Conditional Voluntary

by Geoffrey A. Feller

The bed was stripped of its sheets and Justine was placed on the vinyl-coated mattress. Held down on her back, she swore and continued to struggle as Kris joined Rachel in tying the brown leather straps to the metal bed frame. Simon held Justine’s legs down, grasping her ankles and leaning over to put the bulk of his weight on them. Despite her adrenalin, she couldn’t kick herself loose from that much pressure.

  Justine’s wrists and ankles were pulled into the soft leather cuffs. Each person performing that task had to fasten the cuffs to their tightest notches, Justine’s bones being so slender.

  “This isn’t even my bed!” Justine shouted. “You fucking assholes! I’ll sue you all!”

  “Go for it,” Kris sneered.

  Rachel caught Kris’s eye, gave the counselor a hard stare and shook her head. Kris sighed but otherwise kept quiet.

  “Who wants the first watch?” Rachel asked.

  “I… I think I should go dismiss the ward assembly,” Simon replied, his way of saying “not me”.

  “I’ll take it from here,” Frank volunteered.

  Simon gratefully went to the smoking room to find Frank a chair. As with seclusion room incarcerations, state law mandated that any patient in restraint straps be under constant staff observation.

  Frank settled into the seat and serenely ignored Justine’s outraged cries. One of the nurses would be bringing him a clipboard with the form he’d have to sign and initial as proof that he’d been watching over her.

  I wonder how many of those things I’ve filled out? Frank wondered with his eyes closed. Hundreds since ’75? Most of them never knew we were doing them a favor. What does it feel like to lose control that way? Spinning off like that, identity disintegrating… Nothing but fear and anger left. They lash out, scream at people, break things. Once in a while, you get one who thanks you. One who understands that restraints helped to bring them back under control. A physical imposition of re-integration, that’s what it really is. A patient isn’t literally falling apart but a sort of objective intervention really helps. Looks brutal sometimes, especially these leather straps. But it would only be brutality if there was no need to hold the consciousness together, if it was used as punishment alone. Sure, it’s done against the patient’s will, at least against the expressed will of the patient, against what seems to be their conscious opinion.

  Then again…

  Frank smiled.

  He was remembering one particular young patient who’d been on the ward two years earlier. She had actually enjoyed being put into restraints and sometime went out of her way to receive that kind of attention. Like Justine here, that one had been diagnosed with borderline personality disorder, which spelled manipulative. Such patients were often despised by the staff, although Frank knew better than to single out a particular diagnosis for contempt. But he didn’t suppose that Justine was like her predecessor. Maybe Miss Edwards needed bondage and discipline in a manner of speaking but she wasn’t asking for it, of course. Not like that other girl had. Oh, well. Whatever does it for you.

  Rachel tended the scratches on Patrick’s face herself, dabbing the red streaks with a cotton ball dipped in disinfectant. He was sitting in the chair otherwise used for taking vital signs. Patrick winced at her touch but was grateful for the care.

  “We’ll be shipping her upstairs as soon as possible,” Rachel was saying.

  “Good,” Patrick replied bitterly.

  “The house doctor is on his way to examine Justine. We’ll have him look you over while he’s up here.”

  “That… isn’t necessary.”

  “It’s a regulation and it won’t hurt.”

  “Not like the way this hurt?”

  “No.”

  “Are you done?”

  “Yes.”

  “You can tell the doctor I’ll be in my room.”

  A few minutes later, Simon caught up with the head nurse in the staff office. She was busily preparing to implement the transfer order Dr. Adams had approved as a telephone order. Justine had already been sedated with an intramuscular injection of Thorazine and had lapsed into a fitful sleep.

  “How’s Patrick doing?” Simon asked, walking up to the table.

  Rachel looked up from a three-ring binder and tried not to smile. She was amused and almost charmed by Simon’s concern for “his” patient. Something to be encouraged, the head nurse thought, not laughed at. There ought to be more caring hearts in this business, after all.

  “He’s angry,” Rachel said. “And hurt, too, I expect.”

  Simon nodded.

  “I wonder if I should look in on him. Think he’d mind?”

  “I don’t know,” Rachel said. “You could try. Patrick might tell you he wants to be left alone.”

  “I guess,” Simon murmured, peering over at the calendar. “You didn’t tell him about his discharge date, did you?”

  “No.”

  “I wonder if anyone would mind if I broke the news to him,” Simon asked, trying not to sound too eager. “He could use some good news right now.”

  “Better ask Gloria,” Rachel replied, nodding past him.

  He turned around and saw the team leader entering the office. From her smile, it was clear that she had heard his indirect request.

  “You know Dr. Kearney usually likes to handle that part,” she said.

  Simon nodded.

  “And he might still change his mind at team meeting today,” Gloria added.

  “I guess so.”

  “So when you tell Patrick, make sure it’s clear to him that the date isn’t carved in stone, okay?”

  Patrick was happy that Peter wasn’t in their room. If his self-pitying, obnoxious roommate walked in, Patrick decided he’d tell him to get lost.

  No more Mr. Nice Guy, he thought as he sat there on his mattress.

  Then Patrick heard a knock on the door. It couldn’t be Peter knocking first, could it?

  “What?” Patrick asked sourly, raising his voice.

  “It’s Simon. May I come in?”

  “Okay,” Patrick said unenthusiastically, realizing there would be more Mr. Nice Guy after all.

  “How are you doing?” Simon asked as he walked into the room.

  “How do you think I’m doing?” Patrick answered with a scowl.

  “That’s enough of an answer,” Simon acknowledged, shutting the door.

  “Good.”

  Patrick smirked at the counselor’s awkward demeanor.

  “You know what I thought about you the first time I ever saw you?”

  “What’s that?”

  “I thought you were probably some kind of enforcer. A tough guy they’d sent in to intimidate me.”

  “Is that so?” Simon responded, seemingly confused over the point Patrick was trying to make.

  “Yeah, that’s so. What’s so funny about that now is what a wimp you’ve turned out to be.”

  Simon smiled sadly and leaned on the chest of drawers.

  “What makes you say that?”

  “Sorry. It’s my bad mood. I guess I’m not supposed to talk about you, anyway.”

  Simon shrugged as Patrick clasped his hands together.

  “So,” the patient said, “now you’ve come in here to say ‘I told you so’?”

  “No, I wouldn’t ever do that.”

  “Thanks.”

  “We’re going to move Justine upstairs.”

  “So I heard. Guess that’s one way to keep us apart.”

  Patrick didn’t mean it but he couldn’t resist making an angry, bitter joke about what he’d been through with that girl.

  “Well,” Simon said, “here’s something you haven’t been told yet. Dr. Kearney’s scheduled you for discharge this Friday.”

  Patrick blinked and gaped.

  “Y-you wouldn’t bullshit me, would you?”

  “No way,” Simon assured him. “Sorry this happened first.”

  “I’m not.”

 
“You’re not?”

  “If Justine had to attack me, I’m glad it didn’t happen in my apartment.”

  “Your apartment?”

  “Sure. Now that I’m leaving and Justine’s out of here, too, I guess I can make my confession.”

  “Confession?”

  “Yeah,” Patrick said, looking up at the ceiling. “You see, Justine and I, we had this plan to get together on the outside. Once either of us got discharged, or maybe after both of us did, I don’t even remember exactly. Anyway, we were going to do it in my bed. I’m saying we were really going to do it!”

  “Okay.”

  Patrick looked at Simon, surprised by the calm reaction.

  “We were going to fuck!”

  “So what? That wouldn’t have been any of my business by then.”

  “But don’t you disapprove?”

  “Why should you care if I approve or not?” Simon asked, standing up straight. “Obviously, I didn’t think she was any good for you but I wouldn’t have lost any sleep over it, either. That’s even assuming there was any way I could’ve found out what you two had been up to.”

  “I… I thought you’d get mad when you heard me say it.”

  “I’m not getting mad over something that didn’t happen,” Simon told him blandly. “Especially not over something that wasn’t likely to ever happen in the first place.”

  Patrick felt as if he’d been struck again. I lighter slap, perhaps, but about as sharp as Justine’s nails in a figurative sense.

  “Wh-what do you mean?”

  “Something tells me that Justine wasn’t going to have anything to do with you outside the hospital.”

  “C’mon…”

  “I think she really liked you at first. But it wasn’t the kind of thing you could’ve keep going outside of this place.”

  “Is… is that why you tried to warn me? Tried to keep us apart?”

  Simon looked at the floor.

  “Not exactly,” he muttered. “Well, hey, I’m not supposed to be telling you as much as I already have.”

  “So what?” Patrick said anxiously. “I’ll be gone at the end of the week, anyway.”

  “Probably. I should’ve mentioned the date isn’t absolutely certain.”

  “Hell, I know that. I… I guess what I’m trying to tell you is that I really appreciate you talking straight to me. Really, it means a lot. Especially now.”

  Simon waited for more than half a minute before responding. Patrick supposed that he’d embarrassed the counselor but still didn’t regret having spoken his true feelings. If only Simon would reciprocate just a little more.

  “When you leave here, I hope you never come back.”

  “Me, too.”

  “And not just because I’m being more candid than usual,” Simon elaborated. “A lot of the patients in here at any given time are faces that I’ve seen before, some of them I’ve seen several times. I read their medical histories and see that they’ve been in a lot of places, lots of times. We call them revolving-door admissions.”

  Patrick felt cold. He was barely able to maintain eye contact with Simon.

  “Could that happen to me?”

  “Best thing you can do is cooperate with your outpatient therapy and keep taking your medication. The way that stuff works is, you don’t stop taking it because you feel okay. You keep taking it so you can still feel okay.”

  “Dr. Kearney already told me that.”

  “Well, it’s true.”

  “It sounds kind of like you’re saying all this to scare me into good… into proper behavior. Like that time you scared me into signing the voluntary form.”

  “Just scaring you with the truth, that’s all.”

  “And… and Justine told me not to listen to the staff, to listen to her instead. She said she knew what was going on.”

  “If she really did know what was going on, she wouldn’t…”

  Simon let his voice trail off, refraining from finishing his comment.

  Patrick didn’t bother to push Simon on that. After all, it was clear what he’d meant, anyway. Too bad they couldn’t really be friends. They couldn’t be, right?

  “You… you didn’t really think I’d cooperate when you told me not to fool around with Justine, right?”

  “Okay, listen. This is the last time I’ll say more than I’m supposed to but, yes, I knew that damn well enough. It had more to with making sure you understood that we knew – the staff knew – what was going on between you and Justine. If I say anything more, it’ll start sounding like ‘I told you so’ and I already promised not to do that to you.”

  “Well, uh, I guess that was my own mistake to make.”

  “That’s right. Kind of a normal problem, wasn’t it?”

  Patrick blinked slowly and started to grin. So Simon really understood. It was all right. Patrick felt like he was emerging from a tunnel that had seemed like a terrifying reality when it hadn’t been real, after all. Instead, it was…

  “A tunnel of paranoia,” Patrick muttered out loud.

  “Sounds like an unpleasant ride,” Simon remarked after a moment, a tentative smile on his lips.

  Patrick wished he could have blamed it all on his mother. Not that she actually deserved the blame. Maybe excuse would be a better way to put it. Had she died before Patrick reached puberty, say, then his lack of sexual experience, let alone sexual satisfaction, could be attributed to some Freudian disruption of his maternal connection. Wasn’t that supposed to be the basis for all his future relationships with women?

  But Patrick had loved his mother, even though he felt inadequate as a son. Scott had been the successful one. Patrick had been the child who had needed more attention and support. And he had always received it, resenting the need for it all along.

  It was a good thing that she hadn’t lived to see him descend to this state, staring out the window of a psychiatric ward at the twilight shadows on the quiet street beyond.

  I wouldn’t mind if my father found out, Patrick decided. Look what you did to me!

  However, Patrick wasn’t in a blaming mood the following morning. He had another session with Dr. Kearney right after ward assembly. Patrick didn’t bring up the subject of his parents; he had in fact never initiated a discussion of grief or abandonment. When his psychiatrist had done so, Patrick had insisted that his acceptance of orphanhood was complete. Dr. Kearney had refrained from badgering him and otherwise said nothing to indicate disbelief.

  “What do you want most to have happen to you after you leave here?” Dr. Kearney asked several minutes into the session.

  “Find a girlfriend,” Patrick replied without hesitation. “I mean a real one.”

  The doctor nodded his head slowly and folded his hands over the open chart in his lap.

  “I don’t really blame Justine,” Patrick added quickly. “Not anymore. I want to live a normal life. Normal life, normal girlfriend.”

  “I see.”

  “You think my… my illness is under control, enough to let that happen?”

  “Based on what you’ve told me, I’d have to say it’s a reasonable possibility. You used to include women among your enemies as part of your paranoia. With that paranoid ideation now in remission, you have the opportunity to make what you call normal relationships of many varieties.”

  Many varieties? Patrick echoed mentally behind a frown. I only care about one variety!

  “Are you trying to say I shouldn’t get my hopes up about finding a girlfriend?”

  “I’m saying you shouldn’t push yourself too hard looking for that kind of relationship. I wouldn’t want you to feel frustrated when things don’t happen as fast as you might like.”

  Patrick grunted.

  “You have to rebuild your relationship to the world as a whole first,” Dr. Kearney continued. “Or perhaps build it for the first time as an adult. What I’m referring to is the very definition of what it mean
s to be well-adjusted. Do you understand?”

  “I guess I do.”

  “Good,” Dr. Kearney smiled.

  “So, do I still get to go home on Friday?”

  “Yes.”

  “Would it be all right if I get a pass today… for this evening? I’d like to go to my place, make a few arrangements ahead of time.”

  “Of course, Patrick,” Dr. Kearney replied, picking up his pen. “I’ll write the order for a pass right now.”

  “Thank you,” Patrick said softly, trying to conceal his nervous enthusiasm, based on something more than mere gratitude.