“A Spy in the House of Crazy”

“A Spy in the House of Crazy”

You never knew what you’d get on 5L.  Every shift was a blind date with 25 pacing, bored insomniacs.  Just like any psych unit anywhere, patient mix made all the difference.  Each day, as I keyed the restricted access elevator, as the lift vibrated upwards, I shrank and narrowed.  Nurses got punched in the face.  Glass got broken.  Chairs got thrown. Thick orange pee, from full urinals. Shit.  Now and then angry, psychotic people needed to be tackled, strapped down on the floors of isolation rooms, or given injections in the butt, against their will.  We’d huddle in the nurse’s station and watch on live feeds as they struggled against soft restraints (which used to be made of leather) then slowly, minute by minute, drifted off into drugged quiescence.  I thought of dogs being put to sleep.  It amazed me how meds knocked people out so swiftly.  They were asleep, technically, but it seemed like a dying. It was mathematical.  Yet once they woke, it started again.  It wasn’t about curing anyone, it was almost never about curing anyone.  It was about control.  5L was a “crisis unit.”  The idea was to make the crisis stop.  It didn’t. It got discharged.

5L always smelled. Not a window opened.  The odor was hard to specify:  bad over-microwaved decaf coffee (no regular, except for staff), bad over-medicated breath, sagging adult diaper urine, BO, the residue of bad meals, shit stained sheets dumped in hampers spread around the unit and emptied maybe once per day, if that.  There were five things people always wanted to do.  Smoke (it wasn’t allowed).  Shave (it was, with staff standby).  Shower. Make a free call.  Watch “Fried Green Tomatoes” on the VCR in the day room. Rarely, people asked to read their chart.  This caused commotion.  They would be told they couldn’t.  They would insist, it was their chart, they had a right.  The doctor would be called.  They would be told no again.  Maybe once or twice in 20 years a patient prevailed—the chart, in a sky-blue plastic binder, was given to them.  It wasn’t what they bargained for.  Most likely, it was boring.  It caused no disquiet.  The words meant nothing.  They couldn’t see themselves in the words.

The term you heard more than any other was “inappropriate.”  People coughed inappropriately.  They microwaved inappropriately.  They changed the channels on the TV inappropriately.  They listened to music on their headphones inappropriately loudly.  They loitered around the nurse’s station inappropriately. They put lipstick on inappropriately. This was a land of inappropriateness. People weren’t so much ill.  They were naughty—or so they were told.  They were bad.  What they were missing, what was absent from them, was shame.  They had no governor.

You feared violent delusional people–sometimes they fixed their delusions on you, watched closely as you moved about the unit. You worried, slightly, about the suicidal.  A girl got a Thanksgiving pass and jumped from the top of the parking structure. But the group receiving the most attention–and it was always a group, they came in teams– was borderlines, young women intent on self-harm, addicted to what they called, rapturously, “cutting.” 

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