Mysteries

  MENTAL STATUS EXAM

  Sergeant Greene presents as an angry, distrustful individual who did not appear willing to open up, though he wanted to be compliant within the rules of the military. He reported he wasn't sleeping well but "…that he never really did…" When asked if the circumstances that got him referred to psychiatric help bothered him he responded "…wouldn't you be bothered by something like that?"

  Initially, Greene appeared oriented to time and place, but while in psychiatric care his stability deteriorated. It may be the case that this is related to his post traumatic condition and as time went by the events of the incident exacerbated Greene's condition as he repeatedly found it difficult to rationalize the events in regard to battle circumstances.

  Several medications were tried in an effort to stabilize Greene, but they did not appear to be effective. It may even be the case that his state worsened after medication, though it is impossible to discern if that is a cause and effect related to the medication or just the natural progression of his deteriorating state.

  Tom Schreck

  Out Cold: Round Three of the Duffy Dombrowski Mysteries

  SUMMARY AND RECOMMENDATIONS

  Sergeant Greene came to the military with no history of mental illness. At the time of this summary he shows symptoms consistent with Post Traumatic Stress Syndrome. It is quite possible he also has developed schizophrenia with paranoia and some of his behavior suggests substance abuse. It is recommended that Sergeant Greene receive ongoing care for mental illness and substance abuse and that he remain on a regimen of medication to control his reaction to stress.

  Theodore Martin, MD

  Staff Psychiatrist

  Simply put, at least as best as I could understand it, Karl lost it after he accidentally killed a couple of Iraqi kids. If you were going to lose it over something, that would certainly do it. That made some sense, but it didn't really explain the Redskins gear, the rubber gloves, and his theory on the massive plot to fatten all of us with partially hydrogenated oil. On second thought, maybe living with killing a couple of innocent kids did explain that.

  I flipped through the rest of the chart, which consisted of his medical history, a section on military mumbo jumbo and the day-to-day case notes. I skipped to the case notes to see if Karl was confronting everyone at the VA who used non-dairy creamer.

  Karl was in the funny farm unit for over four weeks so there should be at least a page a day of notes. Hopefully the VA counselors were a little more diligent of their paper work than yours truly and I'd be able to tell what Karl's stay was like. I flipped through the daily progress notes and noticed something wasn't right. The section was too small. The first few days were documented thoroughly then one note went on to a second page and stopped abruptly. Then a brand new page started with two weeks of abbreviated notes. It looked like someone ripped out the original documentation and replaced them with new notes. They did a shitty job because it would've been pretty obvious to anyone who had ever written in a chart. It was even obvious to a counselor who hated paperwork. I was about to get a second opinion from Monique when a shadow blocked the ceiling fluorescent light hanging over me.

  "Duffy I left you a note to come see me as soon as you got in," Claudia said.

  "I was just coming in."

  I followed Claudia to her office.

  I'd been down this road before and it wasn't a good road to go down. Getting in trouble at work was something I had gotten used to. Watching The Michelin Woman gloat as she read me her riot act wasn't.

  "This is a warning of pending termination," Claudia said glaring at me.

  "C'mon Claudia the charts have been worse," I said.

  "Oh, I know. That's why this isn't a termination…yet." She half smiled. "It has come to my attention that you have violated a client's confidentiality."

  I couldn't imagine how she heard about Karl. The Michelin Woman was a nosy bastard and she would've had her ways, but I decided to keep my mouth shut.

  "I received a call from Paula Bentley, the ex partner of your client, Mr. Spain. She says you came to her place of work to advocate that she allow her ex to have visitation with their daughter."

  "And I didn't go to her place of employment. I went to pick up that computer and I bumped into her."

  "It doesn't matter. It is grossly inappropriate."

  "Even so, that's the first time I've ever been caught-I mean-ever done something like that. I've never been warned. You can't fire me for that."

  "No, but if you're charts aren't up to
date I can combine these two offenses and have just cause to fire you."

  "That's a bullshit technicality and you know it." She smiled and closed her eyes.

  "Please watch your language in my office." Under my breath I muttered "Fat fuckin' bitch."

  "Did you say something?"

  "No."

  From there, she outlined her plans to can me. She would further investigate my breach of confidentiality and then review my charts. If she was able to confirm that in both cases I was negligent and inappropriate I'd be out on my ass. I've been close to getting canned before, but on those occasions there were always way outs. I wasn't so sure this time.

  Tom Schreck

  Out Cold: Round Three of the Duffy Dombrowski Mysteries

  21

  I finished the day taking a look through my files. I was in deep shit. Claudia had said she'd review the files and investigate my breach in a matter of days. I didn't see any way possible of somehow tying up both ends and saving my ass. I knew this day would come. I just didn't know it would come this week. My friend, the throb, joined me and Elvis for the ride home. Elvis did Are You Lonesome Tonight and he stuttered through the soliloquy in the middle of the song. The way my head felt I could understand the trouble the king had. My stomach did that car-sick feeling, which I knew wasn't related to being in the car. It had more to do with getting hit on the noggin. I pulled up to the Moody Blue and headed toward the door and immediately got the sense something was wrong. I couldn't put my finger on it and wondered if my new emotional state played tricks on me. The one Rudy told me would involve weird unpredictable mood swings. I realized it was much simpler. There was no barking. Every night Al would start going nuts as soon as he heard the El Dorado pull up. Tonight silence. I ran up the steps and bolted through the door, fearing the worst.

  My fears quadrupled when I rattled the knob and still got no reaction from Al. I opened the door and saw what had happened. Karl sat naked in the center of the floor across from Al. Al's had no collar on so I guess, technically, he was also naked. In between them a candle burned. Karl sat cross-legged staring at it. Al wasn't staring at it, he had his eyes closed, and he snored.

  "What the fuck?"

  "Please, we are centering," Karl said without moving. Having a naked man, in front of you in the middle of your living room, next to your dog, is a bit disconcerting.

  "Join us in centering if you like."

  I shook my head and decided to center myself in my tried and true way and got a Schlitz. I sat on my couch in front of the circle of the bizarre, pondering if it would be okay to turn on my television.

  "KUBALA! KUBALA! KUBALA!"

  Al opened his eyes and furrowed his brow.

  "GONDOFI! OH! GONDOFI! OH!"

  I chugged the Schlitz and got another.

  "OH! OH! OH!"

  Karl slapped the floor three times. Al sat up. Karl looked at me with a big smile.

  "Hello Duffy. Al and I were centering." He had a peaceful grin on his face, which for some strange reason intensified his nakedness.

  "Karl, could you throw on a pair of cargo pants and Tshirt?"

  "I am comfortable in my nakedness."

  "That makes one of us."

  Al went to the window to check the sparrows. Apparently, even with his centering, Al remained suspicious of his enemies. I wasn't nearly as centered as my roommates. Drinking Schlitz twice as fast as usual wasn't speeding my own centeredness. To be honest I was still a bit uneasy about the last panic attack/nightmare. I thought if I stacked my consciousness deck with a few extra Schlitz I might just skip the nocturnal special features I'd been getting.

  I flipped on the TV to MSNBC to watch the evening news. There lead story talked about the price of oil going up. Karl came back in the room and I was grateful to see he'd thrown on some sweat pants and was pulling a T-shirt on over his head. His shirt said, 'If you're not furious you're not paying attention.' I guess I wasn't paying close enough attention.

  "Oil's going up again. Well, they're at it again," Karl shook his head.

  "Karl, what does that mean?"

  "Ha-"

  "Don't give me that 'Ha' bullshit. What does it mean?"

  "What are you getting all ticked off about Duffy?"

  "You keep muttering about shit and then you make some sort of half assed prediction that gets sort of fulfilled. Then you act like Nostre-fucking-damus."

  "The truth hurts."

  "No. Fucking bullshit hurts!" My head started to throb. I noticed my breathing accelerated.

  "You're having a reaction right now Duffy. Slow your breathing."

  "I'm not having a fucking reac-"My chest got really tight and my head felt like a screwdriver went through it. Al came running around the corner and sat in front of me.

  "Rub Al's ears."

  "What?" Everything felt tight. The stupidity of Karl's comment jarred me.

  "Rub his ears and don't think of anything else." I did. I don't know why. The pain in my chest remained, the weird feeling like someone hit the fast forward button on my thoughts was there, and I felt like I imagined asthmatics felt. I don't know anything about this shit, but I knew I hated it. Karl continued to speak softly, in a monotone.

  "Feel the softness of the texture. Sense how it relaxes him. Feel the ears. Feel the ears."

  I did and I kept doing it. It got better than focusing on my chest caving in on me. I kept doing it. Al lifted a paw and rested it on my leg. He sort of purred.

  Little by little my breathing eased. I sweated and I felt, all of a sudden, exhausted. My vision widened and I felt like I just had done wind sprints up a hill. My chest pounded, but slowed. I had no idea if 20 seconds had just passed or a couple of hours. I had no idea what these fucking things were, or what brought them on, but I began to understand how people who got them never left their house or got out of bed.

  I started crying uncontrollably.

  "What the fuck is happening to me?"

  "Now you know why I take drugs. I think you clinical types call them panic attacks."

  "It didn't feel like anything fucking clinical to me."

  "It never does when it's happening to you." I sat up and watched the TV. I didn't want to talk. I didn't want to think. I drank the rest of the Schlitz. The three of us sat in silence while MSNBC went on about oil prices, Afghanistan, and the Middle East. I was barely focusing when, after about twenty minutes, Karl couldn't restrain himself from commenting.

  "The average idiot who thinks they know about these things likes to say 'It's all about oil.' That isn't even the tip of the ice berg, man." He shook his head.

  "When did you start seeing everything as a conspiracy? I mean, damn."

  "I see things that way because I've got a lot of experience getting conspired on."

  "You know, Karl I went out to your old high school. I didn't realize you were such a big man on campus back in the day."

  "Yeah, before the world got in the way."

  "Football star, class officer…Mr. BMOC. Have you kept up with the classmates?"

  "Nah, phony bastards. I've got no use for them."

  "What about Newstrom? Wasn't he in the Corps with you?"

  "Was, then he went private. He was part of it."

  "Part of it. What are you talking about?"

  "The shit went down. I found he planned on going private the whole time."

  "What do you mean private?"

  "He's a mercenary, except now they call them 'private security.' Shit, we got more private troops in Iraq then we do U.S. military. They make three times the pay and have no rules or discipline."

  "And he had something to do with screwing you over?" Karl looked at me and nodded. He got quiet and I couldn't tell for sure if he was sad or really angry. I didn't want to put the guy through the anguish of his memories, but I also had a pretty good size knot on my head letting me know I was intimately a part of his mess.

  "Karl, I read your VA file today. I can't imagine the shit you went through. It's easy to se
e how that could fuck a guy up." Karl stayed quiet. I started to wonder if I should've said anything about his file.

  "So you know about the kids."

  "Yeah."

  "You think that's why I'm nuts?"

  "Well, no, but I can understand the impact-"

  "Now you're talking like a social worker again." Karl stood up.

  "Look, shooting a couple of innocent kids fucked me up, no doubt, but what happened after that sealed it."

  "What happened?"

  "Nah, Duffy, no way, no yet. Don't get me wrong, I appreciate everything you've done for me, but to be honest, I've been screwed before by people who did nice things. No, not yet." I noticed Karl's hands trembled.

  "Do you think whatever shit is had something to do with the Army guys who got me at the medical center?"

  "Without a doubt."

  "And you're not going to tell me what this is about?" Karl looked away and paced back and forth. He chewed away at the tip of his thumb. Al started to follow him as he paced, making the turns, albeit not as easily as his two-legged buddy.

  "I found out about shit that would get a lot of people in trouble. It's important to certain people, very big deal people, I'm seen as a lunatic so no one ever takes what I say seriously. When people start taking me seriously…"

  "What Karl?"

  He didn't answer. He stopped pacing and turned his back to me. I could hear him starting to cry.

  "Karl, goddamn it-what happens if people start taking you seriously?"

  "They'll kill me."

  22

  My head ached both from being whacked and from listening to Karl's logic. I decided to administer my own pain medication and head to AJ's. Karl asked to come along. Before I could come up with an excuse why he shouldn't I said, "Sure." Karl insisted Al come. He made the point I was being species discriminatory and it wasn't right. My head throbbed and it was about to get worse.