Conditional Voluntary

by Geoffrey A. Feller

Frank came by to check on Anthony right after the change of shift report on Monday morning. Anthony had just begun to stir and was carefully easing himself out of bed.

  “Good morning, Anthony,” Frank said brightly. “How are you feeling today?”

  “All right,” the patient said softly as he slid his legs over the edge of the mattress.

  “Time to get ready for the day, huh?” Frank said, standing over him. “A good start makes the day successful.”

  Anthony nodded.

  “Now let’s have a look at that catheter.”

  “All right, but I can do it myself.”

  “I’m not so sure, Anthony.”

  The reservoir bag was full from the night. Sitting in his undershorts, Anthony glowered as Frank took an empty replacement from the closet.

  “Frank, please! I must – I must do this myself! I’ll have to do it on the outside. Please, let me.”

  “Now, Anthony,” the counselor sighed, starting to kneel down, “we’ll cross that bridge later on.”

  “Art let me do it myself.”

  Frank glanced up at Anthony, his gray eyes bright with irritation. But it hadn’t been his patient’s fault. Quickly, Frank altered his expression into a more neutral look.

  “Art let you do it himself? He, uh, wasn’t supposed to do that. Could have asked the nurse to change it if he wasn’t comfortable.”

  “He respected my freedom, Frank. I did a good job, too. I only spilled a little on the floor.”

  Frank, who had been kneeling on the linoleum, jerked himself into more of a squat. He peered down but the black surface made it hard to see any dried urine.

  “It mostly got under the bed,” Anthony reported. “It’s all right, though. No one could step in it there.”

  “Listen to me, Anthony,” Frank said tersely. “Until you can do this without spilling any, I will do it for you.”

  “But…”

  “But nothing. You don’t want to fight over the bag, do you? That would make a real mess.”

  “Will you let me do it myself before I leave, Frank?”

  “We’ll see about that.”

  “Then it is possible?”

  “Yes,” Frank said, already taking hold of the plastic tube.

  Grimly, Anthony now allowed Frank to proceed. He looked up at the ceiling.

  “They kept telling me I was suicidal, Frank,” Anthony said, recalling the old clinic.

  “I know,” Frank told him as he fastened Anthony’s belt buckle.

  “They kept telling me I was suicidal. I said I wasn’t, they said I was. ‘You’re suicidal, Anthony! You’re suicidal!’”

  “Calm down, now,” Frank urged him, putting his hand on Anthony’s shoulder. “Put it behind you.”

  “I – I can’t! They drove me to it, you know. I couldn’t stand it anymore! I ran out of there… I ran and I – ”

  “It’s almost time for breakfast.”

  “But I want to talk about this!”

  “Anthony,” the counselor said, bending down to look him in the eyes, “remember what we’ve discussed. Focus, keep focus. It’s how you have to keep a grip on what’s going on right now, okay?”

  Anthony’s anger simmered behind his scowl. His hands twitched at his sides. Why did Frank have to try and shut him up half the time?

  “Okay?” Frank repeated.

  “All right,” Anthony said through clenched teeth.

  “I’ll help you to your chair,” Frank said, smiling.

  “I can do it myself.”

  Dr. Kearney’s answer had been vague but close enough for Patrick to delay implementation of Plan B. Or maybe, he thought, it should be called Plan E, as in elopement. But anyway, the psychiatrist had said “probably a week from today”. Okay, one more weekend. But no more.

  Patrick asked Justine about her own discharge date. She snapped back that she had none and wouldn’t be getting one until she “kissed up” to Dr. Adams.

  “That means I’ll be here forever,” Justine said with a sigh as they walked back to the elevator from the snack bar.

  “No, you won’t,” Patrick said, caressing the small of her back.

  “Thank you, cutie. You… you always calm me down.”

  They kissed right there, breaking lip contact when they heard the elevator coming to a stop behind the doors. But Patrick was still holding Justine’s forearms when the doors opened to reveal Brenda the counselor. Patrick let go of Justine too late.

  “Hey, uh, no physical contact,” Brenda said nervously.

  “Yeah, like you could get any,” Justine muttered as she walked past the counselor.

  “What’s that?” Brenda asked, sparked into irritation.

  “Nothing. You’re nothing. This whole place is nothing.”

  “If you want to be restricted to your room,” Brenda said, holding the doors open, “keep talking that way.”

  Patrick was still outside the elevator, watching in utter discomfort. He could see that Justine was eager to talk back again and was barely able to hold it in. As for Brenda, she suddenly seemed more courageous than Patrick had though possible.

  This time, Justine was too upset for Patrick to calm her down. No more affection between them as they rode up without Brenda.

  “She’s got a thin little chicken neck,” Justine was saying. “I’d like to snap that chicken neck of hers.”

  She spoke so coldly that Patrick felt queasy. He wondered if Justine really was capable of violence. But, like Charley, she seemed far more of a talker than a doer. Maybe there was something in the air. When they got back inside the voluntary ward, Patrick saw evidence that something was.

  “Well, look at that,” Justine whispered as they approached the sign-in desk.

  Patrick followed her gaze and saw Frank standing outside the seclusion room door. He was looking through the little square window.

  “Someone’s in there,” Justine said. “Wanna bet who it is?”

  Frank overheard her and turned his head towards them.

  “We don’t need any spectators here,” he said firmly. “Day room, smoking room, or your own rooms, okay?”

  “I need a cigarette,” Justine remarked as if Frank hadn’t said a word. “Let’s go.”

  They met Linda in the smoking room.

  “What happened up here?” Justine asked as she led Patrick to the sofa.

  “That maniac Wyatt,” Linda answered with a sigh. “He went off in the day room. Turned over a table, tried to hit one of the counselors before they took him down.”

  “Which one?” Patrick asked.

  “Which counselor?”

  He nodded.

  “Frank. They had to buzz the locked ward to get help. You missed it – quite a show.”

  “What do you mean they buzzed the locked ward?”

  “They got panic buttons down here. The staff can set off an alarm for emergencies with violent patients. Press the button and a buzzer goes off upstairs and they send down some of their heavyweights. Then there’s a buzzer on this floor to call this staff. I heard it go off down here once. You should’ve seen those guys run. Frank, Kris, Simon. They go up and down by the fire door down next to the pay phones.”

  Linda lit another cigarette.

  “I know about how the panic buttons work because I overheard the staff talking about them once.”

  “They’ll ship that creep off to a state hospital,” Justine said. “Or upstairs.”

  “That’s right,” Linda agreed. “Never should’ve been on our ward in the first place.”

  Patrick nodded, remembering how he’d once been Wyatt’s roommate. It could’ve been him that Wyatt had taken a swing at. Wasn’t this supposed to be a safe place?

  Simon was working the evening shift this time. As a treatment team member, he generally performed his duties on the 7-3 shift so that he would be readily available to consult with the team nurse or even the psychiatrist. But staffing ne
eds dictated that he and other team counselors rotate to the 3-11 shift one day a week.

  Simon found it pleasant to sleep late after losing that opportunity over the previous Saturday and Sunday. He rented a room in a large house over in the upper-income suburb of Brookline; having several other housemates made it affordable to live there.

  As was his habit, Simon entered through the south end fire door across from the smoking room. He looked in to see Patrick with Justine but, having heard the door latch click open, they’d had enough time to scoot another few inches apart on the sofa.

  Patrick and Simon exchanged a brief greeting while Justine gave the counselor a sour look. It was not so much whether she actually liked Simon; he was more easygoing than Frank or Brenda, let alone Kris. The real problem was that Simon liked Patrick too much and probably made him eager to break him up with her. Justine wanted to believe that Simon was some faggot who wanted Patrick for himself but she knew better, having observed the big ape staring at the occupational therapy girl’s ass. God help Patrick if he ever did that, Justine thought, clutching her boyfriend’s knee after Simon had moved along.

  Simon met Kris outside the seclusion room door. He frowned with disappointment.

  “Wyatt?”

  “Who else?”

  Simon looked into the room himself. There was Wyatt, pacing around the enclosure. It was not a padded cell; the walls were smooth plastic and the only object in there was a vinyl coated pad for patients to lie down on. There was a toilet behind an internal door and an overhead light was built into the ceiling. A soft bulb was behind a plastic cover instead of something harsh like a fluorescent tube.

  At first, Wyatt seemed placid enough as he paced but his back was to the door. Then, after he turned around at the far end of the chamber, Simon got a look at his face. It was contorted into a vicious scowl, something Simon hadn’t seen from Wyatt before. He looked into Simon’s eyes but gave no sign of recognizing him. Wyatt’s muttering was too quiet to be heard through the door.

  “Has he been medicated?” Simon asked, looking back to Kris.

  “Not yet. Kearney left for the day an hour ago but they already beeped him. No one knows where Adams got to. If we don’t get a chemical restraint and transfer order from one of our doctors, Gloria’s going to call Dr. Brisbane up on the locked ward.”

  “Looks like I got here just in time,” Simon remarked sardonically. “Now I can help hold him down for his needle in the butt.”

  “Yeah, Brenda’s going to be happy to see you,” Kris said with a grin. “There was even more fun on our ward than this but you’ll hear about it in report.”

  By the time Simon settled in at the staff office table with his obligatory cup of coffee, he’d heard that Gloria received a telephone order from Dr. Kearney so that they could proceed after the shift report was done. The locked ward now had a vacancy and Dr. Brisbane had agreed to accept Wyatt following a call from Dr. Kearney.

  As Kris had promised, there had been other developments among the patients during the day shift. Anthony had been put on room restriction until 3:45 due to an outburst in the day room. This had happened before Wyatt’s own outburst in the same location. Only a short while ago, Brenda had caught Patrick and Justine touching each other. Since this was now the second time that staff had witnessed what had already been assumed, the matter now had to be dealt with directly.

  Simon closed his eyes for a moment. He’d almost rather wrestle down Wyatt for the chemical restraint than confront Patrick over Justine. Now he’d have to do both.

  Frank and Kris stayed on past their shift to assist in dealing with Wyatt, Rachel authorizing overtime pay for them. Neither complained about this emergency assignment but Brenda was openly delighted to be excused from it.

  Getting ahold of Wyatt in the close quarters of the seclusion room wasn’t easy but Frank and Simon were able to seize his elbows without being hit. The two burly men used their combined weight to push Wyatt to the floor, face down.

  The patient shouted and squirmed but Kris and one of the regular evening shift counselors quickly grabbed onto his ankles and immobilized his knees from behind with their forearms. It was enough for Gloria to feel confident about moving in with the needle. She pulled down Wyatt’s pants, which had been a loose fit across his hips anyway, and found a fleshy area to make the injection.

  Wyatt howled, perhaps less in pain than in protest. Gloria hurried back out of the seclusion room while the counselors released Wyatt’s limbs one at a time.

  But Wyatt did not lash out and attack them. Rather, he continued to lie on the pad as though conceding defeat. The counselors left quickly all the same. Simon was the last one out; he pulled the door shut behind him and locked it.

  “Let’s give that injection some time to work, then run Wyatt upstairs,” Rachel said, addressing the semi-circle of staff outside the seclusion room.

  “Need us to stick around?” Frank asked.

  “I think we’ll be fine,” Rachel replied. “We’ll have some help from the locked ward counselors when it’s time. I appreciate you and Kris staying to help out but you’re free to go.”

  Kris smiled, nodded, and went back to the staff office to collect her pocketbook. Frank headed right for the main door. Then Rachel asked Simon to meet with her and Gloria in Dr. Kearney’s office. Simon almost sighed out loud.

  What the fuck was a towel doing in the sink?

  Justine glared down at it, soaked and coiled like a snake. She didn’t even want to touch it although there was probably nothing but water to be wrung out of the thing. Justine turned and looked at her roommate, who was lying face down on the bed.

  She felt an urge to throw the towel right onto the back of Cindy’s head. It would be a wonderful sight, wouldn’t it? Water droplets would fan out in an arc, splatter all over the pillow and sheets. That fat slob would gasp, sputter, and mumble something stupid. Something like “whuh?” But it would really be doing her a favor, wouldn’t it? Couldn’t that black, stringy, greasy hair use some nice, clean water on it?

  But no, Justine wouldn’t do that. No need to give Adams any excuse to delay discharging her again. Time to be reasonable.

  “Hey!” Justine said, her voice more shrill than it should have been. “What’s with the towel, Cindy?”

  “Huh?” Cindy replied, turning her face halfway up from the pillow.

  “This God damned towel,” Justine yelled, feeling her anger burning in reaction to Cindy’s stupidity.

  She actually reached into the sink and pulled the towel up, holding it at arm’s length as it dripped over the drain.

  “Look at this! Remember it?”

  “Leave me alone,” Cindy said, pushing her face back into the pillow.

  “What were you trying to do, clog the drain and flood us out?”

  Justine dropped the towel back into the sink. The sopping-wet cloth splashed up a bit of water onto Justine’s blue jeans.

  “God damn it!” Justine yelped. “You worthless cow!”

  Cindy pulled the sheet up over her head.

  “You ugly, stupid piece of shit,” Justine said, her voice hissing but soft in case a staff member walked past their door. “Why don’t you just do yourself in? You’re going to hell anyway, right? That’s what your parents say, right? Why not just get it over with and do the world a favor? You think my boyfriend wants you? He doesn’t! Nobody wants you, bitch! Nobody would even pay to do it with you! You couldn’t pay anyone enough to do it with you! You’re that disgusting, so why bother? Why bother with anything? You listening, stupid? Huh? Are you listening to me?”

  It was afternoon but Anthony didn’t know what time it was. Supper would be up in an hour or so, he reckoned. His restriction period would be over by then. Anthony wondered if Frank would say goodbye to him before leaving for the day. Perhaps not. Perhaps that would be a violation of the terms for his restriction.

  A gross injustice.r />
  Numbly, Anthony reached down to touch his right leg where the catheter’s reservoir was strapped under his pant leg. He felt the bulge; it was far from full, thank goodness. Anthony put his wrists on his knees and let his hands dangle. Lowering his head slightly, he stared at the black floor.

  Anthony heard a politely soft knock on his door. He like that. Not everyone was so considerate.

  “Come in.”

  It was Simon who opened the door. The lenses in Simon’s glasses reflected the sunshine coming in the window behind Anthony.

  “Hello, Simon. How are you?”

  “Fine, thanks,” the counselor replied with a smile. “I understand you’ve had a bit of a frustrating afternoon.”

  “Ha-ha!” Anthony laughed, tilting back his head. “Yes! A very frustrating afternoon.”

  He liked Simon’s sense of humor, the relaxed understatement in his voice. That, and the way Simon always addressed him as Anthony. Simon had only needed to be corrected once. Some of the other staff still called him “Tony” when they ought to have known better. “Tony” was a child’s name; Anthony was twenty-three.

  “Well,” Simon proceeded, his smile persistent, “let’s see if you can have a better evening.”

  “Is Frank still here?”

  “No,” Simon responded, leaning against the door frame, “but he gave me the rundown on your day… in some detail.”

  Anthony, already studying the counselor’s boyish face intently, noticed what appeared to be a slight arching in those eyebrows. “In some detail”! Frank had so many rules, so much advice. It had been Frank who’d sent Anthony back to his room, unjustly. Maybe that subtle reaction in Simon’s face meant that he really understood, that he was a potential ally.

  “It was the TV,” Anthony reported forthrightly. “It was wrong for us to be watching garbage like that. Even Frank said so.”

  “Did he?” Simon reacted with a slight frown.

  “Yes. I wanted to watch something more uplifting. It would have been better for everyone.”

  “Be that as it may, they voted you down. Majority rules.”

  “But what happens to the minority?”

  Simon broke into a grin.

  “You ask profound questions, Mr. Gingarella!”

  “It’s important, Simon.”

  “Of course it is and I wasn’t being sarcastic. I’ve been on the short end of a vote myself, now and then. But you have to accept the will of the people and get over it. What you don’t do is make a scene in the day room.”

  “I was defending my rights.”

  “Choose your battles wisely, Anthony.”