Mental
by Mikael Covey
Denny’s a big round man, loud, aggressive; bushy sideburns. “Been masturbating so much, my dick hurts. Think I got a sore on it, on the side here.” Starts to take his pants down, show me. What the hell…“No, don’t do that, okay” I tell him.
“But you gotta see this.” He insists, thumbs stuck in his underwear. Think quickly “no, really. That’s…you need to show that to the doctor.” “Why?” “Well…it’s a medical thing.
The doctor can evaluate it; see if he needs to give you something. Medicine or… salve or whatever. Anyway, it’s not something I handle, okay.”
My first patient, ever. Disappointed now, let down, you can see that. Exciting news he wants to share with me, show and tell; and I won’t play. Man, what kind of help am I offering him. Sits down, doesn’t wanna sit down. Wants to show me what’s on his mind or on his penis. But I don’t budge. Finally he buttons his pants up and sits.
Pulls the collar up on his old blue jean jacket “makes me look like Elvis, dontcha think?”
“Yeah, a little.” Damn, hard to make that stretch. What can I say, this intake screening is as tough on me as it is on him. Backwards almost, like I’m the patient and he’s the case worker. We struggle through, filling out forms, answering questions, or some of them anyway. Then he leaves.
I gotta have a smoke. Go outside, figure out what I got myself into. They hired me to clean up this mess. The program’s in disarray. Disarray? Suspended by the state director.
Yeah, that’s disarray alright. Brand new program, case management for mental patients. But they got no case plans, no progress notes, nothing. I gotta fix that. Straighten things up.
“I can’t believe you went behind my back.” Winsted’s the boss, he built this place from nothing. “I built this place from nothing.” Started with just him and an assistant. “When there were only two of us.” He’s board-certified and highly respected. “I’m a board-certified psychologist…highly regarded in my field.”
Yeah Winstead, and I used work for the feds,in the prison system. If you wanted answers, you called Washington.Want to know why that ‘gun’ mentioned in the convict’s file wasn’t part of the offense,you call the US Attorney,get it from the horse’s mouth.
Now this little dweeb’s all bent out of shape ‘cause I called the state office, trying to find out how they want our program to be run.How I’m gonna make it work right.
Later get a chance to drop in on the doc, in between patients. “What’s up with Marv Denman” I ask him. “Denny?” Looks up at me and smiles, calmly, graciously. “He’s a crazy nutsy looney bird.”
Okay, that explains it. I like Dr. Ladeen, so cheery and pleasant all the time, like he’s high on Zoloft or something. Figure I’ll just write that in my progress notes.
Conference with attending physician - discussed nature of patient’s illness. Bill the state for that.
Doctor doesn’t remember me though. And why would he? I worked with him twenty years ago, as an orderly on the psych ward. Many jobs ago, many different places;moved away, finally came back here. He was the staff psychiatrist, on crutches then, not the wheelchair. A gruff serious guy, not all smiley, kindly old white-haired grandfather like he is now.
I assisted him one time back then, with an electro-shock treatment; Sidney Shot-with-two-Arrows. Cool guy, had two little round scars on his chest. Probably from a lit cigarette; but it went well with his name. Sid wanted to forget. Nice enough young guy but had been a drag queen out in San Francisco. Wanted to forget everything.
Lying there on the table, out from anesthesia. Dr Ladeen puts the metal collar around Sidney’s head, then zaps him.Body convulses up off the table.
I’m shocked just from watching it.The anesthetist does CPR to revive him. Flying on the EST, Dr Ladeen called it.Scary shit, in my opinion.
Didn’t work though. Couple a days later, Sidney’s alert and conscious, all bummed out.
Still remembers everything. I remember too, like it was yesterday. But a million miles away for Dr. Ladeen now. Seen so many people come and go over the years. No reason to remember me, some young kid with a pony tail back then; now middle-aged, suit and briefcase.
But I still got the touch. Always had a way with people. Like Howard Lowe, big tough guy, dark hair, dark brooding eyes. Never smiles, doesn’t know how. Been a biker out in California, a meat packer in Iowa, farm worker in Oklahoma. All of that, years ago. Now he’s broken, broken completely. Afraid to go outside, afraid of people, or of being with them. Talks so softly, barely above a whisper. Have to strain to catch the words.
Have to meet with him once a week, month after month before he’ll tell me anything or even volunteer something, not just one-word answers to my questions. Paranoid schizophrenics are so wary, so leery of people. Scared to death of ‘em. Even Denny, all bluster and loud talk, wants to be the bull goose looney, like Kesey’s character ‘Randall McMurphy.’ But inside he’s scared to death.
Tells me his foot hurts, his toe, because some guy stepped on it in the bar. Peckerhead Pete, the town drunk. Not even as big as Denny. But Denny didn’t do anything. Just let the guy grind his foot down on his toe. Tells me Pete once raped a friend his, Ron, out in the alley behind the bar. Interesting news. Ron is also a patient of mine. They all know each other. Pretty much all they got.
Quiet sad little people, even when they’re trying not to be. Howard Lowe, after all these months, finally gets to trust me a little. Confides in me about things that happened in his life. “One time a guy came to my house with a gun” he says.
“He’d been sleeping with my wife. Wanted to take her away with him.” “Damn Howard, what’d you do?” “I shot him. Had my gun ready when he walked in.” “Didn’t you get in trouble for that?” “Nah…judge threw the case out. Called it self defense.”
Good story. Don’t know if it’s true or not. Don’t know if Howard knows if it’s true or not. But you hear a lot of stuff like that. I see his cat, or his sister’s cat, I guess. He lives with her now, out here in this big old house in this tiny little village, thirty miles from where I work. I go all over, all over three counties to do these home visits. See how folks are doing.
“Nice cat” I say, watching it peek around the corner from the kitchen. “I used to kill them” says Howard. “Catch ‘em and cut ‘em open.” “How come?” “See if the FBI had ‘em wired, to spy on me. See if they’re any wires inside.”
I like Howard. He’s so quiet, courteous. Wants to be friendly, doesn’t know how. Wish I could do something for him. His file has some stuff in it - locked in the cellar when he was kid. His aunt…was the ‘key keeper.’ Or maybe he just saw that in a movie, I don’t know. Never talks about it. Hardly talks at all. Denny talks a blue streak. I got forty patients on my caseload, but he’s my favorite.
Go to his place once a week, sometimes twice. Lives in a one-room slum apartment, owned by a rich old lawyer. Rich guys own all these slum apartment buildings. Big old junky houses, made into little cramped apartments. Half of ‘em are rented by my patients. Denny’s place is a wreck. Beer cans everywhere. Filthy little kitchen stacked with dirty dishes. I sit down in the broken-down old easy chair. Hope he’s spilled beer in it. Hope it’s not something else.
Denny’s lying in bed. “How you supposed know if it’s two o’clock in the morning, or in the afternoon?” Poor guy, got nobody. No friends, just other patients he knows from all the years they spent together in the state hospital. His folks live halfway across the state. Come down here every four or five months. Clean up his apartment, wash the dishes, stuff like that.
I try to get him to do that for himself. That’s the kinda stuff that’s on his case plan.
Denny’s older than I am, middle-aged, and this is what his life has been. Got nobody, just me. More fun for us to sit around and play guitar, sing songs. He’s got two guitars and I got him to get some strings for the other one, so we can play together. He likes the Beatles, and Elvis. “People tell me I look like Elvis” he says. “Yeah, I can see that” I tell him.
September 5th, 2007 at 11:16 pm
Good stuff.
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