Positive, Negative

He deep inhales

(passion rising),

runs hands through

lank greasy hair,

says

I want shower-sex with you.

Malodorous,

rank

with rancid sweat

and piss-dried jeans

he sits amongst

the squalor

of discarded takeaways

and beer cans;

fag ends flicked

from fingers

stained

with nicotine;

receives messages

from aliens

on dead mobile phones;

hears voices

in his head

torment

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, 

reinforces

the (professional) need for

d i s t a n c e

before she goes.

Stripped down

to his boxer shorts,

hurt,

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!