After Hours (3 page)

We were in a sliver of downtime before the various morning therapy sessions and support
groups began, one of a limited number of unstructured “social” periods that peppered
a given day. Kelly circled like a prowling animal—fluid and silent, watchful. His
sharp eyes scanned everything, but they didn’t dart. Nothing about him promised sudden
movement, and I could understand what Jenny had meant. He was an impenetrable, unscalable
presence, gray and huge and immovable. Comforting to everyone in the room. Me in particular.

There were lots of boring lulls between intermittent administration and meds prep,
and I passed much of it—too much of it—watching Kelly Robak. He was on general duty,
playing UNO with two patients during the pre-lunch break, until one became agitated.
Such a normal scene suddenly launched into crisis.

“Here we go,” Jenny said, getting to her feet beside me. I followed her into the rec
room’s little nurses’ booth, where she prepped a Haldol dose with shocking speed—those
shots were a bitch to draw, but she snapped the vial open and switched out the needles,
smooth as a close-up magician.

“We’ll wait and see if he calms first,” she said, discarding the sharps, “but knowing
this one, he won’t.”

Beyond the booth’s glass, the angry patient was on his feet, as was Kelly. Kelly listened
patiently to the vitriol suddenly streaming from the older man, nodding with his thick
arms locked benignly across his chest. While my body vibrated with adrenaline, his
looked positively serene.

“Red cards!” the man was shouting. “Six reds cards in a row! Six six six! Red like
the Devil! He’s leading me into sin!” He pointed at the other patient who’d been playing.
The accused was so stuporous, he looked close to dropping off to sleep, which seemed
to enrage his fellow resident more. He made to lunge, but Kelly had his arms behind
his back in a blink, holding him in place as two more orderlies ran over. The man
kicked, the table jumping and a stack of cards fanning across the wood. In seconds
they had him belly-down on the ground, a man securing each arm and one his legs. I
hurried out of the booth behind Jenny, heart thumping.

Often a physical restraint was enough to calm this type of episode, but Jenny had
called it—this guy was
not
soothed. Quite the opposite. Normally the shot would go in the patient’s shoulder,
but with a table and two orderlies in the way, we had to go to Plan B.

“Pants,” Jenny ordered me, and in a robotic, unthinking daze, I knelt to pull the
elastic waistbands of the patient’s pants and underwear down. Jenny scouted the injection
site in a fraction of the time I’d have needed, and gave him the dose.

And just like that, I’d taken part in my first restraint and sedation.

It happened so fast, I hadn’t had time to register my fear as much more than a chemical
rush. In its wake I felt high, but knowing maybe I did possess some modicum of instinct
was a relief beyond measure. I got to my feet, shaky but proud, feeling like a part
of a team.

“Well done,” Jenny said, once the patient was calm and settled once more and his doctor
had been paged.

“Thanks.”

Back in the booth, she jotted a note on a clipboard. “Dennis said this is your first
psych gig.”

“Kind of. I was my grandma’s live-in caregiver for six years. She had dementia. My
psych hours for school were at an outpatient substance abuse facility. So no hands-on
experience with . . . you know. Nothing this intense.” Nothing this dangerous.

“Ambitious,” she said, scribbling.

Ambitious
wasn’t quite the word. This position was the only one I’d found within an hour’s drive
of Amber. I’d have far preferred to get work in a nursing home, but I didn’t think
it’d curry me much favor to tell Jenny I was only here as a matter of complete desperation.

“I saw on the roster you’ll be doing restraint training the next three days,” she
said.

“Yeah.” And I couldn’t for the life of me decide if I was pleased about it. This was
restraint
as in wrestling a patient into submission in order to calm him or administer a sedative,
not restraints like you’d use to strap him to a bed. Mastering the drill in the event
of an outburst was essential, of course, but I worried that after I’d completed the
training, the danger would feel all the more acute. The training would also take a
bite out of my days off, Wednesday and Thursday, which I could have used to process
all these changes, get my things unpacked, and explore my new town.

“It usually takes place in the gym in the Warbler building,” Jenny said. “You’re the
only new hire from our ward who’ll be taking part, but Kelly helps teach, so there’ll
be one familiar face, at least.”

As if I could call anyone’s face
familiar
yet. And as if I’d be able to relax, counting down the hours to when six-feet-several-inches
of Kelly Robak would likely be pretending to assault me. The thought of his massive
arm locked around my neck made my southerly lady region flutter to sudden life.

Oh dear. That wasn’t right.

Kelly Robak was
not
my type. He was too big, too covered in bruises, and
far
too married—just too
much
. Most worrisome of all, he looked an awful lot like Amber’s type, which meant I’d
already spent years fostering a grudge against him.

Still, he drew my eyes from across the rec room, some obscene muscle or other flexing
in his forearm as he reached up to change the channel on the television. Knowing my
luck, I’d seize up and faint in his demonstrative choke hold, outing myself as the
neophyte I was. Though perhaps I’d ought to be more worried that some sexual monkey
wrench would jam my good sense during a drill and my body would refuse to fight him
off. In any case, all the logical, northerly regions of my being decided restraint
training was something to dread.

* * *

Things got busy after the morning lull. Lunch meant more meds to organize and distribute,
then Jenny took me through the exhaustive inventory rigmarole in the various nurses’
stations. There weren’t any more incidents after the UNO debacle, and by late afternoon
I’d gotten most of the patients and their diagnoses and treatment plans copied onto
a mental crib sheet, having spent a couple of hours studying their files.

Rattling off their histories and dosages couldn’t hold a candle to actually having
relationships with them, though, and when dinner was getting underway, Jenny suggested
I join her, eating with the residents in the dining room. I’d scarfed a banana for
lunch, feeling pokey with my paperwork, so the promise of a sit-down meal was enough
to steel my resolve.

Since breakfast I’d been hearing mutterings of “pizza day,” and now I could smell
it. Ambrosia. I followed Jenny and we got in line alongside patients and staff at
the S3 cafeteria counter. I grabbed two cheese slices and a root beer, and tailed
Jenny to one of several large, round tables. I caught sight of Kelly not far away,
eating with a group of residents, a circle of gray. He’d taken a seat with a view
of the entire room, and I bet it wasn’t an accident.

“Has everyone met our new LPN, Erin?” Jenny asked brightly, glancing around our table.

There were three patients, and I tested myself on their names and conditions. Lonnie
and Carl, both schizophrenic, and Les, a deceptively cheerful sociopathic type who’d
served three separate prison sentences for arson. I remembered him easiest, as I’d
employed the thoroughly un-PC mnemonic device of “
Les
be sure to not give that one any matches!” while quizzing myself earlier.

The three men murmured greetings, and Jenny nodded to a seat between Lonnie and Les,
taking her tray to the other side of the table.

Conversations resumed, which meant Lonnie and Carl went back to arguing. Paranoid
schizophrenics can be prone to that, and both of the men were clearly feeling a touch
self-righteous. As best I could gather, Lonnie was insisting that the military had
planted him here on the ward, and that they’d be coming any day to collect his findings.
Jenny had told me he was what the Starling staff called a
popper
, meaning his illness was particularly potent and frequently “popped through” the
bubble of civility created by his meds. Carl seemed simultaneously unnerved by the
notion of a government operative in his midst and annoyed by Lonnie’s self-importance.
He’d been distractedly cutting his pizza slice with a plastic knife for some time,
so long he now seemed to be trying to saw through the tray. I stole a glance in Kelly’s
direction, suddenly wishing he were at my table.

Jenny attempted to shift the topic. “I wonder what movie they’ll show in the rec room
tonight.”

Carl dropped his knife, shooting her a patronizing look. “It’s Monday. On Mondays
we watch the singing show. We
always
watch the singing show on Mondays.”

Lonnie wasn’t listening. He was studying me as I stripped the wrapper from my straw,
hazel eyes squinting magnified skepticism through his thick lenses at my hands and
face and the shiny new picture-ID badge clipped to my scrubs.

“Do you like the singing show?” Carl asked me earnestly.

“I don’t think I’ve seen it. Maybe I’ll check it out, later.” There was a TV in my
apartment. I could watch whatever program it was, and have something to talk to him
about tomorrow.

“I know what she likes,” Lonnie said, in a slow, snide, creepy murmur, loud enough
for most of the table to hear.

I took a bite of my pizza, ignoring his attempt to affect me. He was only testing
the new girl.
Don’t take the bait
. “Do you like the singing show, too?” I asked him politely.

Lonnie stood, fast enough to topple his chair. He grabbed a pizza crust, and jabbed
it toward my face and shouted, “You’ll like this when I jam it up your cunt!”

The room went flat, panic reducing everything to soundless slow motion. Like being
underwater. I lunged to the side, a second’s scrambling that felt like an hour’s swim.
Smooth, cold tile found my palms, and legs rustled past from above—orderlies rushing
to restrain Lonnie.

Sound returned. Someone was helping me to my feet. Lonnie was on the ground, face
pressed in my direction, wild eyes locked on mine. One orderly held his ankles while
Kelly Robak knelt straddling his waist, pinning his arms.

“She’s an agent!” Lonnie was shouting. “Don’t trust her!”

Jenny must have dashed for the nearest nurses’ station and prepped a syringe. She
reappeared, offering Lonnie a seeming eternity to settle before deciding to give him
a jab in the deltoid. “That’ll calm you down, Lon.”

“Agent!” he shrieked, eyes blazing hatred up at me through his skewed glasses. “Bitch
agent! Sent by the council!”

The shot took effect in a matter of moments, and Lonnie’s fiery eyes went dim under
heavy lids. I watched him blinking groggily, everything seeming to me as if it were
happening on a TV screen, two-dimensional and glassy and unreal.

A tech was rubbing my back, saying something soothing. She may as well have been speaking
to a coatrack.

The numbness slowly lifted, uncovering a crisis in my body. My heart had never beat
this hard—my head pulsed, my eyes, my bones. I knew my chest was heaving so violently
it must’ve looked as if someone were thumping me with invisible defibrillator paddles,
but it was theoretical. The entire room was a theory, as all I could do was stare
at the floor, blood and breath crashing through me in waves.

Jenny’s hand on my arm. She was saying something. I was being led to the nurses’ station
and steered to sit, my hand wrapped around a white paper bag and coaxed to my mouth.
I huffed into it. Soon I could control my eyes enough to blink and scan the room.
I felt my fingers and toes, my prickling cheeks, the padded chair under my butt.

“There we go,” Jenny said. “Keep that up.”

After another minute my wheezing quieted and my head cleared, the fog lifting to reveal
a massive headache. “Sorry,” I gasped. It came out thin and high.

“Hyperventilation’s a joy to treat, compared to what I’m used to.” She stood and gave
me a soft, casual clap on the back. “Sit tight for a few. Actually . . .” She consulted
her watch. “Your shift’s done in twenty minutes. Why don’t you take your paperwork
down to the sign-in room, have a Coke, take your time with the forms? Don’t worry
about evening hand-off. I think you’ve had enough excitement for your first day.”

As much of a relief as the offer was, I felt like a failure and a coward as I gathered
my clipboard. I thought I could feel everyone’s eyes on my back as I headed for the
stairs, hear them thinking,
Well, she’s done. Another one bites the dust.
Tears stung my eyes and I could feel my face going pink . . . if it wasn’t already
from the anxiety attack.

I bought a pop from the vending machine and sat at the table, pressing the cold aluminum
to my burning cheeks before I cracked it open.

I hadn’t felt this defeated and useless in ages, not since the early challenges of
caring for my grandma. Not even physically touched by a patient and I’d fallen to
pieces. I shook my head and a lone tear made a break for it. I wiped it away with
my wrist and sighed.

My whole life, I’d been the one who kept it together. Grace under fire. I felt more
lost than I could remember, naked with my veneer of capability stripped away.

Paperwork helped. It required me to recount what had happened in clinical detail,
to label Lonnie’s outburst in impersonal terms and remove myself from it. Though it
seemed callous to draw the analogy, I told myself it was no more personal than an
angry dog snapping at me. I’d been nothing more than the least trusted face in the
room. Or maybe he’d smelled my fear.

I’d do best to quit thinking of the patients like they were some other species. I
never,
ever
would have let myself think about my grandma that way, and those men were all somebody’s
family—somebody’s son or father or brother or lover. The thought left me more exhausted
than ever.