A Night at the ER

Occasionally, the clients at the mental health facility where I work have what my coworkers and I affectionately refer to as "meltdowns." These clients are not mentally-challenged, but simply have a very low threshold for distress tolerance. A seemingly-minor upset erupts into spasms of rage, limbs flailing about in all directions but typically aimed at themselves or the staff. At this point we have to physically restrain them, and if they can't calm down, they get sent to the hospital.

This exact situation played out recently before my scheduled shift. Since company policy states that a staff must be present with the client until they are formally admitted to the hospital or sent back to the residential, I received a call to report to the emergency room for my overnight shift. I packed some books, my journal, and a Thermos full of coffee. Not knowing quite what to expect—this was the first time I'd had to do this—I hoped this would keep me occupied.

I spent the beginning of my shift chatting sporadically with the client—a teenager, now calm but tired after the day's events—and browsing Reddit on my phone until she fell asleep. Wanting to conserve battery life on my phone for the inevitable morning calls back to the base for reinforcements, I flipped through my reading material with only a feigned interest born out of circumstance. I and Thou was too heavy for me at that hour. Why didn't I bring some light fiction?

At a certain point, having emptied the Thermos and given up on my books, I pulled out my journal and took to writing about everything I was seeing and hearing around me. Believe it or not, this kept me occupied for most of the night. But as the night wore on and I became more delirious, the observations became more ominous as my sleep-choked brain struggled to make sense of it all.

These are the logs from that night.

1:45 am

Child asleep. People walking around doing hospital things. Slow night. No one seems to acknowledge my existence except the bald security guard who sometimes stares at me.

Drunk rolled through about an hour ago followed by several police. The policemen who brought him in walked by several times, one in particular being rather aghast at the man's capacity to drink. Loud whining coming from either a baby or a very childish man

The doctor looks like Jeff Bezos, found of Amazon.com. He is a gregarious man, well-liked by his co-workers and seems to put his patients at ease. "I'll do all the worrying for you. That's my job!"

1:58 am

Confirmed: moaning is coming from some kind of man-child. I can't see him, but I can hear him. Soft, lilting moans of "ah" at regular intervals, sometimes louder and occasionally followed by "help." Staff glance uneasily towards that end of the hall. Bald security man suggests giving him a muzzle. Jeff Bezos laughs.

In the twilight hours of this corner of the universe, I feel the hospital ward open up into kaleidoscopic strangeness. Moaning, small talk, telephones, the incessant whirring of medical machinery—a panoply of interferences corrupting what once seemed so mundane and organized. Disparate parts operating together but driven by some insane divinity.

2:11 am

The moaning has stopped. A woman sitting with her daughter who had overdosed on some pills checks her Facebook. Someone talks about a Memorial Day sale. She doesn't like "rolling." A bulletin about "Bed Bug Management" pinned to a board in the nurse's station catches my eye and puts me ill at ease.

I am an urban anthropologist chronicling his own descent into madness in a hospital hallway. Several different people cough at once, but why?

2:18 am

A man is being put into a wheelchair. He is wearing a makeshift muzzle. Security guard meant it. That's why the moaning stopped. All this is to bring order to chaos, narratives to weave all this together that we might understand our plight, our misfortune.

2:22 am

False alarm: the moaning had resumed. The man really wants a cheeseburger. He aches for it, the cure that will free his heart from its prison.

All this makes me who I am at this moment: the persona of the journalist. I must find a role to play here, and this is it. I pen these words to find myself in this chaos, the golden through-line to the one unity.

Now I want a cheeseburger. Sudden urge to moan. Reality breaking at its seams. Let us add some more color to the illusion.

2:29 am

It's withering season. A nurse drops a pill like its a leaf falling in an autumnal breeze. The night gets longer as we move into dead time. Less talking, more whirring. The moaning has returned. Get this man a cheeseburger. Are two people moaning now? No, the timbre of his voice changes as he moves around in his room.

I'm turning this small vantage point into a little universe.

Moaning man yells "Fuck!" and gets remanded by the security guard. "These are children out here!" Brief argument ensues. Nurses have settled to do paperwork.

2:49 am

I briefly speculate about relationships among the staff. Does that orderly have something going on with the attractive redhead nurse? More jokes about cheeseburgers.

2:56 am

No desire to do anything other than record this log, all my energy channeled into this pen, mind resting in receptive awareness.

Less action by now, pens tapping in boredom. Intermittent moans. Hallway C is mostly quiet. A nurse implores an older man—here because he was caught running naked through a forest—to pee in a cup. He shuffles off to the bathroom forlornly. Jeff Bezos quotes Forrest Gump: "Life is like a box of chocolates."

3:19 am

Moaning intensifies. We cling to our cell phones for dear life. Staff are eating lunch. More cheeseburger jokes. Scent of lemon cleaning product fills the air. These people with faces full of life.

Meaning dies in these early hours. We're all just putting along, pulled by invisible strings. We know not what ails us. We might forget ourselves.

4:53 am

Passing through 3:30, tiredness grew and I resolved to nap. Didn't sleep but merely rested my head against a wall and closed my eyes. I remember nothing but the vague sensation of hovering between consciousness and unconsciousness in an awareness empty of content. I blink and half an hour passes. I pass through the deadlands of the morning in this manner.

Time grown old. Even the nurses are quiet. They sit at their computers mutely, typing. No more moaning. Emptiness.

5:42 am

Renewed chatter as shift change approaches. Resolving to save my phone's remaining battery life, I put it away and listen.

The is a camaraderie among the staff, tied together from working the same late shift. Dreamy talk of morning staff relieving them, though tinged with envy. A remark about moving to days is roundly mocked. The gathering grown more intimate.

I've forgotten myself entirely. Keen to my surroundings, I've immersed myself in them to such a degree that I forget being a body in a chair. Why this awareness bound to this flesh? The expectations placed on this tenuous amalgam. Injustices beyond fathom in these hours of first light.

6:12 am

The child stirs as tension mounts between security and our elderly nudist, who does not want to be told what to do. He wants to go upstairs. He walks towards the bathroom pursued by staff. He takes an unexpected turn and a brief cat-and-mouse scenario plays out. Easily defeated, the broken satyr returns to his chair.

Morning pervades the room, which is more animated now. We long for the light which is now streaming in through the glass door at the end of the hall. We are all born along towards the end, having ceased to struggle.

7:24 am

Self-consciousness dissolves with fatigue and the sight of morning. The woman with the overdosed child—who, though sitting just feet away the whole night, has not spoken to me at all—approaches and offers to bring me food from the cafeteria. Too tired to contemplate the offer, I decline by default. I'm not hungry anyway.

Epilogue

The log ended here, as I was now too tired to write and frustrated to find out that I would not be relieved until 9:30.

The overnight staff, familiar faces at this point, had begun to depart. The new staff are noticeably older. Clearly they've earned their premium schedules through seniority, while the younger staff are relegated to less desirable shifts. Now being surrounded by strangers, I longed even more to leave. The new security guard stood far too close to me and the child, making us uncomfortable.

The now-awake child ate her breakfast—hash browns, scrambled eggs, and a stale blueberry muffin—while I drank something vaguely resembling coffee. We played cards until a coworker finally arrived to relieve me. I walked out with legs wobbly from disuse, drove home and went to sleep.

Looking over the night's scribblings now, I still remember the lived experience of it all, each state of mind at different points in time unique and discernible. To those accustomed to sleepless nights, a familiar pattern emerges. You grow more and more tired until you reach a point where staying awake seems impossible. But somehow you do it. You pass through the center—of the night, of your fatigue, of yourself—feeling yourself passively carried along by some unknown force. You think strange thoughts. You make arcane discoveries about consciousness that you forget the next day. And you emerge on the other side with a lightness of body and mind, a sense of acceptance and hope.

Then you go to sleep, wake up, and return to your life.