I chose twelve high functioning patients for my vocational design classes. It took a few weeks to obtain permissions from the treatment teams. Zandor persuaded members by explaining and clarifying how my classes met clinical goals for each patient.
Most patients were wary. They said ‘yes’ because I offered an opportunity for a unique experience. Initial classes were discussions and planning sessions for future classes. I needed my teams to feel inspired and look forward to their weekly time slots with me.
You’ve met Jesus, Gene, and Benny. Meet David, Jim, and Juan. This was my first session.
David was a die-hard fundamentalist Jew. While shooting cocaine, he and his best friend fought a life and death battle, a drug-crazed rampage, a War of Good and Evil. David was God. His friend, the Devil, lost his life. David’s thick, dense, tough-skinned hands made me imagine what it might be like to get run over by a garbage truck and walk away. A hefty man, David tried to kill himself by tying a noose around his neck and jumping out of a 2nd story window. He survived and had the scars to prove it. David wanted a relationship with me because I was ‘into’ Jewish mysticism.
Jim was the `guy next door’. While high on crack, Jim pushed a stranger in front of a moving train. He died. Jim was tried and legally committed to a forensic psychiatric hospital. Jim was likable, not angry and intimidating like Gene, Benny, and Jesus. He was remorseful for his actions and hoped to serve his time in the best possible ways, hoping 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. A real `brown noser’, he was always sucking up to the biggest assholes. Juan’s crooked pinkie finger dramatically curved inwardly. He secretly wanted and needed to be what everyone else wanted and needed him to be. He was a peacemaker. Most of the staff appreciated his very positive attitude. It was impossible to be pessimistic, sarcastic, or cynical around Juan. He replaced Betsy as manager of the ‘Scene’, where he found his golden opportunity to publish ‘pep talks’ for everyone. Juan’s OCD for enthusiasm was over the top.
We had a tiny 12′ X 12′ space. Two large wire glass windows overlooked razor wire topping the walls of the yard far below. All the windows on the 11th floor had bright unobstructed views of the Styx River and Purgatory. I arranged two 30″ X 60″ tables in the middle of the room to create a square conference table. We could all sit and face each other with our backs to the walls. I wished everyone to look into each other’s eyes as we spoke. I’d look into theirs. As I turned off the overhead fluorescent lighting and closed the door, the sudden unexpected lack of buzzing was obvious as natural daylight streamed through windows and flooded the room.
Our first session was awkward. Patients paused at participating. I peered into their eyes as I prepared to speak. “Thank you for being here. Does anyone have anything to say before we begin?” Labored breathing from chronic cigarette smoking dominated the anticipation and the silence.
“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, but 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 help your prediction become a self-fulfilling prophecy?”
“No. You’ll see. It’s the system. If we actually accomplish anything of value, 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 to 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. Maybe I could be a 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 and celibacy. 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 see 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”, I exclaimed! There’s plenty of daylight and floor space on the south and east facing windows of a mostly empty 11th floor. I’ll inquire whether space can be designated for greenery. We could have a community garden and cultivate our own healthy sources for veggies and herbs which can be shared by all.
“This is so exciting!” exclaimed Juan. “I’ll write a 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 thing good to talk about. 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 other state institutions and businesses, what they’re doing, and who we can network with? I’m hoping to find people who can help us achieve our goals.” “Yes! I’ll do everything I can.”
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 any of what we earn 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 accounts or find ways to ensure that you’re remunerated properly for your efforts.” I hoped I hadn’t just bull-shitted everyone. I had no idea whether what I said was possible. My team of misfits felt like a union of retired vampires, ready for an infusion of fresh young virgin blood. The fragility of creating and maintaining group trust was at stake. At the moment, everyone seemed happy to be there.
You met Betsy, Virginia, and Manuel. Jack was a religious Jew with skull cap on balding scalp. Jack had led a wasted life of habitual shame, guilt, and obligation. He had always cared for his hypochondriac mother who had desperate control issues. When Jack turned sixty, her clutching suffocating neediness drove him over the edge. He threatened to kill and proceeded to strangle her. She narrowly escaped and managed to get him committed. Jack was a whole lot happier in a loony bin than he was with his mother. His plan was to stay put until she died. He told me that even if he was old, he’d use his inheritance to start over fresh.
Everyone believed Ethan was developmentally disabled. He was unable to form intelligible words. No one ever bothered to try to understand him. Meanwhile, Ethan was highly intelligent. When we placed Ethan in the furniture repair program, he was the fastest learner and best natural problem solver. He’d always choose the right piece of wood, screw, finish, or right tool for the job. Ethan was born with a severely cleft pallet that had prevented him from speaking clearly. Can you imagine how frustrating that must have been? Billy and I spoke to Ethan’s treatment team and a speech pathologist was called in. A plan was conceived to provide Ethan with corrective surgery. This was the first real and true step in Ethan’s recovery and rehabilitation.
Dick made Arnold Schwarzenegger look like Peewee Herman (God bless). Dick was a Paul Bunyan, seven feet tall and three hundred fifty pounds of solid muscle. When I first met him in the art room, he was quietly crafting teensy weensy clay sculptures with his huge powerful hands. One typical afternoon, Dick said to me, “I’m going to take this place apart tonight.” I had meant to but forgot to say anything to anyone. The day got away from me. Dick completely slipped my mind. I might have remembered if it had been a full moon. That night, as I peacefully slept, Dick went berserk.
Staff and patients abandoned the ward while Dick trashed the place. He lifted and slammed a heavy regulation sized slate pool table against the wall. He pried fastened furniture away from the floor and walls. When Dick was done 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, where Dick would surely be murdered. He’d hospitalized several guards in full riot gear on his last visit. Dick liked me. I liked him too but was glad he was well medicated.
I needed to learn more about my twelve patients and began exploring and examining psychiatric records in the hospital basement in a dreary poorly lit room of records. I kept my research top secret. I had access, but it would piss patients and staff off to know I was poking around in their histories.
The most shocking discovery I made was that psychiatrists never appeared to argue with or modify the original diagnosis or treatment plan. The proverbial buck was passed over and over again. Some patients got much better over time, but that didn’t seem to matter. I spoke to Zandor. He said, “nobody takes responsibility”. What if you said a patient was well and she murdered someone? It had happened before and would happen again. The same old tired patient stories were told over and over again before forensic review committees. I felt hopeful and sorry at the same time, especially for patients who were really trying to grow, learn, and earn their freedom.
I was positive there was a ‘secret agenda’ to keep mental hospitals full. There were certainly enough crazies ‘crossing 42nd Street’ to fill many wards. I began to research the mental health system while attending conferences in Lilith, the state capital. I began networking with other members of rehab departments in hospitals and sheltered workshops around the state.
‘Vocational Rehabilitation’ was becoming a gigantic unprofitable industry, subsidized by taxpayers. Sheltered workshops were making the same old outdated crap they’d always made. Some were contracted to assemble items such as pens or package products for a variety of private profit-making corporations. Developmentally disabled people are best at repetitive work like assembly and packaging. Rarely is anyone violent. Loving approval goes a long way toward team building. There was a gigantic opportunity here. I had no idea of how to tap into it yet. I knew workshops were competing for pennies. They hadn’t discovered fashion.
Stay tuned as students plant seeds that germinate, sprout, and flourish…