Wasted: An Alcoholic Therapist's Fight for Recovery in a Tragically Flawed Treatment System (22 page)

“We’ll figure something
out. One day at a time. Let’s just get you there today.”

We arrive at the hospital’s back entrance at 6:25—thirty-five minutes early. “I’m going in,” I say. “I’ll meet you guys at the Fiver and get a ride back to the house.”

The Fiver is the daily five-o’clock
AA
meeting at the Masonic Hall in White Rock. It’s a large open meeting that all the men from We Surrender attend every
day. Eli makes it mandatory. The guys from Mission Possible have recently begun attending too.

It’s quiet at the hospital’s south entrance. All the action happens at the north main lobby and the
ER
. I know—I’ve been there, as both patient and staff. The security guard welcomes me with a warm, tired smile.

As I walk down the first long corridor, my footsteps echo off the pale blue
walls. At the end I notice the familiar sign: Adolescent Psychiatric Unit.
APU
.

The unit is secure. I lost my
ID
pass card that opens the door. I look in the tiny Plexiglas window and see Faith sitting at the nursing station’s main computer monitor. I tap on the window. No response. A little harder and Faith looks up, nods and presses the buzzer to let me in.

I move tentatively
toward the counter, unsure of what to say or do as I move around the desk and into the back room of the nursing station.

“Hi, Faith,” I say.

She turns away without a word and puts her belongings into her backpack. She looks tired. Faith was running the shift the night I was sent home drunk, back in March. She was very nice to me prior to that. Asked me copious questions about my
private practice in Penticton.

“I’m tired,” Faith says. “Ray is in the
TV
room with a psychotic kid who’s been up all night. The meds are counted. You just have to sign. I’m going home. Goodbye.” Silence as the metal door clunks shut behind her.

Ray emerges from the
TV
lounge with a young Middle Eastern boy in his early teens dressed in brown hospital pajamas. Ray is a youth care
counsellor in his mid-forties who wears a perpetual snow-white smile, but not this morning. He’s been expecting me. He too was on shift the night I went home drunk.

“Let’s go, Amar,” says Ray. “I’ll take you to your room. We have to lock your door to keep you safe. Don’t make any noise. Everyone is sleeping.”

I accompany them to Room 1 without being asked. I know the routine. Room
1 locks with a large deadbolt. It is used for kids who are unpredictable and considered a danger to themselves or others. A camera in an upper corner of the room feeds to a colour monitor in the nursing station. Anyone in there is on constant observation.

Ray bolts the door shut to the boy’s protests. Amar beats on the locked door several times then stops. Ray still hasn’t acknowledged
me. I follow him silently back to the nursing station as he scoots a wheeled office chair up to the monitor. He focuses in and observes Amar move about like a silent shadow in the big box with a bed. It always reminds me of security camera shots from the 7-Eleven or the bank.

The unit access door buzzes open. Janice, a veteran nurse in her mid-fifties, hobbles in, her knees already aching
from too many years on the job. The last time I talked to her she was waiting for elective surgery. She’s twenty-one minutes early for her seven-o’clock shift.

“Hello, Mike. You’re back to work again, eh?”

“Yes, Janice. It’s good to be back.”

She nods sideways in Ray’s direction and, just low enough not to be heard, whispers, “Some aren’t so sure.”

“Yeah, I can
see that.”

“I understand you’re on a gradual return to work,” she says to me. “Management says you have to have a buddy assigned to you for the first month until you’re full-time again.”

“Yeah, that’s the plan.”

“Looks like I’m your girl today. I’ll put you on meds with Mark.”

Janice likes to be the boss even when she isn’t the boss.

Ignoring my presence,
Ray debriefs her. “You’re working with Mark and Jim. Busy day. All three psychiatrists are in for rounds. Three sets of parents are in this afternoon for case conferences. Beverly has
ECT
this morning at seven thirty. She’s all prepped to go. Allison cut her wrists when she was out on pass over the weekend. She’s out cold on
PRN
meds. She’s stitched and bandaged up. Be sure to check her dressings.
Calvin’s blood sugars are out of whack. He keeps sneaking food. Kelson keeps spreading shit all over his room. He’ll need a bath this morning. The
RCMP
brought Jess in yesterday. He assaulted his mother. He needs his injection the minute he wakes up. Security is alerted. He punched one of the security guards when we secluded him last night. He spit right in Kate’s face when she gave him his needle.
You have three discharges and two new admissions due at any time. Typical uneventful day at
APU
, eh? Everything else is on the shift report. And oh yeah, a bunch of summary reports are due today. Have fun! I’m gone.” Ray avoids eye contact, grabs his backpack, shuffles past me and heads out the door.

Janice opens the shift report on the computer and reads each patient’s synopsis, as well
as a long list of tasks and duties. “Looks like I’m going to be a busy woman today,” she sighs, and pulls out a clipboard for the staff. She writes furiously on the duties sheet, intent on organizing everyone’s day.

“I know Mark’s in charge,” she says, “but he can’t delegate a damn thing. Too young and too damn nice. How are you doing, Mike? You just started in March and then you were
gone.”

I pause, think the question through for a moment and say, “I’m okay. I had to take a medical leave. It’s good to be back working.”

A pregnant pause hangs in the air. I don’t fill it.

“Hmmmmm. I see. I hope things are okay.”

The door buzzes open. Mark, a nurse, and Jim, a child care counsellor, arrive next.

“Good morning, Mike,” Mark says.

“Hi, Mike. Welcome back,” Jim says.

“Hi, Jim, Mark. Thanks.”

The team is outwardly cordial. But they must resent me. I know
I
would. They fear I can’t be trusted. And that’s a big concern when dealing with the erratic, unpredictable and often violent behaviour of young psychiatric patients. They await my next screw-up.

We all grab coffees and pull a tight circle of chairs
in the tiny staff room.

I haven’t worked in an institutional setting since 1989—over twenty years ago. I was a thirty-five-year-old supervisor in a unit very similar to this one. The technology has advanced so much. The medication has changed significantly. Policies and procedures are different. My brain is older, and alcohol abuse has taken its toll. This team won’t cut me any slack.
Nor should they.

Can I measure up? Can I pull off the role of psychiatric nurse, a real functioning person? I’m scared it’s just a matter of time until I’m discovered to be an incompetent fuck-up.

The briefing barely over, the morning erupts into organized chaos.

Janice barks, “Mark, get security down here. I have to give Jess his injection. He’s pulled out all his stitches.
I need Mark and Jim to assist. You come as a backup, Mike.”

Backup is hard to screw up. Jess is suffering from a drug-induced psychosis, something for which I now have special empathy. The seclusion room is pale blue, with a bare plastic mattress on the floor. A grey blanket lies bunched by the mattress. Janice peeks in the tiny window. Fourteen-year-old Jess curls up in a fetal position,
picking at the open cuts on both his wrists. He has pulled out his sutures. The brown- and red-stained bandages pile in the corner. Finger-smears of blood cover the walls.

Jess screams. “Let me out of hell! The demons are licking my blood off the floor. They want more.”

Three security guards arrive in uniform, pulling on vinyl gloves. They are silent and ready. We all put on gloves
and gowns.

“They want more,” howls Jess. “Let me out. Please let me out.”

Janice, matter-of-fact, says, “Jess, we are coming in with security. We have to clean your cuts and give you your medication. Please get up and stand in the far corner facing us.”

One guard unlocks the two heavy deadbolts on the metal door. The smell smacks us. A pile of feces sits in the corner at
the centre of a pool of urine. Mark’s face contorts in disgust. “Man, that’s nasty! Jim, grab some towels and soap,” he says.

Jess stands up naked, covered in blood and shit. Both of his wrists bleed. Blood covers his mouth and chin. “No! Don’t hurt me! Don’t hurt me!”

“We are not going to hurt you, Jess,” says Janice. “We are here to help you. We are going to take care of your
cuts and clean you up.”

Two security guards flank Janice. We’re behind. A guard grips the sheet coiled in his hands. Janice holds a small plastic tray with two syringes.

Jess’s eyes are wide and wild, his naked, sinewy body taut. His fists curl tightly at his sides. “No,” he says. “You are not giving me a needle. My blood is for the demon vampires.” He thrusts his chest and face
deep into Janice’s and spits in her face.

In an instant, the younger guard jumps in front of Janice and takes Jess down with a chokehold. The boy’s arms and legs flail. The other guard jumps in and hogties his legs with the coiled sheet. Then they flip him over onto his stomach.

“Easy, guys,” says Mark. “Not so rough. It’s okay, Jess. We’re here to help you. Try to relax.”

Janice quickly and efficiently injects two syringes of medication, loxapine and lorazepam, into Jess’s elusive squirming buttocks. Loxapine is an antipsychotic. Lorazepam cuts the anxiety. I know they work. I’ve been on them myself.

“No. No. No,” he wails.

Within minutes the lorazepam begins to take effect. Jess’s squirming eases and his body settles. Jim nods at security and
they ease their grip and, in slow motion, back out of the room.

Mark removes the sheet from Jess’s legs.

“That’s it. Just relax. You’re okay. You’re okay,” Mark whispers as he gently cleans the blood and muck from the boy’s arms and body with warm, soapy towels. Jim wipes up the urine and feces in the room with disinfectant and places clean pajamas on the mattress.

As everyone
backs out of the room, Janice says, “Just let the medication take effect, Jess, and we’ll come back in a little while and put fresh bandages on those wounds.”

“Good job, everybody,” says Jim. “Are you okay, Janice?”

“Oh yeah, I’m okay. Just another day at
APU
.”

Janice is okay, but I’m stunned. I’ve been so long gone from any kind of professional interaction with acutely
psychotic patients, I no longer believe I have the capacity to stay cool under pressure like Janice and Jim and Mark.

I try to be unobtrusive. “Just move through the day and try to do no damage,” I repeat to myself, like a mantra. The psychiatrists arrive one by one. The social worker arrives in his Birkenstocks. The psychologist. The occupational therapist. The recreational therapist.
The unit teacher and her assistant. The unit clerk. The janitor. The lab tech arrives to take blood and urine samples. I get swept up in the steady flow of life on an adolescent psychiatric unit. I don’t have time to think about the dynamics of my return until it’s time to update the patients’ charts.

The patient demonstrates psychotic...

The youth has poor appetite and...

The patient refused to...

Why can I not write? Why won’t my brain function?

In frustration and embarrassment, I turn to Mark, whose fingers fly over the keyboard. He stops and looks at me. “You okay, Mike?”

“If I tell you about my patients, Mark, would you mind writing it for me? Then I’ll sign the progress note.”

I fully expect rejection and putdown, because
that’s the normal response to everything in recovery houses.

Mark sees the anxiety in my eyes. I see empathy in his.

“Sure, Mike. No problem.”

Breathe now.

Three o’clock. The shift ends. Only when I interacted with the children was the anxiety almost bearable. I got through it. I didn’t kill anyone.

I walk off the unit and trudge to the bus stop, aware of
an odd sense of accomplishment. You made it, Crazy Mike. You made it through your first day of gradual return to work.

I step out the back entrance of the hospital onto 94th Avenue, into the bright sunshine. Dozens of teenagers stream from the high school across the highway. They mill about eating chocolate-dipped cones and Dilly Bars. Largely carefree, the story of their lives yet to
be written. I wish them all happy endings.

A survey of the surroundings tells my own story. To my left, Creekside Withdrawal Management Centre, where I spent twelve days detoxing. To my right, the Phoenix Centre, where I spent five weeks in treatment. I see men smoke and laugh at the back entrance. I could be there. But I broke the rules, went on a pass with Dana and relapsed.

Today I pay my full fare when the bus arrives, two dollars and fifty cents. I don’t know how I’ll pay tomorrow.

I get off at the final stop on the corner of 152nd and North Bluff Road. I walk down the hill, south toward the beach. The city bustles with locals and tourists. It’s that time of year. I can smell the ocean mixed with french-fry grease and hot new pavement. The city workers wind
up their day, load construction tools onto a paving truck.

I arrive at the Masonic Hall. The Fiver meets here 365 days of the year. I’m excited to “share” when the chair calls on me, because finally I’ve got good news to report. I’ve got my job back. I’m sober. After a round of congratulations, the meeting breaks up and an old-timer sidles up to me. “Way to go, Mike,” says Sam. “Let’s
go for a coffee?”

“Yeah, Sam, that would be great.”

We pull up to the Tim’s on 152nd Street. It’s packed with the supper crowd, and a long line weaves its way out the door. We wait and I vent.

“I can’t stay at Mission Possible any longer, Sam,” I say. “I have to find a place closer to work.” I tear a huge bite from my whole-grain sandwich, with the wrap peeled back just
enough to expose a wad of chicken salad with lettuce and tomato. I know I should chew slowly to savour every bite, but I’m ravenous. Next, I shovel the piping hot chili back and wash it all down with a gulp of hot, creamy, sweet double-double coffee.