A Rose By Any Other Name

I first met Rose when I started working at MIHS, Maricopa Integrated Healthcare Services, otherwise known as the County. Maricopa Medical Center was the ancient hospital that was its primary treatment facility. And by ancient I mean it was built in the 1970’s. There’s not a lots of historical places in Phoenix.

MIHS also provided psychiatric care, and they had two facilities for that. The first was the Psych Annex. That’s where I worked. It was a nondescript two story building behind the medical center. The second was Desert Vista, a much newer, incredibly secure building in Mesa. It’s the place you’ll end up at if there’s ever a petition for court ordered examination/treatment filed against you.

I’m sure I’ve suppressed some of the memories I have of working there, mostly because I hated the management there so much. I really liked the people I worked with, and the patients I cared for weren’t terribly different than the patients I’d taken care of at the MVAMC.

I left the MVAMC in October of 2007, and started working for MIHS in November. And that’s when I met Rose.

What do you think of when you think of a rose? A beautiful, fragrant flower, right?

Yeah, that wasn’t Rose.

She was loud, intrusive, disruptive and did I mention loud? She was rude and undisciplined. Her hygiene was crude, her manners were random and unpredictable. And watching her eat could ruin your appetite for a few days. On top of that, she was also one of the most profoundly psychotic persons I’ve ever met. I can’t imagine what happened to her to transform her into the person she became.

Rose was possibly cute at one time, but those days were long gone by the time we crossed paths. She always looked disheveled, even after she had just showered. She had no fashion taste. Her outfits could cause seizures. Even if you were blind.

But the most distinctive thing about Rose was her voice. It was harsh, discordant and gravelly. Clint Eastwood sounded almost gay compared to Rose. And after listening to Rose for eight hours, even someone speaking into a megaphone sounded like they were whispering.

Rose could easily be described as a problem patient. She needed a lots of redirection. And there was no such thing as telling Rose something once. It was constant. And exhausting.

“Hey, Rose! Turn down the volume over there, okay!”

“YES, SIR!” I have no idea why, but Rose always called me Sir. She called other staff members by name, but not me. “I’M GONNA TURN DOWN THE VOLUME, ISN’T THAT RIGHT, JEFFREY?” Rose was constantly talking to Jeffrey MacDonald. You might remember him. He was the guy accused of murdering his pregnant wife and two daughters. He was apparently Rose’s imaginary best friend. “YOU HEARD WHAT MISTER SIR SAID! TURN DOWN THE VOLUME OVER THERE, ROSE. WHAT ABOUT YOU, JOHANNES? He was one of the BHT’s at the Psych Annex. DO YOU THINK ROSE NEEDS TO TURN THE VOLUME DOWN? I KNOW JEFFREY THINKS I NEED TO TURN IT DOWN, RIGHT JEFFREY? THATS FUCKING RIGHT!”

And she swore more better gooder than two Portuguese sailors. I purposely deleted about seventeen swear words from Rose’s dialogue. Anyone that knows me knows I don’t have any problem swearing, but even I was shocked by the amount of profanity Rose unleashed in casual conversation. And when she got upset, it was like getting hit by a fucking tsunami.

Rose was rarely violent, but she tended to provoke it in others. I think she wore on the nerves of everyone around her until they just couldn’t take it anymore. And most of the people on the same unit as Rose weren’t all that tightly wrapped either. She made more than one person lose it, and half of them were people I worked with.

I spent a lots of time with Rose. I may have even begged her to quiet down, I’m not sure anymore, but it’s not out of the question.

Rose was at the Psych Annex when I started working there. I’m pretty sure she was still there when I quit six months later. Rose was one of those people no one wanted within fifty feet of their facility, let alone inside it.

I worked Gero/Psych and did a stint in management at Banner Del E Webb for a few years, then moved on to St Luke’s Behavioral Health–straight psych–I was back in familiar territory. I hadn’t been there long, maybe a couple months, when I did something stupid. I started wondering what had happened to Rose.

There’s a rule when you work in Psychiatry: you never, ever mention the name of a discharged patient. You know, I wonder how So and so is doing? If you do, the person you invoked will invariably get admitted. The only way you’re safe doing this is if the person got dead, except if they had gotten dead, you wouldn’t have to wonder how they were doing…  For chronically frequent flying psych patients, the only way you can totally get rid of them is death. I know that sounds terribly callous, but it’s also true. You can ask around, if you so desire.

I never said Rose’s name aloud, not even to myself or any of my imaginary friends, nor to any of my co-workers–none of the people I worked with at St Luke’s knew Rose.

But they would.

Never underestimate the craftiness of a psych patient, especially the really crazy ones. They are spooky beyond belief. And like any other organism, they evolve. When I first started working as a psych nurse, a name had to be spoken out loud. By the time I was getting ready to retire, a simple thought would suffice.

I was walking into work at St Luke’s from the parking lot one day, and I ran into someone from the day shift.

“How was your day?” I asked. What happened on the day shift rarely had anything to do with how the evening shift would go, but it was always nice to ask.

“Oh. My. God. Turn around and leave now! We got a new admit today, wait until you meet Rose!”

I stopped in my tracks, and slowly turned toward my co-worker. I briefly described the Rose I knew, knowing there could be only one Rose that could effect that kind of reaction.

“Oh. I see you already know her.”

Yep. That was my Rose.

AP 5 was my home unit at St Luke’s. It was the court ordered unit. You didn’t have to be court ordered to be admitted to my unit, but if you were court ordered, it was the only unit you could be admitted to.

Rose was permanently court ordered. She was usually admitted to the Psych Annex, or Desert Vista. But the staff at those facilities were burned out by Rose. She was sent to St Luke’s purely out of desperation.

AP 5 was a chaotic place. It was two large dayrooms with the nursing station in-between. The patient rooms were dotted around the perimeter of the dayrooms. The unit was a giant echo chamber, it was concrete and linoleum. The other units had artwork. Some of them had carpeting. AP 5 was like the basement where your family locked up your crazy aunt, and no one ever talked about it. There was no no artwork, nothing for noise abatement. It was almost as loud as the artillery firing range at Fort Sill, way back when I was in the Army.

Added to the abnormally normal pandemonium, was Rose.

“WELL, HELLO, SIR! HOW ARE YOU! I HAVEN’T SEEN YOU IN THREE AND A HALF YEARS!”

I had to stop and think about it, but she was correct, almost to the day.

“Hi Rose. Say, could you do me a favor, and turn down the volume a few hundred decibels.”

“TURN DOWN THE VOLUME! YES, SIR! WHAT DID I TELL YOU, JEFFREY! MISTER SIR STILL WANTS ME TO TURN DOWN THE MOTHERFUCKIN’ VOLUME! YES, SIR! I’LL TURN THE MOTHERFUCKIN’ VOLUME DOWN!!”

I hadn’t even started my shift, and I already had a motherfuckin’ headache.

I filled my fellow evening shift staff members in on Rose. This was perhaps the best crew I would work with in my career. Deb Goral. Luis Hinojosa. Anthony Tafoya. Rachelle Carson. I loved those guys. We were a well oiled machine. And Rose had all of them pulling their hair out within the first hour.

I started herding Rose to her room to remove her from the mileau. She started peeing on the floor. I think Rachelle was ready to kill her.

I spent a lots of time talking to Rose once more. It didn’t happen right away, nor did it happen overnight. I didn’t even notice it at first, probably because it was always so noisy on AP 5, but Rose actually did turn down the motherfuckin’ volume of her voice. She didn’t swear anywhere near as much as she normally did, and she stopped peeing on the floor altogether. I think she actually became one of the better patients on the unit.

I have no reasonable explanation for it.

And then something really weird happened. Rose came up to the nursing station one evening and actually whispered something.

My name.

“Maaaaaaark!”

It was, like, the spookiest thing I’ve ever heard.

Deb could do a perfect imitation of it, and she did it often. But only because she loved me. She became my first work wife, ever. And then she became my first ex-work wife.

I’m in a lots of relationships, and they’re all complicated.

Unlike my first encounter with Rose at the County, her stay on AP 5 was relatively short. Maybe three weeks, maybe a month. She came back again almost immediately, but was discharged later that same week. We had to have set a record for her shortest hospitalization, ever.

I never saw her again, not that that’s a bad thing. There are people you meet in your life that you’ll never forget, but you don’t miss them when they’re gone.

I know a lots of people like that.

I like to think Rose was able to gain a measure of control of her insanity, and she’s doing better.

But that’s doubtful at best. More likely she’s standing on a sidewalk somewhere in Phoenix, saying, “Maaaaaaark!” Very softly.

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4 thoughts on “A Rose By Any Other Name

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