PSYCHIATRIC EVALUATION FORM
GREENFIELD PSYCHIATRIC HOSPITAL
TRAUMA RECOVERY UNIT

Name: Erim (SURNAME DELETED)
Age: Seventeen
Sex: Female
Height: 180cm (5'11")
Weight: 52kg (115lb)
Next of Kin: N/A
Contact No.: N/A
Admitted: (DATE DELETED)
Previous Ward(s): None

Medical Condition:
-Malnourished

Family:
-Mother residing at Brighton State Prison for the murder of her husband
-Father's whereabouts unknown

Particulars:
-History of severe physical, sexual and emotional childhood abuse and neglect
-History of prostitution and drug pushing
-Prone to episodes of self-mutilation
-Panic attacks
-Post-traumatic stress

Treatment:
-Talk therapy
-5mg olanzapine PRN
-4mg diazepam
-100mg sertraline hydrochloride

Recommendations:
-Touch therapy

Treating Physician: Dr William Adrian

Notes: Erim was a sixteen and a half year old runaway when she was treated for an intentional overdose at Wheelway Hospital, and was transferred to Greenfield shortly before her seventeenth birthday. She is a child of neglect, and actually memories of her early childhood are scarce. Her flashbacks include severe sexual abuse and molest at the hand of her stepfather and emotional abuse by her mother (alcoholic). Erim left home at fourteen after witnessing the murder of her stepfather, and lost her brother to suicide last year.

People always tell you how lucky you are. They tell you to be grateful for having luxuries that people in poverty would only dream of having, like a bed or shoes. They tell you to be thankful that you aren't one of those people who has to struggle to put food on the table and only has one pair of clothes.

But what if you were one of those people?

It had been so long since I had been beaten, so long since I had been abused. It had been so long since I'd been yelled at, thrown around, threatened, had a gun pointed at me. I couldn't even remember most of the things that used to happen to me, all I had were snippets of my life that flashed through my mind occasionally, but they were so real I could have sworn it was happening again.

I sat there in the dimly lit therapist's office, surrounded by a swarm of people joined in a shabby circle. The day I was pulled out of Wheelway Lake by security guards and taken to Greenfield Psychiatric to be admitted seemed like years ago. The daily group therapy sessions seemed to drag on for the whole morning. They doped me up with tranquilizers, sleeping pills and happy pills. The Zoloft I took every morning didn't take the pain away; it just caused me to feel nothing at all.

I got a shock when I ran into Lydia. I had been thinking about her probably an unhealthy amount when I left Wheelway Hospital. She came to Greenfield every Friday to run the Dialectical Behavioural Therapy sessions. It was group, and even though it was supposed to be for patients with eating disorders and drug addiction I sat in on a few sessions. I really only wanted to see Lydia. She had her own stories of recurring rape and incest to tell, with her mother's suicide and the eating disorder she battled in her teens. I wanted so badly to watch her beautiful face and listen to someone who understands. I admired her for having the courage to talk about it as well as help others with the same problem. She could relate to every complex metaphorical indication of my inner pain that slipped out of my tongue. She had a warmth and empathy about her that no one else understood. I wanted to get to know her more than anyone else I'd ever met.

My focus slowly went back to the therapy session I was attending as I heard my name called gently by the counsellor, Lena.

'Erim,' she said, and I blinked a few times, refocusing, 'Pipa was just talking about something. Do you have anything to contribute with?'

I looked around at the other patients surrounding me, their faces blinking with anticipation. There were six adolescents on the Trauma Recovery ward, only five in our group sessions, and Isaac was the only male. He was in a wheelchair for something his stepmother did to him, and Pipa was in a wheelchair for something she did to herself. Christine was here for sleeping with her father. Rhiannon came today from Maximum Security, her wrists restrained by handcuffs to the chair. She didn't look violent, and although her flowing dark hair fell over her face we could tell she was frightened. She hadn't said a word that whole session, and Lena wasn't about to make an effort to get her to talk.

'Go on,' I said, gesturing towards Pipa.

Pipa shyly lowered her head, keeping her eyes steady on the floor as she continued with her story. Besides Rhiannon, who never talked, she was probably the quietest. Her wavy cobalt hair slipped further to cover her dark face with every word she pushed out of her slightly trembling lips.

'He beat me so hard that night,' she said quietly, and everyone fell silent. 'I regretted moving in. I was too weak to argue anymore, so I let him take me to a small room near the end of the house. A bunch of men were sitting there. A couple of them called out to me as I walked into the room. It was dark. I couldn't see very well.'

'And how did you feel when someone you loved and trusted handed you over to these men?'

Pipa's face darkened. 'Cold,' she said, her voice barely a whisper. 'Cold all over, and violated. I panicked even more when they advanced on me. They each took turns to rape me. I felt like an object. I was used. And all while that was happening my boyfriend was getting paid for my body, as if he owned it.'

There was dead silence after that. We were all avoiding each other's gaze, and Pipa's was glued to the floor.

'So they were the ones who knocked you up, huh?' Christine broke in casually, twirling a tuft of mousy brown hair around her finger.

'Uncalled for,' interrupted Isaac, leaning foreword in his wheelchair to glower at Christine. 'I think it took a lot of courage for Pipa to bring that up.'

'Sure,' snorted Christine in reply.

'What do you know about fear?' said Isaac angrily. 'All you did was sleep with your father. Fucking slut.'

Christine opened her mouth, looking furious, but was stopped by Lena who held up a hand and interrupted.

'Please, guys,' she said, her voice rising, 'it's always hard to talk about these things. Being negative doesn't solve anything.'

We'd all heard the phrase many times before. Being negative doesn't solve anything. It seemed to be every counsellor's motto.

'Erim,' continued Lena, her gaze swiftly shifting onto me, 'do you have anything you want to say?'

I was silent for a while, feeling expectant eyes fall upon me.

'It's all about control and fear, with men,' I said flatly, averting my gaze back to Lena.

There were nods of agreement from the circle, even Isaac, and Pipa's eyes fell with relief.

'When you talk about these things,' I continued, breaking between my words, 'it's hard, because you can hardly believe they happened. You remember them like they happened to someone else, and to say it all again is… unspeakably awful.' I paused. 'Sometimes I get so angry I want to blow this whole fucking place up.'

There was silence from the circle, and Lena twitched slightly as I said that last part.

'Thank you,' she said icily, turning to the rest of the group. 'I think it's time to finish up now.'

Mika was my roommate at Greenfield. She was actually supposed be down in the Adolescent Unit but they had no room there. She was an obsessive compulsive pyromaniac, sent here after her setting her house on fire. She never had matching socks on and insisted that wearing a bra defied her strongly held feminist views. Despite her noticeable easygoing nature, she admitted that she worried a lot, and that was evident by the way her hands were raw and blistered from her compulsively scrubbing them clean. Apparently she "noticed" germs other people didn't.

We sat there that sluggish Thursday afternoon in the Day Room, Mika flicking through a magazine and me seizing the chance to take a smoke, as the nurses had opened the window that morning. I wasn't exactly eighteen yet but no one seemed to care. A lot of the patients on Trauma Recovery came from the Intensive Care ward, where most of the chronic schizophrenics were placed. They smoked there like breathing air.

Pipa sat by us, sitting peacefully on her wheelchair and resting coffee coloured hands on her swelling stomach. In the corner couch sat a nurse, resting her chin on her palms with her eyes wandering the room with boredom. She was young, and although we didn't know her real name we called her Scarlet, a name earned by the flaming cherry hair we all admired that she always let hang loose.

Mika looked up suddenly and jerked her head towards the nurse.

'Hey Scarlet,' she called out, 'you ever jumped a patient before?'

There was a brief moment where awkward silence captured our tongues, until Pipa let out a giggle and we all laughed with her. Scarlet pretended to be offended but when she looked away she grinned, coiling a wisp of her crimson hair around her finger.

'I bet it was Terry,' added Pipa, holding up a hand to cover her mouth.

Terry was a patient who was recently discharged. He never slept, and sat by the nurses' station all night begging the night staff to open his window so he could take a smoke. "Don't you fucking open my window," he would snap as the head nurse made her way to his bedroom, "I want Scarlet to."

Scarlet looked at us pointedly and laughed. 'I'm supposed to be looking after you girls,' she said, 'not telling stories that involve scenes you aren't allowed to watch in the movies.'

When our laughter died down I brought myself to say, 'Is it legal to get involved with a patient?'

'Not if we're talking about doctors in the mental health field,' she replied, her eyes on me. 'But if they're not specifically treating the patient, it's legal but it's definitely not socially accepted.'

I could feel Mika's grin on me and a tinge of scarlet flickered on my cheeks.

A lot of books and movies romanticise psychiatric hospitals. They make them look like fascinating places where old, deranged-looking men paced the wards with their eyes twitching and their tongues lolling out of their mouths, staring into space holding a drool cup. But Greenfield was often quite a dull place. The rich smell of baked pastry overpowered the usual secluded waves of desolation that crept down the ward, from the cooking we did in occupational therapy. But despite the waft that drifted nonchalantly through the corridors nothing could overpower the after-school boredom that most of us felt in Trauma Recovery. We got so used to routine there; Group in the mornings, school at midday and occupational therapy in the afternoons, that when free time came we were lost for ways to occupy ourselves.

Mika and I decided to go from one room to the other. At least that was doing something. We started off in the Day Room, and sat next down next to Bill with smiles plastered to our faces. Bill was catatonic and had been sitting on that couch for a good seven months. The nurses had to feed him through a tube and hydrate him through an IV pump so he didn't deteriorate. Mika looked over to me and smiled, her short mousy auburn hair falling to her shoulders in layers. Her coffee coloured eyes were bright and cheery, as always, despite the dismal feeling of this day.

We sat there quietly for a while, watching the late radiant sunlight creep across the room and listening to Bill's shallow breaths. It was still light but almost 7:00PM, and the night staff would be coming in soon. The night nurses always felt sorry for us for being cooped up in a mental hospital at such a young age, and usually made an effort to get videos for us to watch and play board games.

After about twenty minutes of sitting there in near silence, the woman who slept in the room opposite us bustled into the room, clutching what looked like a scarf tightly in her hands.

'You said you were missing a scarf?' she smiled warmly, eyes flickering onto Mika. 'Well here it is, dear. Found it just outside the ward, near the vending machines.'

The woman held it out but Mika paled, her hands refusing to budge.

'I can't touch that,' she said quietly, looking nervously up at the woman. Seeing the perplexed look on her face, she laughed suddenly and tried to explain, 'I don't know where it's been.'

The woman chuckled. 'It's got no germs, honey. I swear.'

Mika fidgeted nervously with her hands. 'Hey, I'll tell you what,' she said, 'how about you wash it, and then I'll take it back?'

The woman looked like she was about to say something, but I interrupted, holding out my hand expectantly. 'I'll take it,' I said, pulling the scarf out of her grasp and tucking it under my arm.

Despite Mika's obsessive compulsive disorder, she didn't look like an uptight person.

We often felt intimidated by all the adults on Trauma Recovery, but that day we got a new admission. The boy looked about twelve and he sat opposite the couch we were sitting on, staring at us for the whole afternoon with intensely focused eyes. His whole left arm was plastered with scars and in his hand he clutched a dense book entitled, 'Toxic Psychiatry'.

I don't know how long we were there for, but eventually I moved couches and lay down. The way the sleepy sun stroked me with its long fingers as I rested my head reminded me of how tired I was. There were a lot of demons in my head I hadn't released yet and I could feel them boiling up inside of me. I desperately tried to keep myself distracted from the graphic, blasphemous visions of my past that tortured my mind, and in my efforts I calmly dozed off to sleep.

I woke up to see a dark figure standing over me and I almost jumped out of my skin, snapping up to look hurriedly around the room. Everything was dark and I could barely see a thing, squinting my eyes to make out the shapes of couches in front of me. The outline of the figure looking at me was tall, and as my pupils slowly adjusted I could see that he was a boy about my age.

'Sorry,' he said offhandedly, bringing the thing he was holding between his fingers to his lips and inhaling.

'What are you doing?' I hissed. 'You can't smoke in here.'

'Chill,' he grinned, gesturing over to the side of the room, 'I've got the windows open.'

My expression remained blank, and the boy let out a chuckle.

'I'm Cyrus,' he said. 'I'm not actually in this ward, just thought I'd pay a visit. Sleep fails to reach me where I am. The night nurses are totally oblivious to everything that goes on around them; I swear they're blind.'

With my thoughts neglecting exactly how strange this situation was, I felt my eyes wander around the room. I could recognise the smell, and he definitely wasn't smoking tobacco.

'Think they can smell your weed?' I sarcastically pointed out, sitting further up and crossing my legs.

Cyrus just grinned and grabbed my hand, pressing a joint into my palm. 'Come,' he said, 'I know an outside place we can bail to.'

I was still groggy and tired from sleeping, and feeling slightly disorientated from the dark. I don't know how, or why, but I ended up following him out the emergency exit to a terrace I'd never seen before. We both sat quietly out in the wispy night air and smoked, all my problems wafting away in an air balloon that popped in my head, my tiny little brain cells singing as my ears wept with glee. Cyrus spoke to me and his words were beautifully strung together, whispering to me their colours as suddenly I found a connection to Everyone and Everything on the earth. My hands were breathing as I silently concluded that no one else existed.

'Hey,' Cyrus turned to me, his smile intertwined with its beauty, 'what's your name anyway?'

I let my upper body fall softly backwards onto the ground as I gazed happily into the stars.

'Erim,' I replied.

'Erim,' he repeated, letting the syllables roll around on his tongue, 'do you ever think about getting out of here?'

'Yeah,' I said, 'I do.