Fuck no! Are you crazy?
Dan was almost shouting at me now. He seemed frustrated that I couldnt seem to understand him.
Listen, Dan, lets just try sitting on the edge of the bed. Ill sit with you. Nothing is going to happen.
Cant you see them? He had lowered his voice, but the terror was still coming through loud and clear. Theyre everywhere, all over the place. Fuck, theyre on me. He began to raise his voice again. Theyre on me, he repeated. Do something.
I didnt know what to do. I was as confused as he was. I wanted to help, but I only felt completely useless.
The spiders are everywhere, he shouted. I can feel them crawling on me. I can feel them biting me.
His voice was becoming less coherent as he became more excited. I was at a loss at what to do and so I called the doctor.
Dan was given more medicine, and although it didnt alter his belief in his reality, it did relax him enough that he did manage to get out of bed with a lot of persuasion and a promise that I would stay with him. I also promised him that nothing would happen to him. Another stupid thing to say; all medical people know not to promise anything.
As we began walking along the main corridor Dan suddenly slumped to the left. He couldnt lift his left arm and his left shoulder was 12 inches lower than the right.
Dan looked at me and said, Why am I walking like this?
I knew why, this was a side effect from all the medication he had been given. I even knew the name given to these side effects: extrapyramidal. I was still surprised at such a sudden and dramatic onset of symptoms, especially as I had never seen anything so severe as this before.
Extrapyramidal side effects are a common result of taking antipsychotic medication. They can take the form of tremors, restlessness, sudden contractions of a muscle, or even group of muscles. Some can be life threatening. The most common side effects I had seen were rolling of the tongue and tremor in the limbs.
Dan received further medicine, an injection this time, to counter the extrapyramidal side effects and to our immense relief his symptoms disappeared.
It seemed ironic to think that it was drugs that had triggered Dans schizophrenia and here we were pumping him full of more drugs. It also seemed strange to think that many people take drugs to achieve the sort of effects that Dan had, but still we gave Dan more. For all the drugs we gave Dan, we didnt seem to make a positive difference. Instead, we gave him side effects. It was just as well we had drugs to treat the side effects, too.
I am not discounting the value of psychiatric medicine, because it does make a huge difference for some and it does allow many people to lead normal lives, but with Dan nothing seemed to work. Dan was eventually placed in a long-term community house with 24-hour supervision. He would never be able to look after himself and I cannot see a cure in the near future. Dans life was and will always be a battle between what is real and what is delusion, although it seemed that battle was already lost for Dan.
As time in the psychiatric unit went by, I truly began to appreciate how powerful the mind is. Here the mind reigned supreme. It was strange to see people without physical problems no obvious deformity, no missing limbs, no failing body parts often somehow worse off than those with. To see a young man or woman ruined by the thoughts running through their head is terrifying.
Mr Brown
The front door slammed open and crashed against the wall. All the staff heard the noise and came running to the reception area, where Mr Brown was being carried in through the front door. He was a big, strong, healthy looking man, perfectly capable of walking. But it is rather hard to walk when your feet and arms are handcuffed.
Dont just stand there, the police officer in charge said, noticing me staring. Lend us a hand.
As he spoke, the man in handcuffs suddenly jerked his body to the right, sending the officer on that side crashing into the wall.
The only coherent words that could be heard from all the shouting were fuck and kill from Mr Brown. I leapt into the fray, grabbing hold of his wrists by the handcuffs.
As I pulled the patient along, I got my first close-up glimpse of him. His eyes were red and watering from the pepper spray the police had used to subdue him. Despite this, he was putting up quite a struggle, writhing, almost spasming in our grasp. As we carried him towards the seclusion room, he threw all his weight again, this time to the left, and managed to end up on the floor. The unexpected movement ripped the handcuffs from my hands and left me with a few less layers of skin. This was rapidly looking to be the most violent, acutely psychotic patient I had seen yet. It was an intimidating sight.
As we picked the patient up off the floor I heard a shout from one of the officers: Fuck!
As he had leant forward to pick up Mr Brown, he had left his arm exposed within reach of Mr Browns mouth, and he hadnt wasted a chance to sink his teeth into flesh. The skin was broken, but at least there wasnt a chunk of flesh missing.
We took Mr Brown into the seclusion room. This barren room with a solid wood door with several locks was our answer to those whose energies got out of control. The room was designed to prevent the patient causing themselves harm; it also helped to provide staff and other patients with a safe environment. The room was meagrely furnished, with a thick plastic mattress and a paper bucket to use as a toilet, along with a paper cup full of water. Any patient placed in this room was stripped of their clothing and dressed in a thickly woven gown that was impossible to tie into knots, meaning there was no way a patient could strangle him or herself with it.
He nearly killed one of us before, the officer in charge remarked.
The next trick was to remove the handcuffs and escape in one piece.
The leg handcuffs came off first, and Mr Brown remained still.
Watch him, boys, the officer in charge warned. Hes just waiting for his hands to be free.
He was brought down to the ground, face first. In this position he wouldnt be able to use his arms to hit us as the handcuffs were removed.
There was nothing more we could do until the psychiatrist arrived, which we had been told would be in about 15 minutes. It was time to leave. I instructed the officers holding the legs to go first, then next the officers holding the hands, followed very quickly by me. The secret to a safe exit is simple: move as fast as you bloody well can, slam the door and lock the bolts.
There was nothing more we could do until the psychiatrist arrived, which we had been told would be in about 15 minutes. It was time to leave. I instructed the officers holding the legs to go first, then next the officers holding the hands, followed very quickly by me. The secret to a safe exit is simple: move as fast as you bloody well can, slam the door and lock the bolts.
As the bolts were thrown home, Mr Brown charged for the door pounding on it with fists and feet for several minutes, before giving up and sitting back down on the mattress, staring at the door.
I think he needs a male to look after him, said the charge nurse, kindly volunteering my services.
The police left and I was given the job of sitting outside the seclusion room door and peering in through the tiny reinforced window every five minutes. An urgent call had gone out for the psychiatrist to come as soon as possible. Mr Brown needed some serious sedation; his mind and body needed to rest.
As we waited, Mr Brown came to stand by the door, inches from where I sat, and tried to plead with me to let him go.
Ill be good now. You can trust me. Ill do as you say. You can even open the door and Ill just sit here. Just open the door, thats all.
I ignored him. It wasnt long before he changed tactics.
Let me out, or Ill fucking kill you. Youll be the first. Ill make it hurt. Let me out now and youll live. Do you want to die? Youre gonna die, with my hands around your throat.
He began to kick the door, the old wood taking a hell of a battering. I checked all three locks, to make sure they were all bolted securely. I endured several minutes of some very graphic abuse, before he tried the pleading tactic again. In total I suffered 20 minutes of this barrage of begging and threatening, before the psychiatrist arrived.
Dr King took one look in through the window and ordered a very strong dose of tranquilliser.
He does appear to be in a very bad way, wouldnt you say? he asked casually.
I wasnt sure if he expected an answer or not.
You sort out Mr Brown and Ill draw up the injection, Dr King ordered.
He didnt appear to be the least bit worried by the situation. Of course, at the age of 59, he would have no hand in the upcoming restraint.
The problem now was how to get in there and administer the injection. Since the police had left, I had to ask the staff to assist me and I was sure that help would not be forthcoming. For a start, I was the only male on that shift and, second, the average age of the women was at least 40.
Um, Ive got a bad back; hurt it during my last restraint, said Jane, the only nurse my age.
The other women didnt even bother with an excuse; they said flat out that they did not have a death wish. I had no option but to call in the police.
Before long, the same four officers who had brought Mr Brown in were beside me, peering at the patient who had by now realised we were coming. If there had ever been any notion that Mr Brown was going to make things easy for us, and that he might have calmed down a bit, his shadow boxing performance soon put an end to it. It seemed as if madness had lent strength to Mr Brown.
I motioned for the officers to lead the way.
The officer in charge, Sergeant Perkins, looked at me and said, Hes your bloody patient; you go first.
It had been worth a try.
There is a strategy we use when taking down a violent patient, it involves each person being designated a specific body part, that is, right arm, left arm, right leg, left leg or head. If you are responsible for a body part then that is all you aim for. This strategy requires feeling confident that your partners do their job and concentrate on their body parts. If I was to grab Mr Browns right arm but my partner was to fail to take the left arm I would end up with a very swift hook to the side of the head. Its all about trust.