After Hours (InterMix)(5)
The senior of the two doctors led the brief meeting, which took place standing, most people balancing clipboards and coffees. I noted the bolted brackets pinning the armchairs and sofas in place, precluding the assembly of a cozy circle. The docs ran down their notes on the patients from the latest one-on-one and group sessions, then the senior nurses put in their two cents, then the LPNs and techs and orderlies were allowed to ask for clarification or share their own thoughts on the residents.
Kelly Robak didn’t have a clipboard and didn’t take notes—his role seemed less reliant on dosages and exact times than most people’s. The overnight staff walked me and Kelly and the other day-shifters through any “incidents.” The patients’ names meant nothing to me, and my skittish brain eagerly filtered out the words that validated my fears. Outburst, belligerent, episode, agitated. And these were the men I’d be jabbing full of sedatives. Not a function that seemed likely to endear me to them.
“How was Don?” Kelly asked the overnighters.
A meaty female tech with eyebrows plucked into slashes of permanent annoyance shrugged. “Quiet. But he got a dose at nine. Before that he was his usual effervescent self. I’m sure he’s saving up his energy just for you, Kel.”
Kelly nodded, expression perfectly neutral. I stole glances at him as the meeting went on.
His irises were pale with a dark ring, gray like his self-designed uniform—almost as though he were withholding color on purpose, lest he paint this place as anything other than the stark fortress it was. Clear eyes, pretty and cold as ice. Pretty eyes, pretty name, those ugly scars and bruises along the arms he recrossed.
And a gold wedding band on his left hand.
I wondered idly what Mrs. Robak was like, and whether she occasionally enjoyed getting wrestled into submission by her gigantic husband.
The meeting broke up, and suddenly my workday was starting. Dennis reintroduced me to a nurse practitioner named Jenny—a sturdy gal of early middle age, with tight blond braids like a milkmaid and cheeks stained by rosacea into a look of constant mortification. She spoke briskly. I could sense her patience had bounds, and I didn’t care to ever mess up enough to discover them. She was my supervisor, and I was going to shadow her closely for the first few days as I got accustomed to the ward’s routines. Routines were everything, I’d learned over and over in school.
“Routines are a promise that must be kept,” Jenny echoed, prepping dosage cups at the nurses’ station counter. And with doctors, nurses, techs, and orderlies all on staggered shifts, falling out of sync with the ward’s rhythm was a ready invitation for chaos. “The second we break the promises the ward rules make to our residents, we’re back to square one. Especially with the paranoid cases.”
The patients had to bathe—or be bathed, depending on how lucid they were on a given morning—shave with single-blade safety razors under exceedingly close supervision by the Kelly Robaks on duty, dress, then be led to the dining area.
There were fifteen male residents in the S3 locked unit, plus a handful of women on the Starling building’s second floor. Most arrived in the midst of major psychotic or substance abuse crises—or often a combination of the two—and weren’t expected to stay long before being cleared to move to more lenient programs, other facilities, or back home to their families.
Of the fifteen men in my ward, nine had potentially dangerous disorders and were prone to lashing out, verbally and physically. Contrary to pervasive popular belief, most people suffering from serious psychological disorders, if a threat to anyone, are only a danger to themselves. But our unit specialized in the minority of patients who were subject to fits of deep paranoia and resulting rage. If they acted out, they did so with the fervor of men whose very lives were in danger. Because in their minds, that was exactly the case.
The morning was quiet, which Jenny told me was typical. Patients had a half hour to eat breakfast and come up to the nurses’ booth to accept their little plastic cups of pills. Some were sullen, a few friendly, a couple completely blank. At least five demanded in tones of varying suspicion to know who I was, and somehow I retained their names far more ably than I had my colleagues’.
Carl. Thirty-six, paranoid schizophrenic, said the clipboard I glanced at as I helped Jenny with the meds. He was cheerful, with sharp eyes and a too-eager smile.
John B. Forty-three but looked to be pushing sixty, with a gravelly chain smoker’s voice. He had PTSD coupled with bipolar disorder, and after he left, Jenny told me he often woke thrashing, screaming his brother’s name.