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article: What My Patients Knew
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WHAT MY PATIENTS KNEW

In September of 2001 I worked in a residential psychiatric facility. I was the overnight charge nurse and my residents were what we consider chronically, hopelessly insane. None were criminals.

I liked overnights because my residents tended to need so much then. They needed crackers or a cigarette or just someone to talk to.

When there is no sun (like at night), crazy folk tend to lose their inner compass. And instead of handing out tranquilizers, I made sandwiches and talked to them. I found, in that population, some wonderful people and what struck me the most was how frantic they were to tell me things. They wanted me to know that the phones were tapped. They wanted me to know that aliens came into the building at night and took skin samples. They wanted me to know that sometimes, the radio beside their bed would switch, on its own, to a station that spoke directly to them.

September 9th and 10th were horrible. I remember thinking it had to be a full moon; it's no joke that a full moon makes crazy folk about 200 times worse than usual.

By the way: my use of the term "crazy folk" is not a putdown, it's absolutely what I believe and they did, too. These were not curables. These people would never even make it to a halfway house. These people were wildly insane and I loved them so much that even writing about them pounds me with memories.

On September 11, 2001, this country faced a devastating blow. I worked that night and when I walked in, every resident was sitting in the front lounge watching TV. Over and over again, the Twin Towers went down. Over and over, media folks gave their views on what had happened and why.

My residents were dead silent. They were not surprised. They were not afraid. They were, simply, sad.

When I myself got far enough beyond that horrifying tragedy, I got out all the charts and the med logs and here is what I found, according to the notes I still have: on September 9, 2001, I had given 87% more tranquilizers (at residents' request, I do not like giving meds for something that may need to be discussed instead) and on September 10, 2001, I gave 94% of my residents sedating medication because they were so worried and panicky. I had one resident go so wild with fear that I had to call and get an order for injectable Haldol, something I hate doing, but she was so over-the-top that I feared for her safety and my own.

When I re-read my own notes, I am shocked beyond belief again at what I find. I photocopied certain chart entries and my journal is my own; on charts I scratched out names because of HIPAA (Health Insurance Privacy and Portability Act, or "Our Promise That We Will Not Share Your Health Information With Anyone Unless You Agree" ).

Keep in mind that it was my job to document anything one of them said that seemed significant. It could mean an increase in mood stabilizer was needed, it could mean they had a plan for suicide, it could mean that they were being abused on visits home. We didn't know unless we had a graph, so to speak, of how much medication we were handing out, especially late at night and in the early dark hours of the morning. We also had to document behavior, endlessly trying to solve the puzzle that is "insanity."

In my nursing notes, I found that on September 9 and 10, get this, 78% of my residents had told me point-blank that a crash would happen. Every one mentioned a tall building; all but four mentioned a jet. Only two of that 78% did not specify New York.

In my nursing notes, I found that 69% of my residents said the Pentagon would explode. I am counting those who said it would be in Washington, DC, in a round building.

Some of my residents were too ill to know what the Pentagon is; some had never gotten that much education, depending upon when they had their first psychotic break.

At about two a.m. on the 11th of September (a mere few hours before the tragedy), I had three residents pacing the hall. I allowed that, I forbade any staff member to play bully

and tell them to go back to bed. Pacing can be calming and it sure as hell is safer than Haldol.

One of those residents, a man, came to the nurses' station (I had more freaking paperwork at that job than any job since) and he was crying, an unusual thing, and he said, "Mouse, please. Please call the White House, tell them...." and I said, "Tell them what, John?" and he sobbed, "Tell them that people will die tomorrow, so many people, and they're the lucky ones. Because hundreds more will be left with empty arms."

I didn't do it, of course. I always listened to my crazy folk, but I did not call Washington. What would I have said? And imagine if I had called, don't you see that I'd have been about number ONE on the list of people to investigate?

But that is not why I didn't call Washington. I'd do anything for any patient.

The reason I didn't call was because I knew they were picking up something atmospherically and it could not possibly be buildings exploding in New York. I mean, that's ludicrous.

When I went to work on the evening of September 11, 2001 and found every one of my residents watching CNN, I sat with them. One of the men, a very large man who looked terrifying but was actually one of my better folks (although he could lash out violently, I was always prepared to do MANDT, if you know what that is) came over to me, leaned over and said, "I tried to tell you. I tried five times."

And he had.

I looked around at my residents that night, looked at them watching TV, and I saw no shock or horror. Only sadness.

I know what schizophrenia is. I know what it looks like, I know what it sounds like in those who have it, I've studied it for years an written countless reports and grant proposals and even a textbook....but I also know that such people are on a plane closer to an invisible reality than any of us.

Of course you're free to disagree, but I have the paperwork here, I've kept it in a file, and I know what I'm seeing. I'm seeing incredible doses of Xanax that I gave out, I'm seeing notes about people coming to me and saying it would happen, and I know that not one of them had any connection whatsoever with what happened on September 11, 2001.

But they did know. Of this I have no doubt. And there was nothing they could do, nothing I could do. If I had called someone and said, "Yes. Thirty-four psychotic in-patients are telling me that the World Trade Center is going to be blown up tomorrow", I would have gotten nowhere except, perhaps, out on my butt without a job.

As I sat there on the night of September 11, watching that horrible scene over and over, my residents caught my eye. They nodded. Not as in "See? I told you so!" but as in: "Yes. This is what I saw. It happened like I knew it would."

Despite the fact that I'm currently a nursing instructor, events like this are why I have stayed in psych nursing. I don't tranquilize people out of their heads to make "bad thoughts" go away. I listen, because so very often there are amazing things to hear.

I have written in this blog about time warp, how the light curved around the sun and therefore we know that Einstein's formula is correct. While my main belief is that I feel "aliens" may be ones who have by accident or on purpose crossed through that invisible warp, my other belief is that some people on this planet that we call "sick" are actually somewhere in that warp, seeing what you and I cannot.

I will never forget that late night of September 11, 2001. The therapy dog, Sapphire, sat at my feet and looked at me with mournful eyes (I took Sapphire home on my days off so she could have a break). I made sandwiches and handed out ice cream bars and anything else I could find in the kitchen.

And with thirty-four crazy folk, I watched again and again, my horror dulling to pure pain, as New York did indeed explode at the hands of the truly insane, over and over again as we watched.



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