The picture

I was sitting at the nurses station, finally afforded some quiet with all patients having found their way to bed. It was the holiday season and a time of high census in a psychiatric hospital. It is traditionally brought on due to the pressures imposed by loved ones or no loved ones at all. It brings back memories in a vivid state of times gone with tragedy or happiness embedding itself full force in recall and can bring many to the point of breaking. The critical care area is usually at capacity at this time due to those that have voiced suicidal ideation. They are unable to deal with their tragedies in a productive light of insight with eventual resolution. Rather, they have taken it upon themselves to end their pain by attempts to end their own lives or self-mutilation. It's not pretty but it's real for these many have lost the idea of Santa, and there are no presents under their tree. My job is to medicate them with a concoction of chemicals to allow them some clarity in regards to their actions. I also impart skills to these wanderers enabling them to join and participate in this demanding master that we refer to as life.

With clients in their beds I can sit down to my charting, putting in psychiatric diagnoses and behaviors for each. I enumerate their progress, if any, and attempt to paint a cold portrait of a walking disease that is being handled in a methodical way. Many times I wish that I could merely put down 'abandoned.' It seems much more appropriate.

It is in this time of the dark and quiet night that the afflicted will be accompanied to the unit for admission. Papers are signed, antipsychotics and sleeping pills administered and familiarization with the unit is explained mechanically. All of this is done before being led to their appointed bed. It is a well-practiced, cut and dry routine sprinkled with a welcoming persona and an empathetic ear. You can do it in your sleep it seems, once trained.

Within that sea of faces that pass by your desk are some that you can remember. There had been a bond forged between them during a stay that will be revived unfailingly if you once more see their face. This is about one of those that crawled into my heart and set up residence without my realizing it. Not until she once again walked through the doors that locked automatically behind her was that kinship revived.
I couldn't remember the name but assuredly recognized the face. Her hair was dyed a deep, Goth black and tattoos could be seen running up her arms. The eyebrows were overly tweezed and the eyeshadow was an unmistakable red. Her eyes were downcast as she entered and she did not see my face. It was my voice that aroused her attention with my question of "I know you, don't I?"

The bent head raised itself and the dark eyes began to assume a spark of life with a change in not only her facial expression but her stance. She had been acknowledged as an individual human being worthy of notice. Though tears were still blurring her sight, a minute turn of her lips belied a subdued smile and she reached her hand towards me. Once more our journey had begun. She thanked me for remembering her as I grasped her outstretched hand tightly. I once more saw the ornate mystical form upon her left forearm and called the other nurses to see the subtly shaded artistry. I desperately wanted her to feel special.

We finished the admission process in no time, I gave her the prescribed medications and personally walked her to her room. As I pointed her bed out she turned to me saying how glad she was to see me and how happy she had been to hear my voice at the desk. I responded in kind, assured her that she would be safe and reiterated to come to the staff with her concerns. She entered the room, placed her belongings on a shelf and covered herself with her blankets. I then started my trek back down the hall.

Once back at the desk I began my writing again as our first encounter swirled around in my head. She had last arrived here during the previous holidays and we had spoken regarding her personal life. She relayed to me how she had come to find herself within these walls.
She was a combat veteran aged less than 30, injured, with a lifetime disability. She had constant, haunting of moments spent in Iraq that left her with PTSD (post traumatic stress disorder). This would manifest itself in dreams that would bring back memories and feelings so intense that she would relive the catastrophic events. These thoughts would overtake her mind allowing for no peace or rest. The two of us had bonded through the simple fact that my youngest son had already spent a year in that same country of her psychic devils. I revealed that he would probably be deployed again to another area of that region fraught with danger. It was she who wanted to heal a mother's heart and we spoke often of experiences and the strength that we had both achieved. By the time she was discharged, her dreams had ceased and her posture had straightened. She looked forward to her leaving and I imparted to her how pleased I was with her progress and how her smile would shine. She told me the often spoken words that I'd heard from many that "I won't forget you" and walked back into the world.
It was without awareness that I had any idea that she had put a stamp upon my life. In this tough profession many are treated and few are kept within you for all time. You must protect yourself emotionally from becoming too involved to see situations clearly and hamper your tasks. This may sound cold but it is true in the medical system. Perception is best acquired at arm's length.

I took my allotted four days off consumed with my personal duties pressing upon me at the busy season. The memory of her barely surfaced in my mind at this time. My free hours are all about getting things done within a time frame and I was down to just a few days. Filling them purposefully with demands was a necessity. I could no longer put off tasks and filled my hours to capacity.

I returned to work on Friday evening, received my report and started into my twelve hour grind. As I went to enter the med room I once more saw her, this time with a smile on her face and a light in her eyes. She approached the station asking me if I was her nurse and I told her that she was in the "B" group rather than my "A," Her face fell. She stated that it "sucked" and I agreed with her but told her that it was perfectly fine to approach me as I've echoed to numerous patients that weren't assigned to me. She left the station and went down to her room.

After shift change there is a lull in activity for almost an hour before the real work begins. The patients are ushered to breaks and then a group session as we nurses make our preparations for the evening. It's a relief to have this time slot to plot our course of action for the shift with only minimal interruptions. As I raised my head from my work I could see her walking from her room towards the station with a paper in her hand. I put my pen down as she approached to give her my full attention.

As mentioned before, he unit that I work on is for the acutely ill and just about anything can be used by a desperate person to hurt themselves or others. There are no plastic bags in patients' bathrooms due to their possible use for suffocation, no shoelaces for strangling along with drawstrings for pants. Though they have journals to write their thoughts in, no pens are allowed. They can be used to mutilate themselves and patients have also stabbed themselves or others (including staff) with these seemingly innocuous devices. The only thing that they may write with are crayons that are kept at the desk. During activities they may draw from scratch or even use coloring books as an outlet to vent their frustrations. It's not unusual that pictures are posted at the nurses station for all to see done in the vivid crayons.

Approaching where I was sitting, she came to the place before me and said that she had made something for me. I shifted my weight in the chair knowing that attachment and favoritism could at times not be in the best interest of the client. I casually asked her what it was. She withdrew the paper from behind her back and there was a page from a Disney coloring book with Belle from "Beauty and the beast." Instead of being fully colored she had shaded the face with a light pink upon the cheeks (not unlike the shading of her ethereal tattoo) and rimmed the eyes with red eye shadow similar to what she wore. The hair wasn't black like hers but rather, closer to my color. She asked for a marker to sign it under my direct supervision. It was addressed to me and signed with 'love.' As I took the picture in I could feel her eyes upon me perhaps waiting for a sign of approval. As I told her it was beautiful she immediately explained that it was done especially for me and she wanted me to keep it. I placed it on my clipboard. Satisfied that I was pleased and had put it in a place of honor she made her way to the group room with a smile once more upon her face and that erect posture that I'd seen before.

Where is the picture? It's at home with me and I'll be putting it a frame and placing it on my nightstand. It will be right next to my alarm clock. The next time I'm awakened by the buzzer that signals me to prepare for work I'll be reminded of why I am going.