I had a patient who I grew really attached to beginning when I first met him 3 years ago. He was very, very schizophrenic and lived a very tormented life. He gave everyone he liked their own nickname and refused to use real names. My name was "Virgin Mary". I had to do some pretty painful things to him and trust was a huge issue for him. So we developed a lot of rituals to help. Every day we loudly sang "Home on the Range". We agreed that screaming was ok, but it was best to wait until I wasn't in a position where I could jerk and make the pain worse. After days of practice he understood this and it helped immensely. The most important factor was that with much practice he came to understand that I would never hurt him without telling him first. I always count to 3 before hurting patients so they know and with him I made it very exagerrated, training him by counting to 3 before I touched him and not moving past that until he stayed relaxed. Ultimately he was so good at this technique that I could say "ok, it's time for (the thing that hurt)" and he would chant "do not resist, do not resist, do not resist, ONE....TWO...THREE".
After months of working with him he wasn't on my caseload, but I still visited frequently. Then one day devastating news came. The facility he lived in was closing. He was on the list to be transferred away, to another set of facilities. I kept praying he could be transferred to one of our facilities. After several weeks I learned I had gotten my wish and he would be moved within several days.
By that time only maybe 20 patients were left in the building. They had tried to consolidate them to one ward but this man was terrified of one of the other residents (for good reason) and so he and one or two others were in another ward. I happened to have a few minutes and saw him watching it rain, so we shared a Coke and talked about how "teak is the hardest wood, Virgin Mary. Teak is the hardest wood". I remember being grateful for having that time because normally that was a night I had counseling and I wouldn't have had any free moments. We also had a conversation that was strange, where he seemed to fully believe I was the real and true Virgin Mary, and he was talking about his past sins and his sadness about how he had lived. Unfortunately he had a terrible history of abuse and he had gone to jail for murder as a very young man, and he believed himself to be evil. We talked that night about how he was a good person, that God forgives, and that he was loved. I hope he knew that I loved him too.
I took that Thursday off for a psychiatrist appointment and saw my therapist that day. I even mentioned to her that I was glad for the schedule change because it had allowed me to have that neat time.
Friday I went back to work and was so excited to learn he had been moved to my primary building. I went to see him around lunchtime. He didn't seem himself, but he knew me and talked to me. Mainly he seemed afraid of his new roommate, who was having some behavior challenged moments (ie beating up staff). I started a treatment with him and left it on for some time.
Four hours later I went back to remove it. His door was closed. No big deal, I had to talk to someone else. I did that, came out and his door was still closed. I started to go to it, figuring I'd have to wait for them to finish changing him or something, but a friend stopped me and told me I needed to go say good-bye, that he had just died and she knew I loved him. I didn't believe her for so long and kept making her repeat it. It was true. He had a heart attack at supper and died. I was moments from having been with him; they were still preparing the body when I nearly walked in on that. I did not want to say good-bye; I realized he had done that 3 days before in an eloquent way.
I did run from the building. I have never fled work like that, and have never been affected like that by a patient death. I cried all night.
That was 2 years ago today. He had no family, no known friends. He was cremated and buried as a charity case by the county. I doubt anyone else alive remembers today that this is the anniversary of his death. So to give him some memorial, I love you and miss you Norman. I'll always be your Virgin Mary.