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Jason Toews and fifi (the band)

Hospital 09, June 2014

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Oh, the stories I could tell.

For one thing, I could tell you about our terrifying Sojourn in the Steam Tunnels. Remember that scene in Alien when Captain Kris Kristofferson ventures into the lightless air shafts to find the xenomorph, and Lambert is tracking the alien with some kind of primitive Mario Bros. motion detector, and they’re like, “Oh my god, it’s right behind you!” and Captain Kris is all like, “Hey, hey, hey, Bobby McGee-ee- I’m sorry, come again?” and they’re like, “Not that way! The other way!” and he turns around in the cramped tunnel and the alien is RIGHT THERE and it reaches out with its Black-Lagoon-esque webbed hands and then the video monitor goes dead? It was very similar to that.

I could also tell you about the hour we spent looking out an upper-floor window, agonizing over our exit strategy, at which point we saw a homeless guy walk right in through the front gate – in full view of the security van – and nonchalantly climb in a basement window. Side note: There is a homeless guy living in Hospital 09, which, you know, more power to him. He has scavenged useful items from all over the complex and gathered them into a single room, where he lives. When we first met him, he was cooking a can of beans over an open fire in a modified television cabinet, thick smoke billowing out the window. Despite the fact that we had shown up unannounced in his living room, he was very gracious, if not overly talkative. This encounter left me with confused feelings. On one hand, he has clearly made the best of his situation – he has shelter, a bed, furniture. He seems to have enough food. But the thought of him in that huge building, alone at night – that just seems intolerable. Hard to know how to help, or if he even wants help. Homeless guy of Hospital 09, I’m thinking about you and I hope you’re okay.

Interview

There’s plenty more I could tell you about Hospital 09 – the mangy raccoon who rules the basement, the Kingdom of the Pigeons on the top floor, the inexplicable cache of mugshot Polaroids and wiretap transcripts… But instead, I’m going to interview a great friend of mine, who actually worked at Hospital 09 for twenty years. Dear Readers, I give you… [name of friend redacted]!

How many patients were in Hospital 09 when you worked there?

In 1976 there were approximately 6000 patients. Most of the buildings were in use. A number of those original buildings were knocked down as the inpatient census declined over the years and patients were consolidated into fewer buildings. Some of the buildings were turned over to city (NYPD) and not for profit agencies who turned them into supervised community residences for both developmentally disabled or mentally ill patients who no longer needed inpatient care but still required an intensive level of supervision.

How many staff?

I honestly don’t know the staff numbers. Suffice it to say that given that Hospital 09 is a State Agency, funding was always an issue. Some years were better than others. There were years of severe budget cuts that resulted in layoffs which of course impacted our ability to deliver the highest quality of care. With that said, I never felt that the patients were receiving substandard care. Rather, staff worked harder. In good years, we had more hires and were able to institute many new and innovative programming.

How did mental health care change during the years you were there?

The single biggest change came with the advent of new psychotropic medication. Science gave patients a true chance to improve, to come out of living in a world filled with active symptoms and to “quiet” their brains. This resulted in many patients who were once considered unable to function outside the institution to slowly learn the skills needed to leave Hospital 09. With this came the need to bolster outpatient services and develop community based residences. In those “in-between” years, most patients albeit improved still needed supervision in the community.

The other big change I saw starting around the early 90’s was patients who had dual diagnosis: mental illness and substance abuse. This was a game changer (and not a good one). Patients became more difficult to treat, incidence of violence rose on the wards and there was an overwhelming need to develop new programming and re-train staff to handle this new category of patients (dubbed MICA for Mentally Ill Chemical Abusers).

Any strong memories of individual patients?

I vividly recall the first time I got hit by a patient. I was working in Building 10 which was then an Open Ward (patients were able to go to programs on the grounds in other buildings as well as other grounds privileges). He came flyng at me over my desk. Fortunately I wasn’t really hurt. He wound up being transferred to a maximum security psych. hospital which saddened me but he truly needed that environment for a time.

On a positive note, I happily recall so many patients who were discharged and while attending our outpatient clinics, moved to independent housing situations, jobs, school, etc. I spent the bulk of my career in outpatient services so I was fortunate to see many success stories.

I recall one patient in particular who went on to marry and finished his college degree. He was a really likable guy who just needed the right medication and the right supports in order to flourish. Believe it or not, myself and another colleague of mine still hear from him from time to time.

What was the worst part about working at Hospital 09?

The politics of government and who decided what was best for the mentally ill and hence where the money flowed to (or didn’t).

The stigma of mental illness and the prejudice that patients encountered was (and still is) a major impediment to seeing patients flourish.

What was the best part about working at Hospital 09?

The commitment of many staff to work in Community Psychiatry in a State Hospital rather than in the private sector (where of course you’d make more $) was a wonderful thing to be part of. I worked with a group of people who were bright, innovative and determined to make a difference (I know it sounds corny but it was true).

Was there a conflict between what the staff saw as their mission and what the administration thought?

Periodically, yes. Depended on who was Governor, who was Commissioner of Mental Health and who was Director of the facility. I was fortunate at Hospital 09 to have been given a lot of latitude in overseeing my staff and hence able to get some great programs into action. Every state facility had their own politics, their own problems.

What did it smell like?

In the early days of my career (late 70’s-80’s) when options for treatment were limited, patients were much more regressed and to put it nicely, bodily functions were, well… you get the picture. Really regressed patients loved to “paint” the walls. I’m gagging just remembering this. But that wasn’t the norm and usually the wards had more of a medicinal smell from the cleaning materials.

Any other thoughts on your time at Hospital 09?

Although I had a great career, this was a difficult environment to work in. I was an mid-level administrator for most of my career at Hospital 09. Supervising staff had great rewards and also many stresses. I had the misfortune of working with some very incompetent staff and much energy had to first be put into trying to educate them but that usually didn’t work. As a permanent civil servant (this is government at its worst, in my opinion), it’s extremely difficult to fire someone. I must say I made it my mission to get rid of two doctors who practically killed patients with their mis-medication. I was not a popular person at times. Other staff feared they might be next. Well, guess what? If they couldn’t do the work, they shouldn’t be there. I prided myself on motivating staff to do their best and establishing a support system for them to work in. Other than a handful of staff, I was really lucky to work with some of the smartest and most dedicated staff.

I am sure there are some real ghosts roaming those halls that could tell some horror stories from days of old and even from the years I worked at Hospital 09.

There’s been a variety of homeless people in some of the buildings and I’m not sure why the State hasn’t addressed that. Quite frankly, if these buildings aren’t going to be renovated, I think they should be knocked down. That pigeon poop is enough to make me ill!

Thanks, [name of friend redacted]!

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