From Modesty to Staff…

Rambling disjointed post, but at least I’m back writing something…

I tend to run a lot of errands on my way home from the gym. My partner came along today. She looked at me, still clad in running tights and a pullover and asked me if I wanted to stay in the car. I thought it was pretty amusing. I laughed, “do you realize I have been naked, had people watch me piss, shit, puke, you name it and it has happened, never mind marching in the Pride parade in NYC topless. Gym tights don’t faze me in the least. I could give two shits what anyone thinks. Really”

She wasn’t quite sure to make of that. I guess until you have lived thru that it just doesn’t make sense, or might just sound odd. But it is true. Once you have been stripped of your privacy so completely everything else seems to matter so little. Nudity, modesty all of it. A body is just a body. We all have one. Food shopping in running tights just doesn’t bother me. Though most people do stare. You’d think they had never seen a human in gym gear.
Guess I was pretty content to be complete naked as a kid, or so my parents tell me. That I got from my dad. He was well-known for wandering around the property minus his clothes. My poor aunt (mom’s sister) used to hide in the kitchen until she had figured out whether he was undressed or not. He would prune the rose bushes, weed, go for a swim. It was all just fine with him. The property was very secluded and private, though he probably would have done it anyhow. My mother loves to tell the story of him sitting naked on a chaise lounge in the tropics, naked except for his aviator glasses which he had place on his crotch. Quite a few stares I’m sure. I guess I got some of my c’est la vie from him. Though it still was hard to stand naked in front of a stranger the first time. After that it gets easier. Most good staff learn to look without “looking”. You don’t feel their eyes track over you, as you would if a stranger on the street did it. It is hard to explain. Sure I wish I never had to learn that. I would far prefer to have never had to have someone watch me 24/7. But at the end of the day, I am still here. That means it worked and was necessary. That doesn’t make it easier to think about. Doesn’t negate that stripping bare of the soul. It will never go away. During the various hospital stays I always see that dazed and confused look of a person when they begin their voyage into that world. It is like nothing else, nothing prepares a person for that. Whether it is the click of the door locking behind you that first time, or the sudden endless scrutiny. Maybe it is the rules, or the staff. It is so strange and foreign. There is nothing out there in your life that can prepare you (short of prison). So the look is distinct. I joked with one of the staff they need a greeter, like at Walmart, just to make the process a little less startling. Joking aside, I’m not sure there is any way to make the transition easier. Especially if you’re pissed off and angry. It is easy to see the staff and the hospital as an enemy. Fight them tooth and nail to get away, but there is no away. The door is locked. That look I see if the same as a cornered animal. Scary to see in some. There was a big fella in this past visit. He was mad, that is putting it mildly. But he was disconnected and unteathered. I always note who is around me on a unit. That includes staff. I know where they all are in relationship to me, at all times, unless I am in my room. Even then you can sometimes keep tabs by listening. I usually give them all my own assessment. I rank them each by how they might be a threat. I usually put ineffective staff in that mix too, since they are not of any use if the shit hits the fan. I will keep tabs on things as they change shift by shift, or if someone is really risky moment by moment. It can change really fast. This big guy fit squarely in the risk category. Not because he was mean, or evil. It was because he was so angry and big. In all my years it’s the big guys that tend to worry me. But I have also seen some big ladies give the staff a run. Early on in my treatment I watched a fellow patient return from pass amped on some drug. She was already a handful. Add the high and it was a disaster waiting to happen. The more time you spend in hospitals the more you learn to value good staff. There are plenty that just take up space and clock out. Many that are right in the middle, learning the road and putting in the time. If they stay over time they may become really good, but with crap pay on the bottom end and even worse hours they often don’t stay. In the mix are the committed professionals. They are good at their job. They are reading the milieu all the time and can diffuse a situation long before it gets going. They are the ones that can keep a unit safe and quiet, even with some unsettled patients. They are pretty amazing to watch. That evening on the unit when the patient came back high as a kite we all were a little worried. It was the type of situation that could quickly come apart and get someone hurt, either one of us or a staff person. It happened, by some grace of god one of the seasoned staff was manning the fort. From unit door to nurse’s station was probably just shy of 60′. The patient was raving and carrying on. The more steps she took down that hall the more we all backed up. This was someone we knew, and had lived with for a while. We had not seen this. I had seen her demolish her knuckles beating on a screen, and I knew what she could do. So there we were backing farther in to the unit as she hauled ass down that hall. The unit was pretty light in staff that night, this was back in the days of high patient to staff ratios (long since gone due to bad things happening both to staff and patients). There was no point of any of us trying to reason with her, no she was well beyond reasoning. But she wanted nothing to do with the rest of us, she had her rage directed at the shift nurse. Unfortunately, or fortunately depending on how you look at it the nurse was at the back of the nurses station getting meds together. You can see into the nurse’s station, since they have to watch us. We stood there frozen realizing she had this nurse cornered. I honestly thought she was going to kill her. There she stood in the doorway waving her arms and hurling curse words at the nurse. Rather than back up, which I think anyone in their right mind would do, this nurse walked forward. We all started calculating the likelihood of whether this nurse could get to the buzzer before this patient beat the crap out of her. Even if she made it, would she be able to hold off this woman while staff from other units responded. It’s a big rambling old hospital. Quite the run from one end to the other. I stood with the rest of these people I knew so well. There was nothing we could do. Most that stood with me had endured such severe trauma they were all reacting to the triggering situation before us. I have to say it was without a doubt one of the scariest things I have ever seen. The patient was took a step into the nurse’s station. One of the first rules you learn, don’t ever set foot in the nurse’s station- for any reason. So much for rules, she was two steps in. Towering over the nurse. Forget it, this nurse was going to be pummeled.But we were selling this nurse short, she was good. This wasn’t her first parade. Slowly but surely she started talking to the raving woman who wanted to kill her. Not in a confrontational manner, but not in a submissive manner either. She knew the history, and had spent months with this patient. She used her brain, and found a way to buy some time. Her hand pressed that buzzer and we all held our breath. We figured that would put this patient clear over the edge. But they remained eyes locked on one another, the nurse never stopping her attempt to settle this patient. It was under a minute before the response staff came in. It wasn’t the most attractive submission I have ever seen, and she was a big lady, but they corralled her and medicated her. The shrieks eventually subsided after she was strapped down. The rest of us shaking from the adrenaline and the fear. In that moment I learned a lot about just how important it is to know who is on shift and what they can do.
This past hospitalization, I sensed the situation long before it started. I kept my space and distance from the big guy. The argument started in a pretty benign manner with the patient and his father. I already had him in the threat category, so any shift in his behavior set all the alarm bells ringing. Unfortunately I was in my room with this patient and his father directly outside my closed door. I started calculating the odds of him coming this direction as opposed to down the hall. I figured it was pretty low odds and so stayed still and listened. The unit chief walked thru that door opposite my room. That distracted the patient. His fury no longer directed at this small framed father. It was now aimed at the equally small psychiatrist. But there was a blessing that night. One of the staff was about as good as they get. He, basically single-handedly, dropped a 200+ lb guy on the floor with his hand pinned behind him. It was another situation where I truly grasped just how important they are. It can go either way. Luckily in the years I have only seen a few go bad. The people who spend their days making sure we are safe, most of the time without any thanks, they are the unsung heroes of this system. The ones that pull the long shifts weekend after weekend. Often times being berated and yelled at by patients that can’t yet see their value. I always make a point of thanking them, and of treating them like the valuable people they are. There was a time when I was just as pissed and nasty that I too took aim at these individuals. But I have learned a lot. When I do get angry I make sure I apologize. It is beyond me how they stomach the day in and day out. The burn out must be unfathomable. This post is for all those people working hard, especially the nurses, techs and mental health workers. The ones that don’t leave at the end of the day, or have the weekends off. Amazingly enough there are people still working at that hospital that I knew from my very first visit in 95. Truly remarkable…

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