Headbanger in Paradise, Part 4

CONTINUED FROM  Headbanger in Paradise, Part 3

 

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.

“Frank.”

“Where are you?”

He looked out the bank of steel-framed windows holding yhe world outside in a giant picture frame.

“Valley State Hospital.”

“What day is it?” I asked.

“Wednesday?”

“Right. What’s my name?”

“Shea.”

I smiled, nodding in agreement. “How are you feeling?”

No answer. His forearms rested atop the wheelchair armrests, fingers dangling. He seemed taken in by the giant tulip tree blooms drifting in the courtyard.

I chatted with Frank, other patients, and staff as they drifted into the day hall. Judge Judy ruled the TV in the far corner.

After awhile, Frank said he was cold and sleepy, a common ECT reaction. I wheeled him to his room. He was a little shaky but able to get himself into bed. I covered him with an extra blanket and watched him roll over to face the wall.

“Thank you,” he muttered.

“You’re welcome, Frank.”

This routine went on for a few weeks, one treatment each week, increasing to two treatments, then to three. After four months, Frank was having far fewer instances of violent behavior with only rare episodes of head banging. He slept better. His attitude was much improved. The treatments seemed to be working, with only minor, temporary, memory loss. Some days he would forget having breakfast. A few times, he didn’t remember the ECT treatment at all.

Frank’s parents, far from the norm, came to visit him often. They were amazed at the positive changes in their son’s demeanor. They’d delivered him to us from their foothills home less than six months earlier, after watching his long decline. They were hopeful. I’d seen life changing results in other patients after ECT. It was looking as if Frank really would have a new start in life.

After returning to the unit one day, we were again sitting in the day hall.

“Shea, can I tell you a secret?”

“Sure. Tell me a secret. I may not be able to keep it, though. What is it?”

“During ECT sometimes, I feel really high, like over-the-top stoned. I try to stay there to keep it, but it runs away. I keep trying to get back to it, but I can’t.”

“I haven’t heard that before,” I chuckled.

“Do you think you can get my doctor to give me more drugs to keep it going?”

“Ha, ha. I don’t think so, Frank. It’s just one way you’re responding to the treatment. Do you think, besides the unusual high, you’re improving?”

“When’s the last time I hit someone?”

“A few weeks now.”

“Good,” he said, his blue eyes glistening.

After several more treatments, Frank was showing great progress. No violent outbreaks and no head banging. His depression lifted, he laughed often, and he enjoyed the company of others. His memory loss, though, was becoming serious. In consultation with his doctors and parents, he decided to discontinue ECT.

Just before Christmas, Frank was discharged home. It was a grand gift for him and for all of us who had been part of his success.

He was happy, and I was happy for him.

On a road trip the following summer, I braked for a stoplight while driving through the tiny foothill town of Paradise. I spotted Frank walking in the crosswalk. He was holding hands and laughing with a nice looking woman about his age. He turned his head my way, squinting into the sun behind me.

He couldn’t see through the glare. I’m quite certain he couldn’t make out the big smile on my face.

 

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“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.

If you’d like the entire story in one piece, just ask.

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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