Drooling on the Pillow

Monday, July 18, 2005

Boulder River 

Last week I told a story of winding up in jail in Montana and skating away from most of the charges because the judge's wife . . . well, I won't spoil the end of my own story. I'm not a leaker.

After that near debacle I remained in Montana for around another year. I wasn't hurting for money because I was living for free in my girlfriend's boyfriend's house and driving his car. For a few months I picked up and discarded a few non-career path jobs, like fry cook and taxi driver, but eventually we acquired a few additional hangers-on and started to run a little short of salty snacks and I realized if I was going to continue to live a post-adolescent fantasy life, I was going to have to work for it.

Anne's brother, Rusty, and I answered an ad placed by the state of Montana for hospital workers. The money and benefits were very, very good for back then. I don't remember the ad specifically, but either we were remarkably careless readers (certainly a possibility) or there was a little deception in the writing, because there was nothing in it, the application or the acceptance that prepared us for pulling up to the Boulder River School and Hospital in Boulder, Montana.

It was a hospital for the mentally retarded, or developmentally disabled, if you must. Boulder is, if I remember correctly, around 40 miles south of Helena, with nothing but big sky and beautiful mountains any closer than that. There's a reason. Maybe not a great one, but a reason.

Until I went to work there I had no idea, and I mean not the vaguest clue, how wrong things could go when we come into this world. What a flarking miracle a person with normal abilities is. I saw things and dealt with them daily that have stayed with me ever since and I don't go too long, even now, without thinking of my patients.

For the first six months we were, essentially, orderlies and we spent half our day in class. At the end of the training period we received something called a Certificate of Nursing Care from the U of M and were assigned a ward.

My ward was Adult Non-Ambulatory Female. I had about 25 women, most of whom knew how to chew their food fairly reliably. I had one woman who was taught how to brush her teeth by a well-meaning nurse, but had destroyed her gums by the time it was taken away from her. And that was as developmentally abled as they got.

My job was to first give 25 enemas and then 25 sponge baths. Medicate. Take temps. Feed. Brush their teeth. Medicate. Turn over the ones who couldn't do it themselves. Report bed sores. Change their diapers. Check for menses. Change the kotex where appropriate. And, all day, every day, time their seizures.

Most of them were epileptic and among their medications were phenobarbitals. I would note the time of the seizure and the duration and the doctors would adjust the medication accordingly. Twice, while I was there, I had a woman whose seizures started coming several times an hour and then every few minutes. Both times I came in one morning and found their names off the meds list. The doctors wouldn't discuss it with me, but a supervisor confided to me that the phenobarbs were killing them faster than the seizures. One of them died after a few days. The other stopped having seizures as soon as she was off the meds and, by the time I left, was still fine.

I was the only staff person on the ward during my shift.

Rusty had a male children's ward and had a young fellow with spina bifida and hydrocephalus who could add any numbers you threw at him. Two hundred ten place numbers and he would give you the answer as soon as the last one was out of your mouth. There were a few other very mildly retarded patients who had been put in Boulder as children and now, for lack of stimulation, belonged there.

I don't mean to give the impression that this was a hell hole. The doctors were dedicated and the nurses and ward chiefs gave compassionate and comprehensive care to the limits of our resources. I never once saw an example of abuse or neglect. But the profound helplessness and, from my point of view, permanent disconnectedness of their lives was deeply affecting and wearing.

After being on the ward for four or five months I began to realize that, despite the fact that they had no language and no apparent understanding of the simplest processes of normal life, they did have personalities and they were individuals. There was a young woman I'll never forget who would, whenever I was at her bedside stare at me with the sweetest, happiest smile. She would do it all day if she could. Others would hurt you if you gave them the chance. I had two women who could not abide to have their beds next to each other. No idea why. Their positions were fixed from decades of laying in bed and even if you faced them away from each other they would scream bloody murder until you moved one of them. Some cried all day. Some laughed at any stimulus.

I think the thing that disturbed me the most and that comes back to me when I think of the women is that most of them seemed anxious. Worried. Like something was going to happen that they wouldn't like. You can't reassure them. You can comfort them, which you do, of course, but you can't give them peace of mind any more than you can provide it for yourself.

I left after about a year because I had to go back east. That's another story. I went on with my life. The women went on with theirs.
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