Things are heating up here in the Lakeside area. Believe it or not, May is the hottest month of the year down here. According to everyone we know, it should cool off in June once the rainy season starts.
That’ll be nice. I think it’s rained once since November, and there have been a thousand fires in the last month or so. It’s so smoky/hazy now, there are days when you can’t see the other side of the lake.
* * * *
If you’re a classic movie buff, I don’t need to tell you about Harvey. 1950. Jimmy Stewart as Elwood P. Dodd, an eccentric man whose best friend is a pooka named… what else? Harvey is Elwood’s best friend, and he’s a six foot three and an half inch tall invisible rabbit. If you haven’t seen it, I highly recommend it. It’s a darling movie.
I knew a guy named Harvey. He was maybe five foot four. He had kind of a weather-beaten appearance, and he wasn’t invisible. Harvey was an older guy. He was in his seventies when I first met him. I can’t remember if he was bipolar or schizophrenic. He might have been both. If he was bipolar, he was the quietest manic guy I’ve ever met. And if he was schizophrenic, he kept his psychosis to himself.
Harvey was pretty much an enigma. He was more imp than pooka, and was, at least once, like unto a gremlin that had been fed after midnight. That’s how I remember him. One of our patients at the MVAMC was a guy we called Forrest Gump’s Smarter Brother. Harvey was probably their grandfather.
And I should add this: The female nurses loved him. They thought he was cute.
I probably first met Harvey around the year 2000 or so. He came up the nursing station one day and said, “I want to call my mom. My mom. My mom!”
I took a long look at Harvey and seriously wanted to ask if his mother was still alive, but I asked a different question.
“Do you know her phone number?”
So I set a phone in front of him, and he dialed a number.
“Hi Mom. It’s me. Harvey.”
I decided to look up Harvey’s contact information in the computer. His mother, Olive, was listed. As near as I could discern from his file, his mother was still alive. She had to be in her nineties.
Harvey had a very nice conversation with someone, and a few hours later, a frail little old lady who smelled of cat urine, walked onto the unit with a man whom, I think, was Harvey’s brother.
They brought in a bag of clothes for Harvey, and his glasses. When Harvey was showered and shaved and wearing his own clothing, he looked like he could’ve been a college professor.
All the female nurses wanted to talk to Olive–they might have seventy year old sons to raise someday, and they wanted all the information they could get about Harvey. I can’t remember what he did for a living anymore–if he ever had a job, or if he was on some sort of disability, or if he had a place to live, or much of anything else about him.
There was a lesson for me to be learned. Just because I didn’t think something could be possible, didn’t mean it wasn’t true.
For example, the guy who knew Milton Berle. His name was Steve. He was a local radio personality/comedian who had relapsed on alcohol. His detox was uneventful, and we were getting him set up with follow up care.
For those of you who don’t know who Uncle Miltie was, he was a comedian, and one of the pioneers of early television. He might have been a pooka, but he stood only five feet ten inches tall, and he wasn’t invisible.
Steve was talking on the phone at the nursing station one Saturday morning, and when he hung up, one of the nurses I was working with asked who he was talking to.
“Milton Berle.” he replied, and all of the nurses started laughing. So Steve went to his room and returned with a photo album that contained dozens of pictures of him with none other than Milton Berle.
Yeah, who’s laughing now, nurses?
The sad fact is most psych patients lie about almost everything, so as a psych nurse, you tend not to believe practically anything they say.
“I’m the hair dresser to the stars.”
“No kidding! If you don’t mind me asking, who are some of your clients?”
“Stevie Nicks. Victoria Principal. Morgan Fairchild.”
“Wow. When was the last time you were in Southern California?”
“I’ve never been there.”
“So, they fly here so you can do their hair?”
“Yeah. Pretty much.”
“By the way, I love what you do with Stevie’s hair.”
“Yeah, she’s beautiful. Thanks!”
I met at least two guys who were the hair dresser to the stars, and neither of them had ever been to California. And then there were the guys who were mysteriously drugged at their local watering hole.
“Well, I was at the bar, and then I can’t remember anything. I think they slipped me a mickey!”
“Yeah, that’s why I quit going to bars. I got tired of getting drugged, too.”
“See? This guy knows what I’m talking about!”
I always got a kick out of that story. Fictional private detectives from the 1940’s, like Sam Spade and Mike Hammer, were always getting slipped a mickey, but I don’t think it ever consistently happened to anyone in real life. Until Ruffies became popular, and correct me if I’m wrong, but it was mostly girls who were the target of Rohypnol. Even the girls had their tales of misfortune.
“We just discharged you two days ago. Why are you coming back today?”
“Someone on the bus stole all of my meds!”
“Even your Xanax?”
“No, that’s the only thing they didn’t steal!”
“What happened to that?”
“Oh, I accidentally dropped the bottle in the toilet!”
Well, there are a lots of fun filled activities to do on the bus, so it’s easy to see how that could happen… And toilets clearly can’t be trusted anywhere near controlled substances. But every now and then, you meet someone who actually tells the truth. So, try to remember that.
* * * *
Unfortunately, I don’t have a whole lots of Harvey stories. He was a mostly benign, very quiet guy, who sometimes looked quite professorial.
He did have his Harvey moments. He would randomly bolt down the hallway as fast as could, for no apparent reason. I think that was Harvey. I’m pretty sure it wasn’t me.
He was one of those guys that randomly uttered words of inestimable profundity, most of which I can’t remember, but he did say this:
It became our catchphrase whenever someone went off on a tangent, or for someone with a short attention span who was easily distracted. Like me.
And then there was Harvey’s hallmark admission. And like so many hallmark moments, it happened in the dark of night.
It was probably around 2005. Harvey had been a patient on my unit a couple of times. None of his admissions had been especially remarkable. We stabilized him and sent him home, or somewhere, until the next time.
On this particular night, it just after midnight. Harvey was admitted once more. We got him changed into VA pajamas and settled into his room by the nursing station. There wasn’t much point in trying to do a thorough admission assessment because Harvey wouldn’t answer any questions, so we got all our information from his old charts and our previous knowledge about Harvey.
Most people admitted in the middle of the night just want to go to bed, but that night, for no apparent reason, Harvey decided to demo his room.
I think he started with the baseboard molding, and ripped it all off of the walls. One of the nurses I was working with asked me what we should do. He wasn’t harming anyone, but he was systematically tearing his room apart.
We tried medicating him with Haldol and Ativan. The meds didn’t touch him.
After he removed all of the baseboards, anything that Harvey could disassemble with his bare hands was fair game. We would check on his progress periodically, and remove all the debris from his room from time to time.
When he started to take his bed apart, we rolled the frame out of his room, leaving the mattress and bedding on the floor. By 5:00 AM, the only thing Harvey hadn’t demolished was the light fixture on the wall where the head of his bed had once been.
Around 5:30 AM, we heard a loud crash. Harvey had somehow ripped the monster light fixture out of the wall, leaving behind a few live electrical wires. We were forced to move him across the hall into one of the seclusion rooms. I can’t remember if we locked him in or not, but we probably gave him another cupful of meds, that would have no more effect than an handful of Tic-tacs. Then I entered a whole lots of work orders into the computer so the maintenance guys would start putting the room back together again.
* * * *
It took the VA Corps of Engineers at least five days to repair what Harvey had done in roughly five hours.
I had at least one day off between getting off of Nights and transitioning to Days. I asked the night nurses how Harvey was doing when I returned to work. He hadn’t demolished anything else, but he hadn’t slept since he was admitted.
I have a couple of clear memories of that day. One, I was assigned to do Meds. Two, it was the first time I met Darrell. He was an LPN, and a new hire. He had never worked in a Psych setting before, and my boss asked me to show him the ropes.
“I’ve been doing this job for a long time. I can play this song in any key. I can tell you how you’re supposed to do this job, or I can tell you how I do it. If you do it my way, you’ll work smarter, not harder.”
“I was hoping I’d meet a nurse like you.” Darrell replied. I was going to like working with this guy.
I spent the first couple of hours explaining my unorthodox philosophy to Darrell, and then I decided to show off a little to the new guy. I pulled Haldol and Ativan from the Pyxis, and told Darrell to follow me. And we went hunting for Harvey. He was standing in the hallway by the dayroom.
“Harvey hasn’t slept since he got here. I’m going to send him to the Land of Nod.” I told Darrell.
“Yeah, the nurses tried like hell to put him down for the count yesterday, but nothing touched him.”
“Hey, little buddy. I’ve got a couple meds for you.” I said, and handed Harvey a med cup with a couple pills, which he readily took. Then we escorted Harvey back to his room, and laid him down on his bed.
And I started singing, softly.
“Lullaby, and good night. Go to sleep lit-tle Harvey. Close your eyes, count some sheep, a-and go to fucking sleep…”
I didn’t know many of the actual lyrics, so I kind of made them up on the fly. I sang a few more verses of my impromptu lullaby, and when we tiptoed out of Harvey’s room, he was snoring.
“I don’t know what you just did, but I can’t believe what I just saw.”
“Smarter, not harder.”
“Well, I hope you don’t expect me to sing a lullaby to every one of these guys, because there’s no goddamn way I’m doing that!”
“Nope. It’s probably the only lullaby I’ve ever sung.”
“If you don’t mind me asking, how did you know that would work?”
“I didn’t. It was a gut feeling. Always follow your gut. It’s never wrong.”
* * * *
I know some of the stuff I write is hard to believe, but that actually happened. And as weird as it might sound, I had no doubt my intervention would work. I probably didn’t even need the meds.
However, I didn’t have any qualms about giving them to Harvey. I figured if my lullaby worked, the meds would help him stay asleep, and that’s probably what my little buddy needed more than anything.
Almost every field of Nursing is a science, except Psychiatry. At best, it’s an imprecise science, but it’s mostly an art. Only the really good psych nurses understand this.
The essence of psych nursing is guiding people out of the maze of darkness or whatever else they’ve created inside their minds, and teaching them a few new coping strategies, so they can try to avoid having to repeat it again in the future.
It sounds good in theory, but the reality is the majority of the patients we took care of weren’t all that interested in doing anything different.
You can lead a horse to water…
That part of the job was frustrating, but every now and then, someone would come along, and all they wanted was a second chance. And every now and then, you could sing someone a lullaby.
It was those moments that made the whole thing worthwhile.