Je Saurai Magazine

Here is a link to my essay in Je Saurai Magazine. This article will be in the upcoming print edition of the magazine as well.

http://www.jesaurai.net/jes/ms/337529981664.htm

My job

An average workday for me starts with my entry through a heavy brown locked door. It is early and sun streams down onto the austere stretch of concrete and perfunctory shrubbery that flank the entrance to my place of employment. I fumble through my bag for my picture badge and set of keys to let myself into the large maze-like office that houses nearly one hundred patients daily. My job title is “Program Therapist” at an intensive outpatient mental health program. Monday through Friday, I conduct group therapy with depressed, anxious, and otherwise mentally ill elderly people, although the patients actually range from being in their forties up to 99 years old currently. They come from their homes, assisted living centers, and nursing homes. They are all diagnosed with depressive disorder, and a variety of other secondary mental and physical issues.
After I enter the building, I pour myself a cup of watered-down coffee and stare at the mountain of paperwork that perpetually covers my desk. Billing through federal programs necessitates excruciating amounts of documentation, and I know I must sign my name and credentials at least one hundred times a day. A normal workday consists of running up to six sessions of group therapy, each lasting for forty-five minutes. I type a therapy session note on each patient for each session of individual and group therapy. A company rule states that all notes must be in before the end of the day. Some quick calculations would indicate that on an average day, I may write sixty or more session notes before I can leave for the night. Other frequent occurrences are writing treatment plans, admitting new patients, typing daily notes to communicate with nursing homes, keeping patient charts updated, and assisting our psychiatrist with patients. Less glamorous but also necessary are such tasks as helping serve lunch, rolling patients in their wheelchairs, assisting in the restroom, and the unpleasant duties associated with having patients committed to inpatient hospitals when their mental conditions worsen.
I know the day is in full swing when I hear my favorite schizophrenic patient rumbling through the hall making train noises and sharing that the locomotive that dropped him at group today had 200 cars! I sip my coffee and listen through the crack in my office door as patients shuffle or roll down the halls to their group rooms. Any variety of issues may arise during the hours from 9 to 3 when patients are present. A “normal” day at the program may involve diffusing arguments over buttermilk, house slippers, or an election from 1948. It’s not uncommon to walk in and find an entire room full of patients chatting about the people and creatures that they currently see in the room. Hallucinations have included a naked man named Neckbone, a little girl playing on the floor, and a vicious poodle. Jesus is not currently enrolled in the program, but many of his top officials do participate in group on a regular basis. We have self-professed martial arts masters, captains of ships, world travelers, and prolific playwrights. The truly delightful detail about the patients is that many of them have had admirable accomplishments and exciting lives to share with others. At the program, diagnoses range from the garden-variety depressive disorder to exotic things such as aphasia and paranoid schizophrenia. To compound the mental illness issues, many of the geriatric patients also have severe health problems. Items about which I have learned include Thick-it, a powder that turns drinks into a strange, gelatin-like concoction for patients with choking risks. I am now aware of the range of sugar-free confections available for people with diabetes. With my own two eyes, I have observed a seemingly sweet little old lady produced a clandestine prescription bottle from her purse at lunch. She glanced around the room to see if anyone was watching and, unbelievably, produced not an extra dose of medication to make the day glide by, but a simple mixture of salt and pepper for her meal.
The tiniest freedoms, disruptions, glitches, and joys take on proportions of great magnitude for people who are both aging and mentally ill. People like me who have both the pleasure and woe of working with such patients change and grow in a multitude of ways. I have learned about the painful feeling, as one sweet lady worded it, of being “throwed away” by family. I have seen the often sad effects that poor mental and physical health have on once-vibrant beings. I hear and validate the seemingly unavoidable grief that people experience when they lose their loved ones and their independence. These issues compose the stereotypical picture of what it looks and feels like to age in our society today. The gift that I have received in my work with mentally ill elders, however, surpasses the stereotypes and tragedies. My professional life has been opened up, and my skills strengthened. Even greater, I am witness to one of the most untapped sources of treasure available: the humor and wisdom of people, some of whom have been around for nearly a century. My patients are wise, humorous, experienced, and willing to share their mistakes and triumphs. They seek, at any age, a listening ear and a compassionate friend. The elders with whom I worked have taught me this if nothing else: we all need love, laughter, and respect, no matter what our age. This sentiment is well expressed by Lady Diana Cooper, a public figure who lived 93 years, when she stated, “First you are young; then you are middle-aged; then you are old; the you are wonderful.”

By Leslie Joseph