(A snippet of Downey V.A. Hospital folklore)
I worked as a nurse at Downey V.A. Hospital for several months before I was aware there were women veterans confined amidst the 1600+ men. One evening I received a frantic phone call from a nurse in Building 135 asking if I could come to their ward and start an IV on a patient who was seizing. My recent medical background was an anomaly among Downey nurses. Most nurses employed there had worked on the back wards for decades, allowing their med-surg skills to atrophy. Eager to be accepted in this strange new land, I let it be known if there was an emergent medical problem, I was available to do what I could.
I furiously jammed my bit key into the worn slot on the heavy solid steel door on ward 3A, Building 135 and the portal opened briefly and ominously clicked shut. I was shocked to see an emaciated young lady seizing away on the dayroom floor. I should have suspected that any women patients at Downey VA were sequestered in gender segregated silos. At the time, womens' roles in the military were restricted by gender. It was a male dominated world with tentacles that extended to the V.A. psych wards.
I learned there were two locked female wards at Downey in Building 135 and they were the only ones available in the entire health system. Everyone here was seriously mentally ill and a danger to themselves or others. This arrangement concentrated the most acute patients in one facility while separating them from family and community resources.
The wards at Downey VA were touted for their therapeutic milieu, but it's a real strain to deduce what could be gained by such profound isolation. There was an on-ward dining room where meals were served to avoid comingling with the young bucks in the communal chow hall. Washers and dryers were also available to reinforce that matronly obligation of wash day duties. The place was a tour de force of isolation and womanly perspicacity.
Surfacing from my IV start and a hastily administered bolus of Valium, it was readily apparent that the wards in building 135 were much newer than my native Building 66 which was constructed in the 1920s. These contemporary quarters were straight out of the aseptic construction of medical surgical units. The gleaming terrazo floors and ceramic tile walls were more appropriate to an operating room than a place of comfortable lodging and recovery.
I had the notion that psychiatric units ought to be constructed in the architecture of theaters; not operating rooms. There was no shortage of high drama at Downey V.A. In lieu of a stage, the television assumed the focal point with the viewers numbly looking on like a brace of zombies. The TV came on at seven AM and droned on until bedtime.
I heard rumors that pregnant women gave birth on the unit and indeed there was an exam room eqipped with a table that sprouted stirrups from it's distal end. Hopefully mothers were carefully screened to delineate complicated deliveries, but you can never assume when it comes to VA care. The facility was loathe to having patients treated in community hospitals and had medical surgical units on site so the men did not have to venture off base for care. Pregnant patients flayed by desperate life circumstances giving birth on a psychiatric unit made me wonder what chance the infant had for a normal life.
As I eyeballed and wondered what a lone mattress was doing on the dayroom floor, an attendant enlightened me. "We do takedowns differently here. I know you guys over in Building 66 like to countdown and have everyone grab an extremity to apply full leather restraints, but here we just force the unruly patient into a corner using the mattress as a shield and hold them there until they calm down. Visions of a mattress held vertically and used to pin down a patient reminded me of the Chicago Police in their riot gear and shields at the 1968 Democratic Convention riots.
Walking back to the hallowed halls of building 66 I thought of a cat driven high in a tree by a pack of dogs. Safe at last, but completely isolated like the women in Building 135. Maybe it's time to call the fire department.
Hi OFRN, I just came by to check on you after not coming by for quite a while, and I am heartened to hear you are slowly recovering and back to blogging again!ReplyDelete
I only recently watched One Flew Over The Cuckoos Nest for the first time, what a brilliant movie and your recent posts make me think of it.
I found the suffering of patients on our psych unit hard enough to bear - as we were not a locked unit, the worst cases got sent to the nearby large psychiatric hospital. I doubt I would manage for long at somewhere like Downey. It's good to know there were caring nurses like yourself there at least.
We are having a cold, wet Spring so far - much of Australia has had severe flooding this past year - seems lately if it's not bushfires it's floods. I often take a look at a blog called Pied Type to keep up with things in the USA - she links to some Australian bloggers I follow.
I am glad to see you back here again and send my warmest wishes for you all over there, I hope your family are all well!
Cheers from Sue in damp, chilly New South Wales, Australia!
It's so good to hear from you, Sue. I'm gradually returning to the world of the living after my surgical misadventures with total knee replacement. Folks my age are like old cars; fix one thing like the engine and the transmission goes out.ReplyDelete
Believe it or not they actually showed the movie, One Flew Over the Cuckoo's Nest at Downey. We had a full size movie theater there and it was sad in a way because the patients were happy because a movie was made about them. I can't imagine how beat up by mental illness they were to identify with such forlorn characters.
Being hospitalized was a novel experience for me and I should probably post about what a parallel universe it seemed like. I was very impressed by the youthful zest of the whippersnaperns. They worked so hard and with so much compassion!
As bad as full-time residential care could be, there were compassionate institutions. I worked a few years at Spring Grove State Mental Hospital outside of Baltimore (not in patient care). It was okay. Reagan’s solution was to defund all of it and now we have psychotics with dual diagnoses living in tents on the streets of our cities.ReplyDelete
The Reagan years were well known for the permanent closure of so many long-term government supported mental hospitals. Conservatism to save a buck combined with the other side of the political spectrum which claimed that mental patients were deprived of their rights while institutionalized, really accelerated the closure of mental hospitals. When liberals and conservatives agree, just about any issue marches forward at warp speed.ReplyDelete
Some liberal (if you could even label them) psychiatrists like R.D. Laing went so far as to claim mental illness was a normal adaptive response to an insane world. I don't know about that, but the bottom line was these folks could not take care of themselves and are now living life on the street or in inadequate housing. A very sad set of circumstances.