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My Barbaric Yawlp Archive
Flying
Back Over the Cuckoo's Nest
by Michael Partie |
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“I too am not a bit tamed, I too am untranslatable.
I sound my barbaric yawlp over the roof-tops of the world…”
Walt Whitman
Leaves of Grass
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I first saw "One Flew Over the Cuckoo's Nest" in 1975
while I was in college and readily identified with the hell-raising,
force-of-nature R. P. McMurphy portrayed by Jack Nicholson.
McMurphy represented rebellious individuality and freedom in
opposition to the establishment's spirit-crushing conformity
machine.
Five years later I was a behavior specialist in a secure facility
serving young men with mental retardation who had committed
felonies. Barely 22 years old and working in an environment
with sometimes alarming levels of violence and aggression, I
began to regard Nurse Ratchett with more sympathy. |
After more than a quarter century in the field, with much time
learning, reflecting, and making more mistakes than I can count,
I view things from a certain vantage point. I now see all the
characters in the story - staff and patients alike - as casualties
of a corrosive process of institutionalization. McMurphy may
have had brain tissue extirpated, but Ratchett has lost whole
parts of her soul.
"One Flew Over the Cuckoo's Nest" is full of operatic
moments and epic confrontations. It's theater, not reality,
but it holds a mirror up to a reality with which many of us
are uncomfortably familiar. Nurse Ratchett is a caricature,
but I've known many of her real-life referents, professionals
with power over people's lives, who had neither the wisdom nor
humility to use that power responsibly. I've also seen decent
people with good intentions lose their way with tragic results.
In my experience, poor working conditions, weak leadership,
unprocessed trauma, inadequate supervision, and ineffective
training can be insidious and nearly as destructive as laziness,
arrogance, fear, and selfishness. In this way Ratchetts are
made as often as they are born.
The soul-erosion on all sides can be subtle and quiet, progressing
unnoticed like a malignancy. Neurologist and teacher Oliver
Sacks chronicles this process in A Leg to Stand On,
a memoir of his own hospitalization and rehabilitation from
a life-altering accident. While hiking in Norway, Sacks fell
off a cliff, fleeing from a murderous bull (I kid you not; read
the book). The quadriceps in his left leg tore completely loose
from the patella and his femoral nerve was damaged, leaving
him without sensation or motor control. Completely alone on
the mountain, Sacks realized he would die unless he dragged
his body back down the trail to reach help, which he did.
As in all his books, Sacks takes the reader on a journey through
neurological phenomena and the human experience. This time,
he shares his personal story of struggling to recover from a
devastating injury while enduring spirit-withering treatment
at the hands of his medical caregivers. Perhaps most interesting,
after being moved from a room in which he'd been confined for
several weeks, the author discovered that his visual field,
at least the stereoscopic component, had shrunken to conform
to the dimensions of that room. Everything within the boundaries
of his confinement was clearly three dimensional, but the world
beyond it was curiously flat and less distinct. His vision had
accommodated to the diminished size of his world. In due course
his vision normalized, but the experience provided a profound
insight into what it means to be a patient and what is involved
in recovery.
With
each step, each advance, one's horizons expanded, one
stepped out of a contracted world - a world one hadn't
realized was so contracted. I found this in every sphere,
physiological and existential...
We speak, glibly, of "institutionalization,"
without the smallest personal sense of what is involved
- how insidious, and universal, is the contraction in
all realms... and how swiftly it can happen to anyone,
to oneself. |
The implication for those of us supporting people with psychiatric,
developmental, and physical disabilities is clear. The people
we support live in very small worlds, worlds often kept small
by the manner in which we deliver services. Helping people expand
the size of their worlds -socially, vocationally, physically,
emotionally, recreationally, and existentially - must be a top
priority. Institutionalization isn't about the kind of buildings
or real estate one occupies, it's about the loss of power, movement,
freedom, and vision.
But how do we keep ourselves
from becoming institutionalized?
Oliver Sacks points out that the process is often unseen and
unheard, and can overtake any of us unaware. Awareness and the
will to resist institutionalizing influences in ourselves and
in others is a good start. Reflecting on our own practices and
questioning our assumptions can keep us from becoming lazy or
lapsing into superstition. Celebrating successes - individual
and group - can keep us positively focused. Practicing honesty
and individual integrity, honoring the good work of others,
courageously confronting our colleagues when needed, receiving
praise with grace and correction with gratitude, and perhaps
most importantly of all, approaching the lives of others with
humility, are all ways we can keep our humanity as we help others
to live full lives.
-October 2005 |
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