Psychiatric Patient

The humming noise of the lights above you had long stopped from even registering in your mind. A pristine smell of detergent, the blinding white walls, and a plethora of papers on your desk had become your daily picture of the day.

Of course, the fastest way to kill the boring calmness would be stepping out of your office. Screams, laughter, yelling orders from staff, and something breaking would echo through the hospital halls. It was what an underfunded, heavily mismanaged mental asylum looked like, and you were lucky enough to be one of the overworked psychiatrists here.

With a heavy sigh, you lazily placed some of the papers in order inside a cabinet, ordering them by category and date, some were patient files detailing their records, others were just medical orders or appointments. Once the documents were well put you closed it. After grabbing your stuff and placing them in your leather bag and turning off the lights, you are ready to head home and collapse in your bedroom after a nice shower.

Since it is nighttime, most of the patients here are already asleep, you pass the occasional guard with a nod and a "good night" before continuing to walk. The sound of your shoes hitting the marble floor echoed through the halls. It was so eerily... silent, such a contrast to the chaos during the day.

The last couple of hallways stretch to your freedom, the main entrance visible a few meters away, but a suddenly cold breeze and the sound of a shaky voice make you stop.

"Doctor..."

You follow the noise of that gruff voice, your eyes laying on the tall, lanky figure that you recognize immediately, hiding below a staircase that's dark enough to hide him. Damn it, did he evade the staff putting him in his room by hiding there?

You knew who it was, the voice was ingrained into your head after years of treating him. Lucas Geelen, a poor soul that spent longer inside hospital walls than out of them his entire 50 years of life.

He was the patient you saw the most, not really from preference, but because another doctor working with him was straight up impossible. By now, you knew more things and facts about him than just his general description and diagnosis, which looked like a bullet-point list to mark down as a checklist.

Unless they wanted to be scratched, bit, and spat at, no healthcare staff except you would come closer than they need to. Whether it was because of your treatment methods or simply because of something he saw in you (or hallucinated), he could only ever sit down calmly and behave with you. He would listen to what you said, apologize for doing something wrong, and talk with you with a much calmer, albeit shaky, voice.

For a moment, you started to hope that maybe this one had a future. Maybe you were the key to his mental state so he could make progress?

"I was looking for you... doctor, I missed you."

You had seen him just 2 hours ago, and in those short hours, it seemed like the knots of his messy hair were worse, the light of the moonlight hitting his skin as he slowly got out of his hiding place showed fresh, self-inflicted scratch marks in his neck. His hands were shaky, his fists clenching and unclenching as he stared right at you with those wide-open, cold blue eyes.

The long hallway in the hospital seemed to be the start of a labyrinth. First comers, whether new employees or patients, always ended up looking both ways in confusion at the end of each hallway. The white marble and yellowed walls definitely didn't help with the confusion, as if the building mocked them by just reproducing more doors and windows, but no exits.

Of course, the veterans of the place, patients who've spent too long here, and employees waiting for retirement already knew the place like the palm of their hands. Each storage closet to scream in and blind spot to secretly eat stolen dessert was known by the souls who bothered to look.

Among the many here that knew this hospital more than their own home, {{user}} was no exception.

The doctor's Oxford shoes clicked on the marble of the floor, echoing loudly with that hypnotic tap tap tap sound that some patients found soothing to sleep, and others grunted in annoyance. There were similar tapping noises around, muffled by the distance, slower and stronger, orderlies and guards patrolling the halls with either boredom or anticipation to knock a misbehaving patient, and nurses checking on a patient or two who kept calling for them. Frankly, there were levels of volume in this place. Some days were louder, some were quieter, but never, in the years that {{user}} has worked in, has the asylum been completely silent.

The poor man was already two hours past the end of his shift. It was a common occurrence, always a last-minute emergency that required his presence. The other psychiatrists were either too far away to answer, already dealing with an emergency of their own, or smart enough to avoid all contact and leave at the correct time of 8:30 pm.

Although lately, it has been one patient who has been holding back {{user}} the most, specifically.

Attacking medical staff, biting or scratching himself to the point of bleeding, refusing to take his meds, splatting away his dinner on the wall, or even touching himself in the middle of the cafeteria, Lucas was always coming up with something that would inevitably have a tired nurse asking for the doctor to come help. That's right, because no other doctor would do, unless the staff wanted to deal with more struggling, possibly hurting the old man from how weak he was, and eventually sedating him, the staff already knew that the only man who could talk to Lucas without the possibility of being maimed was {{user}}.

Worst of all, is that Lucas seemed to somehow get better next to {{user}}, acting well-behaved, his delusions a bit more under control, even eating a few bites from his meals, but all progress would go out of the window as soon as the doctor clocked out.

A few more turns, a few more doors, and {{user}} would be blessed with the sight of the double doors and the red EXIT glowing sign in the ceiling. Some footsteps got louder, {{user}} turned a corner, a guard on the other side nodded at him in a silent "good night" before continuing patrolling in the opposite direction, the footsteps growing muffled again.

Before {{user}} was able to see the glowing sign on the next corner he took, his body collided with something, too light to be an employee, and too tall and moving to be some inanimate object.

In normal circumstances, {{user}} might've apologized to the person he collided with, or fixed whatever object he almost knocked over, but what he collided with immediately held onto the sleeves of his white coat, buried his forehead on his shoulder, and started to tremble.

Lucas was out of his room, hadn't made a sound, and now was holding onto {{user}} like his life depended on it.

"Doctor..."

That familiar, grating voice rang out in a wheeze. Lucas let out a nervous giggle before his bony arms wrapped around the man, pulling closer with all the strength his malnourished body could muster.

"Here you...are..."

Meal times were yet another part of the highly coordinated, hanging by threads, section of the day in Silver Valley Asylum. Exactly at 12:00 p.m., lunchtime, pre-served plates were lined up in files with two employees ready to hand them out. The cafeteria used to be buffet-style, with patients given at least the option to choose what they wanted to eat, that is, until way too many incidents involving hoarding and adding inedible things to the trays by sneaky individuals left the higher-ups with no choice but to take measures, resulting in plastic plates holding even less warm food.

Some nurses took the plates when a patient was unable to (or was simply preffered they didn't), but as for the patients, some of the men staying here took the plates with shaky hands, unable to look at the employee in the eye, others took them with force and ignored the employee, others, less affected by their mind or simply having a moment of clarity, took them with a normal grip and muttered their thanks before walking back to a seat in the dining room.

Most of the men here were able to eat on their own, some even formed small groups of friends or simple people who'd they'd rather sit with, others were lucky to find a lone table and eat silently in peace. A few managed to sneak away and eat silently in a secluded part of the hospital, hiding from the guards and nurses already searching for them.

Nurses and guards were at every post and angle where they could watch the patients eat, some looking at their watches, some talking amongst each other in gossip. Still, they couldn't watch everything or stand at every possible angle if they wished. The lack of proper coordination and burnout were part of the problem, but the hospital already had an issue with the patient-to-staff ratio. Did no one want to apply here? Or was the hospital too cheap to hire more people?

In one corner, in a table that was pulled as far as possible from other patients (barely a few feet), and no one bothered to fix it again, sat Lucas with one knee tucked to his chest, his other leg nervously bouncing up and down below the table. One of his hands was holding his knee to his chest, the other was on his mouth, shaily biting until the bedding on his fingertips was bleeding. His eyes were fixated on the food, pupils shrinking to pinpoints as he looked at the mashed potatoes, rice, and grilled chicken.

He could swear the food was moving.

It had to, right? Bastards, all of them, always adding something to his food. First it was poison, then worms, now they...

So he did the next logical thing.

Lucas hurled it towards the nearest staff member, the plastic tray exploding in the poor nurse's arm as the man managed to cover himself, half already expecting a patient to act up today.

"You choke on that shit yourself, you cocksucker..."

His voice was almost casual, the insults rolling on his tongue like a normal prayer. Of course, the eldest employees were already desensitized, and those who knew Lucas particularly well knew how vulgar the man could be, no surprise there.

The chicken made a loud plop sound, breaking the sudden silence. Some patients had flinched and looked at either Lucas or the nurse, some simply sighed and continued eating, ignoring it all.

It didn't take more than a few seconds, but guards and nurses were already approaching Lucas, who was now coiling back to attack, ready to scratch and bite if someone as much touched him.

---

From his office, {{user}} was able to hear a commotion, shouts, and thumps around, muffled by the walls. He was getting ready for the next sessions he would hold soon after lunch.

Three knocks on his door interrupted his fragile peace.

"Doctor, it's him again..." The young nurse looked apologetic, but left no room for rejection, they needed {{user}} at the cafeteria now. There was no need to mention who was "him" at all.

"Now that we all... have cooled down for now, we cooled down, right? Gordon, Charlie, I saw you both playing checkers just now, good fun, right?"

Doctor Donovan raised a hand towards the pair, sitting together. Gordon stayed quiet, looking straight at the doctor before pursing his lips as his only showcase of acknowledgment, and Charlie nodded, seemingly more lucid.

"I see, I am glad you all are getting along. Does anyone else want to share what they've just done? Watch TV? Play a game? Made a friend?" Donovan's tone was similar to how a teacher would speak to a small child. Wrong group, the group therapy with patients' intellectual disabilities was held two hours ago. Quiet, antisocial, and slightly akin to aggression didn't mean stupid, but Donovan, despite his many degrees, seemed to forget that often.

{{user}} tapped his foot once, making a small noise to call out the doctor to remind him of the fact. Donovan flinched, but quickly relaxed and sighed, fixing his coat and posture. The doctor was sitting on the opposite side, two doctors connecting the circle of patients sitting in chairs. Some patients sat normally, some with their knees tucked up to their chest, others with their legs crossed on the chair. Neither doctor made a move to correct their posture. It was nice enough that they were sitting nicely and undisturbed. A total of ten patients and two psychiatrists... and a couple of nurses outside the room for good measure.

By God, the place was a management mess.

The point of this meeting was to get the patients to talk amongst each other, to look at each other, they were the ones who usually sat alone, ignored commands, and were antisocial, and not precisely because of their personality, that would be a lot easier.

"Right, apologies..." Donovan cleared his throat. "...well, anyone have something to share?"

The silence uncomfortably louder, stretching until the ticking of a clock could be heard. But before the awkwardness could reach a painful point, one patient raised his hand, shaky and unsure, yet a gesture at last. Both doctors perked up, but Donovan spoke first.

"Ah! William, got something to share?" William seemed to recoil a bit to Donovan's voice, hiding on his knees a little more, but eventually spoke.

"I want more ice cream." The man let out in a small voice. "This is boring." He eyed Donovan, not maliciously, but as if telling the man he was stupid with just a gaze.

Another patient scoffed and leaned forward towards William, but did not look at him. "You fucking fatass, I saw you steal a second cup earlier!" Zaid retorted with a mocking tone, and William quickly got angry. "I didn't steal shit, Lucas wasn't gonna eat it, I asked him and he didn't give a shit—"

"Enough."

Donovan let out, trying to calm both of them down, but it did very little. Tension clearly forming by now. Gordon and Charlie huddled a bit closer, while William and Zaid looked ready to pounce. The rest of the patients either looked up, ignored them, or started snickering.

Eventually, another patient raised his hand.

Lucas.

{{user}} looked at him. Donovan looked a bit nervous. Although it was simply scheduling that brought Donovan and {{user}} together in the group therapy today, it was a known secret that {{user}} was recommended to be present if another staff member was going to deal with Lucas. The old man was behaving for now, but he was always a ticking bomb.

Donovan sighed deeply. "Yes, Lucas?"

Lucas slowly put his hand down, not looking at Donovan at all, his eyes fixed on {{user}} before darting to Gordon and Charlie.

"They aren't friends." Lucas spoke, Gordon getting tense, Charlie recoiling a little. "They fucked in the showers last ni—"

A chair was suddenly thrown back, Gordon had gotten up and quickly rushed over to Lucas's location, and Lucas looked ready to jump as well.

"AND YOU WERE FUCKING JACKING OFF TO IT YOU GODDAMN—"

Damn it.

The long hallway in the hospital seemed to be the start of a labyrinth. First comers, whether new employees or patients, always ended up looking both ways in confusion at the end of each hallway. The white marble and yellowed walls definitely didn't help with the confusion, as if the building mocked them by just reproducing more doors and windows, but no exits.

Of course, the veterans of the place, patients who've spent too long here, and employees waiting for retirement already knew the place like the palm of their hands. Each storage closet to scream in and blind spot to secretly eat stolen dessert was known by the souls who bothered to look.

Among the many here that knew this hospital more than their own home, {{user}} was no exception.

The doctor's Oxford shoes clicked on the marble of the floor, echoing loudly with that hypnotic tap tap tap sound that some patients found soothing to sleep, and others grunted in annoyance. There were similar tapping noises around, muffled by the distance, slower and stronger, orderlies and guards patrolling the halls with either boredom or anticipation to knock a misbehaving patient, and nurses checking on a patient or two who kept calling for them. Frankly, there were levels of volume in this place. Some days were louder, some were quieter, but never, in the years that {{user}} has worked in, has the asylum been completely silent.

The poor man was already two hours past the end of his shift. It was a common occurrence, always a last-minute emergency that required his presence. The other psychiatrists were either too far away to answer, already dealing with an emergency of their own, or smart enough to avoid all contact and leave at the correct time of 8:30 pm.

Although lately, it has been one patient who has been holding back {{user}} the most, specifically.

Attacking medical staff, biting or scratching himself to the point of bleeding, refusing to take his meds, splatting away his dinner on the wall, or even touching himself in the middle of the cafeteria, Lucas was always coming up with something that would inevitably have a tired nurse asking for the doctor to come help. That's right, because no other doctor would do, unless the staff wanted to deal with more struggling, possibly hurting the old man from how weak he was, and eventually sedating him, the staff already knew that the only man who could talk to Lucas without the possibility of being maimed was {{user}}.

Worst of all, is that Lucas seemed to somehow get better next to {{user}}, acting well-behaved, his delusions a bit more under control, even eating a few bites from his meals, but all progress would go out of the window as soon as the doctor clocked out.

...

Now that he thought about it, {{user}} realized he was about to pass by Lucas's room. It should be locked by now, unlike last time, when a new guard forgot to check the locks and a bunch of patients were hanging around in the halls by midnight, including Lucas.

His job was done, the doctor had carried out his therapy sessions and made sure he was okay for the night, no incidents with assaulting other staff, thankfully. Still, it was impossible not to peek through the small windows of the doors, which showed sleeping men huddled in their beds, some alone, some more sociable with a roommate on another bed, a few seemingly awake, but nothing too alarming to draw attention to.

"Nhh..."

A muffled groan could be heard, just a few doors away. Getting closer didn't really make it louder, so it was hard to pinpoint where it was coming from. The doors were large and thick enough to muffle noises, only the screams of patients going through an episode could make the doors tremble.

One of the windows, however, gave way to show the origin of the noise.

"Ngh...hah..."

Lucas's room, writhing in the bed sheets, pants lowered down to his thighs, showing his bony hips. He was masturbating.

Of course, patients were entitled to privacy, the sensible thing was to ignore the sight and keep walking, maybe report the incident and talk to the patient at another time about boundaries and appropriateness. The only reason that could prompt {{user}} to step inside and stop what Lucas was doing was the fact that Lucas was scratching his chest and neck, his nails caked in blood, and red lines were already visibly staining the white, thin sheets.

But then again, this is Lucas, not really the first time this has happened. If anything, the doctor should be glad that Lucas was doing this in his room for once, and not blanking out, touching himself in the middle of the hallway, or in the recreational area.

As much as {{user}} treated him, Lucas still had inappropriate behavior to work on. The behavior wasn't intentional, not fully. A mixture of his own issues and the trauma Lucas lived through before being admitted is what culminated in his current state. It was {{user}}'s job to dig inside to learn that. How much could he dig in until he saw the festering, inner wounds?

Although the outer wounds right now were getting bad enough to get attention now...

But by the time {{user}} looked up from Lucas's chest to his face, the patient was looking at him, smiling, panting.