Every part of this story is true, except for patients’ names and the name of my friend. I left Mark’s name real, because he doesn’t deserve anonymity.
Adam kept to himself. He always chose an empty table for meals, and during activity hours, he sat in chairs that were farthest from everyone else. If someone approached his table or his corner and asked to sit down, he would nod vigorously but shrink imperceptibly, scrunching up his body so that he was smaller without actually moving away from the new person.
Sometimes, Adam would smile. His smile split his face in two. His eyes would crinkle up and laugh lines would appear. He would laugh – a loud, boisterous, infectious laugh. And as long as we all kept a safe bodily distance from him, we could join in his laughter and joy and he would look at us – just for a moment, making eye contact before his eyes darted away again.
During downtime, when no meals or activities were scheduled, I stayed in my room and read. My friend Margaret had brought me a five-book series she had been trying to convince me to read for a while. I had been too depressed to read anything for months, but here – in the quiet peace of the psych ward, when I had no worries because I could do nothing except eat, sleep, and be taken care of – I was making my way through all five books. I didn’t want to stay in the psych ward longer than I had to, but I set myself a goal: I would finish all five books before I was discharged.
Adam spent downtime pacing the halls. Head down, arms tight and straight at his sides, he marched quickly toward the door that led off the ward, made a quick about-face, and marched quickly to the other end of the floor. As he marched, he muttered to himself, and I heard him as he passed my open door:
“Stupid, stupid,” he would say. “It wasn’t supposed to be like this. This isn’t how it was supposed to be. Stupid, stupid.”
On my second day in the psych ward, it was weighing day. Aides took our vitals every morning when they woke us to give us our medication. But once a week, we all had to report to the nurse’s room where we would be weighed in addition to getting our vitals taken.
It was a jarring experience. I was one of the first to leave breakfast, and I stopped at the nurse’s room on the way back to my room.
Mark was inside, talking on the phone as he set up the equipment. I waited a moment, but his conversation didn’t seem to be ending. I knocked on the door.
“Sit down on the chair out there,” Mark said to me, and then back into the phone, angrily: “I don’t know what you want from me.”
I sat down in the chair and tried to remain calm. Mark was having an argument with someone on the phone, and I felt my anxiety rising. See, the world sucks. See, I was right. See, I don’t want to join a world like this. See, even in the psych ward when I’m supposed to be completely safe, things are horrible.
No, I told myself. Breathe. It’s okay. He’ll be done soon, and then he’ll be calm and quiet like all the others. And then I can go back to pretending I’m safe.
This was my first encounter with Mark. But it didn’t take me long to discover that Mark was not calm and quiet like all the other nurses and aides on the psych floor.
He didn’t finish his conversation. Phone still tucked between his ear and his shoulder, Mark came out of the room to start taking my vitals. He held out the blood pressure cuff and I stuck out my arm, as he said, loudly and vehemently, into the phone, “What do you want? I got you gifts, you don’t like them, what am I supposed to do?”
He wrapped the cuff around my arm and pumped. How can he be concentrating on my numbers while he’s arguing with his girlfriend? I thought. But I couldn’t let myself think about this. So I focused on a spot on the blank wall opposite me, and waited for this to be over.
He pulled off the cuff and held out a thermometer to me. I didn’t see it immediately, because I was still focusing on that spot on the blank wall opposite me. “Open your mouth,” he said, and I turned to look at him and opened my mouth.
“No, not you,” he said into the phone. “You, you need to stop worrying about her. Nothing is happening. She’s the mother of my baby, you want me to stop going over there?”
Almost over, I told myself, and blocked out his voice.
When I was done, I escaped to my room. I could still hear him because my room was close to the nurse’s room, and my door couldn’t close. My roommate was on a 24-hour watch, so the door stayed open while an aide sat outside the door, and of course I couldn’t put on headphones because no one on the psych ward was allowed to have headphones.
I read my book and tried not to pay attention to Mark’s voice.
Then I heard another voice. Louder, more strident, a voice I recognized from breakfast. Blanche, a warm and friendly fellow patient, had stopped by the aide sitting outside my room.
“Should he be on the phone while he’s doing his job?” she asked the aide. The aide shrugged. “No,” she said, with a lift of her eyebrows and a shake of her head. “He shouldn’t. He really shouldn’t.”
“Well,” Blanche said, “is anyone going to tell him to hang up?”
The aide shifted uncomfortably. “When the nurse gets here…”
Blanche wasn’t satisfied with that. She marched over to the nurse’s station. I had abandoned my book by now and was listening attentively from my perch on the bed, filled with a sense of purpose and pride in my fellow patient for standing up for the rest of us.
She demanded that Mark be told to get off the phone, and after some grumbling on his part, he did hang up and finished the rest of the vitals-session in silence.
It was my last day in the psych ward. I was being released later that day. A bit more paperwork, and then I just had to wait for Margaret to come pick me up and take me home.
I was woken up to get my medication, I showered and got dressed, and I sat on my bed. I was almost finished with the books, and I wanted to reach my goal of finishing the whole series before I left the psych ward.
Outside my door, I heard two aides talking. One of them was assigned to my roommate, a woman who lay in bed and stared at the ceiling all day, often muttering things in a language I thought I could recognize as Hungarian but wasn’t sure. The other was Mark, assigned to a boy in the next room who was a suicide risk and needed constant supervision.
Mark was pontificating about another patient, in a room across the hall.
“Tell her she can’t go to breakfast unless she takes a shower,” he said loudly. “No one wants to sit next to a smelly, dirty person.”
I was shocked. This is coming from an aide on the psych ward? Even with all I’d witnessed from Mark over the last week, this was shocking. Does he not realize that telling a depressed person who doesn’t have the energy to shower that no one will want to sit next to them is almost murder? Does he not realize how harmful that is? He works on a psych ward, for crying out loud! How can a psych aide talk like that?
You’re leaving soon, I told myself. Just keep your head down, and you’ll be out soon. But then I changed my self-talk. You’re leaving soon, I told myself. The papers are already signed. You have the power to speak up now, because even if you lose yourself and start yelling or crying, they can’t extend your stay without a hassle.
So I got up and walked over to the door, where now Mark and the other aide sat chatting.
“Hi,” I said. “I just want to say something. I heard a few moments ago how you suggested that the other patient not be allowed to go to meals in the dining room unless she showers. I don’t know what that patient’s exact case is, but having struggled with depression myself, I can say this – taking a shower and going to a social space each takes a whole different set of energy. And I know you all want to get us up and going as much as possible. So if she musters up the energy to go to meals in the dining room but can’t shower, giving her an all-or-nothing ultimatum can actually set her back quite a bit. And to be told that she’s smelly and dirty – that can emotionally kill someone who’s already depressed.”
While I spoke, Mark looked at me with a slight smirk on his face. I don’t know what I expected to happen. I certainly didn’t expect to change his mind. But I also didn’t expect what happened next.
“You’re here to get better,” Mark said. “So go back to your room and get better.”
The air was punched out of me. The other aide, whom I had chatted with frequently over the past week, shifted in her seat.
“Yes, I’m here to get better,” I said. “We all are. I’m just suggesting that your approach, unless it’s been mandated by a doctor, is not going to help us do that.”
“You think we don’t get training?” he demanded. “You think you’re a doctor now? You think you know better than me?”
“I am sure you get training,” I said, keeping my tone even and calm. “And I know I’m not a doctor. I don’t want to argue this, I just wanted to say that.”
“So you think you can come out here and say what you want, and I’m not allowed to say what I want?”
By now, I was utterly shocked. But I maintained control by hanging onto the knowledge that Mark was an incompetent and arrogant idiot.
I tried to answer, but he cut me off, yelling and shouting. Every time I tried to make a point, he cut me off. I could feel my sense of powerlessness, of being silenced, rising, and I knew I had to stop this.
“That’s all,” I said. “I just wanted to say that.”
And I turned and went back to my bed.
Mark turned to the other aide and started muttering about me. I picked up my book, and found I couldn’t concentrate on the words. My hands were shaking. I forced myself to focus on the page and read each word in each line, slowly and carefully.
When the announcement came over the PA system that breakfast was ready in the dining room, the other aide came into my room to get my roommate up. She closed the door behind her.
“Thank you for saying that,” she mouthed at me.
“I’m sorry,” I said. “I know I was overstepping.”
“No,” she said. “You’re right, of course. But Mark – he’s Mark. He does things his way, and he doesn’t listen when anyone tells him he’s wrong. He’s wrong about this patient, and don’t worry, we’re not actually doing that with her.”
Why, I wondered, if he doesn’t listen when someone tells him that “his way” is wrong and even harmful – why is he still on staff? Why hasn’t he been fired, or at least moved to a medical ward where he can do less damage?
I went to breakfast. Blanche was having a difficult day. She and I and the other two patients who had formed a little posse sat in silence at our table. Tears leaked from Blanche’s eyes once, and another patient reached out a hand to her. She grasped it for a moment, and then finished her breakfast and left.
Adam was sitting at the table next to us. After the others at my table had all left, I got myself a tea and sat at the table a while longer.
“Do you want my eggs?”
I was startled by Adam’s voice next to me. He was holding out his tray to me, the eggs glistening on the shiny surface.
“No, thanks,” I said. and smiled. He smiled, and his eyes darted down.
I left the dining room a few moments later. Back in my room, I continued reading.
Mark was now assigned to another 24-hour watch patient, an elderly woman who was physically fragile and often disoriented. At 1pm every day, she would demand to know where her purse was, and get agitated. “My husband is waiting for me,” she would say. “I need to get home. Where’s my purse? Someone stole my purse!”
Now, it was too early for her disorientation to set in. She was walking slowly up and down the corridor, as she did every morning. Other days, when other aides were assigned to her, she would walk slowly on the arm of an aide. When she got to the end of the corridor and tried to open the door, the aides would gently talk to her, soothe her, and turn her around for another lap.
Today, Mark leaned against the doorway of her room and watched her walk. When she got to the door at the end of the corridor and tried to turn the (locked) handle, Mark yelled at her, “Stop that! Come back! Turn around!” And then turned to the aide next to him and muttered, “Can you believe her?”
This time, I didn’t even have a chance to decide whether to say something or stay out of it. I heard Adam’s voice.
“You don’t have to yell at her,” he said to Mark. “You can be nice to her.”
Mark laughed and scoffed. “What is it, is everyone a doctor today?”
“I don’t need to be a doctor,” Adam said. “I’m a person.” And then he retreated to his room.
Mark huffed loudly to anyone who would listen, and some who wouldn’t. “Everyone wants to be a doctor today! They’re here to get better! They need to stay in their rooms and get better!”
Adam didn’t pace that day. In the activity room an hour later, he sat two chairs away from me. He looked up at me, a quick dart of his eyes, and I smiled at him. A tiny smile, proud and shy and so different from the big loud smile he sometimes had, bloomed on his face, and he ducked his head down again.
Margaret came to pick me up a few minutes after that. There were still ten pages of my book left for me to read.
Blanche came out of her room to hug me goodbye, and Adam watched through the glass window of the activity room, eyes focused on us, steady and unwavering.
Image from this NYT article.