CONDITIONAL VOLUNTARY
A Novel by Geoffrey A. Feller
Copyright 2012 by Geoffrey A. Feller
CHAPTER 1:
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Patrick Coyne woke up in a strange place one summer morning in 1987. Right away, he realized that he wasn’t in his own bed. The mattress felt funny and the ceiling was unfamiliar. Patrick flinched and turned onto his left side. There was a second bed a few feet away and alongside the one he was lying on. A hospital bed. There was no sheet on it; the mattress looked like it was coated in plastic or vinyl, which explained the odd feel of what he was lying on.
Warily, Patrick glanced around the room after rubbing his eyes. There were twin sets of lights over the headboards. From their rectangular shapes, it was plain that they were fluorescent tubes instead of bulbs. It so happened that what light there was in the room was coming from the picture window. A shade had been pulled but it wasn’t down all the way and harsh morning sun had broken through to splash over the black linoleum floor.
Two chests of drawers were placed between the beds. There was a door over in a corner of the room, a sink without a mirror, a paper towel dispenser, and then, to Patrick’s right, another door.
His heart was pounding. Hospital! But what for? He reached under the covers, making sure that his thin body was still intact. No bandages, no casts, no stitches. Physically intact. But where had the last several hours gone? This looked like morning, all right. Felt like it. But the last thing Patrick could remember was strolling down a sidewalk near Porter Square under an afternoon sun.
Psycho ward! The conclusion was impossible to resist. It must be… The room didn’t look sanitary enough to be in a medical unit, after all. But what had happened to bring him here?
Trying to concentrate through his anxiety, Patrick dug into his memory. But it was stubborn, unyielding beyond that warm afternoon, however long ago that had been. For all Patrick knew, he had been in a coma for a year, long enough to heal whatever physical injuries there might have been.
“Bullshit,” he whispered.
If he had been in a coma, there would be wires and things connected to him. Monitors beeping, measuring his heart and lung activity, his brainwaves. All in a nice, sterile medical hospital.
“Psycho ward,” Patrick croaked out loud.
He curled up into a fetal position and wondered why he would’ve been put there. Patrick felt vulnerable under the ratty little blanket, only a pair of white underwear briefs away from utter nudity.
There was one reason Patrick could think of for having been taken to this place. It made his pulse speed up even more to consider that he could be under arrest. This could be a prison hospital. That might explain the untidy state of this room. Who cares about sick prisoners, anyway? Then again, Patrick was back to the fact that he wasn’t injured. Otherwise, he felt anxious rather than sick.
Maybe it was another kind of hospital altogether. Didn’t the Soviets lock up dissidents in psych wards? After all, Patrick knew that the Drug Enforcement Agency had been watching him for years. Perhaps there had been some secret amendment to some law that got passed behind the public’s back. Some kind of euphemism could have been used, like the Drug Treatment Act. Several innocuous paragraphs that would seem boring to average citizens followed by fine print about involuntary, indefinite commitment of drug users.
Or maybe it was part of something even more sinister, like a Drug Emergency Act. Maybe the dealers were already locked up in gulags out in the Desert Southwest, perhaps even in some of the old internment camps used for Japanese Americans during World War II. Dealers in gulags; kingpins summarily executed on live television; registered drug users like Patrick forced into treatment. The DEA certainly had a file on him. That’s why they’d been watching.
Patrick could just imagine Reagan signing the act into law in a Rose Garden ceremony. Nancy would be there at his side, smiling with smug satisfaction. They’d call it the Just Say No Act in the media, selling it as a way to protect the nation’s children…
Then somebody opened the door to his right. Patrick was startled although it opened slowly and quietly, apparently so as not to wake him.
A small, slender woman with wire-rimmed glasses stepped into the room. She had short, dark hair, and was wearing a baggy shirt and tan slacks. She was carrying a clipboard with a bunch of keys tied to it by a plastic cord. The woman looked at Patrick and broke into a half-surprised smile.
“Oh, good morning!”
Patrick meant to respond but his words got stuck in his throat.
“How are you feeling?”
“All right,” Patrick mumbled.
The woman’s friendliness seemed forced and was not reassuring in itself. But she didn’t scare him; she looked spindly and frail. And she wasn’t wearing a uniform. Patrick knew quite well that DEA agents worked undercover when they followed him around. But if they had really nabbed him at last, wouldn’t they come forward in their true colors, wearing fascist uniforms to intimidate him?
“My name is Brenda,” the woman said. “I’m one of the counselors here.”
“Counselors?” Patrick asked in confusion. “Where am I?”
“Hillside Hospital in Somerville,” Brenda replied. “You were admitted here last night.”
“I don’t remember any of that. What day is it?”
“Thursday the eleventh.”
“June?”
Brenda replied with a nod and a strained smile.
“Am I under arrest?”
“Oh,” the counselor exclaimed, “of course not!”
“Then what am I doing here?”
Brenda coughed slightly. Her left elbow bumped the doorknob.
“We’ll leave that for Dr. Kearney to explain, okay?”
Embarrassed to have made Brenda so uncomfortable, Patrick nodded quickly.
“Um, you have some clothes in that dresser,” Brenda told him. “If you’d like to put them on, I can show you around the ward.”
“Yeah, okay.”
“That’s your bathroom over there,” Brenda said, pointing to the door at his left. “You’re right across the hall from the staff office. I’ll wait for you there, all right?”
“All right.”
Patrick found no change of undershorts in the dresser drawers. But there was his yellow short-sleeved shirt and gray corduroys. Yes, he’d been wearing them in Porter Square. His running shoes and socks were on the floor in front of the dresser.
The bathroom turned out to be nothing more than a toilet with another door on the opposite side. Patrick locked that door with a push-button in the knob before emptying his bladder, realizing that another scrap of privacy had been taken away from him.
While there was no mirror, Patrick could make out a blurry reflection of his face in the stainless steel surface of the paper towel dispenser. It was his familiar narrow face, all right. Light brown hair disheveled, pale skin dotted by a few pimples on the forehead, brown eyes wide open. No scars or bruises so he hadn’t been in any fights during those missing hours.
Brenda had closed the door when she’d left. It was unlocked and Patrick pulled it open to cross the hall. He looked both ways first. Down on his left were two rows of doors, most of them open, and a glassed-in alcove at the end of the hall that had a Dutch door, which he guessed was the nurse’s station.
To his right was an open set of fire doors and past them a wooden desk, more doors, and a set of gray lockers up against the wall towards the far end. There was a white-haired old lady in a light blue jacket sitting at the desk. Then Patrick looked ahead to see the staff office door.
It was just where Brenda had said it would be. Otherw
ise, Patrick could tell what it was by the big wooden letters nailed into the door itself, spelling out “STAFF”.
And it was closed.
Patrick glanced back up and down the hall, not seeing anyone other than the old lady. She was as still and silent as a wax dummy. After standing there for what seemed longer than a minute, somebody emerged from one of the patient rooms. It was a short, middle-aged woman wearing a T-shirt and white jeans. She looked up at Patrick curiously.
“Hello,” she said.
“Um, do you work here?” Patrick asked.
The woman laughed out loud and grinned.
“I like you already!”
Patrick smiled back. He noticed a pack of cigarettes in her right hand.
“My name’s Linda. I’m just another patient, like you. What’s your name?”
“Patrick.”
“Got in last night?”
“Yeah. I was supposed to meet one of the staff here. Brenda, I think. She was going to show me around.”
“Oh,” Linda nodded. “Just go ahead and knock. You have an appointment, anyway.”
When Patrick hesitated, Linda stepped right up to the office door and rapped on it sharply.
After a few seconds, the door opened with a loud click.
A man’s voice asked: “Yes, Linda?”
“The new kid’s here to see Brenda.”
A slightly more muffled voice responded with an “Oh!” Then the door swung wide open as Linda looked back at Patrick. He thanked her with another smile before Linda started off down the hallway towards the lockers.
Brenda came out into the hall and Patrick caught a glimpse of two more women in the staff office at a table. A portly man with unnaturally red hair was approaching a bookcase full of black, three-ring binders. Then Brenda closed the door before Patrick could notice anything else going on in there.
“Well,” she said, “ready for the tour?”
Brenda started with a linen closet alongside the staff office where clean sheets and towels were kept. Patrick was more curious about the door on the other side of the linen closet. It had a small, square window near his head level. Brenda followed his gaze and explained.
“That’s… the seclusion room,” she said, sounding like she’d rehearsed the words. “People go in there when they need to be alone.”
Patrick was afraid to look through the window in the door and obediently followed Brenda’s brisk pace over the fire-door threshold. He was introduced to the old lady, being told she was Hilda the ward clerk. Hilda’s responsibilities included making sure the ward was stocked with free supplies such as the thin bar of soap and tiny shampoo bottle that Patrick had seen earlier on the sink in his room.
The main entry door to the ward was across from the desk. Like the seclusion room door, it was closed and locked, with a square window in it. Elevator doors were visible through the window. Brenda said they were on the third floor of the hospital. Directing his attention back to the desk, the counselor told Patrick that when he had visitors, they would sign in on the log in a binder. Patient privileges were found on another form in the binder, showing whether they had permission to leave the ward without staff escort.
“I’m sure you’ll be getting privileges soon,” Brenda added.
The words of encouragement passed over Patrick without making much of an impression. Next, Brenda pointed out the two psychiatrists’ offices, reiterating that Patrick’s attending psychiatrist would be Dr. Kearney. The occupational therapy room was past the doctors’ offices and was closed this early in the day.
A shower room was across the hall from the occupational therapy room. Then, a few feet down the wall past the shower, was a fire exit – no way out through that door unless you had a key. Brenda then told Patrick about the locker boxes.
“Patients are not allowed to keep sharp objects in their rooms,” she lectured. “No glassware, no razors. Also no electric appliances. I mean, nothing with cords. They’re dangerous. I don’t mean to you necessarily but we do have some people who might hurt themselves – deliberately – with things like that.”
Patrick nodded, thinking that this had nothing to do with him.
“Since these items are patients’ property, we keep them locked up for safekeeping. You can ask a staff member to get them for you. And also…”
Brenda indicated a tall wooden cabinet next to the lockers.
“…we keep laundry detergent in here plus safety razors and soap. And there’s a box where patient cash is kept safe.”
Patrick blinked when she looked back up at him.
“Don’t worry. You can carry money on you if you like. We strongly recommend putting away anything over a ten-dollar bill in the strong box. Our, um, protocol is to have two staff members present when the box is opened. The key is back at the sign-in desk. As for the laundry detergent…”
Brenda turned and pointed to the washer and dryer to the left of the fire door.
“…you use it there. The machines operate with tokens you get from the staff. Those are two more patient rooms there at the end. And here is the smoking room.”
Now Patrick saw several more patients, six in all, crowding into the small room. They were all smoking cigarettes; a gray haze hung in the air. The room had a small table and some plastic modular chairs in addition to a vinyl, two-seater couch. All the patients looked older than Patrick.
“This is the only place on the ward where smoking is allowed,” Brenda told him.
Patrick nodded indifferently again. He didn’t smoke.
“Everyone, this is Patrick,” Brenda said, turning to face the patients and raising her voice. “He’s new here so I hope you’ll all try to make him feel welcome.”
“We’ve already met,” one of the patients responded.
Patrick recognized her. It was Linda. He smiled again, glad to see even a barely familiar face. The other patients seemed to have only subdued interest in him or were otherwise apathetic.
Brenda took Patrick on a backtracking path up the hallway. His tour continued past the staff office down to the day room. While this was a much bigger place than the smoking area, Patrick saw only a couple of patients there.
Three long tables had been pushed end to end down the middle of the day room for a continuous dining surface. There were also a pair of long sofas on either side of the tables. Brenda showed Patrick the counter at one end of the day room with a bread box and toaster, an instant coffee dispenser, and a refrigerator. Opposite the counter at the other end of the day room was a bookcase – sparsely stocked – and a TV set sitting on a platform bolted to the wall up near the ceiling. Two picture windows revealed trees lining the street outside.
Brenda then led Patrick back into the hall and showed him the nurse’s station, which was essentially the dispensary for medications. They were handed out from the Dutch door at four regular hours during the day or as needed on an individual basis.
The hallway made a short L-shape across from the day room. Three more patient rooms, a second shower, a chair for taking blood pressures, a weight scale, and another fire door took up this end of the ward. There were also two pay-phones on the wall next to the fire door.
Patrick had been listening and looking during the rest of his tour but his reactions were superficial. He kept thinking about the patients he’d just seen. His emotions had softened from anxiety into a numb self-consciousness. The other patients didn’t frighten him so far. That is, they weren’t frightening in themselves.
Was he now one of them? Why else would he be here? The reality of his surroundings were beginning to quash his notions of a DEA conspiracy. But there had to be another reason if not that the federal authorities out to get him. So Brenda wouldn’t say why he’d been sent to this ward. It was up to the doctor to do that. Must be something bad, something delicate.
“The breakfast trays will be up at eight o’clock,” Brenda told him. “You can wait in
the day room or the smoking room.”
“I don’t think I’ll be having any breakfast,” Patrick said. “Could I wait for the doctor in my room?”
“Well, yes, of course,” Brenda nodded without a smile. “But there will be an assembly at eight-thirty, sharp. We have the assemblies every weekday morning and you’re expected to attend.”
Patrick frowned and stared down at her.
“If you miss the meeting,” Brenda went on, “you can’t use your privileges. Once you have them, I mean.”
“If I haven’t got any,” Patrick said, allowing himself to feel angry, “what’s the difference?”
“It’s all part of your treatment,” Brenda said, edging back from him slightly. “Part of your, um, social integration. Y-you have to cooperate with your treatment to be given privileges.”
Patrick grunted. He didn’t care about privileges. All he wanted was to have his admission explained. Maybe it had all been some big mistake. Perhaps he’d had amnesia and it was misdiagnosed. If this Dr. Kearney could have it all straightened out then Patrick could walk out of here just like that and leave all this privilege stuff to people who cared about it.
“Well,” Brenda said, cracking a difficult smile, “wait in your room if you want. I… I just had to let you know what to expect for the day. I mean the ward routine.”
“Just tell the doctor that I’m waiting for him, okay?”
Patrick had found his watch on top of the dresser. Assuming it was keeping accurate time, the noise of a cart being wheeled down the hall came just before eight o’clock. Outside his door, things were much louder now. Patients were obviously up and around, talking and making noise.
Patrick was startled to hear someone bang on the other door to the toilet.
“Unlock the damn door!”
It was a woman shouting at him. Patrick jumped up from where he’d been sitting on the edge of his bed and hurried over to the toilet. Inside, the opposite doorknob was rattling violently.
“Hold on,” Patrick pleaded. “I’m sorry! I’ll get it.”
He twisted the doorknob himself, causing the push-in lock to pop back open. A scowling, fat woman in a cotton nightgown yanked the door open. Blushing helplessly, Patrick backed his way out of the toilet chamber and closed his door.
It’s got to be a mistake, he thought as he listened to what sounded like diarrhea landing into the toilet bowl. Get me out of here!
Patrick had left the door to the hallway slightly ajar as if that would hurry Dr. Kearney along. Now he pushed it shut and got back into bed. Lying there, he covered his eyes with his right forearm, occasionally lifting it to check his watch.
A little past 8:20, someone knocked on the door.
“Come in,” Patrick said hopefully.
This time a big, tall man came into the room. He was wearing a white shirt with red pin stripes and brown slacks. Like Brenda, the man was holding a clipboard. There was no further resemblance. Not only did he look like he was twice Brenda’s size, his manner was much more relaxed. As a counterbalance to the professional wrestler’s build, there was an open, boyish face and friendly eyes behind a pair of oval rimmed glasses.
“Dr. Kearney?” Patrick asked skeptically, sitting up.
The young man laughed loudly yet pleasantly. Patrick smiled despite his anxiety.
“Sorry. When you meet Dr. Kearney, I think you’ll see why I thought that was so funny.”
The big man walked over to the vacant bed. Patrick scooted back to the edge of his mattress to face this latest visitor.
“My name’s Simon. I’m one of the counselors here.”
He offered his hand and Patrick gave it a quick shake. Simon sat on the bare mattress and put the clipboard down next to him. Looking at the thing, Patrick noticed it wasn’t the one with the ward keys.
“I… I want to see Dr. Kearney,” Patrick insisted tremulously, glancing back up at Simon’s face.
“Of course.”
Patrick wondered whether Brenda had sent this colossus in to see him. He supposed that the overweight yet muscular Simon could be an enforcer for the hospital.
“He’ll be in soon,” Simon went on. “It so happens that Dr. Kearney gets in much earlier than Dr. Adams so you’re in luck.”
Patrick nodded although he didn’t fully understand. Moreover, why was Simon here?
“Uh, did Brenda say that I didn’t want to go to the meeting?”
Simon nodded. He was holding the edge of the mattress with both hands, arms spread apart. The plastic squeaked under Simon’s weight.
“Are you here to talk me into going?”
“I’ll try,” Simon replied, smiling. “But first, I wanted to introduce myself. I’m going to be your primary contact person while you’re here.”
“Primary contact person?” Patrick echoed.
“That means anytime I’m in duty here you’ll be assigned to me. Otherwise, you’ll report to a different counselor when I’m off. We post an assignment sheet out near the entrance so you can check that each shift.”
“Oh? I didn’t see it.”
“Hasn’t been posted yet,” Simon nodded. “You’ll see it on the bulletin board next to the shower room. Like I said, I’m assigned to you whenever I’m working. I’m on Dr. Kearney’s treatment team. If you have any questions or concerns, you can come to me first or whoever else is listed by your name on the assignment sheet. If you can’t find your contact counselor, ask any of us – or one of the nurses.”
“Oh.”
“Gloria is Dr. Kearney’s team nurse,” Simon elaborated. “I’ll introduce you to her in a few minutes. See if we can catch Rachel while we’re at it; she’s the head nurse.”
“All right,” Patrick muttered. “So, uh, Simon, you’re a counselor? Like Brenda? What does that mean? Are you guys therapists, or something?”
Simon smiled slightly and shook his head.
“You know what we are? We’re something like attendants, like the guys in white starched shirts and black bow ties like you see in the movies, except we don’t have uniforms. Even the nurses wear street clothes. We just aren’t allowed to wear jeans. But anyway, I’m really something more than an old-fashioned attendant; counselors here listen to patients’ concerns and write nursing notes. Team counselors like me have to report to our team nurses and the psychiatrists.”
Patrick listened impatiently, still frustrated over his predicament going unexplained.
“Did Brenda tell you this is a voluntary ward?” Simon asked.
Patrick shrugged; maybe she had said so while he hadn’t been listening too closely.
“She really didn’t tell me much,” Patrick sighed. “Listen. Why am I here? What did I do? I’m thinking this is all some big mistake.”
Simon started to say something but caught himself.
“What?” Patrick asked desperately. “I… I’m scared I did something bad…”
“I’ll have to let Dr. Kearney fill you in on the details,” Simon told him. “But don’t worry. You didn’t harm yourself or anyone else. It all started as a kind of protective custody. But you’re safe here.”
“Safe…”
Suddenly, Patrick thought of the DEA agents out there. Maybe they’d leave him alone while he was in the hospital. Unless. Unless they were spying on him in here, too. Anything was possible.
“As I was saying,” Simon spoke up, reaching for the clipboard, “this is a voluntary ward. Upstairs, that’s the secure ward. I know your privacy is pretty limited here but you’d have a lot more freedom as a voluntary patient.”
Patrick gaped slightly. What was Simon getting at?
“As of this moment, you’re still here under commitment, what we call a pink paper.”
“I’ve been committed?” Patrick gasped, the signing of the Drug Emergency Act replaying in his imagination.
“It’s mostly a formality,” Simon replied calmly. “Mainly has
to do with ambulance transport from the city hospital emergency room. I’m asking you to sign this conditional voluntary form.”
And he held out the clipboard. If a pink sheet meant commitment, here was a plain white form full of typescript. A line with an “X” next to it was at the bottom. A ball-point pen was pinned under the metal clip. Patrick took hold of the board.
“W-what if I don’t sign?” Patrick asked, looking up from the form.
“Not to scare you,” Simon said quietly, hands on his knees, “but you’d have to be transferred. Either upstairs or, if they don’t have an open bed, off to a state facility. But signing yourself in is no big deal. Everyone else is in here voluntarily. If you’d rather think about it first, maybe you could ask some of the other patients about signing this form.”
“Or I could ask Dr. Kearney?”
“Of course. But I don’t think you’d like it upstairs. The windows are barred and you aren’t allowed to have shoelaces. It’s also smaller, more closed-in.”
Patrick shuddered. Simon’s description sounded like what he would have expected a psycho ward to look like before Patrick had ended up here – on the voluntary ward. He realized that Simon was pressuring him however subtly. Maybe the big ox was afraid to face the head nurse without having Patrick’s signature on the white form. Patrick tried not to smile as he considered this possible leverage.
“If I’m here voluntarily, doesn’t that mean I can sign myself out of the hospital too?”
“Yeah, but look on the form. It says something about – ”
“I see it,” Patrick murmured.
There was some language about his attending physician having the reserved right to delay a discharge for up to three days, giving the doctor the chance to petition for commitment.
“Oh, shit,” Patrick reacted. “God, thanks for telling me!”
“If you want to leave before Dr. Kearney schedules a discharge, you sign a form officially notifying us you want to be released within three days.”
“Does anyone ever do that?”
“Sure, once in a while,” Simon nodded, leaning back a little. “Usually, they end up changing their minds and withdraw the notice. Sometimes…”
Patrick looked up from the form when Simon paused.
“…they just go home.”
After a moment, Patrick picked up the pen and scratched his name into the space by the “X” and handed the clipboard back to Simon as if the object was hot to the touch.
“Now,” Simon said as he stood up, “how ’bout putting in an appearance at the assembly?”
“I… I don’t know,” Patrick answered, feeling very tired all of a sudden.
“Just fifteen, twenty minutes out of your day,” Simon persisted, standing over him.
“I… I’ve never been in one of these places before.”
“I understand.”
“I don’t know what to expect.”
“Like life in general,” Simon replied softly. “But it’s safer in here, I promise.”
Patrick didn’t know whether he could believe that. However, it occurred to him that Dr. Kearney might appreciate it if he was cooperative. Brenda had already said that going to assembly was part of his treatment. They couldn’t commit him involuntarily for being cooperative, now could they?