by Julie Dewey
Our first appointment was with Dr. Saul who would be giving Jenna her psychiatric evaluation. He was very curious upon observing Jenna’s behaviors. She licked the walls in his office, sniffed the air like a pup, and then licked her hands. When she sat before him she took off her shoes and socks, then licked her feet. She had no sense that this was odd or inappropriate. It was as if her sense of right and wrong, along with appropriate manners, were lost.
“Jenna, my name is Dr. Saul. Tell me, what does my office smell like then?” He asked.
“It smells like spices and someplace far away. I don’t recognize it, but that’s okay.” Then she mumbled to herself putting vowels and consonants together making clicking, nonsensical words and sounds.
My daughter and I sat back and listened as the doctor conversed with Jenna about everyday things, such as the concert that she claimed to have missed. After a half an hour of conversing, the doctor sent Jenna and I into the waiting room while he spoke to Camille alone. I gathered from the ghastly expression on Camille’s face when she stepped out of the office that the news was not good. It was my turn to meet with the doctor, although I was not a parent, I was a guardian and primary care-giver. I was her grandmother.
“Your daughter will need support. I fear she is in a state of shock at the moment, Shirley,” the doctor said when I sat down across from him.
“Yes, Camille is already under a lot of stress with her demanding work schedule and honestly, this came on very suddenly.” I confided.
“As it often does in these cases.”
“May I ask you something? My grandmother was insane, she spent a stretch of time at Willard Hospital as a young woman. Can this be hereditary?”
“Certainly it can. It would be most helpful to me if I could obtain her medical records, do you have access to them?” he asked.
“I don’t, but that’s not to say I can’t try to obtain them for you. I have memories that may be helpful and am more than willing to share any information I can remember if it helps my granddaughter.”
“Yes, she will need all the help she can get. I am sending her home because she is not harming anyone right now. She may seem confused at times which is normal for what she is experiencing. You may notice swift mood swings, or changing sleep patterns and I ask you to jot down what you observe. We will meet regularly from now on and keep a sharp eye on her progression.”
“Dr. Saul, what is the diagnosis?”
“It appears she has a psychotic disorder of some kind. It is even possible she may be having a psychotic break. However, until we have her tested for epilepsy, brain tumors, or encephalitis, we can’t confirm this. We need to rule out any other medical conditions, or neurological disorders that involve the central nervous system.”
“Oh my.” I gulped in air, closed my eyes and felt the expansion of my lungs.
“Shirley, are you alright?” the doctor asked.
“Yes, I’m fine. Please go on.” I answered.
“Once this testing is complete and we have more concrete information, we can go forward with a diagnosis. Psychotic disorders are most often diagnosed in teenagers or young adults, but it’s not entirely uncommon to have an adolescent child present with these symptoms. Unfortunately, we have found that the younger a child is when they present with the classic symptoms, the more severe the case is.”
The tears welled up in my eyes, as I listened to the doctor.
“What can we do, Doctor?” I said clutching the tissue he handed me.
“Be patient, be strong for your daughter, and we will meet again next week to discuss Jenna’s CAT scan results.”
“Thank you, Dr. Saul.”
“You are welcome, and if anything else unusual comes up, don’t hesitate to call me.” He handed me his card, with his personal cell phone penciled in the corner.
His office made the necessary appointments for Jenna and now all we could do was wait. My daughter took the week off from work, which would drastically affect her income but it was imperative she be present for Jenna’s testing.
***
The CAT scan was imposing and while we didn’t tell Jenna precisely what kind of test she was getting, she grew uncomfortable when our car turned into the hospital parking lot. After checking Jenna in, she was told to undress and put on a hospital gown that opened in the back. She seemed suspicious of the nurse that took her vitals and attempted to run an intravenous line in her arm. Jenna started talking quickly in gibberish: the nurse looked at my daughter and me questioningly but didn’t say a word. The nurse found a vein and rubbed the spot with an alcohol swab. Jenna clicked her tongue and grew irritable but remained still while the needle was inserted. I wondered what she was thinking when she stared at the ceiling so intently.
Once the line was placed, she was transferred into an adjoining room and laid on a narrow table. Jenna shielded her eyes from the bright lights and looked uncomfortably at the sterile equipment surrounding us. While we waited for the head technician to arrive, Jenna grew restless and fidgety. She began tugging at her tape and tried ripping out the IV needle. She stood up to leave, claiming everyone in the room was out to get her. Her monologue became panicked and she started sweating on her brow.
“Jenna, everyone here is trying to help you. They just have to run some tests to determine your condition,” I said calmly to my granddaughter. I placed a gentle hand on her shoulder, trying to force her back down to the cot. My daughter stood uncomfortably in the corner watching everything unfold.
“They put something in my brain, Grandma, through the needle in my arm and now they want it back. Don’t let them hurt me, they want to kill me!” Jenna was sweating more profusely now and continued her attempts to try to flee. A large black man blocked the doorway and two nurses escorted her back to the cot, where her arms and legs were put in restraints.
Jenna screamed and clicked her tongue, her language strange and confusing to all of us who were around her. I tried to console her but her eyes were wide with fear. When the technician finally entered the room, he had a doctor with him. Jenna was administered a sedative via the IV to calm her so that the testing could take place. Everyone in the room was on edge, but my daughter was mortified.
The blood work and urine culture came back negative. Similarly, the results from the x-rays and CAT scans were normal, Jenna had no problems with her endocrine or metabolic systems. This pointed to the fact she did indeed have a neurological or mental disorder. Dr. Saul phoned my daughter at home and scheduled an appointment for us with a pediatric neurologist the following day. This doctor was a close colleague of Dr. Saul's and he was able to make room for us in his schedule.
Jenna was reluctant to get out of bed the following morning. Camille and I had to drag her into a steaming hot shower to wake her up. Neither of us could get her to use soap or to wash her hair, Jenna feared the substances were poisoned. She dressed with great apprehension and tried lying back in bed, but we urged her to get ready for the day and promised her pizza for lunch. I felt like she was unraveling before my eyes.
The neurologist had a thick foreign accent that was hard to decipher and it made Jenna wary. She warmed up to his nurse, however, during her hearing and vision testing and the remainder of the tests ran smoothly. The exam was straight-forward and the doctor was able to assess Jenna’s motor and sensory skills, along with her speech and balance. He used a reflex hammer to check her nerves and a flashlight to study her eye movement. The exam only took half an hour and when we finished we went straight to Dr. Saul’s office. The neurologist told us he would call Dr. Saul with his results immediately.
The doctor’s door was ajar when we arrived at his office, thankfully this meant we didn’t have to wait. We entered together and took seats as the doctor stood to greet us before closing the door. Jenna squeezed her eyes tightly shut when the door latched shut, her body tensed.
“I understand, Jenna, that you were uncomfortable with yesterday’s testing?” Jenna just shrugged, fearful this do
ctor was out to get her as well.
“Well, the testing came back negative as you know. Jenna does not have any medical basis for her behaviors. I just spoke with the neurologist as well, and those tests were also negative. In other words, Jenna doesn’t have any diseases that might present with speech deficiencies or mood swings. Having this information allows us to move forward with therapy to arrive at a diagnosis.”
“Doctor, what are you looking for exactly?” I asked while my daughter sat by, unusually quiet, holding Jenna’s hands.
“This diagnosis will be tricky. I have ruled out Post Traumatic Stress disorders, because she hasn’t had any traumatic events or accidents.”
Suddenly Jenna stood up. “You don’t know me, you are just like the rest of them!” She yelled as she stormed from the room, slamming her fist against the wall on her way out. My daughter followed her outside and the doctor motioned that I allow them to retreat.
“She is displaying delusions of persecution. As you have just witnessed, she thinks people are out to get her. This is a common occurrence in schizophrenic patients, Jenna may even accuse you of being against her.”
“Okay. Are you saying that my granddaughter has multiple personalities? The Jenna I know would never act like that. She has never had a violent bone in her body.”
“No. Multiple personality disorder is quite different from schizophrenia. I can’t say with one hundred percent accuracy that she is schizophrenic. It is possible she has another personality that is trying to come out, or she could have a mood disorder known as bipolar. If she is bipolar she could be displaying a manic episode at the moment, but only time can tell if this is the case. However, the licking and sniffing and language are not normally indicative of bi-polar disorder. At home I need you to observe Jenna. If she continues to be irritable and accusatory, and restless, followed by extreme fatigue, withdrawal, and depression, I need to know. If her changes are less subtle, then that provides me vital information as well. Diagnosing children with mental illness is very tricky and takes time.”
“Of course, I will keep an ongoing record.”
“Also, it would be helpful if you can attend support groups in order to learn as much as possible about mood disorders. There you will learn what to look for and how to recognize behaviors that point to acute episodes.” He handed me a pamphlet with information for a local support group for families with members who were mentally ill. The group met weekly in an open forum in a church basement in DeWitt.
“Will she ever be normal again?” I asked biting the inside of my cheek and tasting the tangy blood.
“Jenna is being treated early which is good. I have every reason to believe she will respond to therapy and medication with support. Jenna sees the world differently than you and I. She appears to be having a break with reality, and she may hear or see things that don’t exist. You have heard the odd language she uses, this is classic schizophrenic behavior. Often these patients create their own clipped words that make no sense to anyone else. Because Jenna feels like others are trying to harm her, she is slightly paranoid. Just reassure her that she is okay. Try to bring her back to the present using smells and sounds that are familiar and comforting. Sing a lullaby she was fond of as a child, bake cookies, or do something else that engages her.”
“I can do that.”
“Our approach to her care is gentle and conservative. We will try therapy alone first and see what results we achieve, if we are able to manage her outbursts, delusions, and language we will stay on course and hope for a full recovery. If she continues to develop further symptoms, if another personality evolves, or if she becomes a danger to herself, we will need to start medication. All of our efforts are put in place so that she can be a functioning member of society.”
“I understand.”
“You mentioned a grandmother with mental illness, if you can get her records I would very much like to have a look at them. Sometimes this helps when diagnosing a patient.”
“I will do my best. Willard Hospital closed in 1995 but I will make some calls.”
“Very well then. Thank you for coming in with your daughter and Jenna, I can tell they need you.”
I felt a weight bearing upon my shoulders and stood to leave, inhaling deeply as I left to find my family. I would feel better if we had a concrete diagnosis, but I understood the challenges Dr. Saul faced when observing Jenna.
Chapter Nineteen
Medical Records
Willard Hospital closed in 1995, this much I already knew. I thought a lot about my grandmother, Iona, over the years but until now I didn’t have a concrete reason to go digging around her past. My mother, Suzette, told me Iona spent a short period of time at this hospital when she was a young lady for being delusional and disobedient. I knew all about Hetty, because we had a framed sketch of her hanging above the mantel in our family room growing up and sometimes I saw Grandma talking to her. Given what we knew it made sense to me that Iona was delusional. The rest of my grandmother’s story, however, was a mystery. What happened to my grandmother during her confinement? How was she diagnosed and treated both medically and physically? Insane asylums had horrible reputations for mistreating their patients in the 1900s and I could only imagine what my grandmother was subjected too.
I Googled Willard Hospital and was met with an onslaught of information and photographs. Images of abandoned brick buildings with shattered windows and boarded up houses were scattered across dozens of websites. There were photographs of numerous bath-tubs, stained with rust, positioned side by side and surrounded by the peeling paint from the once sea green walls. Wooden tranquilizing chairs with neck braces were centered in large desolate rooms. The scathing imagery sent shivers up my spine. More photos portrayed empty beds in dark hollow rooms. The photographs evoked images of fear and isolation.
Some websites had pictures that focused on the patients themselves. There were women labeled as ‘patients shown working in sewing rooms’ while other patients were photographed enjoying the outdoors playing shuffleboard. Naked, feeble-minded women who indeed looked insane, could be found next to photos of female patients that were clean, well dressed, and looked normal by any standards. I wondered which of these categories my grandmother would have fit into. Was she disheveled and helpless, or did she care about her appearance and keep herself groomed?
Photos of women’s and men’s shoes, boots, and even wooden prosthetics could be found. Similarly, hairbrushes, curling irons, and other items for grooming were evident. Decks of cards and photo albums were displayed alongside photos of other means of entertainment. Steel film reels and a cinema room with lists of the movies shown on concurrent dates were on several different websites as was the infamous Hadley Hall, the place where patients found amusement in the form of theater and games. Patients partaking in activities such as bowling were then followed up with ghostly images of empty lanes with fallen pins and balls.
Perhaps most troubling was the photograph of an empty morgue with tools strewn about, one tool had a deep curvature at its tip that was reminiscent of an ice cream scoop. I wondered immediately if lobotomies were performed at this institution and suddenly felt sick to my stomach.
Interestingly, images of Willard’s patients’ suitcases were all over the web. Over four hundred such suitcases were discovered deep within the recesses of a building’s attic. It appeared the suitcases were stored in one particular building for decades and forgotten about. A group of researchers took it upon themselves to study and catalog the suitcases, and went so far as to have them documented on film.
The suitcases had the original contents still inside them. One lady’s suitcase had syringes and bottles of medicine including laxatives, while another had toiletries and a sewing kit. Some individuals had novels and family photographs and others had bibles and musical instruments. One woman had fourteen pieces of luggage that included furniture. Dozens of medical bags were found as well, which I thought was peculiar.
I wondered if my
grandmother were in any of these images, or if her suitcase was found among the others. It was an interesting angle, and the more research I did, the more I became determined to go to an exhibit and find out.
One of the more informative websites led me to a phone number that I could call for information regarding patients that once resided at Willard. I placed a phone call in order to start the ball rolling and get Iona’s medical records released. Numerous forms needed to be filled out; first and foremost we had to prove we were related to an individual patient at Willard.
Chapter Twenty
Shame
My daughter, Camille, and I quickly learned how shameful it was to have a beloved family member diagnosed with a mental illness. Aunts and uncles, cousins and distant relatives called out of concern, but when we elaborated on Jenna’s condition and possible diagnosis, they became outraged and defiant. My daughter, Helen, was irate that her sister, Camille, would agree to take her daughter, her pride and joy, to therapy. ‘It just wasn’t something we did’, she said.
“If anyone finds out Jenna is in therapy, she’ll never have friends. They’ll think you guys are weird and she’ll become a loner for life,” Helen admonished.
“Helen, with all due respect, that’s not your decision to make.” Camille told her sister.
“I just saw that little pixie six months ago, and she was fine.” Helen retorted.
“Well, things change quickly I guess.” Camille said.
“Did you ever think it could be hormones? I mean all kids get wacky when they go through puberty and I noticed she was developing, if you know what I mean, last time we were there.”
“It’s more than that, Helen. If you’d just listen to me, you might understand.” Camille pleaded with her sister.
“No, nope, I don’t want to hear it. My niece is fine. She is not a schizoid, nor is she mental. The only one I question, is you.”
