Good morning Dr. Lector says Dr. Wracks. I just had an egg, a strip of bacon two toast, and two cups of coffee and I feel great. I have something I want you to see says Dr. Lector. We don’t know what happened to this man or if there are any antecedents but his family brought him here to eventually be committed. We have to evaluate him and the board will agree to a final disposition. I feel he is a catatonic schizophrenic but he could be something else. A fine line exists between genius and schizophrenia. I would appreciate your opinion. The patient is an older man with white hair, tall with an ectodermic somatotype. He sits in a chair and doesn’t move a muscle for hours at a time and the staff cannot even see him breathe. However sometimes upon observation, he will move rapidly to a position of superiority to his keepers, like a caged tiger. Everyone is afraid of him and says it is spooky. One of the staff reports that one day he was hanging from the ceiling like a bat and they don’t know how he did it. The prognosis with the direst eventuality is catatonic schizophrenia and dual personality types. There exists no cure for catatonia or dual personality and clinicians like to keep them sedated for their lifespans. I am going to show him to you, do not speak or make any noises until the conclusion of our observation. Are you ready?
Yes Dr., Lector let’s go.
The padded cells stand on one side of the unit and are sequestered by a huge oak blast door. If all else fails, a staff member must make it to this door and it closes automatically with an audible click. The two clinicians come to the huge door and Dr. Wracks opens it with the key slung around his neck. Dr, Lector precedes and they come to the final padded cell, the one closest to the end of the unit, the one it is easiest to run from. Dr. Lector looks at Dr. Wracks and opens a portal in the solid wooden door. The portal hangs at eye level, has a lock on it and swings open fully so a staff member can look inside. The dimensions are 12 inches by 12 inches. It is unlocked, the door swings open on two sturdy hinges and Dr. Wracks looks inside. Sitting in a chair next to the table is the patient. He has stark white hair and wraps bedsheets around his body so he looks like a Messiah. He is tall and lanky with a long angular head. He doesn’t move, not an inch, not a muscle almost like a plastic mannequin. Dr. Wracks knows he only moves when no one is watching. Dr. Lector Closes the door. What do you think says Dr. Lector?
Catatonic says Dr. Wracks. Overtly catatonic. He washes himself and uses the toilet without help says Dr. Lector. Could he be pretending to query Dr. Lector? What is his medication asks Dr. Wracks. We have him on Haloperidol ten mg each day IM with no effect. There is no betterment or worsening of symptoms and the extrapyramidal effects of the butylphenones do not manifest. If you must go inside bring an attendant with you and have him stand on one side. For some reason, mental patients can move quickly when induced. Please be on your guard with him. You will check him twice a day through the portal and make a report if there are manifest changes of any kind. Please keep me informed, asserts Dr. Lector. I have things to do and he walks off.
Having free rein in a psychiatric lockup may be exhilarating to some, and prestigious to others but Dr. Wracks views the situation as an ominous burden, not to be shared by a single individual. Seven more weeks must pass before rotation back to surgery, thinks Wracks. He hopes the nose of the director heals quickly. Would I like to do this for the rest of my life?
In and out of the subsections with the key and the doors close automatically with a large click. Dr. Wracks makes the rounds. He asks the medication nurse in the plexiglass enclosure if all is well and whether there have been any side effects or adverse reactions to the psychiatric medications. Acute mania and violence quickly resolve with a 100 injection of Benadryl intramuscularly. He asks the muscular attendants who circulate through the unit if there are any current episodes of violence or acting out. They say no and the Wracks circulate and move to the canteen where the stabilized patients of long duration go to pass the time. There is a big color television on the wall, and they sit around in sofas and chairs and smoke cigarettes, and look up at the large ticking wall clock to see how soon the five o’clock dinner will ensue. Dr. Wracks makes rounds one more time and looks in to view the catatonic. There is no one in the room and Dr. Wracks cannot see anything but a chair a table and a draped white sheet. He knows the patient is crouching low in front of the door or to the side to preclude viewing, Dr. Wracks slowly closes the viewport, locks it, and precedes the blast door as fast as he can move. The big door closes with a loud click. Dr. Wracks asks the nurse in charge behind the screened barricade if the catatonic patient is in the medical unit to have some tests. She says he is in his room and this happens often, usually furtive activity precedes a meltdown, says the Wracks. Be certain that the attendants are present should you have to enter or give him his food tray. She says she will and makes a note in her log.
The Wracks exits the section and goes to dinner. He has a piece of chicken, a vegetable, and a small shortbread biscuit. For dessert, a small bowl of apple cobbler appears waiting for him. He goes back to his room in the resident’s quarters and the gang for the most part exits to the local bar. A Cuban student is there in her cell studying for the licensure examination. He goes back to his cell, takes off his clothes, barricades the door with the reading table, pulls the covers over his body, says a prayer and goes to sleep. Seven weeks to go.