jane snyder

The elway cross

This was in 1986 when I worked swing shift, evenings, in the hospital’s psychiatric unit, in the five-bed Acute Care Unit, for patients who were psychotic or suicidal, in need of close supervision. Low stimulus, no TV, no radio. No glass containers, no belts, no shoes. 

It was a good job. I liked it so much I’d go in early, help at the front desk, hang out with the other staff in the conference room before report started.

In summer I rode my bike to work. Sometimes patients from the open side would be outside sitting by the fountain in front of the hospital. They liked seeing my bike, a sky blue Schwinn I’d had since I was a little girl, and they liked telling me about their first bikes. 

One afternoon I’d stopped to talk to Louise, a patient I knew from when she’d been in the ACU. She’d been so shut down when she came in she’d stopped caring for herself, needed reminders to put the food in her mouth, chew, swallow. She’d responded well to meds, was about to go home.

If I stuck some playing cards in the spokes of my bike, Louise said, it would make it sound like a motorcycle. Her kids used to think that was cool.

I enjoyed being teased by Louise.  

Adam, a nurse who’d just transferred to psych from respiratory, came by then, ran a hand over the bike’s white leather seat, said maybe we could go for a ride. 

Louise looked coy, as if Adam was asking me for a date. 

Adam wanted to know if I had another bike. I’d heard him talking to patients about his specially balanced road bike. It cost more than a thousand dollars, he’d said, but so worth it.                                                                                                

               “This is the only one.”

“I wouldn’t be interested in going with you then, not if you can’t keep up.”

“Well, that,” Louise said after he’d left, “was not very nice.” 

Ordinarily I’d have kept smiling, denied taking offense, but I’d been the one to help Louise through the tasks that had become too much for her, tell her to unscrew the cap from the toothpaste tube before squeezing the toothpaste onto the toothbrush bristles, a little more toothpaste. 

“It wasn’t.”

My parents didn’t like me working there, said a psych attendant, a PA, which is what I was, was no better than a nurse’s aide.

I’d had awful jobs in my 20s, at a daycare center where they tried to get out of paying minimum wage, that kind of thing, and this was my first job with benefits. The money was good, too. I got a little apartment in a handsome old brick building near the hospital, bought myself clothes I liked, got contact lenses, had my hair color glazed.   

My parents wanted me to go back to school. Anybody can be a teacher, they said. Get a teaching certificate.

I applied to a graduate program in social work instead. That’s how I’d met my boyfriend. Jon was in the program too. 

In September he asked me to marry him. I was slow to let people know. There was something about saying I loved and was loved in return that made me shy.

We were so busy at work then I don’t think anyone noticed how happy I was.

Tim, the nurse in charge of the ACU, called it the zoo, the ACU Zoo.

When he assigned Randy to me, Tim called him needy. “He gets on my nerves. He talks too much. Like you.”

I thought Randy was interesting. He’d grown up in institutions, read every book available, knew more words than a college professor, though not always how to pronounce them. My blouse was chic, he told me once, saying it chick.

He was waiting for me by the ACU door one afternoon after report to tell me his doctor had given him permission to wear his own clothes instead of the no-tie hospital pajamas. “He thinks I’m doing good.”

“You surely are.” 

Randy was my age, thirty, but his cystic acne and reedy voice made him seem younger, stuck in a particularly cruel form of adolescence. 

When the police brought him to the hospital the week before, Randy was seeing assassins who could follow him anywhere, through walls, through telephone wires, no getting away from them. He was already wet with sweat from struggling with the police but he fought us too, five of us sprawled across him as if in a game of Twister, till we got hold of his thrashing limbs and Tim injected the Thorazine. 

Randy had been in pajamas since. The clothes he was wearing when he came in, stored in the ACU locker, were the only ones he had. I offered to wash them so he’d have clean clothes for the next day.

“I hate for you to do that.”

There was an intimacy to handling his clothes, stiff and salty with sweat, cheap, worn, the underpants stained.

It’s no trouble, I told him.  

“She does it for everyone,” Tim said.  

Randy didn’t have a choice; the patient laundry room was on the open, unlocked side of the unit, and he couldn’t leave the ACU.

Some patients couldn’t remember how they were when they first came in, when they’d been actively psychotic or hypomanic. Others made a joke of it, said it’s hard to believe, isn’t it, how crazy I was. 

Randy approached each of us in turn a few days after he was admitted, wanted to know if he’d hurt us, apologized. The police had carried him into the ACU. His ankles were shackled and he was handcuffed behind his back, but he jerked his head back and forth, bit, rammed, spat.   

The police stayed long enough to help us get Randy down on his stomach and take back their cuffs and chains. 

We had him on the floor because it was safer than the bed, less risk of the patient suffocating. Tim assigned positions, put me on the right leg. He was straddled across Randy’s lower back, facing me, glared when he saw I couldn’t hold the leg still. 

It is all but impossible to kick hard for long when lying on your stomach, but Randy kept going, lifting from the hips, and I struggled to stay on. Wanda, the medication nurse, I saw, had a firm grip on Randy’s left leg, held it in place. 

Adam came in, looked down at Randy. “Looks like you’ve got it under control,” he said to Tim’s back. He must have gone to McDonald’s on his break because he had one of their big drinks, and he sucked some up the yellow and red striped straw. “This guy made a racket just now, upset some of the patients. I’ll be at the front desk, in case any of them need to talk.”

Tim had pulled Randy’s jeans and underpants down a little. With his right hand he was wiping the exposed bit of Randy’s pale flank with an alcohol pad; he’d put his left hand next to mine on Randy’s right thigh, slowing Randy down. “Knock yourself out.” 

The Thorazine took the fight from Randy. He let Tim clean and dress the sores he’d gotten struggling, slammed down cup after Styrofoam cup of the ice water I brought him.

“Easy, partner,” Tim told him. “You’ll suck that cup straight up your gullet.” 

Randy still looked frightened, but he smiled.     

I wasn’t hurt, I said, when he apologized to me. It’s okay.    

I ran the clothes through the wash cycle twice. Adam came in as I put the wet clothes in the dryer. “So Tim’s got you doing his laundry now. When do I get a PA to take care of me?”  

I went back to the laundry room an hour later, was bending down in front of the dryer, taking the warm clothes out, when I felt something, hard but uneven, press into my back and a man’s voice say, “This is a stickup.”

Not a gun, I knew, even before I screamed. A hand. I could feel strain in the pressing. And not a patient, I realized a second later; seriously mentally ill people aren’t well-organized enough for pranks. 

I knew it was Adam, even before he clucked his tongue, pulled me back into his chest, stooping a little to form a shelf, a lap he pushed me into. 

“My goodness. Oh, my goodness. Oh, no. Oh, you’re so scared. Don’t be scared, honey. I’m here.” That was the worst part, even worse than when he tightened his hold and I felt, through the layers of our clothing, the warmth of his groin, his penis springing up. “I’m here.” 

I broke away. Tim, who’d heard me and was on his way to investigate, let me back into the ACU.

A joke, I said. I’m fine. 

I don’t think so, he said. Take a break. Maybe you should go home.

No, please. 

The patients on the open side were in bed or getting ready. They’d heard my scream, wanted to know what was going on. The staff had a time of it, settling everyone back down for the night. 

When Jan, the charge nurse, asked Adam what happened, he chuckled a little, seemed bemused by the fuss. I’d jumped five feet, he said. He had no idea I’d do that.

Wanda said if it had been her, she’d have kicked him in the nuts. 

Tim, Randy, and I were in the ACU patient dayroom. We could hear them because a door in the ACU opened onto the nurses’ station. Tim closed it.

Randy thanked me again for washing his clothes. “They’re so clean they look brand new.”

Tim told him he sounded like a Tide commercial.

   Randy laughed, answered in a high-pitched voice, “‘I wouldn’t trade my Tide for twice as much of the other leading brand.’”

I felt better when I heard Randy ask Tim if he could recommend something for his acne.   

Accutane is the most efficacious, he said, the gold standard. Tim was straightforward with patients, didn’t patronize. I liked listening to him.   

The problem is, he said, it’s associated with increased depression, even suicide. The doctor is going to think it’s too risky to prescribe it for you.

Maybe he should just accept it, Randy said, but I still hope something can be done.  

Tim said his wife’s younger brother had been prescribed a topical application that reduced the redness in the nodules. Not a cure, but why don’t I write your doctor a note? 

  Jon came to see me the next morning, as he did on days when we didn’t have class. If, as they often did, a patient, a client, expressed the belief they were treated badly because they deserved no better, I’d work to help them see themselves as they were, worthy of respect, even love, but I didn’t tell Jon what happened, didn’t want him to think less of me. 

We’d have plans for our mornings, talk of going for a walk or out to lunch, and sometimes we did, but mostly we ended up in bed.

That morning I told him I thought I was coming down with a cold. “We don’t always have to have sex,” Jon said when I apologized. “That isn’t what this is about.”

I said I’d be fine next time, and we sat side by side at the kitchen table, quizzing each other on the Diagnostic and Statistical Manual of Mental Disorders III, preparation for our Social Work Diagnoses test.

When it was time to get ready for work Jon sprawled on the bed, talked to me through the open bathroom door while I put on my makeup, made myself pretty, as I called it.

You don’t need it, he’d say, always so serious. You’re beautiful just as you are. 

It took some getting used to, the way Jon was, is, with me. 

I waited till 2:58 to go into report, not wanting to see Adam.

He wasn’t there. Wanda, looking pleased, told me Allie, the nurse manager, had come in a few minutes earlier, asked him to come talk to her.

The way it worked at the hospital, if you were in serious trouble, they’d send you home for the day at the beginning of your shift. If you messed up again, you’d get a two-week suspension. Anything after that could get you fired, but that didn’t happen much in psych.

Tim told me this was because it was hard to get people to work there. “If you’re wondering why we let you stay.”  

I didn’t think Adam was in serious trouble, not because of me. Allie would have heard about my screaming from Jan, and she’d probably tell Adam people need to blow off steam sometimes, sure, just remember where you are.

If Allie wasn’t going to ask me what happened, I thought, I didn’t need to tell her.   

When we went into the ACU and saw Randy in his own clothes we told him he looked like a million bucks and Tim offered to call his doctor for a pass so they could go to the open side TV room to watch the game that night, the Denver Broncos vs. the Pittsburgh Steelers.

Tim loved football, might have rescinded his offer if Randy had asked to watch something else but Randy was excited, shared Tim’s enthusiasm for John Elway, the Broncos’ quarterback. 

At the start of the shift, I’d set up art projects on the big table in the middle of the ACU dayroom.

We made tissue paper collages that day. You spread a little watered-down white glue on the paper and then covered the paper with pieces of colored tissue paper. No skill required, and we liked seeing the new colors formed when the wet pieces of tissue paper bled into each other.

I had a new patient, Seth, a college freshman who’d slashed his left wrist in the shower of the communal bathroom in his dormitory. When the county designated mental health professional interviewed him in the ER, Seth was sullen, wouldn’t promise not to hurt himself, ended up getting detained “as a danger to himself by reason of a mental illness.”

He kept his bandaged arm in the folds of his pajama top. When he sat down with us I laid a book on one corner of his paper so he wouldn’t need to hold it in place. 

My patient Harriet, an 83-year-old Black woman who hadn’t fully recovered from a stroke she’d had six months earlier, became sad and restless in the late afternoon, missing her daughter, we thought, but she became interested in what the others were doing, joined in. She liked tearing the tissue paper and Randy said she ripped it so fast it made him think of the sounds a Ninja warrior’s sword makes cutting through the air. 

Harriet beamed at him. “I just enjoy this young man so much,” she told me, sounding like the second-grade teacher she’d been for thirty years. 

After her stroke, she’d begun relieving herself in corners. Adult diapers were no use, no matter how securely fastened. Harriet would pull them off, tear them up, leave what she’d shredded beside the feces or urine. 

Purposeful, the doctor said; Harriet’s actions were purposeful, there was no medical reason for them, and he talked Harriet’s daughter Lettice into admitting her to the hospital.

Whenever Harriet could be persuaded to sit on the toilet, we were supposed to give her M&Ms. She’d slap them from our hands, stay on the lookout for corners.

Lettice said we were treating her mother like a two-year-old.

I’d seen research on altering associations as a way of disrupting problematic behaviors, got permission to tape pictures of flowers in Harriet’s bathroom, more pictures leading from the ACU dayroom down the hall to Harriet’s room and into the bathroom. Lettice said Harriet liked to garden before she got too weak.

Harriet and I would walk slowly through the day room and the hall, stopping in front of each picture to examine it as if we were in a museum, her telling me about them. When we reached her bathroom, I’d leave her to go or not.

Lettice said it was just another way to disrespect her mother, but the pictures worked. Even after we began taking them down, Harriet continued to use the toilet.           

Adam returned to work around four; I’d heard him in the nurse’s station arguing with Jan about when he would get his break.   

Harriet was fascinated by Seth’s collage; we all were. He’d made an ocean floor scene, murky with blue and green papers piled on thick, a large, clumsy fish from several layers of dark gray paper over that.

“It’s so quiet down there,” Harriet told him.

I cleared the table when it was time for dinner. The patients on the open side had their own dining room, got a choice of entrees, but I brought food from the kitchen on Styrofoam trays to the ACU patients and we ate together. 

Tim and I sat at either end of the table. This was so we could reach patients who needed help, but Randy told me once he hoped I wasn’t offended and please don’t tell Tim, but he liked imagining we were his mother and father and we were having dinner as a family.

Randy didn’t have a place to go. The group home where he’d been living before he got paranoid and ran away would have taken him back, but they’d filled up. 

Harriet was going home that night. Harriet’s doctor wanted her to stay longer, thought she might continue to improve, pointed out that Harriet couldn’t remember her own daughter’s name. Lettice said she didn’t care; she missed her mother. 

They’d told her on day shift she was leaving, but Harriet looked worried when I helped her dress in her own clothes. She wore compression socks and I knelt in front of her to pull them on, slide her feet into the shoes she hadn’t worn in four weeks. “Because you’re going home after dinner.”

I had big fluffy bangs then and Harriet reached over to push them out of my eyes. “You’re sweet,” she said, “but I just don’t know.”   

It was pork chops that night, boneless, but still hard to cut with plastic cutlery.

I disliked the oily feel of the meat in my mouth but I was brought up to clean my plate. Randy, too, always ate what he was given. The older patients, Harriet, and Dot and Belinda, two elderly women awaiting nursing home placement, considered pork a treat.

Seth thanked me for cutting his meat for him, didn’t eat much.

“You might like some of the other food here better,” Randy told him. “Sometimes we have taco salad.”

When I passed out the little cardboard cartons of raspberry sherbet and Tim wondered aloud why his favorite part of the meal was the smallest, Seth laughed and the rest of us smiled to hear him.

Lettice came right at five, drummed her fingers on the table as she waited for the meds Harriet was going home with to be delivered from the pharmacy.

Harriet didn’t get excited till I unlocked the ACU door. “Oh, honey!” She clutched Lettice’s arm. “Honey!”

I thought it might bother the others, being left behind, but Randy and Tim started talking about what Miss Nancy on Romper Room really said to the Magic Mirror.

Romp, Bomp, Bomp, take your nap or I’ll stomp, stomp stompy you, Tim claimed.

Dot and Belinda thought this was hilarious.

Romper, Bomper, Stomper Boo, Seth said, with an air of authority. Tell me, tell me, tell me do. Did all my friends have fun today? 

Tim and Randy waited till I got Dot and Belinda ready for bed before they left.

  Seth looked tired and I thought he’d go to bed too, but he asked to talk and I sat with him on the low plastic couch next to the door to the nurses’ station.

He’d messed up, he said, was failing every class. He was ashamed to face his parents. He’d let them down, he’d let everybody down. 

I let him cry, loud, gulping sobs, knew not to say it wasn’t as bad as he thought.

Adam stepped in for a moment, made a face of amused disgust.

Seth had pushed his face into the couch’s thick plastic cushion and didn’t see.

I handed Seth a box of tissues. When I looked up, Adam was gone.

Seth had refused to sign a release of information for his parents so, per protocol, when his mother called, we told her, “I’m sorry, I have no information about anybody by that name.” 

After he was done, he asked to call them, get it over with, he said. I’d taken the call from his mother, guessed he didn’t have anything to worry about, but I smiled encouragingly, as if he was taking a real risk, told him to wash his face, drink a little water first, and maybe it would go better than he thought.  

The ACU didn’t have a phone. You took one from the nurses’ station, plugged it in, sat within arm’s length of the patient because the cord could be used as a ligature.

I tried not to listen but, when the person on the other end was loud, or excited like Seth’s father, you’d hear.

He told Seth what you’d hope he would: “Nothing matters except that you’re alright. Whatever it is, we’ll get through it. Never do that again. We don’t care about school. Oh, son, we were so scared.”

When he hung up, Seth asked me how much longer he’d have to stay in the hospital.

Tim and Randy came back in high spirits, saying Elway had kicked ass. What if it was only their second game of the season? They knew the Broncos were going to the Super Bowl.

Tim went to Seth’s room to put on a fresh dressing on Seth’s wrist and I could hear Seth’s soft, sleepy voice, then Tim’s, darker and deeper, wishing him a good night.

“College Boy says you got him squared away,” Tim said when he came back.  

Near the end of shift we were in the nurses’ station, drinking sodas, goofing off. Jan was telling us about the party she was planning for her son’s seventh birthday. The rest of us didn’t have children, and we thought she was funny, worrying she wouldn’t be able to find the Spider-Man piñata the birthday boy wanted.

But, she said, she did have a little present for each child so they’d all have something to go home with, even if they didn’t win a prize at the games, because the one thing she did not want was hurt feelings.

Wanda thought it would be more exciting for the children if they competed for one big prize, fifty dollars, say. She suggested a game of dodge ball, with rocks instead of a ball, the last man standing to receive the purse. 

Tim said no, that would be cruel. “You know what little boys really like? Knife fights.” 

Jan was giggling, saying we were terrible, when I sensed, rather than heard, Adam behind me, making me turn around.

“I need to apologize.” 

“I have to apologize,” he said again, speaking loudly and slowly. “For scaring you.” 

When he said scaring, he held his hands up, palms out, and raised the index and middle finger on each hand, wiggled them.

Quotation marks.

Ordinarily, when someone apologized to me, I would say no need, don’t worry about it.

I looked down at my own hands.  

“If this is the worst thing that’s ever happened to you, Cathy, consider yourself lucky.”

You can keep yourself from crying, or from laughing, if you press your tongue hard against the roof of your mouth. 

Adam sighed, leaned back on a counter.

Fine, I said. Alright.

After Adam left, the others said it was a piss-poor apology, and I should tell Allie, not let him get away with it.

I saw Adam once after I’d left the hospital. I was pregnant with Tad, past my due date, and Jon and I had gone to a show at the dollar theater, figuring even if we didn’t like the movie we’d be a couple of hours closer to the baby being born when it was done. The theater was half-empty and I noticed Adam sitting in front, alone. I had to get up to go to the bathroom twice during the show, hoped he didn’t see me on my way in and out. 

When we went into the lobby after the movie, he was there, standing on the other side of the room, smiling at us both. 

I didn’t want to introduce Jon to Adam, didn’t want to have to smile if he said something about my pregnancy. Bet you can’t wait for that baby to come out.

I pretended not to see him. “What do you know,” I said to Jon. “I have to go again.” 

I saw Adam’s face for a moment before I turned away. He might have looked hurt.    

I didn’t leave the job right away, of course.

Lettice came the day after she took her mother home with two dozen long-stemmed scarlet roses for me, each blossom big as a child’s cupped hand.

She also brought a friend from church to see Randy. The friend owned an apartment complex and he offered Randy a job as assistant manager. Free rent and two hundred dollars a month so he’d maintain his eligibility for SSI and medical coupons. The friend knew about mental illness; he’d had a cousin with schizophrenia. 

Randy wasn’t inclined to look a gift horse in the mouth, but Tim, though he was polite, had questions.

You’ll need to stay on your meds, Randy’s new boss told him when Tim was satisfied.

  Nothing wrong with that, Tim said to Randy. You’re a mess without them.

True, but it was also true Thorazine dulled Randy’s thought processes, slowed him down, made him fat and impotent.  

When we charted that night, I offered Tim the roses for his wife. He asked why I didn’t want them. I hadn’t thought of having to explain, to say the gift was too fine for me. 

I said the card Lettice had given me with the flowers was all I wanted. “Anna will love them.”

“She would,” he said, gently pushing the flowers, in a vase I still have, back to me, “but these are yours.”

On Christmas Day, the ACU was empty at the start of the shift. Enjoy it while it lasts, Tim said, predicting, correctly, that it would be full again before we went home that night. I’d been trying to review one of my textbooks from the coming quarter but Tim had gotten me interested in a Sports Illustrated article he was reading about the home-court advantage. He thought some of those “behavior modification techniques you know about, Cathy,” could be used to help the players with this, and I was telling him I thought it might also be possible to reduce aggressive fan behavior by making the way into the stadium less crowded, when Randy came, bringing us a two-pound box of Mrs. See’s Gold Fancy Chocolates.

He was great, he told us, couldn’t be better. “I’ve been using that acne cream you told me about, Tim. Do you think the red might have faded some?”

“Definitely.” 

Every other Tuesday his boss took him to the community mental health center for his Thorazine shot. He had to lie down for half an hour afterward. His boss waited, then took him to lunch at Denny’s, told Randy he was doing a good job. 

We talked to Randy before he left to help serve the turkey dinner at the Mission with his new friends. 

Tim wanted to know who he thought would win the Gator Bowl on Saturday.

“It’s gotta be Clemson.” 

Tim agreed but said you couldn’t count Stanford out because who was their coach? John Elway’s father Jack, that’s who.

I said I’d heard all I wanted to hear about Elway for the rest of my life.

This, according to Tim, showed how ignorant I was. “I’ll bet you don’t even know what the Elway Cross is.” 

Randy had told me when he was a patient. I’d asked if it had anything to do with the Hail Mary Pass. A stupid question, apparently, though Randy didn’t say so.

“Certainly I know.”

Randy’s delighted gasp should have tipped him off but Tim kept going. “Tell us, smarty pants.”  

I stood, clasped my hands together in the manner of one about to declaim. “Elway throws so hard, sixty miles an hour, the seams on the point of the ball leave the mark of a cross on the receiver’s chest. If he puts his hands up to catch the ball, he’ll get his fingers broken. I’m surprised you didn’t know that, Tim.” 

He laughed so hard he spat chocolate spit from the nice candy Randy gave us.

God, we had fun.

I got jobs with more money, jobs with my own office, jobs where I didn’t have to help restrain anybody, but I never liked any of them as much as I liked working in the ACU.

My problem was I’d thought it was one thing and it turned out to be another.

JANE SNYDER'S STORIES HAVE APPEARED IN BLUE LAKE, ATLAS & ALICE, AND UMBRELLA FACTORY. SHE LIVES IN SPOKANE.