On the bulletin board in the staff area is a notice. The notice reads, “All residents and fifth pathway students report to Dr. Beck’s office at 0700 today.”   The whole gang of Doctors crowd into Dr. Beck’s small room with a huge brown desk.  Dr. Beck reports, “Everyone must leave the complex by 1500 today or stay here the weekend. A huge winter storm will drop at least eight feet of snow tonight and leaving otherwise will be impossible and dangerous.  Make all preparations for evacuation now.  The clinic will resume on Monday or Tuesday when the snow blowers clear the roads.  Any Questions?”

“What if you have no place to go?” asks Dr. Wracker. Dr. Beck says, “Anyone staying will assume the duties of the regular staff and remain in general quarters. The cafeteria will be open at a reduced level on standard meal times.”
Working in a Psychiatric hospital is boring. As long as a person integrates protocol into a mindless act, the rigmarole gets boring. Open the doors and make sure they are closed as a person exits. Genius experts evaluate each patient individually and place them on appropriate medication. What a clinical Psychiatrist does is watch for side effects of a particular medication and administer antidote or note overt change. Any dramatic change of a patient’s behavior in any way indicates failure to take the medication or evolution of florid psychoses mandating a change in pharmacotherapy. Most patients after evaluation and medication do not change very much and the evaluation of these patients becomes automatic and quick. The main exceptions are split personality, catatonic schizophrenia and undifferentiated Schizophrenia. A clinical physician treats all patients with these conditions gingerly, as stress precipitates psychoses with a violent outcome. Once a patient becomes violent he or she must be restrained, paralyzed with medication, and if no remission ensues ultimately terminated. To be a clinical Psychiatrist a physician must be highly intelligent to memorize the pharmacology of the medications and recognize symptoms, the side effects of the medications and the antidotes or remedies for treatment failure. A clinical Psychiatrist must be religious because mental patients in a high percentage are doomed to a precarious existence for life. Once a patient confines to a mental hospital, he or she most likely returns periodically until they die in an abbreviated and shortened life span. To realize most of your patients will die in a filthy or sordid way sobers even the most optimistic of human beings. If you choose surgery, it is a hopeless addiction.
Most young doctors come from rich families. Only rich families can afford the lengthy and expensive medical education. By 1400, all the residents and fifth pathway interns are on the train out of Pookipsie or hook up into carpools to take them downstate. These people will have a tremendous weekend because New York City never sleeps. A bar, a nightclub or restaurant remains open 24/7 somewhere in the city, usually on the upper-class side. All it takes is mountains of non-olfactory money spent in a casual and frivolous way. Money remains the rate limiting factor in the Gibb’s free energy equation. Probably if Wracks had money he would float on a surfboard somewhere in the sun. Dr. W makes his rounds and heads to the cafeteria for the one plus one plus one meal. “It’s so you do not get fat,” she says. Dr. Lecter finds him there. “Why aren’t you gone,” Questions Dr. Lecter. “I have no where else to go and no money.” says Dr. W. “I did not have anywhere to go either,” says Dr. Lecter. Here is the master key to all the wards. This key opens everything, anywhere on the complex. I want you to do morning rounds in our ward and again at 2300 hours before you turn in. We have a new patient from a wealthy family. He was a Viet Nam Veteran and forced to kill people with his bare hands. He was one of the last out at Da Nang. He has become violent and lies in a strait jacket in the padded holding cell. Pay particular attention to him. Remember; do not let chronic schizophrenics get between you and the door. I live close by and will remain in touch. Wear the key on your neck and sleep with it. If it is lost, all the locks in the whole veteran’s complex have to be changed.” “Goodnight,” he says as he walks off into the long corridor.
The Pookipsie Veterans Hospital is a huge apparition set in a park like arcade. The buildings link by means of catacomb tunnels with locked doors at each end. Large fluorescent lights hang in the long, cold, grey, concrete tunnels and sound echoes eerily and reverberates into nothingness. The environment is kind of like a Lon Chaney Frankenstein movie. It must be here where Lon got the settings for the movie. wracks walk alone here late at night in the tunnel leading to Ward 4. He sings and say words to see the ramifications of the reverberations. “Spooky,” Dr. W. says to himself. “Real spooky.”
When the Wracks arrives at Ward 4, everything is mundane. Drugs medicate the patients and they are asleep. The nurse, who looks overworked, stressed and tired, beckons to me from behind the glass blast shield. Dr. W waves back. Dr. W moves to the restraining cells and removes the shield from the glass porthole. As Dr. W Looks into the cell Mr. Glitz looks him back eye to eye in the glass. Only one inch of hardwood door separate our two faces. Mr. Glitz looks more frightened then mean. He must be frightened because he knows that payment is expected for his violent behavior. He stands in a strait jacket in hospital bed clothes. Wracks introduces himself. “I am Dr. W. I will check on you periodically this weekend. Do not be alarmed, nothing changed. Dr. Lecter will see you Monday morning. Get some sleep, it is late.” Dr. W. then looks into the room of the catatonic schizophrenic. Mr. M sits in his chair, wrapped in his usual sheets facing away from him. Dr. W looks away down the hall and looks back in through the porthole. Mr. M does not sit in the chair; he moved out of view. Dr. W instinctively checks the door to make sure it is locked. In ten milliseconds, Mr. M. senses his appearance and moves out of view. He could be juxtaposed behind the door if it is opened. Dr. W does not open the door and walks on. “Make a mental note,” Dr. W says to himself. “Mr. M can feel me.” Dr. W leaves Ward 4 and enters the tunnels. He walks alone through the tunnels. He makes sure the doors lock behind him. He enters the Residents lodging and his cubicle. Dr. W hangs his white smock on the door. Dr. W heats water with his tourist prong and makes instant coffee. Dr. W makes sure the key is around his neck. He adds powdered creamer to the coffee. Dr. W lights a cigarette, opens his books and reads until sleep overtakes him. Locked in a little room in the darkness with the door barricaded with a desk.

It is cold in Northern China, in the winter, away from the city. The wolves assemble, because they are a formidable force, together in a pack, and the temujin is there because no body else wants him. They look at him, and he looks back because he is theirs and they were his a long time ago. Now, amongst people he assembles an army, to unite a nation, but mostly to dispense the pagans who prey on the poor. His men are his, and he is theirs, and they fare well in a fist fight but now they have swords, spears, arrows and more. It is the temujin who invented gunpowder in a standard sixty-forty twenty mix, and his men, and his women, and their children bind bamboo together with sisal rope to make a tube, and with this makeshift canon, he destroys the world. They fire, rocks, stones, and grenades at an enemy that becomes no more. He takes their assets, mostly gold, because it is a noble metal, very strong, but with the ability to be forged with a hammer when warm, into shields, body armor and arrowheads because it is also heavy. His army bathes in gold, they dress in gold, pure gold, and their shields glimmer and reflect in the sun from miles away. The horses too, wear body armor. Leather when soaked in horse urine overnight and then dried becomes a plate that can turn an arow, a lance or an axe. They venture into battle, destroying everything, taking no hostages, and bringing the people together in a nation that will last a thousand years. The men, the women, and the horses too, live on rice made with a gravy simmered from blood. Rice is chosen over the other grains because it is portable, spoils very slowly and cooks in ten minutes. He is the temujin, and they are his men, and they are one, and the women sharpen their swords, rear the children, and care for the animals. In a well formed army, they are indispensable. In this era, with an attack by fire, that is chapter nine, no one can withstand them, no one will withstand them, and if they try, they will perish.
The temujin likes the Russians, maybe he might be part Russian, no one ever told him. He is an orphan. He marries Aphrodite Russia, queen of Russia, with the other and they produce children that color the Siberian epoch for years to come. Now he owns the world, the world is his and he and the other want to go home. The world is too big to rule alone. She is beautiful, even when she dies she is beautiful and Yahweh made her his gift to him for the ends of time. She is tall and strong and wears skin tight leather, not to show off her figure but because tight leather is hard to grab and hold. She wears a dagger in front of her thigh in a leather throng, and a broadsword hung on her back, not because she goes into battle, but because she has to protect his children. She stabs anyone with her dagger that approaches him from behind because he is the temujin.
time elapses and everyone is only here for an instant and the great nation is united, has a capitol and a successor. She eventually dies, in his arms, and he carries her body to the temple of Anghor Wat where she is entombed forever and for all to see because without her, it never would have happened. The temple in Cambodia at Anghor Wat is the holiest place in Cambodia and Gauguin are forbidden to enter it under penalty of death.
The temujin is human, and humans have enemies, and if they outnumber you, they will eventually win. The temujin eventually emigrates to Africa and sits with the great Nebucanezer the great of Africa, in Kenya, until his death. The temujin and Nebucanezer are burried side by side at Mount Kilimanjaro, and anyone who violates their grave will be entirely destroyed. The Nebucanezer who share the same eyes with the temujin are his descendent.
In military history, it is the weapons that define the army that prevail. Exceptional attacks come out of the sky, and a number greater than 3 wins. It is those weapons that are forgotten that become something today. They were called the golden horde not because their skin is yellow but because they dress in 24 carat gold. The wolves that assembled when he was there have gone into Siberia and they watch with bright eyes.

The heat waves rise from the steam radiators inside the Veterans Administration graduate student housing. Revelry and reverie occur at 6 AM and the public showers lie too far away.  The Wracks settles for a sponge bath, a shave and then brush his teeth.  The white smock covers clearance clothes no one sees anyway.  In line at the cafeteria with patients in bedclothes and ragged edges for the sumptuous military repast.  One egg, one piece of toast, a pat of butter, a cup of coffee, and a glass of chocolate milk for desert exists as the morning fare. “Can I have another egg?”  asks the Wracks.   The food server looks at him and she says, “No, it will make you fat.”   The Wracks move on with the other residents in the cafeteria at a bunk table in a large hangar room converted to restaurant. Everyone smokes. The Wracks lights up. A patient dressed in a bathrobe and jeans comes over and begs for a cigarette.  The Wracks gives him two. He lights one up, smiles, sticks the other over his ear on the side of his head, blows a smoke ring and moves on.  We meet today in the main observation area at seven hundred hours military time.

       Schizophrenics do not seem so bad.  For the most part they look the same as normal people, smile and wave to the Doctors as we come in.  There are exceptions.  The exceptions have private suites for everyone’s safety.   Dr. Lecter introduces the Wracks to a Viet Nam Veteran who is cross dresser and sits immobile for prolonged periods of time.  He is the one that broke Dr. Sheldon’s nose.  This patient is an afro American on the gaunt side.  He wears a long evening gown with a pearl necklace and earrings.   His hair is cut short Marine style.  Mr. O, this is Dr. Wracks and he will be interviewing you today.  Should I have an absence, he will be the one interfacing with you. 

    “Hello Mr. O.   My name is Dr. Wracker. How are you today?”

Silence

“Mr. O, be at liberty to tell me if your medication is correct and you feel well each day.  Should you desire more or less, let me know.  If your jaw clenches tight, let me know.  If you can not sit still, let me know.”

Silence

Mr. O smiles at the wracks and says “I like you.  I hear you have good hands.”  Dr. Wracker says, “thank you for the compliment.  If you have anything else to say or want me to write in my notes please speak now.”

Silence

“Good day Mr. O, I will see you tomorrow around the same time.”

“Bring me some cigarettes,” he says. “I like Marlboro too.”  “I will not forget,” says Dr. wracker.  Dr. Wracker slowly, slowly, slowly rises from the interview chair and moves backwards keeping an eye on the patient at all times without maintaining direct eye contact. 

“What do you think about Mr. O?’ says Dr. Lecter.  “Undifferentiated, with catatonia and lack of affect.”  “That is what I think too.” Smiles Dr. Lecter.  “Now I want you to meet Mr. M.  Mr. M. is a chronic patient with catatonic schizophrenia.  He rarely moves in the presence of anyone.  The reason he is a chronic patient is because he likes to hang from the ceiling and fall on people.  He is a violent offender.  In his presence, move slowly and never ever take your eye off his body until you lock the ward door with your key.  Back away from him and never let him get between you and the door. When the lock clicks on the door, then you can turn away.”   Mr. M. sits in a chair, alone in a room covered with white bed sheets.  One arm hangs down low and the other is wrapped around his neck.  He does not move.  Like a statue, he sits there and does not move.  His breathing is imperceptible and his eyes never blink.   “How are you Mr. M.,” says Dr. Lecter.  Silence.   “If there is anything, I can do for your please let me know.” Says Dr. Lecter.  Silence.  “We are leaving now.  See you tomorrow.”  Silence.  We both back away to the door and Dr. Lecter takes the key hanging on his neck while I view the patient and opens the door.  As we slip outside I hear, “Goodbye.” From Mr. M.  When the door lock clicks I look into the room from the observation window above the door handle.  Mr. M. has moved.  Both of his arms lay at his sides as if in preparation for a leap.  The chair has moved a quarter of a circle towards us.   All this happened in ten milliseconds of time.   “Let me remind you to never let him get between you and the door.”  Wracks nods and says, “I understand.”   “Let me now introduce you to a football player who occasionally becomes violent. He is a famous defensive lineman.  When he gets mad he picks up whoever angers him and throws them through a window like a softball.  Do not make him mad.  The reason he is here now is because he threw his wife and her family out a three story window into the street. I maintain him on an indoleamine alkaloid antipsychotic agent called Moban.  Use this drug for violent patients.  Moban works well.”  Mr. G. is a large afro American about six four or six five in height and extremely muscular.  He is famous for tackling fast running backs and hurting them.  “Hello Mr. G. how is you today?”  Mr. G says, “Fine, I like my Moban.  When can I go home?”  “When you are stable, we will send you home Mr. G.” says Dr. Lecter.   “I hope that is soon,” says Mr. G.  He pulls a cigarette from a package on his front pocket, lights it, takes a long inhale, blows it out and says. “See you later.”  He then walks towards the television set and watches the broadcast standing while smoking his cigarette.  “Interview your patients every day, write notes and advise me if a change occurs.”   “Do not change their medication without asking me.”  Says Dr. Lecter.   “See you tomorrow. I have to meet some private patients in my in town office says Dr. Lecter.  He walks off seamlessly and disappears into his office as the door clicks shut. We have missed lunch so Wracks goes back to his room and review his notes and read again the notes Dr. Lecter presented to the group. Wracks will see my comrades at six in the dinner line.  We all are dispersed in the many wards and places around the Veterans facility. Wracks lock himself into the little room and smokes.  He does not want to miss dinner.  Winter still exists outside and the cold seeps in through the cracks in the insulation.  The steam radiator radiates heat and a light mist escape from the relief valve on top of the unit.  Wracks has learned to quick dry shoes and underwear on the steam radiators. He pulls the reading lamp close to his face to illuminate the pages of the notes, his notes and medical texts.  Time goes by quickly and it is time to get a one plus one plus one dinner.  Main course plus a vegetable plus a starch and cool aid from the huge beverage coolers.   Food tastes good and tastes even better when a person is hungry.  Tomorrow will occur soon enough.  Wracks do not want to provoke it.  Now at night in Pookipsie, upstate, ensconced on the road to a career and maybe a new beginning, Dr. W sits by himself with his reading light and cigarettes and a milky way bought from Napolean.

Shout, shout

Let it all out

These are the things I can do without

Come on

Shout shout

Scream it out

This is what I am talking about

Come on

In all these years

You didn’t have to sell your soul

Amongst your peers

You didn’t have to lose control

You didn’t have to lose control

You didn’t have to lose control

Shout shout

Let it all out

These are the dreams I can do without

Come on

Come on

Shout shout

All alone scream it out

These are the schemes lurking about

Come on

I am talking to you

Come on

Its all in my mind

You didn’t have to tear my world apart

Time after time

You didn’t have to break my heart

You didn’t have to break my heart

Shout shout

Scream it aloud

These are the scenes lurking around

Abound, they whisper to you

Abound

Shout, shout

Let it all out

These are the dreams

I can live without

Come on  I am talking to you

Come on

As the earth revolves

Get out of my mind

Night turns into day

I need time to unwind

There exists no reason why

There exists no reason why

“Where have you been?” “We are busy tonight!” “Get your ass into room two. We have a gunshot to the abdomen and we need your hands!” Dr. Mac is an African American built strong and powerful and he is also a trauma surgeon.  His sister could be Oprah Winfrey and probably is but the wracks never asked him.  He is always too busy doing surgery.  the clock says eleven thirty.  Wracks missed the burrito run and will have to settle for chips and a coke and his coat needs washing but no one ever sees it anyway and tonight a gunshot victim lies on a gurney in a pool of blood with two doctors doing what they do and a second-year student cleaning up the mess. The Wracks cleans up messes in the ER. His chores are to clean the surgery rooms and suture sites and then wipe antiseptic on the furniture.  He also lends a helping hand. “Get your white ass over here and take the pail and pour the blood over the screen so we can rein fuse him with his own blood says Dr. Mac.  I have already dropped four crystalloid bags and he still bleeds.  Dr. Mor is on his way and will do it in the penthouse. “The patient is an Arab male of average height with dark hair.  He could be Iranian.  He could be Saudi.  He could be Iraqi but now he is in between life and death and nothing else flies germane.  On the right side of his abdomen is a gaping hole the size of a fist and everyone can see into his abdomen.  Blood drops out of the exit wound in his back steadily and the wracks grabs the stainless pail and hands it to one of the doctors who pours the blood back into a bag hooked up to a large 16-gauge trochanter needle stuck into his femoral vein. The Wracks puts the stainless pot underneath.  The man is conscious but barely breathing and has a vacant expression on his face with sightless eyes staring up into oblivion. Dr. Mac pours the blood on the screen and the nurses enter in and out bringing bandages and surgical sets.  “This guy is the luckiest man in the world says Dr. X.  The 357 magnum slug missed his aorta and right kidney by one inch. If we can stop the bleeding he will live.”  Mac and X clamp the bleeding vessels; insert gauze into the hole blasted out by a 357 magnum revolver. A nurse puts her head through the curtain and says “We have a patient clubbed with a baseball bat on route. He will be in room one.”  Dr. Mac says to me, “Stay with this man until Mor comes for him. Do not let anyone closer than ten feet away. Wracks says, Am I your favorite white boy?  Dr. Mac says; If anyone comes in the door, grab the phone and type in the secret emergency number we gave you and security will come. Do not let anyone near him because he is near death.”  Dr. Mac and Dr. X run into receiving and the wracks is alone. he sits in the wooden chair next to the door with a blue seat and thin legs and I wait.   Five minutes later a person puts his head in the door.  The person is also mid-eastern with thick black hair and a thick black beard in jeans with a mean expression and wild eyes.  The Wracks says “You cannot come into this room or I will call security.  He says nothing and looks at the Wracks. Wracks slowly stands and walks to the phone and slowly pick up the phone and put it to his head. “If you do not leave, I will call security!” says Wrak The man looks at him and the hair on the back of his head starts to crawl.  He holds the phone.  He looks like he will explode. Wracks holds the phone.  He looks at him.  Wracks start dialing the secret code and he snarls and disappears.  Wracks never saw him again.  Dr. Mac says he did well because he probably was the shooter and wanted to finish the job.  Dr. Mor is an Anglo-Saxon man about six feet tall with slightly red hair.  He has good hands.  He and his surgical assistant start rolling the man toward the service elevator to the penthouse.  “Dr. Mac what is the new kid’s name?”  “Wrak”, says a voice from down the hall.  “Nice to meet you Wrak,” says Dr. Moo.  They leave and the elevator door closes.  wracks hear the patient lived and was able to tell his children the tale.  He is a lucky man indeed.  The bullet missed vital targets and Dr. Moo was the general surgeon on call that night.  He lives only fifteen minutes away.  In life, like anything, luck is everything and when a person needs luck, they need a lot of it, now, badly.  This man lucked out.  “Clean the room and mop up the blood.” Says Dr. Mac.  “We need a surgery set in one with proline.” “You can leave at daybreak.”  “who is your favorite white boy,” says the Wracks.”   “Fool” says Dr. mac.   Get back to work.