Catatonic Schizophrenia. I had never heard of it before I started working on S-16 at the NS. I had heard of schizophrenia, but I had no idea whatsoever of what Catatonia entailed. I soon found out.
One day, a patient was admitted to the hospital and to S-16. His name was John but went by the name of Jackie. He was as tall as I am (6'1") but much more slender, almost to the point of being underweight. His hair was thinning excessively. He reminded me of Howard Hughes in those pictures of him from the 1950s, albeit sans the mustache. At the time of his admission to S-16, he was dirty and unwashed. His fingernails were also excessively long and his skin looked like it has suffering from some form of psoriasis.
Despite the fact that his schizophrenia left him suspicious of all the nursing staff, he was not combative or resistive. In fact he didn't move at all. He was escorted onto S-16 by one of the staff from Admissions, but once on the Unit, he proceeded to affix himself to the hallway wall just down from the entrance of S-16 and beside the door of his assigned bedroom. Later, after I thought about it, I figured he knew the routine here at S-16 and that was his bedroom from a previous stay at the NS. It was in this spot where I could find Jackie near all of the time.
When he stood there, he was near 100% motionless, with the exception of the occasional barely audible verbal uttering of paranoiac thoughts. If I walked past, or any staff member for that matter, he might slowly raise his head and cast you a fixed glance of suspicion as you walked by him.
At times, after standing there for a few hours, Jackie would suddenly begin walking towards the nursing station, stop at the door of the station and simply ask if he could have a cigarette (cigarettes were rationed to severely disturbed patients or those being punished in some way). He would then take his cigarette and walk into the nearest patient lounge room and smoke only to return to the exact same spot and begin another catatonic physical state. The nicotine stains on his fingers were the worst I had ever seen on any patient at the NS.
Sometimes, I might find Jackie in his bedroom, just sitting on his bed in a fixed position and muttering away in his unique delusional state. Once, when I found him in his bedroom like this, I decided to sit down beside him and ask him questions about what he was talking about. He had mentioned something about "Space Cowboys", aliens, energy and such. I had no real desire to interpret the meaning of his ramblings, I just wanted to hear him speak and observe him, but what I found sincerely interesting was the look on his face when he spoke. It was obvious, the years of taking anti-psychotic drugs and the ravishing of the disease itself had taken its toll on this man who was no more in age than 35 (again he too looked more than 20 years his actual age). His face spoke of the pain and strife in his mind. I felt so sorry for him. He had virtually no control over his thoughts and his brain.
Of all the patients I met on S-16, I found Jackie the most fascinating and for some reason endeared my self to him. If any patients bothered him, I would immediately raise in his defense and protection. Even if he never responded to me, I always spoke to him. It was almost like you were talking to your dog, half expecting the animal to respond, but knowing full well it could never happen.
The other unique aspect to Jackie was, not that he rarely spoke, but when he did he NEVER referred to anyone by name. It was as if he either could not remember anyone's name or chose not to. None of the staff were certain and none of the staff were ever addressed by name by Jackie.
Then one day, I was sitting in the nursing station by the desk surrounded by the lookout window. There was one of the female CNAs and the Head Nurse in the station with me. I watched as Jackie approached the nursing station, expecting that he was coming for a cigarette.
When he arrived at the doorway entrance to the nursing station, he stopped and sttod motionless just looking at me. I asked him if what he wanted was a cigarette. No response. The CNA and Nurse were now, aslo watching him standing there. I repeated my question to him again. This time he replied, "No" and continued to stand there at the doorway of the nursing station. It was at that moment, that the CNA looked at Jackie and said "Okay Jackie, then what would you like?"
"I wondered if Doug could play some pool with me?"
The 3 of us were stunned. Floored actually. Here was Jackie, the catatonic schizophrenic who never addressed anyone by name, now asking for me in particular and to join in some leisurely activity. So, without hesitation, I got up and said "Sure! I would love to play some pool". Like a dog, he walked behind me and directly to my left all the way to the room where the patients played pool. As I walked away with Jackie, I looked back at the nursing station and the Head Nurse and CNS were still dumbfounded looking. Even some of the other patients were surprised to see Jackie playing pool and join in any activity of any kind.
You must understand, this expression of friendliness and camaraderie was so unusual for Jackie. So unusual, in fact, that the S-16 Psychiatrist Dr. A, took me aside the next day, after he had heard from the Head Nurse about Jackie's unusual display of personality, and asked me everything that had happened and wondered aloud why Jackie would befriend me and no other staff. In a polite way, I reminded the doctor that I was the only staff member that took the time to engage Jackie in conversation, so there was a chance he now trusted me more than anyone else.
In time, I had Jackie doing puzzles with nursing students, I was even eating lunch with him in the cafeteria. One time, I even got him laughing at a simple joke.
Only once, did Jackie offer any resistance to the staff. I think there was a period when his mind & body offered a resistance to his current dosage of anti-psych medications, so after a week or so, his schizophrenia worsened. He was rambling and muttering constantly, at time even yelling at passerbys in the hallway. It was obvious his condition has worsened. So, it was determined by the resident Psychiatrist that Jackie needed some Electro-Shock Therapy or "shock treatment". This was not the first time Jackie has received shock treatment, so on the day of his initial treatment he did not want to go. He did not enjoy the experience and had been able to remember that fact he did not like shock treatment. He remained motionless and defiant to go the shock treatment therapy. When one of the female CNAs went to help him towards the bathroom for his preparatory bath, he lunged towards her. Frightened, she came back to the nursing station and complained that Jackie was acting very agitated about going to shock treatment and wouldn't take the required bath. The Head Nurse looked at me and said, "He's your friend, you better convince him to take a bath and go get the shock treatment".
I went to his room where he was standing in between two beds, flush against the wall. He looked at me when I entered the room. "Jackie, what's going on?" I asked. He looked at me but with no reply.
"Well, you have to have the shock treatment because the Doctor said so. That means you have to take a bath Jackie", I continued.
"I'll have a bath but I don't want no shock treatment" he replied back to me. (This was the most complete sentence I had ever heard from Jackie)
I empathized with him. "I understand Jackie, but here's the deal - if you don't take a bath a go to shock treatment voluntarily, then I am going to be forced to call for 3 other Male Staff and then we are going to FORCE you to have a bath and then FORCE you to have the treatment."
I paused and then said, "I do not want to have to do this to you Jackie. PLEASE, for me, just have the bath and the treatment. I will help you with your bath and then be here when you get back from treatment". I was not forceful in my tone, but more pleading.
"Alright" he complied. From there, I took him to the Male bathroom and proceeded to help him with his bath. When he was finished, I gave him a frsh johnnie shirt and housecoat, along witn a couple of cigarettes, and told him to wait in the lounge for me. I then went to the Head Nurse and asked him if I could assist the staff with Jackie's shock treatment. They allowed me to do this, despite the fact I was not scheduled to assist in ECT for that day. I really just wanted to be there for the poor guy when he was anaesthesized prior to receiving his few thousand volts of electricity top his frontal lobes (I would witness many, many more ECT sessions in my time at S-16)
I never found out what happened to Jackie after I stopped working at the NS. I had heard he was there for a few years post 1981, but now I suspect he has since died.
Jackie is one patient that has remained a strong reminder of my days working on S-16. Like so many patients, his face and hands are etched into my memory banks. The only Catatonic Schizophrenic I have ever met or played pool with.
One day, a patient was admitted to the hospital and to S-16. His name was John but went by the name of Jackie. He was as tall as I am (6'1") but much more slender, almost to the point of being underweight. His hair was thinning excessively. He reminded me of Howard Hughes in those pictures of him from the 1950s, albeit sans the mustache. At the time of his admission to S-16, he was dirty and unwashed. His fingernails were also excessively long and his skin looked like it has suffering from some form of psoriasis.
Despite the fact that his schizophrenia left him suspicious of all the nursing staff, he was not combative or resistive. In fact he didn't move at all. He was escorted onto S-16 by one of the staff from Admissions, but once on the Unit, he proceeded to affix himself to the hallway wall just down from the entrance of S-16 and beside the door of his assigned bedroom. Later, after I thought about it, I figured he knew the routine here at S-16 and that was his bedroom from a previous stay at the NS. It was in this spot where I could find Jackie near all of the time.
When he stood there, he was near 100% motionless, with the exception of the occasional barely audible verbal uttering of paranoiac thoughts. If I walked past, or any staff member for that matter, he might slowly raise his head and cast you a fixed glance of suspicion as you walked by him.
At times, after standing there for a few hours, Jackie would suddenly begin walking towards the nursing station, stop at the door of the station and simply ask if he could have a cigarette (cigarettes were rationed to severely disturbed patients or those being punished in some way). He would then take his cigarette and walk into the nearest patient lounge room and smoke only to return to the exact same spot and begin another catatonic physical state. The nicotine stains on his fingers were the worst I had ever seen on any patient at the NS.
Sometimes, I might find Jackie in his bedroom, just sitting on his bed in a fixed position and muttering away in his unique delusional state. Once, when I found him in his bedroom like this, I decided to sit down beside him and ask him questions about what he was talking about. He had mentioned something about "Space Cowboys", aliens, energy and such. I had no real desire to interpret the meaning of his ramblings, I just wanted to hear him speak and observe him, but what I found sincerely interesting was the look on his face when he spoke. It was obvious, the years of taking anti-psychotic drugs and the ravishing of the disease itself had taken its toll on this man who was no more in age than 35 (again he too looked more than 20 years his actual age). His face spoke of the pain and strife in his mind. I felt so sorry for him. He had virtually no control over his thoughts and his brain.
Of all the patients I met on S-16, I found Jackie the most fascinating and for some reason endeared my self to him. If any patients bothered him, I would immediately raise in his defense and protection. Even if he never responded to me, I always spoke to him. It was almost like you were talking to your dog, half expecting the animal to respond, but knowing full well it could never happen.
The other unique aspect to Jackie was, not that he rarely spoke, but when he did he NEVER referred to anyone by name. It was as if he either could not remember anyone's name or chose not to. None of the staff were certain and none of the staff were ever addressed by name by Jackie.
Then one day, I was sitting in the nursing station by the desk surrounded by the lookout window. There was one of the female CNAs and the Head Nurse in the station with me. I watched as Jackie approached the nursing station, expecting that he was coming for a cigarette.
When he arrived at the doorway entrance to the nursing station, he stopped and sttod motionless just looking at me. I asked him if what he wanted was a cigarette. No response. The CNA and Nurse were now, aslo watching him standing there. I repeated my question to him again. This time he replied, "No" and continued to stand there at the doorway of the nursing station. It was at that moment, that the CNA looked at Jackie and said "Okay Jackie, then what would you like?"
"I wondered if Doug could play some pool with me?"
The 3 of us were stunned. Floored actually. Here was Jackie, the catatonic schizophrenic who never addressed anyone by name, now asking for me in particular and to join in some leisurely activity. So, without hesitation, I got up and said "Sure! I would love to play some pool". Like a dog, he walked behind me and directly to my left all the way to the room where the patients played pool. As I walked away with Jackie, I looked back at the nursing station and the Head Nurse and CNS were still dumbfounded looking. Even some of the other patients were surprised to see Jackie playing pool and join in any activity of any kind.
You must understand, this expression of friendliness and camaraderie was so unusual for Jackie. So unusual, in fact, that the S-16 Psychiatrist Dr. A, took me aside the next day, after he had heard from the Head Nurse about Jackie's unusual display of personality, and asked me everything that had happened and wondered aloud why Jackie would befriend me and no other staff. In a polite way, I reminded the doctor that I was the only staff member that took the time to engage Jackie in conversation, so there was a chance he now trusted me more than anyone else.
In time, I had Jackie doing puzzles with nursing students, I was even eating lunch with him in the cafeteria. One time, I even got him laughing at a simple joke.
Only once, did Jackie offer any resistance to the staff. I think there was a period when his mind & body offered a resistance to his current dosage of anti-psych medications, so after a week or so, his schizophrenia worsened. He was rambling and muttering constantly, at time even yelling at passerbys in the hallway. It was obvious his condition has worsened. So, it was determined by the resident Psychiatrist that Jackie needed some Electro-Shock Therapy or "shock treatment". This was not the first time Jackie has received shock treatment, so on the day of his initial treatment he did not want to go. He did not enjoy the experience and had been able to remember that fact he did not like shock treatment. He remained motionless and defiant to go the shock treatment therapy. When one of the female CNAs went to help him towards the bathroom for his preparatory bath, he lunged towards her. Frightened, she came back to the nursing station and complained that Jackie was acting very agitated about going to shock treatment and wouldn't take the required bath. The Head Nurse looked at me and said, "He's your friend, you better convince him to take a bath and go get the shock treatment".
I went to his room where he was standing in between two beds, flush against the wall. He looked at me when I entered the room. "Jackie, what's going on?" I asked. He looked at me but with no reply.
"Well, you have to have the shock treatment because the Doctor said so. That means you have to take a bath Jackie", I continued.
"I'll have a bath but I don't want no shock treatment" he replied back to me. (This was the most complete sentence I had ever heard from Jackie)
I empathized with him. "I understand Jackie, but here's the deal - if you don't take a bath a go to shock treatment voluntarily, then I am going to be forced to call for 3 other Male Staff and then we are going to FORCE you to have a bath and then FORCE you to have the treatment."
I paused and then said, "I do not want to have to do this to you Jackie. PLEASE, for me, just have the bath and the treatment. I will help you with your bath and then be here when you get back from treatment". I was not forceful in my tone, but more pleading.
"Alright" he complied. From there, I took him to the Male bathroom and proceeded to help him with his bath. When he was finished, I gave him a frsh johnnie shirt and housecoat, along witn a couple of cigarettes, and told him to wait in the lounge for me. I then went to the Head Nurse and asked him if I could assist the staff with Jackie's shock treatment. They allowed me to do this, despite the fact I was not scheduled to assist in ECT for that day. I really just wanted to be there for the poor guy when he was anaesthesized prior to receiving his few thousand volts of electricity top his frontal lobes (I would witness many, many more ECT sessions in my time at S-16)
I never found out what happened to Jackie after I stopped working at the NS. I had heard he was there for a few years post 1981, but now I suspect he has since died.
Jackie is one patient that has remained a strong reminder of my days working on S-16. Like so many patients, his face and hands are etched into my memory banks. The only Catatonic Schizophrenic I have ever met or played pool with.
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