“There’s no water in the woods,” Pat says. “And no blankets neither.” I sit beside her in the hallway, watching the other clients wander around. “There’s no food in the woods,” she tells me. “There are ‘sssssss’.’’ She holds her arm up, wrist bent in the approximation of a snake. “They’ll bite you.”

“That sounds scary,” I say.

She nods like I get it. “You should get some boots or gaiters so they can’t get you.” She points at her round knee. “Leather up to here.”

A few weeks ago, Pat left her group home and lived for six days in the woods of Oregon. They finally found her, dehydrated, hungry, and delirious. Now she’s at the inpatient psychiatric facility where I work as an occupational therapist.

Pat has rotten green-black teeth and a ropey scar above her hairline where her skull was cracked open and never put back together right. Her white cheeks are fat and round, and when she smiles, I feel deep in my bones that I’ve done something good in the world.

“I wanna get blankets, soft ones, and throw them at homeless people,” she says. “There’s no blankets in the woods.”

“That’s nice of you,” I say. But we can’t stay here talking all day. Pat has treatment groups to attend in order to leave the hospital. “What classes are you going to today?”

She screws up her face, expression turning mischievous. She’d been hoping to skip. “What’re you teaching?”

“Sensory connections and pain management.”

Pat heaves a great put-upon sigh and heaves herself up. “Alright, I’ll come, but I’m not talking.”

——

People with brain injuries and psychotic illnesses often experience sensory abnormalities, so occupational therapists teach them strategies to manage the emotional distress that can come from being overly sensitive to sound or so unaware of your physical sensations you don’t notice when you run into things.

It’s actually a lot of fun.

Today there are four clients in class, three sit in the circle with me, and Pat sits in the corner with headphones on, watching us. We stretch and talk about how our bodies feel. When people lose focus, I have them stand up and get in a circle, so we can play a game and toss a big rubber ball around.

“Give me the ball,” Pat says, accentuating the word “ball” in a way that makes another client, Samuel, titter. He straightens up when I look at him—all six foot five of him with a scraggly, gray beard—as though he is scared I will put him in detention.

A client throws the ball to Pat, and she says, “These are big balls. Where’s the sausage?”

I hold my hands open to signal Pat to throw me the ball, and she does. “Alright, folks. Let’s get back to our activity.”

“No more ball jokes?” Samuel says, glancing at Pat as they share a conspiratorial smile.

“You can make all kinds of jokes,” I say. “Let’s just make sure they are appropriate for group.”

It takes a bit of the wind out of their sails. Still, every time Pat or Samuel catch the ball, they pause and look at one another and begin laughing again.

We do a few yoga poses next. I widen my stance, open my arms wide, and face one side. “This is called Warrior Pose,” I say. “Benet, what does your warrior sound like?”

Benet’s gray hair always hangs in front of her face. She’s a poet when she walks in the garden, telling me the words the daisies are singing and the bells that ring when the wind blows through the lilac. Today, she shakes her head quickly, shoulders stiff.

“I know!” Pat says. “Mine sounds like grrrrr grrruf.”

Samuel goes, “Balooga! That’s mine.”

The third client, Arnie, makes a noise that sounds like a dolphin, and everyone claps and cheers for him.

By the end of the class, they are all loose-limbed and relaxed. I’m not sure if they learned anything, but at least they laughed. I’m full with the joy of it, laughing along with them as I walk them back to their unit. Samuel and Pat promise to come next time, and Benet says she’ll think about it.

Later, I tell Crystal, the unit social worker, about Pat’s jokes. They were inappropriate but ridiculous enough to be harmless. It’s good for Pat to be playful, for her to be friends with other patients.

Crystal says, “We need to talk about Pat’s hypersexual language.”

I don’t know. I just thought we were having fun, but she’s reminding me of a line I often cross. I’m a therapist, not a patient. I can’t pretend I’m one of them.

Not anymore.

——

The first time I was hospitalized, I was twenty-one and still a Christian. My husband drove me to the inpatient psych unit in Chattanooga, TN, where I surrendered my shoe laces and peed with the door cracked open. They kept me for three days.

The second time I was hospitalized, my best friend drove me in, because I had run away from the church and my husband. I did inpatient treatment for six months, carried around a stuffed animal, got put on fancy medications before they released me into the wild.

I couldn’t go back to my family and my church had excommunicated me–barred me from the blood and the table. Once in high school, my English teacher had  showed me pictures of the Pacific Northwest and we’d talked about building a cabin there. So with nowhere else to go, I drove my little pickup truck up to Portland and slept on someone’s couch until I learned how to rent an apartment.

I haven’t been hospitalized since then and have gone on to earn my master’s degree in occupational therapy. But I still feel more like a patient than a practitioner. I have money, education, whiteness as buffers, but I’ve also been the one trapped behind locked doors.

——

The next day, I find Pat in the client’s milieu holding a biology textbook from the hospital library. She gestures for me to come over. Once I’m seated, she glances around to make sure no one is watching and opens the book to an anatomical drawing of a nude man.

She plops two sealed packets of Tabasco on the man’s genitals. “If one comes for you, put this on his hot dog and buns and he’ll leave you alone.”

She rolls up the navy pants she has been wearing for days, revealing tall black socks. Underneath the socks, she fishes out two more packets of Tabasco and hands them to me. They are warm and wet and precious. I say, “Don’t you need these?”

She smiles like I’ve said the right thing. “You’ll need them, too. I’ll get more at lunch.”

She waddles off before I can say thank you. And I know I should do something with these, throw them away, maybe, but I keep them in my pocket, and they make me feel warm all day.

——

Once, my wife and I went to a Unitarian Church in Eugene, Oregon. After the service, they served cookies for newcomers and made small talk. Someone asked me where I worked, and when I told her, she said, “Ew.” She said places like that should be shut down and walked away.

She’s not entirely wrong. You can’t get well behind barbed wire fences. But their options in Oregon are prison or the streets. Better treatment is not available for people who have been found to be not guilty by reason of insanity. It’s the best of our bad solutions.

When people ask me why I work inpatient psych, I tell them about how we criminalize mental illness and that everyone deserves a healing space. I say I love my patients and my work.

I don’t tell them about the night in fifth grade when I crept up the creaky stairs and sat outside my little brother’s room. Previously, I had been my father’s main target, the one he apologized to with boxes of sickly-sweet hard candies. But this time he’d taken my brother.

I wanted to scream or bust into the room. Instead I sat frozen, unable to make out what was going on inside. Finally, my father opened the doorway, stepped over me without saying anything and went downstairs.

When I entered his room, my little brother stared at the ground and wouldn’t look at me. He knew I had done nothing to protect him.

I’ve spent my life atoning for that sin. For that betrayal. Hoping that if I do enough good things, that broken part of me will be patched over.

——

I find Pat barricaded in the dining room a few days later. She’s moved all the chairs and tables so no one can see her and has been shouting for people to leave.

“Can I come in?” I say, knocking on a chair like it’s a door. She nods and I clear a path in, and ask the security guards to watch from the hallway instead of in the room.

After sitting on the floor next to her, I say, “What’s going on?”

“They came to my room last night,” she says. “No more. I can’t do it. If they—” she breaks off sobbing. “If they’d just have sex and leave, I could take it. But they beat me.” She lifts her shirt to show me her rubbed-red skin. Hiccups punctuate her words, her chest heaving.

“That sounds awful,” I say. Being assaulted by staff is a frequent delusion of hers, no less terrifying for its lack of reality. It’s real to her.

She nods her flushed face and wipes at her eyes. “The nurse lets them. She slips me pills to make me pass out.”

I say, “I’m sorry. It sounds like you don’t feel safe.”

She nods her head in agreement.

“What can we do together to help you feel safe?” I hate myself a little for saying it. It feels so clinical. So separated from the immediacy of her grief. I want to hold her hand and cry with her, to buy matching knee-high boots to protect us from snakes, to be human with her and not the half-human I’m forced to be when I’m at the hospital.

Pat shrugs and hunches over, hugging herself.

At a loss, I say, “Do you want to see a picture of my dog?”

Pat nods, and I pull out a photograph of my black lab. In it, he’s panting and splattered with sand from running along the ocean. Pat traces her fingers along his muzzle, around the graying fur by his eyes.

“He’s seen some things,” she says. “Bad things.” She continues moving her finger, petting down his flank and his long legs. “But he keeps going. And that’s good.”

——

Later, I file a report with security about Pat’s claim that staff raped her. The security team pulls staffing records and the video feed from the hallway. No one entered her room, and the staff she claimed assaulted her weren’t even on shift.

I knew that already, but we have to investigate each time she makes a claim. Outside of the hospital, Pat has been raped, multiple times, and has two children to show for it. CPS took them before she got to hold them. She was deemed unfit before they were born.

Pat says she reported her rapes to the police, but they didn’t believe her. No one believes a fat homeless woman with rotten teeth.

I get it.

No one believed me either.

——

While I was in treatment, I finally got the courage to tell my mother about what my father had done to me. My dad makes enough money to keep her in a big house on Walden Mountain with a large garden. It’s a comfortable prison.

“If you believe these things about your father, I can’t speak to you anymore,” my mother had said. It might have been tidier than that. Something like, “we can’t be in a relationship anymore.” Something Southern, nicely said, but devastating.

It hurt like a blow to the head, and when I came to, my ears were ringing. I had been naïve enough to think that people who told the truth, who courageously risked everything, would be understood, celebrated.

It didn’t matter that friends of my mother had told me my dad was “creepy.” That Mom had nightly witnesses to his screaming fury. That she herself had called him cruel. She chose him over me.

I suppose that’s a type of courage, too.

All these years later, I wonder if she ever feels the need to atone, like I do. If she’s out there helping people in hopes it will fill her brokenness.

——

Linette, a nurse, calls me to the unit because Pat is having her delusion about being assaulted by staff members again. She’s scratched pock marks in the skin on her forehead and all over her scalp.

“There’s bugs in the woods,” she says. “They’re in me.” She leans her head forward so I can see.

When Pat becomes distressed, she believes bugs have burrowed into her skin and tries to pick them out. The nurses have lice treatment shampoo that they let Pat use when it gets bad enough that she bleeds. She’d use it every day if she could, but it’s toxic stuff.

“Linette told me you are having a hard time,” I say. “Do you want to talk about it?”

Pat shakes her head and leaves the room. The swelling in her legs has gotten worse, and now she toddles side to side when she walks. Knowing she’ll come back, I wait and look out the window.

Solipsists believe they are the world, and everyone is a product of their imagination. Sometimes I wonder if that’s what I am. Just one part of Pat’s imagination, present only for her flashes of empathy, terror, and inspiration. She seems more real than me. Full fleshed right up to the edges. The more I work at the hospital, the more I feel hollowed out or like I’m what’s left in a pan when you take out the bread. Scraps.

Pat returns in a few minutes and by the look in her eyes, I can tell I’ve passed some kind of test.

“They drugged me last night,” she says, her voice low. She glances around and leans forward as though she’s afraid another client will tell on her. “But I woke up.” She pauses and looks me in the eye, so I’ll know she’s serious. “Next to a dead body. They’re killing us old people and taking our bodies somewhere, and nobody’s doing nothing about it.”

“That’s scary.”

She wrinkles her nose, and I amend my statement. “Sounds terrifying.”

She nods, licking her cracked lips.

“It sounds like you don’t feel safe,” I say. If she minds that I’ve said this exact thing to her several times, she doesn’t show it. “Would you like to go on a walk?”

Pat shakes her head.

“Would you like to do some stretches together?”

Pat shakes her head again and stands up before I can suggest anything else pointless. “I wanted you to know.” She takes a few steps away and then turns. “Don’t tell my doctor. She’ll think I’m lying and make me take more meds.”

“I can’t keep secrets,” I tell her, and it guts me to say it. It’s the clearest indicator that there’s a power differential between us.

She looks at me; her face a screwed up mix of anger and disappointment. “Snitch,” she spits out.

I go to the charting room to update her nurse. It’s a locked room with big glass windows the clients can watch us through. Being in there makes me feel like a zoo animal in a closed habitat. Pat sees me go in, and she stands there watching, her face twisted into biblical fury as I talk to other staff members.

She doesn’t speak to me the rest of the day.

——

It hurts not to believe her. Not because I want her to have been raped, but because I know how devastating it is to have someone you trust not believe you.

When someone gets gangrene, the fully rotten part of their foot is not the part that aches. It’s the edges, the pain in the half rotted alive flesh that is excruciating.

Not being able to believe Pat aches along the dead and alive parts of me. It’s a reminder that I’m powerless, able to provide moments of comfort but any healing or helping is putting myself at the center of her story. Her story starts before me and stretches beyond, I’m a witness and a companion, nothing more.

I hate it. I hate having to pay attention to my own rot, to realize I have to excise the decayed flesh instead of cover it up. I hate realizing that the child of me, crouched outside my brother’s bedroom door was as helpless to save him as I am to save Pat.

I go home from work that night and sit in my closet until I come back to myself. I’m trembling with the effort of the day. When I was younger, I used to hide from my father in my closet or in the tight spaces of our attic where he couldn’t see me. Now closets are the only place that help me reassemble the pieces of myself. I’ve put blankets and pillows in there to make it comfortable, and emptied out all the clothes. My dog can’t fit inside, so he sits beside the door, keeping me company.

I eat dinner with my wife and then read until I can’t hold my eyes open anymore. Still, I lie in bed, unable to fall asleep and too tired to do anything else.

After the third night of fitful sleep, my wife takes me to the Oregon Coast for the weekend. It’s cold, rainy and delightful. We pitch our tent in a stand of trees where we have shelter from the wind but still hear the waves.

I write like mad. Like it’s the only thing saving me. Like I’m debriding the wounds of my childhood, making space for healthy flesh to grow again.

My dog and I run on the beach. The sand gets between the paws of his feet, the hairs of his short coat, and he tracks it everywhere inside the tent. In the afternoon, I nap and my wife goes to hunt for mushrooms. When I awake, I pull my dog close, tuck my nose into his neck where he smells most like the beach, and let the sound of the ocean lull me back to sleep.

——

A few days later I’m on Pat’s unit, and she calls out, “There’s my best friend!”

I want to collapse with relief. I’m near breathless with the strength of her forgiveness.

She smiles and says, “I dreamed last night that some men were coming to get me, and you pulled up with a van and hid me in a secret compartment.”

She reaches out to touch my arm, then decides she shouldn’t, letting her hand float in the air. “Thanks,” she says.

“I’m happy I could help,” I say and walk away.  I don’t want to linger and be tempted to gauge my goodness by her feelings about me.

——

When it comes time for Pat to go to a group home, she memorizes the address and says it to me over and over. “We’ll go fishing,” she said. “Or just watch the fishermen catch the fish. I can walk down to the docks if I want to.”

“Sounds like you’ll have a lot of fun there.”

“You’ll come visit?” she says hopefully.

“I’m sorry, Pat,” I say. “I can’t.”

She nods sagely and winks, big and exaggerated. She tells me the address again, just to be sure.

I’d like to visit her, and it’s unsatisfying to say I can’t. There’s something intimate that passed between us, an uneven friendship we’ve built. Who knows? Maybe we will meet next when we are both hospitalized.

For now, she needs to continue her journey on her own, and I need to free the imprisoned parts of me—to release my need for atonement.

 

Andi Brown is a trans writer and comedian. His most recent publications include pieces for Witness Magazine, Cheat River Review, Carmina Magazine, and Spoonie Press. He was recently a semi-finalist in the Lit/South essay competition. You can learn more about him at andibwrites.com.