PRISM, Volume 1, Part 11
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PRISM, Volume 1, Part 11
Dangerous Dwarf Proudly Presents
George C. Chesbro's
PRISM: A Memoir as Fiction
Volume One: "Dark Engine"

Published by Apache Beach Publications

Click here to purchase Prism

Copyright © 2001 by George C. Chesbro. All rights reserved.
Reprinted here with by permission of the author.

Installment #11
iii

On the first day of the summer session, Fugue will find he has five children assigned to his class, three boys and two girls.

Lance is a lanky 14-year-old boy with sandy hair, hooded brown eyes and a perpetual scowl on his face. Lance finally managed to burn down his school after repeatedly setting fires in wastebaskets. He has been in ASP since January, when---in a reading class where Fugue just happened to be substituting for the day---he jumped up and, without warning, punched another child at the base of the skull. Lance refuses to carry a PEM sheet, but if he did it would be blue; Lance is unable to accept negative points without flying into an explosive rage. He is invariably on "Special Precautions," which means a male Therapy Aide accompanies him throughout the school day and is always close by.

Lance has three Axis I, or primary, diagnoses: Attention Deficit Hyperactive Disorder; Disthymic Disorder---chronic depressive or irritable mood; Conduct Disorder.

He has an Axis II, or underlying, diagnosis of Expressive Language Disorder---an inability to express feelings and function academically.

There are no medical complications noted on Axis III.

Psychosocial Stressors noted on Axis IV include the recent death of his stepfather, his mother's injury in a car accident, and an impending court hearing at which the judge, after studying a report written by Little Ark psychiatrists, will determine whether Lance will be transferred to a DFY cell or remain at the hospital.

His Axis V Global Assessment indicates that his ability to function in any social setting is severely impaired, and has been for the past year.

Lance's contract states that he was placed in ASP because he was assaulting others, frequently had to be restrained, and refused to follow instructions.

Lance has four clinical options---excusing himself from the classroom to avoid conflict; drawing, at which he is quite talented; playing a game; asking permission to talk to a therapist.

In order to reenter the regular program, Lance must learn to avoid conflict, be able to "take time out" before losing control, express his feelings calmly, and follow directions without losing his temper. He must get off Special Precautions, require no more than four CIT interventions in the space of two weeks, be able to carry a PEM sheet, and achieve a B level.

Helma is 17 years old, short and pudgy, extremely bright, and suicidal. Although both her wrists are heavily scarred from past, self-inflicted slashings, she is primarily an "eater," compulsively consuming pens, paper clips, pins and even batteries in a habitual pattern of self-abuse. As a child she was repeatedly sexually abused by her father, who subsequently abandoned the family. She has been in and out of mental hospitals all her life, and this is her third hospitalization at Little Ark. Helma is generally disliked by teachers and Therapy Aides, who consider her a manipulator and instigator of her peers, and despised by the other children, who likewise label her a troublemaker. In the past her mother has been supportive, calling Helma frequently and visiting her once a week during all her hospitalizations. However, of late her mother has shown signs of drawing away, and this has been extremely disturbing to Helma.

Helma will turn 18 in three months, and will then have to leave Little Ark. She knows her mother will not allow her to live at home, and she desperately hopes to qualify for placement in a "halfway house" or lightly supervised adult residential center where she can live semi-independently. The alternative, if she is unable to bring her self-destructive urges under control, will be involuntary hospitalization in an adult psychiatric facility, most likely Big Ark. Helma finds this prospect extremely troubling, for she is aware that her life in Big Ark would be considerably different---sparer, constantly adrift in a sour mist created by heavy doses of psychotropic drugs to control her---from what she has experienced in any of the children's hospitals she has been in.

Helma's Axis I diagnosis is Disthymia with Major Depression.

Her Axis II diagnosis is Borderline Personality Traits, which may include a pattern of unstable interpersonal relationships, impulsiveness, depression, irritability, anxiety, suicidal gestures, and self-mutilation.

It is noted on Axis III that Helma is subject to epileptic seizures and is allergic to bee stings.

The major Psychosocial Stressor noted on Axis IV is the continued distancing of the mother, who now refuses to see Helma at all, or even talk to her on the telephone.

Helma's Global Assessment on Axis V indicates that she is more functional than she has been in the past, and her therapists believe there is at least an even chance that she can be successfully placed in a halfway house.

Helma's contract states that she has been transferred to ASP because of continual self-abuse.

Her clinical options include talking to the staff, writing down her feelings, and asking for extra medication.

In order to return to the regular program, Helma must express her feelings, follow instructions, and maintain an A level for two weeks with no self-abusive behavior.

Roy is a 14-year-old boy who looks 10 years old and acts like 7. Roy is experiencing his third hospitalization, and this time the precipitating event was his attempt to strangle a classmate on the school bus. Badly abused by his father, who abandoned the family, and repeatedly raped by his uncle, Roy is considered homicidal. His ongoing fantasy, one of the few feelings he freely expresses, is to get out of the hospital so that he can find and kill both his father and uncle. He has a desperate, unquenchable need for attention, and he cannot abide a teacher spending time with another child unless he is being attended to by a second teacher or Therapy Aide. He is very attached to John Marsden, and Fugue is curious as to how Roy will react to Marsden's absence over the summer.

Roy has an Axis I diagnosis of Asperger's Disorder, a freshly coded mental malady vaguely linked to autism and characterized by an almost total, sociopathic insensitivity to the feelings and needs of others as well as an inability to form peer relationships. He has a second Axis I diagnosis of Attention Deficit Hyperactivity Disorder, or ADHD.

He has no Axis II entries.

On Axis III it is noted that Roy is prone to seizures.

Psychosocial Stressors listed on Axis IV are Roy's homicidal "ideations," the fact that he has no friends, and the recent awakening of fierce sexual desire that frightens and confuses him, since he has no idea how to cope with these feelings.

His Global Assessment is very poor, reflecting his almost total inability to function except with the attention and help of an adult working with him on a one to one level.

Roy's contract states that he has been transferred to ASP because of assaultive behavior and inability to follow directions.

His clinical options include taking time out, expressing his feelings in writing, and requesting additional medication---but pointedly not talking to staff or asking that his therapist be called, because Roy will attempt to exercise these options constantly if afforded the opportunity.

In order to return to the regular program, Roy must learn to accept "no" for an answer, follow directions, and go for one week without the need for CIT intervention.

Adam is 15 years old, stocky, darkly handsome, and very dangerous. As with Lance, Fugue has met Adam before, during the regular school year when Fugue was substituting for a social studies teacher. At that time Adam taught Fugue what Fugue considers a valuable lesson.

With barely fifteen minutes left in the school day, Adam had raised his hand and politely told Fugue that he "wasn't feeling good." Fugue had asked him if he wanted to go to the crisis room, and Adam had declined. Fugue had suggested that Adam go to the back of the room and "take time out," but Adam had also declined this clinical option. After trying and failing to reach the boy's therapist on the telephone, Fugue had pointed out to Adam that there were now only five minutes remaining before he went back to the cottage, and surely he could hold out that long. Adam's response had been to abruptly leap to his feet, pick up a desk and send it sailing across the room, narrowly missing the heads of three students, to bounce off the reinforced Plexiglas of one of the classroom windows. Then he picked up another desk and did the same thing. Fugue had immediately called a "five-second-drill," allowing each of the other students to earn two hundred points for clearing out of the room as quickly as possible and going to the closest room or office. Adam had just finished trashing the entire room when the CIT, alerted by one of the students who had fled, arrived, took Adam down, administered a shot of Thorazine and carried him back to his cottage strapped to a stretcher and screaming.

Now Fugue listens very carefully when Adam tells him he "isn't feeling good."

Adam has Axis I diagnoses of Explosive Disorder and Conduct Disorder, Solitary Aggressive Type.

His Axis II diagnosis is Borderline Personality Disorder.

There are no medical conditions listed on Axis III.

The Axis IV Psychosocial Stressors include the fact that Adam is an orphan who has been put up for adoption on a number of occasions, but his frequent hospitalizations have always interfered with the adoption process. Currently there is a stable, and by all accounts loving, family that has expressed interest in adopting Adam, but that is now having serious second thoughts due to his continued violent behavior and their understandable concern that Adam could pose a threat to their two younger children. Adam desperately wants to be able to leave the hospital and join the family, but he simply cannot control his violent outbursts. Thus far his psychiatrists have not been able to find the proper mix and dosage of drugs to help him; if he is given enough Thorazine or other tranquilizer to keep him from exploding, he becomes almost comatose, unable to stay awake for any length of time. The search for an effective medication protocol for Adam continues.

His Axis V global assessment is ambiguous, indicating that he can and does function at an acceptable level when his medication is working.

Adam's contract stipulates simply that he has been placed in ASP because he cannot control his explosive behavior.

His clinical options are taking time out and asking for additional medication. Also, he may walk in the corridor outside the classrooms for as long as he feels he needs to in order to bring himself under control.

He may return to the regular program when he has maintained a Level A or B for two weeks with no violent outbursts.

Jessica is a 13-year-old, attractive Hispanic girl who has been transferred to ASP because of her explosive behavior and her unfortunate and highly annoying habit of sleeping all day, and then wandering through her cottage at night screaming obscenities and slamming doors until she has to be taken down and heavily sedated, the result being that she sleeps all the next day, and then spends the next night wandering the cottage, screaming obscenities and slamming doors.

Jessica and Helma reportedly cannot stand the sight of each other. Along with Helma, Jessica is the bane of the Therapy Aides' existence. Jessica has a serious language disorder, and her speech is virtually unintelligible except when she clearly articulates the words "shit," "fuck you," "cocksucker," and "asshole," expressions which easily and frequently trip off her otherwise thick tongue.

Jessica is diagnosed on Axis I as suffering from Schizophrenic Affective Disorder, meaning that she frequently hears voices and is out of touch with reality, but not for sufficient durations of time to warrant a diagnosis of full-blown schizophrenia. She is also diagnosed on this axis as suffering the more common Oppositional Defiant Disorder.

Her Axis II diagnosis is Borderline IQ, or mental retardation.

There are no medical conditions cited on Axis III.

Axis IV Psychosocial Stressors include the recent death of her sister.

Her Axis V global assessment indicates that Jessica barely functions at all.

Jessica has no contract; her therapists assume that she will be in ASP for as long as she is in Little Ark.

Then there is Pedro. Pedro is not on Fugue's, or any other teacher's, roster, but Fugue is very interested in the boy. Pedro does not attend school, and he requires the ultimate in Special Precautions; sleeping most of the time because of heavy medication, he spends his days on the ICU cottage in almost perpetual four-point-restraint, his wrists and ankles strapped to a bed, a male aide sitting in a chair at his side keeping an eye on him.

In layman's terms, Pedro is simply a raging lunatic, with Axis I diagnoses of Psychotic Disorder and Conduct Disorder. It is not anticipated that Pedro can ever attend classes, not even in ASP, for he is simply too dangerous. He will remain at Little Ark until such time as the doctors find a suitable mixture and dosage of psychotropic drugs that will leave him with a modicum of awareness and consciousness but which will also allow him to be controlled without restraints. He was transferred to Little Ark for observation and treatment from a DFY facility, where he was serving time for carrying a concealed weapon, after sneaking up behind a physician and punching him at the base of the skull. At Little Ark he almost killed a male aide, again sneaking up behind the man, this time attempting to strangle his intended victim with a towel. The aide survived only because he kicked over a table as he was being pulled backward and this alerted other aides in another part of the cottage who subsequently came to his rescue. The aide spent two weeks in a hospital suffering from a severely bruised larynx.

During the regular school year, while checking records on ICU, Fugue has caught glimpses of Pedro. A tall, emaciated-looking Hispanic, Pedro's appearance, at least to Fugue, seemed to belie his fearsome reputation and obvious capacity for deadly violence. Fugue had wanted to try to work with Pedro after school hours, on the cottage, but when he'd approached psychiatrists and Therapy Aides with this suggestion they'd thought he was joking.

Damaged himself, Fugue related well with other wounded people. Dorothy Evers, now his boss, one of the many wounded women who had fallen into his life, knew this about him. Indeed, he believed that Dorothy knew him better than anyone. She understood his dark engine, the pain, stress, compulsion and obsessions that were the fountainhead of his art. She considered him quite mad, and he suspected she was right.

Fugue often tells his students, only half-joking, that he is as crazy as they are, and probably crazier than most. The reason that he has keys to the hospital's locked doors and they don't is that he doesn't let his craziness interfere with his taking care of the business of everyday life. Fugue tells them that there is nothing wrong in itself with craziness---as long as the crazy person takes care of business. There are areas in every major city that are stocked with a high percentage of "crazy" people---artists, eccentrics, those who reject a "normal" lifestyle. But these people go about their business, paying their bills, fighting their pain and confusion, sometimes even creating something out of their turmoil. When they learn to take care of business, Fugue tells his students, when they learn not to harm themselves or others, when they learn not to break the law and when they learn to consistently get up in the morning and go off to school or work, then it won't matter if they're crazy; they will lose their coded diagnoses when they find their lives. If they learn to take care of business, they can be as crazy as they please while pursuing their dreams, whatever they may be. You eat life, he says, or life eats you.

Fugue does not want to be at Little Ark. He would much rather be home, commuting from his bedroom to his kitchen to make coffee, and then to his office across the hall to write his novels and short stories, the work that has provided his living for the past eleven years, for four years before he went to work at Little Ark for the first time, and for two years after he had abandoned his teaching career to write full time and before he had gone to work as a night security guard. But if he has to take a regular job to earn money, and he does, then Little Ark is where he wants to be. Besides relating well with broken children, even the sickest and most dangerous of them, he knows he is a very good teacher. Dorothy also knows this about him, which is why she asked him to take charge of ASP during the summer in the first place.

Read the next installment.


Copyright © 2018, Hunter Goatley. All rights reserved.
Last updated 25-MAR-2018 21:42:48.71.