Here's Robby
by David Laing Dawson
I heard Robby died last week. A friend had read the obituary, and said, “Wasn’t he one of your patients at the hospital?”
It’s twelve years since I last saw Robby, which means he made it into his fifties, which isn’t so bad for someone mentally handicapped, brain injured, prone to manic episodes, and with a body type one could liken to a fire-plug. I pointed this out to my friend. He didn’t know if Robby died in hospital or not, or in his own apartment.
We had been trying to rehabilitate Robby, that is, get him stable and well enough behaved to live in the community, preferably in supported housing. He didn’t take well to group homes, always getting in some scrap or other. His survival skills, his ADL’s as they call them, were limited. He harboured strong, simple, and somewhat rigid notions of fair play and respect, and reacted vociferously when he felt these were being challenged. But Robby could be likable, even charming. Had this been an earlier era of Mental Hospital management Robby might have settled for life within the buildings and grounds of the institution, as a patient with a job and some freedom, perhaps running messages and memos from office to office. But we had phones and faxes and emails now, and somewhere it was decided that the underpaid employ of patients in mental hospitals was no longer a good thing. Everybody, it was decided, could be rehabilitated, if not to community living, then at least to the streets and jails.
So Robby would be rehabilitated, made ready for community living. Now a touch of mania coupled with brain injury is not a good thing. Energy and appetites are fuelled by mania; while brain injury leaves one judgment-challenged and impulsive. Robby always managed to get into trouble, whether on the street, in a bar, in a group home, or on a psychiatric ward.
Most of the time though, when Robby felt he was being treated with respect, he would be respectful in turn. Whenever he spoke to me his sentence would be prefaced with “Doctor Dawson”, the “t” given short shrift, making it that cutely arresting child-like pronunciation, “Dokker Dawson”. Who could resist? The absence of a “t” in doctor being the verbal equivalent of big brown eyes. “Dokker Dawson, my mom says she’s gonna come visit me. Could I borrow a dollar for a coffee?”
At the time, in numerous committee meetings, we were trying to deal with patient sexuality at the hospital. Not that sex and sexual behaviour had ever been absent from asylums and mental hospitals, but in this particularly enlightened era we were trying to find a way of coping with sex between patients in a manner other than that inherited from Queen Victoria.
It is a complex issue. The hospital has a responsibility to protect patients from unwanted sexual advances or contact, but what of consenting adults? And was it our responsibility to decide who had capacity to consent? The nurses in the infirmary had recently walked in on a demented old man doing a demented old woman on her bed, he standing at the bedside, she sitting on it. They were horrified, of course, and worried what the poor woman’s daughter might think, but then somewhat confused about their responsibilities, because what they heard and observed as they entered the room, was the old woman patting the man on his back and saying, “Good husband. Good husband.” Neither of these apparently consenting adults could tell you the date, the year, or even the city in which they resided. How could they possibly consent to sex? Had they been asked, they probably could not even tell you the identity of the person with whom they were having sex. But was harm being done? And here such discussion becomes a minefield of gender and generational attitudes.
We had managed to overcome resistance and have condoms made freely available on the long-stay wards of the hospital. Sex was happening. Why not at least make it protected sex? But now we were engaged in deep discussion of how to provide comfortable places for our patients to use said condoms. We knew of trysts in the bushes on the grounds of the hospital in the summer, in the washrooms in the winter, and in some secret corners of the tunnels that connected the buildings, in all seasons. But if we were to accept our patients as sexual beings, and no longer prohibit the natural expression of this most human of characteristics, surely we should allow them use of a bed in a private room with en-suite toilet, as we ourselves would prefer. (Notwithstanding the rumour that one of our famous research scientists had been caught in a broom closet with a member of the housekeeping staff).
But then, how does one manage this private trysting room? We could not simply set aside a bedroom which locked and unlocked only from the inside. This would pose a safety hazard. Our – what would we call it? – our conjugal room would have to be a room that locked and unlocked with a key kept at the nursing station, with a duplicate on hand for emergencies. And if the staff were handing out this key upon request, would it be their responsibility to determine that each of the participants was consenting and competent? Would this include same sex couplings? Should we worry about age disparities? Severity of illness? Each of these issues could be answered on paper as policy or guidelines, but in reality we would be asking far more of our patients than we do of ourselves. The experienced desk clerk at a downtown hotel might ask the luggage-deficient guest if he is “staying overnight or simply looking for a place to hang his hat for a few hours”, or, “Would he like the day rate?”, but he would not demand to know the identity of the romantic partner nor would he assess their competencies before giving them a room key.
Such a special privacy room was established at the hospital for a while, but, as one might predict, never used, never accessed. No one came forward to ask for the key. This might have been a problem of insufficient advertising and promotion, but more likely our patients decided, as we ourselves would, that privacy, secrecy, and spontaneity were more important components of the sexual experience than physical comfort.
So it is with this background that I approached the problem of Hanrahan’s.
Robby’s rehab worker, a young enthusiastic man, had told Robby, that for his birthday, he would take Robby to lunch at the restaurant of his choice. When his birthday approached, Robby chose Hanrahan’s, which, for a long time, had been the city’s most notorious strip joint. Robby added that he would be very pleased if Dokker Dawson came too.
This took a moment’s reflection. It would be easy to refuse the invitation by invoking that well-used word of mild condemnation, a perennial favourite in psychiatric hospitals or Centres of Mental Health, “inappropriate.” As in, that would be inappropriate. But here we were struggling to find a way to accept and support the sexuality of our patients, to be responsible but not parental. And, more practically, more to the point, if Robby were to survive living in the community independently for any length of time, he would need the skills to successfully negotiate all the social venues important to him: the welfare office, the neighbourhood bar, the grocery store, the drug store, the drop-in centre, the doctor’s office, the pool hall, and the strip joint. I told them I would join them at Hanrahan’s on the appointed day.
Down on Barton Street, not far from the Detention Centre, and the General Hospital, Hanrahan’s had been a fixture for a long time. Outside it was brazen and flashy, complete with the neon outline of an exotic dancer. Inside, it was seedy and dark, befitting its function. When my eyes adjusted to the poor light I found the rehab worker sitting alone at a table toward the back. I sat down beside him and asked where Robby was. “You’ll see soon enough,” he told me.
Twenty feet away the raised stage was empty, and behind that I could see a glassed-in booth where the DJ spun the platters and announced the dancers. It was a little after 12 noon. A few men were sitting here and there, some looking like they had spent the previous night and all morning at the same table, others just in for an hour’s break from office work. I looked over the sparse menu. Beer and a hamburger seemed appropriate to the occasion.
And just at that moment, over the speakers, coming from the microphone in the booth, I heard the proud and excited voice of Robby announcing: “All right folks. Let’s put our hands together and welcome a little lady from the Deep South. Straight from the runways of Texas and Oklahoma. Here she is, the one, the only, Melanie Starr.”
“I told the guy in the booth it was Robby’s birthday and he always wanted to be a DJ”, the rehab worker explained. Then Robby joined us, his face aglow with pleasure, and we congratulated him on his fine work. I kept my eye on him through lunch, with occasional glances toward the stage, and Melanie, replaced by Kimberley, and then Stormy Weather, their headliner. Robby behaved splendidly throughout. When the meal was over he asked if he could have a table dancer. Now this, I thought, would be an interesting study of the relative influence of brain damage and impulsivity versus context and social etiquette. Perhaps not a well-designed study, not something the journals would accept, but a study nonetheless, albeit an “N of one” study. So I bought Robby a five-dollar table dance for his birthday.
Robby survived the woman’s writhing naked torso within inches of his knees with his eyes wide and staring, his hands at his side, his back straight, a stoic unblinking look on his face. Her breasts swung close to his nose and still he did not move. He was a man frozen, utilizing all his reserves to keep still. And still he kept, even when she ran her fingers through his hair and brushed her hand across his cheek. I thought a footnote in the imaginary paper I would write might point out that Robby’s command of etiquette and social custom in strip joints appeared to exceed that of his command of the same in grocery stores and hospitals.
When it was over he was quiet for a minute, and then he looked at us smiling at him, and said, “Thank you, Dokker Dawson.”
I did wonder at the time, and later, if this had been the right, if not the appropriate, thing to do. I did not ask this question of our Administrator or the Lawyers on call for the Ministry of Health. I understood that from where they sit the answer would have to be “No.” And the “no” would be pronounced in such a way as to imply incredulity. It would be the same pronunciation of “‘no” I use to answer my teenage son’s query re the propagation of marijuana on our patio.
Robby eventually moved into his own apartment, though staying there and learning a few ADL’s required frequent visits from his worker, and some interventions on his behalf with his landlord. Now twelve years have passed and I have learned that Robby died. And later I hear it was a heart attack. I know little of his life in those twelve years, but I do know that death puts much in perspective. The only ambition of which he spoke was to become a DJ, and at least for a moment he became one. However such a psychiatric and rehabilitation intervention might be judged, I hope that Robby kept as fond memories as I have for that particular afternoon we spent in Hanrahan’s Tavern and Exotic Dance Palace.
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