the virgin mary

published in pot muck magazine, october 2015

“I’m not taking those fucking pills!” she screams.

“Mary, please.”

“Let me go!” she yells. Two security guards hold her arms. Another waits, just behind her.

“Mary, take the medication,” I say. I hold out the plastic cup.

“It’s poison! It’s going to kill me. That’s what they want!”

“Mary, I’m not here to hurt you. I’m a nurse. I want to help you.”

“You are a liar,” she says, “leave me alone! What kind of a nurse bothers a poor old lady?”

*****

Mary has been court ordered to be hospitalized for up to ten days, she is to be “compliant with treatment”. Her behaviors have been deemed harmful to herself. According to her chart, she stopped eating two weeks ago, fearful she was being poisoned. She lived on sips of water and packaged saltine crackers, never leaving her one room in the boarding house where she lived, not opening her door, not even when the police came to check on her during a four day long heat wave. They found her, disheveled, dehydrated, delusional, afraid, in a dirty robe, in a stifling room, windows locked shut, flies everywhere, food left in the sink, the place had the stink of garbage and unwashed flesh and rotting meat and urine and feces and something animal.

In the emergency room, she was combative.  She spit on the EMT. She was restrained to a gurney, and given 5 milligrams of Haldol, 2 milligrams of Ativan, and a ½ cc of Cogentin by injection. She has hydrated with IV fluids.  Once she was calm, and medically cleared, her vital signs normalized, she was wheeled, still restrained, to be observed in the psychiatric emergency department. They checked her respirations and pulse, they offered food which she refused. She did not speak. She would not answer their questions.

She arrived on our unit some 15 hours later.

In the Day Room, her first morning, she did not eat breakfast. during the Community Meeting, when the smiling Occupational Therapist asked her how she was doing, She would not respond, a fact that was documented in her daily progress note.

She did tell the psychiatry resident to “Fuck the fuck off, Fucking Fucker!” this was quoted and discussed at change of shift, among the nurses and mental health workers.

She submitted to being bathed the next day, but only because the counselor promised to use a special shampoo. She let her long white hair be combed. She ate lime jello, and drank half a pint of skim milk. She wore a clean Johnny that hung slack off her bony shoulder blades. She wore the green Styrofoam slippers that did not fit her feet. She wore the bracelet that had her name and unit number on it. She let the staff check her blood pressure. In some ways, she became a patient, but not in all ways. She did not go to any of the groups; therapeutic communication, morning stretch, occupational crafts, cookie time, art, afternoon check-in, current events.  She made no phone calls, had no visitors, spoke to none of the other patients, or to any of the staff.

On the third day, she did not get out of bed. She refused to meet with the hospital attorney, who would be presenting her case before the judge later in the day. She turned to face the wall when the director and the nurse manager came to explain to her that she was about to be committed for an extended hospitalization, and forced to accept treatment. Her breakfast tray when untouched. Her lunch was taken away, uneaten, as well.

By evening, her case was heard, and her commitment paper was signed.

From now on, she did not have the right to refuse meals, she would have to accept medications, she would be mandated to attend groups.

“Fuck you,” she says when I tell her this.

I hold out the medications the doctor ordered.

“NO,” she says. Her eyes are sharp and blue, unflinching. “I was named for the Virgin Mary,” she says. “You can not touch me.”

Someone calls Security. Uniformed guys escort her to the Quiet Room where she will be restrained to a bed frame and injected again with a cocktail of antipsychotic meds if she continues to refuse or threaten, the men hold her though she does not resist. She walks without struggle, the green slippers slap behind her along the shiny linoleum floor. Other patients watch as we pass the Day Room. The TV is blaring People’s Court. One guy winks at her. She gives him the finger. He goes back to eating his dinner.

“I’m not taking those God Damned pills!”

“Mary, take the medicine.”

“Fuck off.”

“It’s my job.”

“Get another job!” she screams.

“Take the medications for the nurse,” says one of the guards.

“Screw you, too, Barney Fife!” She spits.

“The court ordered you to take the medicine,” I hold out the cup.

“I was named for the Blessed Virgin!”

She struggles. The guards have her down in seconds. She is small, but they hold her. She screams while leather straps are wrapped around her wrists and ankles. Another nurse rushes in with the staff psychiatrist. “She’s refusing treatment,” the doctor says. He orders medications to be administered by chemical restraint.

Her Johnny is pulled up, her buttocks exposed. My hands do not shake as I swab her pale skin and feel for the gluteus muscle, she is thin, and I feel her papery softness through my latex glove. I have done this hundreds of times. It’s my job. She writhes and screams. She is held more forcibly, to keep her still. I inject her with two needles.

It’s over in a moment.

“You rapist!” she screams. I back out of the Quiet Room. “How could you do this to the Virgin Mary?” She cries.

When I pull off my gloves, my hands still tingle from the touch of her skin,

and the warmth of her fear.