My patients paced the halls in whitewashed pajamas and flimsy cotton robes. Old Mr. Sandvik scuffled by with the peculiar gait caused by long-term use of antipsychotic medications. He smiled sadly, his jaw swinging and his tongue lolling like a cow at pasture. Tardive dyskinesia, I mentally noted. The balance between a therapeutic dose and the harmful side effects of long-term antipsychotic use was delicate. For my private patients, therapy tranquilizers and antidepressants had been the more likely course of treatment. The consequences of irreparable neurological side effects in long-term institutionalized patients were not pretty.
The wide set of swinging doors to the dayroom opened to my key. There was a charged air in the room. I knew the inspection team was there before I saw them. The warden introduced me to the five men and women. They asked a few questions about my patients and left to examine medical records. I breathed a sigh of relief and crossed the room to eighty-year-old Finn Koski. After thirteen years in the unit, he had the ghostly pallor of an undertaker. Soft pouches ballooned under his eyes, the saddest eyes I had ever seen.
Finn was slight and stooped with thinning hair and eyes so blue they were the first thing I had noticed about him. His skin was paper thin and creased. An old man. His prison-issue khakis drooped off his slim hips and ballooned around him. His voice still held a twinge of an accent although I knew he had immigrated to Minnesota from his native Finland almost sixty years earlier.
He sat looking out onto the grounds, his thin skin dripping like wax from his jaws. Tyrell Perkins sat next to him. They looked like two elderly men feeding pigeons in the park, just to pass the time, both lost in the magic of the past. Over the last few weeks, not only had I overheard stories about Mr. Koksi’s life on the farm and Tyrell’s in Chicago, but also about the deep abiding love each had felt for a woman and what they had done for it. They were old men to whom the passage of time had not been kind. I looked at them and wondered what drew me to psychiatry. Most of my current patients, men with less-than-average intelligence and greater-than-average childhood traumas, had been judged criminally insane. Tyrell Perkins had been in prison since the tender age of twenty.
“You know I learned to read by reading the Bible,” Tyrell said. In the tiled dayroom, his voice boomed like a church organ. I stood by quietly and listened. “Yep. That’s my greatest joy. Reading the Bible and doing an honest day’s work. I thank God for these blessings.”
Tyrell reminded me of a retired greyhound who had found his calling. He spread the word of the Lord to anyone who would listen. His was a body beginning to bend with age. He had worn prison garb for so long it was doubtful if he even remembered what other fabric felt like against his skin. His joints groaned like creaking lumber as he rose and returned to his mop and bucket. Dragging them behind him, he shuffled to seclusion and peered through the peephole at Emanuel. It was evident he had respect for the intensity of Emanuel’s sadness. “Waste of a good man’s last years to sit there like that, doin’ nothin’ at all,” he said and then continued his methodical mopping. “It’s a world gone wrong but it’ll be okay, brother. God is with you,” he promised before ambling back into the dayroom.
“Ya know, Finn, I know the power of a human touch,” he settled down in a chair to say. “The scorching heat and tenderness of it. The way it sucks a man in. The thrill of those fingers delicately running their nails down my chest and the A-bomb were what I lived for.” He paused. “Man-o-man. There’s no human touch here. Never dreamed I’d miss it like I do.”
Finn looked at him mutely. His eyes were rheumy and lusterless. “My wife was a woman like that,” he finally mumbled.
Tyrell nodded. “Early on, I dreamed of a woman’s silky smooth skin and way her hips swayed when she walked. No offense, Doc,” he said to me, “but I still miss those ladylike moves–a woman combing her hair, reaching her lips up to be kissed, smoothing a wrinkle from a shirt, maybe caressing my cheek. There’s nuthin’ like it. The love of a good woman can change a man, all right.” He shut his eyes and then after a moment, returned to his mopping. His gaze took in the inmates in the room. “My job’s to help these guys here now. God and time will slow down the desires of the flesh.” He wrung out his mop and it clattered in the pail. The smell of diluted bleach filled the room, and he began the cleansing comfort of back and forth mopping, one foot at a time, as if swathing bandages over burns.
“Good morning, gentlemen. Did you have a good weekend?” I asked, standing next to Finn. A pimple had begun to form on my chin and I forced myself to keep my fingers away from the pre-menstrual breakout. I brought my hands to my lower back and tried to massage the ache away.
“Morning, Doc,” Finn stood and shook my hand, his knuckles shifting beneath my grip. “Just thinkin’ about what Mr. Perkins had to say. You feelin’ okay today?”
My hands dropped to my sides. “Fine. Thanks for asking.”
“You’re looking fine today,” Tyrell said. “You know how it is here. A good weekend is when you see somethin’ good on TV, have enough food in your belly, and sweet Jesus watches over you.”
“How are you today, Mr. Koski?” I sat down next to him and crossed my legs.
He was a wizened old man, his hands as gnarled as willows. It was painful to watch his gait, stiffened from years of labor and osteoarthritis. His voice dropped to a painful whisper. “Say, you don’t know when I’ll be leaving here, do you? There’s so much to do on the farm at this time of year.”
I shook my head. “No, I’m sorry, I don’t. Don’t worry, the farm will be okay.” Confused and disoriented, I mentally noted. “How about working with the landscape crew? I bet you could teach them a thing or two about gardening. There is a lot to be harvested this time of year.”
“I bet I could teach those young men a thing or two.” Something flared briefly in his eyes. Sadness? Relief? Worry? “Just as long as I get out of here in time to plant my fields.” He smiled. A smile that reminded me of my father’s and broke my heart.
“I’ll check with the social worker to see if you can go out with the gardening crew.” I would read his chart and find out what really happened. “I’ll see you tomorrow, Mr. Koski.”
The seclusion room had a mesh-covered peephole in the door. Through it I saw Emanuel lying on his bed staring at the ceiling. His feet hung over the thin mattress. He didn’t turn when I entered. Bud Anderson waited outside, his eye glued to the peephole.
“Emanuel, will you take your medication by mouth today? It would be so much easier, and you’ll feel better.” Another involuntary, court-ordered medication was more than I could bear.
He reached a hand, straddled with ropy veins, for the white medication cup. His hands shook as he put the pill in his mouth, slurped water, and swallowed it.
“I’m going to have to ask you to open your mouth, so I can be sure you have swallowed the medication.” He opened his mouth and although the stench was awful, I checked in his cheeks and under his tongue. “Thank you. May I tell the nurses you would be willing to shower and change, maybe brush your teeth?”
He looked at me without comment and then nodded.
“I’ll come back later to see how you’re doing. I’d like to get you back on the unit as soon as possible.” Unsure of how much English Emanuel understood, I continued, “Josie Garrett, our social worker, speaks Spanish. It might be easier for you. What do you think?”
The patient shrugged, his eyes downcast.
“I’ll see you before I leave today, okay?” I locked the seclusion room door behind me, entered the nurses’ station, and told Hutchings that Emanuel had agreed to take his meds. I asked the nurses to check that he swallowed each dose and the orderlies helped him bathe. I told Hutchings I would talk to Josie Garrett about translating or interviewing Emanuel in Spanish. He gave me a strange look and said, “There are plenty of people around who speak Spanish,” but before I could respond, my beeper went off. consult in medicine. It was turning out to be one of those days when I wouldn’t have a moment to sit down. Still curious about Hutchings’s reaction to Josie, I followed the jaundiced tile floor to the medical building, reading the consultation notes as I walked.
The subterranean passage was warm that day. Josie Garrett, the unit’s social worker, rushed past me in running shoes and turned to wave. Sweat dripped off her wide, dark forehead. My nose wrinkled as she passed—Josie’s deodorant must have given out on her. Between the acrid smell, the heat in the tunnel and my lingering headache and cramps, I felt like I was about to be sick.
“Hey, Josie. Training for the marathon? Wait a minute, would you? I just saw Mr. Koski in the dayroom. Do you think you could get him involved in the spring planting with the gardening crew?” I walked faster, wishing I had worn a cool comfortable pair of slacks and flats instead of a skirt and heels. My control top pantyhose chafed at my inner thighs and squeezed my bloated belly.
“Oh, and I was wondering if you could talk to Emanuel Venegas when you have a chance? He hasn’t said enough to me so I can’t even figure out if he understands me. Maybe he’d do better in Spanish.”
“Sure, I’ll work on it. I’ll be in to see Vengas ASAP. Anyone who was baptized Josefina Antonia Gutierrez Garcia has to be able to speak a little Spanish, huh?” She laughed, her limbs moving with the precision of a marching soldier. “We still have a few months until spring for the gardening. No hurry, right?”
I struggled to keep up. “No. No hurry. He’s not going anywhere. Just wanted to give him something to look forward to. Gutierrez Garcia? Where’s the Garrett come from?” I asked, wiping the sweat from my forehead.
“Long story. Let’s just say I wanted to get rid of Josefina Antonia Gutierrez Garcia, so I married a Garrett. Unfortunately, I fell in love afterwards so I got rid of the man but kept the name. I came out and lost my children. Anyway, I’ve reinvented myself. Now I’m Josie Garret, LCSW instead of, Sergeant Gutierrez. And I have the woman of my dreams in my life instead of Detective Garrett.”
At last I’d found someone who had had more tragedies than I had. Josie was more comfortable in giving out personal information than I was. Fascinated, I took advantage of it by asking more questions. “Josie, slow down! This is a lot to take in. Let me get this straight. You were born Josefina whatever. Got that. Where? You married Detective Garrett and changed your name. You have children? Sergeant Gutierrez? You lost me.”
“It was another life. My life was a mess. I was born in San Juan. I was a cop. Moved to Chicago. Sex crimes unit. I was injured and during the recovery and the divorce, I knew I had to make a change so I got my degree in social work, and here I am. It was better for the kids to be with their father. He moved to Wyoming.”
“Oh, that’s where you get the gorgeous tan and the dark eyes and curls.” Josie’s hair was almost a purple-black in the sun.
“Yep, I’m a mezcla. In Puerto Rico, it means a mix of Taino Indian, African slaves and white from the Spanish who colonized the island. I probably have some horny Spaniard’s golden eyes in my ancestry. Pure Puerto Rican.”
“You were a sex crimes investigator? I mean … I guess it’s a stereotype, but you don’t look like one!” Josie had a lean, muscular build and smooth skin in a hue best described as pecan. Her eyes were large and amber-colored. Her dark curls were pulled into a ponytail. “And what about your kids? How old are they?”
“It was easy to blend in. A push-up bra, some cheap makeup and heels and I looked like I belonged on the street. Ten years of seeing young girls return to vicious pimps did a number on me. I got injured and I wanted my daughters to have a nice, safe life with their dad and his new wife in a small town where nothing happens. Then there was the old Catholic guilt trip about being gay. That was ten years ago. They’re fifteen and sixteen now. Jade and Kira. Anyway, here’s where I get off,” she said, unlocking a metal door to the cafeteria. “I wonder what’s on the menu for today. Hasta luego.” She tipped an imaginary hat as she said goodbye.
Unaccustomed to this much chatter in the prison, I walked slowly to the medical unit, debating whether seclusion and Risperdol were the right choices for Emanuel. I wondered whether Mr. Koski would live out his life on the unit. Both had been sentenced for manslaughter and forgotten like old postcards never mailed.
As the afternoon wore on, the heat refused to budge. Rather than face a hot stove, I called for Chinese takeout from the office. After an eight-hour day, walking out of the prison filled me with gratitude for the simple taste of freedom, even if it was to go home and to do mundane tasks.
I pushed the door open with one foot, juggling my purse, keys and cartons of Chinese with both hands.
“Mommy, you’re home!” Dane wrapped his arms around my waist. I dropped the cartons on the table and scooped him in my arms, savoring his little-boy smell and holding him a second too long. “You missed my game!”
I rustled his unruly reddish curls. “I’m so sorry, honey. I had an emergency at work. I promise I’ll see the next one, okay?” Our ninety-pound yellow lab bounded toward me, threatening to knock me over, his tail whipping against my legs. “Sketcher, get down! Down, Sketcher!”
“You said that the last time. I’m hungry.” He turned away, and I saw Dane had long since outgrown the pudginess of toddlerhood and his jeans were an inch too short again.
I went into the kitchen, washed my hands and became “Mommy” again. I wanted to relish the feel of my arms around him. Since Matthew died, Dane and I had been exceptionally close. “Where’s Caleigh?”
“Here,” she called from the darkened living room, absorbed in the latest issue of Teen Magazine. Backpacks and lunch boxes littered the floor.
The children’s homework and notebooks covered the kitchen table. “Come help me clear the table, okay, honey?”
“Mom! Don’t put them there! The counter’s sticky. Dane spilled the jelly.”
I put the books on the floor and brought my hand to my lower belly, cursing under my breath at the painful cramps. Caleigh’s indignant whining was more than I could deal with. Once the Chinese takeout was in serving dishes, I had poured a glass of chilled white wine, hoping it wouldn’t exacerbate my headache.
Smelling the tangy orange chicken, Dolly, our elderly Persian cat, came into the kitchen and rubbed against my legs. Another reminder of Matt. He had named the cat Doll Face for her sweet nature and flat face but it was quickly shortened to “Dolly” once Dane began to talk and called her something resembling “Dolfae.”
The evening became a blur of homework and baths, which led to me being too exhausted to even try to engage Caleigh in conversation. Once the children were asleep and the house silent, I lay in bed with Dolly at my feet. I reached over to Matt’s side wondering if anyone would ever take his place. As tired as I was, it took me a long time to fall asleep.