Out of the Frying Pan

life on a locked ward

I was feeling uneasy as I approached my new job at a large VA hospital. Newly graduated from college I had only experience working with adolescent females in a group home setting. This was an institution for the hardcore mentally ill.

The hospital was a huge compound of many buildings connected by above-ground tunnels. It had been built right after World War II so the buildings had a cookie-cutter style but also a creepy menacing flavor. I reported to the Personnel Office feeling like I was back in the Navy and my orientation as a Psychiatric Nurse's Assistant began.
Orientation was a three-month-long process during which I was required to work on all the different types of wards (i.e. Medical, Respiratory, Psychiatric, etc.) It was a wild three months filled with every kind of task, some imaginable and some that weren’t. PNA's were the "grunts” of patient care; nothing was excluded from our job description. Everything from shaving a terminal patient to restraining a completely out of control mentally ill patient was part of my daily routine. There was nothing "routine" about my daily routine.

Having completed my orientation I was assigned permanently to the Admissions Ward. Everyone, except the physically ill patients, spent at least their first two weeks on this ward. Often if there were no beds on an appropriate ward for their diagnosis, their stay could be indefinite. This caused the ward to be a mixture of all types of mentally ill people. It was most often a three-ring circus with every kind of addiction and mental illness on display all the time.
At first, I was nearly petrified with fear. Reading about these illnesses was a long way from seeing them being acted out by real people. Some shouting for no apparent reason, others arguing with a lamp, several PNA's tying a patient to his bed and many other actions that were scary or just bazaar. I did not have a clue what to do about any of this or even how to behave. I just tried to maintain a calm demeanor, attempting to act as though none of it bothered me.

As I wandered around the ward, several of the patients wandered right along behind me. They just watched me and occasionally whispered to each other. To say the least, it was very unsettling.

When I stopped to lite my pipe in the day hall, one of the group approached me, got very close, and whispered, "Who are you?"

"My name is Victor. I'm a new PNA.” I whispered back.

The patient looked disappointed and said "No. Who are you?"

"Who am I?," I thought, good question.

The patient (whose name turned out to be George) watched me and waited.

"Are you asking am I a good guy or a bad guy?" I said.

George looked at me with a look of strained patience and said, “Simply put, but for a start, yes."

"Well", I said, "I would like to think I’m a good guy”

George stood there looking at me for a few seconds and then he said, "Time will tell us your story. We will have to observe you for a while before we decide"

Then he joined the others, whispered something to them, then walked away sitting down by himself in the day hall.
The others wandered away each to his spot. No one gave me a second look.

I was intrigued. George sounded very intelligent and I wondered what his problem was.

As I was thinking this, George yelled, "GET OUT OF MY HEAD!" and hit himself in the forehead with an open palm leaving a red mark..

I stood there and stared not knowing what to do. No one else even looked up.

George looked over at me and said in a calm voice, "Sometimes the voices won't leave me alone and I have to beat them out of me".

"Do you have to beat them out of you often?" I asked.

He seemed unconcerned, as he replied, "Not as often as I used to."

He told me this was not a good time to talk and indicated that a few hours from now it would be better. I told him that I would be looking forward to talking with him later.

He just gave me a puzzled look and put his head in his hands.

I walked away thinking about how terrible it must be to have an enemy living in your head. I knew, as well, I did not want to be another enemy. Looking at George, I was fascinated but at the same time wondered what kind of difference I could make in that kind of tortured life. The people I was meeting came straight off the pages of the textbooks, I had studied. I never thought that treatment would include restraining a violent patient and drugging them into a zombie-like trance. I was thinking more along the lines of a couch, chair, and quiet meaningful conversation.
But here I was I the middle of a seeming side-show knowing that I had to help even though I had no idea how. Looking around I could see that not much was being done to treat the illness that was everywhere. It was also clear to me that everyone had given up on curing anyone - this place was the home of hopelessness.

Later as I was sitting there in the day hall a group of four patients, led by George came over to me. George pulled up some chairs and helped one of the other patients to sit..

He then made some introductions, This is Phil “he believes that he is the president.”

“If you prove yourself, there may be room for you in my cabinet,” said Phil through a smile as he pumped my hand.

“This is Dave. He isn’t moving just now. He is off his meds. but make no mistake he can hear you.”

I said Hi to Dave and received no response.

“I can see Dave likes you.”

“How can you tell?”

"I know Dave.”

“I see.”

“I think that you will, in time. I have a feeling about you.”, George went on.

“Finally, this is Jim. He is an addict. Don’t trust him, he will lie and cheat to get drugs. But it’s nothing personal.”

“That’s the truth. I am a liar and will do anything to get drugs. Of course, here they give me legal drugs so I won’t want the bad ones, so much. But given a chance, I would take them if I could.”

“Nice to meet you, Jim. You know I won’t get you any drugs? That’s not my job.”

“We should talk”, said Jim. “You seem reasonable.”

“We know what we are.” said George, “Now we must learn who you are before we trust you too much. It’s not that we expect a friend, we just don’t want another enemy.”

“I think that is more than fair. I don’t know if I can help you guys but I want to try.” I said.

“Good Luck.”, said Carl as he led Dave away and the other two just got up and left.