Lights Over The Inpatient Facility

Lights Over The Inpatient Facility 

By Matt Keating

1990 Words

"Major Briggs, share for us, if you would, your impressions of what you're seeing there."

"Tammy, after seven years as a doctor and fifteen years in the army, I can say without hesitation that this is the most horrifying combination of events that I have ever witnessed any-"

"Colonel, did we lose you? Can you hear me? We have begun to experience the electrical interference that we were warned may be possible when the lights first appeared. We seem to have lost contact with the Colonel, but if we get her back, we will certainly be asking what to expect next."

"-can you hear me Tammy?"

"Yes, we hear you—Colonel? You’re on the air with Tammy. What are you seeing? Can you hear me?"

"I can hear you, but I don’t know for how long. The fires are out of control. It's not just the lights! The electromagnetic effects on our— The interference appears to be worsening. I don’t know if you're picking up that buzzing sound on your end. It's getting worse! If I lose you again than God bless—"

"We may have lost her for good this time. I don’t want our listeners to be alarmed, we are seeking confirmation that the Colonel did, indeed mention fires. If this is the case, we will investigate the source of these fires and what affect they may be having on nearby communities. Our initial investigation was into the lights appearing above the Northern California teaching hospital and psychiatric care facility. If there are fires on the ground accompanying the lights in the sky, count on us to continue this live and breaking coverage of the scene. We have to take a quick break; I'm Tammy Kay and you're listening to National Public Radio."

Before the dying of every engine’s roar, before the lights and the flames and my eventual emancipation from the monotony of mental patients, I smelled only that baby powder smell in that goddamned activities room. The fishhooks that had grabbed my mind and kept me from moving on from that haven of mediocrity had grown into hardened meat hooks and I hung from them like something out of Dante instead of doing anything about it. Until I finally did. I have Will to thank for that. 

I first learned about the somatic effects of delusions when I was in college. That was back when the plan was simple. Start a practice and make a lot of money. Just worry about nothing all day until I started wetting the bed again, until my spit dried white at the corners of my mouth and I stared out from myself with that half terrified, half gentle look of the mindless. 

Somatic delusions were a rare and misunderstood concept back when I began my research. I was young. When words like abnormal or antisocial came up I was immediately turned on. But once I'd matured into my third year and the beginning of my practicum, my tastes matured and became nuanced. I was focused on dual diagnosis patients and delusional behavior. 

My first encounter with a truly doomed individual was the day I met Will.

Dual diagnosis patients suffer from a mental illness and addiction at the same time. A person suffering from certain delusions, somatic delusions in this case, may obsess about some aspect of their body, their skin for instance. There is nothing abnormal about their skin in reality. However, their preoccupation with their skin is so profound that their anxiety about it sets off bouts of psychosomatic rashes and sores. This hell-rot on the tissue is caused by the chaos-storm in the mind. These somatic presentations of irritation, rashes, and open sores occur so frequently that their presence reinforces the sufferer’s belief that there is a physical abnormality and that their psychologist is lying to them.

That word, abnormality, it's delightful.

Will was in his third year at the North Cal. inpatient facility. He had the usual background, nothing too out of the ordinary. Will was homeless before he was admitted. He grew up in an uneducated, lower middle-class family from one of California’s more rural and less discussed counties. His family lacked both resources for managing his care and the understanding that he was suffering from genuine psychological abnormalities. They treated Will first with prayer, then with punishment, finally with an array of sedatives to make him sleep.

Will and I spent silent hours together four days a week. I mostly read comic books. Occasionally, I took notes on what Will was drawing, how he seemed in that moment, whether he was cleaning himself, and shit like that to appease the powers that be. On the Sunday morning before the lights appeared, Will was drawing a brown dog tied to a stick that was driven into the ground in front of a red doghouse. He drew this image and images related to it all the time. I wrote a paper describing Will as the brown dog, his mental illness as the chain, and the red doghouse as the fantasy of a happy, comfortable, and safe home that Will would probably never know. The paper was terrifically engaging.

Slouching in the corner of my preferred leather couch beside a bag of comic books, I was awash in art therapy’s inherent clinical silence. I received a weekly NPR Tote Bag of all the new issues of my favorite comic books, each one tucked safely inside a thin plastic bag with a white carboard backing. I read thirty comics a week during those delightfully wasted therapeutic hours with Will. He drew his scene of the dog and the doghouse. I nurtured a semi while thinking about She Hulk.

The day of the lights I was ruminating on an especially lovely panel in which She Hulk is going into battle with several other Avengers and the X-Men. I was in a moment of filthy rapture observing that She Hulk was drawn in a way that her top seemed almost not even there, just those bulging green muscle mammaries, when Will spoke to me.

He said, "Why do you do that to yourself?"

I was stupefied for a moment while She Hulk, and her green bosom went out of my mind and new fantasies of Will’s spontaneous healing from our therapy sessions became my focus.

"Do what, Will? Are you feeling okay? You seem especially lucid just now."

"I'm asking you why you do that to yourself. We could be discussing any number of topics that interest you. We could be conversing back and forth, sharing ideas about the here and now. But instead, you sit there, mute, achieving barely veiled sexual gratification from pictures of women who not only do not exist but cannot exist in the real world."

I was shocked into focus. Where did this moment of acute judgmentalism come from and what had he done with ol’ delusional dual diagnosis Will?

"I was just biding my time until you brought up something worth discussing Will. I wanted to give you time to enjoy the drawings. If there is something you want to discuss I will be happy to break out the Steno book tout suite good buddy."

"The first thing I would like you to do is to explain this last drawing to me."

"You want a little critique? Is that it? You want me to tell you what I think of the work there Will?"

"Please."

Will was recognizing, I think, that I could be not only a passive care giver, but that I could be his audience. I could have opinions, and Will suddenly cared about those opinions. Will appeared focused and even capable of empathy, probably for the first time since anybody kept charts on the guy.

"Okay Will. In this one I see that the dog is sleeping. He is still chained outside the doghouse, but he is asleep. I guess that makes me think the dog is content, even happy. He could be happy, right? This sun drawn shining in the top corner here makes me think the dog is warm. I think he is a happy, warm, sleeping dog."

I did well in responding to Will’s uncharacteristic acknowledgment that I was present in the room with him. I kept out all the psychobabble, I focused on what I saw, not what I thought. I wasn’t an expert today; I was just a person sharing a couch and an opinion.

Will presented me with a second drawing, this one came from a manila folder sitting on the coffee table that I hadn’t noticed until just then.

"Well, this is a very different scene Will. This dog is on fire. The doghouse is on fire too. There is no sun. There is no chain. Does this mean the dog could only get free of the chain if it was dead? Did the doghouse catch on fire and the dog tried to go inside and that's how he caught on fire too?"

Will was shrewdly staring me down from his chair. One leg was crossed over his knee.

"Those are very reasonable observations. It is interesting that you think the doghouse was on fire first and that the dog might have been a victim of the burning house. However, you made no guess at who or what may have set the doghouse on fire in the first place."

In his calm, in his control, Will was beginning to frighten me. I was good, the talk of the town, the lauded writer of published papers on psychoanalytic assessment of delusional dual diagnosis Will, but I wasn’t equipped for this kind of doctor-patient-role-reversal. I asked Will if he would excuse me a moment, placing the drawings on the coffee table and subtly packing up my comics before extricating myself from the activities room. That was right when the lights appeared overhead.

It was odd to be able to push through the door out into the hall. It was dark. Even stranger, I was able to waltz right past the front desk where there should have been a check-in lady. The TV where she watched her stories was off. I didn’t need her to buzz the front entrance open for me. 

I made my way to the comic book store. The guy there must have been new. He didn’t recognize me, just kind of looked me up and down. I went to the corner gas station. The guy there looked me up and down too. I knew what I wanted so I helped myself and left while he was preoccupied with the lights in the sky.

Will didn’t survive the flames. The sirens screamed. I hope Will went quietly. I hope he thought of me, for a second, at the end. 

People rushed from the building. Patients banged on the steel grates that secured the windows. I guess they weren’t familiar with the evacuation plan. I was never a pyro guy, not really. Most of them were on the fourth floor. They didn’t get activity room privileges. I thought of them, the pyros, as the flames grabbed onto whatever they could burn. Lights darting around in the sky and the two cans of lighter fluid and a Bic from the gas station was all it took. 

I remember the warmth on my face, the thought that those guys on the fourth floor finally got what they wanted, that Will would never be able to judge them. I remember a draft blowing up and me having to tuck my gown down in between my legs as I sat on the hill across the street from the facility. I rewarded myself with another long look at that panel of She Hulk. All the sirens were dead, the lights were off all over, and all the cars had rolled to a gentle stop. The lights in the sky had flown away.