Changing Cocoons

by Morris J. Marshall

For God, my constant ‘cocoon’ in the storms of life.

This is the last place any sane person would want to be on a Wednesday morning in the middle of July. There are no beaches or swimming pools here. This is not a room at the Waldorf-Astoria Hotel. This is a claustrophobic’s worst nightmare and an agoraphobic’s nirvana: no open spaces. All the action revolves around a single room where everyone can be watched simultaneously. This is the Crisis Centre on the seventh floor of a Toronto psychiatric hospital, ground zero for a person’s journey through the ultimate obstacle course, otherwise known as the mental health care system.

I’ve been here since Sunday night, and I’m no longer a newbie. I’ve learned plenty since then, having watched everyone who’s come through the single locked door over the last three days. Actually, you have to go through two locked doors to get into the centre.

If you’re thinking of trying to escape by taking the elevator down to the main floor when the nurses aren’t looking, forget it. That’s locked, too, and monitored by close-circuit cameras. The second day I was here, someone tried to make a break for it and an alarm began squawking. That brought the nurses and orderlies running.

If you ever have the pleasure of coming to a place like this, you’d better add the word “compliance” to your vocabulary. The penalty for noncompliance is steep here. Last night, “Tall Al” — that’s my nickname for him — a schizophrenic kid who’s only a few years younger than I, threw a tantrum in the medication line. Two orderlies the size of New York Giants linebackers came running and took him away. I noticed he wasn’t at breakfast this morning; he wasn’t missing much.

A few hours later, I was going to the washroom when I happened to see Al lying slumped in bed in a partially hidden side room. He was shackled in restraints and medicated to the point of being a zombie. Both his arms and legs were splayed like a large bird and fixed securely to the metal rims of the bed by leather bands. Lesson learned: If you don’t want to take your meds, just hide the pills under your tongue or pillow.

About the accommodations: if you’re accustomed to luxury living, life is going to be difficult for you here. Everybody eats together in one cramped dining room and sleeps together in a large bedroom, much like a hostel. No privacy.

The nurses turn the lights out at ten each night and wake us up promptly at six every morning. No sleeping in. Meals here are basic: scrambled eggs and cereal for breakfast, maybe a sandwich and an apple for lunch, and, on a good day, a hamburger and fries for dinner. Nobody cares about the quality of the food, really. Although the meals are actually quite nutritious, taste is not a priority. Medication dulls your sense of taste anyway.

I don’t even want to talk about the washrooms. As you can imagine, it’s almost impossible to keep them clean in a place like this. Thankfully, the smell of bleach seems to dominate the undercurrent of urine and feces.

You realize quite quickly that most of the patients here live for basically two things: food and cigarettes, and not necessarily in that order. There’s also the large-screen television that we congregate around in the evenings. Most of the patients are too doped to know what’s happening on TV and just stare vacantly at it with red eyes.

The first night I arrived, I was so tired that I actually slept well; the Valium they prescribed me kicked in quite nicely. When I awoke the next morning, I couldn’t find my clothes, even though I knew that I had laid them out neatly at the foot of my bed. I rubbed my eyes and peered up to find Miguel, a middle-aged South American guy, standing beside me grinning and wearing my blue T-shirt, Levis blue jeans and running shoes.

“Umm,” I began awkwardly. How do you respond to something like that? “Those are mine. You’re wearing my clothes. Can I have them back?”

“Sorry,” Miguel stammered, though he didn’t look it, and proceeded to take them off right in front of me. I’m not even sure he knew what he was doing. He’d been brought in by the police the night before, strung out on crack. Clothes are a valuable possession in a place like this. The next night, I went to bed fully dressed.

The staff in the Crisis Centre is pretty friendly. You really only deal with two key people: the nurses, on a daily basis and, if you’re stupid enough to act up, the orderlies, the big guys dressed in white fatigues.

Charlotte, the morning nurse, is in her late twenties, just a few years older than I, and is from the Philippines. She has a great sense of humor and is well liked by all the patients because she makes us feel like human beings rather than freaks. I enjoy hearing stories about her family back home. Her husband and children are still there, and she talks about having them join her here in Canada when she can save up enough money to sponsor them.

Bill is a night nurse and he’s pretty cool, too. He graduated from college with a degree in graphic arts, and, after having a tough time finding work in his field, changed career paths. He’s been teaching some of the patients how to express themselves through drawing and painting. He even showed us a painting called “The Scream” by Edvard Munch, which shows a guy running across a bridge, his hands cradled around his head, yelling in apparent agony. According to Bill, the painting revealed the artist’s depression.

* * *

This morning, Wednesday, after breakfast, Charlotte approaches me and taps me gently on the shoulder. “Doug?”

“Yes?” My attention is diverted from a morning show blaring on the large screen TV. The discussion topic: “How to Deal with Your Autistic Child.”

“The doctor is making his rounds this morning,” Charlotte says. “He wants to see you.” She smiles reassuringly.

“I’m not crazy like the other patients here,” I tell her.

“I know you’re not.” Her smile doesn’t waver.

“When I get out of here, I’m planning to go back to university to get my Masters in Education.”

“Uh-huh.” She raises her eyebrows slightly. I’m not sure she believes me, but before I can say anything else, she’s off tending to two other patients who have begun trading punches over a stolen chocolate bar.

I meant what I said to Charlotte. I am different from the other patients here. I only suffer from depression and am quite well aware of my surroundings. I don’t talk to myself.... Well, maybe sometimes, but, hey, doesn’t everybody? And I don’t have paranoid delusions. I don’t think that someone’s controlling my mind with brain waves, and I don’t wash my hands a thousand times a day until the skin peels off.

That being said, most of the patients here are harmless even though the public would probably be afraid of them just because of stereotypes. There’s the “Professor.” He’s been here ever since I arrived. He’s a guy in his sixties with long, thinning white hair that’s balding on the top. He wears steel-rimmed glasses and talks incessantly about the perils of chemical contamination in the food chain. After one conversation with him, you’ll be afraid to eat almost anything, let alone hospital food.

Then there’s the “Zealot,” a heavy-set much younger Chinese guy with thick dark hair and artsy, black-rimmed glasses. He walks around quoting bible verses out of context and warns us of impending Armageddon. After a while, you learn to tune out the people around you, for your own sanity.

I almost forgot about the middle-aged French guy who sits quietly in a recliner off in the corner, periodically looking out the window. He’s normal. I’ve talked to him a few times in the last few days between TV commercials. His name is Jacques and he’s originally from Bathurst, New Brunswick. He came to Toronto last year and was unable to find work and accommodations, finally ending up homeless.

“I suffer from depression as well,” Jacques confided to me the night before last. “I signed myself in here just so I’d have a place to stay for a while, food and a roof over my head.”

“Don’t the other patients bother you?” I responded.

“Not really. This is much better than being on the street. At least I get three meals a day.”

“I guess.” I shrugged, not really convinced by his logic.

Charlotte returns from breaking up the fight and touches my shoulder. “Doug? The doctor will see you now.”

This is my first time seeing the resident psychiatrist, Dr. David Crispin. He’s in his sixties, bald, with thick white eyebrows and a bristly white moustache. If he had a mane of the same color hair, he’d resemble Albert Einstein. I half expect to hear a German accent when he talks so I’m surprised by his clipped English accent. “You must be Doug Marsden. Come in and have a seat.”

“Thanks.” I ease myself into the comfortable green chair in front of Dr. Crispin. His name makes me think of bacon frying. I wish they’d serve bacon in this facility.

“Do you know why you’re here, Doug?” Crispin begins, looking up from his notebook that is perched loosely on his lap.

“I’m not crazy, doctor,” I retort. “Yes, of course I know why. I’m struggling with a bout of depression.”

“According to my notes, you tried to kill yourself with your dad’s hunting rifle and it went off, blowing a hole through your bedroom wall and your neighbor’s wall. The bullet was found lodged in the main stairway of your neighbor’s home. The Emergency Task Force surrounded your place. They even fired tear gas through the window of your house. Do you remember any of this?”

“Sure, of course.” The event is kind of fuzzy even though I hadn’t been doing drugs or drinking booze. “I left my parents’ place and went out to play pool with a friend. When we came back, I was surprised to discover the police tactical unit had sealed off the whole block. They were looking for me...”

“You were arrested and charged with ‘Careless Use of a Firearm’,” Dr. Crispin says. “The police brought you here three nights ago.”

“Thank God my neighbor wasn’t killed. She was always so nice to me as a kid.”

Doctor Crispin rubs his moustache. “That would have presented a whole myriad of other complications.”

“Why was I brought here anyway, doctor? The last thing I remember was being placed in protective custody in the East Detention Centre. There was this guy in the cell beside me who kept screaming all night. I couldn’t sleep.”

“Once the authorities discovered your suicide attempt, they put you on a temporary regimen of sedatives and sent you here for observation. After extensive testing over the last three days, I believe you’re suffering from bipolar disorder.”

“What’s that?”

“It’s a mental illness,” Crispin explains, “consisting of cycling emotional highs and lows. The highs are accompanied by feelings of elatedness, racing thoughts, excessive spending and even irritability. But it’s the lows that are brutal. They consist of low self esteem, difficulty concentrating and sleeping, and suicidal thoughts.”

“How long am I going to be here?”

“I see you have a bachelor’s degree in math,” Dr. Crispin remarks, smiling, briefly changing the subject. “That’s great. Of course, by now you’ve realized that you don’t really belong here with our patients.”

I nod. Still, I realize that this would not be like solving a math problem. There are many more variables to consider, most of them emotional. Not my strong suit.

Doctor Crispin’s face softens. “I’ve set up a transfer for you, Doug. We’re sending you to another facility nearby. At least you’ll have your own room and some privacy. I’ve contacted the presiding doctor there and asked that you be put on new medication: lithium for the bipolar disorder and doxipine to help get you out of the depression and sleep at night. It’ll probably take a few months for the medication to work fully, and along with therapy, you should be fine.”

“What’s going to happen with the police?”

“You’ll still have to appear in court and face the charge, but I’m willing to write some letters for your lawyer. Given the circumstances, I don’t think you’ll have to serve any jail time.”

As one of the orderlies ushers me out of the Crisis Centre to a waiting taxi, past “the Professor,” “the Zealot” and the other patients, the thought occurs to me that this place is very much like a butterfly’s cocoon. I feel trapped here, but Jacques feels protected. I’ve graduated to the next hospital and will soon have the luxury of my own room and privacy.

I’ve broken out of the cocoon. Going back to the intricacies of the real world — court, school, job, and my parents — would represent that final metamorphosis into a butterfly. It wouldn’t be long until I was free and ready to get on with my life. Unfortunately, few patients in the Crisis Centre could make that claim.