And Some Will Triumph: Stories of the Mentally Ill in a Correctional Setting and the Nurses Who Care for Them

By Virginia Frusteri Sollars

This is a story of a psychiatric nurse named Elizabeth who comes to California with her teenage daughter to work at the Raine Correctional Facility. She tells the stories of the mentally ill inmates in a moving tale of regret and hope, of tragedy and redemption, of lives lived differently from planned, and of lives never lived at all. This novel also encompasses the lives of the nurses who work with her. She is caught up in a world unlike any she has known, a dark place where she must at times fight the system to care for her patients. But outside that building, with its cells and bars, lies a sinister presence that may alter her life forever.

• Language: English
• Publisher: Xlibris US
• Release date: Aug 24, 2016
• ISBN: 9781514477649

Virginia Frusteri Sollars

The author was raised in Brooklyn, New York, and became a registered nurse in 1980, working as a psychiatric nurse for most of her career. She worked in the jail system for twenty-six years, caring for and treating the mentally ill. She lives in Southern California with her rescued cats. She has one daughter, three grandchildren, a sister, and a boyfriend of many years. She loves the outdoors and enjoys hiking and biking.

Book preview

CHAPTER 1

T he building looked large and foreboding as I stepped through its doors. There was heaviness inside, as if the air itself held sorrow. I passed through numerous dark halls, while unseen hands opened heavy steel doors. The doors clanked closed behind me, locking me inside. The oppressiveness swallowed me. I have walked these tunnels made of concrete so often I could do so in darkness, and my soft rubber soles made not a sound. There was no one about, no one crossed my field of vision, no one that I could see, yet coldness engulfed me, and I could feel the ghosts who lived here following me. If I strained my ears, I could almost hear their whispers and cries of loneliness and despair. The tunnels seemed endless, and I thought of the wind and sun outside. There was no wind or sun here, nor would there ever be. The fluorescent lights flickered, making eerie shadows on the walls. I watched them disinterestedly as I hurried on. A roach scurried by, but I barely not iced.

I came to a door with a sign that read North Wing. This was my destination. I rang the buzzer on the wall, held up my picture card to the camera, and waited for the steel door to open. When it did, I walked inside. I looked at the walls that had seen so much but told no tales. The walls stared back, their secrets locked inside forever. I could hear the screaming long before I came to the women’s cells in the medical unit.

The women were in different stages of undress, their hair unwashed and uncombed. Some looked at me, as I passed their cells, with eyes that showed no understanding of why their doors were locked or why there were bars in front of them. Others knew and screamed their frustration and rage. I passed cells with women crying out, asking questions I could not answer. One woman had her pillow in her arms as if she held a baby, a piece of fabric held to her as if she were breast-feeding. She sang a song off key; it sounded like a lullaby. Another woman, naked with cuts on her arms, stared into space, laughing to herself, then seeing me began a wail that set my teeth on edge. A woman was stuffing her gown into a toilet, which was now overflowing, water spilling over her feet and out the door. Next to her, a woman cried a man’s name, saying repeatedly how sorry she was as she paced in the small cell. There was a smell of unwashed bodies and urine in the air.

A nurse sat at a desk in the mist of this cacophony, looking overwhelmed. I nodded to her, but she did not engage and for that I was grateful. The very last cell held the young woman I had come to see. I looked in the cell, watching, not saying one word as minutes passed, though it felt as if time stood still. Her face was turned away; yet, she must have felt my gaze upon her because she stood and walked toward me. I had seen her a few days ago, when she was first arrested, and wondered if the thing inside her, that presence I had glimpsed, would show itself again.

Hello, how are you feeling? Can you talk to me? I asked. Her gaze had been unfocused, but now she stared directly at me. At first, her face was young, thin, and pretty, but before my eyes, it changed. Her nose seemed to widen, her face to broaden, and the voice that spoke was not hers but that of an angry, petulant child.

You will not get rid of me, it said.

I called to the nurse to hurry, to come and see the face that now seemed boyish, to hear the voice that was no longer hers. It grinned at me. It was not a friendly grin, but one that made my blood turn cold. Then it began laughing, a low-pitched rumble at first, and then a higher sound, almost hysterical.

Hurry, I said again to the nurse, and it laughed even more.

The nurse came running, not understanding what was wrong; however, when she looked into the cell, it was the face of the young woman again. The young woman sat quietly, blinking her eyes and looking about her as if she had been sleeping. She looked up and saw us. Her eyes were huge in her thin face and they were filled with sadness. She turned away from us, not uttering a sound and lay down slowly on her cot, and with ever so much care, she covered herself with her blanket and closed her eyes.

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I think if someone had told me that I, Elizabeth, would become a nurse, I would have either laughed in that person’s face or thought him or her crazy. The thought of hospitals, sick people, and blood terrified me. Care for others—hell no; it was hard enough caring for my daughter and myself. I had a fear of the old and dying. I felt threatened by my own mortality and needed no reminders. I was a dreamer, a person who loved the arts and all things beautiful. I would spend my time in the library reading about Picasso, Canaletto, and Da Vinci, staring at their art for hours. I loved the opera and classical music, and my apartment was always full with beautiful voices and booming orchestras. I would lie in bed at night thinking how the universe was expanding, and of a God who always was. I lived in Brooklyn, New York, but dreamed of the mountains and oceans. I majored in English Literature and Psychology in college but did not finish then. I was disappointed to realize I would need my PhD to work in the psychiatric field, and I had no interest in staying in school that long. I always had an interest in people, how they lived their lives and the reasons behind the decisions they made, whether good or bad.

I married young the first time, while I was still in college, but it did not last. My husband was drafted to Vietnam and came back a different person. It was difficult for those young men; they had come from a generation of parents who coddled them. They were not prepared for war, and it did not help that the American people were against it. Vietnam—where was that? Why were we there? Many college campuses were protesting the war, while our boys died. When it was over, they came back shocked and defeated, nothing accomplished, their country turning against them. My marriage, when he returned, was over in months.

A few years later, I married again, and in 1974 gave birth to my daughter Chloe. At this time, we were living in North Carolina. My husband, always so kind and attentive, changed after Chloe was born. It seemed as if he was jealous of my time with her, and he avoided us, spending long hours at work. Therefore, after ten months of living and caring for my daughter alone, I asked for a divorce and moved back to New York, close to my parents.

I worked a series of positions going from job to job, nothing holding my interest. However, in 1977, the government was funding programs, in various states, to assist with the shortage of registered nurses and social workers, and I decided to take the test, hoping for a social worker’s position. I took the test and scored high; it helped that I had almost four years of college under my belt. However, when I met with my counselor, she shook her head sadly. There were complications with the funding for the social workers’ program, and I was told that I might have to wait over two years for them to fix it. I did not want to wait; I wanted a profession now. It was the Registered Nursing Program the counselor was steering me toward, stating it was a wonderful opportunity. Oh my god, I thought, a nurse. I almost panicked. It took all my courage to clean the cuts and scrapes my daughter brought to me.

I spoke with my father. You always wanted to work in the psychiatric field, so here is your chance, he said. He convinced me that I just needed to get through the nursing program and then I could work as a psychiatric nurse. His sister, my aunt, was a nurse, so he understood how the profession worked better than I did.

It’s getting in through the back door, he said.

I groaned. A nurse—me, I can’t stand the sight of blood.

He laughed and said it was a great deal and to sign up. The education would be free, and the government was even going to give me money for Chloe’s care. I would have to give back three years in a hospital of their choosing, but that was years away. I signed up the next day.

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Nursing school was difficult. The only time I felt comfortable was during my psychiatric rotation. To me, the psychiatric disorders were fascinating, and I enjoyed assisting the frightened and lonely patients I saw there. I would sit, hold their hands, and listen to their troubles. They would tell me things they would not tell others. While the other nursing students wanted something tangible they could fix, I found I had a feel for what these people needed. Sometimes it was only a word, a smile, or the acknowledgment that the voices or noises they heard in their heads, their auditory hallucinations, were real to them. They trusted me, and even took the medications I offered, when previously they had refused. The psychiatric patients (now called clients) who were agitated did not upset me; instead, I felt a calm I had never experienced before, the calm of knowing that I wanted to help and could.

However, I had a horror of the medical floors. One day in the hospital, I observed a patient bleed out, literally blood everywhere. I stood by her bed in shock, looking for an escape. While a code was called, and nurses were running around shouting orders, I quickly, on hands and knees, exited the room amid an array of medical equipment, ran to the bathroom, and vomited. I did not go back, and, thankfully, no one missed me. During surgical rotation, I passed out more than once. They were sawing and drilling into humans; it was just too awful.

Then there was the time we visited the old age home. It was a horrible place. It seemed to be more of a warehouse than a home, and the care was minimal. The poor elderly who resided there seemed forgotten by everyone, and some were hanging out in carts outside their rooms. My patient was one who had been there for fifteen years with no visitors, and I was told that she had not been outside for years. So with my pressed nursing uniform, and that silly cap that looked like an upside-down coffee filter on my head, I decided it was time she had fresh air. She did not talk but looked straight ahead. Though she did not seem to know I was there, I spoke to her calmly, telling her exactly what we were going to do. She weighed about seventy pounds, all bones. I picked her up and gently put her in a wheelchair. She did not quite fit; she was stiff from years of inactivity, and one of her legs would not straighten. I could not understand how the nurses let this happen, and then realized there were so many patients and so few nurses in this facility, it truly was a no-win situation. However, this was not living and seemed a cruel existence.

I was determined she would feel the wind and sun on her face. I bundled her up, and off we went. The facility was on top of a long steep road, and the wind was blowing, rustling the trees. I stood there for a second deciding where to go. Suddenly, a gust of wind blew my cap off and as I went to retrieve it, I took my hands off the wheelchair. I had not locked it and off it went with the woman in it. As we were constantly threatened with termination from the program for errors we made, I immediately turned around hopeful no one was looking. Then in that moment, I was annoyed with myself for that reaction. What in the hell was I thinking worrying about myself? I ran down the hill after the •wheelchair, which had stopped at a curb and tossed the woman into the bushes.

Oh my God, I prayed, please still be breathing.

I jumped into the bushes and pulled her up gently, looking her over and telling her how sorry I was. There were twigs and leaves in her thin gray hair and clothes, which I carefully brushed off and oh, so gently, I placed her back in the wheelchair checking to make sure nothing was swollen or broken. She seemed no worse for her harrowing trip. Now there was color in her cheeks, and was that a smile I saw on her lips? Maybe it was my imagination, but just maybe she had enjoyed the excitement. We walked slowly up the hill while I explained to her that medical nursing was not for me.

I prayed each day that I would not kill someone. My teacher wanted my word that I would become a psychiatric nurse, not a medical one. Though my book learning was excellent, my hands on, the practical part of the nursing program, did not convince her nursing was my forte. I told her, in no uncertain terms, that I had planned from the very beginning to be a psychiatric nurse. I don’t know how I got through the program, but it did help that I wrote the nursing plans for many of my fellow nursing students, as I loved to write, and in turn they assisted me with the everyday duties I so hated. I passed the program, took the boards, getting a perfect score on the psychiatric section, and became something I had never thought I could be—a registered nurse. This was truly a miracle and at last, I had a profession.

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My first position was at a hospital on the psychiatric unit on night shift; it was now 1980. It was an eighteen-bed unit that admitted clients who were psychotic (those who were unable to distinguish reality from false beliefs), or who had auditory hallucinations. We also had clients with mood disorders, those who suffered from varying degrees of depression or mania, and the most challenging, borderlines, clients who would cut themselves randomly, and impulsively, and who had difficulties forming relationships. It was an acute unit, and I worked with one LPN (licensed practical nurse) named Kathy and a psychiatric technician. I owe the first part of my career to Kathy; I never would have made it without her. She knew everything. Kathy had worked all her life in the hospital and she was as good as any seasoned RN. Kathy never missed a day, though she had six young boys, and was caring for an aunt, who was dying of cancer. However, she came to the unit at times with her hair uncombed, sticking out in all directions, and one time with her pants inside out.

One night, a frail-looking woman, thirty-six years old, was admitted to our unit. During nursing report, I was told she was a friend of the medical director and to be very careful of her care. Nothing else was said, no history, just that she had suffered a psychotic break. For the first four hours of our shift, she sat quietly on a chair in front of the nursing station. Each time we encouraged her to go to her room and rest, she made herself rigid and held onto the chair. Rather than drag her there, we let her stay. I had just entered the bathroom when I heard a roar and then Kathy screaming my name. I came out just in time to see this frail woman, weighing no more than ninety pounds, lift a huge lamp that had a large cement base, and run toward the nursing station, lamp in tow. The woman leaped over the station, which was at least three feet high, with the lamp, and Kathy dove after her, landing on top of the woman and throwing her to the floor. I immediately called security, though I wasn’t sure what I said as I was stuttering so badly. It was frightening. The woman, who I was sure was possessed by a demon and not just psychotic, spun her head toward me almost at an impossible angle and, with only the whites of her eyes showing and foam coming out of her mouth, stated the word youuuuuu, elongating it in a deep-throated voice. My heart stopped as I watched Kathy grappling with her, trying to hold the woman to the floor, screaming to get medications.

I ran to the medication room, looking first at the orders. It called for Haldol 2 mg, a medication used for psychosis, but an extremely low dose, and Cogentin 1, used for the side effects that came with the use of Haldol. I called out to Kathy.

It’s not a good dose. It’s not going to hold her.

She called back loudly. Do what you need to do!

I pulled out a syringe. I do not remember the exact dose I drew from the vial of Haldol. It was at least triple the dose ordered, and I wasn’t sure if even that amount of medication would stop her. I ran back and injected the woman, who was still shrieking, and then I held on with Kathy. She finally stopped fighting, the medication taking effect, just as security arrived. I never mentioned the amount of medication she received, nor was I asked, and she was transferred to another facility later that day.

It would have been nice to know that she had destroyed her home and almost killed her eleven-year-old child. Her son had escaped into the cellar, and had the forethought to lock himself in until his father came home. Apparently, this was not the first time it had happened. And so two months into the position, I saw a full psychotic break. To this day, I still believe she was possessed, as I have never witnessed anything that resembled her behavior, not even when someone was under the influence of PCP. I was still shaking when I got home five hours later.

Then there was the man who was in the restraint room for a week. At that time, I was working seven nights on, two off, and three nights on, two off. I requested this schedule so I would have two days off in a row, which was an easier transition for my time off when working nights. I was on my first day of my seven-day stretch, when this client complained of heart pain. I called the doctor, who came immediately, and ordered a full workup. However, when the results came back it indicated that all was well. For the next five nights, I called the doctor to the unit with the client’s same complaint; it was the same doctor and again everything seemed fine. On the seventh night, the client made the same complaint and as it was the same doctor, he decided not to see the client.

There’s nothing wrong with him, the doctor said. I documented this comment in my nursing notes and did not worry.

However, while making rounds, Kathy screamed that I should come immediately. I thought, oh, no, it was going to be something medical. It was my worst fear. Although we were supposed to check the man-down bag (a bag for medical emergencies) once a week, none of us did. Clients with medical problems were not kept on the psychiatric unit. The man was on the floor when I ran into the restraint room. He looked bad. I had no medical experience, except for nursing school, however, even I could see the gray in his face was not good, nor was his labored breathing.

Call the doctor, Kathy said. Instead, I told her to help me get him into the bed. Now this was a large man, but we managed, Kathy being naturally strong, and me, I was just damn scared.

I said, Let’s get him next door to the medical unit. They will know what to do.

The two of us managed to push a bed, without rollers, with a two-hundred-pound man on it, out of the restraint room, onto the carpet, and shove him unceremoniously to the unit next door screaming, It’s an emergency! The medical nurses sprang into action. They knew psychiatric nurses were not adept at treating a medical event, and that this man would have a poor chance of survival with us. By this time, he was not breathing and I could not feel a pulse. They called a code, started CPR, and got an IV started. I watched their precision with amazement. They were so coordinated and calm in the midst of this disaster. I later learned that he made it. The head nurse congratulated us for getting him off our unit since it saved his life, though she said that even if he had died it would not have been considered a psychiatric death. From that day on, I religiously checked the man-down bag and learned its uses. I also got my CPR certification, which, at this time, was not required for psychiatric nurses at this hospital.

There were other scary incidences. I remember the woman who pulled the bar out of her bed, something that should have been impossible, and ran down the unit with it gripped in her hand, stating she was going to kill the nurses. I was on p.m.’s now (3:00 p.m. to 11:30 p.m.) working with a nurse named Lori.

Run! she screamed, and after calling for security, we locked ourselves in the bathroom.

Security got there just in time. The client was making progress smashing down the bathroom door. I felt horrible running away, but Lori recently had cervical surgery, and was supposed to be in a neck brace, and could not get injured, and I knew I couldn’t take her down by myself, not with her swinging that bar. Had she been after the clients, we would have stayed on the unit to protect them no matter the consequences, but luckily, most had already gone to bed.

All along, I realized the doctors were too conservative with their doses of medication. They did not spend the time the nurses did with the clients. I continuously advocated for higher doses, writing long notes backing my claims. I also confronted the doctors. I was mostly ignored. Therefore, after this latest incident, I started increasing doses, here and there, when the need arose. There was no prepackaging, at this time, and all the medications were in large bottles. I found, like Lori and many of the other nurses, that this made the unit safer. We backed ourselves up—we had to; it was a matter of survival.

Weeks later, I was working with a nurse who was pregnant. I thought this was dangerous, for both of us, since we had to restrain clients on a daily basis, making sure they didn’t hurt themselves or others. However, there was no policy back then; nurses could work till their due date. We had just finished giving out medications, when a man on the unit, weighing maybe 250 pounds and over six feet, came running down the center aisle, angry, fists at the ready. It was obvious he was having auditory hallucinations. He was making statements, which made it evident that he was paranoid. He was out to hurt us, of that, I was sure. Now I was five feet ten inches and weighed 105 pounds, while my partner was six months pregnant. There was no time to get the clients to their rooms and as he ran toward us, I quickly moved to the side, put my foot out, and tripped him. I needed to protect my clients, my coworker, and myself. He fell hard, and we were able to restrain and medicate him. We were lucky that time. When I called the doctor and told him what happened, the client’s medications were increased by him and also by us. He remained docile for the rest of his time on the unit.

Still, there were times when all was peaceful and we were able to hold groups. These group sessions assisted our clients with socialization skills. During these sessions, we also explained their disorders to them, and the role their medications played in keeping them stable. It was important they understood; many of them would be on medications for the rest of their lives. Though some hated it due to the side effects, it was necessary for them to continue their medications to remain emotionally balanced. For the higher-functioning clients, we explained current theories. It was essential to spend time with them, making sure that when they left the unit and went home, they recognized what part they needed to play in their treatment. We tried to give them the best chance they had of leading a fulfilling life. This was when I was most content with my career choice.

There were also other considerations. I remember an eighteen-year-old male who arrived on our unit. It was his first psychotic break, and he was hearing voices, sometimes command hallucinations, telling him to hurt himself. It took weeks to stabilize him, the psychiatrists trying a variety of medications. He was assigned to me, and I worked with him every day I was on the unit. I helped him to understand that the voices he was hearing were not real, and that he was in control. One day, I observed him crying in his room.

My parents don’t believe I’m not doing drugs, he said. They think this is all about me using drugs.

The next time his parents visited, I spoke with them. His mother was a quiet, reserved woman, and his father a bully.

Stupid kid, the father told me. Thinks I’m an idiot, thinks I don’t know he’s playing around with drugs.

I tried to explain that his son had been diagnosed with schizophrenia, a psychiatric disorder that could be controlled, to some degree, with medication, yet, the father refused to believe me. I think he was frightened. Easier to accept that his son was taking drugs than to admit he was mentally ill. This was not the first time this type of situation had come up.

I decided then, there was a need for a program for the families of the mentally ill who were on our unit. A program that would explain what was happening to their loved ones in a language they could understand. I wrote a proposal for this plan I envisioned, on my own time, and presented it to management. After much discussion with all the staff members, it was approved and implemented. We started to have meetings with the families, twice a week. We explained the different disorders to them, and described what their loved ones might be experiencing. I made a cassette tape for the families of clients who heard voices. The tape had the noises and voices my clients told me they heard. During the meetings, I had the families listen to the tape with headphones, while I spoke to them.

Difficult, I would say to follow a conversation with all that noise in your head. So you might want to reconsider if you think your son, daughter, wife, or husband is ignoring you.

I was sure I got through to most of them. I especially emphasized the need that their caretakers believe my clients. The clients needed to be able to tell them when they were hallucinating, having delusions, when their depression was overwhelming, or that they felt the need to cut themselves. I pointed out the need for medication and follow-up with psychiatry, once they were released. I had guest speakers including doctors, pharmacists, and former clients who were doing well. Unfortunately, it did not help with the father of the eighteen-year-old schizophrenic who walked out on the first meeting, insisting his son was not ill. However, his mother attended every session, as did many others. It was a success, and I was so pleased to help.

I stayed five years in this hospital, though I was only required to do three as payment for my education. I learned a great deal, honing my psychiatric skills.

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As I worked this unit, a man was traveling, searching. He had been doing so for years. For all I knew, he may have passed right by the hospital where I worked. I did not know that someday he would choose me, that I would be in his sights, his prey. The man searched until he saw lights. He saw it was a party; the music was loud, and there was much laughter. He walked inside, though he was not invited; in fact, he had just come to this city this very morning. However, no one was paying any attention; most of the people were drunk, and he was handsome. A pretty blonde sidled up to him, but he was not interested—no, he was looking at the dark-haired girl, the tall one with the beautiful green eyes. He walked over, assured he would be welcome.

Hello, pretty girl, he said, and she smiled.

They danced most of the night, then went to her home. She offered him a drink, which he accepted, but as soon as she left the room to change, he poured it down the sink. He never drank, only pretended he did. They made love. He enjoyed her, and she seemed satisfied. She said he could stay the night; however, she was leaving on vacation in the morning. This was good news. In the morning, after they had breakfast, he hit her hard and tied her to the bed. She was not happy with his lovemaking now; it was rough and cruel. Her green eyes were frightened and wide, and her face swollen. He cut a piece of her hair and tied a knot in it; he would keep this along with one of the earrings she had been wearing. It took four days before she died. He looked at her; she was not so pretty now, not with her torn face and mutilated breasts. He chuckled to himself.

This one had been fun— for him at least, but she had not lasted as long as he would have liked. She had given up too quickly. Time to move on, he mused to himself.

He had filled his quota in this state; he never went over four kills, though he had been thinking about increasing the number. He really didn’t know why he had decided on four. Now, however, he needed to clean up and rid himself of her body. He wondered where he would go next. It was up to fate really; he had no idea where it would be. He looked at his map of the United States and closed his eyes. He had a wand he had stolen from his sister when they were both young and he had kept it. The wand was special to him. His sister had loved the stupid piece of plastic, fantasizing how she could change things. He took this now and flourished it about till it landed on a state.

Hum, he thought, never been there.

So far, the wand had landed on different states. He thought about what he would do if it landed on one he had been to before. Then he admonished himself for even considering a problem. He would go back, of course. No one suspected him; no one was looking for him. He searched the house and found a large suitcase in one of the closets. He took it out and pressed the woman’s body into it, and with a few adjustments, she fit perfectly. He would dump it in the river that was on the way to his new destination. He rolled the suitcase outside and even waved at a neighbor. He drove for three hours. When it became dark, he tossed the body and changed his license plates. Then he stopped at a motel, cut and dyed his hair, and put lifts in his shoes.

CHAPTER 2

T hough I enjoyed working at this hospital, I was interested in obtaining a position at a psychiatric mobile unit. I knew about this unit from Amy, who was employed there. I had gone to nursing school with her and we kept in touch. One night, while we were having dinner together, she stated one of the social workers was lea ving.

However, she continued, I have it on good authority that it will be changed into an RN (registered nurse) position.

But Amy, I said, they want people with their master’s degree. She was one who had continued her education.

Don’t worry, she said. I am going to get you in to take the test. I know the person giving it, and she owes me a favor.

I entered the testing site with trepidation. However, as promised, I was on the list. I passed it with the highest mark ever recorded. The interview was two days later and they hired me on the spot.

I began my new position in the mobile unit on June 5, 1985. The position consisted of working with Amy in the intake center, next to the ER, interviewing clients who appeared to be mentally ill, and determining if they needed hospitalization. The team, which included RNs and social workers, also went out to apartments, condemned buildings, and private homes when an emergency arose. We were funded by federal, state, city, and county agencies, as well as private institutions. Each agency and institution required a copious amount of paperwork submitted for each person treated before money would be forthcoming. The nurses and social workers were constantly buried in paperwork and it affected the number of clients they were able to see. I remembered Amy complaining about this each time I saw her, how time consuming the paperwork was, and I had been thinking about it. It was all about statistics, which always had a degree of inaccuracy.

I went to the administrator and told him that I had an idea, a plan to decrease the time the paperwork took. He gave me time to work on it. The necessary paperwork had to do with demographics, the statistical data relating to the population we encountered based on factors such as age, race, sex, income, level of education, and employment, among other aspects of the person’s life. Each client, seen by the nurse or social worker, had to have these papers filled out for all the places that were funding our unit. I had taken brail in elementary school and still had the boards that we used. I went to a machine shop and told them that I needed five brail boards that would line up with the specific questions we asked answered in five different ways. The pencil, I explained, needed to flow through. The pencil would move down each line, answering the questions differently for each board. It would not be completely accurate, but we were talking about time, which translated into money.

I took the boards to the administrator and showed him how it worked. He stared at me for a long time, judging my face, it seemed. I thought this was going to be the shortest career move ever made and started praying that my last place would take me back, when he busted out laughing. This was the last response I expected. Then he got up and did what looked like an elephant doing a pirouette.

Genius,—he smiled— that is what this is—genius.

He would have to take it to the Board of Directors, as it would require their approval. He explained that though some statistical inaccuracy was allowed, they would need to determine the degree involved. However, he felt it would work. Three months later, it was approved and instituted. With just thirty percent of the money saved, administration was able to procure two additional RN positions. I was a legend.

It was a fast-paced job, and I felt the whole time I was there as if my feet never touched the ground. One of my first outside calls was to a woman hanging out of the eighth-floor window, naked with large pendulous breasts hanging over the guardrail. She was delusional; she thought she could fly. The police beat us there by seconds and we ran up the stairs, hearts racing. The police officers knocked the door down and there she was, grinning at us.

I am going to fly, she said, watch me.

I did not see the police officer move, he was so quick. The firefighters had arrived, but the safety net was not set up yet. If she leaped, she would die. However, the police officer was lifting her away from the balcony to safety. I already had the syringe out, filled with the medications ordered by the doctor. The police officer holding her was calm and spoke to her soothingly. She relaxed in his grip. The injection did not seem to bother her. It was obvious this police officer had a gift. It was also apparent that this type of event had happened many times before and it seemed to be expected by the other officers. They cuffed her, but only until we got the restraints on. Since the elevators never worked in this neighborhood, they carried her in a chair down the many flights of stairs. She never stopped watching her savior, not till the medication took effect and she closed her eyes. She slept in the ambulance that would bring her to our hospital, the smile never leaving her face.

There were daily runs, and we were not always so lucky. Sometimes we were too late; sometimes it did not matter if we made it in time. This was the case when we rushed to the scene where a fourteen-year-old boy stood on a railing overhanging a huge drop to a fast-flowing river. He heard us coming; he heard the negotiator, and even I spoke to him. Despite this, he turned and said he didn’t want the pain of living anymore and jumped. We found out later that the child had been sodomized by his father since age three. I hoped this child was in a better place; I hoped he was in heaven surrounded by angels. However, the prayer I said was that I hoped his father was caught, convicted, and sentenced to a lifetime of abuse in prison. It was a dark thought, but I felt it was justified.

We were called to the home of a woman whom the staff had treated many times. She was notorious for not taking her medications, and was paranoid without them. She had somehow procured multiple guns and was shooting the firearms out the window. Amy came to the woman’s home with me, and she insisted on driving her own car. This was the first time we were on an outside call together, as she preferred staying in the hospital. However, two people had called in sick, after they had witnessed a shocking suicide, and Amy had no choice.

Why do you want to use your car? I asked.

We were allowed to take our own vehicles; we carried extra insurance for this purpose. However, it was more expedient to take the vans that were available to us. We had to lug all the equipment from the van into her car.

For this, she said and took out a joint. I was amazed.

What are you doing, Amy? I inquired, a bit upset.

Getting high. Do you think I’m walking into one of these situations without drugs? She smoked it, all of it. She was stoned. Her eyes were red and we were meeting the police.

You stay in the car, I said. You are not coming with me. I can handle this myself. I hoped the police would not smell the marijuana on my clothes.

She smiled, parked the car away from the police officers, who were waiting, and closed her eyes. I got out of the car, walked to the house, and greeted the officers.

Where is your partner? the sergeant questioned; he knew we always worked in pairs.

In her car, she’s not feeling well.

Are you all right with that? he asked. I replied I was fine.

SWAT came and went in first. The woman fired on them. There was so much noise, the gun firing repeatedly, commands screamed out, and dogs barking. I was caught up in the moment, and suddenly I was in the room with a syringe of medications in my hand. I was walking toward this person, who held a gun, and the police had not yet secured her. She raised the gun. I saw it pointing at me and thought I should have acquired the insurance policy for my daughter that my parents had often mentioned. Why had I not done so? Did I think I would live forever? The next moment, I was thrown hard against a wall as a bullet whizzed past us. It was that police officer, the one with the gift.

It’s not your time, he said, and I wondered if I had heard him correctly. I felt as if I were in a dream. Then they were holding the woman and I was medicating her. The ambulance arrived and we headed back to the hospital.

Amy knew I was angry, but I said nothing. She pulled into the parking space at the hospital, and we quietly went back to our desks. I wrote the report. The next day, I got term insurance and put my parents as beneficiaries. I knew if anything ever happened to me, they would care for my daughter. The next few weeks I watched Amy. I now knew she was snorting cocaine during breaks and had an arsenal of drugs in her car. She came in one day and told me that she hadn’t realized, till she pulled into the parking lot, that she had lost the shell to the back of her truck. She said it seemed strange that I suddenly was going faster. I didn’t say anything. She was still doing her job. I pretended not to notice the runs to the bathroom and her red eyes. Still, I made it a point to check on her clients, making sure she was giving them the proper treatment. We were always on our own; no supervisor ever darkened our doorstep. I felt I owed her for my position, so I said nothing and hoped for the best. It was a difficult situation. However, she left a few months later. Her husband, an acclaimed chef, had accepted a position in France.

It was fun, she said, and left without giving notice. She did write once to say she had a baby and was enjoying France, but did not give an address. I hoped for her family’s sake that she was clean.

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The man was heading north, not somewhere he wanted to be; it was cold this time of year and he much preferred the heat. Yet, the wand had made its decision known, and he must obey. It was the rule of the game, and he could not deviate. He stopped at a store to pick up warmer clothes. His last woman had been wealthy, and he had made a good score. She had gladly given him all he wanted. She really had thought he would just go away, even though she had seen his face. She had not lasted long. Except for the money, she had been a disappointment. He laughed to himself; everything was going his way, it was fate. He secured his purchases, put the music louder, settled back in his car, and started driving.

CHAPTER 3

I stayed at the mobile unit for two years, finishing my English Literature Degree, and was close to obtaining my Psychology Degree as well. It was now 1987. I was thirty-seven years old, and many still considered me pretty with my green-hazel eyes and long lithe body. Still, I was getting older, with no prospect of marriage. I dated occasionally but was not ready to commit; and there was Chloe, who was happy with the status quo. Chloe was now thirteen and a beautiful child. She had thick white blond hair that fell in waves to her waist and the color eyes of a Siberian Husky, which she obtained from her father who never contacted us. She was tall for her age. She had my oval-shaped eyes and full lips. Her nose was a different shape than mine and fit her face perfectly. Chloe was a child who did not talk much about her day. She seemed happy, though, and my parents doted on her. She had two good friends, and their parents and I rotated having our daughters over to our homes after school and on weekends. On my days off, we frequently went to Manhattan, taking in the museums and ballet, eating at different restaurants, and shopping at the many stores. Nevertheless, of late, she balked at going to the opera, though I had raised her with that music. She was a teenager and making her own opinions k nown.

We had just finished dinner one night, and Chloe was working on a project for school, when I opened a magazine and saw a position that intrigued me. It was in one of those nursing magazines, that nurses get free, showing available positions around the country. There was an opening at a correctional facility. I had never thought about correctional nursing, but this was for a psychiatric nurse with five years’ experience. It had good benefits and a retirement package. I needed to start thinking about these things. I needed to take care of my future. The position, however, was in California. It was somewhere I had always dreamed of moving to, but there were many considerations. No more Mom and Dad taking care of Chloe, moving Chloe at the age of thirteen and leaving her friends behind, and sending her to a new school where she wouldn’t know anyone.

The next day, I called a family council. We discussed pros and cons. My parents immediately stated they would care for Chloe while I pursued my career, but that wasn’t really an option. It was October and the beginning of the school year.

My father said, Why don’t you set up an interview and see what it entails? You have time coming to you. Take a week and go out there, and I decided to do so.

I would hate to leave this mobile unit; it had been dangerous and exciting. During my time at this position, my knowledge in psychiatry had increased dramatically. It had been a wonderful opportunity, but they did not offer any retirement plans. I also had limited salary increases without my master’s degree, though I was doing the same job as they were.

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The man was heading west this time and he was happy about that. He stopped at a diner along the way. There was a woman with long dark hair who looked at him with her black eyes. She was not as tall as he liked, but she was voluptuous, which was pleasant enough. He was in no rush, he never was. He would get to his destination when he got there. He thought he would stay tonight. He smiled at her and she smiled back.

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I left New York with the start of a storm, the wind blowing and snowflakes starting to fall. Six hours later, I stepped out into eighty-degree weather. I was immediately dying of the heat and realized I had not brought the appropriate clothing. I rented a convertible, something no one drove where I came from, and settled in at the motel, blasting the air conditioner. I called Darren, the mental health supervisor at the correctional facility, and advised him of my arrival. There was really nothing to do, so I ate at a diner down the road. There was a shop next door and I was able to purchase lighter clothing. Tired from my trip, I called my family then headed for bed. The interview was for 8:00 a.m.

I woke up early looking out the window at palm trees; they were beautiful, I thought. The Raine Correctional Facility was in the foothills in Orange County. The place was just starting to get on the map, and there were a lot of fields and mountains. The area, except for the correctional institute, was desolate. I had good directions and was an hour early. I arrived at the visiting area and the guard there contacted someone in mental health. A woman told the guard she would meet me. She was tall with blonde hair, pretty, small boned, and very thin. She looked elegant. Her name was Simone. She did not look like the type of person who would work in a correctional facility. She let me into the building called West Wing, and I had to give my drivers license to the guard on the first floor. In return, I received a visitor’s card to pin on my clothes. As we went up the escalator, I watched people in orange jumpsuits going down. Simone said that they were inmate workers who were beginning their shift. When we reached the second floor, the place was bustling with activity. There was a nurse at the station to the left and a variety of inmates sitting outside with guards all around. They all looked at me curiously. I looked straight ahead and followed Simone, who was moving at a brisk pace.

That’s medical, she said, and the inmates are coming from their dorms and cells for sick call. You don’t have to worry about that—we are two separate disciplines. Mental health is totally separate, she reiterated again.

That was good news, I thought to myself.

I was led to the back offices where there was less chaos, and everyone here seemed less stressed. There were various people, working on mounds of paperwork, who greeted me. I was handed a cup of coffee and taken into a room that had a desk and four chairs. I was still a bit jet-lagged, so I did not have the energy to be nervous. Darren, the supervisor, came in fifteen minutes later. He asked about my trip and if I had found a nice place to stay. I assured him everything was fine. He was a large man, maybe fifty pounds overweight, and had a head of hair which went in every different direction—cowlicks on cowlicks, it would have been a female’s worst nightmare. The interview commenced at eight. There was Darren, the supervisor, who told me that he was also a licensed psychologist, but except for a few private clients, he now worked in administration. The other two in the interview room were Frank and Harold. They were both registered nurses, but were currently working in administration, helping Darren with his many duties. All three had worked in this facility for years. The questions they asked were many and I felt I answered them quite competently. They seemed amazed at my knowledge and of the work I had done. I assumed there would be a second interview, but there was not. They informed me that the position was mine if I chose to accept it. Darren explained there was the matter of background, which the Corrections Department would handle, before I could start.

Background, he explained, usually takes six months after the paperwork is completed. However, I am going to try to have it waived for now. I am hoping they can do the investigation while you are working. The Correctional Department understands how understaffed we are and how desperate the need is for a psychiatric nurse. Just don’t lie about anything. If you do, and corrections finds out, it could get you kicked out of the facility. I told him that I understood. He handed a stack of paperwork to me and told me to complete it as soon as possible.

We are rushing everything through for you. I have already spoken to the guards in charge, and they will be interviewing you in two days. The paperwork must be filled out by then. If something is missing, you can mail it to us. Things were moving so fast. Simone will take you for a tour of the facility, Darren continued, and show you where you will be working and with whom. We all shook hands.

This is a large facility, so don’t even try to remember where we are going. You will have plenty of time to learn this place—it is a true labyrinth, Simone explained.

We went down the escalator. Simone told the guards that we were headed to East Wing. She told me that East Wing, where I would be working, was a maximum-security area. The guard adjusted the levers, which opened the steel doors leading to the other wing. The doors clanged loudly. The passageway we entered felt oppressive. There were no windows and it was made of cement. We walked down a long