John Clark posting today: I don’t count sheep when I have insomnia, I count people I knew who killed themselves instead. Working in a long term mental health facility makes you do things like that. The number, by the way, is well over thirty people who decided the pain of living was greater that the act of taking their own life. Not all of them were patients, some were co-workers, others good friends. Having looked that demon in the face a few times myself, I can empathize with those souls who weren’t able to pull back from the abyss in time.
I’ve shared bits and pieces of what happened between November, 1970 and August, 1997, but this is the first time I’ve attempted to write something tying my experiences to why I became a writer and how I look at the world in a very different way. I ended up working at the Augusta Mental Health Institute when my draft board accepted my contention that I was a conscientious objector. How I became one is an interesting tale and fit for a column of its own. I had two options: Work for two years at AMHI or do a similar stint at BMHI. Since I lived in Union, AMHI made more sense.
I had one day of orientation to a locked ward on the Harlow Building before being assigned to the 4-12 shift. That certainly prepared me to manage 30+ chronic male patients the next night when the other staff member assigned to the floor called in sick. Fortunately I was too clueless to be as scared as I should have been, even when I had to put an older guy who was in the manic stage of bipolar disorder in a seclusion room without any help. It went okay, but he could just as easily have taken me apart.
Since I wasn’t allowed to live in Union, per draft board regulations, I took a room in the old chapel building. Rooms were assigned by seniority, so I was on the top floor where cubicle rooms were separated by eight foot partitions. There wasn’t much in the way of creature comforts, quiet or privacy, but they were free and that was a big plus when you’re making $86.50 a week.
My head was still messed up from things that happened while I was at Arizona State; Anti-war activity, substance abuse, fraying friendships and family stress had made my life an unpleasant circus. None of it was stuff I was willing or able to talk about or dump, so I embraced the dysfunctional world I found at the state hospital with abandon. It didn’t take long to discover that many of my new co-workers were walking a similar path and before long, there was a core group I took to calling ‘Interchangeable Parts’ because we seemed to fall into short relationships with each other that lasted a couple weeks, before moving on to someone else in the group. The evening shift was perfect for an alcoholic like me. I could party after work, crash, get it together enough to arrive at work in reasonably presentable shape (the day shift was so eager to leave and party or take care of families, they barely noticed my condition on those days when I did arrive still buzzed), slowly return to what passed for normal and then when the midnight shift (many of whom were stoned), arrived, bust out the door to repeat the same insane routine.
If I’d had any sort of mental health or sobriety, I would have left after my two years were up, but things conspired to keep me there. One was an experience I’d wish everyone could have at least once in their life, albeit with happier results. Several hospitals in the area used AMHI for the psychiatric portion of their training programs for nurses. St. Mary’s in Lewiston was one of them. When their group arrived in September of my second year, I walked into the cafeteria for supper one evening and stopped dead in my tracks. A young woman with amazing blue eyes and blonde hair turned and looked at me. When she smiled, time froze momentarily and I was a goner. It took a day to learn her name and where she was assigned. That afternoon, she was part of a pickup volleyball game and when the ball hit her finger, it broke. I was able to overcome a serious case of shyness and helped her get medical attention. Over the next few weeks, we started to develop a relationship that was amazing. There are people who have a spiritual connection so strong they often don’t need to speak in order to communicate. We had one and it was scary. There was one slight problem. She already had a boyfriend, but we set that thorny issue aside and after she returned to school full time, we continued to see each other whenever possible, even going to Montreal and Washington, DC on our way to North Carolina where we walked along the shore at Kill Devil Dunes.
My substance abuse was stronger than the bonds between us and I ended up running away when things got tough. She married the other guy and I haven’t seen her in 35 years.
Despite being a walking moral and spiritual disaster, I made some wonderful friends while working there. The summer after my romance fell apart, I was assigned a willowy blonde who was working as a summer replacement. There was immediate friction between us. My arrogance bugged her, her effete Boston snobbery annoyed me, even though she was from Augusta. This was the time I learned that strong reactions during first impressions are often 180 degrees out of phase. Shannon and I were able to work through our initial dislike and became friends. We realized there were more things we had in common than either wanted to admit. When she returned to school, we stayed in touch and I got in the habit of visiting her in Boston when I had longer weekends. We’dexplore the Combat Zone, Boston Commons and frequently ended up at a night game in Fenway Park. We even explored the historic areas in Lexington and Concord. Perhaps the most vivid memory I have from that friendship happened one night when a bunch of us were sitting in her living room with the lights off, mellowing out and listening to WBCN. This mind-blowing version of “These Are A Few Of My Favorite Things” came on and everyone stopped talking to listen. I was enthralled, but the DJ never said who the artist was. It wasn’t as easy to figure out things in those days, so it took several years before I learned that the artist who hooked me that night was John Coltrane. Shannon and I headed in different directions, but I still remember those times in Boston and they bring a smile to my face.
There was no such thing as political correctness in my early days at AMHI. If something needed to be done, you did it and to hell with such silly things as feelings. Three events during my early years have helped me understand and empathize with people who suffer from PTSD. Before the suicide fence was installed on the big bridge in Augusta, it was a common thing for one of our patients to jump into the Kennebec River. One woman who did so in November, wasn’t found until the following February. The frigid water had delayed decomposition, but her face had rubbed against rocks along the shore and she had frozen into the fetal position. In short, she wasn’t pretty to look at, but we had to get her into a position where we could put her in a body bag and slide her into one of the cadaver slots in our morgue. This necessitated three of us pushing on her knees until her legs were straight. The resulting cracking and crunching is something I can still hear to this day.
Two years later, I was the assistant team leader on a treatment unit serving Androscoggin, Oxford and Franklin Counties. Although it was ill advised, I was dating my supervisor and we took a van load of patients to a hockey game at Colby College. When the game was over, one of the men we brought bolted for the door and we couldn’t find him. Despite searching on foot and spending almost an hour driving around, he remained missing. After reporting the incident to the Waterville Police Department, we returned to AMHI. The following week was an agonizing one. The man was found dead in a corn field half a mile from the college two days later. He had died from exposure. While we had gone on the outing with the best of intentions, the implication during numerous interviews with the police and AMHI administrators was that our personal relationship had made us lax and in some way contributed to this death. That wasn’t as all true, but cast a pall over work and our personal lives for a long time.
The following summer, the most bizarre experience I’ve ever had (or ever will have, I expect) took place. We had established a semi-supervised floor on Upper Elkins where patients who were in the process of transitioning back to the community were housed. The protocol was for a staff member to check on the folks living there every four hours as well as remind them when it was time to eat or get their medication. One Saturday afternoon, the staff member who was doing the 4 pm check came back with a strange look on his face. “You better come with me,” he said. When we returned to the top floor, one of the male patients was hanging from a sprinkler pipe. We removed the necktie he’d used to hang himself, attempted CPR and called for stat medical help. The physician on duty checked for vital signs, pronounced him dead and ordered us to process the body. We did so, removing his outer clothing and zipping him into a body bag before taking him to the morgue in the basement. When we returned, the physician, an excitable gentleman of middle eastern extraction, realized we had violated procedure by not waiting for the medical examiner. He ordered us to retrieve the deceased, then dress and re-hang him. We did so, waited a couple hours for the ME to arrive and do his job, before repeating the steps we’d done before realizing the error. That would have been plenty of trauma for one evening, but after we returned a second time from the morgue, the physician looked at me, threw up his hands and said, “I can’t deal with this situation any longer. I want you to call his wife and give her the bad news.” He stalked off while I was wrapping my head around his order. I did so, but made certain I got as hammered as possible after work.
After that, the workplace insanity assumed more subtle forms. Following another reorganization, I was assigned responsibility for patient education even though I had no formal training as a teacher. I had a small staff and the upper wing of a building. How to figure all this out? It was during the early part of this career change that I got sober. It didn’t take long to realize how overwhelmed I felt. One thing most sober drunks will agree upon is that in early sobriety, you feel like a raw nerve lying on a busy sidewalk. It’s like having to learn to walk all over again. In hindsight, I’m extremely grateful I learned what was happening pretty quickly, because there’s nothing scarier than having a 32 year old body with a 14 year old trapped inside when the world expects you to be responsible and mature. Unfortunately, the people I reported to had serious substance abuse issues of their own and my recovery made them very uncomfortable. That situation was exacerbated when I was moved under the supervision of a woman who was full of bottled up rage at an ex-husband who was a drunk and walked out on her. She found very creative ways to exact revenge on any males working for her and I had a double bulls eye because I was sober. It reached a point where I knew that every time I returned from vacation, either I’d lose a staff member or have my schedule revised without any input from me. It certainly tested my sobriety on a regular basis.
Fortunately, I had negotiated an agreement with the administration that accomplished two important things. I got permission to set up a weekly AA meeting on the grounds for patients and community members. That meeting, known as the Monday Noon Eye-opener, ran for more than ten years. In addition, I was given the okay to use a van and transport patients to AA meetings in the community. For a period lasting about four years, I took people to meetings 6 times a week and in the process, got to witness plenty of miracles. On the flip side, I saw how deep the disease of addiction could dig its claws into some who were unable to recover. I befriended one teen from the Portland area and must have taken her to over 700 meetings, but she was never able to stay sober. I wonder at times whether she’s still alive.
Mental health underwent a sea change in the late 1980s. People coming to AMHI started showing much less motivation at the same time that the patient rights movement went berserk. The patient education program went from providing meaningful education and coping skills to over 100 students per week to having less than a dozen show any interest. I lost my staff and there were days when I felt like I was auditioning for the Maytag Repairman’s role. Fortunately, I had gotten a Commodore 64 computer with some federal grant money and when things were dead, I started playing around with some basic hacking while killing time with some role playing games. That time spent playing with a primitive computer would play big dividends in my next role at the institute.
When Joe Craig, the librarian and man who married us, decided to retire, I went to the assistant superintendent and out of sheer desperation made him an offer he couldn’t refuse. “Let me take on the patient and medical libraries and I’ll modernize them while still teaching anyone who wants to learn.” I had no experience as a librarian, but desperation makes us do the impossible sometimes. He assented and the first thing I did was ask for help. The medical library had a great journal collection, but Joe hadn’t been interested in working with other librarians. I was taken under the capable wings of the medical librarians at St. Marys and Central Maine Medical Center. They answered every question I could throw at them, got me involved with HSLIC (The Health Sciences Libraries Information Consortium) and talked me into joining DOCLINE. This was the National Library of Medicine’s national interlibrary loan service and because I had a really good collection of mental health periodicals, libraries all over the U.S and Canada were eager to establish reciprocal agreements with my library. I also got talked into joining the Medical Library Association and that led to attending and eventually presenting at the annual Medical Library conference. I went to Washington, DC, Kansas City and Seattle. Each time, I made more friends from all over the world. One was Mary Johnson, director of the library at the Missouri Institute of Mental Health. She was the person responsible for my first major piece of writing when she talked me into doing a chapter in Library Services In Mental Health Settings, published by Scarecrow Press in 1997. A year later, she took over as editor of Behavioral and Social Sciences Librarian, a journal published by Haworth Press. Once again, she talked me into writing, this time a column on internet and social science libraries. I continued to do so for the next ten years.
At the same time, I completely revamped the patient library. After I discovered that an endowment had been left by the late Col. John Black of Ellsworth to buy books, I had a field day, poring over the reviews in Booklist every month and adding things that sounded really interesting to the collection. Both patients and staff responded with enthusiasm and in the process, I began learning about the art of matching people with books they’d want to read.
When the late Walt Taranko and Tom Abbott arranged for the University of South Carolina to offer their masters in library science degree via ITV and on-site classes here in Maine, I was initially ambivalent, but realized it was a golden opportunity to move on from AMHI if need be. It was a life changing experience. Because most of those enrolled in the first cohort were older and already working as librarians, the faculty let us do projects in areas where we really had an interest. I loved that.
Unfortunately, while I had more than fulfilled my pledge to modernize the library, AMHI was battling its own demons. Patient rights had gone too far and the staff had very little in the way of power to make patients comply with treatment. Many of my male co-workers were badly injured when patients went out of control. (Several have since died at a much younger age than they should have). Every time there was a crisis, management seemed to come up with another way to circle the wagons and shoot inward.
In late 1996, I was told that in order to retain my job, I had to assume the role of director of staff development in addition to my library duties. In essence, I was to do two full time jobs for one salary. Despite having both resentments and reservations, I went along, but it was an impossible situation from day one. Staff had to meet certain training requirements in order for AMHI to retain Joint Commission on Hospital Accreditation certification. Similar requirements were in effect if we wanted to keep federal money from Medicare coming in. Unfortunately, while I was mandated to get people to training, I had no leverage when it came to forcing staff to come to their scheduled classes. Invariably, they’d be frozen or scheduled for mandatory overtime. When the statistics were discussed at meetings with the administration, my comments about having no power to make people attend, carried no weight. It was still my fault.
By the time I graduated from library school in July of 1997, I was in a very dangerous mindset. I was beginning to understand why people went postal in the workplace. When the thought of wearing a trench coat to work with my Remington 1100 underneath it started having real appeal, I took early retirement instead. I had no job lined up and plenty of bitter feelings toward the mental health system.
Those feelings have subsided over the years, but the experiences during those 27 years still effect my outlook on life every day. Fortunately, I’ve been able to take my darker thoughts and turn them into some pretty decent writing and as time goes on, I’m sure there will be further opportunities based on some of what I’ve shared here as well as things that there wasn’t room for. I think differently and see the world in ways ordinary folks can’t as a result of what happened at AMHI.
I have many other interesting memories of my time at the asylum, things like cleaning hornpout in the medication room and neglecting to let people know the guts were in the contaminated waste can, the giant cockroaches in the tunnels, the midnight motorcycle races through those tunnels and the kids we helped to understand that they were okay, but came from families hell-bent on making them scapegoats. Those may show up in a Level Best story some year.