Kate's Grand Tour
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by Jay Neugeboren
As soon as the aides took over and we left the ward, Kate pushed me against a wall. “I told you to never ever intervene when two patients are fighting,” she said. “But--” “No buts,” she said. “No matter their seeming lethargy, when aroused, patients can become violent, and when they do, they’re indiscriminate: they become violent against staff, against visitors, against one another. They can hurt you, Jerry, and their rage, despite all the meds, is still there--always there--and gives them power out of all proportion to their age, size, or gender. Got it?” “Whatever you say.” “Don’t get snide or I’ll whip your ass.” “Is that a threat or a promise?” I asked. “Both,” she said, and she grabbed me by the back of the neck, pulled me to her, and kissed me. Kate Connaughton was a psychiatric resident at Creedmoor Psychiatric Center who’d been working with my father for the past nine months. My father had been stationed in New Guinea for two years, where he’d flown P 51 Mustangs fighter planes against the Japanese, and where he’d had a major breakdown. He’d been given an honorable discharge, and had spent the dozen years since then shuttling back and forth between state hospitals and veterans hospitals. Ever since Kate had been assigned to him, however, he’d shown clear signs of progress--had become more calm and coherent, and less subject to spells of depression and rage. I was in my senior year at C.C.N.Y., and was working on a novel based loosely on my father’s war and post-war experiences. On visits with him, I’d met Kate a few times, and one afternoon I worked up the courage to tell her about my book and to ask if she’d be willing to talk with me about the medical nature of what was he was going through. We met several times for coffee, she offered to read the novel, and on the evening when she invited me to her apartment to go over the manuscript--“Like you,” she said when I arrived, “your novel is more than merely promising”--we became lovers. After my attempt to separate the two women who’d been fighting, Kate and I continued on our rounds of Creedmoor’s back wards, where she gave out items she’d brought, wrote down requests, and took several patients aside for brief conversations. I saw patients tied into beds with bedsheets and tape. I saw patients lying on urine-soaked sheetless mattresses. I saw grime-and-feces-covered bathrooms. I saw toothless men and women in shabby night gowns who, like monkeys, picked at one another’s scabs. I saw patients in locked rooms that contained only bare mattresses. I saw patients with missing fingers or hands, with weirdly misshapen heads, with faces splotched with muti-colored rashes, and with what appeared to be the raw residue of boils. And I met patients who talked with Kate as if they were ordinary human beings--asking what she’d brought, when she was coming back, and if she’d had time to look into their cases. I met guards who, for crowd control, carried bamboo poles. They were mostly Black men, though several were white, and these men--Irish? Polish?--though often meaner than the Black men, Kate said, could sometimes be surprisingly kind. All the female attendants I met were Black, and Kate talked with several of them, and made suggestions as to which doctors or medications might be helpful for particular patients. I met nurses who, according to Kate, risked their positions by protesting to the administration about conditions, and who, she added, though in a voice without affect, were saints. On wards for demented patients, and patients brain-damaged or disabled by alcohol, syphilis, drugs, and years of neglect, abuse, over-use of medications, and shock treatments, I saw patients whose lifelessness seemed more deadly than any potential for violence they might still possess. They slept, or rocked back and forth, or mumbled, moaned, screamed, talked to themselves, pawed at invisible creatures in the air, moved about in spastic spasms, gazed dumbly at television screens, shredded newspapers into strips of paper they chewed on, or simply sat, immobile, on chairs, or on beds, or on the floor. It was past five o’clock when we left Building D--the kind of place Kate said she hoped to keep my father from having to live in for the rest of his life--a building that, in a hospital with seven thousand patients, housed more than twelve hundred men and women yet had only one physician. “But come,” Kate said. “I saved the best for last.” “The best?” “Irony, Jerry,” she said. “Irony. Irony and alienation--the defining duality of our century. You’ve read your Kafka, yes?” “I’ve read Kafka,” I said. “But he didn’t prepare me for this. How do you do it, day after day?” “I don’t,” she said. “I work in the main building where we still have a chance to do some good work. I only do Kate’s Grand Tour of the back wards once every three weeks. Small potatoes really.” “Small potatoes? But you’re the person patients and staff see as a saint,” I offered. “You make a difference, Kate--” “For them?” Kate said. “Hardly. But for me, yes. These afternoons keep me going--they allow me to live under the illusion that I’m still of some use to others.” “But you are.” “I come and I go,” Kate said. “Their lives stay the same. You don’t get it, do you? I’m using them, Jerry. I’m using them to keep me from...” “From what?” “Look,” she said. “I admit that it is easier for me to take care of others than to let others take care of me--for which job, as I’ve said from the beginning of our friendship, you’re ill-suited. For me to even let you apply would be an act that might violate child labor laws.” “But what about the women who ask you to look up their records--to see if you can get them re-evaluated so they can be discharged and go home?” “The problem remains,” she said. “Because I’m acutely aware of how much greater what I can not do is than what I can do.” Kate turned away, and I followed her into a building she said served as the hospital’s nursery. “Some of the female patients are pregnant when they arrive,” she explained. “Some become pregnant while here--an area where male staff members do show initiative--and, given their emotional states, it’s safer for them to give birth here than to send them to city hospitals. We have no obstetricians on staff, but most of our physicians, including yours truly, have done internships in obstetrics. Which is more than I can say about our psychiatrists.” “I don’t understand--you’re a psychiatrist.” “Be real, Jerry,” she said. “You don’t find graduates of Harvard or Hopkins applying for residencies here. What the state does is to hire foreign MDs who are licensed but have little or no training in psychiatry. Still, most know how to deliver babies--speaking of which, the answer to your unasked question--is that yes, I am almost two months late, and I have made a decision.” “You’ve made a decision--?!” I protested. “But--!” She placed a hand over my mouth. “Shh,” she said. “If it turns out I’m pregnant, I know a doctor who owes me a favor. But look--I am irregular in my cycles, and we will talk about this, only not now. Because now, my dear young friend, it’s time to visit the nursery, and then head home. I’m beat. You wear me out with your innocence.” “And my affection?” “Never that,” she said, and then: “And I’m sorry for the blunt way I said what I did a moment ago. I hurt you, didn’t I?” I smiled. “That’s the first time you’ve ever apologized to me.” “You’re the first person I’ve ever taken with me on my grand tour. It’s become important to me that you see and know what I do.” “And who you are?” “Who I am beneath my well-defended exterior--is that what you’re trying to say?” “Something like that,” I said. “But even the well-defended part--that’s you too.” She kissed me quickly, then tapped on a door, three times. A short, Black woman opened it, embraced Kate, said that the babies were sleeping peacefully. Kate switched on the lights, stepped aside, and I saw two rows of cribs, a wide aisle between the rows, and in the cribs infants whose faces were all a copper-like brown color. Then, as if propelled by a sudden electrical surge, small, dark objects that were on the faces of the infants came to life and scurried away. “Oh my God!” I exclaimed. “Cockroaches don’t like light,” Kate said. Jay Neugeboren is the author of 25 books, including award-winning books of both fiction and nonfiction. SHARE - Issue: 1.8 / April 2026 |