After six to eight working days, I’d met most of the patients. There were five men’s wards and one women’s ward. The wards traveled around the hospital escorted by SHTA’s. One, two, or three wards at a time would meet in the rehab department for recreational/religious services. Many patients found religion while incarcerated. Evangelists, fundamentalists, and self-styled ministers attended every service, along with agnostics, atheists, and heretics. I counted four Jewish patients in the mix. Jewish services were most ludicrous of all. Patients of every shape, size, color, and religious denomination wore yarmulkes (skullcaps) and pretended to chant pigeon Hebrew. For attending religious services, patients received extra rewards such as cigarettes, tea bags, and candy. They also hoped to earn a few brownie points with God and the Forensic Committee when they came up for evaluation.

The next several months were both enlightening and frustrating. It was obvious I needed more clinical training specific to a forensic population. I reached from the Rehab department to make allies on the treatment teams and in the cabinet. Unfortunately, protocol and position are guidelines in public service. If you go directly to someone outside of your department on your own initiative, it can be misconstrued as a breach of faith or as a failure on the part of your supervisor to control her staff. Employees generate truckloads of surplus paperwork and ask permission for everything in writing. Dolores was reprimanded. I felt dejected.

My initial impression of patients was that they were generally dull and apathetic, motivated by bribery or extortion. Cigarettes (nicotine), candy (sugar), tea bags (caffeine), and little packets of Sanka rewarded good behaviors. I believed they were ultimately harmful and destructive. Extortion was punishment for bad behaviors. Having no rewards, no activities, temporary isolation, or mandatory drug treatments is really `Pavlov 101′ in practice.

There were two types of patients. Nearly all had committed acts of violence. Some were there for psychiatric evaluation. Others were assigned for long term care by the court system because they were unfit to stand trial or too mentally and emotionally disturbed to be in a normal prison setting. There were several mass murderers and serial killers. You’d never know it as they appeared meek, apathetic, and ordinary. As they grew to trust me, they revealed hopes, dreams, fears, and tales of intrigue and horror.

I was steadily earning the trust and respect of the rehab staff. I’d read Dolores’s hands. Within a month, I was asked by other staff members to share my insights and observations about them. The rehab staff was caring and well meaning. I observed unhealthy doses of neurosis combined with fear, paranoia, and overdeveloped senses of responsibility, obligation, and guilt. Public service feels thankless and hopeless to many of the staff. I tried to be constructive, helpful, and leave everyone feeling hopeful.

I suggested to Dolores that she practice saying “NO”. I advised Zandor not to react negatively to criticism, even if it’s personal. I nagged Billy (Skinny) to lighten up and see reality as it is and not how he wants it to be. I encouraged Luscious Lips to let go of his guilt, cultivate good habits (like controlling his indulgences), and begin to schedule activities to look forward to in his life. I applauded Barbara’s ability to maintain clear boundaries and thanked her for her honesty with herself and everyone else. I cheered Maya’s energy and enthusiasm. I let her know I supported whatever she wanted for herself. I wanted Janice to clearly see and express herself creatively.

My reputation as a hand analyst spread quickly. Soon, I was in the hospital director’s office reading her hands. Dr. Helga presented a caring and friendly demeanor, but after examining her hands for a couple of minutes, I was positive it was an act. She had the stiffest hands and fingers I’d ever felt, inwardly curving pinkie fingers, and a clear simian line in her dominant hand. Knotty fingers and long index fingers were well suited for a detail-oriented directorship. Helga’s father had been a German SS or gestapo who ran a Nazi concentration camp during World War II. There was no place for emotion in Helga’s formative years. She was calculating, ambitious, and couldn’t tolerate disobedience. She ordered me to never discuss what I saw with anyone and told me in no uncertain terms to stay away from patient hands. I gained insight into the cabinet by reading several members directly and by carefully listening and observing body language at meetings and in casual exchanges without permission.

It took six months to learn the ropes while generating and accumulating huge masses of paperwork and proposals. I was ready to present my syllabus for prevocational classes to the cabinet when the hand of fate unexpectedly intervened. A quirky thing happened. Dolores accidentally caught Janice, the art therapist, in the art supply closet with her skirt up around her ears. She was dispensing her own personal form of emotional and physical therapy to one of the male patients. Janice was fired instantly.

Janice had self-destructed. I’d lucked out. There was no art therapist. I was the only staff member qualified to fill in until another was hired. I knew about art. I didn’t know the first thing about art therapy or forensic psychology. That didn’t seem to faze anybody. I was thrilled to put everything aside to be the new substitute art therapist. I’d finally get to meet patients. Nearly all the patients frequented the art room. It was a chance to play with art materials and express themselves creatively. They could sculpt with clay, draw and paint, make collages, write poetry, and play music. I’d examine their hands, astrology, and experiment with tarot on them. This was an important lesson in human nature and my nature that I’ll never forget.

The art room was small and private (14’X 14′). I was happy about that because in addition to having the potential for intimacy, I was required to inventory every pencil, crayon, scissor, and even staple. These were all considered potentially dangerous weapons. Everything in Rehab was either bolted down or fastened together with special screws and nuts that required special tools to unfasten. Every precaution was taken to protect us from patients and patients from each other and themselves.

One very crazy patient who seriously creeped me out was James. After James’s mother would visit him, staff would find him mutilating his genitals with a paperclip, staple, or whatever he could find that caused damage. James eventually died of AIDS after repeatedly letting other male patients have their way with him sexually. I stayed away from James’s hands, but I do remember ugly brown tobacco stains between the tips of his index and middle fingers from letting cigarettes burn to ash without taking a puff.

I was cautious around patients. I tried to be helpful. I spoke little except when spoken to. I’d sometimes sketch patients. They saw me drawing and sculpting and began asking for artistic advice. I happily provided tips and tricks. It took over six months to locate a new art therapist. During this time, I’d meet a dozen patients who would influence my destiny.

Stay tuned to meet the patients…

Author’s note: If you’ve read the first episode of ‘How I lost my Sanity’, you know my writing is a combo of fact and fiction. Using the same voice as my non-fiction writing may create some confusion. I break rules of grammar and syntax. A generous helping of political and social incorrectness sheds darkness on my protagonist. Made up names and characters from movies parody and give faces to characters in my story. If you have any thoughts, ideas, feelings, suggestions, advice, or whatever about my writing and story, feel free to comment.