The Open Ward
Oops, I forgot to mention we'd find Lulu was sitting in the corridor.
Sorry about that, hope you weren't too startled at the sight of her.
Excuse me?
No, the Open Ward's far from full. She's not out here for lack of space
nor would we usually leave a patient in a hallway but watching the arrivals
and departures is part of her treatment program.
She's not my patient so I can only give you the bare bones of her case.
This particular patient had a thing for dolls, specifically special ones which
she claimed were enchanted. These "magical" dolls are what anthropologists
still call, despite the word having gained other connotations, fetishes.
Lulu was dependent on possessing these dolls in order to function. You
could say she had a fetish for fetishes.
Well I thought it was funny.
Anyway we're trying to wean her away from her dependence on dolls by
replacing it with an interest in flesh and blood people. So she's here where
she can see everyone coming and going. Patients checking in, heading to or
returning from therapy, occasionally attempting to escape or checking out
by the rules. Then there's all the staff passing by on all sorts of errands
or at the beginning or ending of their shifts. Plenty to see and she's unable
to do anything except speculate on who they are and their individual stories.
While curiosity might have killed the cat it may save this patient.
We hope the day will come that she'll pass up the chance to play with a
doll to talk to a person. When she'll be more interested in who they are than
what a doll can do. All of which will make her far less dangerous to society.
No, I can't explain that at the moment.
The Open Ward's just through here. Shall we enter?
While it's called the Open Ward the name is a bit misleading as few of
the patients are free to leave it whenever they want. It really refers to
the patients freedom to interact and live in a somewhat unstructured
environment while not undergoing treatment.
There are two distinct classes of patient residing within the Open Ward.
First there are the voluntary admittees who signed themselves in for
observation and evaluation. If warranted by their initial evaluation period
they remain here to undergo therapy. If we can't find anything wrong with
them they're discharged. This happens rarely as few people sign themselves in
without having issues to address and problems to overcome. We do get a few
who sign in because they just enjoy restraint but as we find most of them have
complexes of one sort or another they tend to stay longer than they intended
as we won't release a patient prematurely.
Anyway the new arrivals and the patients we judge don't pose a danger to
themselves or others are the ones you see wandering about freely as they wait
for their interviews with their therapist, their therapy sessions or the
conclusion of their evaluation periods. That's when they find out if they'll
be staying and what's in store for them if they remain.
Yes, most of the wanderers are wearing straitjackets and they're all
restrained in some fashion but don't assume they've been judged a danger to
themselves or others. It's either because their Therapist recommended it
(there are many reasons for such a recommendation from precautionary measures,
to fitting in and many more besides) or they requested it for reasons ranging
from curiosity, to groups solidarity, to enjoying the sensation. So long as
it doesn't interfere with their therapy we see no reason not to grant these
requests. After all we are in the business of helping people.
While these patients' restraints are worn voluntarily rather than by
medical order they cannot simply ask and have the Orderlies remove them upon
request. At least not unless they're showering, taking a bathroom break, or
otherwise engaging in activities which the restraint would render either
extremely difficult of counterproductive. So with the exception of what we
euphemistically call sanitary/hygienic maintenance break periods once
they've agreed to wear a particular restraint they must continue to do so as
a sign of good faith and co-operative spirit. Until such time as their
Therapist approves a change or they check out of the Institute.
However don't assume our Voluntary Patients are free to walk out of here
any time they like. As we explain to them before they sign the contracts
committing themselves to the Institute's care there is a minimum two week
observation period (which may be extended at their Doctor's recommendation)
during which they have to remain within our care.
After that, assuming their Doctor finds nothing alarming requiring an
enforced longer stay if they won't remain voluntarily, they can leave whenever
they choose after first meeting with their Therapist. However in most cases
the Doctor strongly recommends they complete their therapy program first. Our
Therapists are dedicated professionals and very convincing. Few voluntary
patients depart prematurely.
The second class of patients are the more rigourously restrained ones
you see throughout the ward. The patients wearing the ankle cuffs, strapped
to their chairs (such as Lulu) or wearing other immobilizing institutional
restraints. They cannot move without an Orderly's assistance and a Nurse's or
Therapist's approval. With the exception of a very few voluntary patients judged
dangerous to those around them these are all Involuntarily Committal Patients.
While most of the involuntary patients reside in the Closed Wards these
particular ones are those that (when the appropriate precautions are taken) we
judge do not pose a threat to the other patients or themselves, nor require
the enhanced restraint methods we have to utilize in the Closed Wards. Also
they are here because their therapist feels that they might benefit from the
Open Ward's freer environment and the group and personal interactions. As
opposed to the more solitary conditions you'll find in the Closed Wards for
everyone not in group therapy.
So now that you know the background let's meet the patients of the Open
Ward.
As you can see despite the restraints our patients can still fend for
themselves. For example directly ahead of us you can see a couple of our
involuntary committal patients enjoying a meal without having to be fed by the
staff. Which reminds me I must check on if Akima's getting over her "End of
the World" delusion that was apparently brought on by her acting career
flatlining. But that's for another times as I don't like to disturb patients
while they're eating.
Certainly they look unhappy. They're unwell, that's why they're here.
so that they can finally get the help they need. It's not just our job
it's our duty to aid their recovery.
The main differences between this area and the Closed Ward? Well the
Closed Ward, which is better known as the Grimbor Ward after the Institute's
founder, houses the more violent patients along with those who possess
paranormal abilities. In many cases the patients fit both criteria.
Yes, that does mean there are patients who aren't necessarily violent
and are there solely because of their powers. But with the special efforts
required to contain those talents we can't endanger the patients in the Open
Ward by moving those few from the Grimbor Ward.
Which is not to say that there are no circumstances under which patients
from Grimbor Ward visit this one. If you'll look to your left you'll see
that we've caught up with the trolley distributing the lunch trays. While the
woman pulling it is a patient in the Grimbor Ward she's a regular visitor to
this one every afternoon. The routine is part of her therapy.
Certainly it's hard for her to move and yes the patients are mocking her
as she slowly hobbles along. That's intentional as is the precarious
balance the restraints give her. She has to move slowly to avoid falling
giving the other patients plenty of time to mock her. If she tries to finish
faster she'll likely overbalance, probably spilling food all over herself in
the crash and become an even bigger laughing stock. So she has to swallow her
pride and endure their amusement.
Of course it's humiliating, that's the whole point! Our Ms. Sofia has
a superiority complex that would be hard for you to imagine. The only time
she doesn't go into a fit of rage if you address her as anything other than
"Queen Sofia" is when she is hitched to the cart. Add to that her sadistic
tendencies and you have a woman that all our therapists agree needs to learn
some humility. Believe me if she could break that jacket she'd me trying to
kill everyone in here for the high crime of laughing at her. Including you
and me.
Don't look worried, she wouldn't be allowed in here if we hadn't taken
every precaution. That straitjacket has a core of Beta Latex and it's well
beyond her strength's highest limit to break it. But to be doubly sure we had
her fitted with one of the new Tetch Control Collars to compel her to follow
the set route for the trays day after day. Finally we have a pair of our
Orderlies from the Grimbor Ward watching her for signs of Collar malfunction,
ready to immobilize her at a moment's notice.
You'll see plenty of patients of her ilk if you continue your tour into
the Grimbor Ward. For now let's finish your tour of the Open Ward. Would
you like to meet a patient or two?
I say that because here comes a very special case you might want to meet.
Over here you see another special case but this one's an involuntary
committal.
Ms. Monika is a recently arrived borderline case. By which I mean we're
undecided if she'll remain here or be transfered to the Grimbor Ward. She's
a lot more violent than the usual patient but her Therapist thinks this is
the right environment for her and that so long as we're careful with the
restraints we can handle her. We're keeping her under close observation
twenty-four hours a day in case a rapid relocation becomes necessary.
She's our first patient from her homeland and likely the last. The
local authorities prefer to deal with such matters internally but there were
unusual circumstances in her case. Specifically she had participated in, and
may well have been primarily responsible for, the destruction of a prison
complex known as Skyhold.
No, she wasn't escaping, she was attempting to free a prisoner. That
was the problem. While she was captured by the authorities the associates who
had aided her in Skyhold's destruction remained at large. Not wanting to
risk losing another of their facilities they looked for somewhere else to
incarcerate her. One of their wizar ... wise men had been corresponding with
our Doctor Sebastian for some time and had learned of the Institute. Through
him he asked if we would take her. We responded that we would if she fit our
involuntary admission criteria.
She was secretly transported here and her mental condition assessed. It
didn't take long to determine that she had a vicious temper, pronounced
violent tendencies and a possibly psychopathic amorality. She clearly
qualified to become a patient, was admitted and put under the care of Doctor
Samson who specialises in anger management cases. He recommended housing her
in the Open Ward and, admittedly with some misgivings, I accepted his
recommendation. This is his speciality after all though I agreed with the
understanding that should she prove a danger to the other patients we would
transfer her the Grimbor Ward immediately.
So far there haven't been any incidents but she hasn't made much progress
yet either. Whichever Ward she ends up residing in I suspect she'll be with
us for a good many years.
Unless you'd rather return to the Lobby