Daily Excerpt: From Deep Within (Lewis) - The Tattoo Lady
Excerpt from excerpt from From Deep Within (Lewis)
The Tattoo Lady
“I am not going inside that bitch’s
office!” the woman screamed. “My husband is in prison in Iowa for selling
marijuana. I wish he would come home! I need some help bringing him back and
she just wants to talk about my medicine.”
“Ma’am, please sit down,” Anita, the
secretary at the front window, said. “People in the waiting area are getting
scared by your screaming. Please speak calmly about what you want.” Anita was
fearless in the face of ranting patients. She had seen it all, from seizures in
the waiting room to a patient wielding a knife. We all hid behind her feathers
as she protected her flock of frightened clinicians.
I didn’t know who pressed the
buzzer, the signal used if someone felt threatened by a client, but I heard it
in the hallway. A single buzz alerted other staff for assistance; if two were
sounded, the alarm rang straight to the police station and what looked like a
swat team was immediately dispatched.
When I was new at the clinic, it
didn’t take me long to learn that my safety wasn’t a given. Previously, a
patient had been brought to psychiatric emergency services where I was on call.
I interviewed the client, who sat with his back to the nurse’s station, and I
sat directly facing it. This arrangement had always given me a false sense of
security. A wall of glass separated the interview area from the nurse’s
station. Help was an eye blink away, I thought.
I invited the filthy, malodorous
new patient to have a seat. He had been found darting through oncoming traffic,
babbling incoherently, screaming at drivers, opening their car doors and trying
to pull people out. I told him why he was at the hospital. “The police were
concerned about your behavior and wanted to be certain you were safe,” I said.
He was a big, scary guy. I could
see his musculature through his clothing. His hands were enormous, his thick
fingers gesticulating at me when he spoke. He kept leaning toward me and
banging his hand on the table. I was startled. Then he stared straight at me
and said, “You have nothing to worry about little lady – I have never slugged a
woman.”
Wait
a second, I
thought to myself, I didn’t say anything
about violence. Something about the way he looked at me and the tone of his
voice sent butterflies to my stomach, and my fight or flight response was
suddenly working overtime. I felt the adrenaline pulse through my veins as he
lurched forward across the table. I scrambled to my feet, knocking over my
chair. I raced towards the exit, not looking back. Then, I heard a swoosh near
my ear as he threw his chair past me into the window, shattering the wall of
glass. I wasn’t harmed. I heard nurses yell out to check on me. Police officers
who worked for the hospital ran in and tackled the guy. Three men held him down
and he was placed in handcuffs. He was then tied securely onto a gurney and
wheeled out of the room. There was glass everywhere.
From that moment forward, I became
much more cautious and less trusting of new patients. I tried to read body
cues, listen to words between words and use my gut to check my level of fear. I
was always on guard. Through the rest of my career, it became my custom to
always take the seat closest to the door in my office, in case I needed to make
a rapid exit.
Back in the lobby, my first
reaction when seeing the screaming woman was trepidation. Her face was red from
exasperation, and as she was screaming, spittle was flying out of her pursed
lips. Her arms flailed wildly as she was jumping up and down and screeching,
making no eye contact with anyone. As I watched this show, I realized, on
closer inspection, that her arms, legs and neck were covered in tattoos.
There was a sliding glass window
between Anita and the waiting room. It was a glass barrier like at a movie
theater, where you request a ticket for the show and the cashier delivers it
into a tray underneath. When patients became boisterous or arguments erupted,
Anita could slide the window closed for a brief moment of quiet and communicate
to them through a microphone. I slid the window open and popped my head out.
“What’s wrong?” I asked.
“Nothing.” the woman snapped at me.
“Then why are you screaming?” I
asked.
“I hate my therapist. She doesn’t
believe me. I want to see someone else!" the woman said.
I whispered to Anita, like soldiers
in a dugout, we needed to talk without being heard. I was afraid to speak too loud
for fear of saying something that the patient would perceive as an insult.
“What is her name?”
“It’s Vicky Cosgrove,” Anita
whispered back.
“Vicky,” I said. “How can we help
you?”
Vicky seemed to instantly calm
down. She walked up, pushed her head through the window and looked straight at
me. “I want to talk to you,” she said.
I had no intention of putting
myself in a room alone with this crazy woman and closing the door behind us. I
anxiously wondered why none of the male clinicians had volunteered to help. I
was afraid of her.
Finally, I replied, “I will meet
with you if I can bring a colleague in with us, in the event you become
agitated or angry again.”
“Whatever,” she answered
impatiently.
I turned to my large colleague,
Jack, and signaled for him to follow me. We walked out of Anita’s office into
the waiting area. I motioned to Vicky to join us and then, like ducklings
walking in single file, we went to a large interview room. Jack’s face was beet
red. He was pouting, not a willing volunteer. I didn’t care.
Once we sat down, Vicky immediately
dove in. “That lady doctor I see tells me I’m having imaginary thoughts in my
mind and I need a lot of medicine. My husband is in jail in Iowa for marijuana
possession, and I’m just waiting for his release so he can come home. What do I
need medicine for?”
“When will he be returning?” I asked.
“Any day now, I guess. I write him
letters and take them to the mailbox. About once a week I get them all back. I
know they don’t give him my letters. They just send them back. They know we
love each other and try to keep us apart.” Vicky continued. “At night I can
hear his voice in my cabinets, so I open all of them so we can be closer. I eat
my dinner while he and I talk. He reminds me we will be together soon. I just
need to be patient until he comes home.”
“That sounds difficult,” I replied,
stories like this were not unusual from patients at this clinic. “How long has
he been away from you?”
“Five years.” Vicky said.
Five years for a marijuana
conviction seemed oddly long to me. Vicky and I talked for thirty minutes or
so, with Jack fidgeting in the background. As we talked, Vicky sank into the
chair, breathed deeply and relaxed, which helped me calm down too.
“I’d like to come back and see you,
Doc.” Vicky said at the end of our meeting.
Later, I sat down next to Vicky’s
psychiatrist in the records room.
“I’ve never seen Vicky so upset,”
she said. “I wanted to change her medication and I think I made a mistake
telling her she was paranoid. You saw the result. I am not her favorite person
today. Would you be willing to see her and I’ll continue to prescribe the
medication?”
As I picked up her thin chart and
read it, different scenarios ran through my head. Vicky had already shown me
what she was like when she became upset. I was worried I would get trapped in
an office with her while she was screaming and out of control. What if I got
hit? There was no information in her chart that I found helpful. There was
documentation of service provider visits and what psychiatric medications she
took, but there was no information on whether she was actually married, where
she had lived previously, where she grew up, whether she had a career or even
worked, or details about previous hospitalizations. I am not sure what prompted
my agreeing to see her, but I decided to take the risk.
When I saw Vicky the following
week, I told her that her charts contained little information. I asked her to
tell me about herself. She nodded and said, “Ok.” She told me that she was in
her early fifties and had been hospitalized eleven times as an adult.
When I asked basic questions, she
only gave short answers. “Where did you live as a child?” I asked.
“Kentucky,” she replied.
I continued, “Vicky, who lived in
your household? Did you graduate from high school? Have you worked? Can you
tell me anything about your past hospitalizations? Were any of them helpful?”
“Yes, I did work.” She ignored the
other questions. At times, we were at a loss for words and sat in uncomfortable
silence. It was tough to carry an ongoing conversation with her because her
responses were so clipped.
The silences made me sleepy and
Vicky fidgeted. I often stared at the
clock behind her and counted off the minutes. These were the longest half hours
I had ever spent with a patient. I wasn’t sure why we met weekly, but she never
missed a session. Perhaps all she needed was someone to sit with her and pay
attention, which was fine with me.
One afternoon, trying once again to
strike up conversation, I asked. “Vicky, can you tell me about your tattoos?”
Suddenly, she began to talk
rapidly. “See this blue line that runs from my ankle and is on my arms and goes
up to my neck? This is my lifeline. All the tattoos attached to this line are
stories of my life. This one on my ankle represents where I was born in Kentucky.
The shapes are different houses we lived in. The country was rural and so my
Dad built each cabin by hand. All of us lived in one room. See the little
faces? I have three brothers and four sisters. These bigger faces are my
parents. My mother left when I was ten and I never saw her again.” Her
fingertips flowed over her tattoos as she stopped at each image.
“These were wheat fields at my
house, and there is the dark sky on one side and light on the other. We had
brutal storms that came without warning and my brothers and sisters gathered in
the basement shelter. My dad was never around. He was a hard-working guy, but a
mean drunk. Every night after he finished work and his chores, he went to the
town saloon to get rip-roaring drunk. We hid under the covers during each of
those nights, because when he came home he’d scream at us and then paddle our
butts for nothing.”
As Vicky told me about the meaning
of her tattoos, she travelled up from her legs to her arms to her neck. I
quietly listened.
Vicky moved onto another tattoo.
“This is where Lee, my husband, and I met – see the little shop? We were each
there to buy incense and began talking and then never stopped. This truck is
the trailer we lived in. We didn’t have a big marriage party; we agreed
together that we were married and that was that. We traveled the country in our
trailer attached to Lee’s red truck. We stopped in cities where people were
different from us, but we became friends. Sometimes we slept outside the
trailer in the woods, under the stars.”
“Whenever we were low on cash, we
asked people who lived wherever we had stopped if they knew of any work for us.
Some was manual labor, which Lee did. I often washed dishes. Once we had cash
for food and gas we moved on.” Vicky went on to tell me that her nights
speaking with Lee through the cabinets were special now because they conversed
late into the evening.
I started to wonder if Vicky had a
real husband. Her description of their lives sounded so unreal and idyllic.
That, coupled with her report of talking to him in the kitchen cabinets, led me
to believe this was likely a fantasy. I then understood why her letters were
returned to her; he did not exist. Regardless, it was wonderful to listen to
and she seemed so happy in the telling. He was real to her.
“What do those represent?” I asked,
gesturing to eleven black boxes running up Vicky’s arm and around her neck.
“Those were the times that I went
to psychiatric hospitals. I didn’t want to be there. I hated it. They gave me
medicine that made me a zombie.”
We met regularly over the next three years, and Vicky told me her life’s stories through her tattoo images. It was hard to discern which stories were real and which were not, but I soon decided it didn’t matter either way. With images, she was never at a loss for words. I can still see her leaning forward, smiling, and pointing at another image attached to another tale.
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