4

In the glass Station the Big Nurse has opened a package from a foreign address and is sucking into hypodermic needles the grass-and-milk liquid that came in vial in the package. One of the little nurses, a girl with one wandering eye that always keeps looking worried over her shoulder while the other one goes about its usual business, picks up the little tray of filled needles but doesn’t carry them away just yet.

“What, Miss Ratched, is your opinion of this new patient? I mean, gee, he’s good-looking and friendly and everything, but in my humble opinion he certainly takes over.”

The Big Nurse tests a needle against her fingertip. “I’m afraid” – she stabs the needle down in the rubber-capped vial and lifts the plunger – “that is exactly what the new patient is planning: to take over. He is what we call a ‘manipulator,’ Miss Flinn, a man who will use everyone and everything to his own ends.”

“Oh. But. I mean, in a mental hospital? What could his ends be?”

“Any number of things.” She’s calm, smiling, lost in the work of loading the needles. “Comfort and an easy life, for instance; the feeling of power and respect, perhaps; monetary gain – perhaps all of these things. Sometimes a manipulator’s own ends are simply the actual disruption of the ward for the sake of disruption. There are such people in our society. A manipulator can influence the other patients and disrupt them to such an extent that it may take months to get everything running smooth once more. With the present permissive philosophy in mental hospitals, it’s easy for them to get away with it. Some years back it was quite different. I recall some years back we had a man, a Mr. Taber, on the ward, and he was an intolerable Ward Manipulator. For a while.” She looks up from her work, needle half filled in front of her face like a little wand. Her eyes get far-off and pleased with the memory. “Mistuh Taybur,” she says.

“But, gee,” the other nurse says, “what on earth would make a man want to do something like disrupt the ward for, Miss Ratched? What possible motive…?”

She cuts the little nurse off by jabbing the needle back into the vial’s rubber top, fills it, jerks it out, and lays it on the tray. I watch her hand reach for another empty needle, watch it dart out, hinge over it, drop.

“You seem to forget, Miss Flinn, that this is an institution for the insane.”

* * *

The Big Nurse tends to get real put out if something keeps her outfit from running like a smooth, accurate, precision-made machine. The slightest thing messy or out of kilter or in the way ties her into a little white knot of tight-smiled fury. She walks around with that same doll smile crimped between her chin and her nose and that same calm whir coming from her eyes, but down inside of her she’s tense as steel. I know, I can feel it. And she don’t relax a hair till she gets the nuisance attended to – what she calls “adjusted to surroundings.”

Under her rule the ward Inside is almost completely adjusted to surroundings. But the thing is she can’t be on the ward all the time. She’s got to spend some time Outside. So she works with an eye to adjusting the Outside world too. Working alongside others like her who I call the “Combine,” which is a huge organization that aims to adjust the Outside as well as she has the Inside, has made her a real veteran at adjusting things. She was already the Big Nurse in the old place when I came in from the Outside so long back, and she’d been dedicating herself to adjustment for God knows how long.

And I’ve watched her get more and more skillful over the years. Practice has steadied and strengthened her until now she wields a sure power that extends in all directions on hairlike wires too small for anybody’s eye but mine; I see her sit in the center of this web of wires like a watchful robot, tend her network with mechanical insect skill, know every second which wire runs where and just what current to send up to get the results she wants. I was an electrician’s assistant in training camp before the Army shipped me to Germany and I had some electronics in my year in college is how I learned about the way these things can be rigged.

What she dreams of there in the center of those wires is a world of precision efficiency and tidiness like a pocket watch with a glass back, a place where the schedule is unbreakable and all the patients who aren’t Outside, obedient under her beam, are wheelchair Chronics with catheter tubes run direct from every pantleg to the sewer under the floor. Year by year she accumulates her ideal staff: doctors, all ages and types, come and rise up in front of her with ideas of their own about the way a ward should be run, some with backbone enough to stand behind their ideas, and she fixes these doctors with dry-ice eyes day in, day out, until they retreat with unnatural chills. “I tell you I don’t know what it is,” they tell the guy in charge of personnel. “Since I started on that ward with that woman I feel like my veins are running ammonia. I shiver all the time, my kids won’t sit in my lap, my wife won’t sleep with me. I insist on a transfer – neurology bin, the alky tank, pediatrics, I just don’t care!”

She keeps this up for years. The doctors last three weeks, three months. Until she finally settles for a little man with a big wide forehead and wide jewly cheeks and squeezed narrow across his tiny eyes like he once wore glasses that were way too small, wore them for so long they crimped his face in the middle, so now he has glasses on a string to his collar button; they teeter on the purple bridge of his little nose and they are always slipping one side or the other so he’ll tip his head when he talks just to keep his glasses level. That’s her doctor.

Her three daytime black boys she acquires after more years of testing and rejecting thousands. They come at her in a long black row of sulky, big-nosed masks, hating her and her chalk doll whiteness from the first look they get. She appraises them and their hate for a month or so, then lets them go because they don’t hate enough. When she finally gets the three she wants – gets them one at a time over a number of years, weaving them into her plan and her network – she’s damn positive they hate enough to be capable.

The first one she gets five years after I been on the ward, a twisted sinewy dwarf the color of cold asphalt. His mother was raped in Georgia while his papa stood by tied to the hot iron stove with plow traces, blood streaming into his shoes. The boy watched from a closet, five years old and squinting his eye to peep out the crack between the door and the jamb, and he never grew an inch after. Now his eyelids hang loose and thin from his brow like he’s got a bat perched on the bridge of his nose. Eyelids like thin gray leather, he lifts them up just a bit whenever a new white man comes on the ward, peeks out from under them and studies the man up and down and nods just once like he’s oh yes made positive certain of something he was already sure of. He wanted to carry a sock full of birdshot when he first came on the job, to work the patients into shape, but she told him they didn’t do it that way anymore, made him leave the sap at home and taught him her own technique; taught him not to show his hate and to be calm and wait, wait for a little advantage, a little slack, then twist the rope and keep the pressure steady. All the time. That’s the way you get them into shape, she taught him.

The other two black boys come two years later, coming to work only about a month apart and both looking so much alike I think she had a replica made of the one who came first. They are tall and sharp and bony and their faces are chipped into expressions that never change, like flint arrowheads. Their eyes come to points. If you brush against their hair it rasps the hide right off you.

All of them black as telephones. The blacker they are, she learned from that long dark row that came before them, the more time they are likely to devote to cleaning and scrubbing and keeping the ward in order. For instance, all three of these boys’ uniforms are always spotless as snow.

White and cold and stiff as her own.

All three wear starched snow-white pants and white shirts with metal snaps down one side and white shoes polished like ice, and the shoes have red rubber soles silent as mice up and down the hall. They never make any noise when they move. They materialize in different parts of the ward every time a patient figures to check himself in private or whisper some secret to another guy. A patient’ll be in a corner all by himself, when all of a sudden there’s a squeak and frost forms along his cheek, and he turns in that direction and there’s a cold stone mask floating above him against the wall. He just sees the black face. No body. The walls are white as the white suits, polished clean as a refrigerator door, and the black face and hands seem to float against it like a ghost.

Years of training, and all three black boys tune in closer and closer with the Big Nurse’s frequency. One by one they are able to disconnect the direct wires and operate on beams. She never gives orders out loud or leaves written instructions that might be found by a visiting wife or schoolteacher. Doesn’t need to any more. They are in contact on a high-voltage wave length of hate, and the black boys are out there performing her bidding before she even thinks it.

So after the nurse gets her staff, efficiency locks the ward like a watchman’s clock. Everything the guys think and say and do is all worked out months in advance, based on the little notes the nurse makes during the day. This is typed and fed into the machine I hear humming behind the steel door in the rear of the Nurses’ Station. A number of Order Daily Cards are returned, punched with a pattern of little square holes. At the beginning of each day the properly dated OD card is inserted in a slot in the steel door and the walls hum up: lights flash on in the dorm at six-thirty: the Acutes up out of bed quick as the black boys can prod them out, get them to work buffing the floor, emptying ash trays, polishing the scratch marks off the wall where one old fellow shorted out a day ago, went down in an awful twist of smoke and smell of burned rubber. The Wheelers swing dead log legs out on the floor and wait like seated statues for somebody to roll chairs in to them. The Vegetables piss the bed, activating an electric shock and buzzer, rolls them off on the tile where the black boys can hose them down and get them in clean greens…

Six-forty-five the shavers buzz and the Acutes line up in alphabetical order at the mirrors, A, B, C, D.… The walking Chronics like me walk in when the Acutes are done, then the Wheelers are wheeled in. The three old guys left, a film of yellow mold on the loose hide under their chins, they get shaved in their lounge chairs in the day room, a leather strap across the forehead to keep them from flopping around under the shaver.

Some mornings – Mondays especially – I hide and try to buck the schedule. Other mornings I figure it’s cagier to step right into place between A and C in the alphabet and move the route like everybody else, without lifting my feet – powerful magnets in the floor maneuver personnel through the ward like arcade puppets…

Seven o’clock the mess hall opens and the order of lineup reverses: the Wheelers first, then the Walkers, then the Acutes pick up trays, corn flakes, bacon and eggs, toast – and this morning a canned peach on a piece of green, torn lettuce. Some of the Acutes bring trays to the Wheelers. Most Wheelers are just Chronics with bad legs, they feed themselves, but there’s these three of them got no action from the neck down whatsoever, not much from the neck up. These are called Vegetables. The black boys push them in after everybody else is sat down, wheel them against a wall, and bring them identical trays of muddy-looking food with little white diet cards attached to the trays. Mechanical Soft reads the diet cards for these toothless three: eggs, ham, toast, bacon, all chewed thirty-two times apiece by the stainless-steel machine in the kitchen. I see it purse sectioned lips, like a vacuum-cleaner hose, and spurt a clot of chewed-up ham onto a plate with a barnyard sound.

The black boys stoke the sucking pink mouths of the Vegetables a shade too fast for swallowing, and the Mechanical Soft squeezes out down their little knobs of chins onto the greens. The black boys cuss the Vegetables and ream the mouths bigger with a twisting motion of the spoon, like coring a rotten apple: “This ol’ fart Blastic, he’s comin’ to pieces befo’ my very eyes. I can’t tell no more if I’m feeding him bacon puree or chunks of his own fuckin’ tongue.”…

Seven-thirty back to the day room. The Big Nurse looks out through her special glass, always polished till you can’t tell it’s there, and nods at what she sees, reaches up and tears a sheet off her calendar one day closer to the goal. She pushes a button for things to start. I hear the wharrup of a big sheet of tin being shook someplace. Everybody come to order. Acutes: sit on your side of the day room and wait for cards and Monopoly games to be brought out. Chronics: sit on your side and wait for puzzles from the Red Cross box. Ellis: go to your place at the wall, hands up to receive the nails and pee running down your leg. Pete: wag your head like a puppet. Scanlon: work your knobby hands on the table in front of you, constructing a make-believe bomb to blow up a make-believe world. Harding: begin talking, waving your dove hands in the air, then trap them under your armpits because grown men aren’t supposed to wave their pretty hands that way. Sefelt: begin moaning about your teeth hurting and your hair falling out. Everybody: breath in… and out… in perfect order; hearts all beating at the rate the OD cards have ordered. Sound of matched cylinders.

Like a cartoon world, where the figures are flat and outlined in black, jerking through some kind of goofy story that might be real funny if it weren’t for the cartoon figures being real guys…

Seven-forty-five the black boys move down the line of Chronics taping catheters on the ones that will hold still for it. Catheters are second-hand condoms the ends clipped off and rubber-banded to tubes that run down pantlegs to a plastic sack marked DISPOSABLE NOT TO BE REUSED, which it is my job to wash out at the end of each day. The black boys anchor the condom by taping it to the hairs; old Catheter Chronics are hairless as babies from tape removal…

Eight o’clock the walls whirr and hum into full swing. The speaker in the ceiling says, “Medications,” using the Big Nurse’s voice. We look in the glass case where she sits, but she’s nowhere near the microphone; in fact, she’s ten feet away from the microphone, tutoring one of the little nurses how to prepare a neat drug tray with pills arranged orderly. The Acutes line up at the glass door, A, B, C, D, then the Chronics, then the Wheelers (the Vegetables get theirs later, mixed in a spoon of applesauce). The guys file by and get a capsule in a paper cup – throw it to the back of the throat and get the cup filled with water by the little nurse and wash the capsule down. On rare occasions some fool might ask what he’s being required to swallow.

“Wait just a shake, honey; what are these two little red capsules in here with my vitamin?”

I know him. He’s a big, griping Acute, already getting the reputation of being a troublemaker.

“It’s just medication, Mr. Taber, good for you. Down it goes, now.”

“But I mean what kind of medication. Christ, I can see that they’re pills – ”

“Just swallow it all, shall we, Mr. Taber – just for me?” She takes a quick look at the Big Nurse to see how the little flirting technique she is using is accepted, then looks back at the Acute. He still isn’t ready to swallow something he don’t know what is, not even just for her.

“Miss, I don’t like to create trouble. But I don’t like to swallow something without knowing what it is, neither. How do I know this isn’t one of those funny pills that makes me something I’m not?”

“Don’t get upset, Mr. Taber – ”

“Upset? All I want to know, for the lova Jesus – ”

But the Big Nurse has come up quietly, locked her hand on his arm, paralyzes him all the way to the shoulder. “That’s all right, Miss Flinn,” she says. “If Mr. Taber chooses to act like a child, he may have to be treated as such. We’ve tried to be kind and considerate with him. Obviously, that’s not the answer. Hostility, hostility, that’s the thanks we get. You can go, Mr. Taber, if you don’t wish to take your medication orally.”

“All I wanted to know, for the – ”

“You can go.”

He goes off, grumbling, when she frees his arm, and spends the morning moping around the latrine, wondering about those capsules. I got away once holding one of those same red capsules under my tongue, played like I’d swallowed it, and crushed it open later in the broom closet. For a tick of time, before it all turned into white dust, I saw it was a miniature electronic element like the ones I helped the Radar Corps work with in the Army, microscopic wires and grids and transistors, this one designed to dissolve on contact with air…

Eight-twenty the cards and puzzles go out…

Eight-twenty-five some Acute mentions he used to watch his sister taking her bath; the three guys at the table with him fall all over each other to see who gets to write it in the log book…

Eight-thirty the ward door opens and two technicians trot in, smelling like grape wine; technicians always move at a fast walk or a trot because they’re always leaning so far forward they have to move fast to keep standing. They always lean forward and they always smell like they sterilized their instruments in wine. They pull the lab door to behind them, and I sweep up close and can snake out voices over the vicious zzzth-zzzth-zzzth of steel on whetstone.

“What we got already at this ungodly hour of the morning?”

“We got to install an Indwelling Curiosity Cutout in some nosy booger. Hurry-up job, she says, and I’m not even sure we got one of the gizmos in stock.”

“We might have to call IBM to rush one out for us; let me check back in Supply – ”

“Hey; bring out a bottle of that pure grain while you’re back there: it’s getting so I can’t install the simplest frigging component but what I need a bracer. Well, what the hell, it’s better’n garage work…”

Their voices are forced and too quick on the comeback to be real talk – more like cartoon comedy speech.

I sweep away before I’m caught eavesdropping.

The two big black boys catch Taber in the latrine and drag him to the mattress room. He gets one a good kick in the shins. He’s yelling bloody murder. I’m surprised how helpless he looks when they hold him, like he was wrapped with bands of black iron.

They push him face down on the mattress. One sits on his head, and the other rips his pants open in back and peels the cloth until Taber’s peach-colored rear is framed by the ragged lettuce-green. He’s smothering curses into the mattress and the black boy sitting on his head saying, “Tha’s right, Mistuh Taber, tha’s right.…” The nurse comes down the hall, smearing Vaseline on a long needle, pulls the door shut so they’re out of sight for a second, then comes right back out, wiping the needle on a shred of Taber’s pants. She’s left the Vaseline jar in the room. Before the black boy can close the door after her I see the one still sitting on Taber’s head, dabbing at him with a Kleenex. They’re in there a long time before the door opens up again and they come out, carrying him across the hall to the lab. His greens are ripped clear off now and he’s wrapped up in a damp sheet…

Nine o’clock young residents wearing leather elbows talk to Acutes for fifty minutes about what they did when they were little boys. The Big Nurse is suspicious of the crew-cut looks of these residents, and that fifty minutes they are on the ward is a tough time for her. While they are around, the machinery goes to fumbling and she is scowling and making notes to check the records of these boys for old traffic violations and the like…

Nine-fifty the residents leave and the machinery hums up smooth again. The nurse watches the day room from her glass case; the scene before her takes on that blue-steel clarity again, that clean orderly movement of a cartoon comedy.

Taber is wheeled out of the lab on a Gurney bed.

“We had to give him another shot when he started coming up during the spine tap,” the technician tells her. “What do you say we take him right on over to Building One and buzz him with EST while we’re at it – that way not waste the extra Seconal?”

“I think it is an excellent suggestion. Maybe after that take him to the electroencephalograph and check his head – we may find evidence of a need for brain work.”

The technicians go trotting off, pushing the man on the Gurney, like cartoon men – or like puppets, mechanical puppets in one of those Punch and Judy acts where it’s supposed to be funny to see the puppet beat up by the Devil and swallowed headfirst by a smiling alligator…

Ten o’clock the mail comes up. Sometimes you get the torn envelope…

Ten-thirty Public Relation comes in with a ladies’ club following him. He claps his fat hands at the day-room door. “Oh, hello guys; stiff lip, stiff lip… look around, girls; isn’t it clean, so bright? This is Miss Ratched. I chose this ward because it’s her ward. She’s, girls, just like a mother. Not that I mean age, but you girls understand…”

Public Relation’s shirt collar is so tight it bloats his face up when he laughs, and he’s laughing most of the time I don’t ever know what at, laughing high and fast like he wishes he could stop but can’t do it. And his face bloated up red and round as a balloon with a face painted on it. He got no hair on his face and none on his head to speak of; it looks like he glued some on once but it kept slipping off and getting in his cuffs and his shirt pocket and down his collar. Maybe that’s why he keeps his collar so tight, to keep the little pieces of hair from falling down in there.

Maybe that’s why he laughs so much, because he isn’t able to keep all the pieces out.

He conducts these tours – serious women in blazer jackets, nodding to him as he points out how much things have improved over the years. He points out the TV, the big leather chairs, the sanitary drinking fountains; then they all go have coffee in the Nurse’s Station. Sometimes he’ll be by himself and just stand in the middle of the day room and clap his hands (you can hear they are wet), clap them two or three times till they stick, then hold them prayer-like together under one of his chins and start spinning. Spin round and around there in the middle of the floor, looking wild and frantic at the TV, the new pictures on the walls, the sanitary drinking fountain. And laughing.

What he sees that’s so funny he don’t ever let us in on, and the only thing I can see funny is him spinning round and around out there like a rubber toy – if you push him over he’s weighted on the bottom and straightaway rocks back upright, goes to spinning again. He never, never looks at the men’s faces…

Ten-forty, -forty-five, -fifty, patients shuttle in and out to appointments in ET or OT or PT, or in queer little rooms somewhere where the walls are never the same size and the floors aren’t level. The machinery sounds about you reach a steady cruising speed.

The ward hums the way I heard a cotton mill hum once when the football team played a high school in California. After a good season one year the boosters in the town were so proud and carried away that they paid to fly us to California to play a championship high-school team down there. When we flew into the town we had to go visit some local industry. Our coach was one for convincing folks that athletics was educational because of the learning afforded by travel, and every trip we took he herded the team around to creameries and beet farms and canneries before the game. In California it was the cotton mill. When we went in the mill most of the team took a look and left to go sit in the bus over stud games on suitcases, but I stayed inside over in a corner out of the way of the Negro girls running up and down the aisles of machines. The mill put me in a kind of dream, all the humming and clicking and rattling of people and machinery, jerking around in a pattern. That’s why I stayed when the others left, that, and because it reminded me somehow of the men in the tribe who’d left the village in the last days to do work on the gravel crusher for the dam. The frenzied pattern, the faces hypnotized by routine… I wanted to go out in the bus with the team, but I couldn’t.

It was morning in early winter and I still had on the jacket they’d given us when we took the championship – a red and green jacket with leather sleeves and a football-shaped emblem sewn on the back telling what we’d won – and it was making a lot of the Negro girls stare. I took it off, but they kept staring. I was a whole lot bigger in those days.

One of the girls left her machine and looked back and forth up the aisles to see if the foreman was around, then came over to where I was standing. She asked if we was going to play the high school that night and she told me she had a brother played tailback for them. We talked a piece about football and the like and I noticed how her face looked blurred, like there was a mist between me and her. It was the cotton fluff sifting from the air.

I told her about the fluff. She rolled her eyes and ducked her mouth to laugh in her fist when I told her how it was like looking at her face out on a misty morning duck-hunting. And she said, “Now what in the everlovin’ world would you want with me out alone in a duck blind?” I told her she could take care of my gun, and the girls all over the mill went to giggling in their fists. I laughed a little myself, seeing how clever I’d been. We were still talking and laughing when she grabbed both my wrists and dug in. The features of her face snapped into brilliant focus; I saw she was terrified of something.

“Do,” she said to me in a whisper, “do take me, big boy. Outa this here mill, outa this town, outa this life. Take me to some ol’ duck blind someplace. Someplace else. Huh, big boy, huh?”

Her dark, pretty face glittered there in front of me. I stood with my mouth open, trying to think of some way to answer her. We were locked together this way for maybe a couple of seconds; then the sound of the mill jumped a hitch, and something commenced to draw her back away from me. A string somewhere I didn’t see hooked on that flowered red skirt and was tugging her back. Her fingernails peeled down my hands and as soon as she broke contact with me her face switched out of focus again, became soft and runny like melting chocolate behind that blowing fog of cotton. She laughed and spun around and gave me a look of her yellow leg when the skirt billowed out. She threw me a wink over her shoulder as she ran back to her machine where a pile of fiber was spilling off the table to the floor; she grabbed it up and ran feather-footed down the aisle of machines to dump the fiber in a hopper; then she was out of sight around the corner.

All those spindles reeling and wheeling and shuttles jumping around and bobbins wringing the air with string, whitewashed walls and steel-gray machines and girls in flowered skirts skipping back and forth, and the whole thing webbed with flowing white lines stringing the factory together – it all stuck with me and every once in a while something on the ward calls it to mind.

Yes. This is what I know. The ward is a factory for the Combine. It’s for fixing up mistakes made in the neighborhoods and in the schools and in the churches, the hospital is. When a completed product goes back out into society, all fixed up good as new, better than new sometimes, it brings joy to the Big Nurse’s heart; something that came in all twisted different is now a functioning, adjusted component, a credit to the whole outfit and a marvel to behold. Watch him sliding across the land with a welded grin, fitting into some nice little neighborhood where they’re just now digging trenches along the street to lay pipes for city water. He’s happy with it. He’s adjusted to surroundings finally…

“Why, I’ve never seen anything to beat the change in Maxwell Taber since he’s got back from that hospital; a little black and blue around the eyes, a little weight lost, and, you know what? he’s a new man. God, modern American science…”

And the light is on in his basement window way past midnight every night as the Delayed Reaction Elements the technicians installed lend nimble skills to his fingers as he bends over the doped figure of his wife, his two little girls just four and six, the neighbor he goes bowling with Mondays; he adjusts them like he was adjusted. This is the way they spread it.

When he finally runs down after a pre-set number of years, the town loves him dearly and the paper prints his picture helping the Boy Scouts last year on Graveyard Cleaning Day, and his wife gets a letter from the principal of the high school how Maxwell Wilson Taber was an inspirational figure to the youth of our fine community.

Even the embalmers, usually a pair of penny-pinching tightwads, are swayed. “Yeah, look at him there: old Max Taber, he was a good sort. What do you say we use that expensive thirty-weight at no extra charge to his wife. No, what the dickens, let’s make it on the house.”

A successful Dismissal like this is a product brings joy to the Big Nurse’s heart and speaks good of her craft and the whole industry in general. Everybody’s happy with a Dismissal.

But an Admission is a different story. Even the best-behaved Admission is bound to need some work to swing into routine, and, also, you never can tell when just that certain one might come in who’s free enough to foul things up right and left, really make a hell of a mess and constitute a threat to the whole smoothness of the outfit. And, like I explain, the Big Nurse gets real put out if anything keeps her outfit from running smooth.