Alive and Free

I sat anxiously in the high-backed, cushioned, rolling chair. My legs were crossed, right over left and I bounced my right leg, nervous. The room was small, like a box. Distractions had to be avoided during evaluations. The walls were plain, not even white, but a dull cream color. No pictures hung on the walls, there was no boarder, and the floor was the same as it was through out hospital, boring, but pristine white tiles. Aside from my chair, all that occupied the room was a low coffee table on which sat my clipboard and a stack of files, some were noticeably thicker than others, and a small, not very comfortable looking, metal chair opposite my own. I was already starting to feel claustrophobic in the small box of a room. I couldn’t imagine what this place would feel like to the residents; they were in ones sitting in the creaky, cold, probably very uncomfortable chair, being asked question after question, knowing...or in some cases, having no clue, how important their answers and reactions will be in determining their next year in this place. I was the one, perched in my cushioned chair, grilling these people, what right did I have to be anxious? I shook my head. This was my first time doing Evaluations, it was normal to be anxious. I had to do this to finish my internship, I was so close. My white coat was starting to feel suffocating and I tugged at it, wishing I could take the thing off already. But I did love talking with the residents, I don’t know what it was about them that fascinated me so much, but the idea of evaluations made me a little ill.

I wished Dr. Gavnes would just send in the first resident. I eyed the stacks of files, there was at least twenty there. I hadn’t opened any of them as Gavnes had advised. It was silly, I know, but I didn’t want my impression of these people to be biased. I wanted a true first impression. I did pick the clipboard up and stared at the evaluation sheets. They had the advised questions, the guidelines, reactions to look for and what they meant, advised recommendations, the thing was essentially a cheat-sheet. I pulled my pen from my breast pocket and clicked the thing nervously while reading over the questions once more. The part that scared me most was the recommendations. What I observed in a twenty-five minute long interview decided the next year for the resident. How is twenty-five minutes enough time? Even I could be seen as insane in just twenty-five minutes of hard questions and strict observation. Even now, as I clicked my pen, that was an impulsive nervous habit, and how I bounced my leg up and down, that was two already, a couple more key traits and I could be pegged down as a Hypersensitive Anxious, type B.

God, I hoped the first resident was sent in before I decided to write recommendations for myself. And hell, with my symptoms it would be straight to the operating room for a dosage of the magical K-42 serum. Thankfully, I only had time to click my pen a few more times before the door was opened. A young man was lead in by two orderlies. I let out a sigh when I saw the manacles on the man’s thin wrists. Dr. Gavnes had a strange sense of humor, starting me off with a high-level security resident. Those where the only ones that were required to be restrained.

I fingered the syringe nestled in the large waist pocket. I knew how to use the sedative, should I need to. But I hated the idea. I have seen doctors use the syringes too freely, with no restraint at all, and I’ve seen the effects of too many injections; residents lost so far in their minds that they are basically confined to their beds, cursed with violent spasms, and a complete lost of bodily functions. Of course most doctors didn’t care. I surveyed the young man now seated in front of me. He was only a few years younger than me. He was not still in his seat, and his jittering made the chair squeak angrily. Once he was in his chair the two orderlies turned and left without a backwards glance at me or the young man.

I studied him closely, he was tall, with awkwardly long legs and he was skinny; most people in this place were skinny. I think it had more to do with the medicine than anything else, as food was plentiful and exercise not as much. He seemed particularly thin; his hands mostly. His fingers were long and thin and his wrists were tiny, I couldn’t help but think, that should he tried, the young man could slip from the manacles at anytime he wanted. He was skinny, but I couldn’t help but notice the strong flex of muscle that accompanied each of his movements. He couldn’t be more than two years younger than me, and for some reason that realization scared me. His hair was dark brown and neat, but on the long side, at least for a male. It looked clean, and well cared for, and it covered his face as he was staring intently at the white floor.

I scanned the clipboard for the name printed at the top of the first evaluation sheet and right next to the name was the current status, one through ten. One being closest to release with the most freedom, ten being basically hopeless and least amount of privileges. Next to the young man’s name was a seven. Made sense, only six and above were chained.

“Mr. Marks,” I said, hoping my voice didn’t sound as desperate and nervous as it did in my head.

The man raised his head and his neat hair managed to stay right over his eyes, and for a moment, as I stared at him, something about the way his hair fell over his eyes— shadowing his face, scared me.

“Yes?” he said suddenly and jolted me back to reality. He brushed his hair back revealing pale eyes.

“Um, Jason Marks, right?” I stuttered, wishing I could just get over whatever mental block I was having and just do this already. I had watched Dr. Gavnes do evaluations for years, and he was always completely confident, cool, and intimidating. I probably sounded pathetic.

“Yes, that’s me, or at least, so I am told, anyway,” the man replied lightly. He then propped his elbows on his knees, folded his hands carefully, and rested his chin gently on top of his entwined fingers. All the while the chains clanked and the chair squawked.

I took a deep breath and reached for the top file.

“Lets begin then,” I said, finding myself growing more confident.

I flipped the file open. Without even reading I had what I felt was a pretty good impression of the young man. Hypersensitive, but well controlled, and seemed to either have a

Detachment problem or a Self-Complex. Still I skimmed his file. History of random violence. There were two incidents in the past year worthy of noting. One was where he nearly killed an orderly with a sharpened bit of plastic, and the other was where he had broken another resident’s wrist, and then laughed. It was noted that he was probably more of a bully than they knew, he was constantly covered in bruises and cuts. I couldn’t help but think self injury as I read that. I glanced up from the file and noticed a few fresh cuts on his hands and wrists and an angry bruise on his upper arm, I guessed it was larger than I could see, and just hidden by his sleeve. My gaze dropped back down to the papers. I figured those doctors knew more than I did and read on.

He was sent her about five years ago after being caught attempting to bomb his college dorm with a home made explosive, when he was arrested he was ranting and raving, saying ‘they couldn’t feel!’ and ‘this will help them!’. He was ruled insane and sent here. Prior to that, he had never showed any signs of being violent or insane. He had a high IQ and seemed to have control of self, and didn’t care. He was noted as showing a small amount of progress.

“Mr. Marks, would you care to explain the couple of violent outbursts you’ve had this year?” I said, very calmly.

“Violent! Heh, violence!” Violence is action! For one to even TRY and live there must be action.” he said enthusiastically, his voice carrying hints of madness. He didn’t move from his position. His eyes, however, told the story. They were bright and wide, darting around excited. He was Hypersensitive— defiantly, but he was well controlled, even trapped. That would explain the violent outbursts, he was just a pot boiling over. I studied his pale eyes as they danced around the room; they were full of so many emotions, and I was sure he couldn’t even begin to make sense of them.

“But why the orderly?” I questioned. That had been the most recent occurrence.

Marks suddenly stopped looking around to his wide bright eyes found mine and his lips curled into some sort of half smirk, half grimace.

“Oh, I don’t remember,” he sighed, voice no longer holding any of those tints to insanity it had before. “He did something, I’m sure. Orderlies are annoying, they don’t get it, don’t care—”

“Sure they do— ”I started, but Marks cut in quickly.

“No!” he snapped, and he sat completely attentive in the creaky metal chair. He pulled angrily at the manacles. “They don’t!”

“Okay, okay,” I said, softly, hoping he could clam down before I had to use the sedative. The man calmed suddenly and returned to his original position.

“You’re not a doctor, are you?” Marks asked quietly. I hated to go back to old disorders but from what I had read on Bi-polar I could see some traits in Marks. I still hadn’t looked at his last evaluation— I wanted my evaluation to be completely unbiased.

“No, I will be soon though,” I said.

“Is it hard? The studies I mean?” he asked, a childish curiosity in his voice.

“It is a challenge, yes,” I replied.

“You seemed nervous when I first came in. Am I scary?”

“Not really,” I said lightly and smiled. “Just doing something new is always a little nerve wracking, you know?”

“Yes, yes, I do.” He sounded elated

“So I must ask, you seem to be in control of yourself— what are you willing to do to get better and eventually be free from this institution?” I winced; the words sounded mechanical, probably because I had basically read straight from the sheet. While waiting for a response I scribbled down my notes on his evaluation sheet. I was finally starting to feel confident— even though this really was the equivalent of a final exam, and messing this up could me failing my internship.

“I’d do anything to be free,” he said after a moment. His voice was normal, no childish tones, no hints of madness or anger, it was cool, calm, and monotone. It was as though he was trying to fake Desensitization. He was doing an okay job, but his eyes told the true story. Desensitized eyes stayed cool and calm along with the voice, his didn’t. They were still bright and wide, and dancing nervously around in his sockets.

“Anything? Well, should you control your violent outbursts, your ‘action’ and maybe find another outlet...and of course with the right medicine, you’d be well on your way to be released.” I said, flipping through his chart, to make sure his violent acts were the only problems. He was an intelligent young man that had been under too much stress and just happened to explode. I could very well be him.

“No, no, no, no. That is not what I mean by free,” he said and I wasn’t sure if I was seeing things or not, but I swore his pale eyes darkened several shades. “My freedom is more profound, it is longer lasting, it is the purest kind of freedom, the only kind, really. That is what I meant by free,” he finished simply and shifted positions so he was leaning lazily back in the metal chair. He was bouncing his leg and idling playing with the chains on his wrists, while I noticed, his left eye beginning to twitch, just slightly.

It took a moment to catch on and as soon as I did, I circled something on his evaluation sheet and made an urgent note to the side. I looked up at him cautiously.

“I disagree,” I said and my statement seemed to startle him.

“What?” He said up slowly in his chair, leaning in closer to me. Surprise was evident on his face.

“I disagree. That is not the only freedom,” I said simply.

“You know what I am talking about then...?” he asked softly, and I nodded. He stared a moment before sitting back and smiling, it was the same half smirk, half grimace from before.

”My my, and you aren’t even a doctor yet and you are much more quick-witted than ANY of them!” he said with a laugh.

I ignored the comment. “There are ways,” I asserted, “to be alive and free.”

The man gave a mad bark of a laugh. “Maybe four or so years ago, I could have been convinced, but not anymore.” I made another note on the sheet before looking up.

“What,” I paused and flipped the clipboard upside down in my lap. I was flying solo now.“What could I...could this hospital do to help you see— ”

“Nothing.” Marks cut in. “Nothing. I merely talk like this so when I do achieve freedom I won’t be misunderstood. I don’t want help, nor can it be given.” The twitch in his eye had vanished and he was now tapping his fingers against the edge of the chair. Clank— clank— clank, the noise echoed loudly throughout the small room.

“I have to mark this down, you know that right?” I said, as I idly clicked my pen. The clicks and the clanks joined together in some insane, primitive song, that bounced angrily from wall to wall, never finding a place to rest.

“Go ahead.” I stopped clicking.

I sighed before looking through his file once me. After a moment of reading I looked back up. “You were studying to be a traditional M.D., specializing in neurology, why not go back to that? You aren’t too far away.” I commented, trying to change the subject, and conduct a small test. If he were a Hypertensive type A, this should work, because type A’s generally have little attention span and are eager to answer questions, and he already seemed to have a small attention span. But I feared he was type B, which, honestly, in a round about way, meant he was more sane.

“Doesn’t matter. I’ve made up my mind,” he said plainly. “Now you nor anyone else will stop me.” The tapping stopped and he sat back up. Yes, I though, type B. I sighed.

“We can,” I said firmly. Marks rolled his eyes. I turned the clipboard over and added more notes to the sheet. After a moment I looked up. “You really should give me something positive to write down here.” I tapped my pen on the clipboard.

“I can sleep now,” he said and paused. “I gained seven pounds.” He brought his finger to his chin in a mock action of thought, and because of the chain, his other hand dangled along limply under its twin. “I am in better control of myself, most of the time.” He gave a small smile, different from the smirk, grimace hybrid I was starting to grow used to. “Would that be enough for you, Mr. Almost Doctor?” he asked mockingly. I seriously considered flipping to the very back of the clipboard and finding the code for Bi-polar disorder. I had the more modern codes memorized, but Bi-polar was old, not so common. I didn’t but did write down some of Marks own comments and my own observations that I thought maybe hinted at Bi-polar.

An alarm went off, and I fumbled to silence my beeping watch. That was it, times up. I barely had time to say goodbye to Mr. Marks before the orderlies came in to lead him away.

“Alive and free,” he laughed to himself as he was led through the door. “That would be an oxymoron if I’ve ever heard one!” I shook my head and un clipped his sheet and moved it to the bottom of the stack, after writing out my final recommendation. I had a moment before the next resident was led in so I looked back to see his old recommendation. Level seven of ten— violent, unpredictable, bully, deeply troubled, little hope. Symptoms of mild Desensitization. I looked back at the year before that, pretty much the same. I flipped back another year, the same; I was starting to doubt myself. I had put him at a four and a half. Mildly violent, semi-predicable, controlled, smart, and type B Hypersensitive, and, as any half level implies, suicidal.

I was proud of myself the rest of the day. None of the cases Gavnes sent me were as complex a Marks. Most were easy cases of Desensitization, or old disorders that I could offer easy recommendations for. And Marks was the only one above a level five so he was the only one who was chained.

When I handed my reports into Dr. Gavnes at the end of the day, I asked him about Marks.

“I thought it would be for your confidence to give you someone like Marks for your first evaluation. He’s scary, but easy to peg down.”

I wondered if we were talking about the same man. “I, um, actually wanted to talk to you abut him. I noticed my evaluation differed from the ones he’s had in the past, I think he is, maybe suicidal, based on a few things he said.” I said quietly.

Gavnes pulled Marks sheet from the stack and skimmed over it without a word. I stood by anxious, shifting from one foot to the other. Dr. Gavnes had always been my mentor in a way, and I had high respect for his opinion and his criticism.

“Hypersensitive? Bi-polar traits? Suicidal? My, you certainly were nervous your first evaluation.” Dr. Gavnes said, and I felt my cheeks flush. “Marks is certainly not suicidal, if anything he is Desensitized, and the Desensitized have a very very very low rate of suicide. And Bi-polar? Heh, that is ancient.” The older doctor laughed and slapped me on the back playfully.

“Sir, I mean, he really worried me. Just something he said— ”

“Don’t worry yourself. Trust me, Marks is not suicidal, and even if he was...” Dr. Gavnes paused. “You are naive. You aren’t held accountable should a resident you worked with commit suicide. Don’t worry, you are doing great.” He looked through the rest of my evaluations briefly. “Aside from Marks, you seemed to be right on target.”

I nodded, feeling queasy. I had always know there was a lack of true care among the doctors, but this was the first time I had ever seen it so bluntly.

I tried, for the next week or so to keep an eye on Marks and find times to talk to him, but when Dr. Gavnes caught on he scolded me for overacting and obsessing.

A week later, two and a half weeks after the evaluations, Jason Marks, a level seven security resident, committed suicide, by hanging himself from the bars of his window.

As an intern, the task of a final look over and helping the orderlies fell to me. I passed by Dr. Gavnes as he and the other doctors were on their way out of the room after looking over the scene. He said nothing. In fact, the matter of Jason Marks was never discussed again.

I saw at once the planning behind the suicide. The window in his room was high on the wall, nearly at the ceiling, about six feet up the wall. The bars were heavy and ran vertically in the window, aside from one bar that crossed through the others, it was on this that the makeshift rope was tied. It was made up of scraps of fabric knotted and braided together in such a complex way that I couldn’t help but think of the time and effort that went into making it. The measurement was perfect. Marks was a little over six feet tall, the ledge of the window was exactly six feet up the wall, and there was a little more than a foot from the ledge to the horizontal bar. I noticed how close his toes were to the ground. He must have measured it out exactly.

The orderlies were lurking in the doorway, waiting for my order to cut the body down. I was about to give them the okay, everything seemed in order, it seemed like a suicide, plain and simple, but I noticed a piece of paper clenched in his hand. He hadn’t been dead long so it was easy to pull from his cold hand. It was folded neatly and scribbled on one side was “To the Almost Doctor, the only one with sense.” I found myself trembling as an overwhelming sense of guilt flared up in me. I unfolded the paper and read.

Dear Almost Doctor, the note read in neat curling handwriting, I told you there was nothing to do, you should know now, this is freedom, I am free now, and everyone is better for it, but I must thank you, for you were the first to ever even try to understand, now, I don’t die in vain, despite what they write in my file, you know why I did it. I sought prefect freedom. Heh, you cracked me up, alive and free, what an idea. Don’t give up on that, Mr. Almost Doctor, just don’t.

Sincerely,

Jason Marks

None of the orderlies had noticed the letter, and I tucked it safely into my pocket before I called them over to cut him down.

I was starting to doubt it myself, and it was strange that I found inspiration in this young man’s death, but really, I had to think...Alive and free, what an idea.