Psychiatry was, far and away, my favorite clinical rotation. It lasted for three months, and my patients were housed in the county hospital. This was when I learned that the “Psych Floor” is always on, or near, the top floor, though I have never been sure if this geography is dictated by distance from the front doors, and possible escape, or more a part of an “out of sight, out of mind” mentality.
I was jealous of other students garnering more glamorous assignments; a shelter for troubled children, a drug rehabilitation center, or a home away from home, inhabited by alcoholic men whose families had swallowed the last straw. But, that was before I realized that the Psychiatric Floor of a hospital is very much like an urban emergency room; you never know what you’re going to get, but you can be sure it will be exciting, and if you can shove your fear aside long enough, there is much to learn.
Following an orientation overseen by a frumpy, 30-something man named Mark, who favored once-expensive, over-sized sweaters, and Levi’s, over desert boots, I met with several patients whose grasp on reality was apparently restored by an overnight stay.
And, then I met Tess. Tess was a hard-timer, painfully familiar to staff and patients alike, thanks to her frequent admissions, and long stays. I learned, during morning rounds, that she suffered from schizophrenia, and, despite my training, I entered the hallway, leading to her room, with visions of Sally Field, as “Sybil”, dancing in my head.
The door wheezed as I muscled it open.
“Good morning!” This was the beginning of a verbal assault, suggested by my professor, intended to ground us both with the reality of time. I would go on.
“It’s Monday, February 17th. The sun is out, but the wind is cold!” The words were spoken loudly, with a forced gaiety I now recognize in other nurses, and earned no response.
My eyes rested, for just a moment, on the centerpiece of all hospital rooms. The bed was vacant. She sat next to the window, affording me a view of her long, brown hair, and slender shoulders, covered by a red shirt, putting me in mind of a union suit. I could have stared for as long as I liked. She was oblivious.
As I approached, I strained for a glimpse at what she was watching until, reaching her, I realized I could never see what captivated her. Her eyes were lightless.
I entered her room in this manner for three days to the same response. On day four, the wheeze of the door was barely noticeable above the sound of her mumblings. She stood, just inside the closet door, wearing a mask of complete anxiety. Her eyes, no longer lifeless, danced frenetically inside her head, lighting upon mine just long enough to reignite her terror, before jumping back into the closet.
That she felt she had lost something was apparent. I attempted to talk with her; to discover what she sought. My overtures agitated physically, sparking flailing arms, and a twisting, spittle-producing mouth that quieted mine.
I watched, helplessly, for several minutes, before mutely joining her search. Within minutes, the mumbling ceased and determined focus reshaped her features. She shadowed me, mimicking my movements. Her eyes softened, retaining their light. The corners of her mouth relaxed, and for a moment, I imagined what she might have been like; what “normal” could have been for her.
Our search failed. I left her that day feeling impotent, rattled, and very, very sad. The minute’s vision I’d held of the promise her mother must have seen, long ago, affected me. The fleeting irony of human life was spelled out, succinctly, in language I could understand, before the image, like her eyes, went dark.