Tuesday, December 26, 2006


Yesterday morning at church, our priest read, as part of her homily, an essay about God, supposedly written by eight-year-old Danny Dutton of Chula Vista, California. (Snopes.com argues that this essay is probably a hoax, composed by a much older person, but it was fun to listen to anyway.) One sentence in particular struck me: "Because He hears everything there must be a terrible lot of noise in His ears, unless He has thought of a way to turn it off."

Hearing that, I flashed back to a particularly haunting hospital visit some months ago. I was going to try to work it into the sonnet cycle (and I may still do that), but right now, prose is easier. This one feels right in second person, for reasons I can't quite articulate.


You're on a bed in the hall, huddled into a blanket. When I introduce myself, you sit up and look at me anxiously, nodding when I ask if you need to talk. But it takes you a moment to collect yourself, or to gather the courage to speak. "The doctors don't understand. Nobody understands."

"What don't they understand?"

"The voices. No one knows what it's like. I just want them to stop!"

I kneel next to the gurney so you won't have to strain your neck to look up at me. "It's hard for people to understand something they haven't gone through themselves. I want to understand. Will you explain it to me?"

You say you will, but you're fretful. You don't like being in the hall: it feels like everyone's staring at you. There's a newly empty room nearby, so I get permission from your nurse for your security guard to move you there. (All psych patients are watched by security guards. This sounds unkind, but it's better than restraints, and the guards are profoundly sympathetic people; this part of their job has given them excellent listening skills.) The room gives you a little more privacy, although we still can't close the door or draw the curtain around your bed, because the guard has to be able to watch you from the hall. There's a radio playing in the room, and it bothers you: the guard turns it off.

You ask if I'll sit with you. I sit, trying to be quiet, trying not to press too much, and gradually your story emerges.

You've been here at the hospital for going on twelve hours, waiting for psych evaluation and transfer to another hospital. You've been hearing the voices for twelve years. The voices never stop completely: not even on meds, not even when you're asleep. When I ask what they say, you tell me flatly, "They want me dead." They're never friendly. There are two or three different ones, distinct from each other but always the same, a chorus of enemies. They sound as if they're in the air around you.

"It must be like being in a really noisy bus station," I say, and you nod. They're talking to you now, of course. They're really bad right now, which is why you're here. I can tell how much effort it takes for you to listen to my questions, to talk to me over the din: you wear the strained, distracted expression of someone who's trying to hold a conversation over jackhammers, or screaming infants, or car alarms. Or voices that want you dead.

Your parents hate you, you tell me. You have siblings, but you don't have a relationship with them, either. Your spouse and child have just left you, which is why the voices have gotten worse again. "I miss them," you say, and your voice cracks. "I want them to come back." You have one friend in another part of the state: someone who understands about the voices, someone who loves you. On the phone this morning, your friend told you that you needed to come to the hospital, and you listened.

I tell you that I'm glad you have a friend like that. I ask if there's anything else you enjoy. You think a moment and say, "I like my job." You hope you'll still have your job after you get out of the hospital.

You're tired of waiting, hungry, exhausted from the voices. I find some crackers for you to eat. I ask if you'd like a magazine, but you shake your head. "I can't read when the voices are this loud." I ask if you'd like some paper and crayons to draw with, and you nod, giving me a shy, surprised smile.

I bring you paper and two packs of crayons, one in mostly bright colors and the other in darker ones. I'm curious to see which you'll choose. You choose the bright ones, and start to draw a flower. When I compliment you, you say, "It's not very good," but you smile again when I tell you that it must be good, since I knew right away what it was.

We talk about the psych hospital. I ask if people there understand. "Some of them do," you say. "Some of the doctors. It's okay there. They're pretty nice." But you don't have anyone to talk to once you're out of the hospital, except your friend across the state. You mention NAMI, the National Alliance on Mental Illness, and I suggest that maybe the local chapter has a support group for people who hear voices. If they don't, maybe they can help you start one. That would give you people to talk to outside the hospital, people who understand.

You appear to consider this, but your expression's more strained again. I tell you that I'm going to try to find out how much longer you'll have to wait for the psych evaluation, and I go to find your nurse. The nurse doesn't know. When I go back to your room, you show me the picture, finished now: the flower, a tree, a house, a sun. A heart. The colors are bright, the lines delicate. I tell you that the picture's beautiful, and you look pleased.

I tell you how brave you are to keep going despite the voices: how brave to have constructed a life where you have a job, a place to live, a family (even if they're gone now). I tell you again how beautiful your picture is, how happy it looks. If I heard nonstop voices that wanted me dead, I don't think I could draw a happy picture. "I just want to be be normal," you tell me. "I just want to be like everybody else." It occurs to me then that your picture's a prayer, a drawing of the life you want: sunny, peaceful, calm. Quiet.

I wish you luck in the hospital. I thank you for talking to me. I say, "I know I can't understand what this is like for you, because I haven't gone through it, but thank you for telling me about it. Thank you for helping me understand a little better than I did before."

I can't tell if you hear me. The strained expression is back; I think I'm being drowned out by the voices.

Later that evening, I think about a story I didn't tell you, because it's too sad. In college, I studied poetry with Maxine Kumin, who had been one of Anne Sexton's best friends. One day in class, Maxine talked about Sexton's suicide, which had been no surprise to anyone who knew her. The remarkable thing, Kumin told us, was that Sexton stayed alive as long as she did. "She heard voices. She told me once that the trees spoke to her every June." It had taken unimaginable courage, Kumin told us, for Sexton to function as well as she did for as long as she did.

I pray for you every day. I don't want you dead. I wish my voice could make the others go away, but I don't have that power. Only God and the doctors do.

I pray for your doctors, and I pray that the ones who don't understand will listen to you, and try to understand.


  1. This is so sad. What courage she has. I hope she's doing all right. Thank you for telling the story.

  2. This is the epitome of the therapeutic use of self. What remarkable active listening skills you have!

    The patient was accorded respect, honesty and genuineness, and I suspect, some relief, as well.

    Thank you for writing this.

  3. Thank you both!

    Claire: I hope so too.

    UH: My listening skills vary; they were better with this patient than they often are. I'd like to think I helped bring some relief, but under the circumstances, I doubt it.

    The real credit here goes to the patient, who was somehow able to hold a lucid conversation over the din. I can't imagine how hard that must have been.


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