White veil
January 16, 2010
On a recent Friday afternoon, I evaluated a patient the police had brought in from a nearby drugstore. Apparently, she had attempted to shoplift some gum. When the police arrived, she was agitated, screaming and behaving inappropriately. This was all second-hand information as the police had left long after dropping her off in the ER. She was moved into the trauma bay initially. She was screaming, threatening people and spitting at staff. Somehow she managed to avoid being placed in 4 point restraints, probably when she agreed to take some medication to help with her agitation. She was given 10mg of Zyprexa.
I evaluated her several hours after she was medicated. She was sitting in a chair outside of the trauma bay, completely doubled over and sleeping. Laverne, I said. She bobbed up. Laverne was a black woman in her mid-60′s. She had a round, small head that made her look somewhat childlike save for the fact she did not have one tooth in her mouth. Her lips curved into her mouth involuntarily. Her hair was very short, showing some patches of gray and loosely concealing some dirt. She smelled strongly of urine. Her movements were jerky, spasmodic, like a poorly controlled marionette. She was on the edge of teetering out of her chair but somehow recomposed herself enough each time to prevent falling.
Laverne asked for some more crackers and soda; she clutched at an empty can and some graham cracker wrappers. She was loud and seemed unable to modulate the volume of her voice. Given that she had no teeth, she was at first profoundly difficult to understand. Spittle flew out of her mouth at every sibilant. I offered her a wheelchair and she told me she would do just fine with her cane if we didn’t have to walk too far. I put all of her belongings in the wheelchair instead and she followed me to my room. She walked painfully slow, with a pronounced stoop and shuffle. But she was determined. She looked up every once in a while, squinting into the flourescent lights and grimacing. We arrived in the room and she sat down on the bed heavily. She was holding a bible.
I brought her some more food and drink. A banana, some jello, a small sandwich and juice. She laughed. I better not eat right now unless you got a bathroom close. I sat down next to her to talk. Her constant jerks and loud halting speech made her seem more animated than she was. When do I get to go home, it’s probably late. What time is it? Five-thirty PM I told her. I asked her about what happened at the drugstore. Well, see, I have nine dollars on me. But I think I tried to buy too much gum. Wintergreen, you heard of that? Thats my favorite. She didn’t know why the police got involved. I didn’t try to steal nothin. I got money, see? She showed me a small hazmat bag that hospital security had placed some coins and crumpled up bills in.
I told Laverne that she was here for a psychiatric evaluation and she was agitated earlier so the doctors had to give her meds. I asked her if she lived anywhere. Wanda. I live with my daughter Wanda. She got a house on the South side and I live in the basement. It’s nice, warm, I got a lot of food and I just bought a big TV for $50 at Salvation Army. She spread her hands to show me how big the TV was. Wanda’s car is broke so she can’t come get me. I can take the bus home. I take the number three then transfer over to number 55. I have money for a transfer. But maybe you can get one of those cars for me. What hospital is this? Oh. Maybe you can do that.
Laverne was born in a small town in Mississippi. Her father was a captain in the military, stationed in New Mexico. When she was 2 weeks old, she fell seriously ill. Lumps on my neck and such, but I got good care cause of my daddy. My grandmother took care of me pretty good. She said I was born with a white veil. Do you know what that is? I’m clairvoyant. I see things other people can’t see. Sometimes I know when certain people are gonna die just by lookin at them. My momma used to beat me for sayin this stuff. Locked me up in closets or the attic without food sometimes. One day, I looked at her, and I saw she had rotting flesh. I knew she was going to die soon and I told her. She nearly beat me to death. But a week later, she got cancer. Knew the neighbor was gonna die too, heart attack. Sure enough. I told my momma that when I was eight. But I learned to be quiet, people didn’t like hearing that stuff. I could also see demons, dead people. Ever seen Sixth Sense? She laughed. I know when people are using drugs too. I can see inside them. I got to preachin around Hyde Park one time. Took my bible out with me, foretellin the end of the world. People didn’t like that neither.
Laverne was married for a while. She said her husband beat her. He died 27 years ago. Can I have a pain pill? My legs hurt. See this scar? It’s from an accident when I was 19. She showed me some old scars on her swollen left knee. She rubbed on her lower back. Had spinal surgery too. Three thousand stitches. The car she was in at that time was hit by another car and spun them around pretty good. Probably before seat belts. It don’t stop me from walkin though. I need to get air every day.
I asked her if she had ever taken psychotropics before. Well, I don’t remember their names. Thorazine, that was one. But I don’t need medications. I didn’t bother asking her about hospitalizations. I imagined there was a long pattern of involuntary admissions when she did talk about demons and prognosticating people’s deaths, let alone preaching in the street.
She finished eating and I helped her to the bathroom. I ordered a medicar for her that would take her from the ER to her doorstep. I gave her all of her belongings back. Her winter boots were soaked in urine. She had a big purple faux fur coat and she wore 3 pairs of pants. It’s cold out there for an old lady! The medicar wasn’t going to arrive for about 90 minutes. I gave her some Tylenol for her pain. She sat back down in a chair quietly and slumped over to sleep, waiting to go home.
