I'm feeling worn-out today. I think part of it is that I spent from 0915 AM to 1400 doing nothing at all but reading my textbook (two and a half chapters!) and playing on a computer which I snuck onto when someone didn't log out. No patients at all. And then three in a row - a work-release who needed his meds, a kid who was threatening suicide because he didn't want to go home and get beaten (with the belt end of a buckle), and a woman who's completely manic.
Compare with yesterday, in which a paranoid schizophrenic got unruly and threatening down at the jail, and was brought in. Ask a question, get a novel. Ask another, get another. Rambling, circumstantial thoughts in which each person was identified by race, gender, and position. "A black female police officer. A hispanic male waiter. The caucasian female judge." Sometimes, he'd throw in a name. We couldn't get much of a story out of him, but he said he wasn't taking his meds at one point, and we believed him.
Then staff came over. Then staff said "There aren't any psych beds."
Oh, he says, suddenly no longer rambling. Then I need a meal and to go back to the jail. I'm taking my meds as prescribed, I'm not a danger to myself or others.
We got all the way out of the Emergency Room before we broke down in laughter. "Think he's been through the system?" Dr. B says to me.
Seventeen days to go, O Best Beloved. I want to tell you my stories, but I am spending my days in an environment without structure, where I am responsible for checking the front office to see if there is a chart there, and then watching the clinicians to make sure they don't go see all the patients without me. I have no structure, nothing I am supposed to do on a regular basis, no guidelines for how to spend my free time. I am going mad with it. I pace the office, I read my text, I sneak onto the computers. I play Solitaire on Taika.
This not-knowing exhausts me, because I must work so hard to keep from going through everything in the office, organizing it, reading it. I prowl into offices. I sit on the couch. I do not fidget, although I spin back and forth when I am in a spinning chair. I do not want to fidget and distract everyone. And it is wearing on me already. This is only the third day.
Today I left the hospital at 1745. I began driving and switched off the radio, sitting with top down and window open. I made an impromptu decision to go looking for a photo place to get a picture taken so I can send off the second copy of my Step II letter stuff. And as I was driving, I said nothing, there being nothing to say. And then I walked into the mall, and as I walked through the mall the realization grew in me that I had said nothing for nearly half an hour, and it was accompanied by the sudden conviction that I should not speak.
I knew that I could, but I could not force myself to open my mouth without a meaningful stimulus. The woman in LS Ayres who said "Hello, cutie," only got a nod and a faint smile; I felt myself fading away, out of sync and out of step. The mirror reflections of me were suddenly so strange and distorted that I could not look at them for fear of falling down in a stupor, like Sleeping Beauty with her fatal spindle. I would not speak. I had forgotten how to make lips and tongue and tracheal musculature coordinate with the soft whisper of my breath.
I walked the halls of the mall, attempting to discern what sort of thing had ratcheted my lips shut. I could chew, could swallow, but my lips would not part and my tongue was an alien thing in my mouth. And I found myself in front of a broken photography booth; I had counted on the force of a genuine smile to pry my recalcitrant features into shape - but it was not to be. I tried to say "Oh, well," but there was insufficient need; my tongue shaped the rounded syllables within the midnight cavity of my mouth for no end.
I kept walking, and I found myself at a first a photo studio - which I bypassed without entering - and then a one-hour photo shop. I walked in, I looked around, I searched for a sign that would indicate that they took photographs of the type I was seeking. Nothing. I almost left again, without speaking, without a word, but I was hailed by a young, shaggy-haired blond camera boy who asked what I wanted.
"Do..you take passport photos here?" The words were soft, but they had both phonation and vocalization to them. I felt a mental twang as the delusion that had captivated me was broken. There was no pain, no sudden roaring flame, no danger to speech. It was gone, passed completely, as suddenly and as utterly as it had begun. It was 1845.
The people who took passport photos were not there. He looked to see when they would be back, but I did not hear the answer; as the ability to speek waxed so did the strangeness taking over me. I have not looked at myself in a mirror since I went into the mall, and I am a bit afraid to, still. I cannot shake the feeling that I am not completely in sync again.
You see, O Best Beloved, this has all happened before.
I went to the store and bought sushi, ate in the parking lot. I felt better. But now there is the ghost of pain on the right side of my head, and I begin to wonder if this is not all prodromal to a migraine I have not earned and do not deserve. In any case, I am drained of my energy by watching our manic patient, and I cannot find the words to bring her to life for you, though she is alive in my mind - a pretty but puppetlike creature of words and thoughts and expansive dreams and motions. She understood the choice between "voluntary commitment" and "emergency detention" and chose to go voluntarily, but it was a reluctant volunteerism, requiring Security to keep an eye on her. I got to do the physical exam. She talked the whole time.
She smoked in the bathroom; I could smell it on her. It was almost preferable to the damp, musty, hamster-bedding scent that seemed to hang in the air around her.
What is wrong, that in virtually every woman who'd ever had anorexia and took a particular mood-stabilizing medication - regardless of clinical state - generalized seizures developed? I wish I could see into the most intimate connections of her mind and find the strange and twisting pathways that taught her to believe she had to melt forks in the oven to cleanse her body of plastic residues.