Friday, November 03, 2006

Wasted Politeness

There is a marked contrast in how I treat the patients currently in the hospital and those at the group homes across grounds. Many of the latter were inpatient clients of mine at one point, and some will be again.

With current clients, I am rather stern until the day of discharge, because I expect people to work hard, and my expectations are high. But I also have recognition of the enormous pressures people with emotional or psychological issues face outside the hospital. They are often not treated with respect, or even avoided. Many of them have endured this lack of respect and fellow-feeling for years or even decades.

I speak to them much as I would an old school friend, a previous co-worker, or any other person I meet on the street, taking care to neither overdo it nor remain too aloof. They don’t get a lot of people just treating them like regular people in their lives. I like to think that they feel a touch more valuable without knowing why.

The system doesn’t always work. I have greeted Nancy for years, even though she dislikes nearly everyone and barely grunts in response most of the time. She is slightly older than I, college educated, and believes she has no mental illness. She bitterly resents the guardianship and legal commitments that enforce treatment upon her. Yet she will smile in spite of herself at humorous or wry comments, and has stopped to speak with me several times over the years, even enduring my gradually changing the subject from her mental health complaints to more neutral topics.

I thought we had developed a decent rapport over the last two decades I have known her. So it took me rather by surprize when my wife was overnight at the local hospital and Nancy, who was visiting an aunt, approached me. She seriously and calmly said “I have never forgiven you for accusing me in front of all those people of having sex with George. That was completely uncalled for,” and walked away.

Who’s George? What people, where? What decade was this? Hey, wait a minute – I would never do such a thing to anyone.

I didn’t think it would be helpful or kind to shout after her down the radiology corridor “Nancy, I have never made the slightest sexual comment about you in any context.” Weird. Even after all these years, things can still take me by surprize.

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