Saturday Musings, 07 August 2010

Good morning,

With a stout cup of French Market on the tiled table beside me, near the newspaper, overshadowed by the gardenia that I have yet to kill, I am again enthroned on my beloved porch. The heat has abated, at least for this morning, and the breeze wafts the American flag, lifting it to unfurl and stretch, and wave with a heady reassurance that time has only served to perpetuate.

My stubborn allegiance to my particular vices can be forgiven, I hope, as I raise my cup to a passing neighbor. I do not drink alcohol to excess; I've never been one for drugs, except the prescription kind; and I don't beat my child except with hopelessly maudlin metaphors.

I started drinking coffee at 17, during weekend stints at St. Vincent Psychiatric Hospital in St. Louis County -- the old facility, with a sweeping, wide driveway, Gothic turrets and frightening back hallways. I served as unit secretary for 3South, the acute ward. On Saturdays and Sundays through my senior year of high school and first year of college, I transcribed doctor's orders and served the clerical needs of the patient care staff, watching the truly ill wander the hallways and sometimes, climb the walls.

I have only to catch sight of a slender woman lighting a cigarette -- of old, in a restaurant or an office; but these days, more often on the patch of concrete in front of any building -- to remember my favorite patient, and wonder where life has taken her, with her anguish, and her desperation.

Her parents gave her the name of Sydney, and they told everyone whom they met, including a scrappy little ward clerk with a tumble of hair, that they had wanted a boy. Sydney's frame mimicked the thin body of an adolescent; she wore her hair short, with a pale blond lock across her forehead. She favored body-hugging ribbed turtle neck sweaters and hip-hugger blue jeans. During the time that I knew her, Sydney was in her early twenties, and spent several months each year getting stabilized on 3South.

Our ward consisted of ten patient rooms, a nurses' station, a dining room, and the back hallway where the EST treatments took place. The dining room stood at one end; the nurses' station, where I worked, at the other. Between them, the patient rooms flanked the corridor, five on each side; and in the corridor itself, clutches of chairs stood at intervals in a clumsy effort to make the place look homey.

Sydney paced from one end of this confine to the other for most of the hours between meals every day. The aides placed breakfast in the serving trays at 8; lunch at noon; and dinner at 5. Sydney went through the line and took minuscule helpings of each offering, huddled in a metal chair at a Formica table by herself to nibble at the tasteless food, and then, greedily lit a cigarette.

She pulled huge gulps of smoke into her lungs, closing her eyes, holding each draw as long as she could, then releasing it slowly, purposefully, taking several quick breathes between drags of cigarette. Her smoking fascinated me; my parents both smoked at the time, but I did not, never would, and I could not understand her obsession.

One afternoon, halfway between lunch and dinner, I chanced to be returning from my afternoon break and saw Sydney in the dining room. I don't remember what caught my eye -- the peculiar cant of her head, perhaps; or a fleeting look of restrained panic. I paused, standing outside the door, watching. I glanced at the house phone on the wall, prepared to summon help by calling a code if I needed to do so, but waiting, in case I did not.

Sydney walked, hesitantly at first but with a quickening pace, to the long table on which clean, unfilled serving vessels stood. Her hand slowly rose, suspended above the empty space where aides would later stack dishes for the next meal. I swear that I could see her take a plastic plate from a ghostly stack; and lift a spoon to serve a scoop of invisible green beans, then mashed potatoes, then a piece of gray meat vaguely reminiscent of steak. I narrowed my eyes and blinked; but the serving trays remained empty, the spoon nonexistent, the plate imaginary.

But Sydney carried it gently, gingerly, to the table and set it in front of her. She took up an unseen fork, and speared a bite, sliding it between her lips, and chewing. I shook my head, turning my gaze to each end of the hallway, hoping a patient aide would chance upon this scene. When I looked back into the dining room, she still sat, eating food that I could not see, from a plate that did not exist, with a fork that I could swear she held but which still rested in the buffet behind the locked door of the downstairs kitchen.

She finished, and rose to take her plate to the bus station. Reaching towards the bin in which the dirty dishes were to be stacked by the patients, she released her hand and I will swear, to this day, that I heard the clatter of the heavy plastic plate falling onto others already there. Sydney turned, then, and saw me; I drew back, but I need not have worried. Her dance had its own choreography.

She sat again at the table, and took out her pack of cigarettes. She drew one out with a smooth and practiced motion. Placing it between her lips, she leaned forward, and I could see the form of a patient aide not yet on duty, leaning to light the cigarette for her; and I watched the rise of her chest as she drew a long, unbroken swell of unseen smoke. Then she closed her eyes, and euphoria settled on her features as I jumped back from the sight, stunned, saddened, and suddenly, ashamed.

Much of my day consisted of transferring medication orders from patient charts to requisition forms. Hospital care has greatly advanced in its record-keeping aspects with computerization; but forty years ago, the pen and the three-page carbon-paper form served as the vehicles for communicating with the various departments of the hospital. Ostensibly, I did not need to read the patients' history to perform my duties, but that afternoon, I read Sydney's chart, and learned that her father only allowed her to smoke after she had eaten. I mentioned what I had seen to the head nurse, who shrugged her shoulders dismissively. Nothing surprised her. She did not even make an entry in Sydney's daily log, though knowledge of this behavior might surely had aided in her treatment.

Later that summer, Sydney came again to 3South but on a stretcher, strapped and submissive, probably sedated. She lay in her bed for several weeks before whatever she had taken or been given worked through her system, and then resumed her pacing, up, down, nurses' station, dining room.

Between my desk and the rest of the floor stood a dutch door. We kept the top half open and the bottom half shut, supposedly locked. On a late August day that year, I was transcribing orders from a stack of charts at my desk, unaware that the last nurse to leave for lunch had failed to latch the door behind her.

As I tried to decipher one doctor's particularly nasty scrawl, a large drop of red, viscous liquid fell upon the page. I looked up. Sydney stood over me, her wrists held out in front of her, blood dripping from puncture wounds up and down her slender arms. Sydney, I said, you are bleeding on my charts.

What should I do, she asked, in a barely audible whisper, her eyes wide, her face blanched. Bleed somewhere else, I snapped.

She moved, then, to the end of my desk, holding her arms over my waste basket. With only a small glance back at my work, with only a brief hesitation, I lifted the phone, to call the code, and then stood back while all hell broke loose.

My last sight of Sydney was of her eyes: large, luminous, not even pleading, just watching me, from the cart on which the code team had placed her, as they pushed back through the hallway, and furiously raced towards the medical unit, where tired nurses would try to stench the flow from holes created with the narrow end of a rat's-tooth comb.

The coffee has grown cold, forgotten beside me. The black cat came home a few minutes ago, with a new, disturbing gash in his neck. My son still will not let me get this creature fixed, and so he fights with anything that challenges his territory, and I am waiting for the day when he is not brushing up against my legs when I come out onto the porch to get my newspaper. I understand why Patrick insists that we not curtail his cat's true nature. But freedom has its price, just as captivity does; and I am sometimes unable to decide which is worse.

Mugwumpishly tendered,

Corinne Corley