Wednesday, 30 May 2012

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!

Friday, 25 May 2012

Blue

It is months since I thought
of decorating the hall
and I guess the stairs
and the landing too,
but when I attempt
to picture the finished wall
I always picture you instead
lain nestled in that empty bed.

The bed an empty tribute
(of a kind) to you,
the room a shrine,
your Rhapsody in Blue,
I never liked that you know,
you knew. 

Glissando  or portamento
I never really gave a fig –
that I ate today (well four)
with Weetabix, milk
and fromage frais,
But it’s important!,
you would say
as if it mattered
in the great big scale of things.   

I got weighed today
and knew I
would not want to know,
why is it that
my mind gets smaller
while my body grows? 
Middle aged spread
she kindly said
as I slipped back on
my cool alligator shoes
(that I wore when we danced
and you sang the blues).

I have the wallpaper
that will cover the cracks –
God I love you so
and I  want you back   
Tomorrow
 I will paste it, lay it
and paint it blue
(the colour I feel
when I think of you).

Anna :o]

Written for dVerse, the challenge being to write a Stream-of-Consciousness poem thus:

Choose a topic. You might think of a person, and activity or even a dream. Take a walk, go someplace public, and let your thoughts take flight.
Write with pen or pencil on paper. Draw pictures. You may even choose to use your writing journal to jot down your own little (schizophrenic) episodes.
When you write in your journal, be different. Write with your non-dominant hand, write all over the page, not just in lines, write from bottom to top. Write in spirals or shapes. Forget grammar and syntax.
Review your writing for any connection you can discover between words and phrases and see where your poem will take you.
Put your work aside for a while before returning to it.

Cheers dVerse!

Monday, 21 May 2012

Fool


The Circus With the Yellow Clown,
1967, Marc Chagall

See you;
heart goes into overdrive,
somersaults,
thump, thump, thumps,
wants to get out.

I gave it to you,
it beats for you,
gave you all of me,
I exist for you.

You took it,
took all of me,
messed me up,
made a fool of me.

Carnivalesque;

grotesque fool
now wise,
hell now heaven,
now it's me, me, me,

want your heart,
will cut it out.

Who knows what lies behind the clowns’ happy/sad face?  We all wear our masks and do not need to apply face paint to become a fool or indeed anything else…

With thanks to Tess at Magpie Tales for the inspiration.

Anna :o]

Friday, 18 May 2012

Wednesday, 9 May 2012

Male Elderly Long Stay

Use it or lose it
has no place here. 
What better than
to restrain (by indifference)
in chairs upholstered
in the ghosts of those long dead. 

There is no stimulation here;
they sit in regimental rows,
row on row on row,
like some old soldiers
waiting for their final orders,
or some waiting room,
waiting for a doctor
who never shows.

This reinforced apathy
brings atrophy, weakens limbs. 
A fleeting insight
brings panic,
he rises, knees buckle;
he free falls, hits terra firma
with an almighty thud.

This morning
there is only two of us,
short staffing brings many risks. 
Who knows how many
signs and symptoms missed
as we hurriedly stuff thirty men
into waiting clothes,
stack them in the waiting rows,
stuff them full of
cereals and toast. 
(Well as many as we can,
for at 8.30 – finished or not
the breakfast trolley goes.)

They need time,
there is no place for it here. 

There are the wanderers of course
who will not conform;
who wander on their eternal journey
to God knows where.

There is a new admission;
he still has fight in him.
It will not last. 
Soon he will become like them,
his remaining memories
will leach into the chairs.

They need compassion,
there is no place for it here.

As a student nurse, my first ward placement was on female elderly long stay.  I must admit I was na├»ve – I had this silly notion that my days would be spent sharing tea and sticky buns with confused little old ladies, enjoying their muddled conversations and listening as they reminisced about the good old days.  How wrong I was.

My first shift was that of a morning, there were two qualified staff, a care assistant and two students (including me and we supposedly supernumery) and we had forty patients to assist to rise – that is eight patients each.  We students had no idea who could weightbear, who was mobile, who was aggressive and so on, but this seemed to only bother us and we had to get on with it.

It took me well over an hour to wash and dress and seat my little ladies in their chairs – in fact they did not have their chairs – anyone was good enough.   I was totally exhausted and perspiration was dripping off my forehead.  I remember thinking ‘What the hell am I doing here?  Is this really what I want to do?’ as I realised my silly notion was indeed that – silly.

The majority of the ladies had dementia and were either admitted from the great outside or were ‘long stay’ patients who had spent much of their life in the hospital and had succumbed to dementia as they aged.  A couple were long stay patients who had not demented but reached the ripe old age of sixty and had been transferred as that is how things worked.  They were floor pacers – like caged lions bored out of their minds – both with ‘acquired’ OCD – their rituals their only means of escape from the eternal ennui of ward life.

All the ladies – bar the two floor pacers - were sat row on row on row, there was no stimulation whatsoever – no radio, no record player, no television, not a thing.  Any new admission that rose from her seat was told to sit down and soon learnt that that was her lot and after a few days did just that – sat (and died inside).

My fellow student and me attempted to converse with our patients – but lack of stimulation had had devastating effects – rarely were words spilt from their mouths – they existed in body only.

Male elderly long stay was my fifth placement and it was very much the same bar a few wanderers - not pacers, most of whom were demented and had held onto remnants of their personality.

I saw an awful thing there – it was not direct abuse but that of sheer and utter thoughtlessness, a manifestation of the warder-inmate mentality that still very much prevailed there, and it reinforced my vow to myself that once qualified I would never work in a psychiatric hospital – this vow I had made on female elderly and it is a vow I kept.

Anna :o]

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