There is nothing like being on a locked ward to shed light on just how many hours there are in a day. On the outside there are distractions, and things to do.Life carries us along at a somewhat brisk clip. We go from one appointment to another, with driving or walking in between. If seated, or still for more than a moment the smart phone is in use. Every waking moment is consumed by some activity. Now think for a moment if suddenly you found yourself without the iphone, no appointments to go to, no groceries to buy, and no emails to return. Then couple that with a locked door barring you from going anywhere. The result is boredom. I don’t mean your run of the mill, average boredom. I mean the mind numbing, shrivel your brain type lack of stimulus. In this world there are bland walls, and staff watching you grapple with this boredom. The watching takes as much getting used to as the boredom. As humans we are pretty well programmed biologically to notice when someone has their eyes on us. Not to sound paranoid, but think about it. We are prey animals, of course we have this ability. To be inside, is all about the scrutiny. Staff actually have a chart which allows them to track and note where you are and what you are doing every 5, 10, 15 or 30 minutes, depending on your status. This is often referred to as “checks”. If you are in your room there will be a knock on the door and someone will stick their head in. They must lay eyes on you. Yep, more looking and watching. It is like being in a fish bowl. The first hospitalization is the worst. The reality of this scrutiny sets in, and it is very uncomfortable. Especially if you are a private person. After a few times at this dance, it doesn’t even register.
So, how do the hospitals attempt to ease the boredom?. Most of them structure the day with various groups, lunch and outside time (if you have privileges). This helps at least break the day up into blocks of time. It makes it more manageable. One of the common groups it “current events”. Since we are a bunch of psych patients in a locked ward, it is easy to lose touch with the outside world. The better units have TV, and provide newspapers to keep us grounded and in touch with the outside. This current events group tries to help even the most compromised patients discuss what’s going on.
During one particular hospitalization, I was amongst a group of about 18 residents. Many were very high functioning, but others were in the grip of psychotic episodes (loss of touch with reality). These patients barely functioned. Despite this the staff made sure they were rounded up and ushered into the group. On this bright afternoon they were talking about Wal-Mart attempting to get the town to move a road so they could build one of their Super Centers. I guess there was quite an argument going on from the citizens of this town. A couple people in the room voiced their opinion, but mainly it was quiet but for the staffer doing the talking from the front of the room. As a lull bloomed in the midst of the group, a fairly scruffy very obviously psychotic patient got to his feet. He was about 50, unshaven and dressed in a robe and hospital gown. Took him a moment, but he got himself upright. This in and of itself was remarkable, since he normally was seated staring off into space muttering to himself. The room grew perfectly quiet. Every eye in the there was on him. I watched as he steeled himself to say something. He rose up and grew tall. I wasn’t sure if I should inch toward the exit. Not sure if the next moment he would act out in some way. I was absolutely riveted. “MOSES” he bellowed. Oh dear I thought, religious delusions. Nothing new or exciting in the world of schizophrenia. My heart went out to him in that moment. The staffer at the front of the room promptly shooshed him. She told him very pointedly this was “C-U-R-R-E-N-T E-V-E-N-T-S”, carefully sounding out each syllable like he was a toddler. It was so very sad to watch. Again he yelled, MOSES, for all he was worth. The room got noisy with all the patients speaking amongst themselves. The staffer running the meeting knew she was perilously close to losing all control of the room. Another mental health worker came and stood next to the man as he continued to eye the room, but did not yell again. They slowly ushered him out. He shuffled in his slippers. The all too familiar shuffle of someone tanked on antipsychotics. He probably had been medicated for years, and his body had finally just given in. As he went by me, head bowed and muttering, I heard him say Robert.
It clicked in my brain. He wasn’t a psychotic fella ranting, in that moment he was very lucidly adding to the discourse of the group. Robert Moses, was the man behind almost all the roads and highways here in the tri-state area. He was the mastermind that decided how the city and its suburbs would connect. This patient was right on point when he said, Moses. For all I knew Robert Moses had designed the road we were talking about in that Current Events group.
My mind skittered back over all the times I had dismissed what someone had said. Someone I judged as very ill, and believe me once you have been in, it is something you learn to do. I try to do it within the first hour or so of stepping foot on a unit. For me it is a matter of safety. I have seen psychotic patients lose their shit, and I don’t want to be anywhere near them when it happens. I know that sounds harsh. It makes me sad. But you have to consider for a second, that when someone has lost that tether that keeps them in the here and now, they become unpredictable. Not that we all can’t be. Any psych patient can lose it. If you have been reading this blog, you know I have lost it. That is probably why I do such a careful inventory of the patients when I arrive. See my next entry for the second half of this post.