There were two more discharges scheduled for Monday, as announced in the ward assembly. The two patients were not people Patrick had either been friendly or unfriendly with so he took the news with indifference. He was sitting a couple of seats away from Justine for the sake of discretion. Charley was right next to him as usual. Anthony was on the other side of the room from them, sitting in his wheelchair alongside Frank.
Since this was Anthony’s first ward assembly since being admitted, he was subjected to the same ritual Patrick had been through four days earlier. Patrick was both surprised and impressed to hear Anthony say out loud what he himself had not dared to say in front of everyone. When asked what had brought him to Hillside, Anthony said: “A gross injustice, a big misunderstanding.” But Frank had talked Anthony down out of his waxing agitation and swiftly changed the direction of the introduction.
And that was that until the “clear the air” segment of the assembly. Simon opened the floor to any ward issues that anyone cared to discuss.
“We’ve got mice up here,” Linda declared.
Charley laughed.
“It’s true!” Linda exclaimed. “I saw one of them last night. I want to know what’s going to be done about it!”
“Housekeeping has been notified,” Rachel reported. “They’re looking into getting an exterminator up here.”
“Looking into it?” Justine sneered. “Is that all?”
“No,” Rachel said coolly. “In the meantime, we need to be careful to clean up after ourselves. I know I’ve seen food crumbs on the floor and on the counters. That’s what brings mice up here.”
“So clean up after yourselves and the mice won’t have anything to feed on,” Frank added pedantically.
“Mice have a right to eat, too!” Anthony shouted.
His observation was met by a chorus of groans and more laughter from Charley. Frank leaned over and whispered something to Anthony, who broke out in a soft giggle.
Patrick leaned forward and looked to his left, trying to gauge Justine’s reaction. She was staring across the floor in Anthony’s direction. The look on her face was one of utter contempt.
But her mercurial moods allowed her to smile at him after the meeting had broken up. Patrick ached to touch Justine again, unthinkable though it was. They had to settle for sustained, intense eye contact.
Charley prodded Patrick in the ribs as they started out to the hallway for the tables. Assuming that he was about to be teased about Justine, Patrick held his breath.
“Some fuckin’ nut, isn’t he?” Charley said, pointing over at Anthony, who was rolling forward in his wheelchair.
“He’s no so different from any of us,” Patrick replied firmly. “You heard what he said about… about injustice, wasn’t it?”
“So?”
“That’s what I thought when they sent me here,” Patrick explained as they reached the first table. “You too, man.”
“Me too?” Charley asked with a puzzled grin.
“Somebody get me a cheap lawyer, remember?”
All Patrick accomplished with that was to make Charley laugh once again, louder than ever. He was sure that his buddy had missed the point entirely. Oh, well. It had been worth a try.
Frank Devenau was the most experienced mental health counselor on either psychiatric ward at Hillside. He had twelve years of hospital work behind him, some of it in drug and alcohol rehab, most of it in psychiatric facilities like this one. He had been employed at Hillside in particular for three and a half years by that summer.
Frank liked to remind people about his experience and occasionally bragged about his knowledge. What Frank did know was mostly self-taught. He was inquisitive and intelligent; Eastern mysticism fascinated him and he had chosen to limit his material possessions. Frank lived in a clean boarding house within walking distance of the hospital.
One thing that his one-the-job training had taught Frank was the importance of structure. Apart from organic brain dysfunction, the patients had difficulty coping with the outside world because they lacked structure. Prior to admission, most of them were too distracted by their symptoms to maintain the mundane, routine, repetitive behavior that keeps human beings connected with reality.
Frank’s faith was that as the medication and therapies brought patients out of psychosis, the imposition of structure would allow them to readapt to the world. There was no sense in patching together someone’s broken psyche and then toss him out to the sidewalk without preparation for everyday living.
Some patients needed little help in making the adjustment. Linda would be one example. All they had to do was cooperate with group and meeting schedules, obey the rules governing the use of privileges. Even if they struggled against the rules, at least the higher functioning patients acknowledged their existence. That was a good thing.
Other patients needed far more staff direction. There was work to be done to get their lives structured. Frank regretted that many of his colleagues, past and present, didn’t comprehend the significance of structure. But Frank would always work hard with patients like Anthony Gingarella.
Of course Stacey had been only too happy to pass on certain responsibilities to her eager counterpart. Anthony had lost bladder control due to his injuries and Stacey hadn’t been enthusiastic about handling the catheter and reservoir bag strapped to Anthony’s leg.
But Frank had asked her to instruct him on how to change the catheter in case Anthony couldn’t do it himself. With more patience than usual when it came to talking with Frank, Stacey demonstrated with a spare, empty catheter set from the supply room.
She had failed to offend him by referring to the reservoir as a “piss bag”. Despite his earnestness, Frank had usually been a good sport when it came to the dark, dry wit of veteran staff members. After all, he was capable of it, himself.
Patrick had another session with Dr. Kearney that morning. This time, he was much more relaxed. Patrick was less defensive when the doctor questioned the basis of his fears, having allowed himself to doubt them on his own. He appreciated Dr. Kearney’s good humor and general attitude of encouragement. Patrick was especially relieved that his psychiatrist never mentioned Justine.
Maybe their budding romance had actually gone unnoticed by the staff. Could the precautions have been working? Patrick felt lucky.
After the session, Patrick was able to join a group of low-privilege patients on a staff-escorted trip to the snack bar. Brenda was taking charge of them. Patrick was able to tolerate this undignified excursion because he knew that Dr. Kearney was about to write an order to upgrade his privileges. The medication order was not to be changed given Patrick’s improvement and lack of side effects.
He was in for a surprise when he returned to his room. A stranger was sitting on the other bed. Patrick stood still in the doorway, looking him over. The stranger seemed unaware of Patrick’s presence.
The man was clearly a good ten to fifteen years older than Patrick. He looked enough like Fred that for an instant, Patrick feared that his ex-roommate had made a return appearance. But the new man was balder than Fred and his remaining hair was darker or perhaps just greasier. Instead of a smirk, this patient had a quivering lower lip above a weak chin. He was also sitting slouched forward, elbows planted on his thighs.
Since the new patient didn’t look up, let alone say anything to him, Patrick backed out of the room. He wandered back down the hallway, looking for Justine. Pausing by her door, Patrick heard his girlfriend talking with somebody in the room. Her tone was shrill, although Patrick could make out only a few isolated words. Justine seemed to be voicing her usual gripes. Nothing new, so Patrick turned and walked into the smoking room to wait for her.
He chose a seat from which he could monitor the hallway. After hearing a door open, Patrick saw the nurse Stacey striding briskly down the corridor, a frown on her face. Then Justine appeared, smiling when she saw Patrick.
“Hey, there!”<
br />
“Hi,” Patrick responded. “I… I was afraid maybe you just got restricted to your room again.”
“Not this time,” Justine said, scowling a bit.
They didn’t touch each other when she came to sit down because there were too many witnesses in the room. The other three patients were all part of the more lucid segment of the population. There was a certain social distinction on the ward and, in this context, Justine was the biggest snob of them all.
“What was that about?” Patrick asked.
“Oh! They want to try a new pill out on me.”
“Really? Dr. Kearney just told me they’re keeping me on the same stuff.”
“Yeah, well, what did I tell you before? Dr. Adams loves to experiment with the chemicals.”
“Too bad.”
“I’d like to trade doctors with you.”
“No thanks,” Patrick said, wishing he could hold Justine’s hand to comfort her.
A moment later, Kris led Patrick’s new roommate into the smoking room.
“This is Wyatt,” she told the gathered patients. “He just arrived. Make him feel welcome.”
The silence that followed her words was variously embarrassed, contemptuous, fearful, and apathetic. Kris lit Wyatt’s cigarette and left the room. Wyatt was standing with a stooped posture. He shuffled over to one corner. Whether consciously or not, Wyatt sat as far from the rest of them as possible. Patrick was nearest to him.
Linda sighed and got up from the short sofa. Justine had been sitting next to her. Now she smiled and patted the vacant cushion. Patrick hurried to join her as Linda entered the hallway.
Patrick looked back at Wyatt, who was duplicating the posture he’d taken on his bed, gazing sleepily at the floor in front of him. The cigarette kept burning in his fingers; Patrick hadn’t seen Wyatt take a puff so far.
Then Wyatt started mumbling to himself, speaking too softly to be heard from Patrick’s vantage point. Just seeing Wyatt’s lips move was disturbing enough.
“My new roommate,” Patrick whispered.
“You want to listen to his mumbling all night?”
“Shit!”
“Go tell ’em you want a room change,” Justine said, nudging his elbow.
“Can I do that?”
“Of course! Don’t wimp out. Tell ’em right now!”
Patrick got up and left the room slowly. Although feeling slightly guilty about going along with the patient caste system, he couldn’t get over how intimidating Wyatt’s behavior was. He thought it would be best to approach making the request with humility; if he acted like Justine, they’d probably deny him a room change out of spite.
The door to the staff office was closed so Patrick had to knock. Rachel opened it wide enough for him to see her face and nothing much else.
“Yes, Patrick?”
“I… I… have a request.”
“A request?” Rachel echoed, smiling. “What might that be?”
“Um, I think I’d like to change rooms.”
“I see.”
Patrick heard someone walking up behind him. It didn’t sound like Wyatt’s shuffling, at least. Looking over his shoulder, he saw Simon.
“Hey, what’s up?” Simon asked.
“Seems Patrick here wants a new bed assignment,” Rachel answered, swinging the door open all the way.
“Is that so?” Simon asked, passing Patrick on his way into the office. “Better check and see what we have available.”
He and Rachel went over to stand near the table. Kris was already sitting there, a patient’s chart open in front of her.
Simon reached over and got the floor plan down from the bulletin board. He and Rachel leaned over it at the end of the table. Patrick wasn’t sure what they were doing but noticed that they both had wide butts.
After some brief murmuring that Patrick couldn’t make out, they turned around to face him.
“If you’re sure you want to move,” Simon began, “we can do that for you. But be warned: the only open bed is in Charley’s room.”
“Oh, I don’t mind,” Patrick said quickly. “I like Charley. Th-that new guy, that Wyatt…”
“Say no more,” Simon told him. “Need help moving your stuff?”
“No, it’s cool,” Patrick replied, almost giddy with relief. “Can I move right now?”
“Of course,” Simon told him as he started to close the door. “See you later.”
He pushed the catching lock into place and turned back around.
“Well, that was easy,” Simon remarked.
They had planned to move Patrick down the hall into Charley’s room shortly after receiving the full report on Wyatt Halliday. Kris was still fuming over the revelations from Wyatt’s halfway house. After all, he’d been assigned to her.
“Twenty-two separate incidents!” Kris snapped, swatting the stack of forms in front of her. “This is so God damned wrong! They lied to us!”
Simon sat down next to her and glanced at the forms she was talking about. Kris slid them over to him.
“Incident reports,” she said. “Twenty-two documented assaults. We aren’t supposed to have assaultive patients here!”
“I know,” Simon muttered, flipping through the forms himself.
“What are we going to do about it?”
“Nothing much we can do,” Rachel said calmly. “You know this happens sometimes. They lie to us over the phone; Stella isn’t a mind-reader.”
“I don’t blame Stella,” Kris reacted. “I blame the halfway house.”
“Half-assed house,” Simon quipped.
“I wish we could just ship him right back.” Kris went on. “Return to sender, delivery refused. But since that’s not going to happen, why don’t we put Wyatt upstairs where he belongs?”
“I already checked into that,” Rachel told her. “No available beds. Now, you said Wyatt doesn’t appear agitated right now?”
“No,” Kris admitted. “But isn’t that just from the Thorazine?”
“Whatever it is,” Rachel said, “as long as he’s calm, we have to deal with him. And hopefully he’ll stay that way on his meds. He can’t be transferred to a state hospital unless there’s an incident.”
“What if he hits another patient?” Kris argued. “Do well tell the person he hits, ‘Sorry about that but since you were part of Wyatt’s “incident” we can get rid of him; thanks for your assistance’?”
Simon laughed softly, shaking his head.
“We’ll keep a close watch on Wyatt,” Rachel insisted. “Have his meds in liquid form so he can’t cheek them, which could be why he acted out in the halfway house. Gloria’s meeting with Dr. Kearney about all that right now.”
Kris started to say something else but she stopped herself. The young counselor was never afraid to be opinionated but she was also bright enough to recognize when a decision had been made and her influence was negligible.
Simon, who felt the same way about the situation, caught Kris’s eye and joined her in a wince. At least Patrick was going to be safer. If Wyatt did strike another patient, Simon hoped it wouldn’t be someone he liked.
Conditional Voluntary Page 13
