4IT AIN’T KING OF HEARTS By Evan Kaeser Drawing by Elsa Warnick My charge of menacing carried seven years of jurisdiction under the Psychiatric Security Review Board. Out one night, I was drunkenly testing my knife’s sharpness on the paint of a car; someone came out of the nearby bar and yelled at me, whereupon I screamed back, “Come any closer and I’ll kill you.” With a previous mental record, I pleaded insanity and was placed at Oregon State Hospital (OSH). Contrary to what some thinkers have suggested, I will always testify, based on seven years experience as a manic-depressive, to the existence of something called insanity. The line between sanity and insanity may be hard to draw at times, but that an unbalanced mood can rapidly escalate into unmanageable psychosis I am sure. Unfortunately for the patient, most mental hospitals are ill-equipped for the job of constructive intervention. Useful treatment is the exception, not the rule. Ward 50E, a ward for the criminally insane at Oregon State Hospital, is a definite improvement over the anarchy that reigns in most state hospitals. At least there is some program structure. My first impression of this ward was positive. Though tightly locked, with surveillance cameras in place, 50E had plants hanging from the white walls and both men and women strolling the halls. A co-ed, medium security ward, one of the few in the nation, this environment was a welcome change from the barren, all-male maximum security ward from which I had been transferred. As I entered the conference room for my first briefing, they scrutinized me. Seated around a table in a tight semicircle was the ward M.D., a recreation therapist, a social worker and my assigned case monitor. I felt on trial again. After a few introductory remarks, the M.D. asked me if I had any questions. I asked about sex. “How far can one go with a patient?” Straightening in moral rectitude, the doctor replied in no uncertain terms: “There is to be no taking advantage of female patients. Any such action will get you shipped back to maximum security.” Feeling I had disturbed a sacred cow, I hastily concluded the session with a goodbye and left the room. My days began around six a.m., when early morning sun lifted me out of a light sleep. I never slept too soundly in the hospital, and felt this was a good sign. I* refused to crawl between my sheets at night, preferring instead to sleep on top of the covers. I never wanted to concede that the hospital was really home, that I was getting to used to my circumstances. It was, at best, a psychological battle. Adjusting to this first hour of the day was difficult, as smoking was prohibited until the night curfew ended at 7 a.m. Fighting these early nicotine cravings, I’d push away at the minutes in my room by plugging into my radio or writing a letter. Elsewhere, the night shift, with it’s glass-enclosed purview of the ward, was usually engrossed in a game of cribbage. At OSH, passing time was as much of a challenge for staff as it was for patients. Tobacco is a very important means of communication and exchange on the ward. Even the few non-smokers among us bought cigarettes, which they used to barter with other patients for laundry chores, typing, mending and other favors. Those with the largest financial resources smoked name-brand cigarettes, “snipes” as we called them. Others, attempting to stretch their meager dollars through the month, smoked generics. The rest, who had only the allotted state monthly allowance of $25 spending money, rolled their own. With $250 in monthly disability payments, I was one of the fortunate ones. The dining hall doubled as the smoking lounge. Matches were prohibited on the ward, and only patients with upper level privileges were allowed lighters. So most of us lit those first smokes of the day on the contraption which looked like an electrical outlet and was the official OSH cigarette lighter. Slugging down a cup of atrocious OSH decaf (caffeine products were also prohibited because, we were often told, they could bring on or worsen a psychotic episode), I’d settle into a dining room chair and watch the other patients filter in, searching for cigarettes. One schizophrenic woman who always held my attention communicated a tough, don’t-mess visage as she single- mindedly pushed her way to the lighter. Looking the part of a hard-bitten hooker, she was crudely and heavily made up and often had a look of disdain on her wig-framed face. After lighting her cigarette, she would find a chair and commence the crosslegged swaying motion with which so many chronics or long time hospital veterans amuse themselves. Seemingly rooted to the spot, the patient rocks slowly in time to the music or some internal rhythm, like a metronome; side to side, over and over again in one continuous motion; sometimes to the sound of one song, sometimes for hours. One day her mother and sister came to visit. They were attractive and well-manicured women, in strong contrast to the image their relative presented. Together they went into the study, sat down at the raunchy house piano, and played. To my astonishment, they played classical pieces with real skill. . . the schizophrenic woman keeping up. Somehow, I had never thought of mental patients playing Beethoven. Cigarettes were followed by medications, which were served up like cocktails four times a day. Patients rushed to be first in line, pushing and shoving in a rare display of horesplay. Medications were very important. “Non-compliance” with the prescribed medication program meant you had little chance of getting out of the hospital. As a veteran of several hospitalizations and the effects of different medications, I gave high marks to the M.D. in charge for his conscientious and sympathetic listening to patients’ complaints about medication side effects. Breakfast followed medications, and a quick perusal of patients in the food line revealed that the most pressing nutritional and physical problem on the ward was obesity. Patients were constantly outgrowing their clothes, as the rolls of institutional fat poured over their belts, stretched and ripped their pants. Even I, always hard pressed to gain a single ounce, put on 25 pounds during my stay. Calories were high, portions were large, and heavy on starch and dairy products. I concluded that patients ate out of boredom. There was little else to do to overcome the haze of torpor that is institutional life. Closely following breakfast, three days a week, patients gathered for the required exercise program. I never worked up a sweat in these rudimentary stretches and arm-leg movements. “This is absurd,” I’d shout out. For patients without upper level privileges, this would be the only exercise they would get. Only the most chronic of the chronics escaped the work detail which followed the exercise session. Floors were mopped, bathrooms cleaned, the laundry room given the once over. Those who tried to dodge these twice-daily chores risked level and privilege reductions. Those progressing up the rungs of the privlege system usually had other jobs as well; serving meals, calling out medications, monitoring the noise level on the ward. Meeting these responsibilities was taken as a sign that you could function in the community at large. Group therapy Started promptly at ten a.m. Group was the most important part of the program. This collection of staff and patients decided your fate in the program, discussing your transgressions against ward policies, your relative social abilities and failings, raking your crimes—past and present— over the coals. Among the criminally insane in my group, all had some history of psychosis Each group member had their personal version and most were schizophrenic. One member was a small town cracker-hippie that had ever seen a black until he arrived at the state pen on a firearms charge in his teens. While at the pen he had fallen I refused, to crawl between my sheets at night, preferring instead to sleep on top of the covers. I never wanted to concede that the hospital was really home, that I was getting too used to my circumstances. under the influence of some fascist cons and taken to Third Reich, white power politics. Though I hated his politics, I said little, as he was big and when incited made death threats to the staff and patients who got in his way. Another member was the only black man on the ward. The father of two kids, this seemingly gentle man had kidnapped his kids and forced his wife to have sex in a rage of jealousy and stress. A Jehovah’s Witness, the man disavowed 36 Clinton St. Quarterly
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