I chose twelve high functioning patients for my prevocational design classes. It took a few weeks to obtain permissions from the treatment teams. Zandor persuaded them by clarifying how my classes met clinical goals for each patient. The patients were wary, but said ‘yes’ because I was offering an interesting opportunity for a unique experience.
Initial classes were discussions and planning sessions for future classes. I needed my teams to feel inspired and looking forward to their weekly time slots with me. You’ve met Jesus, Gene, and Benny. Meet David, Jim, and Juan. This is my first session.
David was a fundamentalist Jew. He’d been heavily shooting cocaine when he and his best friend fought a life and death battle in a drug-crazed rampage. In the War between Good and Evil, David was God and his friend was the Devil. David’s friend lost. David’s thick, dense, tough skinned hands made me imagine him getting run over by a garbage truck and walking away. It was true. David tried to kill himself by tying a noose around his neck and jumping out of a window. He had the scars to prove it. David nurtured my friendship because I was into Jewish mysticism.
Jim was the `guy next door’. Obliterated on crack, Jim pushed a stranger in front of a moving train. The man died and Jim was committed to a forensic psychiatric ward. Jim was likeable. He didn’t threaten or intimidate like Gene, Benny, and Jesus. He was remorseful for his actions and hoped to serve his time in the best ways. Jim wanted to be a useful member of society one day. There were three leaders and three followers. Jim, David, and Juan had no desire to lead.
Juan was resident Pollyanna. An obvious `brown noser’, he was always sucking up to the biggest assholes. Juan’s pinkie finger dramatically curved inwardly. He wanted to please everyone. The staff appreciated his attitude, but Juan’s ‘Enthusiasm OCD’ was over the top. No one could be pessimistic, sarcastic, or cynical around him. Juan replaced Betsy as manager of the ‘Scene’, the patient newspaper. It was a golden opportunity to publish ‘pep talks’.
We had a compact 12′ X 12′ space. Two large wire glass windows overlooked the Styx River facing Purgatory. All the windows on the 11th floor had unobstructed views. I arranged two 30″ X 60″ tables to create a square conference table to sit around. I wanted everyone to be able to look at each other while we spoke. As I turned off the overhead fluorescent lighting and closed the door, the lack of buzzing became obvious as natural daylight flooded the room.
Our first session was awkward. Patients patiently paused as I peered directly into each of their eyes and prepared to speak. “Thank you for being here. Does anyone have anything to say before we begin?” Labored breathing from chronic cigarette smoking disconcerted me. “Gene, what would you like to get out of the time we’ll be spending together each week?”
“No offense, Mark. I’m curious to see how you’re going to fail. You’re a nice guy with good intentions. No one has ever created anything meaningful here. At the moment, you’ve got energy and enthusiasm. People come and go. Eventually, you’ll get discouraged or be fired and have to leave. We’ll never hear from you again.”
“Are you planning to make your prediction a self-fulfilling prophecy?”
“No. You’ll see. It’s the system. If we do anything important, the cabinet will create a new policy to inhibit or prohibit whatever it is.”
“Leave those problems to me. When they arise, we’ll discuss them together and decide what to do about them. I’ve promised I will give you my best. That’s what I have to offer. If you have something more important to do with your time, you should do that”.
“What would you like to get out of this class, Jim?”
“I’m glad for an opportunity to do anything. I want to make things and work with my hands. I want to go into the building trades when I get out of this place. Maybe I could be a general contractor.”
“I’ll do my best to help you achieve your goals, Jim”.
“What about you, David?”
“I agreed to come here, but I don’t want to do anything. I’ve never really done anything. I had a sixth grade education, but I study Torah. When I get out of here, I’m going to find a trailer in the woods and live in solitude. I could maybe have a garden and grow some good pot to smoke and study Jewish mysticism.”
“OK David, I won’t force you to do anything you don’t want to do. When you’re ready, we welcome your participation in whatever way you deem fit.”
Jesus spoke up. “I love gardening. I’m responsible for the care and maintenance of the patient garden in the yard. David, you can help us with planting this spring. We’ll have tomatoes, beans, carrots, and lettuce this year.” David nodded affirmatively.
I thanked Jesus for his offer, “Maybe we can get permission to have an indoor garden for the off season. There’s plenty of daylight and floor space on this building’s southern and eastern sides. I’ll inquire whether space can be designated for greenery. “This is so exciting!” exclaimed Juan. “I can write a monthly column about our class in the ‘Scene’”
“That’s a wonderful idea Juan, but I think we should keep a low profile until we have some momentum. Negative publicity could be destructive to our cause. Let’s achieve something of value before going public. Can you put your communications skills to work by researching other projects and networking with people who can help us?” “Yes!”
The last member was Benny. “Is there anything you’d like to say, Benny?”
“I don’t know what I want… I want to make some money. I doubt we’ll ever see a fraction of what we’re worth and we won’t see that until we’re free.”
“I have no idea how money works around here. I’ll find out. I will say this. There are many ways and means to an end. If we create something substantial, I’ll do my best to arrange escrow bank accounts or find ways to ensure that you’re remunerated properly for your efforts.” I hoped I hadn’t just bull-shitted everyone because I had no idea whether what I said was possible. Our team looked like a reunion of retired vampires having an infusion of fresh young virgin blood. Everyone seemed happy to be there.
You’ve met Betsy, Virginia, and Manuel. Jack was a religious Jew with skull cap on his balding head. Jack had lived a wasted life in habitual shame, guilt, and obligation while caring for a hypochondriac mother with desperate control issues. When Jack turned sixty, his mother’s clutching neediness drove him over the edge. He threatened to kill and then proceeded to strangle her. She narrowly escaped and managed to get him committed. Jack was a whole lot happier in the looney bin than he was with his mother. Jack planned to stay put until she died. He said he’d use his inheritance to start over.
Ethan was developmentally disabled, unable to form understandable words. Seemed like no one ever bothered to try to understand him. Can you imagine how frustrating that must have been for Ethan? Billy and I realized he was highly intelligent when we placed Ethan in the furniture repair program. He was a fast learner and great natural problem solver. He’d choose the perfect piece of wood, screw, finish, or hand tool for the job. Billy and I spoke to Ethan’s treatment team. We learned that Ethan had a severely cleft pallet that prevented him from speaking clearly. A speech pathologist was called in and a plan was conceived to provide Ethan with corrective surgery. This was the first real step in his recovery and rehabilitation.
Last and not least, was Dick. Dick made Arnold look like Peewee. He must have been seven feet tall and three hundred fifty pounds of solid muscle. I met him in the art room as he silently crafted tiny clay sculptures with his huge practical hands. One day, Dick said to me, “I’m going to take this place apart tonight.” I meant to tell someone, but the day got away from me. Dick completely slipped my mind. That night, as I peacefully slept, Dick went berserk. Staff and patients abandoned the ward while Dick trashed the place. He picked up and slammed regulation sized slate top pool tables against the wall. When Dick finished wrecking the ward, he fell asleep. Hospital security crept in, medicated him, and put him in a strait jacket. The cabinet wanted to send him back to Criminal Island, but Dick would be murdered there. He’d hospitalized several guards in full riot gear on his first visit to Criminal. Dick liked me. I was glad he was medicated.
I needed to learn more about my twelve patients and began examining their psychiatric records. I kept my research top secret because it would piss off patients and staff if they knew I was poking around. My most shocking discovery was that psychiatrists never seemed to argue with the original diagnosis or treatment plan. The proverbial buck was passed over and over again. Out of concern, I spoke with Zandor. He told me that nobody would take responsibility. What if you declared a patient better and then she murdered someone? It had happened and would happen again. Patient stories were told and not heard, over and over again, before forensic review committees. I felt sorry for the patients who were really growing, learning, and trying to earn their freedom.
I wondered whether there was a secret agenda to keep mental hospitals full. There were more than enough crazies crossing 42nd Street in Purgatory to fill many wards. I began to research the mental health system by attending conferences in Lilith, the state capital, and networking with rehab departments in hospitals and sheltered workshops around the state. ‘Vocational Rehabilitation’ was a gigantic industry, mostly unprofitable, and subsidized by taxpayers. Sheltered workshops were making the same old outdated crap they’d always made. Many had been contracted to assemble items such as pens or package products for a variety of private profit making corporations. There was a huge opportunity here, but I had no real idea of how to tap into it yet.
Stay tuned as my students plant seeds that begin to sprout and flourish…