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December 17, 2018

Back in 1988 working on an adolescent psych unit I learned about Risk

Risking

It was back in 1988 and my second job in nursing, the start of many. The medical director of the small psychiatric unit that housed adolescents with mainly substance abuse issues was a small charismatic man with a wry smile.  He didn’t think young people went through withdrawal nor did he ascribe to medication as a treatment for children. He came from a behavioral perspective and it was a rarity when he would prescribe.

The unit was set up on a point system.  The kids came in on level one with few privileges and left when they climbed to level 4.  We searched their bags for contra-band taking most of their belongings that marked their individuality and independence.  Their nirvana music, “inappropriate” t-shirts and cigarettes.  There was a list of things that we would pull from their bags when they arrived on Level 1. When they got to level 2 they could smoke and when they achieved the upper levels they got to go home for weekend visits and then would eventually leave.

They came from middle and upper-middle-class families.  They were hospitalized for their uncontrollable incorrigible behavior at home.  I do remember a few of them distinctly.  They had their own stories behind the bravado.  Mostly their stories had to do with adoption, divorce or abuse.  Once in a while you’d think that maybe they didn’t fall into any one of these categories but then you’d uncover that indeed they did.

Dr. J wasn’t concerned with coddling or showing pity rather getting them in shape to be in a good enough place to go home someday.  He felt that a family approach was also needed to address their problems.  There were weekly parent education and therapy groups that he and the head nurse and the social worker conducted.

Many things happened in that short year back when I worked there.  There was the sweet, young mental health aide who was attending school to get her master’s in social work degree who had a similar story as the kid’s and her suicide and how devastating it was to all of us.  And then, tragically a week after her death, one of the nurse’s sons took his own life. The only clue him asking his mom why did she (the aide) choose such a violent way to die?

There was the 18-year old kid who was over 6 feet tall, who terrified us all.  The other kids on the unit started to act out when he came to the unit. He was scary; with glassy eyes made especially so by the strong psychotropic med that he was on that did nothing to dull his frightening energetic presence.  His diagnosis was antisocial personality disorder with psychotic features. He bragged about the horrifying things that he had done.

I didn’t stay at the job long because it didn’t pay well.  I approached the head of the hospital for a raise after I had completed my first year and when I was told no, I put in my resignation. We had just purchased our first house and money was tight. It was a for-profit private hospital.  There were perks though; the morning coffee and the elaborate hot meal at lunch that was free to the staff.

There was another aide who drove a motorcycle. He was tattooed which was less common back then.  He could relate to the kids and they to him.  He was in his mid-thirties, a decade older than me. He taught me about recovery, AA and how sobriety didn’t have shades of gray.  It was an all or nothing business.  He would talk about giving the kids an attitude adjustment.  He worked in tandem with the medical director to help break the kids down and get to the core of their problems; why they were there so it could be uncovered and healed.  I don’t remember any of the kids going into placement when they left the unit.  I do remember that a few returned shortly after they left.

There was another young woman who would eat all kinds of strange and healthy foods (stuff I probably eat today) and had all kinds of testing to uncover her maladies through methods such as kinesiology.  I found the health techniques that she sought interesting, others found them strange.  Then there was the LPN and our candid discussions on race and prejudice.  How she gave me the best piece of advice that I have ever been given,  “People only push you as far as you let them.”

A few months after I started on the unit, the medical director threw a Christmas party at his and his wife’s home.  I vaguely remember his wife being a small woman, deferential to him and I also remember a plaque on the wall with this poem about Risk on it.  I stared at it for the longest time, loving its words and meaning.  I must have told him how much I liked the poem because he later wrote it up and gave it to me.  A friend looked it up and found the original writer and also the full version of the poem, the doctor’s had been missing the last verse.

Inspirational Poem: William Arthur Ward on “Risk”
To laugh is to risk appearing a fool,
To weep is to risk appearing sentimental
To reach out to another is to risk involvement,
To expose feelings is to risk exposing your true self
To place your ideas and dreams before a crowd is to risk their loss
To love is to risk not being loved in return,
To hope is to risk despair,
To try is to risk failure.
But risks must be taken because the greatest hazard in life is to risk nothing.
The person who risks nothing, does nothing, has nothing, is nothing.
He may avoid suffering and sorrow,
But he cannot learn, feel, change, grow or live.
Chained by his servitude he is a slave who has forfeited all freedom.
Only a person who risks is free.
The pessimist complains about the wind;
The optimist expects it to change;
And the realist adjusts the sails.

William Arthur Ward
https://realisticrecovery.wordpress.com/2009/05/13/inspirational-poem-william-arthur-ward-on-riskn-risk/

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