A Hero for Hero

Reminder: Hero is a hybrid accumulation of memories and a fictionalized version of experiences with my patients. All identifying traits have been modified and scrubbed. Though there is no actual Hero, I believe the essential truths his story reveals are accurate.

Hero asked nothing of us, not to be off meds or on meds, not to be discharged or transferred, not for a job on campus or a pass off campus, nothing. The hospital met his basic physical needs of food, housing, and medications by osmosis. He was our Tibetan monk living entirely off the offerings of us strangers. He relied on no one and, in a way, on the anonymity of everyone.

There is a specific loneliness I associated with some of my mentally ill patients. It was found in those who had divided themselves in order to provide their own company. I am not talking about DID or what used to be called multiple personality disorder. That has a different mechanism and purpose than the split I am talking about. What I refer to is a fracturing of the spirit in response to the vicissitudes of life, and yet the individual still knows themselves to be one person.

This sort of schism made sharing a common reality with them harder. It also produced a hauntingly hollow ache that was painful to see. At times, like with Hero, it was surprisingly hard to reach them. We had to be careful. For us to be constantly asking for a connection was not the answer. That could have the effect of pushing the individual further away. He would hide deeper in the jungle on his island if we nagged or pressed. And frankly, the rhythm of what patients needed and when was often difficult to discern in its fullness.

Though this may all sound complicated and psychologized, it wasn’t. It ended up being a dance of offering here and there, mutual tolerance, and ultimately acceptance of the patient’s choice. Thankfully, usually, one of the team could reach the most isolated person. Someone could figure out how to connect with the grump, or the angry guy, or the paranoid person, or the terrified fellow.

But as the months passed, Hero’s isolation took on a kind of mythic status. We kept trying to connect to him without much success. Maybe we over-tried. Or maybe he was a master at using reverse psychology on us. The less he asked of us, the more we gave. (By the way, please don’t put a thumbs-up on this essay or pass it to friends.) This kept going until...

At various places on campus, there are dedicated phones with a direct line to the hospital switchboard. These phones were for patients to use in case they needed emergency assistance. The residents used them often and frivolously. The operators, often kind and patient women, received a massive number of wild complaints and demands. There were appeals to notify the local police department to report a kidnapping (the caller was reporting their kidnapping by the hospital). Several requests were made to reach current and past presidents. The power of advertisement was also evident, as there were many entreaties to be connected to lawyers seen on TV.

Hero started to use this phone system a lot. But his use of it was not to report trouble or request help. Instead, he always asked the switchboard operator the same thing. “Did the cousins deliver the package yet?”

I would walk by and hear him describe its potential size or color to them. Sometimes, he’d mention a delivery truck he’d seen on the road in front of the hospital, and this meant that the operators should be on the lookout for a delivery soon. Some days, Hero would remind the operators which ward he was housed on, so they knew where to send the item when it came.

But no package ever arrived. These calls represented another disconnect in his life, and I kept worrying for him.

Hero’s calls to the switchboard got more frequent, and he stayed on the line for longer periods. The operators, whenever I saw them in the administration building, would warn me with a question. ‘Are you aware of how many calls Hero is making?’

They didn’t ask me to do anything, per se. I think the operators would have preferred the hospital to be full of hundreds of phones so that every patient could be heard whenever they wanted to be. But if Hero’s use became a block to the other patients’ access, there could be problems. If this misuse of the phone reached the resident grievance committee, the treatment team might have to restrict Hero’s access to these phones or even his ability to roam the campus freely.

For several weeks, things stayed under the radar. But one day, I noticed Hero at one of the phones. A line of disgruntled patients fidgeted behind him. These other patients needed to warn the White House or whatnot. I tried to bribe Hero off the phone by promising him a snack back on the ward (preferably something with a long shelf life in case he hid it under his pillow). Hero kept talking and ignored me.

My pleas got more panicked as the mob grumbled. I plied him with various choices; fries at the canteen, a get-out-of-bath-free card... Nothing worked. I resorted to the nuclear option.

“Hero, give me the phone now, or I am calling security.” I stuck my hand out. His crestfallen look softened my edge. “I’ll ask the operator to call me if any packages come.”

He handed me the receiver.

“Hello, Operator,” I said.

All I heard was the dial tone. I thought hard about what to say next. He had obviously spent 10 to 20 minutes talking to a hallucination. “She hung up on me,” I said loud enough for everyone in the queue to hear.

I took Hero back to the ward. At the nurses’ station stands one of the operators. She must have been on break, or maybe she had come to tell us about Hero tying up the line. I knew her by sight. Hero did not. We got closer, and he heard her voice.

“Betty?” Hero asked with a hopeful lift to his words.

She smiled widely in reciprocal recognition. “Hey, still no package yet, but I’m keeping an eye out.”

Hero grinned as if he had just met Alexander Bell.

A small but magnificent change happened after that day. Hero talked to us a little more, participated in groups a little more, and at one point asked for a job. (Which he got and promptly quit.)

Here is what I believe. One of the disembodied voices had stepped into the light. Hero discovered that part of the cacophony in his head possessed warm wishes for him, had a solid memory, and had not betrayed him to the authorities. This handhold helped him navigate between worlds. Maybe this was the last straw of the cumulative effort by the staff, and it enabled him to find a path to a safer shared reality.

This statement might be a stretch, but a little mental yoga is a good exercise. There is a metaphor for our many-voiced insane world in the above story. We need a group of people, and I suspect they will be mostly women, who specialize in communication, connection, and handling emergencies. They will need to have a good grasp of the facts, solid recall of history, accepting spirits, and a willingness to consider the unlikely. This is the group I believe has the best chance of helping us through the polycrisis that is upon us. Thanks for spending some time with me on this.