1. Glover, Eileen J. RN


Contemplating the intractable misery of certain psychiatric conditions.


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I'm putting on my socks in preparation for a little hike before work. They are ankle style, cheaply made, and each one sports a penguin in a pink knit cap. He is executing a twirl on ice skates though he appears lost in thought. Simone gave them to me. She had received them as a Christmas gift, but they weren't really her style. As I think of her my heart warms, but then, to my surprise, I find myself thinking, "I hope she's dead."

Figure. Illustration... - Click to enlarge in new windowFigure. Illustration by Janet Hamlin.

I know how harsh that sounds, and I know it's not for me to reckon the value of any other life to the person living it. The feeling that accompanies the thought is one of caring and wishing relief for her. Simone suffered terribly and there was nothing anyone could do to fix it.


For three years I was one of her nurses. Simone and I first met in the intensive unit for patients who were deeply and chronically mentally ill. Sometimes people got a bit better and left, but most patients' illness just ebbed and flowed, never really improving.


"Good morning, Simone," I said with a smile. She was heading up the hallway barefoot, wearing a long, simple, black-and-white-striped jersey knit dress, her white hair up in a messy bun. She didn't meet my eyes, her gaze staying steadily forward, but once alongside me she declared, "You're a whore. The worst one. The president's whore." She was shaming me for ruining the beautiful marriage of the U.S. president at the time.


Simone would spend most of the day lying in her bed. She'd try to rest, but the visions and horrors wouldn't let her. She would call out loudly, swearing at who or what she thought was there and yelling at them to go away. This was pretty much baseline for her. When she started to refuse her meds, it would get worse, but it never got better.


Her constant suffering was obvious. Alone in her room, Simone would call out, "Aaagh! Put me down!" A string of curses would follow. She had the recurring experience of being in the jaws of a giant dog, its teeth piercing her flesh, its slobber coating her. Simone said her brother came to torture her. She regularly told staff how people came down through the light fixtures to rape her in the night. Family members could come into her mind and cause great psychic pain.


To her, I was a whore and that was that. I stayed cordial and continued to check in on her and offer her things I thought she might need. Simone didn't waver for months, until one day she approached me in the hall. She was carrying a hairbrush and had a scowl on her face. "I can't get my hair up! It's not working!"


I gently offered to help, fully expecting to be shot down and called by my usual epithet. Simone paused and glared at me briefly before assenting to let me try. She sat on the stool in her room, and I began to carefully brush her hair. She sat with her eyes cast down. Then she looked up and quietly said, "You're not a whore."


I don't know if it was bravery or desperation on her part to crack the door open for me in that way, but our connection grew. Most days she just couldn't focus, but I would read to her a few times a week when she felt up for it. She chose a cheesy romance novel, and we worked our way through it. We would giggle together when it got steamy. She would stop me when a passage jogged some sort of memory. She told me about her time in Paris as a college student. She had gone shopping with some girlfriends and bought a yellow dress.


Simone seemed to briefly enjoy these recollections before a wave of sadness would come over her. She remembered when she was whole and well. Then her face would fall, and she'd say, "I wish I was dead. I can't stand this. Why do I have to be tortured like this?"


There is no DNR in psych, no living will, no natural death from the illness. In medical nursing a patient or their designee can decide to transition to comfort care and then eventually the end comes. It's different in psych.


As nurses we all care. It's what we do. We care until our hearts hurt like an overused muscle. To find myself presiding over a void of trapped souls was not what I thought I was getting into, and so I focused on making their lives as pleasant as possible. As Simone's nurse I learned to focus on what I could do in any given moment to make her life more enjoyable, more comfortable. The goal became solely caring, not curing.


My mixed sentiments as I was pulling on those socks that morning shocked me. I cared for Simone and wished for her to have some peace. At least I know that I was able to provide some relief, some joy, and a bit of fun in our time together.