The View from the Vue Read Free Page B

preventive medicine, thereby usually giving the illness a generous head start before they dragged themselves in for care.
    And where did these disease-ravaged persons go for help when the inevitable could be put off no longer? To an institution chronically short of critical equipment, nurses, and aides, whose physical facilities seemed to sag in response to the weight they were forced to bear, where interns less than a year out of medical school and often with no sleep the night before tried to cope with, understand, and adjust to a constant struggle of life-and-death proportions.
    No wonder Bellevue was the setting for innumerable astonishing episodes of peculiar, eccentric, and downright zany behavior. Patients and staff alike were subjected to pressures capable of taxing minds beyond the limits of tolerance; and to survive in that unusual environment sometimes required behavior which, viewed dispassionately, would have to be classified as something other than normal. Try to keep this in mind if the view from The Vue seems a little distorted in spots.

1

Don’t Go Away Mad
    Once, when I told a young woman that I was working at Bellevue Hospital, she burst out with, “Oh, that must be just
fascinating
. That’s where they send all the
real
nuts.” I assumed that she was referring to the patients in the Bellevue Psychiatric Pavilion, but I did worry a bit. In any case, my new acquaintance rapidly followed up her emphatic declaration with a request that I tell her “all about it.”
    That, in fact, would have been a major project. The Bellevue psychiatry building, constructed in 1935, was already long outmoded by the time I went to work there. Its seven floors of wards were divided into facilities designed to provide care for inmates according to their degree of impairment. The most seriously disturbed patients were confined on the top floor; below them were the moderately ill. The remainder of the building was given over to the care of patients with less critical mental disorders and to outpatients. Parts of two of the floors were set aside as psychomedicine wards, for mental patients who also suffered from serious bodily illnesses.
    The physical characteristics of the psych building did very little to enhance the moods of inmates suffering from depression. Any patient who was not depressed on admission, and was capable of relating to his environment, didn’t take long to experience a whopping dejection of spirits. Windows were few in number, and those that did exist were covered with bars. The hallways were long, dark, and dirty. Wards were overcrowded, understaffed, filthy, and malodorous. The beds were crammed into every available alcove, one right next to the other. Patients were either sprawled on the beds or sat on wooden chairs, usually clutching their belongings in paper bags, to guard against the otherwise inevitable theft. Too often, they simply stared into space; there was nothing else to do.
    The wards for the most serious patients were genuine chambers of horrors. Shrieks, screams, and groans reverberated down the corridors in a never-ending cacophony. Here and there a patient stood motionless, perhaps with a stream of urine running down his leg to form a puddle at his feet. Others lay uncommunicative, apparently unaware of the feeding tubes which were keeping them alive.
    The worst patients, those reduced to either animal or vegetable status by deficiency or aberration of mentality, passed the time by mutilating themselves or others at every opportunity, or by assuming a rigid fetus-like posture for weeks or months on end. Therapeutic psychiatry being as primitive as it was, all we could do for these people was to keep them fed, relatively clean, quiet, and as far from harm’s way as possible. Had they been dogs or horses, we’d have shot them without a second thought. But they were human beings, so we gave them tranquilizers.
    My first exposure to psychiatry at The Vue came during my second year of