her arm to lift Helen to her feet. “Come on, Helen, let’s go back to your room and get another dress. You really did a number on this one!”
Helen looked down at her naked breasts and pubic area, which seemed to bring her back to the present. She pulled the two buttonless sides of her dress together in an attempt to cover herself, and turned toward her room with Tom’s help. She was silent now, head hung down, eyes fixed on the floor. It was as if her outburst of anger had drained all the life from her body and she had no reserve left. Still staring at the floor, she walked with Tom back through her open door with no resistance or further hostility.
“You all go on down to the nurses’ station,” Tom called over his shoulder. “I’ll be there in just a little bit.” With that, her door closed and the hall was strangely silent once again.
Within fifteen minutes or so, Tom had rejoined Kathryn and company at the desk. “Sorry about that, kids. Wasn’t the introduction I had planned for you, but hey, life is what it is. That’s why I like working here—you never know what’s coming at you next!” he grinned at the students’ obvious discomfort. “It’s not always like that,” he added reassuringly. “Just sometimes. And when it hits, you had better know what to do to diffuse the situation and protect yourself from harm. As a rule, these people don’t mean to hurt you, but they can, and will, if you’re in the way or you inadvertently antagonize them. Just remember, they’re all a bit lacking in self-control, which makes their world a bit more dramatic than yours.” He smiled again, knowing that this was probably a morning these students would not soon forget.
“Anyway, back to what I had originally planned to tell you, this is a twenty-bed acute psych unit, and now I think you have a pretty good idea what I mean by ACUTE! We have about fourteen patients at the moment and two other staff besides myself—another RN and an orderly. When the unit has more patients, we generally add a third RN. To your right here is the activity area, where patients can sit, relax, and read or watch a little TV. We do some group counseling here, and have a couple of private rooms for individual or family counseling. There is a psychiatric resident assigned to our unit, as well as a couple of clinical psychologists. Our average length of stay here is one to two weeks, and then the patients are referred to more appropriate long-term treatment environments. Some go home, some to other institutions, and some to jail. We do our best to stabilize them and develop a treatment plan to be implemented in whatever environment is appropriate. Patients have no personal belongings here and no access to most items that could be used to harm themselves or others. Occasionally they get creative, as you just witnessed.”
As Tom was speaking, Gin leaned over, smiled, and whispered to Kathryn, “This place kind of reminded me of home there for a minute. That girl Helen acted a lot like my sister Margie. I can vaguely remember her tossing a chair in my direction back when we were about eight. Not quite the same language, though!”
“Well, Ms. Morrison,” Kathryn whispered, “you should be used to keeping on your toes and covering your backside, then! I suspect you will do well here. Maybe even pick up some new vocabulary that might come in handy elsewhere,” she winked back at Gin.
As Tom was finishing his One-Minute Orientation, he added, “Right now most of our patients are in a group counseling session over there in the far corner of the activity area.” He pointed over to a group of about eleven patients and a mixture of staff who seemed to be having an animated discussion among themselves. “There are a couple of patients not in that group, though, that you all might find interesting. LaShon, the young black male sitting to your left by the wall with his head down, hasn’t said a word in the five days he’s been with us. He is only sixteen and was unfortunate enough to watch his father blow his mother all over their dining room wall with a shotgun before turning the gun on himself and decorating the opposite wall. A neighbor heard gunshots and called 911. When the officers arrived, they found LaShon sitting in the corner, looking pretty much like he is now. The absolute horror of that scene was more than he could cope with, and he’s been catatonic ever since. He shows no signs of emotion or even recognition of voices. Really sad.”
“Well, what can you do for him, then?” queried Arthur, the token male student, who still seemed a bit unnerved from the previous incident with Helen. “How long will he stay like that?” he asked, hoping for a more positive response.
“Hard to say,” Tom replied. “We don’t see this severe of a post-traumatic reaction all that often. Most of the ones I have seen generally snap out of it in a couple of weeks, IF they’re in a safe environment. At first, maybe just a flicker of recognition, then more as they begin to process what has happened to them and where they are. Cortisol-lowering meds can help to diminish the stress response. It’s very unpredictable, though. I’ve heard of people never coming out of it. Sometimes, the younger the patient, the more pronounced the reaction. Probably fewer life traumas at those ages and less coping ability.”
Tom glanced to his right over to the other patient not presently in the group—a thin and rather scruffy-looking midthirtyish man, with his feet propped up in a chair, watching Wheel of Fortune. “That’s Frank—he’s a regular here…alcohol, drugs, sex, pimping, petty theft, and a whole arsenal of totally bizarre behavior, which frequently gets him a paid vacation in Hotel Happy Times. Usually he lands on the medical floor first for a bit of detox and drying out before he makes it up to us. I think this is about his fourth visit in the three years I’ve been here. Just a menace to society that nobody can figure out how to redirect. He’s very disruptive in groups, just a big cut-up, which is why we do one-on-one with him. This time we’re running some biochemical and neurotransmitter profiles. Last admission we did a brain speed analysis on him, which was just amazing. His brain is smokin’ fast, about like a coke addict, which I guess was no surprise, although he’d been in for a couple of weeks, which should have cleared most of that stuff out. Could have been residual, I guess, but for my money, I think he’s naturally like that, and much of his behavior is just misdirected attempts to maintain that level of brain activity. If he’s still around next week, when your training formally starts, maybe Kathryn will assign a couple of you to Frank—should make for some interesting class discussions! Anyway, before you go, let’s walk on over there and I’ll give you a taste of Mr. Scumby. Can you believe that name?” With that, Tom headed over to the TV, with a rather-impish smile on his face. “Hey, Frank, got some company for you!”
“Hmmm,” Frank responded rather pensively while glancing over his shoulder at the approaching group. “Mother hen, her chicks, and one ugly duckling—no offense, pal,” he smirked, glancing in Arthur’s direction. “Can’t blame you, though, dude. Probably some good pussy in this group. Hey, who’s the redhead with the big tits? I’ll bet I could bang her right here in front of this wide-screen!”
“You’d lose,” Gin snapped back, fairly certain that he was referring to her. “Better stick to Vanna, cowboy. I’m sure she’s more your type.”
“Oou, this girl’s bedside manner rocks!” Frank continued with obvious sarcasm. “Maybe the old lady here can give you a few pointers on therapeutic responses. That tough talk probably gets your pussy wet, though, dudn’t it, baby?”
Gin turned, stared Frank squarely in the eye, and hissed, “In your dreams, you pervert!” She would have said a lot more, but a sharp tug on her arm aborted her attack.
“Ms. Morrison,” Kathryn whispered, “you’re out of control, and he’s manipulating you. Responding like this is just adding fuel to the fire. I can see this rotation will be quite a learning experience for you.” Then turning to Frank, Kathryn smiled and said, “Thank you so much, Mr. Scumby, for that delightful dialogue. It’s truly been a pleasure, and we hope to be seeing you again very soon. I’ll be taking my little chicks back to the henhouse now, so goodbye sir.”
Before Frank could respond, Kathryn had herded her students away and toward the doors with
