by Jamie Mackay
***
Unit Three was their next destination and Tatum was riddled with anxious excitement. She was excited because she had never before been in a real honest-to-god mental institution, and she was anxious for exactly the same reason.
Unit Two had interested her, but it was not so much different than other places she'd worked. It was the more severely ill that she had much less experience with.
"Are you ready?" Anne asked with concern. She must have seen that Tatum was nervous.
"Never more so," was her decided answer.
.
Tatum was at first a little disappointed. Unit Three looked remarkably like Unit Two with peach as the colour of choice in place of Unit Two's pastel green. Structurally she saw few differences, the same type of large common room with a kitchen, lazy boys, small tables and a television, and then lower level treatment rooms and upper level housing units.
The first obvious difference that Tatum noticed was the noise. Unit Two appeared relatively calm; patients watched TV, played cards, talked or participated in other mundane daily tasks. In contrast, Unit Three had no sense of calm.
One patient was yelling "here they come, here they come, here they come" as he ran from one corner of the common room to another.
A female patient was sitting at one of the small tables pulling her hair and screaming something indecipherable. Another patient was beating a spoon against the table repetitively, while the patient across the table from him methodically kicked the table legs with the same rhythm.
Tatum noted that despite the incessant noise occurring in the unit, not everyone was participating in the noisemaking activities. There was a larger man who appeared to be in his mid-40s sitting in the corner simply looking out the window. A young woman was holding the mirror and was brushing her hair and singing softly to herself. A thirty-something man with a badly cleft palate appeared to be reading quietly in the corner.
Tatum continued to look around the room and take in the wide variety of patients that shared a single living space. On her second take she noticed a younger man, maybe in his early 20s, who sat alone in the corner. His behavior would have seemed fairly typical if it were not for the strange hand movements he was making in front of his face; he watched them intently. Tatum recognized the stereotypical hand maneuvers.
"Is he Autistic?" she asked as if she didn't already know.
"Yeah. Good call," said Larry, the Unit Three head she had met only a few minutes earlier. "Do you know anything about Autism?" Larry asked. "Because we sure could use some specialization around here, nobody really knows what to do. James there hasn't spoken to anyone in more than 20 years; just sits there wiggling his fingers - day in day out. We have some others like him, but at least the others interact a little. Talk a bit and such. Not James. Not ever."
Tatum resisted her immediate desire to share her full family history with Anne and Larry. Although she was not the least bit ashamed of her family's difficulties with Michael, she understood that in a professional environment it was work before family, at least where she came from.
"U3 is dedicated to patients that require long-term, full-care inpatient services" said Larry. "Not so different from U4, but no-one that is a risk to themselves or someone else. We also send any one with sexual aggression or deviance to U4. But overall, in here we've got lots of psychosis, delusions, obsessions, compulsions and anyone who has some kind of developmental or other disability that requires long-term institutional care. Like James there." Larry paused then said, "Well, wanna go upstairs? Or have you seen enough?"
Tatum definitely wanted to go upstairs. Similar to the rest of the unit, the upstairs was laid out exactly as Unit Two had been. But, again, Tatum noticed that although the structure was the same, the patient activities differed. Tatum looked through the small institutional type window that had been strategically placed in each dormitory door - the staff needed to be able to observe the residents at all times.
No-one was in the first room, and in the second the patient was having a nap, pretty mundane stuff. Then, in the third room, she saw a patient lying on his stomach beating his bed with his hands and feet. It looked like a small child having a tantrum, but it continued for much too long and the patient made no noise. In the fifth room there was a woman who looked about thirty-five sitting on her haunches rocking in the corner.
Room after room Tatum saw patients completing rituals, self-soothing and/or pacing in a desperate attempt to escape whatever voice might be in their head for the day. For the first time, Tatum knew what the inside of a mental institution actually looked like.
She had always seen her brother as severely disabled, even compared to many of those that she saw during her clinical work. Michael would fit in perfectly here, Tatum thought to herself. She felt just a touch sick to her stomach.
.
"Well Hun, it's just about four. I think we should probably call it a day." Anne said. "Lucky you. You're not a shift worker like the most of us. Means you get to clock out now, but ya got be back bright and early tomorrow."
"Tomorrow is Unit Four and Five?" Tatum asked hopefully.
"Nope, sorry hun. For now your clearance is only Units One through Three. Units Four through Six you'll get access to in time. Tomorrow will be your first in the trenches. I'll meet you in the morning and then I'll place you in the capable hands of Dr. Glaser who you'll shadow for tomorrow. We'll have to wait and see what his plans are after that. I'm not sure whether he will want you to continue on with him, or whether he will pass you off on days when he has manager kinds of things to do."
Tatum heard little of what Anne said. She was still stuck on the fact that she currently had no access to Units Four through Six. She was overwhelmed with curiosity about why someone with her training and credentials would be disallowed from any part of the hospital.
