Free Associating On The Upper West Side
Evan Krasnik is a 59 year-old man who wakes up at 6 AM most mornings. He scuttles toward the shared bathroom in his pajamas and sandals and bangs on the door. “Jim, when are you going to get out of the bathroom? What if you never get out of the bathroom?” Afterwards, he eats a bowl of cereal, using a napkin as a bib. By this time, he is dressed in a blazer, white shirt, an oftentimes soiled tie, slacks, and orthopedic shoes.
His head is a little bit too big for his frame and he often squints his eyes as if he is going to cry. Evan never has facial hair, nor does he ever have bad breath. After finishing his cereal, Evan brushes his teeth and rinses his mouth out with mouthwash. (Again, he yells and stomps if Jim is still in the bathroom.) He then proceeds to the second floor of the residence to take his medication.
Evan lives in a treatment program for people with major mental illnesses on the Upper West Side of New York. There are 18 other “members,” in the residence, most of them living with schizophrenia.
“LelandLelandLeland,” he usually yells while walking down the stairs. “Where are you? Where is you?”
When he walks in the door, I greet him. “Evan, how many times have I asked you not to yell people’s names throughout the building?”
“I need my medication,” he says, biting his lip.
“I know. If you’re looking for somebody, quietly come down the stairs.”
“But what if you’re not here? What if I never get my medication?”
“Evan, there’s staff here 24 hours a day.”
“What if I never leave this place? It’s times like these that I want to go back to King Solomon’s Manor.”
“You’re making me go into a tizzy, a quandary, and a conundrum!” he says, accidentally spitting on me.
By this time, Evan is whipping his hand either with a thick rubber band or the band of a wristwatch, both of which he carries in his coat pocket. In his pockets are also a half-dozen pens, a small notepad, and various papers and appointment slips. He then approaches me–perhaps only a few inches away–biting his lower lip.
“Back up, Evan, and please lower your voice.”
He backs up. “I know I should lower my voice,” he mutters, glancing at me. I hand him a coin envelope in which his AM dosage of medication is stored. Each week, I sit down with Evan and package a week’s worth of medication with him. Evan writes the names, dosages, and time of day on the coin envelopes. He takes Zyprexa, an atypical anti-psychotic, Kemadrin, for side effects such as akathesia, and Colace, a stool softener. I have to remind him to write clearly since his penmanship is nearly illegible. Evanshuffles over to the counter to take his medication.
“I know I should lower my voice,” he mutters again. “You didn’t have to tell me.”
Evan then takes his medication. He always brings his own cup so he can mix a glass of Metamucil. I have to remind him to periodically wash the cup. He claims he does.
Evan has recently acquired a one-day a week job placement through the day program that he attends. The goal for many members of this program is to try to live as independently as possible. Often, they try to get jobs or re-enter school. Most of the members also go to the main clubhouse, a day program in Midtown that members and staff run together. There are no formal groups there, but “units” in which staff and members work together to get things done. There’s a clerical unit, an education unit, and so on.
Evan once asked me: “Why is that when I’m at the job I don’t have thoughts that intrude in my brain? You see, I free associate, but there I’m able to control my impulses, but when I get back here at the residence or at the day program I feel like I’m in hell.”
Evan gulps down the Metamucil and the pills. He signs his initials on a sheet that lists each of the medications he takes. Each of the residents has a sheet that they and the staff must sign after they take their medication. “I’m sorry,” he mutters like a child while looking at the ground. “I’m sorry for what I said.”
“It’s OK, Evan. Have a good day at program,” I say.
He leaves the room, pushes the button for the elevator, and walks back into the staff office. “I’m sorry for what I said. I’m sorry.”
“I accept your apology. Have a good day at program.”
He begins to walk out of the room. “I’ll be back after 10 PM. I’ll be back after 10 PM.” He shuffles toward the elevator. He says, “Leland, I’m sorry for what I said. I’ll be back after 10 PM.” He walks back into the doorway.
“Leland, I’ll be back after 10 PM.”
He walks toward the elevator. I wait in the staff office, not sure if he’ll come back and repeat himself. “I’ll be back after 10 PM. I’ll be back after 10 PM,” I hear him say from the hallway.
He walks into the elevator and the door closes.