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"Ramblings on the Psych Ward"

Room 110:  Seeing this patient for the first time, I greet him with: “Good morning, Joseph, what brought you into the hospital”?

 “Doc, my name is ‘Big Joe’, that’s what everyone calls me.”

“OK, Big Joe, I got it; thanks.”


Room 111:  Sarah tells me her mother hates her and so she feels so rejected that she cuts her arms and her thighs. 

 I ask her what her talents are.  Her eyes light up, for a second.


 Room 112:  “Thirty years ago I found myself in an elevator with Stevie Wonder, you know, that famous blind singer.  Well, he stepped on my foot as we were getting out.  He said he was sorry but he did it on purpose.  He’s not really blind, I know it.”


 Room 113:  “Doctor Guterson, there’s this new patient who says I should call him ‘Big Joe’.  What should I do?”

 “Call him ‘Big Joe’.”


 Room 114:  As I walk in, Rebecca is sitting by her bed, her hands folded, praying.  She turns and looks at me and says she’s been asking the Lord for peace in the world.   

 “That’s beautiful, Rebecca. I wish more people would pray.  Thank you.”


Room 115:  “All I wanted was to fly to England to visit the Queen and Ralph The Bunny but my therapist said I’m acting manic and told me to come into the hospital.

I’m telling you - the Queen is going to be SO DISAPPOINTED when I don’t show up, and I’M NOT MANIC!”


Room 116:  “Why did I try to kill myself, doctor?   Well, you see, I’ve been trying to make peace with those poets who write about the beauty of life, but then Shakespeare says this whole stage we’re in is a big nothing.  Sound and fury; sound and fury.  I mean, there’s falsities, falsities everywhere! Surely you know that, doctor, don’t you?   

 It’s all unanswerable.

 So why go on?”


Room 117:   As I open this patient’s door, Jim lunges at me, connects his fist with my nose, and then is immediately stopped by two psych techs.  A fight breaks out.  I yell to the nurses who give him a shot of Haldol and Ativan and, as Jim continues to be violent, we place him in restraints…


 A few minutes pass and, with lots of emotions flowing on the ward, I gather all the patients together in the meeting room.

As I’m holding a towel with blood dripping from my nose, I assure them that I am fine, that all is under control and safe.


Another day in paradise!


 (P.S. - please know that I have “only” been hit three times in my 28 years working in a psychiatric hospital.)

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Fifty two year old Micky D was walking and weaving into traffic along the Pennsylvania Turnpike.  When he told the police that he was heading to Philadelphia (250 miles away) to his girlfriend, they committed him to my psychiatric hospital.


“Let me go, doctor, let me go!”, Micky pleaded with me,  “I don’t mean no harm. I just wanted to see Laura and I didn’t have money for a bus.”


It turned out that Micky fell in love with Laura back in his freshman year at Penn State.

“How long did you date her?”, I asked him.

“Oh, doctor, we never dated….we actually never talked….but, doc, the way she looked at me, I’ll never forget.  She loves me.”


Tragically, near the beginning of his freshman year, Micky’s life fell apart.  He started hearing voices and then believed that he had special powers to read others’ minds.  He stopped washing his hair and brushing his teeth. He lost contact with his friends and fell behind in college, ultimately dropping out.  Micky was hospitalized and diagnosed with Schizophrenia .  

But he never forgot Laura.  She became embedded in his memory, his passion, his life.  Forever.


Every couple years since, Micky would venture from his Schizophrenic group home and trek eastward.  His destination was “somewhere in Philadelphia“ where he was certain Laura would be waiting for him.


Micky’s records indicated that no medication had ever helped his psychotic symptoms nor was there any treatment that could quell his devotion to Laura:  “She wants to marry me, doctor, please let me go.”……..

And then, wouldn’t you know it, Micky asked me to join with him to sing a famous oldie:

“Tell Laura, I love her…!”


…One year later, long after his discharge from the hospital, I heard that Micky had died, died from cancer.  I cried that day.  But I also smiled, recalling Micky and his singing with so much heart and affection.


As the years have passed, I think about Micky from time to time - his trek, his long journey not only to Philadelphia, a destination never realized, but also his journey through life.  Micky was all alone in the world, his family having abandoned him years earlier when he fell ill.  And so he carried Laura inside of him, forever.  She became his life’s mission.  He never let go of her, and in his own way, he found purpose and connection.


Life is paradox.  


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Room 101:  Gus, a former heroin addict, is in an intense manic episode. He’s hyper, with pressured speech, screaming out his mantra: “Give me Adderall!, give me Adderall!”.


I try telling him about Lithium, the gold standard medication for mania.   He responds, “F… you, doctor, I don’t take shit.” 



Room 102:  Lisa’s arms are all bandaged due to self injury.  She said that she is so upset that she will hang herself.  (I assign a female staff person to stay with her.)



Room 103:  Feces are noted, on the wall.


Fred says: “I couldn’t wait….please, doc, discharge me.”



Room 104:  Julie says I must get her out of the hospital  immediately or else her boyfriend will be coming to the hospital with a rifle to shoot everyone. (We warn the security guards and the police.)



Room 105: Bill tells me that he’s a reincarnation of Abraham Lincoln.



Room 106:  Fifty year old Sharon looks directly at me, smiles and says: “I pray for you every day, Dr. Guterson.”



Room 107:  Tommy asserts:  “Chess is like life and I’m a champ.  When that guy beat me, I knew he was cheating.  He denied it so I beat the crap out of him.  Am I sorry?  I don’t know.”



Room 108:  Ruth is disheveled and malodorous, oblivious to her appearance:


“Your nurses here are so nice.  I made a picture for them.”



Room 109:  Tony, who previously had served five years in the state penitentiary, asks me: “Doc, what are those strings hanging down from your pants?”   


Me: “They’re called tzitzits. They are considered a holy garment and Jewish men wear them in order to encloth themselves with something holy.”


Tony:  “Wow!  That’s the coolest thing I’ve ever heard.  Where can I get a pair?”




Yes, another day, another day of ramblings on the psych ward…



Each of these persons, rooms 101 to 109, are not simply patients.  They are human beings, souls who are in pain. 


And pain can express itself in all sorts of ways.



Look closely and you will see that every one of them craves connection . 



Just like us.

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