Images: September 16, 2005
The first thing I notice when I walk into the ward is the fact that the walls are nearly entirely windows. The drywall has been cut off approximately four feet from the ground and everything above that line is all clear so the staff can keep an eye on the residents. The ward is horseshoe-shaped, with the Nursing Station in the center, the patients' rooms lining the perimeter of the horseshoe. I see several elderly patients sitting in the common room, which has a television, several couches, and several dining tables. And I hear screaming.
The Screamer1
The Screamer is sitting in what is supposed to be a second common room, perhaps a space reserved for group therapy sessions. The Screamer has earned this space all to herself, as the noise probably drives the other patients into agitated states. The Screamer is an elderly woman with late-stage dementia, probably Alzheimer's, and during the times that she is lucid, she is able to describe the auditory and visual hallucinations that she experiences. The rest of the time, she is yelling at the top of her lungs. The screams make no sense - rarely there is word formation, so for example, one could hear:
"AAAAAAAAAAAAAAAWHYYYYYDIIIIIDYOOOOOUUUUAAAAAAAAAAA"
but most of the time it's merely babble. Babble at a really loud volume.
Earlier this week, The Screamer was agitated, and the babble was especially loud. Apparently, during one of her lucid states, one of the other patients had gone up to her and told her that she had been "molested" by several men earlier (but not in those words). This upset her, as it would anyone, and it manifested in a particularly disturbing screaming fit. You ask yourself what kind of person would walk up to someone else and say something like that, which brings us to...
The Shark2
The Shark is an elderly man who is confined to a wheelchair because his right leg was amputated above the knee sometime during World War II. He also is suffering from dementia. The Shark likes to prowl around in his wheelchair all around the floor. One morning during rounds, we heard someone fiddling with the door handle. I turned to look, and saw the top half of The Shark's head cutting across the base of the windows as he made his "escape". The image reminded me of the shark fin cutting through the water in Jaws - explaining the 'dah-dum...dah-dum...dah-dum-buhm-buhm...dah-dum-buhm-buhm...' as The Shark wheeled himself by the windows.
The Zombie
Imagine walking down a street and seeing a complete stranger who absolutely needed a hug. Multiply that by a factor of 20 and you have The Zombie. The Zombie, to me, defines the image of depression. Every symptom of SPACE GAS is there. His depression is so profound that he has tremor in his right arm which worsens when he gets upset; the length of his stride is about 8 inches max. He can't eat, can't sleep, has no energy, has no interest in life - we're watching someone die extremely slowly. To me, the most striking element is the level of guilt this man carries. Being a Conservative Baptist, he believes he's being punished for his sins. He's even fabricating guilt: yesterday The Zombie saw a pair of pants on his bed - these pants belonged to his roommate, and The Zombie, rather than thinking that these pants had been mistakenly placed on his bed, believed that he had stolen them and placed them on his own bed.
What hurts is that The Zombie has not shown very much improvement at all. There is not enough staff around to give him adequate psychotherapy, and his depression has so far been resistant to antidepressant medication. He is a superb candidate for electroconvulsive therapy (ECT), but he and his family have so far refused the treatment, most probably because of the the negative images it conjures up in the imagination. We're planning a group meeting with The Zombie and his family - hopefully, we'll be able to educate them on the benefits of ECT. Otherwise, we fear The Zombie will never feel happiness again.
1 I've given the patients nicknames, which are for descriptive purposes only. Not that I don't trust everyone's reading comprehension abilities, but I think it needs to be stated that I intend nothing derogatory.
2 The Shark broke his hip a while ago and still had staples in his leg from the surgery. The resident let me take them out. It wasn't that exciting, but I noticed that my hands were shaking throughout the procedure. I wasn't especially nervous, and I'm hoping that the shakes were from the caffeine I'd taken in earlier. If not, it doesn't look like I'll be following my father's footsteps into surgery.
Right now I'm listening to: (What's the Story) Morning Glory?, Oasis
The Screamer1
The Screamer is sitting in what is supposed to be a second common room, perhaps a space reserved for group therapy sessions. The Screamer has earned this space all to herself, as the noise probably drives the other patients into agitated states. The Screamer is an elderly woman with late-stage dementia, probably Alzheimer's, and during the times that she is lucid, she is able to describe the auditory and visual hallucinations that she experiences. The rest of the time, she is yelling at the top of her lungs. The screams make no sense - rarely there is word formation, so for example, one could hear:
"AAAAAAAAAAAAAAAWHYYYYYDIIIIIDYOOOOOUUUUAAAAAAAAAAA"
but most of the time it's merely babble. Babble at a really loud volume.
Earlier this week, The Screamer was agitated, and the babble was especially loud. Apparently, during one of her lucid states, one of the other patients had gone up to her and told her that she had been "molested" by several men earlier (but not in those words). This upset her, as it would anyone, and it manifested in a particularly disturbing screaming fit. You ask yourself what kind of person would walk up to someone else and say something like that, which brings us to...
The Shark2
The Shark is an elderly man who is confined to a wheelchair because his right leg was amputated above the knee sometime during World War II. He also is suffering from dementia. The Shark likes to prowl around in his wheelchair all around the floor. One morning during rounds, we heard someone fiddling with the door handle. I turned to look, and saw the top half of The Shark's head cutting across the base of the windows as he made his "escape". The image reminded me of the shark fin cutting through the water in Jaws - explaining the 'dah-dum...dah-dum...dah-dum-buhm-buhm...dah-dum-buhm-buhm...' as The Shark wheeled himself by the windows.
The Zombie
Imagine walking down a street and seeing a complete stranger who absolutely needed a hug. Multiply that by a factor of 20 and you have The Zombie. The Zombie, to me, defines the image of depression. Every symptom of SPACE GAS is there. His depression is so profound that he has tremor in his right arm which worsens when he gets upset; the length of his stride is about 8 inches max. He can't eat, can't sleep, has no energy, has no interest in life - we're watching someone die extremely slowly. To me, the most striking element is the level of guilt this man carries. Being a Conservative Baptist, he believes he's being punished for his sins. He's even fabricating guilt: yesterday The Zombie saw a pair of pants on his bed - these pants belonged to his roommate, and The Zombie, rather than thinking that these pants had been mistakenly placed on his bed, believed that he had stolen them and placed them on his own bed.
What hurts is that The Zombie has not shown very much improvement at all. There is not enough staff around to give him adequate psychotherapy, and his depression has so far been resistant to antidepressant medication. He is a superb candidate for electroconvulsive therapy (ECT), but he and his family have so far refused the treatment, most probably because of the the negative images it conjures up in the imagination. We're planning a group meeting with The Zombie and his family - hopefully, we'll be able to educate them on the benefits of ECT. Otherwise, we fear The Zombie will never feel happiness again.
1 I've given the patients nicknames, which are for descriptive purposes only. Not that I don't trust everyone's reading comprehension abilities, but I think it needs to be stated that I intend nothing derogatory.
2 The Shark broke his hip a while ago and still had staples in his leg from the surgery. The resident let me take them out. It wasn't that exciting, but I noticed that my hands were shaking throughout the procedure. I wasn't especially nervous, and I'm hoping that the shakes were from the caffeine I'd taken in earlier. If not, it doesn't look like I'll be following my father's footsteps into surgery.
*******
Right now I'm listening to: (What's the Story) Morning Glory?, Oasis
posted by Mikey at 11:50 PM
1 Comments:
what's the story morning glory -
shut up-that's totally a 'memories of English boyfriend album'. Funny. great music, though, anthemic english music rocks.
so, wow. I'm pretty geeked up on caffeine so, there isn't anything else that I need to say right now. Check back with ya later (felt great to see SPACE GAS at work lol).
ciao
kinjo: thanks for your vote! that totally made me laugh and feel so validated (it doesn't take much these days lol). not to be dramatic, just, well, ....dzzt!...A.D.D. nevermind lol
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