I had the key, the key. Why was a given two? I hoped they would open secrets of the mind along with the heavy metal door.
I put them on a large brass ring. They were like the keys the woman was holding in the picture. I had bought the pair of paintings from the doctor. They were reproductions of medieval painting. Each portrait was painted onto the canvas, which was then applied to wood. They curved at the top like a church window. One woman had a lamp. The other had a ring of keys. Big keys. Similar to those I had to be used twice a week.
I came to Manhattan State Hospital in the late winter of 1974 as a field requirement for my psychotherapy training at the Westchester Institute. I was just beginning my psychotherapy studies.
I had been assigned to Ivan. He was the best, the woman in charge of volunteers told me. He worked on the tenth floor, in the Dunlap building. That's where the elderly patients, and the so-called ‘odds and ends' were. Every morning he would lead group. He got folks awake and moving. They were delicate flowers opening to the sun with him around. He would take them from the ward, where they were sitting, like bumps on a log, to a smaller room. While they sat in a circle, he would guide them through gentle physical exercises. He gave them a mirror to have a look at themselves. He would finish the session with singing and holding hands. There was a woman intern working with him. She played the piano for the singing part.
Ivan had wanted to be an opera singer. Once he reached his thirties, he put that dream aside and earned his living as an occupational therapist. The patients on the tenth floor were vegetables, until Ivan got a hold of them. They became alive…for a couple of hours a day, anyway.
Ivan never displayed his authority but he was totally in charge. He had an office but preferred to sit on a chair in the hallway. We'd sit there, and discuss what took place that day. A young Jewish man of about 18 would pass by. He shuffled close to the wall, drawing an invisible line with his forefinger; dividing the wall into two parts. Which part was kosher, and which part was off-limits, would remain his secret. “Hi David,” Ivan would greet him warmly. David didn't talk. Before Ivan was in his life, David didn't move. He stood in rigid catatonia.
After six months, I was offered a part-time position as a recreational therapist. It was to be on the fourth floor, in the Murray Hill section.
This was my first morning. I put the key, the key in the lock, turned it and entered the ward as an employee. The place was vast and empty. Morning light streamed through the windows that were protected with heavy steel mesh. I stepped into the room. The door slammed shut. I walked to one of the tables in the back of the room and waited.
Before long, the heavy door opened and the nurse's aide ushered the patients into the ward. About 20 men and women shuffled in and scattered themselves around the room. Most everyone was smoking or begging for cigarettes. I waited a bit. Then I tried to coax people into a circle for an exercise group, like Ivan had taught me. I was able to gather five of the men. They were like docile children who drank coffee, and smoked cigarettes. They followed the movements and seemed glad that someone was paying them attention.
I took out a red, white and blue polka dot beach ball from my recreational bag. I tossed it back and forth with a couple of women patients seated in the back of the room. That was good for about five minutes. I waited a bit.
I tried to engage a young woman in a simple conversation. It was going fine. I maneuvered the subject matter. It was an inauthentic moment. She burst into flame – raising her voice screaming. I moved away. I missed Ivan.
The head of the ward, a Dr. Mavorvik, had a pleasant attitude like Ivan. I remember on day in July, sitting under a tree, doing a female patient's nails. Dr. Mavorvik was seated amongst other patients on a bench. A scruffy patient with a tobacco-stained demeanor thrust his face into Dr. Mavorvik's and defiantly asked for a cigarette. “Sure,” Dr. Mavorvik said. “If it wasn't for you, we wouldn't have a job.”
Other doctors I met there, albeit briefly, had a different outlook. They didn't much express the “we're-all-in-this-human-thing-together” attitude. They seemed to opt for control as a means of relating.
Not that control wasn't necessary. There were times when control saved peoples lives. Such as the time I came to work and found the heavy wire covering completely indented and unhinged on one of the windows. The window was all-over cracked. Fresh gashes shouted from the rim of the window. “What's this here?”'
“One of the male patients had a rage attack.”
“Oh…what happened to him?”
“They put him in a straight jacket. It took four men. He's on the violent ward now.”
We were to have a staff meeting. The purpose was to introduce Dr. Talbot, the new head of the hospital. Dr. Talbot was a rather tall, nice looking young lanky fellow with red hair. He said all the right things; about the hospital making improvements, about looking forward to working with everybody. A short stocky psychiatrist gave a report. Then it was Ivan's turn to report about the tenth floor. Maybe Ivan would clue them in on how patients were really people, with hearts and souls? How the healthy part, that human part could be nourished and grow?
But to my dismay, Ivan didn't speak after all. He sent David, as representative. David drew a line at this meeting, too; and all of us were off-limits. The kosher communicative part he kept secret. It sounds absurd but the person giving the report must have been David. It wasn't Ivan or if it was, for some reason he was acting like David. Ivan's beautiful voice was reduced to stammering and stuttering. We could hardly follow what was being said. None of the people here would ever know or believe by this presentation what healthy work Ivan on the tenth floor was doing.
Perhaps Ivan took one look at all those “real” doctors, and therapists and felt that slot was taken. Ivan seemed to flip into patient mode instead. I have come to learn that one role implies the other. Everyone has a little bit of patient in them. Most just keep it to themselves. Ivan let it all hang out, being a former opera singer and all – he was more expressive about it. Although catatonia is not very expressive – it's dramatic. Stammering and stuttering and looking totally inept, he did a rather good impersonation of one of Manhattan States many patients.
I began to understand why I was given two keys when I started to work at the hospital. They were for the same door and the same lock. One key was for going into the ward. The other key was for going out . Just in case if we flipped into Patient-mode, at least we had the key to get out of it.
Ivan moved to Arizona with his lover not long after that meeting. He wanted to go where it was warmer, he said. I left the hospital a couple of months later. I handed back the key, the key and signed for my last paycheck. I had worked at Manhattan State Hospital a year and a half.
I'll always remember Ivan. He brought something to that tenth floor that was beautiful and rare. He wasn't afraid to be on the inside of the ward with his heart, along with his therapeutic skills, which were exceptional. There were at least two Ivans. This got me wondering if there weren't in fact, two or more of me.