Albert carefully opens his notebook and smoothes out the pages with his enormous hand. He plucks a pen from an afro bristling with lint and sticks, and then stares up with his giant doe eyes.
‘Can you repeat that, please?’
My partner clears his throat. ‘Big Gulps, huh?’
Albert focuses on the pen and carefully writes ‘BigGulpsHuh’ at the bottom left hand corner of the page, capping off his long list of psychiatric meds with a quote from Dumb and Dumber.
My partner leans back on his heels as a huge smile spreads across his face. This has become his favorite game.
You see, one night last year my partner convinced Albert Brass Monkey wasn’t just a Beastie Boys song but an anti-psychotic medication. Skeptical at first, Albert thought his way through it, let it roll around on his tongue for a minute and after careful consideration he agreed.
‘I need to write that one down,’ he said, taking out his pen. ‘I think I’m supposed to be taking that one, too.’
Ever since that night my partner has been slowly adding phantom meds to Albert’s list. At last check BringOutTheGimp, CharlieDontSurf and BigLebowski have been entered into the US Pharmacopeia. BigGulpsHuh has just made the list.
It’s a harmless joke but as Albert jabs his pen back into his afro and shifts his considerable weight, his bull shoulders blocking out the light behind him, it occurs to me that someday Albert is going to snap. And considering genetics have hung four hundred pounds on his six-foot-ten frame the question of how I would go about dealing with him ceases to be academic.
Not to mention he’s a schizophrenic. Rule number one with mental patients is never turn your back. Even the ones who take their meds have bad days and clearly Albert has an incredibly loose sense of what defines a medication.
Once Albert has tucked away his notebook I ask him what I can do for him.
‘I gotta go to thirteen,’ he says.
Thirteen is Grady’s psych ward.
I may be sarcastic and cynical but I will readily tell you there are signs that all has not been lost. That the psychiatric facility at Georgia’s largest public hospital occupies the entirety of the building’s thirteenth floor is one of them.
That’s right. The thirteenth floor. You can’t help but laugh. You can’t help but wonder if it was an oversight. I hope to God it wasn’t.
In today’s era of public apologies and oppressive political correctness, housing psych patients on the Thirteenth floor is an all-too-rare but gloriously unrepentant prank.
It has always stricken me as something George Orwell, Joseph Heller or Kurt Vonnegut would have dreamt up: Not so much a dig at the nuts confined within its padded walls as a cosmic joke played out on those of us who must venture up to its paranoid halls in the name of patient care.
As I start my paperwork I ask Albert why now. Why at twenty past eleven in a driving rain has he decided he has to go up to Thirteen?
‘It’s twenty-six past eleven,’ he says.
Fine. Twenty-six, forty-six, a hundred and six. Why now?
‘I can’t listen to them anymore.’
‘You’re hearing voices?’
He nods and bobs his shoulders and the ambulance rocks like a small boat.
‘What are they saying?’
‘Bad things. Mean things. Telling me I ain’t worth nothing.’
‘They telling you to hurt yourself?’
He nods his head and the ambulance crests another wave.
‘They telling you to hurt other people?’
Albert looks away; a nervous child caught lying to his parents.
‘Albert. Are they telling you to hurt other people?’
‘They want me to purge myself. I’m rotting inside and I have to be ripped open so the foul can come out. I have to be relieved of this burden.’
There’s just not a whole lot you can say to that.
‘But they want me to wait. To do it at ten seconds ‘til midnight.’
I check my watch. 11:28.
‘You’ll probably still be here then,’ he says. ‘You’ll probably try to stop me. I’ll probably have to kill you.’
The next fifteen seconds pass in silence. Albert, of course, does not sense my unease. That I have picked him up dozens of times in the last several years, that we have talked and joked and extended to one another a certain degree of mutual respect does not, in his mind, preclude sudden senseless violence.
At least he’s given me a warning.
All too many times we pick up psych patients who calmly walk to the ambulance, buckle themselves into the bench seat and ride happily for ten minutes before deciding to listen to the advice of an entity created by their particular chemical imbalance. Get out, the voice tells them. Now. And all hell breaks loose.
My partner clears his throat and says ‘Five and five and a four-point?’
What he’s asking is if I wanna sedate Albert with five milligrams of versed, five milligrams of haldol and then tie him down by his wrists and ankles.
I tell him I think we’re good but I don’t really believe it. In reality, the task of trying to sedate a gargantuan man with doses made for regular people is difficult. Not to mention Albert’s tolerance.
Haldol works wonders the first few times it’s used on someone but after that you might as well be blowing kisses. Some of them get it so often they remember it by name.
Useful tip: if you’re ever in an ambulance with someone you think might be crazy ask him if he’s allergic to haldol. Anyone who answers yes not only has needed it in the past but should be considered a high risk to need it again.
The true elephant in the room of course is that brawling with Albert might simply be more than we’d like to bite off. As I said he’s four hundred pounds. Jumping him, holding him down, sedating and then tying him to our stretcher would be neither easy nor fun.
‘Let’s just get rolling.’
My partner nods and hops behind the wheel, cranks up the ambulance and off we go.
It’s 11:29. We have thirty one minutes.
Once we start moving Albert settles in, crossing his legs so the untied size nineteen on his left foot dangles in midair.
‘There’s gum on your shoe.’
He knows this already. He also knows about the hole. He doesn’t remove the gum or fix the hole because he doesn’t want to destroy the evidence.
‘Evidence of what?’
‘They’re putting gasoline into my body. Every night. It goes in through that hole.’
‘And the gum?’
He smiles. ‘It’s not gum. It’s a plug. Remove it and you can see all the way to my brain.’
‘So if I removed the gum...’
‘Bad things could happen.’
11:33. Twenty seven minutes and counting.
Somewhere a few miles from Grady we hit a red light. The ambulance eases to a stop and the constant noise – the rumbling diesel engine and the air snapping through the passenger compartment’s cheap plastic windows – stops.
And the voices immediately come back.
‘I don’t care what you say,’ Albert says. Not to me of course, just an offering to the ether. ‘No, we already agreed. Stop bothering me.’
11:35. Twenty five minutes.
Thankfully the light turns green and the rumbling resumes. But just as I’m about to relax, my phone rings. Albert jolts forward.
‘Who is that? I said no one back here but us!’
Albert reaches for his seatbelt and my stomach plunges. I yank the phone out.
‘Look! Its’ my phone. Just a phone. It’s just us.’
He stares at my phone while I tighten my grip on the heavy laptop in my hands.
Breathe in, If he attacks me, breathe out, I’ll raise this computer, breathe in, and smash him over the head.
Albert nods and settles back into his seat.
Time keeps ticking and 11:36 slowly melts into 11:37. Twenty three minutes.
At 11:40 the back-up alarm sounds as my partner eases us into a parking space on the Grady ramp. One hurdle crossed. Twenty minutes to go.
Albert unbuckles his belt, gathers up his stuff and hops out like a child hustling into McDonald’s for a happy meal.
I tell my partner we’re good and follow Albert in alone.
We hit the brightly lit emergency room and find it quiet and calm. This is good. That Albert gets worked up by stimulation should come as no surprise. And this being not only a large public hospital in the middle of one of America’s largest cities but also the only major trauma center around, it tends to be hectic.
In fact it’s not uncommon to walk through the door and find a mouthy drunk cackling at his nurse, an overdosing teen flopping like a fish on his stretcher, a badly injured shooting victim leaving a trail of blood all the way to the trauma bay and a quiet old lady calmly vomiting into a basin.
But not tonight. Tonight we breeze through without a hitch. When we hit the elevators it’s 11:42.
The elevators, of course, are quiet. And so Albert begins to wind himself up again, standing in the corner and grumbling under his breath. Three people have hopped in here with us and now as they press the second, fourth and sixth floor they’re beginning to realize their mistake.
I smile at them and they give me the look of terrified spectators. Any hopes I had for a quick and easy trip disappear as riders hop on at each floor, pushing buttons, stopping progress.
At one point conversation begins to build until Albert shifts his weight and rocks the car. Suddenly you can hear a pin drop.
At 11:44 the doors open and we step out onto Thirteen.
The interesting thing about Thirteen is that you never know who you’re looking at. Some of these people are easy to mark as patients but some aren’t. And then you have family members, friends, visiting health care workers and the odd wanderer who simply got off on the wrong floor.
Whoever they are, they all get the same welcome. A security checkpoint immediately outside the elevator doors.
It’s manned by a single guard sitting behind a desk plopped down next to a metal detector. The procedure is for everyone’s belongings to be searched. Thoroughly.
Tonight there are four people in front of us. Two of them have bags.
‘How you doing, buddy?’
No response. Albert rocks back and forth like a fighter staring down his opponent.
‘Okay. Well, you just be cool and they’ll get to us soon.’
The next six minutes pass in a terrifying, frustrating, clock-watching blur.
It’s a thousand degrees up here and everyone is sweating and irritable. Every few seconds the elevator doors ping, causing Albert to jerk. There’s a patient just beyond the secured area who keeps knocking on the locked double doors begging to be let out so she can smoke a cigarette.
And the people in front of us? All patients. All in need of help.
The guard is harangued constantly as he checks their bags, sorting through old perfume bottles, CDs, cell phone chargers, crumpled bus maps, bits of cigarettes, lighters, butter knives, old lottery tickets, broken sunglasses and dirty underwear.
‘Take everything out,’ he says over and over. ‘Your pockets too. I have to see everything.’
They fuss and grumble, accuse him of stealing their stuff.
‘Last time I lost my paperclips.’
‘Last time you smoked my cigarettes.’
‘Last time that fat bitch stole my bra.’
All the while the patient behind the doors keeps knocking, keeps asking to get out. And the elevators ping and the patients argue and the room gets hotter and the clock ticks.
It’s beyond loud now, it’s riotous and I keep waiting for all four hundred of Albert’s psychotic, unmedicated pounds to explode in a wild rage.
It’s our turn. I hustle Albert to the desk. We only have ten minutes.
This part, thankfully, goes quickly. Albert really doesn’t have much besides his notebook and some clothes. His notebook. Shit. The pen in his afro.
The guard misses it but it sets off the metal detector. I hold my breath. Nine minutes and counting.
Albert hands over his pen and we proceed through the doors. As we pass the Cigarette Lady she begs to be let out, begs for just one smoke break. I keep a hand on Albert’s elbow and we pass her by.
Grady does a wonderful job of keeping this area as calm and normal as possible but there’s only so much you can do. It smells like dirty socks and is filled wall-to-wall with men and women who, for one reason or another, need immediate psychiatric help.
When we reach the triage area I’m hoping the nurse will be there to receive us but of course she’s nowhere to be found.
Albert’s nervous now, pacing.
‘What time is it?’
I tell him we have time. All the time in the world. He just shakes his head. It’s getting close and he knows it.
If he was anxious before the crowd in here has brought him to a whole new level.
There’s a woman wrapped in blankets spread out across three chairs, a man covered in grass and mud no one wants to sit next to, a furious-looking teenager talking to himself and a couple, completely cracked out, pretending they don’t need to be here.
The man looks at me and shakes his head as though to say ‘Can you believe these people?’ I can’t, I think to myself. Then again, I can’t believe your girlfriend thought that t-shirt was a dress.
There’s also a man wandering around wearing a hat with CIA printed across the front in big yellow letters. He eases up next to me and leans in close.
‘You see any documents? I lost all my documents. My mints too.’
And of course there are the Combatants. If you blindfolded two angry psych patients and dropped them off in Tiananmen Square they’d find each other in less than a minute.
Our contenders tonight stare, make threats, pace, stand up, sit down, get in each other’s faces and then pace some more. They’ve probably been carrying on like this for hours and will continue to do so until one of them gets distracted.
Despite all this, it would be tolerable in here tonight if it weren’t for the Screamer. There’s always a Screamer and when the Screamer gets going the rest of them join in.
The Screamer’s always mad, though about what it’s difficult to say. Our contestant tonight is a woman. She’s wearing a dirty sweater and no pants, though someone has been kind enough to wrap a sheet around her waist. She might be only half-naked but she is fully pissed.
‘What the fuck you lookin’ at? Huh? Tryin’ to get my booty?’
She goes from person to person, making accusations and threats, swinging her barely concealed ass around like a wrecking ball. She punches the air and giggles and spits on the floor.
All of this has distracted me from my main purpose, which is trying to keep Albert calm. It’s less than two minutes to blast off and he’s getting worked up.
He is sweating now and refuses to acknowledge me. He tears at his shirt, his hair, scratches his nails down his arms and digs them into his stomach.
He throws a shoulder into the wall, shakes his head at some ethereal accusation and stares at me with red, wild eyes.
‘I can’t take this anymore,’ he stammers as sweat runs down his face. ‘I have to be opened, I have to be relieved.’
‘Be cool. We got time.’
‘No. No, we’re out of time.’
I throw open the doors, dash into an area marked Staff Only and bang on the first door I come to.
A slow-moving sleepy-eyed woman answers.
‘Look, you have a patient in triage who’s threatening to kill himself and anyone who tries to stop him.’
If she senses the urgency it doesn’t register on her face. She tells me flatly the nurse will be with us in a moment.
I look down at my watch and the last twenty seconds of the countdown have begun. I hustle back down the hall and, shouting through the double doors like the Cigarette
Lady, tell the security guard there’s about to be some trouble.
As he makes his way to the triage area I grab his arm.
‘You might wanna call for help.’
In that instant someone screams and there’s a crashing sound like breaking chairs.
We rush in to find the Screamer standing on top of a table, sheet off, shaking her ass like a stripper. Everyone is gathered around her laughing and hooting, even the combatants have called a truce to watch the show.
In fact everyone is enjoying it except the CIA man, who’s still on the hunt for his mints.
As the guard tries to break-up the show I notice Albert isn’t here. Could he have slipped out behind me, snuck into some hidden part of the ward to disembowel himself?
The guard has his hands full with a half-dozen howling patients and one naked Screamer.
I’m on my own. I spin around, looking for the most likely hiding place. And there it is: The bathroom. I rush over, grab the handle, deep breath and try the door...
A calm voice echoes from beyond the door. ‘Who’s there?’
‘I’m relieving myself.’
I laugh. My back is covered with nervous sweat and I lean my head against the wood.
‘I haven’t had a good movement in a week. The gasoline, it binds me up. And this is the only place they can’t infiltrate.’
‘So that’s what you...Good. Good. That’s really good news, Albert.’
‘Can I have some privacy?’
‘Sure. Anything you need.’
Across the room the guard has gotten too close to the Screamer and she’s wrapped her left leg around his neck. His back-up is trying to free him but they can’t break through the line of spectators tossing cigarettes and crumpled ones onto the table.
The nurse arrives, followed by four more guards and I leave Albert in their capable hands. He’s no longer a threat and, besides, his enormous presence is completely overshadowed by all the yelling and cheering and the Screamer’s gyrating ass.
Outside I take a minute to relax and enjoy the cool midnight air. Sirens wail in the distance. As we drive away I see a figure lumbering down the sidewalk like a battleship with an engine out.
It’s Albert. In the chaos someone left the doors open. The Cigarette Lady is probably out here too.
After a few seconds he disappears around the corner, munching CharlieDontSurf pills and shouting at the heavens.
He’ll be back of course but tonight he is free of gasoline.
Tonight Albert has been relieved.