The Man Who Almost Walked on Water

Laura recommended I do one-on-one therapy with D.A. on my first day in Building 10. He wasn't much older than me and he offered to shake my hand, showing some semblance of etiquette. This won't be too bad, I thought.

After scanning over the lengthy initial psychiatric assessment of D.A., the behavioral stuff really jumped out of the page at me. D.A. liked to swim on the floor. He touched female staff inappropriately, grabbing their hair when he wanted attention. He was depressed. He cried. He had the potential for physical aggression. One medication he was on was fluvoxamine, prescribed for obsessional thinking and compulsive behavior.

A word on his appearance. Dark, sullen eyes and disheveled hair. Very little effort toward personal hygiene. He was always hunched over, as if he couldn't muster enough energy to hang his head high and proud. Pajama bottoms were his favorite delicacy. He farted a lot, and whenever he farted, he waved the air and broadcasted to everybody the bad smell.

Prior to his hospitalization, D.A. had been in a severe car accident. He suffered a traumatic brain injury. Laura felt he belonged in a different treatment center, since the LRC offers rehabilitation for a large population of sex offenders and a number of psychotic individuals, neither of which made D.A. a likely candidate for a stay in a psychiatric hospital. D.A. needed companionship. Our first conversation shed some light on his current mental state.

Me: Do you like to read?

D.A: Yeah. Harry Potter. But I'm dumb. I'm stupid.

Me: No, you're not. What else do you like to do?

D.A: Well, I like video games. Hey, I can't swallow.

Me: You what? Why not?

D.A: I don't know. The muscles... the muscles in my throat don't work. When I eat, the food doesn't go to my stomach.

Me: Why not? Are you sure?

D.A: I don't know. But there's no food in my stomach. Hey! HEY! I CAN'T SWALLOW!

This was a weekly occurrence, D.A. acting immature and convincing himself that swallowing was an impossible task. In reality he could swallow just fine. It was established these were somatic complaints and not necessarily psychosis. Once or twice a month, D.A. had to get a CAT Scan. I wish I'd read the results. Staff monitored his weight. D.A. ate very little when his throat "didn't work," so I assumed staff wanted to make sure he wasn't afraid of food. Last I checked he was eating properly.

I feel bad for D.A. because the LRC has been his home for the past year. Building 10 is a short-term care facility. If a traumatic brain injury is the real issue here, why does D.A. remain at the LRC?