A winter wonder land greets the imagination on Monday morning.  The snow is ten feet high.  How this much snowfall can occur in two days remains a mystery.  One of the residents who is a retired pitcher from a minor league team throws a packed snowball at Wracks head.  A good reaction time saves the day and a medical book takes the damage.  The blow stings the fingers exposed to the missile.  “Thanks for nothing,” Dr. W says.  “I like you,” says Dr. A.  He then proceeds to bean another helpless doctor in a white smock. “I love snowball fights,” he says.   The rest of the team hurries to the main building before Dr. A can pelt any more of us.  At the doorway is Dr. Lecter.  “Give me my key back,” he states with his hand outstretched like a beggar.  “I have it with me,” says Dr. Wracks.  “Here it is nice and warm from around my neck.”  Thank you he says.  Dr. Beck storms into the room and says. “You bastards left on Friday without finishing interviewing the in patients.”  “I am going to flunk the lot of you,” he promises.  “I was here,” says the Wracks.  “Shut up, I was not talking to you.”   “We had to get out before the storm,” said the rich Dr. who drives a Lincoln town car.   “Your first duty is toward the patients,” stammers Dr. Beck.  “You have not heard the last of this.”  Dr. Beck then spins on his heels and vanishes in a flash of anger.   “After taking role, go to your respective wards and interview your patients,” says Dr. Lecter.  Back in the lockup Dr. Lecter and Dr. R. go to interview Mr.  Shine. Shine sits in the padded cell in a hospital gown and underwear.  “Mr. Shine, a person cannot run around hurting people and get away with it.” Says Dr. Lecter.  “I have my reasons,” says Mr. Shine.  Mr. Shine appears to be a Caucasian of average height and build in his early forties.  Brown hair and a fair complexion do not reveal that his job in Viet Nam was to interrogate prisoners and cut them with a Kbar knife for information.  Wracks thinks, I pity the poor slob who gets in a knife fight with him. He has traumatic stress syndrome and when put under pressure has a breakdown and beats up everyone around him.  This could number up to ten people in an episode.  “Mr. Shine,” says Dr. Lecter, “I hear you stopped taking your medication”.   “The medicine makes me restless and makes my jaw stiff, “says Mr. shine.   “We will change the medicine to something else that does not make you restless.”  Says Dr. Lecter.  “However you must stay here until you are stable.”  “When you are stable, you can go home.” “I understand,” says Mr. shine. “Hello Mr.,” I Shine I am Dr. W.  “I remember you.” says Mr. Glitz. “Nice to meet you,” Dr. W. says.  “Today you will administer Psychological therapy to Mr. Heim.  He is a paranoid schizophrenic who used to be a financial genius. See what you can do with him.  “I will,” says Dr. W.  “But first you are to interview Mr. O.  Your rotation nears its end.” I will be in my office.”  Dr. Lecter turns and disappears into the corridor.  “Be sure to maintain distance. He regards proximity as an affront and will break your nose.”

     “Hello Mr. O. “says Dr. W. “Can I sit down?”  “Silence” Dr. W pulls up a chair in front of Mr. O.  Mr. O sits in the recreation room in the Pookipsie VA center.  He wears a long red dress and a string of pearls around his neck.  His dark black curly hair sets close on his head.  He wears a big grin on his face. “Mr. O, how are you doing today?  Do you like your medication?” “Silence”  “Would you like to relay any concerns to Dr. Lecter? I will see him presently.”  “Silence.”   “Before I go, is their any thoughts that you would like to share with me.”  “Yes, he says.”  “Can I have two cigarettes?”   “Sure,” says Dr. W.  As Dr. W. hands the cigarettes to Mr. O, he keeps the distance between Mr. O and himself to a maximum and pays particular attention to Mr. O.’s hands.   “Thank you.” Says Mr. O.  “Good day. “Says Dr. W.  Dr. R then looks for Mr. heim.  Mr. heim locates in his room.  He is not so sociable.  “Can I interview you in the consultation area,” says Dr. W.  “Yes,” says Mr. Heim Dr. W leads Mr. heim to the consultation area.  He decides to use Rogers’s sounding board implosion therapy.  Mr. Heim is a small man with dark black hair and not muscular and should be easy to dodge should he decide to strike.  Rogers sound board implosion therapy translates to mimicking what a patient says or does just as they do it and locate the mimicry temporally so the patient sees for themselves what behavior they manifest simultaneously when they exhibit it. Mr. heim sits down and starts telling Dr. R about the stock “Chock full of nuts.”  Dr. W mimics him.  Mr. heim finally discovers that Dr. W repeats what he says like a tape recorder and starts making animal noises.  Dr. W mimics the animal noises.  Finally Mr. Heim leaps up on to the table, pulls down his pants and exhibits himself.  “That is enough.” Says Dr. R.  “Pull your pants back up.”  Do you understand the content of your verbal discourses?  They make me angry too.” “Some of what you say has no basis in reality.”  Mr. heim sits back in his chair and thinks about it.  The revelation becomes so awesome to his psyche that he sits their dumbfounded.  “Thank you for the interview. I must leave now. ´” Dr. W gets up from his chair and with his eyes still on the patient fluidly exits the consultation room. Mr. heim sits their dumbfounded.  Dr. R moves on in his rounds. 

     Unless a person stirs the muck and becomes intrepid, nothing really happens in a Chronic Psychiatric facility.  The patients come and take their medication and sit like dazed animals in house until the Psychiatrist dischargers them.  Some patients stay forever.  Some patients return periodically as they lose the ability to cope with the environment.  Mental illness stigmatizes human beings. Mental illness is a self-fulfilling prophecy in the sense that if a person can not be trained in a new line of work they become slaves to the system and permanent part time inmates.  The urgency with mental illness remains to try to get the person back to reality in the workplace as soon as possible.  This maneuver becomes inordinately expensive.  Money has been and is the power to drive reeducation of a person with a shattered existence.  Without money to send a person back to school, to retain competent health advisors and physicians who monitor the chronic medication and to house mental patients, mental illness penalizes  human beings and converts them to useless appendages of society who die alone, unhappy.  Most people can not afford the cure.   The cure comes from money, honesty and the undying care from health science personnel.   “Time for my plus three dinner,” thinks Dr. W

     On the last day of the rotation, Dr. Beck approaches Dr. Wracks.  He asks, “What did you do to Mr. Heim.”  “Rogers sounding board reverberation therapy,” says Dr. R. “Sounding board therapy becomes efficacious when used with a high functioning schizophrenic who can learn from his behavior what works or not.”  “What ever you did cured him,” says Dr. Beck. “He is going home tomorrow.” “I guess I am really lucky,” says Dr. W.  “Thank you for the rotation.  I learned much about Psychiatry.”  “After you finish your fifth pathway, come back here if you want a job,” says Dr. Beck.  “Thank you very much, I will certainly keep your offer in mind.” says Dr. W.    

     In life luck is everything.  Beginners luck is even better.  Chalk one up for the gipper.  Victory is sweet

The train in Pookipsie looks like the train in Harry Potter’s “The sorcerers Stone.”  The train rambles slowly downstate and eventually ends up at Grand Central Station.  On the train sits Dr. W, in a suit and tie, with his bag of medical books bound for Amityville and the surgical rotation about to begin the next day.  The scenery in the country side after a late winter storm swims by slowly.  White juxtaposed on evergreen, separated by skeletons of ash and birch. Connote the scene.  Dr. W reads from one of his books and occasionally looks up to view the panorama.  The train rocks and sways, slows and lurches and rumbles with a knocking vibration heard and felt at the same time.  He will probably do simple stuff like wound suture and suture removal.  This will give him time to review for the California board Examination.  The train rumbled on and darkness slowly permeated the scene and the interior lights of the train card turned on.  The seats were comfortable enough and the comfort is the day drawing to an end.  Dr. W thinks he is on easy street.  Just a little cutting and tying in surgery and checking outpatient bandages, thinks Dr. R.  Amityville hospital is about to administer a surprise to Dr. R like he has never been surprised in his life. The hospital staff will also throw in the ICU as a bonus prize. Before he left, Dr. Lecter floated into view, long jet-black hair in a white smock.  When you get your license, stop by.   By the way my name is Hannibal.    “Tis folly to be wise when ignorance is bliss,” muses Dr. W.  “Amen.”  “…..and so it goes.”