Bethesda Daze

By Morri Namasté

Bethesda Daze is a look behind the curtain, detailing the experiences of a young mental-health worker working in a private psychiatric hospital in the mid-seventies. These are stories of successes, of failures, of mistakes, and of personal and professional growth. Bethesda Hospital was a place where people gained perspective on life’s challenges. It was a place where, at times, it was difficult to see the differences between staff and patients.

The mid-seventies was a time when there were many psychiatric facilities. Patients came voluntarily and stayed for weeks and months. The job of the staff was to develop and maintain a therapeutic attitude that was supportive, challenging, and helpful. Guided by professionals, primarily psychiatrists and psychiatric nurses, each patient had an individualized treatment plan. The staff promoted an environment of trust where difficult issues could be addressed in a safe setting.

• Language: English
• Publisher: Newman Springs Publishing, Inc.
• Release date: Jan 21, 2021
• ISBN: 9781648018244

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Bethesda Daze

Morri Namasté

Copyright © 2020 Morri Namasté

All rights reserved

First Edition

NEWMAN SPRINGS PUBLISHING

320 Broad Street

Red Bank, NJ 07701

First originally published by Newman Springs Publishing 2020

ISBN 978-1-64801-823-7 (Paperback)

ISBN 978-1-64801-824-4 (Digital)

Printed in the United States of America

Table of Contents

Bethesda Hospital

My First Week

The Therapeutic Community

Pond Therapy

Just a Hop, Skip, and a Jump

Pool and Ping-Pong Are Not Just Games

Sherry

Shrinks or Psychiatrists

Jim Bob

The Old Man Blues

Mother and Son

Let’s Get Together and Be All Right

Snake Boy

And Then, There’s Sex

Charting

Guns and Roses

Power and Control

Work Is More Important Than Play

Electroconvulsive Treatment

Suicide Is Painful

Snippets

Psychodrama

Multifamily Group

From Personal to Professional to Personal

Introduction

The process of becoming an expert in one’s chosen field is a long undertaking. It involves reading and studying, learning from mentors, making mistakes, and ultimately, developing a professional sense of oneself. This takes time. There are no shortcuts. While there are certainly those who are born savants, they are rare. This is why they are special. The rest of us have to practice long and hard if we want to attain our own personal greatness.

A story is told of a wizened old master plumber who was called by a homeowner to come and fix a clogged pipe. After a careful inspection involving touching the pipe and gentle taps with a hammer while listening intently, the master hit the pipe smartly with his hammer. Problem solved. The homeowner was thrilled until he saw the bill for two hundred fifty dollars.

What is this? Two hundred fifty dollars! All you did was hit the pipe with a hammer. I could have done that.

The master putting away his hammer turned to the distraught homeowner and calmly stated, Yes, you could have. But I knew exactly where to hit it.

C. Henry Kempe, an advocate for the well-being of children, was heard to say, See one. Do one. Teach one. In six simple words, he captured the essence of being a pro. To learn. To master. To mentor. To develop what is often referred to as practice wisdom.

These are the stories of my ascent into increasing levels of responsibility and complexity in the mental-health field. The descriptions of events are as accurate as I could possibly remember them. To the best of my recollection, this is what really occurred. Names have been changed. There is a confidentiality thing.

I was initially assigned to work on Unit A, a thirty-bed inpatient setting for voluntary patients. Since I seemed to have an affinity in working with adolescents, I jumped at the chance to transfer to Unit B, a twenty-bed locked unit, when it became an all-adolescent unit. After a relatively brief period, I went back to Unit A as the youth worker assigned to oversee the six to eight teenagers on that unit. I finished my Bethesda Daze working in the Adolescent Day-Treatment Program.

I have great respect for those people who I came in contact with over my years (1976 through 1987) at Bethesda Hospital. They came in many forms. Patients and their families, psychiatrists, psychiatric nurses, mental-health workers, social workers, psychologists, occupational therapists, recreational therapists, and even the maintenance workers who were sometimes called upon to assist in some really strange and bizarre events. We were all in this together, and each one touched me in ways that contributed to my own personal and professional development. Even when they pissed me off. Thank you.

Bethesda Hospital

Bethesda Hospital was founded in 1910 by the Dutch Christian Reform Church. It was originally designed as a tuberculosis (TB) sanatorium, and people came in droves for a time. Fresh air was thought to be good for TB patients, and Denver had plenty of that back then. As the advent of drugs replaced clean, fresh air as the treatment of choice, the administration altered the focus to mental health. This change occurred in 1950, and Bethesda continued to operate as a psychiatric hospital until 1993, when it was forced to close due to changes in insurance reimbursements.

Bethesda operated as a private, freestanding psychiatric facility. Tucked away in a small south-Denver neighborhood, the campus comprised several buildings surrounding a small pond with one huge carp swimming around. The main building, where Unit A was situated, was also home to the administrative offices.

Unit A was unlocked, affording up to thirty patients the opportunity to get life right. It was considered an open unit, so patients could literally come and go as they pleased. Long narrow hallways with many large windows, harkening back to the TB days, opened wide to views of the beautiful grounds speckled by walkways and trees with the Rocky Mountains in the distance.

Units B and C were twenty-bed, freestanding buildings servicing both adults and adolescents. In the early 1980s, things shifted a bit. A new Unit A was built and continued to operate as an adult and adolescent open unit. Unit B was designated as an all-adolescent unit and was locked. It housed unruly teens who needed external controls in order to maintain appropriate behaviors. Unit C was designated as an adult unit and was a locked environment as well. Some people needed to be locked up while others were free to roam the grounds.

A separate dining hall was a short walk away and provided three square meals a day. Lunch, which was referred to as dinner, was the biggest meal of the day. Supper happened later. Most patients took their meals at the dining hall. For those who were unable to leave their units, meals were brought to them.

Another building housed the occupational therapy program. Think high-tech arts and crafts with a therapeutic bent. The focus was on developing and enhancing job skills and hobbies. There is that thing about idle minds. A freestanding full-sized gymnasium was built where the therapeutic recreation therapists did their thing. All that was missing was a swimming pool. But then again, there was the pond.

The setting was warm and inviting. Who would not want to spend some time here, contemplating life and all of its challenges? All in all, a very nice place to come to work.

My First Week

Does anybody really know what one is doing the first day on the job? Any job! I find it strangely comical to think back and remember the very first patient I encountered. What did I know? I was fresh out of college and in my second real job. The only relevant experience I had up to this point was working a five-month stint as a residential correctional counselor at a group home for paroled juveniles. The job schedule involved working five days one week and two days the following week. There were overnight shifts and ensuing mayhem. I learned how to fly by the seat of my pants. Management was the name of the game, so very little therapy went on. At least, I was not doing any therapy. I was feeding and keeping an eye on teenage madness. This new job was the real deal. A psychiatric hospital with professionals running the joint. There were doctors and nurses, and then, there was me.

After a week of orientation which consisted of learning the basics of hospital work (taking vital signs, CPR, rules and regulations, etc.), I was set loose. The staff were friendly and seemed self-assured. I certainly was not—self-assured, I mean. I must have looked like a deer caught in the headlights.

Then, I met Moshe, a man in his early thirties who looked like an offspring of Rasputin with long uncombed and matted hair dripping down his face. He was the poster boy for Jethro Tull’s Aqualung. He paced the halls, smoking cigarette after cigarette for hours on end, and he drank a lot of coffee. Paradoxically, coffee seemed to have a calming effect. Cigarettes and coffee. These appear to be the main staples of the chronically mentally ill. Not that you have to be mentally ill to smoke cigarettes and drink coffee, but it does give those in need something to do when those voices and strange ideas come into consciousness. Moshe would stand in line with the rest of the patients when medications were being handed out. He was always there at the appropriate time (we use the word appropriate a lot, and of course, we would characterize bad behavior as inappropriate).

Are you a Russian agent? You look like a Russian agent. Did my father send you here? asked Moshe with his head turned down and piercing dark eyes looking up at me. He was checking out the new guy.

Uh, no, I’m not. Why would you think that? What if I was? What’s the big deal?

Well, needless to say, that double message—something that I would later appreciate more fully—was more than enough to make me persona non grata to this paranoid schizophrenic forever. Moshe was not a well man, and my comments served to make him more unwell. People who suffer from this diagnosis may see things that no one else can see. They may hear things that others cannot hear. They may distort aspects of reality and come to believe them. Talking with Moshe about his delusions—in effect, trying to deal with these distortions of reality through logic—just made him more anxious and crazy. He was convinced that his father headed up the Russian KGB in America. He had thought this for a very long time. Nothing, it seemed, would deter him from these views. His history indicated multiple police contacts for disorderly behavior and psychiatric interventions. It was a mystery to me how a person could get this way. Nobody seemed to know, or at least, it was never communicated to me. There were always unknowns. I needed to learn to accept the unknowns in life. Mine, as well as others.

The staff’s job was to assist in keeping Moshe, and other patients like him, clean and neat. But the most important task was attempting to keep his head in the game. For Moshe, it meant getting him stabilized on medications so that he could reasonably function in society.

No, Moshe, my uncle was never a part of any underground attempt to infiltrate the White House. Try to remember that you are in a psychiatric hospital to learn to relax.

This is what was referred to as reality testing. There appeared to be very little value in discussing life’s complex challenges with someone that out of touch. It just made things worse by increasing his anxiety. The more upset he became, the more his delusional thoughts seemed real to him. The crazier his thoughts, the more disturbed his behaviors became. A vicious cycle.

I felt totally out of my comfort zone. I questioned my choice of profession. Here I was, a twenty-one-year-old paraprofessional, pretending to be something that I could not now even fathom. Patrick, a fellow mental-health worker, took me aside and eased my mind.

Morri, he offered in a kind and calming voice, it’ll be okay. It just takes time. Explaining the role of the staff in these types of chronic cases, he said, These are the easy cases. Their psychopathology is so obvious. It is all there in living color. Even the housekeeping staff know who is really crazy. We just calm things down and focus on good behavioral habits. And we keep it simple.

I began to observe the manner in which the staff observed and intervened with Moshe. Never once did they bite on his delusional rantings. Every word was spoken softly and kindly.

Hi, Moshe, you look upset. Remember, yesterday, when you were upset. What helped?

I smoked a cigarette and watched television.

Right. Would that help now?

Yes.

Let’s go find a cigarette for you. Oh, and it’s time for your meds.

Once he regained some semblance of stability, he went home. The discharge plan was the same as before. It was a good plan. He was to be involved