Wednesday, 30 May 2012

Positive, Negative

He deep inhales
(passion rising),
runs hands through
lank greasy hair,
I want shower-sex with you.

with rancid sweat
and piss-dried jeans
he sits amongst
the squalor
of discarded takeaways
and beer cans;
fag ends flicked
from fingers
with nicotine;
receives messages
from aliens
on dead mobile phones;
hears voices
in his head
in condemning tones,
tell him
he is he is a f***ing
waste of space,
a f***ing pile of shit,
tell him to kill himself,
that he’d be better dead.

She doesn’t want to,
but wants to
for the good in her
knows that if any
poor damaged soul
needs love and shower-sex
its him,
but remembering her role
says Sorry No, 
the (professional) need for
d i s t a n c e
before she goes.

Stripped down
to his boxer shorts,
he watches her from the door,
the voices begin to ridicule,
tell him he’s a f***ing t**t
a f***ing fool to believe
that f***ing whore
would want sex with him –
a f***ing heap of shit.
He returns to his room,
lights up a spliff and sits -

just sits…

The above words are an odd kind of tribute to someone, ‘Dave’ say, who I had the privilege to meet in my nursing student days.  (Believe me the bad language accurately depicts his experience and is perhaps even quite tame.)

My student days were those of enlightenment, actually talking to and also hugging patients was actively encouraged; patients had become ‘clients’ and their individual rights were paramount (oddly this only appeared to apply in acute settings) and wisely, we students upon meeting a patient for the first time, were advised only to familiarise ourselves with the presenting problem and not that of the full history, lest our judgement be coloured and our treatment of the patient thus become sullied.  (We should read the history later after developing a rapport.)

As a tactile sort of soul, hugging was fine by me and indeed patients welcomed this strange new closeness, this friendliness, the chatting and this new strange thing where students appeared actually interested in them as people and not as an illness.

I was on an acute ward placement when I met Dave, he, sectioned in his best interests, suffered with refractory schizophrenia, the onset of his schizophrenia presenting in his early-teens causing gross personality damage as the illness progressed, savagely took hold.  Despite this, he was happy with himself as he had no insight into how his illness had affected him and indeed how his illness and damaged personality impacted on others.  To himself he was a likeable fellow.

Dave became one of ‘my’ three patients whose care I had to focus on to meet the requirements and learning goals of my placement there.  I found him likeable – despite initial nervousness of his social and sexual disinhibitions.

He was treated abominably by qualified staff and indeed (in my humble opinion) by the docs as he was judged and thus treated on his presenting personality –the fact this damage was caused by his illness did not seem to enter into things.

Despite all his problems his one and only Care Plan was that of addressing his body odour and it was my task to tackle this sensitive issue with the intended goal that Dave will attend to his personal hygiene.  (Why is BO such a difficult thing for us to address – why can we talk with relative ease of so much more complex issues and not this?)  (More importantly – why was this his only care plan?)

Possibly because I was the only person – whether it be staff or fellow patients – that gave time to Dave, he fell in love with me.  This was my first encounter with transference/counter transference and I like to think I handled it well, professionally if you like and our rapport continued without this unwanted (to me) obstacle.  (It did strike me at the time that of all the patients in the hospital that desperately needed to be needed, needed a hug – it was Dave, but I could not do this as I knew he would misread it.)

After qualifying I met Dave again as he was an occasional visitor to one of our female residents (with whom he had fallen in love and who did not want his attentions) in the hostel where I worked.  It is a pity that we eventually had to bar him.

It was while working at this hostel I became involved as a ‘friend’ of the  Hearing Voices Network and through this I began to understand more about living with schizophrenia.  I learnt of the horrors of auditory hallucinations.

A colleague and I began to hold our own Hearing Voices Experience Workshops for our colleagues throughout the hostels/organisation country wide.  At this time I also mentored SW and nursing students who were placed in our hostel and they too attended these workshops and learnt from it.

Our approach was quite simple in that my colleague and I sat at each side of our victim and began to insult a running conversation into their ears – the remarks for the most part being abusive, negative, foul and derogatory – for this is often the everyday experience for some/many of those with schizophrenia.

I can recall one male social work student being reduced to tears for some of the comments we made had per chance hit home in that they echoed his own self-doubts.  However he was grateful for the experience as he felt it left him more equipped to work with those he would come across when qualified, as he now knew, understood.

For any docs and nurses out there who might read this – I recommend, even urge you have a Hearing Voices Experience amongst yourselves and then you too will know will understand your patient more. 

Later I met Dave again – I had commenced working at a drop-in centre which I then discovered he attended.  My new manager had remarked “Oh you’re Anna; Dave talked about you when he came out of hospital as you were kind to him.”  I must admit that this made me feel good as making a difference was the given remit for RMNs when I did my training.

Unfortunately Dave misread my reasons for working there in that he thought I was there as I realised that indeed I did love him after all.  This delusion was quite fixed and after a few months I left – for to me moving to another job was less damaging than the possibility that Dave might be barred (for his unwanted attention) from a place in which he found solace and so much needed.

A few years later I learned that Dave had become much more damaged, was sectioned often as his illness aggressively progressed to the point where even he couldn’t cope with it.  He had commited suicide.

Dave is not the only patient I remember from my student days.  I might write about why I remember them someday.  I never did work in a hospital after qualifying as some aspects of ‘patient care’ left me feeling dirty…

Anna :o] 

Entered at Open Link Night at dVerse Poets Pub – thanks dVerse!


Brian Miller said...

i feel sad for did handle it have to draw those lines pretty clearly because it can become more than compulsion for them...and it keeps setting them up too for those condemning voices as well telling him how bad he is...a very real verse today...nice...after teh opening i wasnt sure where this was going but i was pleasantly surprised...

Jenny Woolf said...

I was saddened by this story. I find mental illness very frightening, perhaps because it is NOT understood and the consequences can be so distressing. From experience of a relative and a friend with mental illness, it seems to me that the treatment is pretty poor. I have concluded it is because it is poorly understood medically and hence it is a poor relation of the medical services.

ME said...

You commited perfection, again.

This poem reminds me of freedom only some homeless people experience and of purity society is trying to superimpose on them. Interesting essay on purity by Mark Titchner, a_b_s_o_l_u_t_e_l_y brilliant guy, 'You can never be too pure' can be found in 'Why And Why Not'.

I say that only freedom gives you purity (freedom is excluded from mental illnesses; purity even more so - society is deaf-blind to improving, or improvement in mental illness). And yes, I still think that m.i. should be seen by others as any other illness.

For you Anna, Titchner may definetly be the guy to read, he's got the answers to your questions about feeling dirty and about love, this 'rusty old blade' and its usfulness in fighting off death.

Anonymous said...

This is a beautiful tribute to such a sad story. Thank you for posting it.


Claudia said...

dang...that's a moving story anna..not easy to handle this and you made some wise decisions along the way..

Leo said...

But for the explanation, which saddened me heavily, I'd have imagined it a totally different way. You have a gift, and I'm glad to have come by this poem.

Alex Dissing said...

Powerful, powerful stuff. You made the right decision - by setting a boundary and by posting this poem. There's a lot to learn in those lines... thank you for sharing this with us.


ayala said...

Sad, honest and powerful write!

Mama Zen said...

Wow. The Hearing Voices Experience is absolutely fascinating. One of the more difficult patients (for me) that I ever worked with was autistic / schizophrenic with sexual disinhibition. Those are some tough boundaries to maintain.

Semaphore said...

Wow, that is an amazing story, and your poem is an perhaps-too-clear Polaroid of both the outward experience and the interior monologues plaguing the man.

joanna said...

wow. powerful stuff. thanks for sharing your experience with us.

gay ok said...

LOL for 3 last comments.

Laurie Kolp said...

Well you really caught my attention with shower sex and I wasn't sure where this was going, but after reading your notes I can truly say this is heart-wrenching... and you are a wonderful, caring person.

Dave King said...

Like Jenny, I found this story ultimately sad. At first I was horrified by the technique used, but then my own professional training kicked in and I thought I saw where it was coming from. Like Jenny, too, I can find mental disturbance frightening, for it is often of unknown aetiology, however we might like to dress it up as otherwise. Your poem, though, reminded me how so often art can reach the spots not open to the priest or doctor. Well crafted.

Anonymous said...

Whoa, very powerful very very sad poem. K.

Luke Prater said...

great to see this blogged... remember it from the board well. Fantastic and slightly disturbing piece

hyperCRYPTICal said...

Thanks for your welcome comments folks.

Jenny, Dave: mental illness is poorly understood by those who do not suffer it for it makes us uncomfortable as we don’t know how to deal with the emotions it brings. It is true that mental health is the poor relation (probably worldwide) in funding and treatment and support is thus often not optimal. It is also true that some who work in mental health are in the wrong job as it appears they view mental illness as a crime deserving of punishment…

Dave re your ‘horror’ of the technique used – are you referring to the Hearing Voices Experience? Participation was totally voluntary and two minutes or so was a profound learning experience for those who took part, leading to understanding the torment often suffered on a daily basis by those suffering from schizophrenia. It does open your eyes…

Thanks again for your comments folks.

Anna :o]

Heaven said...

I really enjoyed your poem and your backgrounder story. It made me appreciate your work and what you have done to ease his "sickness" and loneliness. An eye-opener for me ~ Thanks ~

Steve E said...

Like I know, we each have numerous stories, and you relate yours well, Anna :0] And Dave certainly has his, real or not.

You must know how much I (we) admire peeps as you, who have and show true empathy, and help to make a different in someone others (one or many) lives.

For, if not to be of help wherever I am, what am I doing, living, eating, breathing?

Gonna take a shower now-no sex-grin!

Dr Erhumu - twitter@drerhumu said...

Reading this piece, my mind goes back to the film "The Beautiful mind", though his case was much more positive than Dave's. You did well in the handling of his delicate mind, you should have no regrets.

Dave King said...

Sorry to be so tardy coming back to you. Yes, I was referring to the hearing voices technique, but did not intend it as a criticism of your method, only my personal reaction to it - which is why I wrote "then my professional training kicked in". I should have made it clearer

kaykuala said...

An eye opener on life's the other side, Anna! Not many have experienced the frustrations on dealings with the mentally challenged. We couldn't be sure what worked for whom. It took special persons to be able to do so. Your verse is indicative of the caring individual you are! Great write!


Olivia said...

Hats off to you...

for remembering Dave still!
caring enough to write about him!
making us know his story!

I knew there was more to just wanting to sex up, and did you do an awesome at that?

hugs xoxo

Paul Andrew Russell said...

A lovely post, Anna.

I knew someone who loved and lived with a partner who suffered from a mental illness.

She is a wonderfully, kind and compassionate person who took all that on because she loved him. I wish I was half as kind and loving as her. Some people are just special.

Cathy said...

I've met someone like Dave, though not in a professional context. You've captured it very well.

Muhammad Israr said...

i was beginning to wonder wht happend to your language :) none the less a beautiful tribute :)

hyperCRYPTICal said...

Thanks for these welcome comments my friends - much appreciated.

Anna :o]

Stafford Ray said...

Every 'caring' profession needs a writer like you who sees problems clearly and is brave enough to explore them.
Now, re the shower sex poem.
Of course you could not 'oblige'. To do so is unthinkable but as one of the lucky ones, who is ageing with all functions working, I wonder if people from the next generation (who will become our carers) realise that we are still sexual beings, probably as interested as they are, and do not see it as their duty to block opportunities for its appropriate expression.
In the story of Dave, it appears from your comments on his 'falling in love' at the hostel that you do understand their needs but also understand how distressing unwanted attention can be and the need for the carer to intervene where and when appropriate.
I well remember Ruth Cracknell (Aussie actor, then in her seventies) in an interview, replying to questions about ageing.
Question: Do you still enjoy sex?
Answer: Yes, but I do not have a partner, unfortunately!
Note: One of her most endearing roles was in the TV series Mother and Son, a comedy where she played the mother, who was in dementia and Garry McDonald played Arthur, her long suffering son and carer. It was funny and did educate people on how dementia can effect their loved ones. While we laughed at her twisted logic and her manipulations to keep Arthur away from 'other women' who might lure him away from her, we came to understand her fear of being abandoned. It would now not pass the political correctness test!

Sreeja said...

No words to say hw I felt while reading this...I personally know somebody with this illness..and how hard it is for them to tackle life...but they are really very religious and is tackling it fine I think...where man is helpless..God can act...