The Man Who Swallowed a Spork

He was in his mid-30s, nice-looking guy, short blond hair, blue eyes. It was his eyes that got my attention. His stare wasn't vacant, but it did not meet my own. He had his boundaries, and he was not going to connect with or acknowledge anyone. He was shackled to the bed at both wrists and ankles, plus the nurses had put soft foam wrist restraints on him, mostly to protect his skin from the hard metal cuffs placed by the police. Two security guards were stationed in the hall outside his door. They were required to be present because this was a prisoner, and one who had assaulted a police officer.

According to the record, the man had been seen beating his head against a brick wall on the main street of our little tourist town. Someone called the police, who stopped him from doing this and brought him to the hospital for a medical checkup. He was found to have a mild concussion, but no internal bleeding or fractures, and he was sent back to the police station. He was placed in a cell and given food, with a plastic spork  instead of dangerous metal utensils. Later he was noted to be choking, which required another trip to the hospital, this time to remove the spork from his esophagus, which was fairly easily done by the docs.

Now they ordered PT to get the patient up and exercise or walk him, so he wouldn't get deconditioned from so much bed rest. (This is where I always come in. I'm the getter upper.) I was allowed into his room with the two-man security team.  The patient followed commands for muscle strength and range of motion testing. He was normal, strong and fit. The guards released his shackles so I could get him out of bed. He stood up, all the while focused on a point about two feet in front of his face, totally without expression. As he let me guide him to a chair, I noticed a trail of blood drops on the floor. I asked the guard to pull the curtain, then I looked under the patient's gown for the source of blood: there was a three inch wide shallow hole gouged into his buttock, fresh and beefy red, where I assume he was somehow able to rub against one of the shackles or maybe the bed itself, until his flesh opened. I left him with the guards and found his nurse, who applied bandages, and in another day or two he was discharged, probably to a psych facility like the one he was recently released from, before he decided to come visit our town.

Mental health facilities are overburdened. People who do well on their medications are released, no doubt with some kind of plan of care, but they often go right back on the street, maybe in a different town, and descend back into their personal hells, right in your backyard or on the main street of your town.  I don't have answers. I don't know what this man needed. I know we didn't fix him.