Learning Breath Awareness Controls Fear

In the Emergency Department a woman is screaming in a room across the hall, but we students continue talking through it because it shows how professional we are, how unfazed. We discuss the fact that my 80 year-old cardiac patient with a history of increasingly frequent syncope drove herself to the hospital from Fairfield that morning. “As if merging on I-95 didn’t make me frightened enough,” I joke, “now I have to think about the fact that one of my fellow drivers might pass out at any second.”

A male patient waiting on a nearby gurney overhears us. “Frightened isn’t good,” he says. “Frightened means you’ve got no room to think. What you wanna be is concerned.”

“You’re right,” I say. “I should remember that. I’m not a frightened driver, I’m a concerned driver.” This is a lie that anyone who has ever driven with me on any sort of highway could point out immediately. An important message to send to patients, I think: that I am not easily frightened.

Twenty minutes pass and the woman is still screaming; our poker faces are beginning to slip. The same patient comes over to me and hands me a piece of paper on which he has written: “Learning breath awareness controls fear.” I’m not sure which one of us the message is most intended for.

A few months later I am at an inpatient psych hospital on a locked unit, trying to meditate with patients while seated on the floor. We are taking deep breaths and repeating chosen phrases. “May I be peaceful. May I be happy. May I live my life with ease.” A short man who looks much older than his reported 60 years tells me his name is Arthur and asks me where my shoes are from. After a while, he leans over as though intent on sharing a secret. “Please will you pray to God for the thoughts in my head?” I promise him I will.

After our meditation finishes, the short man is at my elbow. I ask him about what group therapies he likes the best, what his interests are, and the talk turns to football. He tells me that he respects the Steelers; doesn’t like them, but respects them because they win the game without any touchdowns at all. He never liked the Patriots, hated them even. “But I am here,” he says. “I am here and you gotta like the home team. You gotta support the home team. I do not kill babies. My name is Arthur. My profession is comedian priest. I will pray to God for you if you will pray to God for me.”

He suddenly reaches for my hand and kisses it and I tell him that’s not appropriate. He tells me that I am beautiful like a model and that the other patients are ugly. He repeats this several times. He says that they are ugly and bad and crazy and that it hurts him when he sees me helping them because you can’t help too many people; first I’ll be helping two and then four and then sixty. He begins to rub himself vigorously and I feel panic. I remember all the chart notes about his past stalking of female staff members, about episodes of sexual aggression and common-room masturbation and I think ‘Fuck, I am too timid with boundaries and now he’ll be in trouble and how? how? how do I handle this???’ But then I stop my mind from running and I really look at Arthur, and realize that he’s actually just reaching into his pants to scratch his thighs intently. His stomach and hips are covered in red bumps arranged in the little straight lines that are the hallmark of scabies. I think about him grabbing my hand just minutes earlier and feel itchy.

I slide through the door to the nurses’ station and make sure it’s locked behind me, slowly releasing a breath I hadn’t even realized I was holding. One of the mental health workers gives me a nod.

“Back from the land of the walking dead, I see.” I let the comment pass. We talk about Arthur, who has been here since 1999 and who will probably die here.

“He sleeps a lot sometimes though. I hate to admit it but it’s better around here when he is sleeping. Have you heard the story about what he did to the poodle?” I shake my head and then I hear it, and I immediately wish I hadn’t.

After lunch there is knocking on the enforced glass window of the nurses’ station and it’s Arthur. “I’m sorry I was inappropriate. I don’t think I have a soul or a spirit anymore--I think it traveled out. The others are too ugly and it hurts me when you talk to them. But maybe I am ugly. My nose is very crooked and I have no teeth. Maybe I am ugly.” He opens his mouth to show me and starts to paw at his nose and tug at his hair. “I am ugly,” he repeats. “Tell me, tell me if I am ugly.”

I step out into the hall. He is standing very close and I don’t quite know what to say. “Shhh. It’s okay, Arthur. Don’t worry about that stuff. That’s nothing to worry about.” I count aloud each inhale and exhale while Arthur breathes in rhythm with me.

“Nothing to worry about,” he repeats flatly. “Will you be coming back here soon?”

“I don’t know, Arthur. I am here now though. I’m right here.”

Arthur closes his eyes. “I am here,” he whispers. “I am here.”

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