The Princess of the Psych Ward.

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Four years ago and I’m working C Unit in the psychiatric hospital, where patients go for stabilization, usually after a trip through the psych ER. Hopefully the hospital can motivate the patients to actively engage in their healing process so they may return to society and function appropriately. Some do, some do not, but our focus: get them better.

This evening a young lady appeared at my med window, fake name of Mari, she was 20 years old, a movie-star beautiful Mexican-American girl. I had heard about her in pre-shift report, the scoop was that because of her we needed to keep an extra eye on the ladies’ wing of our ward. Think of the unit as shaped like a capital J, the girl’s wing is in the long vertical stem, the men’s rooms follow the curve. The nurses’ station is between the wings, separating the unit. Anyway, I saw the girl face to face, and no offense to anyone who may read this, Mari was in the top .001 of rare beauties on this planet. I realize that is subjective, but the unanimous opinion amongst the nursing staff: Miss Universe is on the Unit.

The patient’s laundry room was in the ladies’ section, unfortunately, so the guys might have reason to wander down that corridor. With the drop-dead gorgeous rare raving beauty on the ward, we had to be on our toes. Already most of the male patients had tried to chat her up, and one would have to be blind not to see why. Large dark eyes and naturally long lashes, high cheek bones, slender face, perfect smile, I cannot describe her appearance and do her justice, however I can testify to her schizophrenic behavior.

Later that night, around 8:30ish and after snacks, Mari walked out of the girls wing stark naked and marched up to my med window. Said window was open as I surveyed the unit from inside. Mari glared at me and stated she did not like Diet Coke, spun on heel and marched away; leaving me gawking at her perfect jiggling butt and thinking I did not like Diet Coke either. I should have shouted it at her I suppose. So Mari also had a perfect figure to go with her lovely face, and thankfully she was swiftly covered by a nurse grabbing a blanket from a nearby linen cart. A nurses’ aide helped to walk her back to her room and all was quiet for about 10 minutes.

Mari’s nurse said she would call the doctor and the nursing supervisor to get a staff girl for a 1-to-1 sitter assignment for Mari. The nurse asked me to step out of the med room and cover that wing of our ward, so I did. I stood guard in the corridor entranceway, allowing no males to enter. As the supervisor came on the unit, a guy named Jerry (who was Nurse of the Year btw despite the false name I’m giving him) Mari sneaked up behind me as I said hello to him. Jerry pointed behind me, I turned around and Mari gave me her million-watt smile and held her arms out for a hug. Still naked and beautiful, she was, and she grabbed me before I could react. Normally I am slightly fleeter of wit, but it is difficult to physically detain a naked girl and not look like a groper while doing it. Or maybe I was just stunned.

I gently took her shoulders as Jerry arrived, him not even breaking stride, and we spun her around and trotted her back down the hall to her room. I sat her on the bed and threw a gown around her and asked her to please, please, please do not stroll out onto the unit nude again. She was pissed because I broke our hug, I guess, and said “Okay now get the hell out of here” and slung her gown on the floor. I looked at Jerry in the doorway and he just shook his head. Fortunately, we were able to get a staff girl over to our unit to keep an eye on Mari, and I received an order to give her a little something to calm her down. She was compliant with taking the meds and everything was cool for the rest of the night.

My next encounter with Mari came the next night. I relieved a nurses’ assistant for lunch and inherited the client census duty. This meant I kept tabs on all the patients, every 15 minutes, so I walked all over the unit and documented everyone’s whereabouts as I saw them. My journey took me into the ladies’ wing of course. I walked north, Mari walked south with her sitter, a nice young lady named Patty. Mari was dressed for once, but she saw me and stepped towards me making goo-goo eyes, hands on her hips, doing a little hoochie dance while shaking her rump back and forth and smiling. I said “No, no, no …” and tried to curl up while standing against the wall. Mari flattened me against it and rubbed all of herself all over all of me.  

I was afraid to touch her so I clutched my clipboard for dear life while wondering what the heck she saw in me, being 30 years older, not that I was knocking it to be honest. I knew the girl was sick. Hmm. Right. Why else would she fixate on me? Okay, got it. Anyway, Patty and Jerry pulled Mari off me and I managed to stay away from her for the rest of the shift. That was my final physical encounter with young Mari. She was able to resolve her psychosis in the respect she found the appropriate meds and moved on. I do not wish to say what caused her psychiatric break as that is not the focus of the story.

On the whole, I must say that pretty Mari was not a bad customer, especially when compared to the fact I’ve been slugged a heckuva lot more times than I’ve been hugged in this business.  

The 8-Year-Old Ninja.

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Fake names, fake names. Back 25 years ago I was teaching kung fu full bore, meaning four days a week, junior and adult classes, plus one of my peers, Gousei Kara (fake name I tells ya) ran a rape-prevention class one night a week wherein I would don protective gear, charge the ladies, and they would beat me bloody. Regardless of the ill-aimed punches and kicks I received, kung fu gousei was my fave job amongst the three part-timers I worked.

For clarification: Gousei (GOW-say) means teacher, it is the Chinese equivalent of Sensei, the Japanese word for teacher. No, it does not mean master, it means teacher. Now you know.

Twice a year we had “Ninja Night,” for the juniors, so the kids could get together for some full-time fun for a change, instead of straight yoga and kung fu. We did stretch the kids out when the evening began, because it would get a bit physical, yet not intensely so.

After some film shorts (karate clips, mostly) we played Ninja Ball! We divided the dojo into 3 equal sections. The middle was no-man’s land; the kids took one side of the dojo and the instructors (the owner, called just “Gousei,” and another instructor, Dave). It was an inside dynamic you may recognize, there were a few “gouseis” who worked at the dojo, but when you said Gousei everyone knew who you were talking about: the 5th degree black belt who had been doing this kung fu stuff for 40 years and could probably beat you to death with his face.

We had 3 small inflatable balls, a little smaller than volleyballs, so essentially we played dodge ball but called it ninja ball. If you got hit with the ball you were out. If someone caught the ball you threw you were out. Fairly basic, easy to remember rules. The gousei squad almost always won, because we were good, I guess, and because none of the kids were over 12. So we’re flinging the balls back and forth, yucking it up, having a great time, kids are going down one after the other, then the kids took out Gousei with a slick fastball, and a few seconds later a girl caught a ball that Dave threw, so he was gone.

Suddenly it’s just me against two boys and a girl. I blasted the girl out with a nice slider to the thigh and caught a ball another kid threw at me and 2 kids are gone in about 3 seconds. I laughed at the kid whose ball I caught (he looked sheepish) and blam! Right in the face! This little 8-year-old boy, Jerry, had stood at the front of his boxed area against one of the walls, trying to blend in and I guess it worked. He hit me with the ball and I was out and it stung like the dickens so I was glad he was only 8 and not 12. Jerry won; he was the last kid standing. The new champions: the Juniors. The other kids pounded him on the back and I smiled, chagrined at losing but what the hey? I’ll nail him next time with my best fastball right in his little elfin face.

But for a few seconds life became much bigger than the Ninja Ball championship of the dojo. Jerry gave me a Look while his buddies were congratulating him and we had a Moment. We have all been there, I’ve been on both sides many a time and this was our moment, Jerry and I. I was Jerry’s main gousei, and we had a silent conversation between student and teacher, or father and son, mother and daughter, apprentice and mentor, in any occupation or circumstance, the moment where the eyes of the student ask “Am I doing this right?” I nodded at him, seriously, not smiling. Jerry nodded back. Heck yes you’re doing this right, kiddo.

Next on the night’s agenda was a “kata” contest. Kata: a stylized form of physical movement utilizing martial arts punches, kicks, blocks and whatnot; think of it as a dance with karate moves, that makes it easier to envision. Every belt level (belts in my system of self defense went white, yellow, green, brown, red then black) has its own kata. They have to be done correctly, that is you don’t punch when you’re supposed to block or step back when you need to step to the left, and so on. Like Dancing with the Kung Fu Stars, I suppose. So Jerry, of all the kids who participated, won the contest because he knew the next higher level of kata, and did it perfectly. Big surprise. I mean a really big surprise. Jerry was a yellow belt, and knew that kata, but he had been watching the green belts and learned theirs. It was not a difficult one but hey, very cunning and innovative of Jerry.

The last contest of the night was Gousei Says. This is like Simon Says except only kung fu movements are ordered and of course the leader says “gousei says” instead of “Simon says.” Gousei’s wife, Sandy, a 2nd degree black belt, led this one. The parents sat in the foyer, waiting to take their children home. I have noticed that parents enjoy watching their kids in the dojo and usually become much stressed when their child is competing, more so than the child. So, Sandy is giving the orders, and the chat sounds something like this: “Gousei says, left outside block. You’re out, Terry, you did right outside block. Good block though. Okay, everyone, right front ball snap. Okay, you, you and you are out, I did not say ‘Gousei says,'” and so on. The kids went down one by one, as usual, until only one remained, standing by himself on the side of the dojo, his back to the wall, and of course it was little Jerry.

Gousei walked over to Jerry and raised his hand like you do the winner in a prize fight and said “He’s 8 years old.” That was it. The parents all stood up and applauded, it was a really nice round of clapping but I believe most of the enthusiasm was because Ninja Night was over and they could take their little monsters home. Yep, Friday night, the kids would fall asleep early because they had been playing all evening, then mommy and daddy could … celebrate. As everyone left the dojo in a mob, Jerry turned to me and bowed quickly and I bowed back. Then he was out and down the stairs with his folks. We cleaned up and out we went too.

As I drove home that night I thought that at 8 years old, that may have been the greatest night of Jerry’s life. My girlfriend agreed when I discussed it with her, the event just stayed in my mind and still does. Jerry stuck with kung fu and made junior black belt, then instructor, one of the youngest we ever had. The kid was smart and he applied himself, and I like to think I helped him grow up, as it was my role to do so, after all. Well, I haven’t seen him in over 20 years, if he turned out to be a serial killer or a sex predator I had nothing to do with helping him grow up, let’s keep that straight.

And as I write these words it occurs to me that the part-time job I had teaching kung fu was the greatest job I ever had. The greatest by a country mile.

Beating Up on Nurses Again.

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One of the tougher aspects (and there are many) of psychiatric nursing: you cannot hit back. You must be able to weather a sucker-punch or kick or slap or whatev by going against the natural instinct to defend yourself by striking back. That is one of the more difficult things for many to do: keep your fists off of the patient’s faces, no matter how badly they asked for it by rabbit punching you behind the ear then laughing at you and asking what are you going to do about it? If you cannot follow that simple albeit thorny guideline, better go do bedside nursing, or better yet, another career. Everyone eventually loses their temper in this business, there are no saints wearing nursing scrubs (close, though) it is what you do after losing your cool that counts. Not saying it is easy.

So we have this patient, I will call him Joe. Joe has been through the “system,” he has been in long-term lockup, but when he got out and went home he did not continue with his medications so now he is back in the bin, locked up for the good of civilized society. You see, Joe likes to hit, and he’s a big boy in his late 20s, and the last time he did a stretch in this hospital he tuned up a nurse and put him in the regular hospital for a month. I worked with the guy, Rick, never did ask him about it. You don’t walk up to people and say “Hey Rick, tell me about that time Joe beat the living hell beat out of you.” It is not nice to remind people of such things. Nurses who worked with Rick before said he was not “right” after that beating, some joy and humor had gone out of his life, no more funny banter from him. I had noted Rick was rather staunch, or dour, and I also took note that Rick walked rather stiffly, although I am not saying it was because of Joe.

Joe had a 2-to-1 sitter dynamic, a security officer and a staff employee assigned to hang around with him and make sure he did not clock anyone. Complicating matters was his father, who visited often, and he was a foul-tempered man who looked like a fire hydrant about to explode. He always came in the hospital angry, face red, wearing a forbidding expression. Once he chewed out the guard for being too close to his son; I tried to intervene by telling him it was for safety reasons (if Joe starts swinging the two sitters would lay down on him until I could stick him with a syringe of Love Potion and cool his jets). His dad told me to shut up or I might find myself getting pounded on by him. Oh? That right, mister? I excused myself, scuttled into my med room, and called the police to escort the man out of the building. Threatening me constitutes assault; I could have had him jailed but that was not my intent, I just wanted him out of the hospital. He straightened up when the cops arrived, but I had the police take him out anyway. We did not need his drama; we already had a psych ward filled with it. It was not a mystery to me where Joe inherited some of his “anger issues.” Two other times they called the police to get the man booted out. And by the way, sir, while I’m on the topic of your addled son; why did he not take his meds when he got out of that other hospital? Who was the parent who is supposed to oversee that? Who is responsible for him coming back to this lockdown unit? That’s right; it was you, tough guy. Still, I would rather fight his son than him.  

We had a fight break out in front of the med room, which is always locked, has a little Dutch door with a metal corrugated rollup window like a mini-garage. The patients like to hang out there sometimes and pepper me with questions if my metal door is in the up position. I usually keep the door in the down and locked position of course, because these types of patients like to trap you with your words to create even more drama. Example: patient asks me why a doctor prescribed a certain medication. I might respond with “perhaps it is for voices, or psychosis, I don’t know.” So the patient runs to another nurse or doctor and says “He said I was psychotic!” The psychotic part is most likely true, regardless of what I said, otherwise why would they be here in the first place? One quickly learns the best answer most times is “I do not know. Ask your doctor.”

Back to the fight; from inside the med room I heard an angry outburst of bad words mixed with the sounds of people struggling. I step out of the med room, shutting the door behind me, look around the corner and 3 patients are going at it, 2 girls and a bald guy. A black girl is hitting him with a carton of milk and a white girl keeps trying to kick him in the balls, and he is slapping at them both and calling them ancient whores (yes, ancient). Joe was in the vicinity and his sitters ran to break up the fight, Code Green clanged over the intercom, the other patients stood in a semi-circle around the combatants, like in grade school, calling out encouragement, laughing, crying, jumping up and down; all kinds of stuff. A couple of guys with beards started square dancing, a pair of other girls began throwing dukes at each other – it was instant chaos, Lord help me but I’ve seen it hundreds of times. The other nurses on the unit pitched in to try and restore order and it was just a big mess of people running around in circles.

Joe’s sitters had left him to his own devices so they could break up the fight. Joe turned his head and saw me, about 15 feet away. He grinned and came at me. I had watched Joe attack before and it was always the same thing if he had to travel any distance. If you were within arm’s length he would just pop you a good one, but at 15 or so feet away he lowered his head and charged like a bull. I took a defensive stance; my intent to step aside, grab an arm as he went by, then body-slam his ass on the floor. If he got hurt, well too bad. I really hoped not, and would do my best to not harm him, but what happened would happen, that was my attitude about it. Containing Joe was the standing order, and paramount, but it was just him and me and I was not about to let that young man put me in the hospital for a month like poor Rick.

So Joe began to drive towards me as I bent my knees and took my stance and whammo! The black girl with the milk carton tackled Joe in a beautiful blindside takedown and they both fell into a small shower room across the hall from my med room. They were halfway in and halfway out, trying to punch each other while face to face, cursing each other to beat the band. Joe had hit the black girl a few days before and she had not forgotten about it. For a skinny woman, she could fight like a wildcat. I didn’t want any part of her.

About that time the hospital staff arrived (thank God) around 20 people hit the door with more coming. Everything was set to right in a few minutes with all fighting, jumping, singing and square-dancing stopped. We had to drag Joe and the girl out of the shower room in a gob then untangle them. It ended up being one of those shifts where I had to have another nurse help me load syringes with Happy Juice, there were so many people to inject.  

It was just another day in the work life, a near riot in a hospital, and actually not all that unusual for my occupation. What is the lesson here? I’m not really sure, but I think it is that if you have to call the cops on someone, just go ahead and have them arrested. If they’re going to be an asshole all their life, like Joe’s dad, send them to jail so they can hang out with the others.

A Fun Morning.

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Driving to the gymnasium this morning, all geeked up to do my treadmill workout and sling a few iron weights around, sitting in traffic on one of the more popular “shortcuts.” Let’s face it; there are no shortcuts in a.m. San Diego, there are a couple of million people living around here, driving all over the place and sipping coffee. So I’m stuck in the queue to make my right turn to go down the mountain into Mission Valley, resigned to my early morning fate of not getting there when I want. Not to be confused with not getting there on time. The former will make you crazier, but I’m already crazy (certified!) so it has little effect on me these days.

A guy got out of a parked vehicle beside me and my eyes zeroed in on a fold-up cardboard sign he carried. The card said “Will work for food.” Hmm. He exited a Hyundai Tucson, a very nice SUV. He wore faded jeans and a tee shirt and scuffed sneakers. He checked out his reflection in the sideview mirror, folded his sign (while looking around guiltily, IMHO) and walked on, going to find an unoccupied traffic island I imagine. I had not seen this action for about 20 years, in Clearwater, FL, when they filmed a guy doing this very same thing. Homeless or pseudo panhandling must pay pretty well.

Gym time was cool, the old men gave me condolences because my precious Kentucky basketball team lost the national title last night to those city slickers from Connecticut. One of the trainers, hot babe Misha, who did undergrad work at UCONN, laughed and pointed at me, as apropos to the losers. I gave her a sad smile, best I could come up with. It still hurts.

Leaving the Y, I got stuck behind a guy on a bicycle who preferred to use my lane as opposed to the bicycle lane. Traffic moved rapidly in the other lane so I couldn’t get around him. Come on, buddy, don’t you think I would like to toodle along in the bicycle lane? Got your very own piece of the road and yet you have to mess up my morning. Poop head.

Went on to the mental health clinic to watch the show, and it was pretty good this morning. I plopped down in the lobby and opened my notepad to catch up on things. A guy came in and inquired loudly of the receptionist if this was the place to get counseling because he just came from the regular health clinic yesterday and he had Hep C and nowhere to live but he was an alcoholic too and he might get a part time job because he’s a helluva worker and he needed psychiatric meds. All in one loud, long stormy sentence, so that everyone in the lobby knew his business. The receptionist handed him a clipboard and pen and asked him to please fill out some forms and the man said “They didn’t say nothing about filling out no forms at the downtown clinic.” The receptionist tried nicely to explain they needed information before he could be treated but the guy said “Fuck it” and walked out.

Another girl got up from her seat and went to the receptionist then. She had come in the clinic like the Hep C dude who just left, as a “walk in” wanting to see a shrink. When you come in from out of the blue like that, you just have to wait your turn until a doctor can see you, which means when someone else does not show up for their appointment. You can always count on no-show no-call in a mental health clinic. The girl complained that she had been waiting 20 minutes. I looked over at a regular visitor to this clinic, a homeless guy named Morgan, who rolled his eyes and shook his head. People do tend to get impatient, but in a situation like this you just have to bite the bullet and wait.

A blond girl came in and sat beside me. She chewed gum while eating Cheetos and drinking a Starbucks Iced Mocha. She was cute, but looked high-maintenance, to I kept my nose in my notepad, reading about “10 celebrities who have ugly spouses.” Yes, that is a trending topic.

Morgan and another guy discussed a friend of theirs who got stabbed a couple of weeks ago. Just part of their lives, stabbings and other assorted violence. Hard to say what roads they have walked.

A doctor and a tech got in a big fight in the administrative area, yelling at each other for being incompetent or miss-filing or something. We could all hear it; it was a no-holds barred yell-out. You get that now and then; I’ve been on one side or the other a few times in my career.

The impatient girl got up, yelled at the receptionist because the doctor and the tech were calling each other bad words, saying “I didn’t get up this early to listen to this shit!” then she left too. The guy talking to Morgan barked out a little laugh about something, and the girl favored him with a withering glare as she went through the door.

Okay, enough, that is a taste of my day. I’m sure it’s pretty boring, but it is what I do. Partly. Oh, and all this happened before 9 o’clock this morning.

Kentucky Lost.

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The Wildcats lost last night, they could not handle the guard play of UCONN. Wah. Now I am bummed, but it will get better, and by the time the next college basketball season rolls around I will be pulling for the Cats. Go get them next year, and all that. Still love you.

Kentucky Wildcats: God’s Team.

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Last night I dreamed that MY team, the team of my youth, the legendary Wildcats of the University of Kentucky, won the national title over UCONN. We shall see tonight if the dream was prescient or just wishful/hopeful thinking. Impossible to tell in advance; I’m pretty goofed up in my dreamland adventures so you never know.

We are indoctrinated in the religion of Wildcat worship when we are very young. I’ve been following the Wildcats since I was in single-digit years; I remember a young classmate who lived across the street, her name was Sheila and she wore a UK tee shirt. I recall another young man my age saying “F*ck Indiana!” and getting his fanny busted for that one. He was confused like we all are, wondering why daddy and mommy can say the F word but not an 8 year old.

One does not have to be gifted athletically or any other way to be a Wildcat devotee; we will take anyone who is sincere. We gather together in front of the Sacred Television to watch our boys gallop up and down the court and slam basketballs through the hoop. Then we discuss it the next day, around the water cooler, in grocery lines, at the bank, the # 1 topic: the Cats, Big Blue.

People tend to make fun of Kentucky as if we are backwards bumpkins from the hills who drink moonshine and run around naked. I have always held a minor resentment over this prejudicial slur, as there is nothing wrong with getting drunk and running around naked but you have to pick your spots of course. On the other hand this contempt prior to investigation it is good, very good, for they who utter contempt without investigation are prone to underestimation. Meaning, go ahead and think I’m a hick, I don’t care, I’m busy right now getting ahead of your lame ass while you’re laughing and trying to think up hillbilly jokes. Me no care, you slack-jawed fumble-d*ck, and my basketball team is going to stomp yours so hard your entire family will have to go to the bathroom. And then I’m going to celebrate with a shot of white lightning.

Yes, Kentucky Wildcats, the team of God. Don’t let me down tonight, oh glorious ones. Even if you lose we will love you, but we will love you more if you win. That’s just the way it goes, I’m afraid. No unconditional love in Eastern Kentucky. We have coal mines to deal with and you have the Huskies. Stomp them in the name of Louisa, my home town.

When Women Attack.

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The names are changed to protect me, because of the events that occurred. This is a litigation-happy society wherein people will sue other people at the drop of a hanky. I don’t need it, and I have better things to do than go to court.

I worked as a nurse in a privately owned mental hospital. We called the patients “clients.” Yes, even schizophrenics have nickname preferences, but the entire enterprise is stigmatized anyway by the word “mental.” Mental Health or Mental Illness sounds the same to lay people; it sounds like insane, as in people running around in circles laughing and playing with their junk. Our staff was coached to never say the word “crazy” or speak a foreign language where the clients could hear it. For some reason this regulation offended a certain cultural faction of the employees. Their response was to make fiery speeches in closed meetings amongst themselves, so I do not think the speeches swayed anyone, and someone anonymously posted a missive on the time clock bulletin board that said something along the lines of “next you will try to take away our (insert ethnic food)!”

No, removing the horrid tripe from your menu is not on anyone’s mind but yours. No one wants to strip you of your culture and I for one was interested in your customs and background but no! You totally cold-shouldered me and insist on blathering in an unknown tongue in front of paranoid schizophrenic patients! What the hell is wrong with you? Administration doesn’t want you to speak another language around these guys because they think you’re talking about them! They are paranoid! They are mental! It is common sense to everyone but you so for the love of God if your reading comprehension is so piss poor just shut up and stop trying to make a dietary issue of these schizoids! Please!

Sorta got off track there. One of our clients was Mandy, a girl who stood about 5 feet 8 inches tall and weighed north of 350 pounds – that is as high as our scale went. Mandy was what you call morbidly obese and she looked the part. Her head appeared to be smaller than it really was, due to an optical illusion created by her gigantic body. I won’t give out any more minutiae about her body shape, because it would not be nice. She did sort of look like a walrus balancing a little ball on its nose, though.

Also on the girls’ unit was Kathy, a petite and cute young lady with borderline personality disorder. She was prone to the occasional loud emotional outburst. Once she chewed me out because I refused to get her something she was not allowed to have. She called me a redneck and a dumb moron (redundant) and many, many bad words. She was livid, her face burned red and her fists were doubled up. I waited until she ran down and then I asked “Are you angry, Kathy?” She went off again, but I weathered the noun and verb storm. I could have simply goaded her from inside the nurses’ station; she could not get to me. But watching her jump up and down in unrequited rage is not progressive or positive.

Anyway, this was another night, and Mandy and Kathy were in the queue to come back on the unit after a smoke break. The patients march outside, smoke their Marlboros, and come back inside 15 minutes later. I stood in front of the nurses’ station and watched Jean, a nurse assistant, unlock the door (50 feet away) to allow the girls access to the ward. When the doors popped open the queue dissolved into the regular “me first” 40-yard dash of the demented to the dayroom. The girls are far more judicious than the boys when it comes to deciding what to watch on television, but the seats are always up for grabs so it pays to get there first. As the girls trudged up the hall towards me Mandy suddenly turned and punched Kathy in the face with a straight right, then followed up with a couple of body shots before Kathy went down.

I was already sprinting their way after the first punch, and when Kathy hit the floor, Jean pinned Mandy’s arms to her side and took her down. The other female patients helped Jean until more staff showed up and piled on as I arrived. “Call Code Green!” Jean said from somewhere in the pile. I noted one of the female patients trying to slip a punch in as they wrestled on the floor. I would deal with it later. I ran back down the hall to sound the alarm. When I got inside the nurses’ station I unhooked a phone and then wondered why I was doing this because we already had Mandy neutralized. I pushed the appropriate button anyway sounded Code Green over the intercom. We contained Mandy in our seclusion room and I put an ice pack on Kathy’s face so it would not swell.

By the time I took care of Kathy, Bon-Bon the Nurse Supervisor was on the scene with a doctor’s order for injections of Happy Juice (ativan, haldol and cogentin) to put Mandy down for a bit. I drew up the medicine into two syringes, the big ones you use to give dogs shots. I snapped on my gloves and went next door to the seclusion room, where the staff made sure Mandy stayed on her face on the stark bed. We could tie her down, but Mandy did not fight us so she didn’t warrant it. She shyly exposed a bit of her ginormous quivering rump and I stuck her with the Happy Juice. As I squeezed the concoction into her gluteus medius muscle, she told Jean “I don’t know why I hit her. Then I didn’t think I could stop.” She made with the 1000-yard stare and shook her head.

After that remark I made eye contact with the Nurse Supervisor, who looked at me and raised her eyebrows. Jean spared me a flick of her eyes also, to see if I got it. I put band aids on Mandy’s continent-sized ass and we were basically done. Mandy was remanded to stay in the timeout room for 15 minutes. The medication should kick in by then and Mandy would float down the hall on her tippy-toes and lie down on her bed and when she did the birdies would sing and everything would be cool.

Mandy’s two statements were some of the scariest I have heard, and if you dig into them and think about it you will agree. Bon-Bon and Jean heard the same thing and this is the stuff the shrink likes to hear. I will decipher: Mandy owned up to attacking Kathy for no reason, just thought of it and went for it, and would have continued bashing Kathy if Jean and her peers had not intervened. This is not poor impulse control on Mandy’s part; this is an utter lack of control. I have had only one other patient like Mandy in this respect, a girl who jumped off a roof. I do not understand why they do such things although they seem to be driven by my personal motto “it seemed like a good idea at the time.” To the best of my knowledge an organic self-protective mechanism is broken in their brains, and I do not know if it is fixable.

Kathy was eventually sent to an all-girl board and care facility. I’m not sure how that worked out. A lot of clients in this business I see over and over, and some only once. Same way with the staff. I bump into someone now and then and we catch up. 

But what do we do with someone like Mandy? When I moved along from that job Mandy was still a client in that hospital. She is capable of knocking the daylights out of someone, anyone, because she does not appear to be in control of her violent actions. What to do with her is not my call, but she is a big girl so I recommend she gets rigged up with electronics so she beeps when she backs up.

Punched by a Girl.

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Many times I have been koshed by one of the fairer sex. It can happen at almost any time in a psychiatric hospital setting, with potentially lethal consequences. This is a non-lethal event I am about to describe, just to set the tone, sort of. More malicious content at another time. Names are changed to protect those involved, etc. I would prefer that none of these ladies find my address. There is always a chance someone will hunt me down and attempt to finish the job. Girls with OCD can be as relentless as Terminators.

In this particular hospital I ran the ladies’ unit most of the time, per admin assignment. One of my co-workers, Penelope, told the DON “He sure can handle those women!” Sounds like a compliment, and I’m sure it was meant that way, but they were all locked-up mental patients so I guess it is a good power to have. We got along well, for the most part.  

Lilly was a schizophrenic patient, very cute except for 3 missing teeth in the front upper left of her grill. She used to follow me around like a puppy wanting orders – I’m guessing she had a crush on me – and some of the staff referred to her as my girlfriend.

But one day Lilly took a purse from another girl and ran into her room with it. I do not know why she did this; the purse came from a thrift store and cost a dollar or two. I’m sure Lilly had a very complicated reason for the theft. They usually do. Another nurse, Barbara, and I went into her room to fetch yon purse and we heard the toilet flush. Lilly wanted to send the purse into the sewage system but it was too big to go down the tubes (literally for once). You’re supposed to recycle that stuff anyway, as far as I know.

Barb and I began donning plastic non-toxic gloves we carried in our scrubs (prepared, we were) and as we snapped them on Lilly stepped around us, grabbed the purse out of the potty and darted into the hall before we could stop her. Barb and I followed with a sigh. Lilly was not very big, smaller than me for a change. She was in her early 30s, maybe 5 feet 2, weighed 115 pounds or so, very fit, but she did not look to be much of a problem if she wanted a scrap. Barb and I were both veterans, and Barb was a little bigger than me.

We were in a long hallway with doors to other patients’ rooms on either side. Any girls already in their room when the show started stood in the doorway so they would not miss anything, half of them cheering and laughing and the other half asking what was going on, as if I was going to call a time out to explain that a few minutes ago Lilly complained of an acute stomach ache and before I could get the Maalox she went off her flipping nut and pooped out a leather purse, shoulder strap and all and now she wanted to keep the foul thing as a trophy. I heard “Code Green Unit B” over the intercom so it was on; in a couple of minutes I would see the rest of the p.m. staff when they came to help Barb and me.  

Lilly was almost comical as she jumped in and out and danced around dodging us although we did not grab at her. Evidently Lilly had not participated in many Code Greens called in her honor so she was unsure of her role. She silently shuffled back and forth, eyes buggy, the purse clutched against her chest with one hand, her other little fist held up in a defensive posture, all the while making progress toward a locked door at the end of the hall. Barbara and I followed her – as opposed to herding her – in the direction she was already going until she Texas 2-stepped to the locked door and could proceed no further. By then other staff members arrived, including ancillary staff like Ed the cook and the maintenance guy George (with his broom) packed in behind Barb and me. That’s the way we do it on the evening shift: everyone comes running when we hear the Code Green. Ed the cook was a certified expert in using all manner of restraints, btw. He helped teach classes at the hospital. Just saying.

This assignment was not easy – they never are. We had to contain Lilly without hurting her. She could take a full run-and-kick and knock someone’s teeth out to match her own jack-o-lantern smile but we could not hit back. The policy pertains to everyone, and patients know it, and some assholes take advantage of it. The consequences are usually just a couple of injections and some contemplation time in a timeout room, but if they are incorrigible, they get sent to a facility far, far away from the madding crowd.

Lilly was cornered by a dozen of us. No one crowded her; we showed her open hands displaying our palms. Barb and I spoke calmly and asked Lilly to put the nasty purse down. We told her that she was not in trouble, blah-blah and yadda-yadda. Lilly looked around at the staff and gave everyone a sheepish and sad “I’m sorry” grin, looked down at the floor for a few seconds while we reinforced that everything was fine, she said “thank you” then threw the purse at my feet and as I skipped to avoid it she stepped up and popped me in the mouth with a left. Didn’t really hurt, just a little “doink.” I noted she did not make a proper fist and I’m sure I could train her how to sucker-punch more effectively, but I did not have any women’s self defense classes scheduled for the near future.

We jumped her; grabbed her and took her right to the floor. She was neutralized in seconds. We pinned her limbs, head and torso to the floor. I held down her left biceps, another nurse her left forearm and hand and so on. She could not move and did not struggle much. Yet another nurse, Melky, patted my shoulder and asked me to back out, so I did. Good thinking, Melky. Lilly had hit me. I was the focus of some hidden inner rage. Maybe I reminded her of someone, maybe not, maybe I just got lucky. Regardless it was best medicine for me to remove myself from the immediate area, so I went into the charting room and began filling out the incident report forms. Always the most un-fun part of nursing, but as most folks in any job will realize at a young age, it’s all in the paperwork, or rather, these days, it’s all in a database in cyberspace.

My fault I got hit, of course. I got too close, yet if the patient was somewhat bigger or I did not know them well, I would not have gotten as close. When I did get hit, it was not a good shot by any stretch, so I got lucky there. What to do? Be more careful, that’s all I can do. Keep more distance when I have someone backed into a corner. I’m very careful, we all are, but we still get punched. Lilly isn’t a bad person, I do not know what caused her to snap that day, but I don’t hold it against her. Lilly is pretty sick, there is something wrong with her brain chemicals and it did not help that she used a lot of drugs.

That was “attacked by girls light.” I will try to bring more recollections of 4-fisted tales of going toe-to-toe with the abrasive aggressive girls who never did like me. I was lucky to get out of there alive, I suppose.

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