Headbanger in Paradise, Part 3

CONTINUED FROM  Headbanger in Paradise, Part 2

 

Calm again, Frank watched the tip of the needle disappear into his right shoulder.

I applied electrical leads to the pulse points on Frank’s head, chest, and feet while the docs reorganized the scattered equipment. Dr. Afzal added blood pressure cuffs, one on Frank’s left arm and another on his right lower leg to monitor the immediate ECT effects.

Frank’s chest swelled up and down, slow and steady.

Dr. Umbar methodically cleaned Frank’s right arm around and inside the elbow. “You’ll feel another pinch now.”

           Frank flinched as the anesthesiologist slid the needle tip into his vein. The IV drip assured good fluid intake while providing a line to piggyback Frank’s treatment meds.

“You’ll be getting sleepy now,”Dr. Umbar said, opening the valve to adjust the flow.

Frank eyed the milky white liquid slithering down the thin tube from the tiny valve below the IV bag. A snowy river streamed toward him. His lips stirred, occupied by his inner self-talk.

            Three, six, nine, twelve. One, two, three. Three, six, nine, twelve. One, two, three. Three, six, nine, twelve. One,two, three.

Frank looked at me. I took his hand in mine as his eyes glazed over. His eyelids fluttered in rhythm to his heartbeat until both eyes closed.

Dr. Umbar told us Frank was receiving IV Propofol, the same medication Michael Jackson received shortly before he died. It gave me the chills. I wasn’t concerned Frank would die, merely aware of a brief pall of sorrow paying me a visit from the King of Pop.

Within three minutes, Frank was deep in sleep.

“Dr. Umbar? Are we ready?” the psychiatrist asked.

Dr. Umbar nodded in agreement. “Good to go.”

Dr. Afzal looked to the black metal box. A paper strip spooled out like a receipt at a checkout stand.

He pressed the red button, holding it for a count of three seconds by the machine’s digital readout. Frank’s body twitched, just enough so you couldn’t miss it. His upper body and head spasms lasted six seconds. His fingers and toes continued their tiny dance for another dozen beats on the monitoring strip.

We were all quiet.

Soon enough, Dr. Umbar loaded Frank’s IV with a massive dose of caffeine.

While we waited for the caffeine to kick in, I asked about Frank’s unexpected pre-ECT behavior.

“That was an unforeseen experience,” Dr. Afzal said. “I believe the anti-anxiety medication given on the unit beforehand induced an abnormal response.”

“Surely, that wasn’t all of it?” I asked.

“Frank talked to me last Friday,” said Dr. Afzal, “before my weekend off. He told me about a dream he’d had recently. It involved him rolling in a wagon through a dark cave, eventually landing in a sunny arena filled with children at attention, all outfitted in white playsuits. I think, this morning, our patient confused reality with his dream.”

“So,” Jerry said, “next time he walks here. No rolling.”

            My goodness. It would have been nice to know about the damn dream.

Thirty minutes later, Frank was up, still groggy from the ECT and the assorted meds swirling around in his body.

Jerry helped him to the wheelchair.

The return trip seemed much longer than the previous one. I was still shaken by Frank’s outburst.

Hospital policy dictates one RN accompany patients to and from ECT and continually monitor health status two hours post-treatment. I charted Frank’s vital signs every fifteen minutes, relieved to see no blood pressure spikes, paranoia, fear, or loss of consciousness.

Short-term memory loss is a common side effect of ECT. The extent of memory loss after additional treatments would determine whether or not to continue the therapy. The positive aspects of ECT would be weighed against any detrimental memory loss.

It was warm where we sat in the day hall, sunlight streaming through the windows onto my assessment sheet.

“What’s your name?” I asked.

 

 

memory-loss-1

 

_____________

“Headbanger in Paradise” was originally published in its entirety in Untold Stories: From the Deep Part of the Well. 2016 Redwood Writers Anthology, Roger Lubeck, Editor. September 2016.

I’m choosing to publish it here in four parts. Stay tuned for the final Part 4. KT

Headbanger in Paradise, Part 1

“Headbanger in Paradise” was originally published in its entirety in Untold Stories: From the Deep Part of the Well. 2016 Redwood Writers Anthology, Roger Lubeck, Editor. September 2016.

I’m choosing to publish it here in four parts. Stay tuned for later segments. KT


 

Visitors are rare here. On admittance, our patients generally see that their friends and relatives have a way of moving on.

Three-dozen men, twenty-two to sixty-three years of age, live on my unit, a drop in the bucket of over a thousand patients, hospital-wide. They share bedrooms, bathrooms, and just about everything else. They struggle with schizophrenia, depression, and psychosis. Delusions, hallucinations, fear, and paranoia routinely show up.

Our patients often have little or no self-control. When paired with anxiety and anger issues, they act out on a regular basis, assaulting staff or one another. Often confused, they lack motivation to do much to help themselves.

Behind our backs, patients cut themselves with sharpened plastic utensils, broken CDs, pencils, or worse. It’s a tough place to be a patient. It’s a rough place to work.

Breakfast was over and done with. It was quiet on the unit, and I was glad of it.

I heard keys jangling from the other side of the door. Right on time, here he comes.

He walked into the unit, escorted by one of the psych techs from the admission unit.

Frank’s arms hung like flabby sausages. Thirty-three years old, he shuffled like an old man, a side effect of medication to reduce aggressive behavior.

His man-sweat, accompanied by a robust urine aroma, percolated the air as he approached me. Frank had been next door for thirty days now. He’d refused to shower every one of them.

“Morning, Shea,” the escort said.

“Good morning,” I answered. “How is everyone?”

“Not bad. He was at it again last night. Fine this morning, though.”

I noticed the bruises on Frank’s swollen forehead where he’d smashed his head against the wall.

“How do you feel, Frank?”

Silence.

Head banging was Frank’s unique trademark. One minute, he’d be standing quiet as a doorknob. Next minute, he’d be methodically slamming his forehead against the wall. No wailing, no crying. Just slamming his forehead against the wall.

I started ransacking through the black trash bag, AKA patient’s luggage, which Frank handed to me. I latched onto a pair of hospital-issue sneakers, a denim jacket, a pair of sweat pants, and a San Francisco Giants T-shirt.

“Is this all you’ve got, Frank?”

He didn’t answer.

His escort did.

“That’s it, Shea. Here’s his chart. Have fun now.”

He fist-tapped Frank’s shoulder as he turned back to the admission unit.

I’d met Frank a week earlier on a help call to his unit. One patient had cornered another in a bedroom. They were pounding each other with fists, their obscenities scouring the room. They each weighed close to a couple hundred pounds. It was all we could do to separate them. The hospital police arrived in time to catch a young nurse being thrown to the wall.

Frank watched the action from across the hall. Leaving the room, I didn’t realize he’d quickened his step behind me until I felt him punching the back of my head.

He was sedated then, but my neck was stiff for a week. The real injury was to my psyche; a potent reminder to keep those eyes in the back of my head wide open.

He couldn’t help it, really. The voices crawling in his head screamed danger. It sent him straight into attack mode. A variety of meds helped only sometimes.

“Come on, Frank. Your bedroom is up the hall,” I said. He flinched when I placed my hand behind his elbow.

“Okay,” I said, pulling back. “It’s okay.”

I carried his meager belongings to his room.

“Do I know you?” he asked.

“Yes, I’m an RN. My name is Shea. We met next door. I work this unit most of the time.”

He slowly nodded yes. “I hit you, didn’t I?”

“Yep,” I said, smiling. “It’s okay, Frank, I’m fine.”

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No Means Everything. Parts 1 & 2

A story in 4 parts.

Part One

It was 1967. Iris lived with her mom and brothers on the California side of South Lake Tahoe. If you were standing in her room, you’d have heard any combination of rock and roll blasting the airwaves, including, but not limited to the Beatles, Paul Anka, Connie Francis, and the Rolling Stones.

She’d graduated high school the previous summer (’66) with her class, known officially and forever as the ‘Rebels’. After a wild and crazy senior year, full of class cutting, skiing, and hot springs soaking over the Markleeville ridge, she was delighted to be finished with South Tahoe High.

Iris got a work permit and a busgirl job in one of the casinos. Soon enough, before she knew it, she was 19, pregnant – and married. She hadn’t planned on being pregnant. She hadn’t planned on being married. But all those noes of hers, in the still quiet of a dark room, fell silent on Alan’s ears.

Six years older than she was, Alan drove a shiny black Mustang. He had striking blue eyes. He was her neighbor. Their moms were best friends. He worked with Iris’s brother. Iris was in love.

There were times, though, when she worried. She and Alan spent quite a bit of time in the house Alan shared with his mom and brother. It was during those family visits that Iris witnessed the man she loved being extremely cruel. He criticized, belittled, and blamed his mother for everything. His behavior, his words, his rage, gave Iris the shivers. She found no pleasure in recalling her own abusive household as a young girl. Iris did what most irresponsible young women did. She swept it to the back of her head. She kept quiet.

Alan told Iris he didn’t want a big wedding. She said that was fine, though secretly, she was disappointed. Alan arranged for a few days off work. He and Iris eloped to the Nevada ghost town of Virginia City, where the Justice of the Peace married them. The courthouse cleaning lady and the bar owner next door were the witnesses. Surreal, Iris thought. In the mirror behind the judge’s desk, she observed Alan, his arm wrapped tightly around her. Iris was in her favorite pale blue blouse and mini skirt. Alan was dressed in his typical every day black slacks, white short sleeve shirt, black shoes, white socks. No friends, no smiling moms wishing Iris congratulations from the mirror.

They recited their vows. Alan smiled with Iris’s grin as he paired the wedding band to her engagement ring. They kissed. Man and wife. They were married. They hopped back in the Mustang. They drove over the mountains, down to the ocean, to spend their honeymoon on Monterey Bay.

Iris ended up sick most every day. The fog was wet. She was cold. She just wanted to go home. Awake sometimes in the dark night, she worried over a conversation with Alan’s mother in which Iris had been warned to be very careful of Alan’s terrible temper.

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