"Grandpa"

Kelly, a 25 year old patient in the psychiatric hospital, walks by me and yells “old man!”

Thirty minutes later she walks by me again and yells, “grandpa!”

And then, a little later, as she passes me, she yells “Jew!”

The truth of the matter is that she is correct. At age 68, I guess someone might say I’m old, especially with my shining white beard. And, yes, I am blessed to be a grandpa. And proud to be Jewish.

The cool thing about working in a psychiatric hospital is that barbs like this get cast my way every day. In contrast, threats of violence happen two or three times a week. And legal threats about once a week. I don’t ask for these, but admittedly I do get constant practice in self control, in keeping calm no matter what is thrown my way.

I’ve also learned that emotional pain, like Kelly’s, expresses itself in different ways. Sometimes you have to look beyond the barbs and the threats to find it.

It Starts With An Apology

Every other day in the psychiatric hospital someone swears at me and/or threatens me. What’s intriguing is what can happen the next day:

“Dr. Guterson, I’m sorry about yesterday. It’s just that I’m so angry about being here.” “Hey Jim, that’s ok. I understand. If I got upset about these things, I could never last here. I appreciate your apology. Let’s work together.” What I love about this is that the patient (here, ‘Jim’) himself is the proactive one, the one who first starts the dialogue of apology. He is able to have perspective and look at himself. Even if he’s saying it as a ‘manipulation’, a strategy to hopefully get out of the hospital soon, I still honor his insight and vulnerability. Makes me think of a quote I once saw:

“The first to apologize is the bravest; The first to forgive is the strongest; The first to forget is the happiest.” (author unknown) Research has shown that people who are able to apologize, people who allow themselves to be vulnerable, and people who let go of their anger, will live longer and happier.

Our Man Hugh

Hugh was diagnosed with Schizophrenia when he was 19 years old. That’s when he started hearing strange voices and experiencing grandiose delusional thoughts. He stopped paying attention to his hygiene. He could not hold a job. Hugh simply could not navigate the world. He was alone in the world. Every two months there was a striking pattern. Hugh would show up at the emergency room with voices telling him to walk into moving traffic. It was always the same story. Was he telling the truth? Or did he just want a bed to sleep in for a few nights? And three meals per day? But - what if we refused to admit him to the psych ward and he subsequently walked into traffic…..? And so we thought, better safe than sorry. Once in the hospital, Hugh would be restarted on his schizophrenia medication, medication which he was never compliant with outside the hospital. Sure enough, in a few days he would say with jubilation that the commanding voices had died down: “I’m feeling better, time for me to leave!” And then Hugh would sign himself out of the hospital. We told him we could find a group home for him, but Hugh would have none of that: “I don’t want to be stuck somewhere “‘ he would say; “I just want to ramble around.” Two months later, our friend Hugh would show up again and the cycle repeated itself. Again and again. I must say that we who worked at the hospital loved Hugh. He was a very engaging and spirited fellow, always with a twinkle in his eyes and a smile on his face. Our hearts went out to him - a life utterly alone. I believe that his short stays in our psych ward were his main social outlet. From his perspective, he seemed quite happy with his lot. One day I was walking down the street and suddenly ran into Hugh. He gave me a big smile and yelled out: “Guterson, Guterson! See you real soon! I’m coming back to the hospital next week!”