Chats With Staff

I am sitting in one of the privacy booths when Chuck comes in. The five privacy booths line one side of the locked ward’s main hall; it’s here you can go when you need to get away from the staff and the other patients for a time of quiet, or if you want to visit with your relatives somewhere other than the common room. The booths are all the same: about eight feet square, with run down vinyl chairs or couches, maybe a little table. One has an old record player and a stack of scratched L.P.s. They are not very private; every hall-side wall is taken up in large part by a plate glass window. In theory you can cover the windows with blinds, but in reality all the blinds are broken and no one seems to want to fix them. The staff has to be able to keep track of the patients at all times, in case someone takes it into her head to hurt herself or create some other kind of emergency.

“You haven’t been eating,” Chuck says.

I look at him, trying to get my eyes to focus. I cannot remember how long I have been here, but I think it has not been too long. Three days, maybe. Everything is a blur. I am still wearing the shorts and tank top I had on when I cut my legs, the same ones I had on when they admitted me. If my mother has delivered any other clothes, I can’t remember that, either.

“Well?” Chuck prompts me.

“I… I don’t understand how the food thing works.” I’m not sure if this is true. I have seen…I think I have seen the big dining carts being wheeled down the hall to the common room three times a day. I have a vague memory of finding a tray with my name on it and pulling off a dish of green beans. The thought that I could be here for several days without anyone explaining the system to me strikes me as unlikely, if not ludicrous. But I have no memory of that happening and my head contains no information.

“It’s simple. You just look for the tray with your name on it. Then you fill out the menu for what you want at the next meal and send it back with your tray.”

Menu. I have noticed the menus: slips of paper in different colours, red, green, blue. I had not thought they had any use.

“I’m a vegetarian,” I say. “And I have low blood sugar. I can’t eat anything.” I flash on the last tray I pulled off, loaded with beef in gravy and mounds of mashed potatoes. My stomach heaves. Ah. This is why I ate only the green beans.

“Well it’s easy enough to get a special diet. Your doctor has to order it, that’s all. You mention it next time you see him. He’s doing rounds this afternoon.” Pause. “So how are you doing otherwise?”

I shrug. I don’t know. I don’t know anything.

“Evaluation coming along okay?”

“Evaluation?”

“Nobody’s mentioned it to you?” He has the grace to look chagrinned. “Everyone is supposed to do an intake exam. It’s nothing much, just a bunch of true and false questions.”

“Oh, the MMPI.”

“You’ve done it before?” This seems to offend him somehow. Maybe he thinks that the psych unit of the community hospital has dibs on administering this kind of test.

“Once. A year ago. At Lafayette Clinic.”

The mention of the clinic seems to mollify him somewhat. He goes out and returns with what looks like a test booklet and answer sheet from a standardized test like the SAT. He gives them to me along with a couple of pencils that are not too sharp.

“Work on it when you can. There’s no hurry, but the sooner you finish the sooner we’ll know something about you.” He smiles in a way that is meant to convey an element of camaraderie and leaves again.

I set to work. One of my peculiarities is that I like taking tests, even standardized tests; I’m good at it.

The new version of the test is much less cumbersome than the old one, with its stacks of computer cards. I simply read the statement off the test booklet and mark the corresponding box on the answer sheet. I need to be a little careful, because it’s easy to skip a line and fill in the wrong box if I’m not paying attention. That would throw the whole thing off.

I recognise many of the statements from last time:

People talk about me behind my back.

Others are conspiring against me.

I feel hopeless.

I cry often.

Outside forces control my body.

I think about killing myself.

Sometimes the statements repeat themselves, often in different words. When this happens, I carefully go back and check what I have answered before, so I don’t contradict myself by mistake. I think if I contradict myself, the people grading this test will not take me seriously.

Much later, I will learn that this is the wrong thing to do. The MMPI is meant to evaluate a person according to an arcane system of scales, each scale corresponding to an aspect of personality: paranoia, depression, sociability and the like. One of the scales is truthfulness. This is where the repetition comes in. In some way that I still do not entirely understand, consistency in identifying the repeating statements as true or false is seen as a sure sign that the person taking the test is lying. So by making sure that I give the same answer to the same statement each time, I am not making sure that whoever reviews this test will take me seriously. On the contrary, I am ensuring that I will be branded as sly, manipulative and dishonest.

But I don’t know that now.

I wonder about some of these statements. “I hear voices.” I don’t, and I mark it false, but I wonder if someone who really did hear voices would do any different. Would they know they were hearing voices that weren’t there, or would they just think it was normal? I begin to think that this test is flawed, simply because it was written by a person with little or no direct experience of what goes on in the minds of the people whom it is meant to evaluate. But I am required to take the test, not question it.

At noon I hear a commotion in the hallway and look through the window to see an orderly pushing the meal cart down to the common room. Dutifully, I follow. The orderly leaves the cart just inside the common room doors and beats a hasty retreat, looking over his shoulder as if to ward off whatever mysterious sickness has brought the third floor patients here. A crowd forms around the cart as the inmates retrieve their trays. I wait until it disperses and find mine, then hesitate, wondering where to go. Most of the others are sitting in groups of five or six and the common room has taken on the noisy, convivial atmosphere of a school cafeteria. I don’t know anyone yet, and although there are a few empty places I don’t feel comfortable joining a group. Finally I spot an empty, two-person table by the window and go there.

Lunch is a grilled cheese sandwich, a covered bowl of some kind of soup, a scoop of gelatinous brown goop that I think is pudding, and an apple. A bulbous, narrow-necked flask covered with a paper doily contains coffee. There is also a carton of milk. I eat the apple and half the sandwich. I drink the milk. The soup is tomato, which I don’t like, so I leave it alone, as I do the pudding and the coffee. Finished, I replace my tray and go back to the privacy cubicle. I am one of the first to leave. The others are talking and joking over their empty trays, in no hurry. Someone has turned on the television in the corner; a soap opera is on but no one is paying it much attention.

I continue working on the MMPI. Just as I am finishing, there is a knock on the door and Dr. Rosenberg enters without waiting for me to answer. I put my papers away and wait politely while he sits in the chair opposite me. I have actually been looking forward to seeing him, ever since Chuck mentioned that he would be in this afternoon.

“Katie,” he says in that jolly, Santa Claus way of his, “how are you settling in, all right? They tell me you haven’t been eating.”

“I ate lunch. I was just…confused, I guess. I don’t remember much since I came here.”

“Well, we’ll be starting you on some medication that should help that. I’ve okayed a sleeping pill for you if you need it. Now, about your program. You’ll be joining my group Tuesday and Friday mornings and Dr. Butler’s group Monday and Thursday. Dr. Butler’s my partner. Afternoons you’ll be in O.T.; that’s only three times a week. I want to have you do a few more tests; someone will contact you about them. For now you’re on precautions. If you’re doing all right next week we’ll see about some privileges. Okay? Okay.”

Then he stands up and leaves. My head is spinning, both from the onslaught of unfamiliar terms and from the speed of the interview. I was expecting I would actually get to talk with Dr. Rosenberg, tell him what was on my mind. I thought that’s what a psychiatrist was for. It seems I was mistaken. I didn’t even have time to mention my need for a special diet.

A few minutes later the door opens again, admitting a woman I have never seen before. She’s tall and older, in her forties, maybe, with ash blonde hair that curls under just above her shoulders. Her face is shiny and tired, but kind.

“Katie? Hi, I’m Claire. I’ve been off the last few days so we haven’t met. Have you finished that MMPI?”

I hand her the completed test.

“Did Dr. Rosenberg find you?”

I nod. “For what it was worth,” I can’t help adding.

“Oh. Katie, the doctors run the groups, but they don’t do personal counseling here on the floor. They just don’t have the time. No one told you about that, huh.” She seems unsurprised.

“No one told me a lot of things.”

Claire sits wearily in the chair Dr. Rosenberg has lately vacated. “I’m sorry, but it happens. There’s so much to do, some things just fall through the cracks.”

I think that the staff, no matter how overworked, ought to give some sort of priority to actually treating the patients and keeping them informed, but I keep this observation to myself. I am, after all, merely an inmate of a psychiatric ward. What do I know?

“Outside of group, we do most of the counseling.” She waves her hand towards the window to indicate this mysterious “we.” “Everyone is assigned two counselors, one on the morning shift and one on the afternoon. I’ll be your afternoon counselor; Chuck is your morning counselor. You get along with him all right, don’t you?”

I nod, but I wonder what would happen if I said I hated him.

“We try to meet privately with each of our people for at least an hour twice a week, but if you want to talk any time just grab us and we’ll try to fit you in. We’re the ones who’ll be handling your case for the most part, and we’re the ones you should come to if you need something, or something isn’t right.”

“Okay.”

“So, do you have any questions? Or do you want to talk?”

I think about this. “Not really.”

She regards me steadily for a few minutes, the rises with a sigh. “Well, all right. I guess you’re still settling in. Just let me know when you’re ready.”

She leaves me alone, then. I sit in the privacy cubicle until dinnertime, watching people move up and down the hall. When the meal carts arrive again, I go to the common room, retrieve my tray, and find the solitary table where I sat at lunch. I eat the soggy green beans and half the potatoes but leave the anonymous slab of meat alone. I remember my father telling me that if I was going to follow some weird dietary practice I was on my own; no one was going to buy or prepare any special food for me. I remember how, when I was very small and my sisters were still at home, they and my dad attended Weight Watchers and how my mother prepared stringy broiled chicken night after night, and the whole family was forced to eat it.

After dinner, I wander the halls until visiting hours, when my mother arrives. We go back to the common room, to the same little table. For the next two hours she tells me how her garden is doing, who she saw at the pool that day and what my nephew said when he came over to cut the grass. I nod and try to be interested. I am, in fact, glad for the attention, which she very rarely shows unless I am sick, but the superficiality of the conversation grates on me. Finally the announcement comes that visiting hours are over and she gives me a cold, dry kiss on the cheek.

“I’ll see you tomorrow. Love you, honey,” she says. The words already have the feel of a ritual that has been performed so many times that there is no longer any meaning to it.

With the departure of the last visitor, the ward seems to breathe a sigh of relief. I feel it too, this sense that the interlopers are gone and now we can drop the masks we put on to make ourselves acceptable to those who have no understanding of who we are and what has brought us here. We can drop the pretense that our reality is the same. Groups that have split apart in order that their individual members can receive friends and family come together again. A counselor comes and opens up the little kitchenette at one side of the common room to dispense snacks and sodas to those who want them. One woman ensconces herself in an armchair with a bag of knitting; two men pull out a checkerboard and start a game. One young woman is crying over something her visitor said or did and her companion is patting her on the back and nodding. There is support here, and understanding. It strikes me that though our blood relations may have left with the end of visiting hours we are not without family. If family is a set of people who accept you for who you are, completely and without question, then our families are here, among others who, despite differences in backgrounds and social status, have felt the same feelings and experienced the same things.

Into this peaceful time come the nurses, dispensing evening medications. One comes to me with a little pink and blue capsule in a plastic cup. Under her watchful eye I put the cup to my lips and swallow, chasing the pill with water from a Dixie cup she hands me. She smiles and goes away again. Shortly thereafter, I am aware of a disturbance on the other side of the room; someone has refused to take her meds.

“Come on, Ginny,” the nurse says. “I don’t have time for this.”

“I don’t want to,” the patient says. I recognise her. It is one of my roommates, a frail blonde in her early twenties, about seven months pregnant. “It doesn’t do any good, anyway.”

“We go through this every night. You know you need to take your meds.”

Ginny shakes her head, her lips pressed together in a stubborn line. The nurse sighs and rolls her eyes.

“It’s not too late for me to call Dr. Butler, you know. You wouldn’t like him to revoke your weekend pass. I know how you’ve been looking forward to getting off the ward.”

“You can’t do that!”

The nurse shrugs. “Well, Ginny, if we can’t trust you to do what’s healthy for you here, how can we trust you off the ward?”

Ginny hesitates, the struggle plain on her face. Finally she accepts the cup and swallows the pill.

The nurse beams.

“There! That’s a good girl.”

“Fucking blackmail,” Ginny mutters. The nurse pretends not to hear.

Soon after this I decide I am tired and take myself off to bed. I lie awake a long time wondering what I am doing here. I am still awake when Ginny comes in, crawls under the covers of the bed beside mine, and cries herself to sleep.