Tuesday, January 26, 2016

They Cut Lund's Brain

He came back to the hospital around 1980, after having been out since the early 60's.  Richard had been able to be placed at one of those small-town boarding houses that still existed then, where a woman would take you in and cook your meals and do your laundry in exchange for your disability check.  You got to live with a couple of other guys, equally disabled, and got to sit on the porch and smoke cigarettes, waving to the people who came to recognise you and your harmlessness. The family might drag you to church or to Grange or some hobby of theirs like flea markets.  They remembered your birthday and they gave you a cake.  They had a stocking for you at Christmas. If you said crazy things no one minded, really. A sparse life, but not abusive, usually.

Things could go wrong.  If you got violent or uncooperative, they would send you back, and after we had tuned you up and haggled with them a bit, they would have you back. But not always.  You might have become difficult beyond their ability (or at any rate, their willingness) to have you back.  Maybe you hit one of the other men, who was still afraid of you. Or maybe you had said alarming things to the granddaughter that made them think you were no longer safe.

So Richard was back, and it was our job to fix him and then sweet-talk and reassure the landlady that he could be wedged back in.  Letting her complain about how bad he'd been and go on irrelevantly and at length how hard her life was, with her daughter moving back in with a baby and her husband's back finally gotten too bad for him to work anymore.

But Richard wasn't fixing up all that well.  He was difficult and now refused to clean his room or take a shower, even when I was hooshing him in good directions.  He might suddenly turn and get combative - our word for when someone is violent in response to intervention but not initiating violence - but generally he was just stubborn. He had been very assaultive years ago in the hospital, but had been a lamb, mostly, since he had gotten a frontal lobotomy at our facility in the late 1940's.

Not all lobotomy patients were alike.  They were less violent and angry after the procedure, but their impulsiveness or delusions might remain. The older staff had general advice on what to do with them, as they had known many in earlier years, but it was generally acknowledged that it was all still very unpredictable, and some were still obstreperous or surly even after they'd had their brain messed with and been placid for years.  Just one of those things.

I'm sorry, I have to stop for a bit.  The memory is very painful now that I'm in it again, back there with Richard Lund 35 years ago.


Richard Lund isn't his real name, of course. Even now I couldn't identify him clearly because of confidentiality laws.  He had no wife, no children.  His parents had died.  I want to say he had no siblings, but perhaps there was a half-sister, now living in western New York or some such. There was no mention of her in the record beyond his childhood. Revealing his name would hurt no one, and my inability to fully commemorate him is ironic in terms of what I will write later, but there it is.  Rules are rules.  Even if I were to reveal it, you would be unable to track him down, because he shares a name with a semi-famous person from a few decades ago, who gobbles up all the search engine space.

He was my assigned patient, and he was annoying in a few ways. He was always reluctantly cooperative at best, and likely to sucker-punch me at odd moments once a week. Yet what grated on me most was his vocabulary.  He was a poser, showing off that he knew words, but using them wrongly. Underneath it all, there was the unspoken assignment that I was supposed to be brushing him up, or his placement would be lost. As if this were my fault. I was increasingly frustrated, and it must have showed. One of the nurses suggested I take an hour or so to read through his old histories and see if there were anything helpful there. I took the hint, and gratefully accepted the time off the unit.

State hospital records were a ridiculous contrast in those days.  There would be a shift note by the unit staff 3 times a day, 365 days a year, for as many years as a soul lived in hospital, pages and pages of slept 6-7 hours...ate 75% of dinner...attended walk group without incident. Useless after a week or so but preserved forever. Clinical notes, by psychiatrists, social workers, or psychologists, were more sparse.  In one of the oldest charts I ever saw I read Virginia's yearly notes from the psychiatrist, 1926-1935, two sentences each.  One learned to paw through the thick brown binders ignoring whole sections in order to find some three page treasure:  a social history, psychological testing, a school record.

Richard's chart from the late 1930's - 40's bounced back between two dramatic themes: he was continually assaultive, responding to no reason, no sedative, and no intervention.  He had an eye for the helpless victim and wreaked havoc among them, poor quivering souls who wanted only to be left alone. So frontal lobotomy, in the context of no restraining medications and the other choices being physical restraint - in chair, in cuffs, on bed - was the kindest choice, however grim it seems now. I had seen enough of the violent preying upon the innocent, and the violent in restraints for days on end, to know that the choices were not clean.

The other theme was his poetry.  He had been published in a half-dozen of the small, ephemeral literary journals of the day. Taped into his record were two Table of Contents from reviews I had not heard of, but also included poems by William Carlos Williams and Ezra Pound. Someone in 1944 had included three of his published poems, and in the back section were replies from editors and poets who he had evidently appealed to to get him OUT of this hospital. His requests are not recorded, but a secretary for William Carlos Williams had sent a rather odd, distant reply, saying that there was nothing that could be done but praising a poem he had written years earlier. An editor of Pound's replied that he no longer had any contact with that man since his arrest after the war. (Pound was confined to an institution himself at the time.)

So he was a poet - perhaps second-tier but real, and rising - and the State of NH had given one of its sons a lobotomy.  Local Boy Does Good, from a town too small to have its own high school. But that all came to an end.

For good reason, but I still hated it.


I went back to the nurse and said "You knew what I was going to find when you sent me, didn't you?"  She allowed that she had.  One of the older nurses had vaguely remembered Richard was a poet, and knowing me, she thought I might be one of the few who understood what it signified. I am no fan of any poetry, but I was enough of a failed writer myself to understand what he most have dreamed and nearly grasped.  I brought the thick binder down to the day area where Richard and a few others silently sat and asked: "I found some poetry that Mr. Lund wrote years ago. It was published in real literary magazines.  Do I have your permission to read it aloud?" His expression changed not in the slightest. He had a perpetual look of one-half tick above neutral, except when he would instantly turn to fist-clenched anger for a minute or so, and I detected no flicker.  That's not enough for "consent," but I really wanted to read the poems and I pressed on. 

One nice woman listened intently and gushed after I finished the first poem, looking at Richard and praising him in cooing tones. I couldn't tell if he had heard me, or cared in the least.  He was unmoved by the second and third readings as well, except that he corrected my pronunciation of the name of an obscure Greek goddess, putting the accent on the correct syllable. Nothing more.

"Mr. Lund, if you want to do any writing again, I can get you notebooks, and put them in a safe place every night.  And I promise to read what you write."  He did not look at me nor turn a millimeter in my direction nor blink an eye.  "Nope.  They cut Lund's brain and he's in a wall.  It's all Ozymandias now."

I thought for years that the Ozymandias reference was just his broken posturing again.  I get it now.

But this is the last thing that will ever be said or written about him, and I can't use his name.


Unknown said...

Now I understand "poignant" and Ozymandias.

Unknown said...

Now I understand "poignant" and Ozymandias.

Retriever said...

You are a very good writer. Brought me to tears. That poor man. You know which people it instantly made me think of. Having been around a lot of psychotic violence in youth I realize all too well the need for even our blunt instruments to keep the family and caregivers safe. BUT. It is a tragedy when a light is dimmed. Most of us aren't half as creative or artistic as we would like to think. But I have known so many genuinely talented people tranquillized into somnolence and cloddishness. We silence a bird's song. We turn dancers into immobile TV watchers. It sucks. Sorry.

I was rereading some stuff by Laing (who I always like to dismiss as a total wack job and whose personal life I disproved of) and there's a lot there one could apply to this case.

I probably shd be dead because my mushy and ignorant sympathy used to get mobilized when we cooked for and sat and talked w homeless Mr Lunds at my parish after college. I would prattle w lonely people, about the stew, and their lives, and their ideas about the government (as a social misfit myself, i cd talk to anyone). One afternoon, one of the men I was friendliest w (we let them sit in our library on winter afternoons to read and drink Cocoa til the shelter opened, and we would drop by to chat and see ways we might help, clothes, references, etc)smashed a beer bottle without warning on the rector's head (he survived).

The boy kid has inherited my tendency to talk to waifs and strays and used to give to every beggar despite his father's warnings that this was a mugger's first step (he was never mugged, tho)

dmoelling said...

Tough choices indeed. This is the hard part of medical care in that the methods available are always short of the need. Chains weren't intended to punish but protect. You wonder about the terrible dangers that his mind was perceiving but will never know.

HMS Defiant said...

Thank you for writing this. Everybody dies but what a tragedy to vanish into a wall and know it years before dying.

bs king said...

I am continuing my campaign for you to write a book. That is all.

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