Partial Sanity: Stories from the Edge of Mental Health

By Beth A. McLaughlin

Partial Sanity: Stories from the Edge of Mental Health is a memoir about jumping feet-first into adulthood. Fresh from her undergraduate degree, twenty-one year old Beth works as a psychiatric case manager in a rural mental health program. This unique group of people teaches her that sometimes the only remedy for anguish is compassion.

• Language: English
• Publisher: BookBaby
• Release date: Jun 23, 2014
• ISBN: 9781631920936

Book preview

Mary

Witness

I heard the screaming before I ever saw who was doing it.

This is my earliest memory. I was one month past my third birthday. It was late December. I was sitting on my grandmother’s yellow couch in Van Wert, Pennsylvania in her old farmhouse with its crooked staircase and red linoleum kitchen floor. Her kitchen always smelled like sugar cookies. My chubby legs stuck out toward the edge and ended in the ugly orthopedic shoes that were supposed to straighten out my right foot. My blue socks had white ruffles around the top which helped distract me from the thick leather that imprisoned both feet. I hated those shoes and loved my socks.

I should have been playing with my Christmas toys in the back kitchen with my brother. David was busy building a house with his Lincoln Logs. Instead, I sat by myself on Nanny’s couch. All I wanted to do was look at the pictures in my new Little Golden books. I had never seen a tugboat before, especially one named Scuffy. I studied his smiling face.

I wasn’t sure why we were here. The weather was cold and the roads were slippery with sleet. Normally we would have stayed home on a day like this. My dad had buckled me in tight with the harness he’d constructed in the back seat of our big white Dodge. The straps cut into my shoulder blades but held me immobile.

The air felt heavy on top of my head. Nearby, a group of big people were drinking coffee in the dining room. Their voices muffled behind porcelain cups between mouthfuls of white cake with peanut butter frosting. From my place on the couch, I watched as these people had carried food in with them and their different-colored casseroles sat, still warm on the sideboard. It smelled like a holiday.

Footsteps outside on the porch mixed in with a high, shrill keening shriek like a terrified cow makes giving birth to a calf turned the wrong way. The front door burst open and a blast of cold air whipped against my bare knees. Aunt Jean stood alone in the doorway. Her tan and black checkered wool coat was falling off one shoulder. I had a coat just like hers. She looked lop-sided. She heaved her pocket book into the room. It made a loud thump when it landed on the braided rug. Then, she stepped through the door.

I looked up into her face. Her eyes seemed to be going in different directions. I could see her pink tongue inside her mouth. She opened it even wider and screamed so fiercely that Fluffy, Nanny’s grey cat, hissed and fled beneath the curtained piano bench. I wanted to follow her but I couldn’t. I was frozen on that couch. I watched my aunt, whom I dearly loved, unravel in front of me. In the bare moment it took for my mother and grandmother to cross the room and take hold of her, I knew that something horrible had happened. I looked around and counted my family: father, mother, brother, grandmother. Who was missing?

I soon forgot all about my books. Instead, I watched what unfolded in front of me. While everyone seemed to start talking at once, I was a silent witness to my aunt’s pain. She continued to scream and moan and shriek. I covered my ears. My mother began to shake her. My father tried to hold her in a bear hug. My grandmother pleaded with her to calm down. The other adults kept their distance, their heads down like they couldn’t bear to watch what was happening. One man kept twisting his felt hat between his hands, taking steps forward and then backward. They whispered things I couldn’t hear.

She kept on screaming. My books slid to the floor in a heap. At some point, it dawned on me. Where was Uncle Bill? Why wasn’t he here? Where was Puddles, their little yellow dog? I began to cry.

The next thing I knew Nanny was lifting me up, putting on my coat and boots and hat and mittens. I cried harder. I didn’t want to leave. I wanted to stay. I jerked myself around but she patiently and expertly got me dressed. My screams joined those of Aunt Jean’s. Nanny soothed me but firmly handed me to Ibby, the neighbor who lived down the road. My brother and I were to go with her and play at her house for a while. She had a big black dog I really liked. Nanny wiped away my tears and snot with her embroidered handkerchief and told me to be a big girl. That everything was all right. That she loved me. I grew warm with my outside clothes on inside the house. My face was hot. I couldn’t breathe through my clogged nose.

I kept twisting and turning to see Aunt Jean who was now slouched on a chair at the far end of the living room. She was crying so hard that her face looked distorted, like someone else was wearing her coat. A woman I didn’t know. My mother kneeled in front of her focusing solely on her sister. Her back was to me. I couldn’t see my mother’s face. I really wanted to. I strained in Ibby’s arms. I needed to. If I could only see my mother’s face, I would understand. I would be safe. I squirmed toward her. She didn’t turn around when I was carried outside, mute, into the gathering darkness.

Nineteen years later, I heard the screaming before I ever saw who was doing it.

I ran out of the office and saw Ruth, a client, standing just inside the door of the mental health program. Her shrieking filled the large space and other people shrank against the walls and tripped over themselves to get away from her. Ernie spilled his coffee. Lena dropped the ceramic bowl she’d just been painting a vivid yellow. Doris crouched in the corner by the copy machine. Margaret coughed into her hand and turned away. Rick pulled his cap down over his eyes.

Ruth stood alone. She wore no coat or hat or gloves even though it was frigidly cold. I stepped toward her and then stopped in my tracks. The sound emanating from her was like a concrete wall. Her face was rigid in the ugliness of powerful emotion.

It was December of 1988. I had recently just taken this job as a psychiatric caseworker in the Houtzdale Partial Hospitalization Program in rural Pennsylvania. During the past few months, I had been learning my role. I slid out of college armed with a bachelor’s degree and a desire to help people. That was the extent of my career goal at the time. I was one of the first of my many cousins to get a college degree and my parents expected me to use it to establish myself and to provide for my husband who was finishing his degree. It was one huge step into adulthood.

The job was nothing like I had expected. Most of my time was spent helping people with the basic details of a barely functioning life. I taught them how to cook, how to create a simple budget, how to breathe deeply for a more relaxed state. I taught them things I didn’t really know how to do myself. My dad always said that ignorance made the best teacher. I finally began to understand what he meant. I felt like my four years of college discussing the many theories of Rogers and Jung and Freud had taught me nothing about how to really help anyone.

I made myself take a step toward Ruth. I held my breath. I walked quietly. I made eye contact briefly, and then looked down. I used the same approach I would have used with a terrified horse. Ruth’s screams began to lessen while at the same time her body began to shake. And still she stood, rooted to the spot right in front of the door. Her gaze met mine briefly before she looked away and up to the right. Out of the corner of my eye, I saw Lena and Doris trail their gaze after Ruth’s, as if an answer was written on the ceiling. I forced myself not to look.

There was nothing I could do to lessen her pain. In those moments, I felt completely helpless. The weight of my own arms held me immobile. Then, in my mind’s eye, I saw the image of Aunt Jean’s face contorted in a similar way as Ruth’s. I recognized the horrible shock of grief.

This time, I knew what to do.

I stepped within arm’s reach of Ruth. Now she was only moaning even though her screams still echoed around the room and inside my head. I stood in front of her. I slowly reached for her but she jerked back from me. I dropped my arms and stood still. Her voice and her movements began to quiet. I made soothing murmurs. I touched her hand and lightly held it. She didn’t touch me back.

In silence, I patiently waited for her to find the words to tell me what had happened.

Making Meatloaf with Larry

I fumed at the coal truck ahead of me. Flint-like pieces of dust fanned my windshield. Coal grit smeared before my eyes. I had been following this belching monster for ten tedious miles on a twisting road between the towns of Osceola Mills and Houtzdale. At every dotted line, the truck sped up just enough for me to remain stuck behind and unable to pass. When the truck finally turned, I honked my horn in frustration and barely kept my middle finger hooked over the steering wheel.

I was already twenty minutes late on my first day of work. I sped up the hill and pulled into the lot across from the building, slamming the car into park. Grabbing my briefcase, I jogged toward the front door of the Houtzdale Partial Hospitalization Program. Nausea rose in my throat. I made myself walk more slowly, more professionally. One man stood at the top of the steps.

He had the stance of a boxer, hair like an oil slick, and skin the texture of elephant hide. He wore a western hat and deeply inhaled smoke from a cigarette. His face looked tan and deeply creviced as the billboard Marlboro Man. As if in solidarity, we descended shoulder to shoulder the four steps to the front door. Reaching forward, he slightly opened the door, staring at the ground as he did so. Chivalry was still in evidence in this small town in central Pennsylvania.

Thank you, I switched my briefcase to my left hand and offered my right. He mumbled something under his breath. He kept his eyes down. The door banged shut.

I’m sorry? I tried to catch his eye off the ricochet of the cement.

He cleared his throat and reached with his right hand, ignoring mine and grabbing my briefcase instead. Smooth, he whispered. He caressed the side of it with his thumb.

Thank you, I said. We stood in an awkward greeting pose, my hand shaking air and his stroking my briefcase. I glanced up. Two faces peered at us through the front door’s window. Their images were distorted by the light’s glare. The morning sun beat on my shoulders and I smelled my wool-blend suit jacket warming in the September heat. The day after Labor Day was as hot and muggy as August but I had dressed like it was November. I grew increasingly uncomfortable, but I wasn’t sure what to do. It seemed like this man could stand here forever, or at least until it turned colder. I tasted bile rising in my throat.

I tugged the briefcase away from his grip, I should get inside. I’m the new caseworker.

As he turned away to walk up the short flight of stairs, he said, Full of air. Although I believed he meant my briefcase, his words landed like my first professional evaluation. He was right about both me and my Samsonite briefcase which held only what my father had forgotten to remove: two pens, a stained notepad, and a pack of Wrigley’s Spearmint gum, minus two stale sticks which had served as my breakfast as I drove to work. I had forgotten to ask the most basic of questions: his name.

I opened the door and walked into the next five years of my life. Twenty-six sets of eyes watched me. They had been waiting for me. As a twenty-one year old I was still operating on what my friend Jill called CST—college standard time. I had successfully survived for years by sliding into my seat just as the professor placed her transparency on the overhead projector. My sliding days were over. Then and there I resolved to get up earlier. I swallowed the granite-like piece of gum and mustered a smile.

The rest of my first day went by in a blur of faces and strong cups of coffee laced with clumps of non-dairy creamer that no amount of stirring would dissolve. My first impression of mental health clients would remain the most lasting one—the sheer amount of coffee they drank. Sometime during that first day my boss, Mary, gave me the twenty-five-cent touf of the building. It was called the Old Woodward School Building. Its ground floor housed our mental health program, the senior citizen center, and the home health nursing agency. Low-rent apartments finished out the second and third floors. It was a stocky brick building surrounded by tall evergreen trees that had the droopiest branches I’d ever seen. It sat on a hill above the town of Houtzdale in Clearfield County, Pennsylvania.

The town of Houtzdale had seen better days. The county of Clearfield had as well. All around the state King Coal had come and gone, leaving behind a failed economy. Collapsing buildings dotted the landscape that had once housed large manufacturing enterprises. In past prosperous years, many of the clients had worked in the shirt factory or the cigar factory. Small bars and large Catholic churches remained to provide solace to those who stayed.

The tour ended at our office. Mary led me to the desk I would occupy. I had held no illusions of having my own office. However, I hid my dismay when I saw it. Three of us were to work in a fourteen by six foot converted closet, including three desks, three chairs, and one two-drawer filing cabinet. My desk crouched in the farthest corner away from the door and the only way to get to it was to slither behind Brenda’s chair once she slid in tight against her desk. Shelving balanced precariously above me as the DSM III-R threatened to crash onto my head at any moment. This psychiatric desk reference was bigger than our family Bible. Dark paneling covered the walls and the ceiling. In-door/out-door once-green carpet covered the floor. Silently I deemed it the cave. It smelled musty and damp like my grandmother’s cold cellar. I glanced for traces of mold beneath my desk and prayed I wouldn’t hyperventilate. An intricately woven spider web graced the corner nearest my head.

You’ll want to read that, Brenda pointed above me.

Sure, I wasn’t exactly