Conditional Voluntary

Patrick was reunited with his second-favorite patient when he walked into the OT room. Charley was grinning at him from the big table in the middle of the room. This was Patrick’s first look inside the place. There was a set of picture windows with a panoramic view of the hill across the street. A church was on top of the hill and the hospital parking lot spread out below it.

  There was a kiln over in one corner and several rows of cabinets, mostly closed and presumably locked. Unfinished ceramic projects were sitting on a two-shelf table. There was a sink and a paper towel dispenser on the counter opposite the windows. Drawings and watercolors were taped up here and there on available wall space.

  Erin the occupational therapy assistant introduced herself to him. She had to monitor the room while Frank chased down the straggling patients scheduled to attend. Erin was lovely, Patrick thought. Her hair was long, red, and thick; she had smooth fair skin and blue eyes. Erin was wearing a kind of hippie-style blouse with a long, flowing skirt. She seemed to be only a few years older than Patrick and Charley.

  Patrick became fixated on those blue eyes, nicely complemented by Erin’s rosy, apple cheeks. Erin smiled at Patrick as she set art supplies on the table and he shyly looked away, only dimly aware of Charley’s manic chatter.

  Erin hushed Charley when the final participant arrived. Then she worked to maintain everyone’s attention on her instructions, which were simple enough. For the next half-hour, Patrick and the other six patients sketched on large, thick sheets of paper, using charcoal pencils.

  Charley was so energetic that he couldn’t come up with a subject and drew a jagged-lined, abstract mess. Patrick drew a seascape with thick, black clouds overhead and a lonely, vulnerable lighthouse on the rocky shore. The ocean was roiling and Patrick had detailed white caps on the plethora of waves. A crashing wave tossed up sea spray in the foreground.

  “Hurricane’s coming,” Patrick commented in response to Erin’s question. “Hurricane Ronnie.”

  When Patrick asked if he could keep the drawing, Erin had said she would save it for him in the OT room until his discharge day. He could pick his seascape up then if he still wanted it. Patrick had nodded, understanding that Erin and her colleagues would want to interpret the subconscious expression that had come through his sketch.

  He went to find Justine, hoping she would come through with his coffee. After a false start in the smoking room, Patrick remembered that if Justine had brought coffee up onto the ward, she would have had to take it into the day room.

  No such luck. On the other hand, Patrick found a copy of the current edition of the Boston Globe. Sometimes the staff tossed a copy to the patients after they were done reading it. None of them seemed to read the tabloid Herald, although some patients sometimes brought back copies of it when they returned from using their privileges.

  Patrick preferred the Globe, anyway. He didn’t trust the rival paper’s conservative editorial slant. The DEA obviously influenced the content; sometimes the sensational Herald headlines screamed anti-drug propaganda.

  He settled into one of the sofas and pored over the news section of the paper, checking stories for references to anything like the feared Drug Enforcement Act, or whatever they chose to call it. No word of any such legislation being proposed so far although there was some copy about the Iran/Contra congressional hearings, which at least peripherally involved alleged government-sponsored drug trafficking. More to the point, it plainly demonstrated to Patrick that secret government policy was certainly a reality. Laws against such activity didn’t seem to deter it.

  Patrick spent more time reading the paper than he realized. Justine actually found him instead of the other way around. Sure enough, she was brandishing a paper coffee cup. It must have come from a Greek restaurant, given the illustration of yellow columns on a blue field that went around the cup.

  “You didn’t say how you wanted it,” Justine told Patrick in a rapid voice. “So it’s black. I figured you could add anything you want to it from what’s in the kitchen area.”

  “Thanks,” Patrick said, prying off the plastic lid. “I like it black, anyway.”

  Justine smiled and sat down on the arm of the sofa, much as she’d sat over him on the smoking room table the day they’d met. Sipping the coffee, Patrick had another chance to study the anklet above her running shoe; Justine was wearing cute white socks: short, with little pom-poms at the Achilles’ tendons.

  He didn’t doubt that Todd Her Boyfriend had given Justine that bit of cheap jewelry. At least Patrick hoped it was cheap.

  “Sorry if that’s a little cold,” Justine said. “I just had to have a cigarette before I came back up here. I guess you understand why.”

  “Coffee’s still hot,” Patrick reported.

  “Good. Enjoy your group?”

  “It was okay. How ’bout your walk?”

  “Oh, Patrick!” Justine gushed. “You’ll love it when they give you high-level privileges! It’s so nice to get out, breath fresh air, see normal people.”

  “I bet it is.”

  “And,” Justine said, lowering her voice in such a way that Patrick was compelled to listen closely, “when you do get those privs, we can go to walks… together.”

  “Great,” he croaked.

  But we’re only friends, right? Patrick thought. Still… Still and all…

  “Sometimes it’s hard to talk in here,” Justine said, looking around the day room. “If it’s not staff, it’s that geek Charley.”

  Patrick laughed nervously and took another sip. This wasn’t gourmet stuff but it was strong and reassuring in its way. Suddenly, he though about how he’d given Simon the brush-off that morning. Maybe if he didn’t use the privileges they’d given him so far, he couldn’t expect to have more. That would suck. It seemed like he and Justine had spoken as much and as frankly as possible under the immediate circumstances.

  “I think I should see what it looks like downstairs,” Patrick said softly.

  “Oh, sure,” Justine agreed, smiling as if she’d read his mind. “I’m supposed to see my quack doctor at eleven, anyway. That means I have to smoke again first.”

  “Ever try to quit?” Patrick asked.

  “Hey,” she replied, still smiling, “they stop giving me pills, I’ll try to quit smoking. ’Til then, forget it!”

  Justine slid off the sofa armrest and gave Patrick a wink. He nodded at her and then watched his friend stride off into the hallway.

  Patrick felt tricked. After he’d allowed Simon to give him a guided tour of the more public areas of the first floor, the counselor had waited until they were back up on the ward to talk about the room change.

  Not that Patrick minded relocating from the hot spot directly across from the staff office. He wasn’t comfortable with the idea of having Fred for a roommate. The older man was disheveled and smelled bad. He also had a nearly-perpetual doglike smirk on his face that made it seem as if he was keeping a sly secret from everyone else.

  But Patrick didn’t protest because he was sure it wouldn’t do him any good. Simon had already mentioned that there were no other beds available for male patients. He didn’t explain why the new admission needed a room to himself so Patrick assumed it was standard operating procedure when someone first came onto the ward.

  At least he wouldn’t be the newest arrival anymore.

  The move was done just before lunch and it was easily accomplished, given the lack of many personal effects. It made Patrick think of his brother. Scott and his girlfriend Arlene were off having a good time in Florida at that very moment. Patrick supposed they were walking along some white-sand beach, hand in hand, the very picture of a happy couple. Happy and blissfully ignorant of what poor loser brother Patrick was going through now.

  He dreaded the inevitable phone call. Sunday night hopefully, just to get it over with. There were two dimes Patrick had set aside for just that purpose. That was one dime for Sunday night and th
e other for Monday morning.

  His imagination provided the scene. Scott would most likely have said goodnight to Arlene before carrying his luggage up to the apartment. He’d find the door locked but that wouldn’t mean anything. Once inside, he’d call out to Patrick, saying I’m home. But there’d be no reply. That’s odd. Patrick? Scott would check the bedroom his brother used, then his own bedroom just in case. It was a small apartment and it would take just a minute or two for Scott to confirm that Patrick was missing.

  “Maybe he got lucky,” Scott would say to himself hopefully, as hard to believe as that would be.

  Simon took part of his lunch break outside. He had thirty minutes of paid time to eat and otherwise decompress from the ward. The eating part hadn’t taken long: a tuna sandwich, some tortilla chips, and a cola from the snack bar. Per order of the director of nursing, patients were banned from that room during the 11:30 to 2:30 period to make sure hospital employees had space for eating their lunches.

  Smoking was not permitted in the snack bar at any time. That didn’t matter to Simon, who only breathed nicotine smoke on a second-hand basis. A certain illegal substance was another matter but that was very strictly for his off-duty, personal time and never so soon before work that he’d show up with even a slight buzz going.

  But Erin the OT assistant did smoke cigarettes. After both she and Simon were done eating, he followed her outside where she could light up.

  They crossed the one-way street and headed through the parking lot. Walking uphill, they reached a spot under an elm tree where they could sit. From here, the entire hospital was visible. It was a drab and utilitarian building, rectangular like a giant cracker box. The hospital had been built into the slope of the hill so that the north side of the third floor was at street level while the first and second were actually underground.

  In addition to the snack bar, the first floor contained the lobby and admissions office, the morgue, medical records, administration offices, emergency room, radiology, and the pharmacy. The second floor housed the detox ward, billing, and exam rooms used by the internists. And then there was another wing to the third floor, perpendicular to the south end of the voluntary psychiatric ward.

  This was the normally vacant medical ward. The hospital was owned by a partnership which also operated a nursing home and on rare occasion some of the residents of the sister facility were admitted to medical for short-term care. In effect, it was a geriatric ward; otherwise its very existence had more to do with keeping a majority of beds at Hillside classified as medical. The detox ward was already considered a medical facility, at least for billing purposes, and even if the geriatric ward was usually empty it still meant that Hillside was a general hospital and could thus bill Medicare and Medicaid for services.

  The fourth floor was divided between the secure psychiatric ward on the north end and more offices for doctors, social workers, and the occupational therapists on the south end. There was also a spare, undesignated office that was used by a contracted clinical psychologist to administer his tests on patients as needed.

  If Simon and Erin could look at the hospital from their spot under the elm, they could also be seen from any of the east-facing windows. Among them was the window in the staff office.

  “Simon likes Erin,” Stacey sang, using a schoolyard melody. “Simon likes Errr-innn!”

  “Get away from that window,” Rachel scolded. “You’re such a brat!”

  But Stacey was right: Simon did like Erin Rourke. She had been working at Hillside Hospital for a little more than three months now and had been friendly with Simon from the beginning. But only to a point; Erin was happily engaged to a fun and exciting man who’d given her a nice little diamond ring, half-karat.

  Simon always noticed it because he liked to look at Erin’s hands, just then extracting a cigarette from her pack. Her hands were slender, delicate, and smaller than usual for a woman of average height like Erin. Her weight seemed average as well and Simon thought she carried it very well.

  “You can’t do anything unless you’re able to catch them touching each other,” Simon was telling her. “No P. C. – physical contact. That’s one rule.”

  “Not even a friendly hand on the shoulder?” Erin asked, preparing to ignite a butane lighter.

  “Right. But I tend to let that stuff slide.”

  “Good. The thing that gets me about that No P. C. rule is that these patients have been in isolation, some of them, afraid of other people. Afraid to reach out. Sometimes they need to do it literally. Then the rules say no, they can’t.”

  “Yeah,” Simon murmured, thinking of how badly he wanted to touch Erin.

  But it was another one of Simon’s hopeless workplace crushes. Other than a recent fling with a temp agency nurse – a forty-ish, lonely, and neglected married woman – his love life was in a persistent drought. Those days as a college Casanova seemed as far away as the planet Mars.

  “Did Patrick enjoy the OT group?” Simon asked, eager to change the subject.

  “He seemed to,” Erin replied, exhaling smoke. “Showed some talent with a seascape he drew.”

  “I’d like to see it.”

  “That can be arranged.”

  Some of Erin’s exhaust was carried by the breeze into Simon’s face. Noticing it, Erin waved her right hand to try to disperse the smoke.

  “Sorry,” she said.

  “It’s all right. Funny how few of us on the voluntary staff smoke.”

  “Just the opposite on the secure ward.”

  “Took the words right out of my mouth.”

  “Seriously, Simon. It gets to me and I go through half a pack a day.”

  “I hate it up there.”

  “Come on,” Erin replied with a grin.

  “Don’t get me wrong. I like some individual staff members from the fourth floor. But they have a closed society; they aren’t like us.”

  Simon was delighted by Erin’s soft laughter.

  “Are you working this weekend?”

  “No,” Simon answered. “Thank God! It’s my turn next time.”

  “Still, I don’t envy you losing half your weekends.”

  “But it’s nice to have one weekday off to compensate. As for you, at least you get to do fun things with the patients all the time. What I do is normally mundane and sometimes dangerous.”

  “Hey, don’t tell me about dangerous,” Erin said with a playful scowl. “I used to work in a state facility, remember?”

  Simon nodded.

  “I used to go right into a locked ward with some pretty scary people.”

  “But they didn’t bother you?”

  “I was always pretty calm.”

  “No, I meant did they bother you as in gave you any hassles? That kind of bothering.”

  Erin shook her head.

  “Like you said, maybe it’s because I was bringing them something fun to do.”

  “Didn’t you have an attendant escort you?”

  “Not really. They were in the ward with me, of course, but not always close by, like a bodyguard.”

  Simon thought of something from his early days as a counselor, then mulled it over a little before deciding to raise the subject.

  “Years ago, when I was starting out on the night shift, I used to work with this one nurse more than any other. Her name was Rhea. She didn’t tell me right away but I made a good first impression on her.”

  “How?”

  “When she saw me, Rhea was glad to see that they’d hired some big guy to work nights with her. It made her feel safer.”

  “On the voluntary ward?”

  “Well, Rhea was very experienced but she’d been assaulted more than once on the job so that made her very safety-conscious.”

  “Wow, I bet.”

  “It was flattering when Rhea started calling me her night shift hunk.”

  “I’ll bet,” Erin replied, looking Simon over. “I guess that’s one w
ay to describe you. You know what? I feel safer with you around as our day shift hunk.”

  Afraid he’d blush, Simon looked away as though he was interested in the car moving up the street at that instant. On the other hand, he didn’t want to endure an awkward silence.

  “I’ve got a membership at the ‘Y’,” Simon said, looking back to Erin. “Haven’t gone in months.”

  “Shame on you.”

  “I know. And I have a reputation to live up to… I guess. I think I’m starting to get soft.”

  When Erin made no comment, Simon flexed his right arm and felt his biceps with his left hand. He realized that it seemed as solid as ever.

  “I’m sure you’re still twice as strong as I could ever be,” Erin said.

  But she didn’t take the bait. Simon relaxed his arm, barely more disappointed than relieved that Erin hadn’t chosen to sample his muscle tone. He looked at his watch.

  “Lunch break over?” Erin asked.

  “It will be by the time I get back in. Are you going to stay and finish that cigarette?”

  “Yeah.”

  “See you later, then,” Simon said, standing up carefully.

  He walked briskly down towards the parking lot, the heaviness of his body adding to the momentum.

  Patrick hadn’t seen Fred since the ward assembly that morning. His grubby roommate had been given privileges to leave the floor by himself so Patrick hadn’t given Fred’s absence much thought. But by nine o’clock that night, Fred had disappeared.

  “Looks like he eloped,” a counselor named Art told him after the late medications had been dispensed.

  “Eloped?”

  “Yeah.”

  Art was a short, dark middle-aged man with a thick mustache.

  “Pardon the hospital jargon,” he said. “I mean it looks like old Fred signed out for a walk and decided to keep on walking away from here.”

  Patrick tried not to look too happy about the news.

  “So, what happens when a patient takes off like that? You call the police?”

  Art smiled crookedly.

  “This isn’t a jail, Patrick. No one in here is dangerous enough that we’d have to notify the authorities if they do elope.”

  Patrick nodded. So maybe that was the secret Fred was keeping behind his canine smile. It really so easy to escape. So easy that the staff didn’t even bother to call it an escape.

  He thanked Art for sharing the news and went to find Justine. It would be nice to give her more good news.