Woman on the Edge of Time

She broke the bottle under running water without touching it and washed the pieces down the shower. They’d most likely find them, but it was the best she could think up. Then she washed her hands a last time and went in search of Sybil. When she found her in the lounge she said to her only, “Soon!” Sybil looked into her face. A tear formed and hung in her eye. Then she looked down and said nothing, alert, ingathered, ready. Connie went to her room. As she passed Valente, knitting, the attendant nodded to her.

She thought of Luciente, but she could no longer reach over. She could no longer catch. She had annealed her mind and she was not a receptive woman. She had hardened. But she thought of Mattapoisett.

For Skip, for Alice, for Tina, for Captain Cream and Orville, for Claud, for you who will be born from my best hopes, to you I dedicate my act of war. At least once I fought and won.

After a while she heard the commotion and they came with stretchers–four. Dr. Morgan was trying to cut down on coffee, and Miss Moynihan was being sick in the staff bathroom. I am not sorry, she thought, her heard pounding terribly, and she sat on her bed, waiting.

TWENTY

Excerpts from the Official History of

Consuelo Camacho Ramos

State of New York–Department of Mental Hygiene

Bellevue Hospital

CLINICAL SUMMARY

IDENTIFICATION: This 35‑year‑old Mexican‑American Catholic woman separated from her husband Edward for the past three years has one child, Angelina, aged 4. The patient has been on Aid to Dependent Children since last May.

PRESENTING PROBLEM: This patient brought her child into emergency at N.Y.U., stating that she had accidentally broken her wrist. The child was bruised. When questioned by caseworker, the patient readily admitted beating her daughter, while drunk or drugged. The patient was incoherent, weeping, and exhibited bizarre behavior.

PAST HISTORY: This socially disorganized individual has been in an increasingly deteriorating state since the breakup of her marriage. Whereabouts of husband unknown. This patient has been in conflict with the law for two years. Convicted of aiding and abetting a pickpocket and given a suspended sentence and a year’s probation last April. The patient refers to an illegal abortion, followed by severe hemorrhaging and complications, for which a hysterectomy was performed at Metropolitan. The patient has recent alcohol and barbiturate problems. Seems hostile and suspicious toward authority. Lack of control and frustration tolerance. The patient has a tendency to act out problems with violent expression and hostile and extrapunitive tendencies.

MENTAL STATUS: This patient is disheveled and appears to be older than her stated age. She readily admits needing help. She is cooperative but confused and occasionally suspicious. Has not demonstrated assaultive behavior on the ward.

STREAM OF MENTAL ACTIVITY: The patient is incoherent. The patient’s thinking is extremely concrete.

EMOTIONAL REACTIONS: The patient’s general mood is anxious and exhibits extreme guilt. The patient’s affect is inappropriate, marked by crying without cause.

CONTENT OF THOUGHTS: Denies suicidal ideation. Denies delusions or hallucinations.

SENSORIUM, MENTAL GRASP AND CAPACITY: Sensorium clear. Oriented times three. Recent and remote memory appear weak. The patient has somewhat slow intelligence and answers questions poorly.

DIAGNOSIS: Schizophrenia, undiff. type 295.90.

State of New York–Department of Mental Hygiene

Rockover State Psychiatric Hospital

DISCHARGE NOTE

Dr. Messinger

HISTORY: This 35‑year‑old Mexican‑American woman, Catholic mother of one daughter, was hospitalized at Bellevue because of child abuse, alcohol problems, confusion, and bizarre behavior, and admitted here February 8.

HOSPITAL COURSE: The pt. responded well to medication, although with pronounced side effects, swollen tongue, etc. Her behavior slowly normalized and the pt. exhibited decreased psychiatric signs and symptoms.

PRESENT MENTAL STATUS: Alert, cooperative, coherent, relevant, with no abnormalities of stream of thought or content of thought. Acceptable insight. Oriented times three.

PHYSICAL CONDITION: Ambulatory–no physical abnormalities. Can care for self.

TREATMENT PLAN: Pt. discharged to welfare hotel until welfare finds her an apartment. She will report to Aftercare Clinic at Bellevue weekly.

MEDICATION: 1. Thorazine 200 mg. o.d. at 5 P.M.

                2. Prolixin 1 cc IM every 2 weeks.

                3. Artane 2 mg t.i.d.

CONDITION: Improved

DIAGNOSIS: Paranoid Schizophrenia, type 295.3.