Mundane Sadness
Bill’s announcement that Ella’s not ready to be discharged from the psych ward triggered a full-blown fit of rage. Now I am forced to pin her down on the treatment couch, while she cries, screams, curses, and trashes beneath me, and even though she’s severely underweight, she possesses a surprising amount of strength.
My brother takes a quick glance at his watch. He presses the emergency button on his pager and starts preparing a syringe.
When Ella sees this, she goes still and stiffens under me. She’s highly alert, like she’s ready to bolt. I`m gripping her wrists tightly because I do not want to risk her escaping. It makes me feel like some kind of monster for doing this to her. Her body is so frail, and I’m afraid that I’m causing her bones some serious damage.
“I’ve been eating normally for a whole fucking month,” she sobs as tears stream down her hollow cheeks, „yet you refuse to release me from this shit-hole!”
“You were nowhere near eating normally,” Bill replies. „You’ve still been throwing up, and your BMI is still within the critical range.”
“But I’ve gained ten pounds!”
“The weight gain you’ve experienced is due to drinking gallons of water.”
“So what?” she screams at the top of her lungs. „It’s still a gain, isn’t it? I just want to get out of here!”
“You will be discharged when you no longer need to be here.”
“I want to leave NOW! Give my treatment slot to someone who wants it, because I DON’T!”
“We’re doing what’s best for you, Ella.“
“No! You’re doing what the fucking court ordered!” Ella is sobbing so desperately that my hands arounds her wrists start trembling. I swallow and bite my lip, all of a sudden very close to breaking into tears myself.
Bill comes over with the syringe. “Relax. It’s almost done. Just relax,” he says as he injects the sedative. I don’t know if he’s talking only to Ella or also to me. Maybe he is trying to calm both of us.
Anyway, I’m glad that my brother is here, because often, he’s not. Technically, we work on the same ward, but most days he appears only briefly – just long enough to discuss pros and cons of treatment or to see new patients - before he’s off to assist another ward. He’s always about to leave, because – as he likes to say - it’s his duty to be flexible.
Within seconds, Ella becomes limp and quiet. And my heart turns awfully heavy.
Am I doing the right thing? Do I want to witness forced treatments like this over and over again? Do I want to be a nurse for the rest of my life just because my father wants me to?
It’s not the firsts time I’m asking myself these questions.
Chief nurse Linda enters the room. Bill tells her to take over Ella’s care. I cast a sad glance at the blonde patient before turning to leave.
“Don’t forget the meeting,” my brother reminds me. “It starts in five minutes.”
Actually, I did forget. It’s unusual for me to get invited to a meeting other than the monthly Friday informal meetings.
I nod to Bill and hurry into my tiny office. The struggle with Ella has made me start to sweat. I yank my wardrobe door open and pull the blouse over my head with an angry move. Truth be told, I’m not in the mood for a meeting.I’ve already have enough, and it’s only Monday.
I’m so fed up with my work. As much as I care about people and want to help those in need, working in a psych ward is wearing me out. Aside from tragic cases like Ella’s, which gnaw at me long after I get home, I have to witness the frightening depths of the human mind on a daily basis, and it`s taken its toll on me.
Bill always says I have to learn to distance myself from it. Easier said than done. I never wanted to become a nurse in the first place, but this job is family destiny - in the truest sense of the word.
It all started with my German-American grandfather, Peter. He was a neurosurgeon who settled in Las Vegas and married an American nurse - my Grandma Teresa - who died of cancer long ago.
Gramps was the one who founded Castell Private Hospital, which specializes in psychiatry, neurology, and neurosurgery. He worked into his late seventies, even though most surgeons retire at sixty.
After his death, my father took over the clinic. A medical journal recently named him one of the top neurologists in the United States. Castell Private Hospital has enjoyed an excellent reputation since its founding—not only because of cutting-edge treatment methods, but also because it offers free care to severe cases without health insurance. That’s what Ella is currently receiving—or rather, what she’s being legally forced to accept through her guardian. He obtained a court order that mandates her treatment here, even against her will.
Bill is following the male family tradition. My twenty‑eight‑year‑old brother is in residency and on his way to becoming an MD himself. His chosen field is psychiatry.
Our mom was a nurse in this clinic, too. She worked in the acute ward – until that terrible day three years ago.
Unspeakable dread settles over me whenever I think of that day.
My mother loved cooking. As a vegetarian, she often prepared mushroom dishes, many of them from her own foraging. That evening – Bill and I weren’t home as we had already moved into our own places – she made dinner for herself and Dad, and invited Gramps as well. Just a few hours later, all three were admitted to the hospital with symptoms of poisoning. Dad barely survived, while Mom and Gramps died of multiple organ failure. Apparently, Mom had mistaken the highly toxic false morel for the popular morel mushroom.
After their deaths, nothing was ever the same again. I moved back home immediately to run the household and to be with Dad. I had a Bachelor’s degree in physical therapy and was studying for a Master’s at the time, but he wanted me to start attending nursing school instead. He said that just like Bill makes him proud by following in his footsteps, Mom would be proud of me too if I became a nurse at our clinic.
He basically talked me into quitting my studies. I felt cornered and morally obligated and eventually, I agreed to Dad’s plan for my life.
I finished nursing school. Since then, I have been working at Ward 5, a locked ward at Castell Hospital. But unlike mom, I’m just a registered nurse. I don’t have specialized training in psychiatric nursing, and luckily Dad hasn’t yet come up with the idea of talking me into that as well.
For quite a while now, I’ve secretly been thinking about abandoning my profession. Although I have no idea how to break it to my father. It would be easier if he hadn’t lost his wife so early in life, and if he weren’t battling a deadly disease…
The door flies open and Bill comes in. It snaps me violently back to the present day, because, of course, he can’t be bothered to knock.
“Ready, Sis?”
I quickly get a fresh shirt out of the wardrobe and pull it over my head. After redoing my waist-long hair into a ponytail and snatching up my staff lanyard, I follow my brother out of the room.
“I hate being that mean to Ella,” I say as we’re riding the elevator up to the seventh floor. “I truly feared that I would break her tiny wrists.”
“You did what is best for her.”
“But I caused her pain.”
“Ash, that girl suffers from the worst case of an eating disorder I’ve come across in this clinic. Her mental condition is what her real pain is about.”
I sigh. “I was so happy that she had been so eager to put on those ten pounds.”
“I knew right away something was off. She was just trying to get released ahead of schedule. She wants to starve, binge and barf in the privacy of her home until she dies.”
“Don’t speak so negatively. It’s your job to keep the faith.”
“This isn’t about faith, Ash. It’s about assessing a situation realistically. Do you know her London story - the ruptured esophagus?”
“Yes, but that was back then.”
“No, it`s today. Her mindset hasn’t changed.”
“People can overcome their mindset. That’s why she’s here.”
“Ella is a hardship case. Practically destined to fail.”
“Great psychiatrist you will be. She might be a hardship case, but she`s not a hopeless one.”
Bill shakes his head. “If I had your optimism.”
The elevator stops at the seventh floor. My brother looks me straight in the eye with a seriousness that I find a bit startling.
“What Dad is about to tell you,” he says slowly, “is a matter of importance. Don’t make it more difficult for him than it already is, and please, join us.”
“Join you?”, I repeat in mild confusion. “What are you talking about? You already know details about the meeting?”
“You’re gonna find out soon.” Bill steps out of the elevator, and I follow him, irritated that he knows things before I do.
Dad is waiting for us in front of his office. My heart makes a painful leap when I see him. He’s lost weight again, the lines around his eyes and mouth have deepened. It seems like they’re getting deeper every day.
My father’s had periods of sickness over the years, but he’s been too busy to see a physician. Recently he finally did, and he was diagnosed with chronic leukemia. Now he’s taking the standard drug used in cancer treatment. It has wrecked his appetite and caused mouth sores, which make it difficult to eat. These are common side effects of that drug, but his physician, Dr. Darrel, thinks it’s a promising therapy.
“Come in,” Dad says with a tired smile.
I force a happy expression onto my face as I pass him. He doesn’t like seeing me worry about his health so I try to hide it.
Dad‘s office is impressive. It’s spacious and flooded with light, with floor-to-ceiling soundproof windows overlooking the Las Vegas Strip — one of the most famous streets on earth.
To my surprise, Mitch and a black-haired, stern-looking woman are sitting at the conference table. Although Mitch is our uncle, we`ve never been close. He’s a high-powered lawyer with connections to the upper class, never got married and has been focused on his career only.
While Bill makes a beeline for Dad’s automatic coffee machine, I take a seat.
“Hello, how are you doing?” I greet Mitch as well as the woman. She has a white folder in front of her and is gazing at me in a rather unkind way.
Who is she? I wonder. I would guess her to be around my father’s age.
At least Mitch replies to me. “I’m great, Ashley, thanks.” He’s smiling, but his tone of voice is somewhat superficial.
Bill sits down next to me with a cup of coffee, and Dad takes a seat at the head of the table.
“I want to thank everyone for coming,” he says. “Ashley, you might be wondering why Mitch is present. He makes sure everything that’s being said will stay inside these walls.”
My eyes widen. I turn my head to look at my brother, but he avoids my gaze.
Dad motions to the woman sitting opposite me. “Sweetheart, this is my assistant, Tonya Jeffers. She’s a DNP and has been supporting me for decades.”
Now that’s news to me. “’Decades?” I utter in disbelief. “How come you never mentioned her?”
“You weren’t supposed to know about her. Before I go into further detail, though, I need you to sign the document first. Mitch, would you, please?”
My uncle pulls a paper out of his portfolio and shoves it towards me. I quickly read it: it’s a statement of secrecy.
“What’s that for? I already agreed to professional discretion before I started working here.”
“The current case is different, Ashley,” Mitch replies and hands me an expensive looking pen. “The standard discretion doesn’t cover the project you’ll be getting involved in.”
I’m confused, and all of sudden, a bit scared. “Project? What project?”
“Please sign the document, sweetheart, and listen to what I have to say.”
Bill is staring at me from the side, I can feel his burning gaze. I glance sharply at him. He doesn’t look away this time. There’s a fierce pleading in his eyes and I can literally read his thoughts. ’Don’t dare refuse our father’s wish, who knows how long he’s going to be with us...?’. I’m pretty sure it must be something like this.
He’s right, actually.
I pull myself together. Of course I will listen to whatever my father wants to tell me, there’s no harm in that, is there? And what’s the worry anyway? It’s just a statement of secrecy. A piece of paper that means nothing except to keep quiet about what I’m going to learn.
I sign the document. Mitch grabs it and puts it back into his portfolio.
Dad smiles at me. “Thank you, sweetheart. Now, I’m not going to beat around the bush. I’m going to tell you everything as it is, right from the very beginning.”
There’s a queasy feeling in my gut. “I’m all ears, Dad.”
His face turns serious. “This project came to life fourteen years ago. I started it together with your grandpa and Tonya. Tonya had already been working at our clinic for many years and has proven herself a hundred percent trustworthy. She is the only non-family person who is involved right now. Gramps was against getting support from strangers, he wanted it to be a family thing for reasons you’ll learn about later. For a long time, the three of us worked on the project alone. Eventually, we realized we needed additional support — especially with regard to the project’s future. So we brought Bill on board. I’m proud to say that he supported us every free minute he had, even during medical school. He worked incredibly hard for the project. He still does.”
Here, he looks at Bill approvingly.
“We let you mother in as well. We showed her the ropes and she became a part of the team, too.”
My face has slowly faltered during his talk. “My whole family has been keeping secrets from me?” I ask hoarsely. “Even Mom?”
“Please don’t feel offended, sweetheart. When I asked you to become a nurse, I was counting on having you join our team someday as well. However, I couldn’t burden you with this project before you had finished your training successfully, and that’s what you did. The confident way you’ve been dealing with patients has made it clear to me that you’ll be able to handle this job professionally. The time has come to let you in on the project.”
I sit there, thunderstruck. Suddenly it seems all the more logical to me why he had pestered me to quit my original studies. But me? A confident nurse? I guess I’m a rather good actress.
Dad gives the black-haired woman a sign. She leans over the table and pushes the white folder toward me. I feel uncomfortable under her stern expression. She is not smiling one bit, not making a friendly face at all.
“This file is an overview,” my father says. “There are many more documents regarding the project. Due to safety reasons, they can only be viewed at Tonya’s office, though.”
This ongoing secretiveness is getting on my nerves. “Where is her office?”
“Under the underground garage in a security ward.”
I almost gasp in surprise. “There is a floor below?”
“Yes, indeed. The whole project is happening there. It was a repository until we turned it into a ward.”
“How does one get there? The elevators end at the underground garage.”
“The south elevator doesn’t. We had it modified, so that no third party can enter that ward. You’ll gain access as soon as your identity card is programmed. Now go on,” he encourages me and nods at the file. “Have a look, sweetheart.”
Don’t do it, my mind whispers. If you open these white covers, your life will be turned upside down forever.
