Reminiscing in a familiar fear, he crouches tightly against the corner of the dark room. Moonlight shines down from a small window on the ceiling above the towering, uncomfortably silent, cemented walls. Covering his ears, the voices of disappointed role models only grow louder. He screams beginning to wail his fists against the thick concrete wall until his knuckles bleed. Not out of insanity, but just in the hopes he can be heard. Within this tight space; a bed frame and urine stained mattress stand center stage lined with restraints awaiting his momentarily lapse of judgment. Grinding his teeth, flashbacks of drunken screaming from the other side of a dark broom closet veil this already cruel reality. The mental health workers arrive in drones dragging him off the floor slamming his already defeated torso upon the bed face down. One by one, each limb is restrained as he cries for anyone to help. Laughing, they advise him to calm down before the head RN makes her way onto the unit. His shrieks begin to fade into a defeated sobbing as he tires himself out wrestling against the restraints. The mental health workers make way as the head RN approaches wielding a syringe filled with a powerful sedative. Puncturing his skin, directly injecting his bloodstream, what feels like wet cement quickly starts flooding his body growing heavier like an unwelcome embrace. Within a few moments, his body lays tired and conquered while a few final tears roll down his face onto the mattress as his eyes begin to close. “Feel free to try again tomorrow.” A mental health worker mockingly utters as he begins to exit laughing under his breath. As the door shuts behind them a deafening silence covers the room like a thick fog on a humid Maine morning.
The phlebotomist makes her way onto the children’s unit bright-eyed and cheery. Opening the door, she immediately turns the light on without warning waking the boy. Still groggy from the sedative, he can barely open his eyes to see who’s there. Releasing his restraints, she helps him sit up. Trying his best to regain consciousness she preps his testing materials. “Pick an arm for me buddy and hold it out.” He does so. “Now make a fist.” As she searches for a vein to puncture she recognizes the boy from a previous visit. “What brings you back to us so soon?” Attempting to hide his black eye and bloodied lip he turns away with a silent mouth and shamed face. With only a slight grin and grinding of his teeth, she digs the needle into his vein. The absolute presence of silence joins their awkward conversation, becoming quiet enough to hear the plasma exit his body into the vial. Pulling the needle out, she places a cotton ball over the pinhole wrapping tape over top. Helping him lay back down, she turns the light out as she exits with a gloomy demeanor.
The sun begins to rise, shining through that tiny window above. Feeling the warmth of the rays, the boy begins to writhe like a worm under a magnifying glass. Still bleary, he lays in bed a while as the mental health workers begin making rounds of vitals to the other rooms. After he gathers the energy to sit up he holds one arm close to his chest. Examining the loosely secured bandage he gags at the sight of the blood-soaked cotton ball. Opening the door slowly, the assigned psychologist to his case enters with a blood pressure monitor and thermometer. Although a familiar face, the boy makes little to no effort to acknowledge the doctor’s company. Making his way over to his bed, the psychologist sits next to him in attempts to strike up a conversation while cleaning up his bandage. “You know, we’re here to help you. Trying to fight us just makes it more difficult.” The boy is silent, he turns away. “Those people…the ones that keep hurting you, they’re gone. You don’t have to be afraid anymore.” The boy smirks just a bit, laughing under his breath. Proceeding to take his vitals the psychologist explains the boy’s treatment plan. “With last nights outburst and your frequent flyer miles here, we’ll be keeping you on SP1 for the first few days until we think you’re safe to leave the unit.” (SP1, Special Precaution 1, the highest level of surveillance a patient can receive. You can’t even shit without someone watching you.) Expecting a reaction, the doctor pauses only to receive a villainous glare from the boy. “Ninety over fifty. Your body’s tired, be sure to eat your meals. They’ll be brought onto the unit. We’ll revisit your status at the end of the weekend, I hope to hear good things.” The psychologist says finishing up a few notes into the boy’s chart. Make your bed and head out to the day room, breakfast will be here soon.” The boy sighs irritably as he begins to tuck the paper-thin sheets neatly around the mattress.
The boy shuffles aimlessly into the day room taking a seat next to a few other kids waiting eagerly for breakfast. Glancing around the room he soaks in the faces of others who’ve been hurt, it’s bittersweet for him to witness. Almost comforting to know he’s not alone but horrified at the same time. Beyond the usual cuts and bruises, burns and welts cover their bodies. Before the group lines up for breakfast, the morning group therapy session consists of a tedious questionnaire. Each child is handed a paper and a half eaten or broken crayon. Accustomed to the content, the boy quickly circles his usual answers.
On a scale of 1 to 10, how’s your mood this morning?
1 2 3 4 5 6 7 8 9 10
Do you have any pain? If so, where: _____________ On a scale of 1 to 10, how much does it hurt?
1 2 3 4 5 6 7 8 9 10
Within the last 24 hours have you had any homicidal or suicidal thoughts?
If yes, explain:
If you were to have thoughts of harming yourself or others, would you let someone know?
Are you hearing things or seeing things?
If yes, explain:
What’s your goal for today?
After everyone hands in their sheet, they begin to line up for breakfast. The boy stays seated in the day room knowing he’s unable to join them off the unit. As the others head off, nursing interns from the local university in Augusta step foot onto the unit. Ready to learn, their ignorant minds are complemented by wide smiles and hopeful cheer. After a quick briefing from the head RN, the interns start to make themselves comfortable around the unit. Seeing the boy sitting alone in the day room, one makes his way in to speak with him. “Hey bud, my name’s Adam, what’s yours?” The boy doesn’t respond. “Can I look at your morning questionnaire?” Without permission, the intern grabs the boy’s sheet evaluating the boy’s answers aloud. “Feeling like a three this morning, huh? I’d say I’m about a seven.” The boy turns to the intern with an ever so judgmental expression as he continues to read. “No pain, that’s good. No homicidal or suicidal thoughts, visual or audio hallucinations. You said you wouldn’t let anyone know if you felt like hurting yourself or others, why is that?” The boys’ hypercritical glare evolves into a defeated smile as he laughs a little to himself. “When you admit your pain, they try to help. Their help…it hurts.” Befuddled, the intern pauses attempting to calculate the boy’s response. Another intern enters the day room with a meal tray from the cafeteria placing it on the table. The boy hops up sliding his socks across the floor thankfully taking a seat in front of his breakfast. “Thank you.” He states his gratitude with a smile to the other intern as he unfolds the top of the milk carton. “You’re welcome.” She returns sitting across the table from him. Glancing awkwardly over at the other intern Adam, she’s somewhat impressed at how fast the boy devours the soggy waffles and bruised banana on the tray. “You like the food here?” She says in hopes of small talk. “Sometimes.” The boy replies after a final swig of his milk. “My name’s Evelyn, what’s yours?” Without responding the boy stands heading towards the day room door placing the trash from his tray in the bin walking out to the nurse’s station.
A loud buzzing comes from the unit door as the rest of the kids arrive back on the unit. The head RN stands from her station and struts towards the medication window, the boy follows. Knowing that he’s trailing, the head RN speaks up. “Hope you’re doing well this morning.” She starts. Reaching the window, she unlocks the door and steps inside. As the shade rises, the kids line up for their punishment in form of prescription pills. The boy looks up gazing upon the head RN as she hands him a concoction of sedatives and anti-psychotics. With a small glass of water to wash it down the boy places the colorful mixture of capsules and tablets into his mouth. After a splash of water and a painful swallow, the boy looks once more to the head RN opening his mouth wide. “Lift your tongue.” She utters knowing he’s one to hide. He does so. “Good boy.” She says in a demeaning tone. Lowering his head in embarrassment, he shuffles back into the day room.
With group therapy about to begin, everyone gathers in the day room as one of the therapists enters introducing the interns. “Before we get started on our goals, we have some special friends joining us this morning. Adam comes to us from the Auburn area and will be joining us for group therapy, Evelyn will be with the nurses this morning and she’s from the Winthrop area. Let’s be gracious hosts and offer our attention to them.” Urine begins to spill from the chair next to the boys as his neighbor begins to seize. Most of the other kids begin to scream in disgust or fear that it might happen to them. The boy sits patiently watching the room turn into complete chaos as mental health workers arrive like riot control officers grabbing the boy next to him and exiting swiftly like nothing had happened. “Alright, alright, everyone have a seat so we can start group now please.” The therapist declares attempting to bridge the gap between what just happened and the fact that Adam the intern looks petrified. The boy laughs to himself as the kids around him find their seats. Noticing his snickering, the therapist asks the boy to go grab a mop and bucket from one of the orderlies. “It’s not my fucking piss!” The boy shouts. Everyone stops, the room is silent. Mental health workers wait patiently right outside the day room door. “Can you please grab a mop and bucket to clean up our friend’s accident?” The therapist asks once more in a softer tone attempting to keep her patience. The boy stands, locking eyes with the therapist he begins to piss on the floor soaking his hospital gown. Adam the interns’ jaw is completely dropped as the mental workers approach the boy. He runs around the room grabbing anything he can to throw, screeching as he tosses crayons and bits of trash at them. As they finally get a hold of him, the boy bites down on one of their arms breaking the skin. As blood flows out from the man’s arm, he releases the grip he has on the boy. With a moment of freedom, the boy flees towards the door as a Code White is called over the intercom. Making his way to the massive unit double doors he wails on them aggressively in hopes that they’ll open. With a loud buzzing sound, the doors open, and he’s met by three larger mental health workers swooping him up instantly carrying him to the quiet room. One by one his limbs are restrained once again. A few final tears hit the mattress as the head RN punctures his skin with that syringe of prescription wet cement. His cries are silenced by the dense quiet room door closing. The head RN observes the boy tire himself out from a surveillance stream at the nurse’s station. An orderly enters the unit with a mop and bucket rolling into the day room where group therapy continued as scheduled.
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