CHAPTER 3: One More Case
by Doug Dean
Bottom Up or Top Down?
It would come to be the hardest case he lent his analytical skills to. Could sense be made of a disjointed life by connecting the dots into a coherent whole? The partial records from Illinois State Psychiatric Institute would be the only records to work with.
Three pages of faded progress notes provided the only independent information available. The fourty year old mimeographed records, filled with typos and corrective pencil markings, were as hard to decipher as the patient himself;
“Patient received a significant amount of over protection during his childhood years particularly from mother, an aggressive dominant figure in the home. The relationship between the parents was a poor one and the over protective attitude of mother appears somewhat to have been a displacement of feelings from father to patient. This displacement included not only affection but probably also hostility and aggressiveness.”
– ISPI Records No. 01-78-71
Doug took his family, education and career seriously – and in that order. He was known as a hard worker and delighted in working the toughest cases. Thirty years in mental health told him it was a worthwhile project to “soften the landing” left by the time vacancy of his retirement.
Doug learned to deal with the mentally damaged by starting from the bottom up. He honed his ‘no nonsense’ approach from directing a chronic mentally ill facility after implementing behavior modification programs for developmentally delayed residents. He liked to get his “hands dirty,” he would say, after convincing some schizophrenic to put down a weapon. But nothing prepared him for the most difficult population anyone has ever work with teenagers.
“There appears to have been repeated traumatic experiences associated with death of grandparents and finally a parent during grammar school period of this patient’s life. Patient became even more insecure and threatened by separation and abandonment and was thus even more vulnerable to the overtures of mother during this period. Patient’s self-esteem was inadequate and this too was useful in fitting into the relationship with mother who appeared to nurture the patient’s feeling of inadequacy and dependency upon her.”
– ISPI Records No. 01-78-71
Doug was unusual for someone working in an educational bureaucracy because he thought out of the box. In fact, he could be heard complaining that he couldn’t think in the box. Humor peppered his interactions and he was said to become calmer when others became more upset. Doug took his career as an educational psychologist seriously. Priorities were important to remember when decisions are weighed in the day to day world. Doug knew his priorities.
This case was different, Doug thought, it felt heavy in a way that would test his ability to stay objective. Staying on top of any therapeutic situation was vital for a patient to feel free to subject themselves to awful memories. He knew overwhelming pain had to be kept in check in order to function normally. “I just got on with life,” Doug heard many a survivor say.
“As adolescent activity and growth ensured, the patient was confronted with feelings of aggressiveness and the reality situation of progressing in school, employment, and maintain a position of increased independence. These factors were significantly threatening for the patient and only served to foster a regressive type of behavior which was further aggravated by use of alcohol and drugs.”
– ISPI Records No. 01-78-71
Doug knew he had to get beneath the hard calluses built up from people constantly rubbing others the wrong way. “It’s a emotional callus cushioning the trauma experienced of being institutionalized followed by homelessness,” he thought. What would it be like to reliving that part of life left numb by years of conscious neglect? “One more case,” Doug thought.
Before retiring Doug learned what ‘keep your friends close and your enemy’s closer’ meant in real time. Survival in a bureaucracy depended on it, especially when making six figures during a world recession. Parents considered it their responsible to see to it that public employees did their jobs rightly, while teachers resented colleagues earning more than them. Retiring two year ahead of time was not in his plans, but Doug had enough of union loafers and self righteous administrators.
“The kid doesn’t have a chance,” was all Doug said. The principal of Doug’s school wanted nothing to do with this homeless family anymore. Little did Doug know that this would be his last day employed as a school psychologist. He had managed his way through twenty-five years of working with special education students, whom he enjoyed immensely. It was everyone else that drove Doug nuts; parents, teachers and administrators. He liked the clerks and maintenance crew.
The department clerk, the first defense from becoming a bureaucratic scapegoat, rang Doug’s extension; “You might want to know there’s something brewing in the Seriously Emotional Disturbed (SED) class,” the clerk reported. “I’ll deal with it when I learn about it through the proper channels,” Doug reluctantly responded. “Okay. Good luck” could be heard as the receiver fell back into its cradle.
True to clerk’s words, in three days time the principal himself called, “I need to see you in my office immediately, there’s another expulsion.” “I’ll be right there,” Doug replied. He had been the psychologist for this particular high school for close to a decade, far longer than the average psychologist lasts. His office had been cleared out of what he absolutely couldn’t leave behind. It seemed only a matter of time before the new district administration short circuited due process with their “Just obey, don’t ask” attitude. He would be ready either way.
“You’ve been here through many emergencies,” was the first words out of principal’s Ben’s mouth. Doug felt old and worn out; six student suicides, a racially motivated student homicide by students, and both male and female teachers found molesting students all came to mind for starts. “Yeah,” Doug said, following with a quick “what’s up,” in hope of avoiding nostalgic paths.
“A terrorist bomb threat had been reported through 911 dispatch,” the principal said, accepting the hint. His large thick hand fumbled a few buttons and an audio recording began:
“He’s crazy and said he was going to blow up the school,” a hysterical teenage girl shouted. Beep. The dispatcher calmly returned, “Is he there now?” “No, he said that in class earlier today,” the caller said in a quieter, meeker voice. “What is your name?” Beep. The dispatcher heard a whispering voice coaching the girl in answering, “He’s just crazy and scares all of us. He doesn’t need to be here. His name is Jason Powers”
Ben wanted to expel this SED student and he needed the case evaluate before being able to expel him from the district. The law requires students with identified disabilities to be evaluated by a school psychologist before being recommended for expulsion. It first had to be determined if the student was responsible for his actions or if the action in question was a manifestation of his disability.
This was one of the requirements within the law that kept school psychologists, like Doug, employed. It was up to him to collect evidence in support of deciding which explanation the school district may need to defend in court. At least that’s the way he had come to think about it.
Years back Doug came to the conclusion that even if a case never went to trial this was a way of thinking which coincided with the best interest of the student. Administrators had their careers to think about and parents never seemed to find their children responsible. Doug strove to be as objective as possible, which rarely went without being attacked by one side or the other.
Having presided over a hundred of these sorts of meetings, Doug immediately knew the administration had been stalling for four out of the five days Doug had by law to complete his evaluation. The student in question was a teenager living with his, off and on homeless, parents. All were certified mentally ill. Ben explained that the district’s administration was very concerned “from the very top-down.”
Ironically, the story did start at the top in that a wife of a school board member was the 911 dispatch operator that took the call. This meant that the school board, as well as the chief of police, had determined to see justice completed for a case they brought to light.
Doug reviewed the four inches of Jason Power’s records and was relieved to discover a clear argument for the case based on documentary evidence. Jason’s first evaluation, made during kindergarten, described the very same symptom he continued to suffer from in high school. That was why he was in the SED classroom to begin with. He wrote up his findings based on his clinical expertise as he had done weekly for twenty five years. That’s when it hit the fan.