My first day of work at the Lodge. I woke up at six o’clock with excitement and went down to the kitchen. It is pleasant to be up ina house while the others are still sleeping. I wonder what it is that makes certain moments so splendid and permanent? I think I shall always remember that half hour, sitting in the quiet kitchen, smoking a cigarette and drinking a cup of coffee, smiling to myself with happiness. I don’t think I have ever been so happy since before my mother died.
We met at eight-thirty in the craft shop, and Bea introduced me to the staff. They are all very pleasant (one possible exception here), and I am sure I shall like them. There are five permanent workers and four students from Antioch. I liked best Greta Pearlman, who is in charge of Recreation, a stocky, dark-haired woman of about thirty-five with a plain, humorous face; Carl Lindquist, the shop attendant, whom I met yesterday; and Iola and Robert Clayfield, a newly married couple who are attending Antioch and training together. Bob is studying on the G. I. Bill, and is about my age, or perhaps a year or two older. I will write about the rest of them as I get to know them better.
The staff is divided into two categories: Recreation and Shop. The Shop workers instruct patients in crafts, and the Recreation group take them walking, supervise them at athletics, etc. I am in the latter group, although I hope I shall be able to learn the shop procedures too, as I am sure I would enjoy it greatly. I love lumber, leather, raffia, clay and everything that you can work with your hands.
At the morning meetings Bea outlines a schedule for the day. Attendants are assigned to certain floors, and try to divide their time as fairly as possible among the unprivileged patients on their floor. It was easy to guess, from the degree of enthusiasm with which assignments were accepted, which floors are the most popular. Fourth Floor is the least so. It is for very disturbed female patients who have to be watched closely, kept from using dangerous tools, and to have their poor concentration and coordination constantly stimulated and corrected. Some of them, apparently, have particularly formidable reputations—one woman, whom they call “The Duchess,” seems to be held especially in dread. I hope I will be spared her company for a while.
Third Floor is for disturbed male patients, who, strangely enough, seem to provoke less apprehension than the women. Second Floor is divided into both male and female quarters for patients in relatively good contact. Many of these have ground privileges and do not need to be attended. Field House inmates can come and go at will, without supervision.
Bea has assigned me to Bob Clayfield. I am to accompany him everywhere for a week, observing the way he deals with patients, learning Lodge rules and procedures, and becoming generally orientated to the hospital. At the end of that time, or perhaps of an additional week, I will be issued a set of keys and allowed to escort patients on my own. I must confess this prospect seems none too distant at the moment, for after visiting the floors with Bea this morning I have developed a set of nervous misgivings as to my own capabilities, although she assured me that this is always an unsettling experience to new attendants.
It would have been less harrowing, I think, if we had begun on the second floor and worked our way up through the progressive levels of disorder; but Bea took me directly to the fourth floor. I was prepared to be shocked, or repelled perhaps, and was fiercely determined to survive my first impressions, however forbidding they might be, so important has it become to me to succeed at this work. But the sight of so much tormented, derelict humanity, crowded together in such oppressive, desolate conditions—however necessary—without comfort, privacy or a single grace to dignify their lives, is overwhelmingly sad.
The floor is divided by a wide corridor running down its center, from which the patients’ rooms, five on each side, open off. These rooms have no doors and are completely unfurnished except for a wooden bed and a locked wardrobe. Each has a single uncurtained window, barred with steel wire. At the end of the hall are the heavy metal doors of two isolation rooms, each with a small observation window at its top. Immediately beside the elevator door there is a small cubicle which serves as office for the floor attendants, furnished with a desk, a drug cabinet, a steel sink and a small gas burner. On either side of it are the grilled metal doors of two bathrooms. The south end of the corridor opens onto the wire-barred concrete porch with which each floor is fitted.
Sitting on their heels, crouching or wandering about these bleak surroundings were eight or ten women patients, most of them quite young and many of them barefooted, with unkempt hair and torn, stained clothing. One girl ran softly on her toes in little darting steps, humming to herself and picking daintily at a rip in her dress. Another, with tangled black hair, leaned against the wall, beating it hopelessly, spasmodically with her palm while she sobbed with despair. A young woman whose face I could not see sat on the floor staring down into her lap, her forehead resting on her knees, completely motionless for the whole time we were there. A stout, sly-looking woman of thirty with a flushed and haughty face spit at us and smiled sardonically. From within the rooms came the sounds of quiet moaning, excited chatter or sudden hysterical laughter. The whole floor was permeated with a faint sour smell of sweat and urine, like that of a locker room. Spaced here and there along the walls of the corridor were white-coated attendants, watchful and impassive. They lifted their hands sometimes to disengage gently the fingers of patients who wandered close to them and clutched at their clothing, peering and giggling.
Bea introduced me to the nurse in charge, a strong, sober-looking woman in her forties with a broad freckled face, who sat on a tall stool in the tiny office, brewing a pot of tea. I can’t remember her name, but I remember Bea telling me that she has been at the Lodge for six years and is one of the finest psychiatric nurses in the country.
I was silent as we went down in the elevator to the next floor, and Bea said only, “It’s rather shocking, isn’t it, the first time you see it?”
“Yes,” I said and asked her suddenly a question which, although it was quite spontaneous and sincere, must have sounded very strange: “Why do you work here?”
She did not seem to be aware—as I was almost instantly—of the foolishness and possible impertinence of the question, but smiled and nodded as if it were not only relevant and logical but anticipated.
“That’s something that all of us who work here have to ask ourselves,” she said. “And we’re better off if we answer it as honestly and thoroughly as we can. I hope you will, too.” Although impressed by this answer, I could not help being aware of its obliquity.
The third floor, although it was very much like the fourth with the exception that these were male patients, I found less depressing. Perhaps this is because I was better prepared for what I would see there, but I don’t think this is the entire reason. It seems to me that insanity is much less disturbing—I am not sure, here, of the exact word that I want to use—less sinister, perhaps, in a man than in a woman. It may be that violence is more compatible with a masculine nature, or that derangement is manifested in less subtle, less elaborate ways in men. There was something eerie, something witchlike and profound about those women above that I cannot forget and which I did not feel about the men. I had the impression that the strangeness, the faint alarm they made me feel, was invoked not by the loss of their powers but by their
added
powers. Perhaps this has something to do with my attitude toward women, which has never been very real. [The line which follows has been blacked out vigorously with ink, but I remember it imperishably:
I kept thinking about Mother.
]
I believe that Bea’s intentions, in taking me to the fourth floor first may have been calculated, for on leaving the relative order and normality of the second, which we visited last, I had regained my composure to a passable extent. Here the rooms were furnished in a perfectly orthodox manner, simply but cheerfully, with curtained windows, vanity stands, chintz-covered chairs and all the ordinary appurtenances of a woman’s boudoir. There was a common room, as well, with an old upright piano, a writing desk, bridge tables, playing boards and racks of tattered magazines. The patients were neatly dressed and groomed and exhibited at least a social degree of self-control. Several of them asked me intelligent and courteous questions and expressed their pleasure at meeting me.
When we stepped out of the building into the bright morning sunlight I felt exhausted. Bea made us a cup of powdered coffee in her office, and we chatted for a while. I was not very attentive, and I think she must have sensed this, for her conversation was very general and untechnical, as if her purpose was not to equip me with any more information for the moment but to study my reactions to the morning. She said that she would see me again after the evening O. T. meeting.
I spent the afternoon with Bob, working, to my great relief, with second-floor patients. I found this so absorbing that my apprehensions of the morning disappeared very shortly into my fascination with the work. Our first patient was a Miss Behrendt, a slender, intense, darkly pretty girl of about twenty-two, with a sullen manner and enormous energy. She asked to be taken walking, and we accompanied her at her own ferocious pace up the back road past Doctors’ House (the big old farm building where many of the resident doctors live), Crowfields, and the pond. She strode with her fists in the pockets of her poplin jacket, her chin held very high with a look of contempt for us and our obvious difficulty in keeping abreast of her. Beyond the pond the road turns to the left, continuing on out of the hospital grounds and joining the state highway which runs adjacent to them; she made directly for it. When we were within a few yards of the road Bob stopped and said, “We’ll have to go back now, Miss Behrendt.”
“Why?” she asked indignantly.
“I’m sorry, but you’re not allowed out of the grounds.”
“I went to the movies in Stonemont just two nights ago.”
“You had town privileges then, but they’ve been revoked since.”
She stared at him for a moment, her face growing pale with rage, and advanced one foot slowly in front of her. Her socks and shoelaces were plastered with little green “beggar lice” pods from the weeds that grew along the roads.
“There are burs in my shoelaces,” she said. “Take them out for me, please.”
“We’re your attendants, not your servants, Miss Behrendt,” Bob said easily.
“
Take them out immediately
.”
“This isn’t a very good way of getting your privileges restored.”
“What do you mean by that?”
“I mean that I’ll have to report your behavior, and if it doesn’t improve you stand a very poor chance of getting your privileges back very soon.”
“Are you trying to bribe me?”
“No.”
“I’m going to report that you attempted to bribe me.”
“Just as you like. Now let’s go back to the Lodge.”
She stood staring at him, her nostrils whitening with tension, and said shrilly, “This is outrageous. Outrageous!”
“Are you ready to go now?” Bob said.
She turned swiftly and walked back, at an even faster pace than we had come, toward the Lodge. When we had returned her to the floor, Bob took me into the office. The charge nurse here is Miss Jackson, a younger woman than most of the charge nurses, with red hair and a droll and melancholy face.
“How was Behrendt?” she asked.
“Pretty nasty,” Bob said.
“She’s been getting high for the last couple of days. You’d better write it up.”
“Yes.”
She handed him a report form, which he explained to me as he filled it in, writing the patient’s name, the date and the time of the contact. Below, he wrote a brief summary of her activities and behavior:
Patient asked permission to go walking. Surly and uncommunicative. Attempted to leave hospital grounds by entering state highway. When detained became hostile and defiant. Threatened to report being bribed. No physical violence.
He signed the report,
Robert Clayfield
, O. T., and returned it to the nurse.
“We make these reports after every contact,” he said. “They’re very useful to the doctors. They can be pretty brief, but they ought to include anything unusual that happens.”
“I see.”
“What else can we do for you?” he asked Miss Jackson.
“I’d like to get Meaghan out, if I can. She hasn’t been out of the building for days. See what you can do with her.”
“All right.”
We knocked at Mrs. Meaghan’s door and were admitted by a cool, cultured voice, slightly European in quality. Mrs. Meaghan sat by her window reading a paper-bound French novel which she lowered into her lap, her forefinger dividing the leaves, and smiled at us formally. She is a slight, fastidious, Latin-looking woman in her middle thirties, with very fine features, a mass of black, severely styled hair and a constant controlled expression of pain. She said it was “very kind of us to call” but could not be persuaded to leave the building, as she was sure she would be done harm to. “I have many enemies,” she explained to me gently.
“I’m sure you’d find it was perfectly safe,” Bob said. “In any case, we’d be more than capable of protecting you.”
“It is very kind of you. Perhaps another day. I would enjoy playing cards for a while, though, if you have the time.”
“Yes, of course,” Bob said. “Shall we go in the common room?”
“Yes, perhaps we would be more comfortable.”
We sat in the common room and embarked upon a game of five-hundred rummy, Mrs. Meaghan manipulating the cards with a graceful shrewdness that reminded me of a countess playing baccarat. It was now about three o’clock in the afternoon and the room was illumined with a soft golden glow from the afternoon sunlight, which fell halfway across the carpet and our table, casting a rime of radiance on motes of dust and strands of hair. The room was full of warm silence, broken only by the occasional creak of our wicker chairs or a murmured comment on the play, and a sense of peace, strangely innocent and nostalgic, like that one experiences in looking at old faded photographs in a family album—of people in straw hats, huge mustaches and ankle-length skirts, gathered about an ancient automobile and smiling into the sunlight of a long-forgotten afternoon—a timeless peace, undarkened by any future or anxiety. We had played for perhaps ten minutes when, stealing tranquilly into the still, archaic climate of the room, as if to furnish it appropriately with music from another time and world, came one of the loveliest sounds I have ever heard: a fragile, plaintive fluting of woodwind notes, ruefully, tenderly unreeling the melody of a folk tune, “The Ash Grove.” I lifted my head to listen, enchanted by the sound.