I met Billy on the medical unit at the Regina Correctional Centre. At first encounter, Billy seemed akin to a hypothetical cross between a vampire and a rabid dog. I had never heard a human being create the kind of noises Billy made. He would spend his days crouched, barefoot and shirtless, on the table that was the only piece offurniture in his prison cell. He was emaciated and it was painful to look at the bones protruding from his chest. From his perch, he would howl, hiss, and mutter obscenities. Needless to say, Billy was an incredibly angry young man; he’d been sentenced to six months for ripping the family cat in half and eating it in front of his foster parents. They were completely traumatized, and needed extensive therapy after the event.
My first attempts to communicate with Billy were met with a series of sharp
fuck offs.
It took a great deal of time and persistence on my part, but eventually he came around. Once he asked if I could bring him an elastic band for his hair, and when I did I was shocked to see how appreciative he was of such a simple gesture. I learned that Billy’s biological family was beyond dysfunctional and that Billy had been the victim of horrific abuses. Billy’s foster parents had taken him in with the best intentions, but Billy was too far gone by the time they received him. After the cat incident, they were unable to allow him back into their home.
Somewhere, deep inside Billy, there was a frightened little kid. He hated to let this part of himself show through, but I could see it clearly while he wrestled with all of the horrible memories from his past. Billy told me that his older brother had killed his father before he ended up killing himself. Many of the prisoners at the Correctional Centre had witnessed countless suicides
and yet they still stuck around, dysfunctional, ill, and angry, but surviving. I rarely wonder why some people kill themselves; it’s those that don’t I find fascinating.
I eventually moved on to work at the Regina Mental Health Clinic, where I’ve been part of the crisis response team for the past ten years. Billy became one of my first patients at my new job. He was homeless at that point, and finding him a place to live was next to impossible because, well, he scared the hell out of everyone. My experiences with patients have taught me that psychiatry is just as personal as it is clinical. I’ve formed many close relationships with my patients. I care about them, and my desire to help them doesn’t cease with the end of my workday or their release from a facility. A lot of the way I understand a person can’t be pinned down to his or her diagnosis, or life story, or even the way he or she speaks or behaves. I can remember driving Billy around, and literally feeling this intense energy coming out of him. I’d tell him, “Calm down, man. I can feel you over here.” He’d always laugh. At that point, Billy was back into solvents. He had a girlfriend who was extremely malnourished, wide eyed, and had such awful tremors from sniffing lacquer thinner that she could hardly walk. I can still see Billy pushing her around in a shopping cart; all they had was each other. I helped Billy and his girlfriend get bus passes. He loved riding buses, spent all day transferring from one to another. When Billy went missing one day, everyone assumed he was dead. But three or four months later, he called me from a shelter in Ontario. He wanted to let me know he was all right. He said I was his only real friend, and he believed the right way to treat a friend was to let him know when you’re okay. I never heard from him again.
There is often truth to madness, and mental illness is largely
the process by which people attempt to make sense of their relationships with their environments. Many patients struggle to overcome their pasts, and yet many more need help coming to terms with the present. Every week I get calls at work from elderly people who believe they are being poisoned. Their bodies are breaking down, their short-term memories are deteriorating, and when it becomes too difficult to accept these changes as part of the aging process, many people create myths in their minds to explain what is happening to them. And so the ninety-year-old man who habitually misplaces his glasses may eventually become convinced that his neighbor breaks into his house and moves them around out of spite.
I worked for a time with a retired foreman who was known simply as “The Captain.” He had a very old fashioned sense of sophistication and throughout the entire ten years I knew him he wore the same suit jacket every day, a sort of self-imposed uniform. The Captain had been emotionally wrecked when he was arrested and charged with trying to break into a building. He told me that he had lived in the same city his whole life and was single-handedly responsible for the town’s growth and expansion in the previous twenty years, and that he would never attempt to commit such a crime. I asked him how he could achieve so much by himself, and he explained that, even though he was “retired,” he was busier than ever, telepathically transmitting plans to the mayor’s office or various construction companies and keeping tabs on each organization’s schedule to ensure all projects were completed on time. He told me that if a house was ready to have its foundation poured, he would use his mind to instruct the cement company to send in the cement trucks. For years before
he was arrested, The Captain walked through town, checking local businesses to ensure they were locked and secured. He took great pride in his work.
I got called in to assess Sarah, a retired schoolteacher, whose house had been completely overrun by mice. There were hundreds of them, scurrying through the walls and the ceilings, leaving behind enough droppings to coat the floors. When I told Sarah that this was no way to live, she didn’t appear the least bit perturbed. “Ah, what’s a few mice?” she said. “They’re not bothering anyone.” On the way to the hospital, Sarah confided in me that she had been buying large bags of peanuts to feed the mice because, to her, they were pets. Once, Sarah asked me if I wanted any life advice. When I told her I was always looking for advice, she solemnly suggested, “Never think your co-workers are your friends, because when you retire, they’ll all go away, and you’ll have no one.” In light of Sarah’s situation, her point was well taken.
I began receiving calls from concerned neighbors about a woman who’d flail her arms about for hours in front of her apartment window. She’d been performing the ritual regularly for months, so when I visited her home to do a mental health assessment, I was curious about what I’d find. I discovered that Dianne had been retired for several years. She’d been a telephone operator her entire adult life and she was extremely proud of a plaque she’d earned in honor of her exceptional service. She told me the story about how she’d been presented the award by the premier of the province at her retirement. It was her favorite story, and she’d recite it without fail each time I visited. Dianne had been standing on a small foot stool at eight o’clock every
evening, and for the following three hours, she would direct traffic, coordinate all the lights, and send her energy out to ensure everyone’s safety. She considered these hours her shift and she took her job very seriously. During one visit, I noticed Dianne was wearing an elaborately knitted sweater, constructed of beautiful, thick stitches. I asked her where she got it and she told me she’d made it when she was younger, before she forgot how to knit at all. She invited me to look at all the other sweaters she’d made and as I handled all the luxurious garments I noticed each had a major department store tag stitched onto the back.
Sometimes, the origin of a person’s mental illness isn’t traceable to a tragic set of circumstances or a sudden loss of purpose. During fifteen years counseling patients and inmates, I’ve encountered all sorts of obsessions, delusions, and hallucinations. And I’ve become desensitized to things that most people would find profoundly disturbing. The first time I talked to a man about the voices he was hearing in his head, I was completely blown away. Now, a lot of the outrageous fury and lunacy I experience becomes ultimately just part of a day’s work, to be filed away in the dark recesses of my memory. I’ve met people who swear they’ve seen Jesus. I’ve met people who believe they
are
Jesus. And even more who believe
I’m
Jesus.
I’m often asked, “Who is the craziest person you’ve ever known?” Back then, I would have immediately recalled a man known, infamously, as “The Claw.” I never could have prepared myself to encounter such a person because, in most ways, The Claw didn’t resemble anything remotely human. The Claw was in his fifties, round and balding. He had an extremely odd-shaped, spherical skull, which sat on his shoulders in the absence of any
significant stretch of neck. His ears were large and prominent, like an animal’s, and his face was masked by a mass of thick, gnarled scars. I am almost certain he hadn’t bothered to look at his reflection in the previous few decades; if he had, I’m positive he would have scared himself.
His mannerisms were oddly timid for such a frightening figure He kept his head slung low, and would peep up from beneath his brow only when addressed. Even then, only half of his expression would be apparent, because his left eye always remained closed. The Claw’s behavior, of course, was significantly more bizarre than his countenance. Most of the staff members and inmates at the Regina Correctional Centre had fantastic stories about The Claw, because he had attained mythological status, even living among some of the strangest people alive. He drank solvents, cleaning products, really anything he could get his hands on. And he would eat everything he could put into his mouth: coins, pens, measuring spoons. If you happened to leave your car keys within his reach, The Claw would somehow manage to swallow them in seconds.
The Claw’s most distinguishing feature had earned him his nickname. His hand had been severely disfigured in an incident during which he’d held an unwilling Rottweiler by the tail and licked the dog’s genitals while masturbating. The dog was desperate to get away and resorted to chewing off most of his molester’s hand and arm in order to free himself. What remained of the limb was fashioned into a makeshift appendage that strongly resembled a claw.
The Claw was an extremely high-risk individual. He couldn’t be trusted unsupervised, by himself or with others. He was kept
in a locked room, with a small rectangular window, through which he had to be checked on every fifteen minutes. Despite this rigorous monitoring system, he somehow managed to get hold of a plastic knife, and with the flimsy utensil he cut off his penis, spraying blood all over his cell. He put the severed appendage on the end of his index finger and began showing it off like a finger puppet. The Claw seemed really happy then, very satisfied with his achievement.
The clinical definition of psychiatric nursing is “therapeutic use of self.” In hindsight, I clearly see how I ended up in psychiatry. I’ve always found it easy to connect with people. Establishing a connection requires giving someone your complete attention, without judgment. That is all you have to do; it’s that simple. I’ve always been interested in people, thankful and humbled by the diverse men and women who have let me into their lives. There is an intimacy to what I do, a connection, and a higher level of sharing. Unlocking the secret to understanding psychiatric patients is actually about suspending the need to help them. The goal is to empower people, so that they can gain enough strength to carry themselves through their own pain. To give your complete attention to a person as he or she exists is the greatest gift you can give. It can be enough to change everything.
I believe anger brought me to psychiatry. I’ve always advocated for the “underdog” and I hated watching people suffer, it made me angry. That great poet and philosopher Johnny Rotten once said, “Anger is an energy.” and I believe that anger lead me to psychiatry, that was the motivating force. I’ve always advocated for the “underdog” and I hated watching people being taken advantage of. I couldn’t stand seeing people suffer, or watch them
being abused, it made me angry. At the deepest level, there is a spiritual element to every relationship, and within the realm of my relationships with my patients, I have truly been tested. I’ve worked with people who have done things so sick and vile, people for whom any other sane human would wish death, people who have no redeeming qualities, people who don’t seem to be people at all. I’ve looked into eyes that reveal nothing, eyes that scare the rest of the world. But all of these people were innocent children once, before something descended on their sanity. The innocent parts may be gone forever, but I can’t forget that they were once there.
I’ve met some of the most extreme, intense, complex people on the planet. But neither these individuals nor their stories could remotely prepare me for the most complicated encounter of my life. I was about to become friends with Charles Manson.
They Represent the Law?!
I’m 1967 in Frisco from Alcatraz; this was during the hippie trip. There used to be Bohemians, and they were “hip” ‘cause they were shooting dope in the hip, and that’s what they call hippie. I was standing on the corner with a gun in my pocket. I’m not playing. I’ll do whatever it takes to survive. Don’t go messing with me. I’m going to do whatever I do. Now I see this woman on the street corner, this guy comes along and I see she got a baby in her arms and he just knocks her down. The baby falls in the gutter. He throws her dress up, goes up in her, fucks her, wipes his dick off on her dress, and walks on down the road. The cop’s standing there on the street corner. I said “Hey man.” He said, “Yeah?” I said, “Why didn’t you do something about that?” He said, “Well a lot of political pressure around here. I’m not going to get involved.” I said, “Oh, is that right? I just got out of prison, man. I got put into prison for doing less than that, been therefor years and you’re letting that happen.” I said, “Well, man, you’re supposed to be the father figure here, man, you’re supposed to be looking out for these people.” He said, “They’re not my children, my children are at home, if they didn’t want to get raped then they should stay at home. If they get raped, that’s good, maybe they’ll go home then.”