When I was in nursing school 17 years ago, we did a 2 week psych rotation in 2 different facilities. One was a crisis stabilization unit, the other an inpatient facility. During my rotation, I happened to meet a young adult patient — let’s call them Sam — who was in both places. I was able to have more contact with this particular patient than with any other during nursing school, and I have never forgotten them. (To be clear, I am using gender-neutral pronouns to avoid any chance of identifying them, not because they were non-binary). This patient suffered from paranoid schizophrenia, was very bright, could be funny, and had zero insight into their illness. They literally could not tell that the voices were not real. They knew that when the loudspeaker came on at the supermarket everyone could hear it. But they also believed that sometimes only they could hear certain special messages.
A few years before I met Sam, I learned that a college friend, Giles, had committed suicide due to his schizophrenia and depression. He was still in his twenties, and his death shook me. It was not a surprise, but certainly a heartbreak. I had no real understanding of mental illness. I thought Giles could do something different. I thought friends or family could have tried harder. I mean, I didn’t really think that, but I wanted to believe that. I wanted to believe we could have saved him. Giles was the first classmate I met when I arrived at our small college. He was sitting with his father on the bench by the administration building. He came to school bright, beautiful, goofy, multi-talented. When he was expelled, he was broken. When he died, he was crushed. Without yet being a parent, I knew that his family had been suffering terribly. I took the time to write them a long letter with every single good memory I had of him. Most of my memories came from after he had broken with reality. He could still be extremely good company at the pub. His mind was wild, but not threatening. He loved my puppy. He rambled, but sometimes listened. He recognized me most of the time and was glad to see me. He offered to help with small things. I left out the parts where he begged for change, had signs of having been beaten up, smelled like urine.
When I met Sam, I could see their future looking like Giles’s life. On the last day of my psych rotation, Sam gave me a drawing, and I never saw them again. Statistically, the lifespan of people with schizophrenia is significantly less than average. Over the years, I have thought about them frequently and wondered. Both Sam and Giles have informed my nursing practice to a huge degree. They both made me more compassionate toward patients and families. They are educators in their own way. In making me a better nurse, they have affected the lives of many people well beyond their own spheres.
Recently at work I noticed Sam’s name on our emergency room board. At least I was pretty sure it was them. The age was right, and the admission reason seemed plausible. I went downstairs to check, and I was right. There they were, unmistakably, older, fatter, grayer, just like me. I woke them up to say hi. I introduced myself, and told them how I met them. I told them I had never forgotten them. When I said, “I’m so glad to see you!” They said, “Well nobody’s ever said that to me.” They were friendly and seemed basically the same as their 17-years-ago self. I asked about their mother, whom I had met years ago, their eyes darkened. They mumbled, “I don’t want to talk about that right now.” As I recall, their relationship was strained. I had to return to work, but I told them again that I was really happy to see them again, and I hoped they stayed safe. Then I said, “You’re really important, you know.” They said, “Well, it’s good you’re still a nurse.”
If any moment could be simultaneously heartwarming and heartbreaking, that was it.