She Never Saw the World

 "Her name was Virginia - she never saw the world."

"Virginia" wasn't just a song I wrote. She was a unique human being. For legal and ethical reasons, I'm reticent to go into too much detail, suffice to say that she was a resident in a facility I used to work at. For those unaware, I spent the better part of 30 years working with adults with developmental and chronic mental health issues. I met Virginia in 2010, and I can tell you this: our first meeting was legendary (at least to me). 

I had just accepted the position as the overnight manager in a small section of a larger facility. The company I worked for leased out a 12-bed section for our mostly older, more chronic clients. Most lived with schizophrenia, and/or other chronic mental illness. Our folks lived alongside 100 or so other residents, most with some level of chronic illness. Without giving away too much information, the place was sad and, in some ways, absolutely disgusting. Cleanliness was at the barest minimum and the smell - it was putrid at best. Imagine the smell of old urine, body odor, and physical and emotion decay. If you ever need an example of why healthcare should never be for profit, this place was it. The employees of the facility were overworked and underpaid, which I'm sure sounds cliche to many. From my own professional experience, this was beyond bad. The guy who owned and ran the place paid his employees the least he could and also ran a bit of a loan sharking operation. He'd offer small payday advances to his employees, thereby keeping them stuck. They couldn't quit when they were in arrears to their boss. I was an employee of an outside agency, and while my pay wasn't great, I wasn't stuck like most of the employees. 

I spent my first week working the day shift, getting accustomed to the paperwork, medication charts, the flow of the place, and of course getting to know our residents. I would spend a few hours each day reading case histories, medical histories, etc. I reviewed incident reports, making note of potential behavioral issues and their triggers. I wanted to make sure each night I worked would go as smoothly as possible. A number of the residents lived with sleep disorders, so I rarely had a quiet night (which was OK with me). 

The first time I met Virginia (who was legendary among the facility staff), she was just returning from lunch in the dining room. I saw she was giving me a look, probably wondering who I was. I stopped her and introduced myself and inquired how her lunch was. Her response told me volumes about her, her manner of thinking, and her own unique defense mechanisms.

"THEY PUT GODDAMNED GHONORREAH SPERM IN MY SOUP!", she yelled in response to my inquiry. 

I knew she was testing me. As unusual as this scenario might sound to many, this wasn't the first time I'd had an encounter like this. This 'shock & awe' type response was clearly displayed to keep me at a certain distance until she figured me out for herself. Many would have responded to her statement exactly as she intended. Not me. I took it in much as I would if she'd told me she'd been unimpressed with the culinary delights. 

"You know what that tastes like HOW?", I asked, in a matter-of-fact tone. The look she gave me was priceless! I doubt anyone had ever called her bluff before.  

"You're WEIRD! Stay away from me!" That was her response to me and it was her way of maintaining distance from me. Over the next few days, she would come into the office to complain about me, threaten to have me fired, etc. My boss chuckled every time. She'd known Virginia for years. According to her, I'd made quite an impression. My boss added the following statement:

"I think she likes you!"

If Virginia did, she had a unique way of showing it. I did notice, however, she spent a lot of time hovering outside the office. I was told this wasn't unusual except that she seemed to be focusing on me. 

To give some idea of who Virginia was, she was tiny, barely 5 feet tall. She was old, nearly 80 but could have easily been closer to 90. She was dirty, unkempt, and would have been happiest left alone to chain smoke cigarettes. According to some research done in the 1970s, tobacco use among schizophrenics is often extreme. High nicotine consumption seems to produce more lucid thought processes among them. Pharmaceutical companies have spent decades trying to find the exact chemical reaction, so it can be synthesized and sold as a treatment. So far, they've failed to do so. There was a problem though. Cigarettes are expensive and our residents had extremely limited finances.

I would grab a cheap pack of smokes every day before work, in case our folks really needed a cigarette. (They always did)

Another of Virginia's quirks was the refusal of medication. A stated goal for our residents was to become as independent as possible in their own medication management. Legally, medication can't be forced on anyone for any reason. Virginia was well aware of this and used it to her advantage as often as possible. 

At medication time, the staff was supposed to discuss the medication with the individual. What each pill was and its intended purpose. Virginia would usually shout and refuse medication, stating things like "I can't take Artane! I'm allergic to Artane!" even though she wasn't prescribed that particular medication. i never understood why, but many staff members would try to convince her to take her medication. I wouldn't. I would simply explain that she was within her rights to refuse medication. I would then attempt to explain the benefits of each medication and her doctor's reasoning for prescribing it. She would continue to argue. I would then explain that I would check back in 30 minutes. If she still refused, I would just have to document her refusal and her reason. This would usually be followed by another threat to have me fired as she would storm out of the room.

Within 20 minutes she would always return and complain that she hadn't received her medication. And so it went, night after night for the better part of a year. Other staff members would try to concoct methods to trick Virginia into 'medication compliance'. They would complain about my methods. My boss would then remind them that I was the nightshift manager and that she had no qualm with my methods. I've never condoned any sort of dishonest methodology in a professional setting. If a person refused a medication, they had their reason. That was good enough for me. 

For the first few months, Virginia would either yell at me, insult me, or ignore me. She would threaten my job at least once or twice a week. I explained that while I enjoyed the job, I could make more money doing almost anything else. One night, as she was threatening my job, I asked if she'd like me to quit. I explained that I could transfer to another site or just change jobs altogether. I explained that if my presence was so disruptive to her life, it would probably be in everyone's interest for me to do so. She just looked at me, then walked out of the office. 

She came back awhile later. I was sitting at the computer, typing up some paperwork, and she asked what I was doing. I suggested that MAYBE I was writing my resignation but hadn't totally decided yet. Her response was hilarious. "You can't quit! You always give me cigarettes!"

Rather than continuing the conversation, I went back to my paperwork. She sat down in a chair in the office and just watched me. After a while, I finished up and decided to take a break. I poured a cup of coffee and explained that Virginia would have to leave the office while I stepped outside. She followed me. I sat down outside and pulled a pack of cigarettes from my pocket. I lit one and offered her one. She graciously accepted it, used my lighter, and we just sat quietly in the night air puffing away in silence. I finished my coffee and excused myself as I was heading back to my office. As I neared the door, I heard her quietly say "please don't quit." I turned, gave her a smile and went back to work. 

I can honestly say that I enjoyed this job. It was never boring! Our residents were all characters. I became pretty close with the facility staff and the other residents in the building. I was often considered the go-to guy if there was a problem. Most nights residents would stop by the office to say Hi or come to me with concerns. The nursing staff and I were especially close. They couldn't figure out why I chose to work there. They thought I was too smart and had too much experience for my particular job. I'd just smile and tell them I enjoyed it. 

I worked there for another couple of years, before our site was closed. The state implemented an across-the-board 60% funding cut. For reasons I still don't understand, our site was closed because we managed to come in under budget. From a personal point of view, I was glad that most of our residents would be moving someplace less disgusting. Some chose to leave our program and stay. Others, like Virginia, we had barely 2 months to scramble to find them housing. Most of the staff took transfers to other site or just quit to look for other jobs. Towards the end, it was my boss and I splitting 12-hour shifts, marking the days to the end. I'd agreed to work with this group and wasn't about to turn my back on them. For this, I was given a year's severance. 

My last night was, admittedly, a bit emotional. It was the night of New Year's Day. Our 12 beds had been reduced to 4 or 5. Most of them slept through the night, except Virginia. She spent the night either in my office or following me on my rounds. It was obvious that she was struggling to stay lucid. I bought her a pack of cigarettes. About 4am, we were sitting in the office, just chatting. Out of the blue, she inquired if she could ask me a question, to which I agreed. "Can I hug you?" I told her it might not be professional or appropriate, but what the heck. It was my last night. Virginia smelled like cigarettes, body odor, and urine-soaked diapers. But it was probably the most genuine hug I've ever had. She told me that she would miss me. 

Due to her nearly lifelong institutionalization, Virginia was difficult to find housing for. Her sister eventually found her a placement in a facility in a different part of the state. Virginia died about 6 months later. My former boss called me to tell me the news. The news wasn't unexpected but still saddened me. In a perfect world, her mind would have been healthy. She would have been able to think clearly and not live with the fear of unseen voices and delusional thoughts. In the few brief years I got to know her, I was able to figure out her thoughts, and her views on the world. Hers was a sad story, but in her own ways, she made the best of her situation. 

I was moved to write the following song. It was heard by a handful of people who knew her, and it brought them all to tears.

Her name was Virginia.

She never saw the world. 

Because she talked to strangers

that no one could see.

It started when she was a girl.

Her name was Virginia.

She was scared of the dark,

and the voices that cried out

and called her rude names,

and the thing that lived in the park.

She took drugs by osmosis

through a hole in the wall.

She wanted a cigarette at 4am -

screams were heard down the hall.

Her name was Virginia.

She smiled sometimes.

But they put her away

on her 14th birthday

man that's one hell of a crime.

Her name was Virginia.

She was 80 years old

when she took her last puff

of a stolen cigarette

and said goodbye to the world.

She took drugs by osmosis

through a hole in the wall.

She wanted a cigarette at 4am -

screams were heard down the hall.

Her name was Virginia.

She never saw the world. 

Because she talked to strangers

that no one could see.

It started when she was a girl.