nightshift (part 5): Jill

(part 4)

Stories from a previous job. For the privacy of those involved, names and details have been changed.

I.

August 2004:

I stay in the break room most of the shift. I read a bit. Fill out forms, try to catch up on paperwork that I am weeks behind on. I eat lunch at 3a.m. It's a quiet night, the clients sleep soundly.

At 5a.m., I hang out in the common area...recliners, two couches, a television, a pool table. Clients slowly rouse, make coffee. They hang out in the dining room and the common area...I small talk with each client, try to chat them up, see how they're doing. Some of them don't respond; they just stare at the floor, sip their coffee, lost in thought.

Jill drifts by, going straight from her room to the back porch, where she proceeds to chain-smoke for 15 minutes. She smokes furiously, rapidly...her hands shaking either from the massive nicotine hit or from anxiety, I can't tell which.

I join her on the back porch. I say, "Hey Jill. Hope you're doing okay this morning." I generally avoid asking her questions directly...she rarely speaks. It's a recurring topic in staff meetings: did anyone hear Jill speak this week? We gather her statements like pieces in a puzzle, try to gain some sense of her internal life.

On average, she speaks once a year, sometimes twice.

I hang out with her for a few minutes. I stare out at the horizon, at clouds. I drink coffee. I stand up, ready to go back in. That's when Jill shocks me. She says, "They put blue light on my face."

I slowly sit down, feign nonchalance. I ask, "Who put blue light on your face?"

She doesn't respond. I ask a few other questions, but she just smokes and says nothing.

The morning goes by. The shift ends. In the staff log, I write: "Jill spoke. Said, 'They put blue light on my face.' She was tense, shaking; otherwise no change."

I do not hear her speak again for two years.

II.

Jill: 29 years old. Average height, dark hair. Thin...she forgets to eat. We remind her, put food in front of her. Sometimes she eats, sometimes she doesn't. We have to give her nutrient shakes to keep her weight up.

Schizophrenia often develops slowly, over a period of years. It hit Jill rapidly and at a relatively early age. 4 months after her first psychotic episode, at the age of 19, she was severely withdrawn and almost completely non-verbal.

She had the psychotic episode while at college. She was there studying painting and education...her goal was to one day teach art classes at the high school level. She was outgoing, had a lot of friends. She was involved with a volunteer organization, one focused on teaching art to low-income children.

One day her dorm roommate called Jill's parents and said that Jill had been acting strange. She'd begun to socially isolate...to miss classes...and to make statements that no one understood.

A few weeks later, Jill disappeared. She walked off campus and vanished. The police found her three days later, sleeping on a sidewalk. She had apparently been wandering aimlessly the entire time. She was delusional, hallucinating. Most of her statements were gibberish...she was chanting the same set of syllables over and over. The chanting went on for two days. Then she was silent.

From that point on, she remained in a cycle common to the seriously mentally ill: short stays at home; lengthy periods in psychiatric hospitals; occasional bouts of homelessness.

The cycle became her new life.

III.

When I trained new staff, I would tell them that the clients are expected to be relatively independent. Clients need to take care of their own hygiene and chores. And, they are expected to do their own shopping. Hearing the last part, new staff would invariably ask the same question: "Jill doesn't speak. How do you know when she needs to go shopping?"

This is how it works.

Twice a week, staff drive a van to the grocery store so that the clients can buy whatever they need. If you ask Jill, "Do you want to go?" or "Do you need anything from the store?" she won't say anything. She'll just stare at you. So what you do is say to her, "We're leaving for the grocery store in ten minutes." And if she needs anything, she'll just follow along. She'll get inside the van, go to the store and buy whatever she needs.

A trip to the store can take a long time due to her odd gait: she lifts and lowers each foot very slowly, as if she's walking underwater. And when she's in the aisles, she tends to pause for a long time and stare at the items. But eventually she'll pick out her toothpaste or socks or whatever and check out.

It works, but it can be awkward when cashiers say "hi" to her or try to engage her in small talk. She never responds, just stares blankly at them. She then gets strange looks from the cashiers...and people in line often begin to watch her, suspicious. I would always hang back, watch, ready to step in...but mostly it went okay, she would get through it.

III.

This story was related to me by Allison, the staff who worked weekends and who spent the most time with Jill:

Allison arranged numerous activities during her shift, tried to keep the clients busy. She would take them to movies, fairs, festivals, any sort of public event. She also put a lot of effort into finding hobbies or interests that might appeal to each individual client.

Jill never went for any of this. She just smoked, paced the house and kept to herself. It was hard to get her out for anything other than a grocery store run.

One day Allison announced that she was going to a book store to browse and drink coffee. A few clients headed towards the van...including Jill. Allison couldn't believe what she was seeing, she was thrilled.

At the store, everyone browsed. Jill wandered up and down aisles...she didn't pick up any books, but Allison had never seen her look so alert. Allison told her, "I'm going to buy a few coffees if you want one". She bought one for herself and set the extra one on the table. Jill picked it up and walked to a table outside. She just sat and sipped coffee until it was time to go.

May not seem like much, but this was major progress for Jill.

After that, Allison tried to make a habit of the bookstore trips. She offered to take her each Saturday morning...and Jill went along.

After six weeks, though, the trips ended.

They were at the bookstore one day. Allison was wandering the aisles, browsing. Jill was doing the same, in a different part of the store. Allison then saw two police officers walk through the front door and converse with staff. The staff...all grouped together at the front of the store, all looking anxious...pointed at a certain aisle.

The officers walked to the aisle and approached Jill. They asked her, "Ma'am, is everything okay?" Allison interrupted and said, "She's with me. And yes, everything is okay. We're just looking at books."

Allison spoke with them for a few minutes. She did not give them any information about Jill, but the officers seemed to understand what was happening. They were polite, quickly left.

They told Allison that someone had called 911 and reported a "suspicious person" at the bookstore. The caller had said that the person was acting "weird" and making customers "uncomfortable". Jill is calm, aloof...I can only assume that her idiosyncratic gait made some of the staff uneasy.

Allison took Jill out to the van, made sure she was buckled in, ready to leave.

Then she walked back into the store. She put her finger in the managers face and said, "She didn't deserve that. You should be ashamed of yourself." She marched out, drove back to the facility.

Allison offered to take her to a different location the following week, but she showed no interest. Jill just resumed her habit of pacing the house, smoking, keeping to herself. She never went back to a bookstore.

IV.

Two years after she made the "blue light" remark:

Jill walked up to me one morning. For a full minute she just fidgeted and grimaced. After having worked with her for 8 years, I heard her speak for only the second time; this would also be the last time.

She whispered, "Cigarettes." I didn't respond; I just nodded, drove her to a gas station. She bought cigarettes.