Into the light: the post-"asylum" experience — 3

Here are Parts One and Two.

Psychiatry as it was practiced in the cheerful bright wing on the fourth floor of the Montreal General Hospital was, to quote myself, "leaping ahead by a couple of centuries" from our experience at the Verdun Protestant Hospital. I'm pretty sure there's been another great leap ahead since then but at least at the time, we felt we had very much moved into modern day.

My most vivid memories of the fourth floor are not so much the dramatic treatments still in use — electro-convulsive therapy (ECT) and insulin shock therapy — but the relaxed atmosphere and the emphasis on talking. The patients weren't nearly as ill as the patients in the Verdun and individual psycho-therapy and group therapy were widely used. A lot of the therapy was private between the patient and her psychiatrist but we got to sit in on certain group therapy sessions and it was endlessly fascinating.

We were also encouraged to sit and talk with our patients as much as possible and they really meant it in this case. In theory, we were supposed to talk to our patients on our other floors but in practice, we never felt quite comfortable with that. We felt there were more points to be scored by looking busy even if we had to invent extra tasks.

But on the fourth floor, talking — listening really — and taking and recording copious notes, were both expected and evaluated. Many of the patients, suffering from what is now known as bi-polar disorder (known then as manic-depressive disorder), depression and schizophrenia were often pleasant and good conversationalists. Our notes were expected to be detailed, reporting dialogue, facial expressions, hand gestures — we were to paint a word picture so a psychiatrist reading it would feel all aspects of our encounters.

Our patients also were prescribed lots and lots of drugs. Many of the psychiatric drugs were in their infancy so much of our job was also to watch what happened after the drugs were administered — behaviour, thought and speech patterns, side effects.

I have specific memories of only a few patients; the great majority have become anonymous beings that I remember only as treatments or as room locations. One of the patients I do remember was a 17-year-old boy, a very smart boy who was bi-polar and who was barely in control when he was manic but who also spent whole days in bed. It was always very mysterious to see a brain working two very different occupations.

Even though the listening and the talking and the writing are the most memorable, most of our patients also were treated with ECT and insulin and these were major events in our nursing week. Both these treatments were labour-intensive for the nursing staff, in the preparation stage, at the height of the treatment and probably most importantly, bringing our patients back from a sometimes terrifying trip. After ECT particularly, the patient's memory would be mostly gone with even the simplest functions forgotten as the brain waves had been zapped and fragmented with the electric shock. The patients were also usually sore after having had violent seizures. It took days to recover.

Following the insulin, they were often sick and disoriented.

My goodness. What they went through all just to try to feel somewhat normal and to be able to function out in the world.

The treatment I haven't mentioned, which in fact I only encountered once, was the lobotomy — a procedure almost too painful to think about.

The purpose of the operation was to reduce the symptoms of mental disorder, and it was recognized that this was accomplished at the expense of a person's personality and intellect. . . Following the operation, spontaneity, responsiveness, self-awareness and self-control were reduced. Activity was replaced by inertia, and people were left emotionally blunted and restricted in their intellectual range.

The woman I saw who had had a lobotomy appeared to me to be simply a shell, looking straight ahead out of empty eyes, not reacting to anything around her. No one knew quite what to say.

There was a very dramatic incident during my time on the fourth floor. We had a patient who was suffering severe post-partum depression. She had spoken not a word since the birth of her baby and was non-reactive to everything around her. She was admitted because she was considered a severe danger to herself and was on high suicide alert. This meant that anything that could cause any harm was removed from the room and someone popped into her room every 10 minutes or so.

Shortly after one of the routine checks, there was a mighty crash from her room. Now you have to remember, this was a woman who hadn't spoken or moved or reacted to anything in weeks. This crash was unfathomable.

But apparently, someone had left a heavy glass ashtray in her room.

That is thick glass and it must have taken superhuman strength to hurl it with such force that it broke on the tile floor. But break it did and by the time staff reached her room, she had used a piece of the glass to cut her wrist and was bleeding heavily. Staff sprang into action, got the material needed to stop the bleeding, called emergency and within a very short time a stretcher arrived and she was taken down to the emergency department where she was met by a team to deal with all aspects of the care that was needed.

As far as I know, she survived and I've always hoped that she defeated the post-partum depression and was able to enjoy her family and the new baby.

My "asylum" experience continues: Part 2

Here's Part 1.

I've written only about the women's ward in the psychiatric institution called the Verdun Protestant Hospital but part of our group also worked on the men's ward. I have no real impression of what their work was like. In a way, there was such a feeling of intimacy with some of our patients on the women's ward, I wonder what could possibly duplicate that feeling on the men's ward? We were warned of — and experienced — dangerous situations with the women so I can only imagine what it must have been like working with the men.

I do remember that our whole group — and maybe some other groups — were taken on a chilling tour of the locked ward where the most dangerous patients were kept. These were people who had come through the criminal justice system, who had been charged with serious violent crime and who had been found not guilty by reason of insanity. This was maximum security; we were accompanied by a contingent of security staff and doors were unlocked and re-locked as we approached and passed through.

It was scary and sad and it was also a bit mesmerizing, in the way of a horror movie.

When I was looking up a few facts about the Verdun hospital, I came across a survey that had been done in 1937, detailing the state of the hospital, the staff, the patients, the food, the dress, the recreation, the care. It makes for interesting reading and although I'm sure many of the changes that it recommended had been implemented by the time we came along, there were some descriptions that sounded very familiar.

Without enumerating the details of all the wards, certain general remarks may be made. As has been stated before, there is very serious overcrowding in all of the wards devoted to public patients, and at least one ward now in use, namely "A" and "Observation", which is located in the basement, is not at all suitable for the care of patients.

In spite of that fact, 70 male patients, of various types, are housed there at present. The beds are crowded much more closely together than should be the case, with the result that the ventilation which even under ideal conditions of ward population would not be entirely satisfactory, is decidedly inadequate.

So far as could be observed, the housekeeping was reasonably good. The beds were clean and in spite of the woeful lack of bathing facilities, the patients appeared clean and the wards in general were free of odor. The natural lighting of a number of the wards is poor, and the arrangement is such that adequate supervision of the patients could not be obtained without a large addition to the personnel.

It's so polite and tactful, isn't it?

I think the main impression that comes across in the survey is cheerlessness and that's definitely one of the feelings I was always left with. My memory may not be terribly specific about the conditions in the hospital but my impression is that it was dank and dark and lacking in cheer and colour and hope.

At some point in our training, we were taken on a field trip to another "asylum" — the vast institution in the East End of Montreal called Saint-Jean de Dieu.

We went there on a bus and I remember being taken in by a back entrance to a sitting/waiting room until our guide appeared — a nun in full habit. Saint-Jean de Dieu, run by the Sisters of Charity, at that time housed over 5,000 mentally ill patients. I didn't know it then but I found out later that it was, in fact, an incorporated municipality and the Mother Superior was also the mayor. The hospital/town had its own police force, fire department, post office and its own polling stations during elections.

It also had shops and small businesses along its big main hallway — shoe repair, bakery, sewing and weaving — all operated by the patients. You couldn't help but think of that old observation that "the inmates have taken over the asylum" — but in a good way. I don't know how it looked to the patients and their families but to me it seemed bright and cheerful and hopeful. It was clean and well-lit.

That hospital was so big, it had a tramway inside to transport goods and patients from one place to another. Do you see the rails?

Most people remember — and she was memorable — the patient who believed she was Queen Victoria and dressed and behaved accordingly. She had a regal wave that Queen Elizabeth II would surely envy.

(This is the look she was going for.)

You can only conclude that the difference in the two hospitals was the presence of the nuns. There would have been a good population of nuns in Quebec at that time — this was still pre-Quiet Revolution — and nursing nuns were dedicated to service and to their patients. The survey I mentioned above about the Verdun centred in so many areas on lack of personnel.

I learned a lot from comparing these two settings.

We did eventually get back to the Montreal General and it was like leaping ahead a couple of centuries. I'll come back and tell you about that.

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Here's Part Three.

Incurably insane to treatable psychotic: my asylum experience

There are times I look back on the psychiatric training we Montreal General students got just after the middle of the last century and wonder if we somehow fell into the Middle Ages. We were right on the cusp of some major changes but we were still in a time when the hospitals were called asylums and some of our mentally ill patients still had the diagnosis "incurably insane" written on their charts.

It was the early 1960s, but a couple of those patients had been admitted to the hospital back in the '30s and I think there was one — her name was "Baby" — who had been there since the '20s. I think she had been admitted as a teenager after being accused of killing someone. (I'm saying "I think" quite a lot here because it was a long time ago and the nature of some of the memories I have are almost dream-like.)

Our hard-core psychiatric work — I'm not sure I can honestly call it "training" — was done at what was then called the Verdun Protestant Hospital. It's now called the Douglas Mental Health University Institute. We referred to it only as "the Verdun" and my memories of it — of the actual hospital — are spotty. I remember the large grounds, with laid out walkways, because we were allowed to take certain patients outside for walks and I remember it being pleasant out there.

If this is how the hospital looked, this would have been much earlier than my time. I can see it being like this however, before those trees matured.

Dr. Heinz Lehmann, who became very well-known for his work in psychiatric drugs, was director of the Verdun and in some of my reading, I see that he described the hospital before some of the big changes that were to come, as a "snake pit." Oh yes.

I worked on the women's ward. Most of the women had been there for years, some for decades. When we had some spare time, we could go into the record room and read some of the charts. There were thousands and thousands of pages written about each patient although we were astonished to discover that some of the charts had ended years before. It was as if there was nothing more to say.

Some of the patients were harmless but we were warned that most had a very dangerous side. A couple of them, we were cautioned, were cleverly manipulative and they would behave almost normally around us, smiling, being helpful and conversational. The more experienced among us watched carefully because those patients regularly attacked young nurses after lulling them into feeling secure. It didn't happen to me but I saw it happen once; it was horrible and involved alarms going off, burly men appearing on the scene, our patient being held down (not easy, even for the burly men) and a vast amount of a tranquilizing injection administered under indescribable duress.

It was scary and I realize, looking back, that there were a lot of things to be scared of there. We had to go through a tunnel to get from our residence to our work. That tunnel was awful and if we ever found ourselves alone down there, it was a nightmare. We did try to stick together.

It was surely a stressful place to work but there were pleasant times too. Some of our patients were adorable, child-like almost (I guess we would be too if we'd been there for so many years, being treated like a child), wanting approval and loving hugs and hand-holding.

There were two patients called Tilly. One was Tilly the White Rabbit who had been walking hurriedly up and down the same small piece of hallway all her waking hours for many years. She had worn a groove in the floor.

Tilly the Police Officer walked purposefully around the ward, not looking as if she were noticing anything but in fact, aware of every little detail of what everyone was doing. If we needed to know something about one of the non-communicative patients, Tilly was our woman.

But we always had to be careful. There was one patient, much much bigger than I, who liked to wrap young nurses in a bear hug. She got me in her grip one day and wouldn't let me go. I quite literally couldn't move and could barely breathe. I tried talking to her calmly, saying everything we'd been taught to say, but I finally had to yell for help. It caused quite a crisis on the ward. She was a difficult patient and she clearly enjoyed having the upper hand. I was never sure after if she remembered having done that. That was scary in itself.

Our patients — as far as I know, looking back — were psychotic and they were being treated with massive doses of anti-psychotic drugs. I think this was a fairly new development and it was probably why the patients were able to function — in their own way.

The thing that got me thinking about all this was reading lately something that referred in passing to electro-convulsive therapy — which we were ordered to say — also known as "electric shock treatment" which we were ordered never to say.

Electro-convulsive therapy (ECT) and deep insulin coma therapy were both used at the Verdun but not so much on our ward. I think they must have been used in areas where the patients had a better prognosis. I only remember seeing the treatment once or twice but I do remember this: the shock was administered with no general anaesthetic and the thought of that is another kind of shock. (I assisted with ECT many times in the psychiatric unit back at the Montreal General where the second part of our affiliation took place and there, we did use general anaesthetic. It was still shocking — sorry, it just seems to fit — but a little easier to take.)

I was still a few years away from being able to look at the incarceration and treatment of the women at the Verdun with a feminist analysis. For Her Own Good hadn't even been written yet. That will be a subject for another time.

But I obviously have more to say about life in the asylum and being a nurse to the mentally ill so I'll be back with Part Two.

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Here are Parts Two and Three.

Anxiety, panic, drama: life in the operating room (2)

You can read part one right here.

Operations were always scheduled in advance unless there was an emergency which didn't seem to happen as often as you might think. A GI bleed, a perforated appendix, a patient from Casualty who may have come in after an accident — these are the types of cases that weren't planned ahead.

I had gone back to sleeping at night and managing with my OR routines. As we all realized at some point, the operating room bosses had nothing invested in us and it was as if our operating room experience had been divorced from the rest of our quite intense training. I've thought about it some in the years since and my theory is that if a student showed interest and aptitude, the powers-that-be would lavish attention on her and prepare her for induction into their exclusive club.

As for the rest of us, we would put in our time and meanwhile, we'd be assigned lots of cleaning jobs. There definitely were times when we thought we'd joined the housekeeping staff.

And then one day, about two weeks in, I checked the next day's schedule on my way off-duty and there was my name: scrub nurse. My surgeon was Dr. Harry Scott, already well-known just for being interesting and flamboyant, not yet a legend for being a pioneer in cardio-vascular surgery — specifically, open-heart surgery.

Don't worry. I wasn't going to scrub for open-heart surgery! Dr. Scott must have still been doing some general surgery; I don't remember what the operation was but I think it was fairly routine.

It was my first time as scrub nurse but not my last so I don't have specific memories of getting ready for that one. This time, of course, I had the circulating nurse working for me and it was a whole set of new experiences to be the one being dressed and masked.

The scrub nurse put on her own gloves. When the circulating nurse opened the cotton packet, the gloves were lying on their backs, palms up. The wrists were folded back a couple of inches. With your bare right hand, you held the left-hand glove by the fold, touching only the inside of the glove and pulled it on — leaving it folded. With your gloved left hand, you slid your fingers under the fold on the right glove touching only the outside of the glove and pulled it on. With sterile fingers on both hands, you then flipped the fold up over your wrists and voilà — gloves on both hands whose outsides have not been contaminated! Aren't you glad I told you how to do that?

I do remember the intensity and the focus required while getting the instruments ready with the circulating nurse. And then getting ready for the surgeon.

The surgeon came into the theatre gowned and masked and scrubbed but not gloved. I just described to you in a short paragraph how to get those sterile gloves on without contaminating the outside but for some reason, this was not taught in medical school. The surgeon's gloves were put on to his hands by the scrub nurse. As she was already wearing her sterile gloves, she could pick his up, stretch out the opening, point the fingers to the floor and he would lower his hand into the glove.

You may have noticed I've said nothing about the patient in all of this. The truth is, the patient — the reason we were all there — was not prominent in our preparations. At this point, the patient was heavily sedated and was the responsibility of the anaesthetist. All we did was prepare and lay down the drapery that would render the patient even more anonymous than s/he already was.

When we were ready to start that morning, Dr. Scott asked me my name. We can only see each other's eyes in this situation but he at least recognized that he didn't know me. I told him — "Miss" of course. There were no first names in the hospital, ever.

The operation started and it really is much like you've seen in the movies. The surgeon puts out his hand and you're expected to know what to put into it. The scalpel first and then, for a few minutes it gets really tense, as controlling the bleeding becomes the prime focus.

"Forceps. Gauze. Gauze. Gauze. A little more gauze."

(If you listen carefully, you might hear the voices of Mike Nichols and Elaine May.)

Once the bleeding was under control and the surgeon was working away, he would often relax a bit. In my first case, Dr. Scott asked me where I was from. New Brunswick, I said. We continued, handing the instruments back and forth. The circulating nurse and I did the count that always followed the first round of bleeding — scalpel blades, forceps, bloody sponges. They were all placed in a basin nearby — more counts to come.

When we settled back into the operation, Dr. Scott said, "Do you know where Harvey Station is?" "Yes, I do," said I. "Then you're definitely from New Brunswick!" he said, quite gleefully. I thought he said he had been born in Harvey Station but I read later that he was born in Montreal so maybe he said his father was born in Harvey Station. It was a nice memorable little exchange anyway.

As far as I remember, everything went smoothly and there was no drama in my first scrub. As always, when the operation was finished, the surgeon leaves and asks someone to "close" for him. It would generally be an intern or resident or, depending on the time of year or the day of the week, it might be a medical student. "Closing" was quite a complicated procedure, dealing — as it did — with several layers of patient and several different kinds of sutures. But we all have to learn somehow.

Dr. Scott thanked me for my help before he left and I thought that was gracious and unexpected.

There were, without a doubt, many surgeons who were not nearly as well-mannered as Dr. Scott. There were surgeons who threw their instruments across the room, causing the circulating nurse to have to duck to avoid a forcep in the eye. There were surgeons who lost their temper and swore and blamed others for their own mistakes. I was very lucky not to have had any of those experiences but I know for certain they happened.

Memory is an amazing thing. When I started writing this, I thought — in fact, I wrote, "The memories I have of the time spent there are vivid, vague and jumbled up" — that I would have a hard time remembering almost anything of the operating room experiences. I remember way more than I thought I did and the more I write, the more I remember. I could probably go on for several more pages!

Don't worry though. I'm not going to.

This is me, just after our capping ceremony — probably several months before my operating room experiences.

Anxiety, panic, drama: life in the operating room (1)

The morning I got off the elevator on the 8th floor of the Montreal General Hospital and headed toward the operating theatres, I hadn't slept a wink the night before and for all I knew, I would never sleep again. Anxiety had never been an issue for me but I was starting my affiliation as an operating room nurse and, as a second-year student, I had reached a whole new level of near-panic.

I can't remember being with anyone although the six members of our affiliating group were mostly close and usually travelling together. My memories of that morning are that I was completely alone as I walked down that long hall to meet the nurse in charge.

We had heard about the nurses in charge of the operating rooms. They were legendary and all the stories were scary. Some of the top nurses were from England and they had brought with them not only those frilly pill-box caps — some of them with the short veil attached in the back — but utter disdain for frightened students and a fairly obvious joy in being able to intimidate so easily.

I looked for stock photos of nurses of that era to help you picture what I was facing but all the nurses in the pictures I found looked too kind for my purposes. This is the closest I could come:

(Yes, you're right. It's Agnes Moorehead from Magnificent Obsession. She's got the expression though.)

I think there were 12 or 14 or 16 operating theatres. I honestly don't know how many there were but my memory is that there were favourites that seemed to be in use constantly and then there were the others — for some reason, just not up to surgical standards.

In this picture, pretty much dead centre, you can see a floor extending from the tall wing on the left to the short wing on the right that has no windows. There are two windowed floors above it. The floor of no windows is the 8th floor.

So there was no natural light on the theatre wing of the 8th floor and it was kept at a very cool temperature at all times. There was something disorienting about working there all day, in the cold under bright lights.

At least two of the theatres had galleries, where spectators — medical students usually and sometimes nursing students although if we were on affiliation there, we were more likely to be down on the floor — came to watch the big surgeries. Some of the surgeons were showmen (always men in those days) and they loved an audience.

The memories I have of the time spent there are vivid, vague and jumbled up. I have no idea of the order things happened in but I do remember some of the things we learned.

We had already learned, in other circumstances, the principles of sterility and the method of preparing a sterile field. That remained the foundation of our duties but there was so much more. We learned the name and function of hundreds of surgical instruments. We learned how to clean and sterilize them. Most importantly, we learned how to set up the basic surgical tray.

The instruments had to be placed in the order the surgeon was going to use them. The lay-out had to be the same, every time. I so remember the stern unapproachable nurse who was teaching me this task telling me that if I were blindfolded, I should be able to locate the instrument immediately when the surgeon demanded it.

I can't remember the exact order of the instruments but this looks like it could be close:

There were several people around when an operation was about to get underway but on the nursing side, there were the circulating nurse and the scrub nurse. In our lowly position, we had to do a lot of scut work before we got to either of those roles but eventually, we made it to circulating nurse.

I always thought the circulating nurse was not accorded nearly the respect she deserved. She performed a number of essential, important tasks throughout the surgery but sadly, she never had the status of the scrub nurse. She was the theatre's Cinderella and a lot of her job before the operation began involved getting the Princess Scrub Nurse ready.

Fortunately, we students had been well-schooled in humility and this was right up our alley.

The circulating nurse was ready and available as the scrub nurse was getting scrubbed. The water faucets and soap dispensers were foot-controlled but when the 10 minute scrub was finished, the circulating nurse was waiting with sterile towels. She then dressed the scrub nurse in sterile gown and tied it at the back, never touching the front or the sleeves. She capped and masked the scrub nurse, then opened the sterile folded cotton package that contained the gloves.

When the scrub nurse reached the patient's side and the circulating nurse opened the draping on the instrument tray, the scrub nurse was immaculate in all the areas that were anywhere near where the surgery was going to happen.

During the surgery, the circulating nurse was in charge and in control of the room — who came in, how they were dressed, how near to the patient they were allowed. Before, during and after the surgery, she — along with the scrub nurse — was responsible for counting and recording all instruments, needles, blades, sponges.

She would anticipate needs throughout the surgery and be ready at the end with a selection of suturing materials and then, of course, be ready and responsible for the big clean-up.

I came to enjoy the role of circulating nurse. It was busy and challenging and required constant responsibility and accountability but even with all that, it didn't come close to having the tension and the drama of the lead role: the scrub nurse.

I still remember my first time. I'll be back to share that story — and maybe more — soon. (Part two here.)

A tale of the times (2)

"What did they call sexual harassment back then?"

"Life."

I had a hard time writing A tale of the times (1) and I'm not sure I ever succeeded in saying what it was I wanted to say. I think it shows how complex these issues are.

I began to write this story because of the news — not just today's news, but yesterday's news, and last year's news. I wanted to bring clarity to the complexity but I'm pretty sure I've just added new layers of confusion.

Two things I wanted to make clear: I liked Mr. J. He was a nice guy and I enjoyed his company. I get really impatient when reading the news of sexual assaults and harassment and I see the perpetrator described as a "monster" or a "jerk" or a "creep." My experience — and I have quite a lot — is that the men involved in these cases are not monsters. They're regular guys. That's part of the problem and that's what makes it so difficult.

But the second thing is, no matter how hard I tried and after all these years, I still couldn't find a way of saying that I liked him without feeling that I was taking responsibility for what had happened. I felt I would be admitting that this was, indeed, my fault and my nursing superiors were absolutely right to burn me at the stake.

(Cartoon by David Hayward)

The third thing is, Mr. J. was genuinely surprised at my rebuff. He obviously felt entitled and he truly believed I would welcome his advances even though I had been very clear about where the line in our relationship was.

Mr. J. and I continued to see each other on the ward. There was no way I could avoid him and I didn't really want to avoid him. I wanted, as Lucy DeCouture said about Jian Ghomeshi after he attacked her, to "normalize" the situation and thus, to make it seem that it had never happened. (I want to acknowledge that what I went through in this case is nothing like what Lucy and the others went through with Jian.)

When you have been raised and socialized in a certain way, not to make a fuss, this is a natural way to behave.

The incident with Mr. J. happened in the mid-1960s, just before women's liberation was about to break through into the mainstream. The question that still needs to be answered is this: why are the reactions of women facing this today so similar to the reaction I had 50 years ago? Why have we not moved beyond women trying, on some level, to placate, to explain and excuse and protect the men who attack them?

Stay tuned.

A tale of the times (1)

The Montreal General Hospital is built on a hill — the hill, Mount Royal.

This (above) is how it looks when you're looking up the hill and if you enter from this side, through Emergency and Out-patients, you're on the first floor.

But if you walk around the block — quite a long irregular block — you'll come to the main entrance to the hospital and when you go in this door, you're already on the sixth floor.

I worked on the sixth floor for a couple of years in the mid-'60s, as a young graduate on a brand new ward called the Diagnostic Unit, 6 West. Looking back, I think what a coveted job that must have been and how lucky I was to have such a job.

The patients on 6 West weren't sick. They were there for tests, for diagnostic purposes. They were all up and about, they ate in a dining area near the nursing station, they mostly took care of their own personal needs. There was a kitchen next to the dining area and they could freely use the kitchen for snacks — some of which were provided, some of which they or their families brought in.

As nurses on 6 West, we did a lot of paperwork; we kept track of all the tests, made sure our patients were prepared for testing — whether they needed special medication, needed to fast, needed a close record of vital signs. We made appointments with the various labs and departments and transported our patients around the hospital as needed. There was plenty to do but no bed-baths, no bedpans, no enemas or other nursing treatments, no back-rubs or passive exercises or IVs.

There was a very casual atmosphere there, an informality that we had never experienced on other floors.

I remember many patients I had there but this is a story about just one. I'll call him Mr. J. I thought of him as "older" but I was in my early 20s and now that I think about it, I suspect he was in his 30s. He was very good-looking and charming and he liked me a lot. He wanted me to call him by his first name but I didn't. There were two other guys around his age there at the same time — the three of them hung out together. They liked me too but I think of them as his wingmen — they were very careful how they treated me because they thought of me as "taken."

Mr. J. took pictures. He took lots of me and I still have them, to this day. He used to go home sometimes during the afternoon and do his developing. This is one he took of me and the two sidekicks:

You can see that hospital life was very different in those days. People smoked everywhere (not the nurses though; we never smoked in view of our patients). The little glasses with the thermometers in them were a 6 West thing: our patients came along and took and recorded their own temperatures on a little nearby chart.

I treated Mr. J. with the same warmth and friendliness I had toward everyone. I never encouraged his romantic overtures and I shut him down quickly when he wanted to talk about the problems he had at home and how he and his wife were having serious marital difficulties. I told him I could make him an appointment to talk to someone about that but it wasn't me.

I worked a lot of nights on 6 West. Mr. J. always knew my schedule and he and the pals would usually stay up late when I was coming on. He would send the others to bed at a certain point and sit nearby while I worked on my paperwork. I almost always had to really persuade him to go to bed because I'd be expecting the supervisor on her rounds and I didn't want to get caught.

One night, alone on the floor, I was working through my nightly list and, with my arms full of equipment, I went into the treatment room. I heard the door close behind me; I turned and it was Mr. J. I put my stuff down and asked him what he was doing up. He said he couldn't sleep. He came toward me and reached for me, trying to put his arms around me. I put one arm straight out and said, "Stop this." He told me he knew the supervisor had already been there on her rounds because he had been keeping watch. He tried to overpower me. He was quite persistent and a lot bigger than I but I fended him off and managed to reach the other door of the treatment room which led into the nursing station.

I put my hand on the phone and told him I wanted him to go back to his room and we'd pretend this had never happened. I certainly had no wish to call anyone; neither did I want to fill out an "incident report."

Here's why: If I had described the incident to officialdom, there is only one answer that I could have given that might be accepted as they bound my wrists and led me to the stake. It didn't matter that I had never encouraged him. It didn't matter that I was simply re-stocking my treatment room, as was my job.

The only thing I could have said was, "This was my fault. I'm sorry it happened. It will never happen again."

And they probably would have burned me anyway.

This story has a point. I'll be back later to let you know why I wrote it. (It's right here.).

Miracle of miracles

(Jack Inhaber: Unbroken by the Holocaust*)

In the late '60s as a young nurse, I worked for a few years at what was then called Maimonides Hospital and Home for the Aged. It was in Côte Saint-Luc — still on the Island of Montreal but a good long bus ride from where I lived in downtown Montreal.

I don't really remember how I came to be working there. Did I answer a newspaper ad? Did someone tell me about the job? I can't answer that but there I was — head nurse on the fourth floor. This is how Maimonides looked then. (It has since been topped up with two more storeys.)

Geriatric nursing is not for everyone but I was good at it. As always, I was much better taking care of my patients (and my staff) than taking care of my paperwork. Priorities, let's say.

My patients were mostly all in their mid- to late-80s. Some were in their 90s. They had all, without exception, come to Montreal from Eastern Europe (mostly Russia, Poland and Romania) around the turn of the last century, many fleeing pogroms and other persecution in their home countries. They covered the whole range in religious practice from orthodox, conservative and reform. At least a couple were secular Jews although they didn't broadcast that.

They all spoke Yiddish and although their English was good, it was peppered with colourful Yiddish expressions and their inflection was text-book. Kosher dietary laws were all practiced in our dining rooms and regular worship was offered in the beautiful Synagogue.

On my floor, there were two men who spent much of their day in the Synagogue, praying and studying the Talmud and the Torah. They would leave the floor right after breakfast, wearing the prayer shawl and the tefillin.

Tefillin are a set of small black leather boxes containing scrolls of parchment inscribed with verses from the Torah, which are worn by observant Jews during weekday morning prayers. . . The arm-tefillin, or shel yad, is placed on the upper arm, and the strap wrapped around the arm/hand, hand and fingers; while the head-tefillin, or shel rosh, is placed above the forehead. The Torah commands that they should be worn to serve as a "sign" and "remembrance" that God brought the children of Israel out of Egypt.

The orthodox men were uneasy with us but they were not unkind to the nurses. It was clear though that this would not have been their ideal living situation and I encouraged my staff to respect their religious privacy.

Our oldest patient was Mrs. Kimmerfield (the rest of her family went by the name Field) — she was 98. She was a tiny little woman and never said much. She gave the impression that she had already said everything she had to say. One day, I went into her room and she was sitting going through her photo album. I sat down with her and looked at some of her photos and heard some stories. As so many of us lament about our own parents and grandparents, I wish I had paid more attention to the stories I heard at Maimonides. I passed up a lot of social history.

When she had closed her photo album, she sighed a little sadly and said, "You know, there's no one left who calls me by my first name." I asked her if I could and she happily said, "Yes." Her name was Leah and from that day on, we were Leah and Sharon. We had made a real connection — and I have never forgotten how important it was to her to hear the sound of her first name.

One hot summer's day, I had a phone call from Leah's daughter with a message. I went down to her room and said, "Ruth called to say she's not coming this afternoon because she's playing golf. She'll probably be here later." Leah asked me what the temperature was and I said it was hot — it was in the high 80s. "Playing golf," she scoffed. "The old fool." What a good laugh we had together.

We had two husband-and-wife couples on our floor and thankfully, they each had their own double room. The Steins were a fractious couple although that's probably an unfair description. Mr. Stein was grouchy and Mrs. Stein had to spend a lot of time pacifying him. He took a lot of his grouchiness out on her and although we tried to act as a buffer, she was stoic and for sure, truly believed that he was her duty. He had certain lovable qualities but he wasn't an easy husband.

The Herers were entirely different. Mr. Herer was grumpy (it's different from grouchy) but no one could ask for a more devoted and tender husband. He got Mrs. Herer out of bed in the morning, helped her get dressed and settled in her chair, brought her breakfast and sat with her while she ate and then left her with her radio and reading material while he went off to his daily routine. He spent much of his time in the art/craft room and I was honoured — really I was — when he presented me with one of his mosaics. That was almost 50 years ago and his creation is still with me and is in regular use on special occasions.

This is it. (Don't forget to click on the picture.) I'm still so impressed by the meticulous artistry:

I started writing this because I was going to tell you about a book I've just read called Wonder of Wonders: A Cultural History of Fiddler on the Roof. The book "traces how and why the story of Tevye the milkman, the creation of the great Yiddish writer Sholem-Aleichem, was reborn as blockbuster entertainment and a cultural touchstone, not only for Jews and not only in America." (Amazon says.) It made me think about my years at Maimonides and my beloved patients there — so many things in the book reminded me of them — and it made sense for me to reminisce a bit before I told you about the book.

Obviously, I'll have to come back tomorrow to tell you about Wonder of Wonders.

(*The painting at the top is by a current patient at Maimonides, Jack Inhaber. This was painted in 2009.)

(The two parts of Wonder of Wonders are here and here.)