Word Salad

Jody Keisner

He wandered into the Common Room one evening, wearing a puffy blue winter coat despite the persistent eighty degrees of the facility where he lived and I worked. Ed’s thinning brown hair was unwashed and unkempt; his teeth and long fingernails were yellow with cigarette residue. His hands trembled from lithium. Most of the other residents avoided this towering, beefy man. I stood near the back of the Common Room, swinging a set of staff keys from a lanyard, hoping that the action made me look casual even though I was new and viewed the residents as bewildering question marks.

On the box TV at the front of the room, two bloated wrestlers pounded on each other with their open hands, elbows, knees, and feet.

“Did you see that foot to his back?” Ed said, pointing a shaky cigarette-stained finger at the TV. “That was a superb jollywanch of jestered muckamuck. He flabbergasted the ubernack twily gad!”

The others ignored Ed. Virginia stood a few feet away, shifting her weight from one white orthopedic shoe to the other. Connie, wrinkled and arthritic, watched the TV from a couch. Walter, an elderly black man wearing red suspenders, slept in a chair. His walker was parked next to him. On the TV “Stone Cold” Steve Austin chopped Mr. Perfect in the neck for the third or fourth time.

“Throat thrust!” Virginia said. “Knock him on his ass.” She spit chew into her empty Pepsi can.

“Oh, Virginia,” Connie whined. “Why do you talk like that?”

Stone Cold lay on the mat, covering his head with his hands as Mr. Perfect stomped on his back. While the others grew quiet, fearing for Stone Cold, the facility favorite, Ed gobble-de-gooked on. “Oh, boy! That was a dounding dollycab of fermilipee.”

“Shut up,” Virginia said, adjusting her hearing aid.

“Oh, Ed. Why can’t you just be quiet?” Connie said.

“Don’t give me that counchacrack! I’m King Gracula. Leader of all the Graclamites!” Ed’s face quivered.

Ed was about to have another “episode,” as the staff referred to it when he lost control, and it was the first time that I was going to be alone when it happened. Not alone—Virginia and the others were there—but alone with them. Them and Us. Residents and Staff. That’s how I thought of it. I stopped swinging my keys.

“Be quiet!” Connie whined.

“You piece of muck. I’m gonna clock your stinking guffagang and you piss off garl farder!” Spittle flew from Ed’s lips.

Connie cringed.

Virginia threw up her hands.

It was my turn.

“I can see that you’re upset,” I said to Ed, taking a few steps toward him. I did my best to sound calm and authoritative, feeling neither. Aside from a perfunctory introduction, Ed and I had never really spoken to each other. His height and nonsense-talk were intimidating. “You might be scaring the others. Why don’t you sit down in that chair?” Empathize. Address inappropriate behavior. Make a suggestion. It was textbook de-escalation.

“It won’t help,” Connie said.

Ed ignored me and stared at Virginia and then at Connie, his finger shaking at them each in turn. “I’ll blast you with my phaser! I’ll turn you into a five-headed Dradzilla! I’ll rip off your heads and put your sallory bodies into outer space!”

Virginia turned and left the room, cussing under her breath. Connie got up off the couch and followed her, saying, “Oh. Oh. Oh,” down the hallway. She had a panic disorder and would need to be soothed. Walter started to snore.

Ed’s face went slack. He lowered his arm and sank into the nearest chair.

“I’m sorry, Dollop,” he said, staring straight ahead.

Stone Cold, now upright, kicked Mr. Perfect in the stomach.

I sat down next to him. “Let’s talk about better ways to express your anger.” Procedure was a buoy I clung to when I didn’t know what else to do.

“Not that,” he said. “I’d rather smoke, Dollop.”

“My name is Jody.”

“Whatever you say, Dollop.”

Dollop. Every time Ed said it, I tensed. The episode was over and Ed was composed, but I could still feel my heart thumping. Ed sounded crazy. He was crazy.

At the time I knew Ed (a pseudonym, as are all the names I use here), I was a recently hired rehabilitation specialist for a twenty-eight-bed residential treatment facility for the severely mentally ill. I took the job because I didn’t know what else to do with my lapsed English degree. Since graduating college eight years earlier, I had quit one job after another. This one promised better pay, and the weekend and weeknight hours meant I could dabble in classes at the local university. Daily confrontation with troubled teenage girls in my previous job had left me weary. I had thought that working with adults would be less stressful than working with teenagers and still be more fulfilling than waitressing (which I had already tried at two establishments), but I could see now that I was wrong about the first assumption, anyway.

One night Ed invited me to play King’s Corner in a large sitting room nicknamed the Pink Room. He spent most of his evenings in the Pink Room, wearing his blue winter coat, his hands trembling as he shuffled a deck of cards for a game of solitaire—the only activity that kept him quiet, which is what the other residents wanted. The Pink Room had pink carpet and walls, a color palette that was once believed to promote a feeling of calmness in the occupant, similar to the once-hoped-for effect of Baker-Miller pink in the Santa Clara jail. It was a short-lived effect: after fifteen minutes, the inmates began scraping the paint off of the cell walls with their fingernails.

“Walla with me, Dollop,” Ed said.

Walla. Some of his word salad was easy to figure out. Play.

My options were to play cards with Ed or persuade Bill to take a shower. Coaxing a seventy-two-year-old naked man into the shower was unappealing—especially when the man saw blood spraying from the showerhead—but so were threats of interplanetary violence from Ed, who sometimes believed he was an intergalactic warrior.

“Okay, Ed.” I sat down across the table from him. “Fair warning though: I’m pretty competitive.” Someone else would have to look after Bill’s hygiene.

Ed’s hands shook as he dealt the cards. I was surprised when his mind made order out of the numbers and symbols on the cards. He easily won three of the four games that we played. I had bored and also pleased him. He leaned back in his chair and opened his mouth. He raised his eyebrows and opened his eyes wider, exaggerated gestures that I was learning prefaced his version of a conversation.

“Do you whorl, Dollop?”

“My name is Jody.”

“Whatever you say, Dollop.”

“It’s Jody.”

I’d heard him say whorl before, when he and the other residents crowded outside the front door, wind, rain, or shine. Smoke.

“I don’t smoke,” I said.

“You’d lie about your wallery life story, wouldn’t you Dollop?” Ed took a deep breath in between sentences. “I used to smother marijuana when I was in the Navy, but it jangled my brain until images were appearing and they had to callory me back to the civilized world for safe-keeping.”

His brief moment of clarity startled me. Did the Navy discharge Ed because he was schizophrenic or because he smoked pot? What was that first hallucination like? How old was he? It seemed too personal to ask, like asking a sick acquaintance to describe the moment she discovered that she had cancer. Some things were between Ed and his psychiatrist. I knew from staff training that schizophrenia most often presented itself in young adulthood. Ed had been a star basketball player in high school, popular with the cheerleaders, nominated for homecoming court. His life pre-schizophrenia sounded like a teenage boy’s dream. Normal. It was hard for me to imagine him bouncing a basketball with the severe hand tremors he had now. It was even harder for me to imagine him whispering into a woman’s ear. What words would come out? Would she mistake his word salad for sweet nothings or him for an eccentric poet? I doubted it. His words were too strange.

We staff were supposed to rehabilitate residents like Ed—“clients,” we were told to call them but never did—so that they might move out of the facility and into apartments of their own. Then again, everyone understood that our particular facility, one of eight operated by the same nonprofit agency, was a next-to-last stop. Unlike the other facilities’ residents, most of ours were elderly, but if they were fairly young, as Ed was, their mental illnesses were so debilitating that they weren’t able to manage life without round-the-clock care. Residents either died of old age—in one case, of a narcotic overdose—or moved into nursing homes. They lived with at least one mental health diagnosis and the usual physical problems that came along with aging. Several suffered from liver disease caused by years of self-medication with drugs and alcohol. They came to us from a local assisted living facility that had closed its doors and from the locked wards of psychiatric hospitals, the result of a state-wide effort in Nebraska to de-institutionalize mental health care and move the mentally ill closer to their families and into the communities where they had once lived. That was the idea, anyway. Many wound up on the streets or in the ER. More wound up in jail. Exactly one resident would be rehabilitated during my two years at the facility, a young woman in her late twenties. Sometime during the first year after she was released, she lost touch with her Community Support worker and relapsed; a concerned neighbor found her in an alleyway behind her apartment, barking and snarling at passers-by, actively hallucinating that she was a dog. The staff didn’t have much hope that Ed would leave.

I watched Ed from the opposite side of the serving line at dinner one night as he pointed to the large bowl of mashed potatoes between us. My responsibilities on the evening shift were to serve dinner, assist the nurses in doling out nighttime meds, and follow the residents’ treatment plans. Ed’s treatment plan was concise: speak in standard English.

Ed’s face turned red and he took a deep breath, straining for a word. “Give me more p-p-p-pollycakes.”

“Potatoes,” I corrected. “And say ‘please.’”

Leaning over the serving line, Ed stuttered: “Po-po-po-ta-toes. Please.”

“Good work, Ed,” I said. I scooped a large heaping onto his plate, and when he walked away, calling over his shoulder, “Thanks, Dollop,” I smiled at what I was beginning to recognize as his charm.

The other residents didn’t find him charming. As if they were teens away at summer camp, they formed cliques. Rules of common interests and the more elusive rules of popularity applied. Ed had neither. A few of the residents paired off for romantic encounters, finding solace in a similar diagnosis, and went out on dates. Ours wasn’t a lockdown facility. Residents could come and go as they pleased as long as they signed out and left with a visitor who had been pre-approved. Ed didn’t go out on any dates. Of course, other residents had been diagnosed with schizophrenia—a woman who complained half of her face was missing, for instance, and a man who suffered from delusions of grandeur and regularly barged into staff meetings to fire us—but you could understand what they were saying. You had some common ground, a starting point. Not with Ed. Most of our residents had hyper-stimulated brains. Many heard voices. Others saw things—scary things. Ed’s word salad was too much. They left rooms when he wandered in or loudly complained until he lost his temper. We frequently escorted him back to the Pink Room where solitaire and silence awaited him. His only visitor was his mother, and more often than not she skipped her scheduled visits, sending him into a word-salad tantrum. Within our strange community of outsiders, Ed was alone.

His only source of companionship was his card games with staff. I accepted his nightly invitations. I was proud of myself for feeling more at ease around Ed, for learning the ropes. My time with him bolstered my own sense of accomplishment and, perhaps selfishly, coolness: look at me, talking to the word-salad-speaking man! His ways interested me more than the cat-napping, sedated ways of the elderly residents. Ed won most but not all of our card games. Afterward, he leaned way back in his chair and—in what seemed like slow-motion—started talking. He spoke predominantly in word salad; I offered alternatives in English, which he ignored. But more than hours logged in his (failed) treatment plan transpired between us. He told me about his life before he was first hospitalized, and I started to tell him stories from mine. Sometimes —only when it wasn’t expected of him—he spoke in English. I learned that his father left him when he was a young boy and never returned. He learned that although mine mostly stuck around, we didn’t get along.

One day the supervisor approached me to confirm what I’d written in the staff notes the prior evening. “He’s never talked to any of the staff about his father before. It’s painful for him. Many of his problems can be traced to his father’s abandonment. He must trust you.”

Her words pleased me. For the first time since I started work at the facility, I felt something more than the desire to be competent at it or entertained. I felt the startling responsibility of it, too.

I was swallowing a bite of canned ham at dinner one night when Ed came up behind me and lightly brushed his hand across my back. “I wish that you and I were spaghetti so that we could eat one another,” he said. I’m sure that my face showed my surprise.

Rose, a grandmotherly type sitting with me at the long, cafeteria-style table, had just weeks before relapsed into a full psychotic episode. She had appeared in the hallway between the staff office and the front door, barefoot, dressed in white lingerie, and wearing a lot of red lipstick. Like an apparition. Or like a woman with a severe mental illness. She’d been on her way to meet her hallucinatory lover at a hotel. The police had had to escort her to the hospital. She was staring at her plate when Ed walked in, but now she watched me closely.

“Ed,” I began, but I couldn’t think of what else to say.

The others could.

“Oh! Why is he so awful?” Connie asked.

“It’s okay, Connie. He’s making a joke,” I said.

“That’s a terrible idea of a joke! Why can’t he just be quiet?” Connie whined.

Virginia, sitting with us, chimed in: “I can’t stand his goddammed gibberish.”

A third: “I can’t stand him.”

And another: “He never shuts up.”

Rose had returned to the facility a week after her relapse wearing sensible clothing and shoes, her face clean. She looked a little dull. Maybe she’d had electroconvulsive therapy. I thought of “Mr. Whisper,” a song by Dory Previn that I had listened to during a mandatory training session: Just when I am sure he’ll stay, they shoot me with a bolt or two. They try to drive my mister friend away, and damn it all they nearly always do. I wondered if Rose would go easier on Ed.

“I don’t like him,” Rose said abruptly, aiming her spoon of mashed potatoes at him and looking at me. “I can’t understand a single thing he says. Does anyone ever know what he’s saying? How can a person get on in the world like that?”

Ed didn’t need to get on in the world, only in the facility, but he didn’t get on there or anywhere, really. I’m certain that he heard every word.

The peculiarities at the facility became routine after a while, Ed and the others who lived there and their symptoms of mental illness something I became used to, as they became used to me, the most recent stranger in their home. There were piss-stained bedsheets, dusty knickknacks overcrowding bedrooms, and radios played loudly in the hopes of drowning out auditory hallucinations. There was a mother who had lost custody of her teenage daughter, a woman who saw fanged rabbits hiding under her bed, and a man who lay in his bed, nearly catatonic, fasting because God had asked him to. There were emergency hospital stays where residents sometimes received electroconvulsive therapy and an adjustment of medicine (which meant an increase) before being returned to us, with flat affect and shuffling feet.

But there were also nights when medicine and minds collaborated, nights with pool playing in the Recreation Room, movies in the Common Room, warranted complaints about the canned and frozen foods served at meals, outings to the park and library, and a throng of elderly women who displayed no outward signs of the mental illnesses they’d been diagnosed with, except for the pills that they swallowed up to three times each day. There was piano playing by Walter, laughter, card games with Ed, knitting, childhood and family stories, anger when a favorite chair was taken, childish antics—especially when the sign-up sheet for the TV and wrestling were involved—and deep, hallway-echoing sadness when a former resident passed away.

Once, during a group outing to a grocery store, the flustered clerk looked at me when Ed asked for “smorgaloops.” I didn’t know what he meant, either, but I took a guess: “Snickers?” My guess wasn’t right. Ed stomped off and found the licorice whips he wanted. Word salad had been explained to me by Ed’s psychiatrist as “incoherent rambling, symptomatic of a thought disorder.” Curled ropes of licorice did look like something that ought to be named “smorgaloops.” I was beginning to wonder if Ed’s unique lexicon was something more than incoherent rambling. The parts of his word salad sentences were becoming clear to me. Subject. Predicate. Clause. Modifier. His sentences and thoughts made sense in the same way Lewis Carroll’s poem “Jabberwocky” and Dr. Seuss’s imagined universe in Horton Hears a Who! did. Ed was a wordsmith of sorts, something I had once wanted to be.

Ed hung around one evening after the slowest of the slow had shuffled out of a resident meeting, held in one of the facility’s classrooms. Recently, he’d had his hair trimmed short, military-style. He looked maybe five years younger than the 45 typed at the top of his medication list. I took a seat next to him. The two of us were alone in the room, a situation that not so long before I had found disconcerting.

“Do you want to talk?” I asked, taking a seat next to him. It was unusual for him to stick around after a meeting.

Ed breathed in deeply and then it was as if words came out of his mouth instead of breath when he exhaled. “Do you know how to float in the blue?” Each word was exaggerated and over-enunciated, his mouth wide as if mid-yawn. He frowned in concentration. “Swim. I mean swim.”

“Why do you ask?”

“On TV some offspring sunk in the blue because they didn’t have a father.”

Earlier a newscaster had reported on the drowning of three-year-old twin girls. The girls had been alone at a Newfoundland lake with their father. How they ended up in the water was a mystery, as was the father’s ever-changing story. “Sick bastard,” Virginia said. “Oh, how twisted!” Connie whined. Some of the residents used the same words to describe the man on TV that people on the outside used to describe them. I had once used those words, too. I couldn’t believe that I hadn’t figured this out before: none of our residents had ever harmed anyone. It was simple and also complicated. Our residents weren’t dangerous. They were unusual, and sometimes this made other people fear them, but they weren’t dangerous.

“Yes, I can swim,” I said.

“That’s good, Dollop,” Ed said.

It was the first time that Ed had so directly expressed his concern for my well-being.

“Ed, do you know how to float in the blue?” I asked.

Ed looked at me and our eyes met. His were moist and deep brown—I’d never noticed before. “I float in the blue every day,” he said.

Jody Keisner’s essays can be found in Hunger MountainVIDASo To Speak, and elsewhere. She is at work on a book about the landscapes of fear.