“I’m not taking those fucking pills!” She screams.
“Let me go!” she yells. Two security guards hold her arms. Another waits, just behind her.
“Mary, take the medication,” I say. I hold out the plastic cup.
“It’s poison! It’s going to kill me. That’s what they want!”
“Mary, I’m not here to hurt you. I’m a nurse. I want to help you.”
“You are a liar,” she says. “Leave me alone! What kind of a nurse bothers poor old ladies?!”
Mary has been court-ordered, she is to be hospitalized for up to ten days, she is to be “compliant with treatment.” Her behaviors have been deemed harmful to herself.
According to her chart, she stopped eating two weeks ago, fearful she was being poisoned. She lived on sips of water and packaged saltine crackers, never leaving her one room in a boarding house, not opening her door, not even when the police came to check on her during a four-day-long heat wave. They found her, disheveled, dehydrated, delusional, afraid, in a dirty robe, in a stifling room, windows locked shut, flies everywhere, food left in the sink. They noted the stink of garbage and unwashed flesh and rotting meat and urine and feces and something like animal terror.
In the emergency room she was combative, she spit at the EMT. She was restrained to a gurney and given 5 milligrams of Haldol, 2 milligrams of Ativan, and ½ cc Cogentin by injection. She was hydrated with an IV of normal saline. Once she was calm and medically cleared, her vital signs within normal range, her behavior subdued, she was brought, still restrained, to the Psychiatric Emergency Department for observation, where they checked her respirations and pulse every 15 minutes. She was offered food and drink, which she refused. She did not speak. She did not answer their questions.
She arrived on our inpatient psych unit some 15 hours later.
In the day room, her first morning, she did not eat her breakfast. During community meeting, when the smiling occupational therapist asked her how she was, she would not respond, a fact that was documented in her daily progress notes. She did tell the psychiatry resident to “Fuck the fuck off, fucking fucker,” which was quoted and discussed at length during change of shift among the nurses and mental health workers.
She submitted to being bathed the next morning, but only because the counselor promised to use special shampoo. She let them comb her long white hair. She ate lime jello, and drank a half pint of skim milk for breakfast. She wore a clean Johnny that hung slack off her bony shoulder blades. She wore the green stryofoam slippers that did not fit her feet. She wore the bracelet that had her name and unit number on it. She let us take her blood pressure. In some ways, she became a patient, but not in all ways. She did not go to any of the groups; therapeutic communication, morning stretch, occupational crafts, cookie time, art, afternoon check-in, current events. She made no phone calls, had no visitors, spoke to none of the other patients, or to any of the staff.
On the third day she did not get out of bed. She refused to meet with the hospital attorney who would be presenting her case before the judge later in the day. She turned to face the wall when the director of the unit and the nurse manager came to explain to her that she was about to be committed for an extended hospitalization, that she would be forced to accept treatment. Her breakfast tray went untouched. Her lunch was taken away uneaten as well. By evening, her case was heard, and her commitment paper was signed.
From now on, she did not have the right to refuse meals, she would have to take medications, she would be mandated to attend groups.
“Fuck you,” she says when I tell her this.
I hold out the medications the doctor ordered.
“NO!” she says. Her eyes are sharp and blue, unflinching. “I was named for the Virgin Mary,” she says. “You cannot touch me.”
Someone calls Security. Uniformed guys escort her to the quiet room, where she will be restrained to a bed frame and injected again with the cocktail of antipsychotic meds, if she continues to refuse or threaten. They hold her though she does not resist. She walks without struggle, the green slippers slapping behind her along the shiny linoleum floor. Other patients watch as we pass the day room. The TV is blaring People’s Court. She gives them the finger. One guy winks at her, and goes back to eating his dinner.
“I’m not taking those fucking pills!”
“Mary, take the medicine.”
“Why do you care if I do?”
“It’s my job.”
“Get another fucking job!” she screams. “Leave us old ladies alone!”
“Take the medication from the nurse,” says one of the guards.
“Fuck you too, Barney Fife!”
“The court ordered you to take the medicine.” I hold out the cup.
“I was named for the Blessed Virgin!”
She struggles. The guards have her down in seconds. She is small, but they hold her. “Fuck you!” she yells. Counselors wrap leather straps around her wrists and ankles. Another nurse rushes in with the psychiatrist. “She is refusing treatment,” the doctor says. He orders medications to be administered by chemical restraint. Her Johnny is pulled up, her buttocks exposed. My hands do not shake as I swab her pale skin and feel for the gluteus muscle. She is thin, I feel her papery softness through my latex glove. I have done this hundreds of times. It’s my job. She writhes. She is held more forcibly, to keep her still. I inject her with two needles.
It’s over in a moment.
“You fucking rapist!” she cries. I back out of the quiet room, her words follow me down the hall. “You fucking fucker! How could you do this to the Virgin Mary?!”
When I pull off the gloves, my hands still tingle from the touch of her skin, and the warmth of her fear.
Norman Belanger is a nurse by profession, and a writer by some character flaw to be worked out in therapy. He's had a few pieces recently accepted, in the July issue of Aids & Understanding magazine, and Blunderbuss online publication, and in an upcoming number of Jonathan, a gay men's lit mag. While a lot of his writing does relate to his experiences in the LGBT community, he is hoping it will also appeal to a wider audience.