TEMPORARY  INSANITY

      Susan O'Neill 

It was 1970, and I was new: newly returned from Viet Nam, newly civilian, newly married and newly pregnant. I was newly ensconced in my husband’s home town in Western Massachusetts—an expat Midwesterner with no friends of her own.
         I was also a new college student. Paul and I both studied at UMass. He was in graduate school, while I took three yawningly-elementary evening classes.
         As Army vets, we both got GI Bill education benefits. Paul held down two very part-time jobs. Still, money was short.
         I needed a job of my own. I needed it for the money, yes, but also for the camaraderie, the self-esteem, the feeling of contributing to humanity.
         I was not then a real writer, although I tinkered with stories and even published one. I was taking my first shaky steps on a long road that would eventually lead to a Journalism BA and jobs as a reporter.
         In the meantime, I was an RN.
         It was a solid, practical profession. In good times, it guaranteed steady work. Unfortunately, the early ‘70s were not good times for nurses. Jobs were underpaid and scarce. The only real hospital in my new town had no openings, not even in the Operating Room, the specialty I’d earned in the Army.
         And so I walked six blocks down the street, across the Smith college campus, up a hill and into the one institution—literally—that would hire me

*

        I was flattered to be named a charge nurse in the women’s Acute Ward at Northampton State Mental Hospital. At 23, I’d never really been in charge of anything before. This was the bustling, all-important day shift, too.
        Wow.
        I’d studied Psych in my Midwestern nursing school: I’d spent three months working at a private mental hospital, set amid lush, misty hills near Louisville, KY. I’d learned to Listen Therapeutically. I’d crafted Individual Patient Treatment Plans. I’d enjoyed it.
        Some day, as a reporter, I could even write about my experiences at Northampton State.
        Double wow.

*

        My first day, the personnel department gave me an engraved plastic name badge: Susan O’Neill, Day Charge Nurse. They sent me to my new ward for orientation.
        There seemed to be a staff shortage; the only person who could orient me to my ward, and to the 26 patients in its beds, was Mrs. Flaherty, the LPN who would be my assistant. She was a large, florid, middle-aged woman, perpetually short of breath because, she said, she had a “heart condition.”
        Mrs. Flaherty told me that my “acute ward” served women suffering active schizophrenia, mania, depression, alcoholic tremens—anything that qualified as mental illness. It also served women who’d been in the hospital for as long as anybody could remember, who were kept docile by anti-psychotic medications in doses that would stun an elephant.
        She warned that there were always a few “special” patients, sent by nurses on other wards who found them disruptive. Or who didn’t like them.
        Or who, as I later discovered, didn’t like ME.
        I was responsible for everyone on the ward, and everything that happened to them. And, of course, for the huffing, puffing, Mrs. Flaherty.
        “Everything” included: admitting and discharging patients, keeping them clean, fed, medicated, uninjured, and dressed in hospital-issued housedresses. We answered phones, ordered laundry, sat with patients while they smoked (Mrs. Flaherty smoked, so this was her bailiwick). We prepared patients for doctors’ visits, escorted them from the locked ward to the lunchroom, the clinic and, when appropriate, outdoors for strolls. We mopped the floor, changed the linen, checked bedside drawers for contraband food (the 100-year-old building was prone to mice). And I signed off 26 charts before the end of the shift, when I gave report to the evening Charge Nurse.
        It was going to be a challenge to fit in Therapeutic Listening and Individual Patient Care Plans.

*

        We quickly settled into a routine, Mrs. Flahety and I. I’d sit with a patient for about 15 seconds of Therapeutic Listening, then run to answer the phone. I’d pass medications, check to make sure each patient swallowed what I gave her, then lock up the cart and run to answer the phone. I’d change linen with Mrs. Flaherty, then run to answer the phone and leave her to finish the task.
        I ran to answer the phone because Mrs. Flaherty couldn’t run because of her heart condition. Besides, she was smoking with patients or transporting them or mopping the hall.
        The phone rang because of the laundry. It was all about extra-large housedresses.
        Patients institutionalized for a long time became mellow and slow and big. Most of my “acute” patients had been there forever. They wore extra-large housedresses. There were Not Enough extra-large housedresses. Not Enough dwindled to Practically None with every laundry delivery. Perhaps they went to that place that swallows up socks. Certainly, nobody was stealing them, because they were astonishingly ugly—shapeless yards of once-cheery flowers and plaids, faded to a mockery of a mockery.
        So I called the laundry to beg and cajole and, when that failed, called other wards to bargain and swap. I had to be diplomatic. If I alienated a nurse on another ward, she might send me one of her “special” patients.
        This ongoing battle consumed my day.
        I did, however, get a half-hour for lunch.

*

        The first two weeks, I brought lunch and tried to eat it. But there was always something—a patient falling, or terrified because she’d been cornered by a mouse, or attacked by one of those “special” transfers. There were questions. Voices commanding someone to eat the toilet paper. I worked hard to rectify everything, to do it all.
        I nearly starved.
        In truth, the interruption was usually something Mrs. Flaherty could’ve handled. I staggered our lunches so she would be there when I ate.
        Still, the patients came to ME. Because I was the Charge Nurse.
        Mrs. Flaherty, for her half-hour, escorted the more able patients to the cafeteria and ate there. “You should do that,” she said. “It’d get you off the ward. The patients eat together; you sit with other staff, and nobody bugs you. I’ll switch with you Monday.”
        The next Monday, I escorted my patients to the cafeteria while Mrs. Flaherty ate on the ward. I followed everybody through the cafeteria line without incident until we reached the big tub of jello that served as desert. The patient in front of me, a chronic schizophrenic with a zombie lurch betraying too many years of maximum-dose Stelazine, scooped out a handful of jello, dumped it on her plate, wiped her green-smeared fingers on her extra-large housedress, and moved along.
        The next day, I brought lunch, locked myself in the office, and told Mrs. Flaherty to tell the patients I was gone. It felt cruel, but strangely liberating.
        And it worked.

*

        The ward doctor came once a week to review the patients. I called them into the office one-by-one for this important event.
        The doctor was a young woman from the Philippines. She was actually a pediatrician; she needed these hours of state-sanctioned work for her accreditation
.         She insisted I stay with her during interviews. After each patient left, I’d close the door. “Now—what did she say?” she asked each time in heavily-accented English.
        I spoke very, very slowly.

*

        We did occasionally get new patients. One woman checked herself in after a fight with her husband. “He kept yelling at me, ‘You’re crazy. You’re crazy,’” she said. “So I sez, ‘Okay. You think I’m so crazy, okay—I’m gonna go commit myself up to the nuthouse!’”
        After five minutes of watching stoned women lurch around the room in extra-large housedresses, she decided to check herself out. Unfortunately, there was a minimum stay for self-committed patients. She spent it alternately hiding in bed and chain-smoking with Mrs. Flaherty.
        We sometimes got new patients who were truly ill. The teenager who’d flipped out during an acid trip; alcoholics in DTs; the odd bipolar or schizophrenic who really was “acute.” They didn’t stay long, no thanks to my hasty Therapeutic Listening and non-existent Individual Care Plans; the medication flattened them, and they went home to family willing to care for them.
        One affable new patient thought she was Pope John XXIII. She responded well to anti-psychotics. The doctor discharged her after a month.
        The day she left, one of the old chronic patients knelt down at the door. The home-bound Pope held out her hand as she passed, and the supplicant kissed her ring.

*

        I was seven month pregnant when I quit my job.
        It was an icy December. I was big-bellied, cumbersome, and the walk down the street, across Smith’s campus and up the hill had become precarious. I found myself fearful of those “special” patients I’d gained through laundry negotiations. I was tired, tired, tired. I had lost my illusions about Therapeutic Talks and Individual Care Plans.
        I had ample reason to quit. Still, I didn’t.
        Until I met my nemesis.
        She was deposited on the ward an hour before my shift’s end. Pretty, young, dark hair, brown eyes, no firm diagnosis. A drug high, mania, delusions; whatever the case, she would not answer intake questions. She would not unpack her bag. She planted herself on her assigned bed, looking fit and slim in a dress that was far too good for the ward, stiletto boots on her feet, nylon-clad legs crossed, and she cursed us—the patients, Mrs. Flaherty, me.
        I asked her to do something essential, I don’t remember what. Something that required her to move off the bed.
        She called me “a stubborn fucking Irish bitch.”
        Maybe it was the long day, or the hormones, or the fatigue. Or maybe I had been around crazy people so long that I was crazy myself.
        I remember that I grabbed her wrist and pulled her up off the bed. I remember her eyes widening—surprise, then a spark; and I recognized in that instance that she was consciously considering hurting me badly.
        Then she laughed. She shook her hand free and came with me, cursing with every cooperative step.
        I checked her in, handed her a small housedress, signed my charts, gave my report. I walked to the administration building. I wrote out my two-week notice, handed it to the personnel director, and went home.
        I thought, someday when I’m a reporter, I’ll write about my experiences at Northampton State Hospital.

SUSAN O'NEILL is the author of Don’t Mean Nothing: Short Stories of Viet Nam, and has edited Vestal Review (http://vestalreview.net), an ezine/literary journal for “flash fiction,” since it began nearly ten years ago. Her stories and essays have appeared in such varied media professional journals (e.g.: RN Magazine), lit magazines (e.g.: Indiana Review) and Spoken Word sites (http://BoundOff.com). She eventually graduated with that BA and starved for a couple years as a reporter, and is now one step away from living under a bridge in Brooklyn, as a writer. Her more-or-less monthly essays can be found in a Blog linked to the bottom of her website (http://susanoneill.us). She is still technically an RN, but would probably kill somebody—unintentionally . . . although you never know—if she went back to work in the field.

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