Shortly after graduating college with a psych degree, I got a job working at a mental hospital. The place looked like an asylum from a scary movie. The facility was 200 hundred years old, with gothic architecture composed of dark brick. The main hall even had a small museum with relics from the past, like cribs with locks on them and newspaper clippings from the 1920’s touting Insulin Shock Therapy as the latest cutting edge in treatment. The inside of the place was always hot, no matter the outside temperature. Every inch of the place, the rooms, halls and offices, close smelled of disinfectant, mildew and body odor.
Most of the patients were not dangerous, in fact most of them were very pleasant and friendly. But it’s still good to be cautious because sometimes close quarters and an unfriendly environment can make people do things they would not normally do.
Despite being relatively new, I was assigned to conduct daily interviews with certain patients. The interviews were done one-on-one in a small private room down the hall from the common room. The room had a two way mirror so security of patients and staff could be unobtrusively monitored. I was never sure if there was anyone was ever on the other side of the mirror, but I felt better thinking there was.
The interview procedure was simple. I got a patient from the common room and brought them to the private room to be interviewed. I had a sheet paper with questions to ask. I wrote down the patient’s response with a felt tip pen, then sent the patient back to the common and handed the interview paper into the nurses’ station. I was only to ask the questions on form. I was not to say anything else or engage in any type of conversation. There was even a reminder at the top of the paper not to deviate from what was written.
You would think the procedure was simple. Step 1) Ask the questions; Step 2) Write down answers; Step 3) Don’t say about anything else. I had been told that over and over by the supervising doctor. He had stressed the procedure for a very specific reason. I wasn’t given the reason; that apparently wasn’t important. Just ask the questions, write down the answers, and move onto the next patient. The procedure was simple enough even a neophyte like myself should have been able to handle it.
I screwed it up.
The first few dozen times everything went fine. I asked questions; wrote down answers; the patients didn’t say much else, and I knew the procedure.
Then during one interview I asked the question, “Did anyone visit you yesterday?” Until now, everyone had just said no. But today, a patient, we’ll call him Joey, said, “Yes.” Joey seemed to be in his 40’s, but one thing I’d noticed is that everyone in the facility, even the employees, all looked much older than their actual age. Joey may have been in his 20s for all I knew.
There was a follow-up question on the paper, “If so, who?”
“My Mama,” Joey replied.
“That must have been nice.” That wasn’t on the paper. But I had said it, a polite conversation reflex, without thinking.
Joey’s face morphed from peaceful to angry. At what I assume was the full volume of his voice he screamed, “It wasn’t, I hate that bitch. She comes in here and touches me and has sex with the doctors.” This tirade of the filthy acts his mother had committed while visiting continued for what seemed like hours. I thought the screaming would alert someone, a team of ninjas with anti-psychotics and sedatives hopefully for both of us, perhaps. But no one came into the room. A screaming patient in a mental hospital doesn’t cause the alarm you think it would.
I sat there; looking around; helpless. Having gone off script once and having it blow up in my face made me leery say something else. My instincts told me I should talk to him, try to calmly reassure and sooth him. There had to be some combination words that would miraculously shut this down. I tried to think through every class and experience I’d had, but nothing was coming to mind. I must have skipped magic calming words day.
The top of the interview paper said reiterated, “Don’t say anything not listed here.” Based on what was happening, that seemed like good advice.
After what seemed like a very long time, Joey paused from screaming about his mother her sexual relations with the doctors, patients, nurses, guards and their pets, long enough for me to ask the next question. “What is your goal for today?” My ears were ringing so badly I couldn’t hear myself ask the question.
As though the last few minutes had never happened, Joey says, “To stay calm.” I was amazed he still had a voice after screaming for so many hours.
I wrote this down and look at what’s next on the paper. “Thank you. You can return to the common room.”
Joey left the room.
What the hell just happened? I laid my head on the table for a moment; my heart was beating at a speed I didn’t know it could achieve while sitting still. I knew I needed to get the next patient, but I needed a moment to decompress.
“His mother’s been dead since he was five,” a voice at the door said. The doctor entered the room and closed the door. “That outburst was only about a minute, he’s had them last for hours. He’s loud but so far he’s never been physically aggressive.”
My first thought was, Apparently somebody had been behind the mirror.
My second thought was, How the hell had that only been a minute?
Feeling embarrassed and unprofessional, I sat up straight and tried to compose myself. The doctor, seeming to understand my current state, dismissed my concerns with a wave of his hand.
“The reason we ask the question about visitors is to assess for psychotic episodes. I’d say Joey had one. But we also don’t ask follow-up questions to avoid what just happened.”
I wanted to make a witty, or at least compelling response, but all I managed was, “Sorry.”
“It happens,” the doctor replied. “But the important thing is you stayed calm, at least outwardly and didn’t make the situation worse. There aren’t too many people that can do that, my colleagues included. I hope you plan on being here for a while.”
I absolutely did not plan on being here longer than I had to. Though the doctor’s words made me feel better and gave me confidence, I knew this was a place I didn’t want to be for very long.