Psychiatric institutions have a long and colored history. There are some dark narratives. There are, as well, pockets of more hopeful times. One of those is known as the moral treatment era, circa 1790 through 1890.
I don’t believe my time on the inpatient wards is known by any particular descriptor. I do know that I found my way into fortuitous circumstances; skilled physicians, devoted nurses, and supportive administrations. During the better part of 40 years, I came to discover that there is a delicate dividing line between who stands on which side of the nurse’s station. I came to understand that we are all in search of the same thing. We want to be seen and heard. We want it to have it reflected back to us that ‘we exist’ and that we matter. Ideally, we need to see and be seen as through the eyes of Christ.
Many thanks to the clinicians, friends, and patients that I was privileged to know during those decades. Our bonds cannot be broken nor our memories and opportunities taken from us.
The crosses that He sends us, He has considered with His all-knowing eyes, understood with His loving mind, tested with His wise justice, and warmed with His loving arms…to see that they be not one inch too large or one ounce too heavy for us. Our trials are blessed by His Holy Name and perfumed with His consolation…an alms of the all merciful love of God. Excerpt from a prayer by St. Francis DeSales
It looked more like an upscale ski lodge than a psychiatric ward. Light entered from nine channels. Cast shadows played on the walls, rotating images like a carousel slide projector dependent on the sun’s position. Light hearted chatter issued from hallways, settling into a soft buzz as it reached the nursing station. Patients gathered for breaks between therapy sessions. They napped, rocked, and sought distraction from the voices. For the moment, they were safe and sheltered.
Multiple hallways led to patient rooms and offices, while two served as portals to dining areas. Administrative offices, occupational therapy, and classrooms were past the main cafeteria. The concierge desk, otherwise known as the nurse’s station, was centrally located inside the ward entrance.
Attached to this was a well-fortified medication room with a small sliding glass window. It was not uncommon for the nursing staff to shimmy through this window when medication keys had been inadvertently locked on the inside. Comedy gold.
The shining star of this premier inpatient psychiatric facility was, without doubt, its therapeutic ridiculousity. That is to say, perpetual humor reigned as a pinnacle healing tool. Along with it, a magnanimous regard of staff for patients, and their return of that esteem.
The tall, strategically located nurse’s station allowed a coteries of staff and patients to gather on their respective sides, in both social and therapeutic conversation. This hub also served as the understood symbolic fine line, separating the two groups, though hesitatingly.
There were private spaces for sensitive matters, yet ward dynamics ordained this space as the unit’s heart and soul. The place “where everybody knows your name”.
At this lax border, between the worlds of insanity and somewhat sane, two evening shift nurses casually discussed assignments. The four-pm sun emptied its warmth onto them from skylights overhead. It was an atmosphere of easiness, and all was well.
The shift-change report indicated that a 17-year-old male patient had eloped. In other words, he left without saying “goodbye”. Although secured, the ward was not locked. With moderately dense woods to west, this was the traditional elopement course. Flight protocol had been initiated by the day shift. Security, city police, and doctors were en route, and a phone call placed to the minor’s guardian.
As the first nurse began her departure for rounds, she noticed her cohort lingered. Postured with elbows on the high desk and chin supported by a palm, her gaze was fixed skyward. She stood motionless, wide-eyed, and pale. Others instinctively tracked her gaze.
Some 30 feet overhead, the absconded 17-year-old was sprawled across a skylight. He lay prone in the form of a cross, seeming content with his view of life below.
Emergency personnel arrived and a swiftly assembled rooftop crew set into action. The fire department’s telescoping ladders prepared access to a steeply pitched roof-line. They were first up, followed by security, police, and physicians. A male orderly, having developed good rapport with the young patient, completed the rescue team. Within moments he engaged the boy in relaxed conversation and effortlessly directed a return to ground level.
One quarter hour after ladders had been raised, all staff and patients, including the boy, were once again gathered around the nurse’s station. Other than a necktie left on the roof by an attending physician, there had been no harm or loss.
The shift continued its ordinary course and took its place among many recollections of a time when some of life’s most disenfranchised soul-journers had been able to find rest, hope, and even laughter.
St. Louis Martin and St. Dymphna, pray for us.
Where does your deep joy meet the world’s deep need?