“May I help you folks?” asked the hospital employee as he adjusts the drawstring on his scrub pants.
“We’re looking for the third floor-the psyche floor. Is this the right elevator?” I’m with my husband, and my 10 year and 6 month old daughters.
“Yes, just get on the elevator and follow the directions,” says the man who disappears around the corner.
I notice that the hospital in which I had volunteered as a teenager and pre-medical student in college, had had a cosmetic makeover since I’d last been there. The old corn-blue vinyl design schema had been replaced by taupe and rose colored draperies and chair covers. The hospital, itself, however, had not changed much. The second floor looked abandoned with an empty nurse’s station, no patients on what looked to be a medical/surgical unit, and only a few unused stretchers and empty sharps container peppered the hallways.
We get on the elevator and select the black Three button. Nothing happens. The sign indicates no children under the age of 14 on the Behavioral Unit as well as a host of other restrictions.
My husband selects the button with the telephone icon and we wait for the disembodied voice to answer.
“Yes? May I help you?”
“I’m here to see my brother, ________ __________?”
“Do you have his code?”
“It’s 3416.”
“Okay, hold one moment,” says the voice.
The elevators begin to move and the doors open.
A short, solidly built male orderly stands just outside the open elevator doors. With hand still holding the elevator key into the stainless steel lock on the wall, he gestures towards the sign inside the elevator indicating “No children under 14. You don’t want your children up here with this bunch. There’s a waiting area in the lobby on the second floor” he says.
My husband says, “ You go ahead, I’ll wait with the kids.”
I step off the elevator to a drab, cinderblock walled unit painted white with no accent colors. No artwork adorned the walls; and as I followed the stocky orderly down the hall towards the nurse’s station, I notice that I’m walking between patient rooms. Each room has two headboard-less beds, some occupied, and nothing else. The orderly nods his head towards one of the rooms on the left side indicating my brother but continuing his stride towards the nurse’s station. I notice my brother stooping over to pick up a small Styrofoam cup from the floor. Ice and water are spilled in front of the cup. The orderly waves me towards him mumbling about the sign in sheet. The unit is a vapid void and my presence alone offers stimulation to both the patients and the personnel. Thoughts from my clinical psychology rotations from nursing school jump to the forefront of my mind and I think “show your patients respect, look them in eye, don’t infantilize them” A man in a robe worn over pajamas stands in the doorway of one of the rooms, watching me as I walk up the long corridor towards him and the nurse’s station. He smiles. I say, “How are you?” He responds loudly, “FINE, HOW ARE YOU?!” And laughs.
Laughing guy with pressured speech standing in a doorway with pajamas, robe, and slippers… How cliché, I think. I keep a straight face, but laugh inside. At home with the crazies, I must be.
After mentioning that visiting hours actually begin at 6:30 pm (10 minutes from now), the orderly hands the clipboard to me, then a pen, and I sign in.
Brother is thinner than when I last saw him, he’s wearing a pair of long shorts and a white turtleneck. Walking back up the long corridor from the nurse’s station, I see him leave his room and head towards a white table just across from the elevator. When he walks, his gait is unsteady and when he speaks his words are slurred.
“What brought you to THIS floor, brother?”
Well, A few weeks ago I had a seizure. Around that time…
Dec. 18, 2010 Dad, [OB], and Mom’s joint account
Younger Brother [[YB]] begins his account of the events of December 17, 2010, three weeks earlier, when an altercation between him and our father escalated into a family ordeal that left one brother in the emergency room and the other, eventually in the adult psyche unit of the local hospital. I just happened to have called my mother the morning after the event just as my father was bringing my oldest brother [OB] back home from a night spent in the Emergency Department. I was placed on speakerphone and along with NMother, NFather, and recovering-addict-oldest-brother, they give a frenzied joint account of the incident.
Mom begins: “[YB] had a rage on your Dad last night, OB heard about it and he rushed over to help. Your Dad had called me when everything was happening, so I was on the telephone when I heard the phone get thrown and the line went dead. Aunt E (89 year old Alzheimer’s great aunt whose social security income covers the costs of living for [YB] and father, all of whom live in one of NMom’s properties) was in the house and I feared for her safety. [YB] was choking Dad, his hands around his throat!!”
Me: “Why would he do that?!” There was a silence, followed by a combined grumbling of voices, each saying something different under their collective breath. The gist: “Same as always, [YB]’s rage comes from out of the blue.”
OB exclaims, “I don’t care about why he did it, you all can talk about that at some other time. All I know is I [YB] knocked me over, hurt my back so bad I went to the emergency room, only to find out that I have a spiral fracture in one of the bones of my hand. I felt like a woman, being abused. I couldn’t get up. He had me pinned down, he stomped on me, kicked me, all I could do was to keep kicking him in the knee, while he was blindly punching me. I’ve been in fights before, but this time, I actually feared for my life!”
Mom interrupts, “empathizing” with OB, obviously shaken from his frightening depiction: “I know how that feels! Your Dad pinned me down, when he beat me up that time. I’ll never forget it!
I assume Dad, whose voice could not be heard over the speakerphone, was still standing there.
Me: Did he seem sorry?
Dad: It always takes him several days to be repentant, then he’s crying and sobbing all over the place.
Mom: maybe, we need to have David committed…
OB: “He just kept saying 30 years! He’s got 30 years pent up in him! That for 30 years I haven’t been a good brother, or role model. He talked about me being out there doing drugs and not being there for him.”
Dad: “You know the one good thing that came out of it?”
OB: “That nobody got hurt?!” He chuckled, but I wasn’t sure if he was being sarcastic or not.
Dad answers: “Yeah, that…but also, that he can’t just go around handling people like that. He got it himself this time.
Me: “What do you mean?”
Dad: “That he can’t just go around putting his hands on people. That maybe somebody’s got something for HIM, sometime.”
December 20, 2010-Mother’s account three days later:
NMom: OB and your sister want to institutionalize [YB]. And I tried to talk to them about why your brother would behave like that, but it’s just too soon for them to talk about it. They want him put in a home or something. But after talking to YB, I think your Dad needs to move on… I’m about ready to put your father out. But OB and your sister don’t agree. [Sister] wants her Daddy to stay at the “family house,” as she calls it. Do you consider that house “the family house?”
Me: “No, I always thought it was [YB]’s house. That he lived in it for many years after you moved out and before Aunt E and eventually Dad moved in with him.”
NMom: “I didn’t tell you earlier, but, a week before the choking incident, [YB] began doing some work for me for pay. Just odds and ends around the house, moving some stuff around, answering the telephone, stuff like that. OB was trying to give [YB] some advice on how to answer the phone correctly. OB also corrected his younger brother on some other small task that [YB] considered easy enough to handle on his own. [YB] expressed himself to his older brother, saying ‘Look, I think I can handle this, brother. Back down.’”
NMom: “During the fight between your brother and father, your father called me so that I could hear just how terribly [YB] talks to him when I’m not around. It was pretty bad. They were fighting about your father’s hoarding. There was a fridge full of stuff. The den is filled with fridges, and this was a reason why [YB] would not be able to have his three kids in his home for Christmas. [YB] was going on about the filth and telling his father exactly what was on his mind and heart. He was really rough. Your father said to [YB], ‘You talk to ME like that?! I’m NEVER taking you to see your children again!! And in a triumphant ‘gotcha moment,’ Dad revealed to [YB] that I’d been listening the entire time.”
NMom: “I could hear your brother coming closer and closer towards the phone before everything just cut off, it just went dead. I didn’t know what to think and I had no way to get over there myself, so I immediately called your sister to go over there and find out what was going on. Well, she wasn’t getting over there soon enough, so I called OB to go over there and intervene. I told him it sounded like his brother was about to kill his Daddy. When your older brother walked in, your younger brother was hovered over your father with his hands around Dad’s throat like he was about to choke him out… They want to put [YB] away in an institution.
Me: “In an institution?”
Mom: “Yes. They think we need to call the authorities so that they can come and get [YB] to take him somewhere and be observed.”
Me: “Exactly one week ago, we were talking about this very thing for [sister]. What ever became of that?”
I was speaking of my mother’s efforts to have my Nsister, who during a conversation with NMom about how nobody cared about her, threatened suicide and harm to her twin girls, evaluated by a mental health professional. My mother, a RN of 35 years, and former supervisor of a state mental health hospital, knows the protocol for assessing threats of harm. When she came to me for input regarding the next course of action, I asked my mother if my sister mentioned having a plan for her suicide, or if my sister seemed emotional vs. calm with resolve. At the time, I reminded my mother of my sister’s children’s fathers, both of whom would use the threat of suicide to manipulate and control her. I urged my mother to have her evaluated by a professional because the threat is so serious, if she didn’t do something about it, she would regret it if something terrible happened to sister or the babies.
Mom, (in an increasingly irritated tone): Well, we have bigger fish to fry, now!! Plus, like you said earlier, she was probably just faking the suicide threat. She even admitted to saying it to get us to pay more attention to her. She said, ‘Mom, look at what lengths I have to go to get you to pay more attention to me.’
Quickly she returns to her story about YB. When I spoke to your brother, he told me he was trying to clean up to prepare for his kids coming over for Christmas. He became disgusted by the state of the refrigerator and he began to get on your Dad about the mess. Dad remained calm in demeanor at the time, but his words were reckless and mean, saying he would never see his kids, knowing that YB has seizures and cannot drive for six months at a time, depending on his Dad for a ride everywhere. Your father’s hoard is becoming huge with multiple refrigerators in the den where YB wants to put up his Christmas tree. And the smell and mess is not sanitary for young children. And your Dad has a way of tearing you down with his mouth. He degrades you and makes you feel small. He praises everyone else but you. I was never a good mother. Other kids were perfect and he would tell me that they must be doing something right and me something wrong. He would tell YB, he would never amount to anything.
Me: Two weeks ago, when Dad lost his job, you mentioned feeling extremely sorry for him. Do you still feel that way, or no longer?
Mom (stuttering): I…I…I.. don’t know. I guess it’s my compassion for people in general. When I got your father to move in with your brother he was living in a 1 room studio apartment with a turned over sofa with a blanket, a jar to pee in, and the bed… He had a smell about him. He brushed his teeth in the kitchen sink. One time, when he was still pasturing that church, he stayed in a hotel after he lost our old house, then he stayed in his car for a while, then he started sleeping in the back of the church. They had to have a meeting to have him removed from the back of the church. There have been some pitiful times where he’s been like a homeless bum…
And sometimes I feel like, he’s your father!! How can I let him be homeless?! I mean he had holes in the bottoms of his shoes and his clothes weren’t taken care of!
How can you let your children’s father be a bum on the street? It’s my compassion, I guess… But I do think your Dad needs to move away from [YB] because whatever they are going through is not good. Dad with his problems. Aunt E and her problems… It’s too much for your brother.
Dec. 30 2010- Mom’s recant
Mom: I was just sitting here crying?
Me: Really? What’s wrong?
Mom: “I was just talking to your father, he’s all sad, despondent and ready to move away from here. He says that everything’s so bad with the kids and he’s not helping any. I had a dream last night, about these large worms, and Daddy was trying to kill the worms, that were not deadly, but a nuisance definitely. He was doing it to protect the kids, your sister and her children, mostly. I found myself surrounded by a few worms and I realized I would have to fend for myself. Because he was busy helping the children… I woke up upset and later in the morning, I called him to come to my house and help me with putting on my shoes. [YB] had to wake him up because he was sleeping in. He was obviously sad and depressed, because he never sleeps in. He told me he just couldn’t find any peace in his home. And [YB] trying to choke him left him feeling terrible. He said he thinks he might move to Arizona to live. ‘If the kids wanted to see him, they could come out there and see him.’”
I don’t say anything, but I think to myself that this is not the worst idea I’ve heard.
Mom: “But I think about how life would be if he were to leave. I feel like your Dad really helps to pick up the slack when the children can’t be here for me. But am I supposed to give up my life and my peace?!”
Me: “You think you would lose your peace because Dad would leave and you would have no one to pick up the slack with [YB] and [NSister] and her children.
Mom: “No! I think I would lose my peace if your Dad were to come to live in my house?
Me: “And THAT’s the alternative to his leaving for AZ?
Mom: “Well, he doesn’t really have any money to go anywhere. He’s struggling with the money he’s getting for social security. I figure, how much am I supposed to give up for these kids? And I’m having a hard time dealing with [YB] trying to choke him to death. I’m having a problem with that! [YB] is saying he’s sorry and all that kind of stuff. But how can a child you raise and take care of bring himself to want to hurt you? And did you know, [YB] took the keys and drove up to a town 2 hours drive away from FOO’s hometown, [a town] unannounced to visit the old girlfriend with 11 children. We had to go get him from up there. He fooled his Daddy, said he was going to take his kids to the movies. He ended up in [a town]. Then he called your sister and told her where he was telling her he was dizzy and that the old girlfriend didn’t have very much food with which to take his anti-seizure medication. He just took the car after being bored and laid up with the children for two days. And he had just had a seizure on the previous Tuesday, but nobody told me. So, I decided I was going to get down to [a town] and get him.
Me: “Nobody told you?”
Mom: [YB] had been in a fight with your sister and her oldest daughter about caring for your aunt. Your sister is working as a home aide for Aunt E now, and she was supposed to be getting paid to ‘watch’ Aunt E while [YB] spent time with his children. I guess with all the fighting going on lately, nobody wanted to tell me that [YB] was still having seizures. They didn’t call the ambulance or anything. He was telling his father about the argument with your sister and niece when he went into another seizure. He knocked down the Christmas tree, bent up one of my old walkers. Your Daddy let him lay there and have the seizure and didn’t call the ambulance. I’ve been trying to get myself together because I didn’t want my BP to go through the roof. The next thing I know, [YB] is in [a town]. So when your sister told me where he was, she said, ‘Don’t worry, Mom, I’ll take care of it!’ But she didn’t move fast enough. I had your father to drive me down there because [YB] was like a loaded gun with those babies in that car! I just felt like it’s my fault if anything happened. So I jumped up and asked your Dad to take me down there. He didn’t want to do it. He’s nervous, you see because his son almost choked him. It’s really bothering him how [YB] did him. And it’s bothering me that Dad saw him have a seizure and didn’t help. And when I did find out about the seizure, Dad made it seem like it was my fault because I didn’t put [YB] out of the house when he choked him. I asked him, ‘Why didn’t you call for help?’ Dad said because they were just going to keep him in the Emergency Dept. for a long time, only to send him home without doing anything. So he really didn’t want to drive to [a town] but I made him…But he’s ready to leave [FOO hometown] now, and if I don’t let him move into the house with me, he’s really praying about leaving. The kids are begging him for money all the time, won’t leave him alone, Aunt E is cussing and carrying on and he just can’t get over your brother choking him.
Me: So it sounds like you empathize with both sides of the story.
NMom, (in an increasingly agitated tone): I do, but I don’t want to threaten my own peace. I want a couple of years where I can live in my house and enjoy my home. I really don’t want anybody to come in here and live. But I also know what Dad is going through and he’s in a situation where he can’t afford to go elsewhere. So I guess he could come over here for a few days and pray and not bring more than a change of an outfit.
Jan. 2, 2010- [YB’s] account
Me: Hey brother! What’s all this I hear?
[YB]: It’s been tough for me with Daddy and his refrigerators and his squash and beans and all his stuff. I’ve been frustrated with living in the house with him.
Every month I say, ‘Dad, the fridge is nasty. It smells. I clean it over and over and it just gets worse and worse. Once I didn’t clean it just to see how long he would go and fur was growing all over everything. You know he’s always pulling stuff from gardens and he brings them home and don’t clean them. He leaves the vegetables there to rot and mold. And he also has a refrigerator sitting right in the middle of the den. And I’ve been telling him he needs to move the fridge because my kids were coming and I wanted to put the Christmas tree up… We get into a heated debate and then “The Supervisor” showed up. I call [OB] “The Supervisor” because every time he comes around, he’s trying to supervise everyone. I was in my room trying to calm down.
Me: “So, you weren’t engaged with Dad when [OB] showed up?
[YB]: No. Dad and I had finished. I was in my room. I was very upset. I found out that Dad called Mom and she called [OB] to come over to see about the situation. [OB] came after everything was over and was saying, “What are you DOING, [YB] to me, yelling and such. He and I got to scuffling and [OB] got his hand broke. Sister, it’s like this, you fuss with me I tell you to leave me alone. I tell you once. I tell you twice. I tell you three times…Next thing I know I’m grabbing somebody. And they look like they are scared…
Me: “So it’s like blind rage?”
Him: “Yes, it’s like that. It’s like, ‘Can you clean the fridge, Dad?’ Or I’ll tell our niece to stop playing so much with me. Then, the next thing I know I’m yelling at her and she’s jumping out of the car. So I went to a doctor and they are going to give me 6 weeks to have some counseling. The best thing to do is for Dad to move out. And Mom gets mad because I have been disrespectful to Dad. So it’s best for us to separate. Before he moved in, I had fuel assistance for both the summer and winter. When he moved in, he insisted on taking care of the water and electricity bill. So he won’t let us get a clothes-dryer or to turn the lights on because he’s covering those bills. So the regular home aide that comes in washes the clothes and then leaves them outside to dry until someone takes it out of the rain or snow. “
My brother then recalls what life was like inside the house we were teenagers in. He complained of newspapers being everywhere and food, tvs and furniture being locked up in closets. “ Now he’s stockpiling expensive furniture and fixtures outside in the elements. I don’t know where he gets the stuff. But he gets a lot of stuff and there’s all this stuff out in the yard and there’s trash spread among it. He covers things with tarp held down with cinder blocks. Well, you know how Dad is…
But when I say something about being tired of living like this…The only way things are going to change is if Mom comes in and specifies which of these things have to go. And I know I wouldn’t be living like this if I lived by myself. So I got my own fridge, to put in my room because when I clean the fridge in the kitchen, in 7 days it’s completely nasty again. And I am thinking about getting one of those small electric stoves to go in my room. I’ve already got the big TV y’all gave me last year, a stereo, and my CPAP machine. With my $150 in food stamps and my disability check, I get a little money to get myself a t-shirt, and my toiletries.
Me: So you had a seizure recently
[YB]: I was playing on the piano a couple of days after the incident between Dad and me happened. I felt the seizure coming on and I tried to walk fast to the living room to be with Daddy and out of the sight of the kids. I didn’t make it. I fell. I woke up in the living room. It was a mild seizure. I think it came on because they recently changed my meds, plus, I’ve been very frustrated, and a little overwhelmed. They (Daddy) took the keys away because I had the seizure the week before. But I made Dad give me the kids Monday, because the kids and me wanted to see [mother of 11 who now lives in ‘a town’] for Christmas. When I went to her house, last Monday with the kids for a couple of days, I started to get a little dizzy. I stayed an extra day because I wasn’t feeling good enough to drive back home. Mom insisted on coming to get me after day three and she took the kids back home.
Me: What do you think should happen?
[YB]: Dad should move out and take his trash and fill it up somewhere else. And let Aunt E. stay and let her get old or whatever. I can live with her now, with the aides coming in to help her everyday. I was doing just fine until I let [mother of 11] move in with all of her children. I let them move in for a while, but they had to get out of the house, because of Mom putting a for lease sign in front of my house, trying to make her sign a rental agreement, and because of the incident with her daughter cutting me in the arm with a knife. Once they left, I had a seizure and when I came back home after the seizure, Dad was living here. And I know how he lived before, in filth. But I know how I want to live. It seems like the more I clean up, the more mess he leaves. Its like chaos.”
Me: So, you’re going to talk to a therapist?
[YB]: Yes, I have a prescription for 6 weeks of counseling.
Me: What do you think you’ll talk about?
[YB]: Lack of quality time with father growing up. It affected me that I had so little quality family face time. Dad was in church every day of the week and after a day at work, he would come home and sleep all day. I really lost control with Dad, I remember the look he had in his face, like a helpless child. Sometimes I catch myself and I think of my children.
Jan 5, 2010-Dad’s account
Dad: “Your Mom and I had had a spiritual day at church this Sunday past, her first time back in a really long time. Service was beautiful. We ate at Golden China. And we had gone to Staples to get some supplies because she wants to get the new year started off with work tomorrow. Just the day before [YB] had apologized and committed to attending therapy. But then Aunt E had a really bad day. One of those days where she keeps saying, “I wanna die! And she hits herself and cries. When I get home, your sister, who was there to watch Aunt E, started screaming at me. ‘Whose going to take [niece] to school tomorrow? She’s so used to depending on me. She’s got a car, and she’s working. But I have to be up at 6:40 in the morning bringing [niece] down near where your mother lives to catch the bus. But this is a new yeae and I’m not going to be…And your brother, he wanted so badly to go to [a town] to see that girl with all the kids. Do you know he had the nerve to ask [OB] for some money after what he did to his hand? [YB] was demanding the car keys from me again. With all that noise coming from every direction, I just grabbed my grip and came back to your mother’s house.”
Me: Sounds like a lot of stress…
Dad: “And all [YB] wants to do is to get together with [mother of 11]. He told me that he wanted to take his children to a movie or something and the next thing you know he was off in [a town]. [Mother of 11] was not expecting him. It was the end of the month and she had hardly enough money and groceries to feed her own kids. [YB] had a little money because your mother gave him money to buy his children Christmas presents. When we went down there to get them, all he wanted to do was stay and let us take his kids back. The round trip to where the children live from your brother’s house is 130 miles. And it’s mostly me going to get them.”
Me: Do you have a problem with [YB] getting together with [mother of 11]?
Dad: No, I don’t have a problem. He can chose to be with whomever he wants to be with. (After a pause…) Well, I DO have a problem with her because she’s got all those kids and because one of her children almost sliced your brother with a butcher knife!
Me: Sounds like a lot of violence going on there…
Dad: Well, in one of your brother’s blind rages, he made it so that he can no longer get into his children’s mother’s gated housing community And me too because we have the same name. That night he had snuck off with the car and ran out of gas and I had to go and get him anyway. When he took his kids down there to [a town], he threatened the kids not to tell their mom. If these people find out that D’s been having all these seizures, we might be liable.
Me: Would it be okay for [YB] to go see her if he didn’t drive?
Dad: Yeah, but [YB] can’t keep his own kids. After 3 days, he’s debilitated, he’s wore out. And there have been times when he goes to get his kids then he gets someone to keep his kids. And he’s having falling out seizures. He’s free to go. He’s is own person. And I don’t want to see him in Central State [Mental Hospital]. He’s on a breathing apparatus. And he forgets to take his medication. [YB] will sit in the car, with the trees going by and it will trigger a seizure. How is he going to fare? He’s getting worse!
He’s going to have to deal with [mother of 11] and her kids and with his children’s mother and their kids. And he snaps in a minute and he’s ready to fight. I recently attempted to help cash a check for [family friend] from the pastor of the [YB’s} church who paid the family friend for cutting the grass. [YB] got mad because some time went by before the check was cashed and [YB] went down to his house, snatched up [family friend] and demanded that he take care of the issue promptly. [YB] was trying to protect his reputation with his pastor. [Family friend], your sister, and I had already discussed how we were going to settle it. [YB] snatched [family friend] and dragged him into the street and down to our house. [Family friend] stormed out and called the cops and your mother. She agreed to hire [family friend] to do $30 worth of housework. [YB] has a short fuse. When I walked into the house after church Sunday, [YB] and your sister were both at a heightened level of rage and they both were acting exactly the same. And your Mom’s talking about a change that has to happen this year.
Me: It sounds like a powder keg.
Him: It IS a powder keg! And we are going to fix it.