Dead and Gone

by Tina Glasneck

  Angie shook her head when she considered just how awful the mental health system was in the U.S. Depressed, deranged, and addicted psychiatric patients could no longer come in for a few weeks of therapy, get their meds regulated, have a few art classes, and play some board games to learn to control their anger. Why, just last week they had discharged a newly diagnosed Bipolar II female patient who had attempted suicide and been in a coma for ten days with an aspiration pneumonia. She only stayed on the psych unit for two days, because the patient promised, "I'll never do it again. I don't know what came over me." Of course, her insurance didn't want to pay either, but the hospital would have been ethically bound to keep her if she had asked to stay. In Angie's mind, that bordered on gross negligence. Suppose that woman went home and “offed” herself with her small children in the home? Worse still, suppose in her psychosis, she killed herself and her family? It had happened before. What safeguards had been put in place? Oh, I forgot, Angie admonished herself. She had two days of counseling and three days of Lithium. At least that’s what the attending shrink had told Angie when she questioned the discharge. That should do it. Yeah, sure, Angie thought. She was disgusted with the entire U.S. mental health system. How in the world could anyone get better in only several days? These poor, mentally sick, often physically ill patients were discharged back on the streets of NOLA or even to their homes with no regulated medicines or skills to fight back against the demons that endlessly plagued their minds.

  Her walk in the black night seemed endless. Even this late, the Southern air was stifling and viscous. She was sweating, but she felt cold on the inside. Angie continued to think about the dangerous patient population at the Pavilion. Many of CCMC’s psychiatric admissions were initiated at the hands of the New Orleans Police and the local magistrate who had them committed after they had been picked up for a crime or some sort of outburst. Angie quivered again when she thought of some of the deeply psychotic patients trying to live on their own. They also had to medicate several of the most violent patients prior to bedtime. Angie had doled out six Thorazine Slurpees like they were health food drinks, but even then the brutality was awful. She thought about it and then deliberately pushed it from her mind.

  When she was honest, Angie admitted to herself that she hated working in psychiatry. She hated it because she was afraid. And she knew the patients knew. It was almost as if they could smell it on her. She could see the recognition in their eyes when they realized it. They seemed to give her a secret smile. Many of their eyes seemed to have an evil glint. Besides, on the critical care units or in the emergency room, you could predict physiological changes in patients. You knew if a patient was going to "go bad" and have a heart attack or throw an embolus. You knew what to expect. But, in psych! You just couldn't tell. You couldn't anticipate the interworking and short circuitry in the minds of the profanely and criminally insane. They'd go off at the drop of a hat over nothing. You could hand them their fork the wrong way and they'd come after you. It was frightening. Many of the patients were violent criminals, who had committed heinous crimes, yet CCMC cared for them and she didn't mind caring for them. She just wanted to have enough staff to work in a safe place.

  Angie continued her musings on the way to her car. Her background was critical care and emergency department but there'd been an opening on the psych unit where she could work just weekends and get paid for full time. This was ideal in many ways as it allowed her time with Jessica. She could be the kind of wife her husband wanted – at least most of the time. Besides, the money was good. Everybody at CCMC knew the Psychiatric Pavilion was the armpit of the hospital and that nurses were paid a premium to work there because it was dangerous. The Pavilion was also isolated, turbulent, and chronically understaffed, especially now because nobody really knew what health reform was going to do to psych care. Usually Angie didn't mind so much. But the past three nights had been particularly stressful for her, more so than usual. She had been on a different unit each night and besides, Jessica had a cold and she always felt bad leaving her baby in daycare when she was sick. Her Catholic guilt kicked in every time.

  It was darker than the blackest of nights, as an ominous feeling of dread hung thick in the night air. Thunderstorms earlier in the evening had created a mass of low, overhanging clouds that completely obliterated the moon. Suddenly, Angie felt a chill come over her. She looked over her shoulder as a quiver ran up her spine. Her legs tingled. Did she hear someone breathing? She strained her ears. She couldn't hear anything strange. The hum of the cicadas and other night insects was deafening. Angela picked up her step, making a pact with herself never to walk to the parking lot alone again. Not ever. It was scary and unsafe. What in the world was wrong with her? Why had she made such a reckless decision? After another minute or so, she heard another noise. It sounded like a set of keys hitting the pavement or, perhaps, like metal hitting metal, she thought. Then, she heard a cough and a sigh of what seemed like satisfaction.

  Angie's autonomic nervous system kicked in. Fight or flight! She started running for her life, but was no match for her assailant. He quickly overtook her, grabbed her by the hair, stuck a rag in her mouth, and pulled her over into a crop of trees to the right of the road. Her attacker seemed huge and had a large scarf tied over his face. His head was covered with a hat. Angie looked into her attacker’s face as he leered over her. Her eyes widened in disbelief when they adjusted to the darkness. She knew this man! Her heart was firing erratically and she was dizzy and weak with fear. Her assailant looked at her and laughed.

  "So, you recognize me, you little slut bitch. We can't have that now, can we?” Her assailant spat the words at her.

  Angie was paralyzed with fear. Her hands were pinned down and her assailant's knee was in between her legs. Her captor outweighed her and was strong. She couldn't move, but struggled against him anyway, trying to overcome his strength.

  He let one of her hands go for a second while he pushed one of the metal spikes into the soft ground.

  Angela's hand ripped the hat off her assailant's head and she dug her nails into his hair, pulling as much hair out as she could. She had wanted to poke out his eyes, but had missed.

  "You little bitch. I could kill you for that! How dare you touch me. You are one of them.” The man slapped her, dislocating her jaw.

  Angie felt the bone pop near her ear. The pain was overwhelming and she started to vomit. This further enraged her captor and he slammed her face into the dirt, ripping off her uniform pants. His intent was clear, but all Angie could do was lay there and focus on the smell of the rotting vegetation on the side of the road. She tried to detach herself from her surroundings. It didn't work.

  She heard him grunting while he pushed three more stakes into the ground, singing quietly to himself as he moved methodically through his tasks, clearing old leaves and trash out of his way and away from her. It was like he was cleaning house. For a moment, she thought he had forgotten about her and she felt a bit of hope. But it was far-fetched. He turned to her, smiled sweetly, and bit her on her shoulder. Angie screamed and then her attacker hit her in the head with a piece of metal pipe.

  Angela felt the searing pain rip through her head and down into her neck and shoulders with the first blow. The second blow didn't seem to hurt so much. Her last conscious thought was how pretty the twinkling lights looked in the intensive care unit in the main hospital building. She could see them clearly from where she was and she wished she were working a double shift up there where everything was predictable, where the patients were harmless and appreciative. Then, finally, blessedly, she lost consciousness.

  6

  “Oh, no, no ... no ... oh, no ... it can't be. It just can't be. This has to be a joke and it isn't funny. Stop telling me these things. Angie's at home right now taking care of the baby. She worked last night; she only works on the weekends. Today is Monday," Bridgett insisted.

  A short silence followed as Bridgett continued to listen to the voice on the other
end of the phone. Her voice was confused, skeptical as she responded, "You've got to be kidding me. This is wrong, wrong, WRONG! It's not funny!" Bridgett's voice reached a fevered pitch as she continued to argue with the person on the other end of the phone for playing games with her about her sister. Finally, she slammed the phone down and marched into Alex's office, all legs, high heels, and long, blond hair.

  Alex, the legal counsel for Crescent City Medical Center, looked up from her desk, startled to see her normally good-natured, fun-loving secretary glowering at her, full of rage. Bridgett could best be described as a blond bombshell. She was tall and beautiful. She wore bright colors and survived a full day in the highest stiletto heels Alex had ever seen.

  Bridgett's big blue eyes flashed anger and her voice was clipped as she addressed her boss. "I'm so mad, in fact, I'm pissed. Somebody from the E.D. just called and told me Angie is all beaten up and a patient there. It really isn't funny and it's a sick joke. I know Angie's at home taking care of Jessica." Bridgett glanced down at her watch and added, "Besides, it's 10:00 in the morning, and she worked last night over at the Pavilion. I know, because I talked to her."

  Alex stared at Bridgett, confused by the conversation. "Who called you, Bridge?” Alex asked, her voice soft and concerned.

  “I've no clue. I didn't hear their name. I'm sure it's a mistake, but I am still pissed because they got the wrong person. They need to be more careful over there. Besides, I'm too busy for this stuff today. I love to have fun and cut-up, but not about sad stuff. This just isn't funny. It pisses me off." Bridgett fumed, her blue eyes stormy with anger.

  Alex and Bridgett heard a knock in the outer office and stared as the door to Alex's private office slowly opened. Crossing the threshold into her office were Dr. Monique Desmonde, the chief of psychiatry at CCMC, Commander Jack Françoise of the New Orleans Police Department, and Alex's old nemesis, Bette Favre, the chief nursing executive at CCMC.

  Alex felt a cold, numbing twinge in the pit of her stomach and the hair on her arms began to rise. She knew something was very wrong and surmised what was coming next.

  Dr. Desmonde gave Alex a hard look, shook her head negatively and then turned her attention to Bridgett.

  Jack moved into a position behind Bridgett and gently directed her towards the elegant sofa grouping in Alex's office.

  Alex felt as though she were watching a perfectly choreographed production.

  Bette Farve stood uselessly to the side of the group for a moment, studying her bright red manicure, and then took a seat in a Queen Anne chair.

  Alex's heart was thudding as Monique motioned for her to join them on the sofa.

  Bridgett seemed transfixed, unable to talk. She looked like a tall, beautiful Barbie doll.

  Dr. Desmonde began slowly, "Bridgett, I'm afraid I've some bad news for you."

  Bridgett's eyes were blank as she stared at Monique, a beautifully groomed, dark-haired woman in her forties.

  Dr. Desmonde began gently, "Bridge, can you hear me? We must talk, now."

  Bridgett nodded her head slowly.

  Alex could feel fear and uncertainty crawling up her spine. Her knees began to shake and her heart was pounding madly. It was the same feeling she always had when something bad had happened. Alex felt her knees jerking so badly that she was sure they would cause her feet to jump out of her 4-inch heels.

  Jack touched her knee, realizing Alex's discomfort and offering support.

  Alex gave the police commander a small, tight smile.

  Dr. Desmonde continued, her voice soft, her eyes meeting Bridgett's straight on. "Angela worked yesterday, Bridgett. She worked the 11a.m. to 11 p.m. shift on the psych unit."

  Bridgett interrupted Dr. Desmonde. "Yeah, yeah, I know. I tried to call her last night. I called early in the evening, but she was working on the prison or forensic unit or wherever. We never spoke, at least last night," Bridgett continued, the irritation in her voice unmistakable. "The idiot from the E.D. said she was over there and had been beaten up or something, said she couldn't speak so I didn't believe them." Bridgett turned and noticed Commander Jack Françoise at her side and addressed him, her brilliant blue eyes full of anger. "Commander, can you do something about this? Someone is harassing me about Angie,” Bridgett said as she started to rise from the sofa. "I've got to go. I have a ton of work to do." Bridgett rose from the sofa to leave, as if nothing real had just happened.

  Jack looked over at Dr. Desmonde who gave him a thumbs-up sign. He took Bridgett's hands in his own and said, "Bridge, it's not a joke. Someone hurt Angie after she left work last night. She was attacked and we didn't find her until this morning and..."

  Alex's heart lurched at the sight of Bridgett's big blue eyes. They were filled with terror and uncertainty. Her pupils were huge, surrounded by liquid pools of white. Her long blond hair created a halo around her head. Alex wasn't completely sure if Bridge understood what the police commander p had said.

  Dr. Desmonde interrupted, "Angie's over in the E.D. They're going to take her up to surgery and I thought you might like to see her before she goes." Monique's voice trailed off, uncertain of Bridgett's level of comprehension.

  "Yes, yes, I would. Is she okay?”

  Monique continued, slowly as she shook her head, "No. Not really. She is very sick. In fact, she is in critical condition. She has a machine breathing for her, a ventilator, and she has some head injuries. She's lost a lot of blood. She also has some internal injuries and Dr. Goshette wants to do an exploratory to be sure she isn't bleeding on the inside."

  "How'd she get hurt?" Bridgett asked in a dazed and child-like manner as she looked around the room. It was clear to all of them that Bridgett really wasn't getting it.

  Alex couldn't help but be amazed at how good the brain was at screening out bad news.

  Being the psychiatrist that she was, Monique tried hard to work through Bridgett's shock and denial. She started again, "Bridgett, Angie was attacked and beaten last night after work. She's very ill. Do you understand?"

  Bridgett nodded impatiently. "Yes, you told me. I'd like to go see her now, if you don't mind. You said she was going to surgery, right?" Bridgett stared at Dr. Desmonde as if she was a moron for not understanding her.

  "Yes," Monique sighed. "Bridgett, you must understand that she has bruises and cuts on her face and that ...,” Monique stammered, searching for words, "You must understand that she looks very different. Someone beat her badly. Are you sure you're up to seeing her?"

  Bridgett nodded her head impatiently. "Of course, Dr. Desmonde, of course I am. But it isn't all that bad, not nearly as bad as you say. Angie and I are twins. If she were hurting badly, I'd be hurting too. It's always been like that, since we were babies." Bridgett smiled and continued, "I'm really not worried, let's go." She looked around the group. "Hurry up! I just need to get my purse."

  Alex, Jack, and Monique looked at each other while Bridgett went into her office.

  Bette Farve had completely removed herself from the situation and was flipping through a copy of "Architectural Digest” she'd removed from Alex's coffee table.

  What an uncaring bitch, Alex thought silently to herself.

  Monique rolled her eyes at Bette, shrugged her shoulders and said, "Well, Bridgett doesn't really get it. Angela looks pretty bad, and believe me she’s really hurting. The reason Bridgett isn't feeling any pain is because Angie is in a coma."

  Alex was startled. "Oh no, is it really that bad?" She searched the faces of her good friends and colleagues. Her crystal blue eyes locked with Commander Françoise’s dark ones. "Please say it isn't, Jack," she implored.

  "Wish I could, Alex, but I can't. It's bad. It’s real bad. I'll fill you in later. Let's get Bridge through this part first." Jack lifted his large, bulky frame from the chair and moved into the outer office to help Bridgett gather her things.

  Dr. Desmonde added quickly to Alex, "Jack's right, Alex. Angie is pretty beat up. She may be bleeding internally. She has a skull f
racture and some seriously broken bones. Her jaw is broken, as well. She was out there for hours before anyone found her. She lost a lot of blood and Lord knows how long she’s been unconscious. Her crit, CBC are way down.”

  “Shsssst!" Monique put her finger to her lips as Bridgett and the commander returned to Alex's office. "We'll catch up later.”

  Bette looked up from her magazine and spoke for the first time. "My secretary called Bridgett's husband and he'll meet us in the E.D. They're looking for Angela's husband. He is supposedly on his way.” Farve’s voice was flip and tinged with sarcasm.

  Alex immediately moved into Bette Farve’s personal space to confront her, but Monique waved her away while she motioned for Jack and Bridgett to wait in the hall for them.

  "Later, Alex," she cautioned, "We have enough going on here and you're not dying on the Bette Farve hill right now." Monique glared at Bette Farve. "See me later, Ms. Farve. I want to discuss the concept of empathy with you. And I do mean it.”

  Alex smiled to herself as she watched Bette bristle with anger and then felt ashamed for enjoying the exchange. Dr. Desmonde was probably the only person at the medical center who disliked Bette Farve as much as she did and this behavior was so unlike Monique it was a bit shocking. They both had Farve’s number and supported each other when the nurse executive ran roughshod over the staff. Bette was uncaring, incompetent, inept, and not very smart. Unfortunately, the CEO, Don Montgomery, didn't share their opinion of Bette – most likely because they were very much alike. If you were to believe the hospital scuttlebutt, they were lovers. Gross, yuck, is all Alex could think about that rumor. It made her feel slightly sick.

  As Monique and Alex joined Jack and Bridgett in the hallway, Alex began to feel angry about what had happened to Angie. For three years, Alex repeatedly asked the hospital executive committee to move the psych units closer to the main hospital, if not into the main medical complex itself. Of course, Don had a shit fit over that one. He would never tarnish his "world-class, prestigious medical center, soon to be a health sciences center" with the likes of the crazy lowlifes of New Orleans and criminals with HIV. He had even declared at the Board of Trustees’ meeting that he would never turn CCMC into an insane asylum or increase the number of beds for the psychiatric community. Alex doubted if he ever knew how much he had appalled the board or that he had made an enemy of Monique Desmonde for life, which was probably not a good thing.