Three Days in a Mental Hospital

(The author, Kenneth B. Klein, is a senior associated with Leverett House. During the summer of 1968 Mr. Klein worked for a PBH project at Lombard Farm. This is the story of his three-day orientation.)

AT ONE O'CLOCK we all assembled in the conference room of A-Building at Boston State Hospital. The boys all talked about how they would deal with homosexual advances and the girls about what to do in case of rape. I found I was assigned to ward O-2, which was on the notorious East Side of the hospital. I'd been assured by patients I knew that the East Side was a real horror-infested with big rats and mean psychiatrists.

I got into the director, Ian's, VW and we drove over to the East Side. It was bright and sunny and warm outside. It was the end of June. It was incongruous. We arrived at O-Building and entered through the canteen, where patients can buy coffee and chewing gum. The yellow walls carried a huge mural of Snoopy and Charlie Brown and said "Happiness is the O-Building Canteen." Typical volunteer propaganda, I thought.

We climbed up the stairs to the second floor. Through the heavy wire screen I could look down the stairwell to the basement, bare except for huge cans of civil defense water. Then I was on ward O-2; home.

Ward O-2 was home because I needed preparation, preparation for my summer job. I had volunteered to spend the summer in an experimental rehabilitation program for mental patients. Twenty-four other students and I had agreed to spend the summer at the Lombard Farm on Cape Cod living with twenty-five mental patients. The proposition was that being surrounded by relatively healthy albeit untrained people would be more beneficial for the patients than living in the mental hospital back wards.

But now, to get a feel for how our summer roommates had lived for the past twenty years or so, we were being admitted as patients to the state hospital in Mattapan. For three days we would be patients at the hospital, experiencing for a short while what had become year-in and year-out routine for the other half at Lombard Farm.

AFTER I ARRIVED in Ward O-2, we went immediately into the nurses' office. Ian introduced me to Mrs. Snowden, the head nurse. He told me that she was under strict orders: 1) not to talk to me, and 2) not to tell any other nurses, doctors, or patients who I was. The idea was that I should have as "uncontaminated" an experience as possible, that I should be treated as much as a patients as possible. Ian said goodby or something like that that made me scared and he smiled and left. I smiled to Mrs. Snowden and walked out onto Ward O-2.

It was very different from any ward I'd ever been on as a volunteer. There was a very long hallway with a row of ten doors lining one wall. Each door led to a small bedroom. The opposite long wall, coated with thick yellow or green hospital paint, was pretty bare except for the door that led onto the ward, an old Gauguin print, and halfway down the length of the ward, the TV. I glanced up and down the long narrow room and noticed a few middle-aged men, either skinny or fat in cheap untucked cotton shirts and chinos. Mostly they were sitting in couches or chairs and sleeping or staring at the TV. I took a seat.

I sat curled up in a fake leather chair for some time. Gradually I became accustomed to what little activity there was on the ward. The dominant sound was the TV. Below the TV there could be heard occasional snoring and shifting and shufling. And once in a while a far-away telephone ring from the nurses' office. That was all.

Finally I was able to look up: half way down the hall I saw a big man with an immense stomach taking off the top of a floor-stand ashtray. Looking for butts. He did that about every half hour for two days, and then disappeared. I heard that had been sent to some sort of a nursing home.

In a few hours, as I sat curled up in the armchair, I gradually made the transition from person to patient. The movement was down, and especially in. I experienced a luxurious, guilt-free withdrawal into myself. Eventually there was just me on Ward O-2 and a bunch of other crazy people with whom I felt close, and some vague abstractions like Harvard and Cambridge and Cape Cod.

A BELL RANG, like a high school hall bell, and everyone got up and slowly walked away somewhere. I was hungry so I figured it was a bell for supper but I wasn't sure. So I missed supper. I was all alone on the long hall of O-2, except for the synthetic voice coming from the TV.

After half an hour guys started coming back on the ward again, and then disappeared into their rooms. I was still alone. So after a while I went into the room that Mrs. Snowden said was mine. It was just like the other nine tiny singles of our ward: bed, chair, dresser, mirror.

It was highly unusual to have a single. I found out later that O-2 was for patients that were about to go into family-care units-living with a family as a sort of foster kid and occasionally returning to the hospital. The idea of singles was so they could practice taking care of themselves and things.

Reflexively I started opening the drawers of the dresser. I was surprised to find them not empty. There was a green baseball cap with BSH printed in it and there were some blue and yellow T-shirts on which was printed "BSH." A patient told me BSH stands for Boston Shit House.

Also there were a few crumbs of tobacco, and a pad of cheap newsprint that said American Eagle on the cover. I took the pad and used it for writing things down.

I WALKED out of my room back onto the ward. I sat in one of the big brown chairs across from the TV and for a while wallowed in the luxury of time. I knew I was going to be in the hospital for three days and during that time I had absolutely nothing to do. The only comparable experience I can remember was when my family was camping out on Cape Hatteras. It was Sunday night and raining and there were no books to read and no radio to listen to and no place to go. Then it was great.

So I sat there in the big brown chair and after a while I looked around and saw a guy in his thirties with short hair sleeping on the sofa, and a guy in his fifties with bristly gray whiskers rocking back and forth in a chair like mine, sort of chanting to himself. Every one else on the ward was in bed. I wondered how long it would take for the luxury of time to turn into the horror of waiting, endlessly. By the third day I had strong hints that it didn't take very long.

The TV was going loud and strong. It always went loud and strong. Television is an immensely important fact for mental hospitals. It provides an automatic something-to-do. If I'm just wandering around the ward or coming back from supper or from the bathroom, I'll have to pass the TV and since it provides constant change and because it's something that is acceptable to sit in front of while doing nothing it is tremendously attractive. You can almost fool yourself into thinking that you're watching TV. But really watching implies participation which means activity. And activity, as opposed to total passivity, is the most difficult thing to achieve in an institution. So you're not really watching TV, you're sitting opposite the live machine and doing nothing, instead of doing nothing in your bed or at the end of the hall. This form of doing nothing is acceptable to yourself, to other patients, and to the nurses. You can in an abstract way maintain self-respect: "I'm not doing nothing, I'm watching TV."

THE NEXT MORNING at about 5:30 or 6:00 a bell sounded from the depths of Boston State Hospital which, I found out, meant get ready for breakfast. Then I heard a huge relay click and all the lights came on. The cheery voice of Mrs. Snowden called out, "O.K., get up, get up right away. Come on, now!"

Breakfast wasn't really too bad because it was so early in the morning that nothing seemed real. Lunch though was a real horror show. On the way down, through the tunnel, I was walking behind an old lady with no shoes or socks who was skipping and singing "Here We Go Loopty-Loo." I followed her to a table and asked her if I could sit down; I was pleasantly surprised to find that I could still speak. She said yes.

As I sat down she was buttering her bread with her right thumb. At the table next to us two ladies were sitting across from one another, eating. A third came along with her tray and started to sit down. Immediately one of the sitting ladies jumped to her feet, grabbed her tray, and walked away. The third lady sat down and began eating. Not one work was spoken.

The loopty-loo lady smiled with half a set of teeth and said that her name was Catherine Glenn; it has fourteen letters in it. A lady sat down next to her, across from me, and Catherine said that she won't eat because she can cook. I looked at my plate of food and understood. That lady had a few long gray whiskers on her chin, a side reaction of the ubiquitous tranquilizer Thoridine. Her dress wasn't buttoned much above the navel, and her right breast was half hanging out. She stared at her food and then put a fork in her coffee.

A nurse eventually came over and with tremendous efficiency shoved forkfulls of food into her mouth, which she swallowed without bothering to chew. It would have been hard for her to chew because she had no teeth, but anyway lunch was so soft and mushy that it really didn't make much difference. After a while the nurse, with a few razor strokes of the fork, scraped the mashed potatoes off the women's chin and left. She remained frozen with something that might have been a smile, and gravy for a beard. When I looked up again she was in a new position, with half of a brownie in her right hand and a piece of gravy-soaked carrot in her left hand. I had to leave the table.

AFTER LUNCH I went outside. With the use of tranquilizers many wards have been unlocked and the patients are free to leave during the day. Hardly any do. I walked over the grounds and brooded over my patienthood. Already the enormous dull routine of back ward life was getting to me. Already I was beginning to feel dead. And lonely, terribly lonely.

Since I'd been on the ward only one person had spoken to me besides Catherine Glenn. A guy in his thirties came up to me and said, "Hi, are you going to be living here?" With great effort I pulled a voice out of myself: "Yes, yes I guess so." He sort of smiled and shook my hand. "My name is Marc." I said "I'm Ken," and walked away, feeling very bad about my lie.

And just as patients rarely communicate, the nurses never talk to you either. They seemed nice but never had time for the patients except to occasionally hand out a cigarette or say "mop the floor." And the doctors were so distant they might have been another species. They strode through the ward on long rubbery legs at ninety miles an hour and the only thing they seemed to have to do with the ward was to use it as a path from where they had been to where they were going. Once a doctor slowed down to thirty as he passed the chair where I sat and bellowed "HI, how are you!" and then zoomed away. I was so overwhelmed with the attention that I nearly fell out of my chair. Of course BSH and all other state hospitals are quite understaffed so the doctors are the way they are at least partly out of necessity.

After a time I couldn't take the huge empty loncliness of the hospital grounds so I went back into O-Building and stood in the corner of the canteen. To the left was the stairway up to O-2 and next to it was the entrance to O-1, a women's ward. Two women patients with gray hair ran the canteen. There was always a buzz of activity around the counter where coffee and cigarettes and doughnuts and candy were sold. It wasn't especially living activity, but it was activity just the same. Patients from other wards on the East Side would walk in, hobble in, drift in with a completely blank face or a frozen ear-to-ear smile, and look at the ladies behind the counter.

Sometimes they'd order coffee or cigarettes and sometimes they'd just stare and the ladies behind the counter would confer and decide what the person wanted. Then the patient would hand over his dime or thirtyfive cents, just like a poor kid in a candy store, and shuffle away with his purchase.

A few social workers were usually around, talking with tremendous enthusiasm to the one or two patients who were in good enough shape to respond to them in the way they expected. Sometimes some volunteers would come in from the B'nai B'rith or some women's club to ease their middle class consciences, and shower the area with synthetic smiles, and say to a patient they knew, "WELL III THERE, HOW ARE YOU TODAY!"

Well none of these people seemed to notice me and I had no money with me to buy a doughnut so I stood next to the door and pressed my forehead against the glass-paned door. The sky grew gray and it started to rain.

I stood with my head pressed against the window for a long time. Sometimes there would be a bit of movement and life when a student volunteer came in, breathless, out of the rain. She would take off her rainhat and shake her hair and her vinyl raincoat would sparkle with raindrops. She would move so gracefully, and so quickly. I wanted so much to talk to her. Although I knew I was like her, a student, a volunteer, I felt so far away from her.

I wanted very much for one of these volunteers to talk to me but they wouldn't; they all went straight for the one patient they knew, the one they felt comfortable with. I hated these volunteers.

EVENTUALLY I left the canteen and walked up to O-2. The caged-in stairwell was like a pressure chamber and I felt as if I were passing into a deeper, deader, and even more remote region.

I went to a chair and sat curled up as usual and realized that I wasn't particularly depressed any more, or even particularly lonely. The only feelings I had were deadness and dullness. Stiff, slow-moving, lethargic. Didn't care. Dead.

In a way, this deadness and withdrawal, this feeling of being insulated from everything in bales and bales of thick cotton is comforting. Things are so ordered and stable and predictable. And the movement of the hospital machinery, the getting up and the going to bed, the meals and the TV are as vast and certain and ineffable as the rising of the sun or snow in winter. It's comforting; one is protected against feelings. Sometimes the insulation grows so thick that not even sound or light or touch gets through. It's almost cozy.

AFTER A while the dinner bell rang and everyone on the ward started shutlling a little, and a few minutes later we were trooped down through the tunnel to the cafeteria.

After dinner the thought of returning to O-2 wasn't especially savory so I decided to go for a walk. I wanted to see what the outside was like after what seemed like months in this other world so I walked across the grounds to Blue Hill Ave. and up to the Dunkin' Donuts shop. As I approached the place I grew very uncomfortable and nervous and scared. I guess I was nervous because I had choices: I could walk whichever way I wished, and with my two nickels at the doughnut place I had to decide what sort of doughnut to buy.

At the Hospital there are no choices whatsoever.

And I was frightened because I was going to have to deal with people again, critical, defensive, suspicious, normal people. When I entered Dunkin' Donuts the first thing that struck me was the tremendous quantities of light and color. Everything was glowing and sparkling with activity and light if not with life. Things seemed to be moving so quickly and hecticly.

I was sort of passively pushed around and ended up on line. Then two cops came in and I thought to myself the jig's up, before I get my doughnut they'll realize where I'm from and put me in a straight jacket and with a blaze of lights and sirens whisk me back to O-2. But miraculously they didn't even speak to me, though I was sure that they and everyone else in the place was staring at me when I wasn't looking: I felt like a fugitive, so tremendously different and apart from everyone else. With great difficulty I managed to get myself together enough to order a jelly dough-nut, paid, and quickly left. I walked back to O-Building fast.

THE NEXT morning when the bell rang I woke up excited because this was the day that I was to resume my life. At breakfast though I actually felt the premonition of nostalgia for the egg yolks swimming in water and the coffee that tasted like tea and the nurses standing sternly with crossed arms under the pillars and my fellow patients dressed in cheap cotton with a half a set of teeth each. And back in O-2 I began expectantly thinking about what it would be like to have lan walk onto the ward and say let's go and as easy as that leave this enormous machine that endlessly cranks out thick swatches of time like huge strings of taffy. It was absurd to be able to simply walk out. Some elaborate rite of passage seemed called for.

Finally lan came with a big smile and we went into Mrs. Snowden's office to say goodby. I talked to her for the first time since I met her, three days ago. I think that all I said was wow. She laughed and said she thought I was a monk because all I did was sit curled up in a chair and never spoke to anyone. Then lan and I walked down the caged-in stairwell and I looked down and said goodby to the civil defense water and then we walked through the O-Building canteen and said goodby to Snoopy and Charlie Brown on the wall, still saying that happiness was the O-Building canteen, and then out into the sunlight.