The Opened Door

“We talk,” mused Williams, “of doors opening to freedom - to new opportunities. Too

often, in my experience, they open instead only to further constrictions, additional

limitations— physical, psychological, cultural, sometimes religious.”

Nobody spoke. “Williams,” we thought, “in one of his pessimistic, philosophical moods.”

Williams took our silence as an invitation to elaborate. “Let’s take the case of a young

aboriginal we’ll call Gary.”

“Gary was brought to us from a dementia unit in another town. They had almost given up

on him and now his general health required him to be close to a hospital.”

“He appeared a hopeless case: alcohol-damaged kidneys and advanced dementia. The

first few days he spent curled up in bed. Then he emerged into the unit’s day-room.

Before long, he took possession of a chair opposite the entrance door of the unit—one of

those key-pad security-door affairs. This became his permanent roost. He would go

there soon after breakfast and return after lunch. We came to accept this as Gary’s

place and let him be.”

“He would sit for long periods of time, eyes fixed hypnotically on the door. Only its

opening and closing could break his obsessive stare. When the door was open his face

became animated; closed, the fixed, hopeless stare returned. We became accustomed

to this behaviour and thought little of it. Perhaps, we supposed, he was waiting for one

of those intermittent visits from relatives. We had no idea when any such visit might

come. They just happened. We felt for him, but we had no control over their frequency

or timing. Truth be told, they were usually at the most awkward times for us: one of us

had always to be on hand lest that door be left open and a patient go missing. And at

times like meal-times, there was such demand on our attention we could hardly avoid

being distracted.”

“Before long we noticed Gary sometimes moved close to the door. More than once we

found him, hand on the security pad. We were able to distract him and gently lead him

back to his favourite chair, but it was worrying. Eventually one of the more experienced

nurses, Julie, suggested we should release him into the garden area outside the unit.

‘It’s worth a try,’ she said. ‘I’m fairly sure his relatives aren’t the problem; they’re here

too infrequently. I think it’s the aboriginal craving to be unrestrained. Any locked area

must be like a gaol for him, and he’s had some experience of that’.”

“Set up a sort of free-range dementia unit?” quipped Smith, our group jester.

Williams ignored Smith’s sally and went grimly on.

“‘Short of confining him to his room which would probably set back his improvement,’

continued Julie, ‘the time’s coming when he’ll solve the key-pad. It’s bound to be when

none of us is about. Besides, I think he’s one of those not inclined to wander far once

he’s outside these walls.’ ”

“A few days later the Head of Patient Care announced we were to give the idea a trial.

‘Julie, as it was your suggestion, can you be responsible for it? But don’t neglect your

other duties. Heaven knows, the time we spend watching Gary is a problem. And it just

might work. The rest of us will help wherever we can.’ ”

“Well, we waited, anxious and curious as to what would happen. Next day Julie took

Gary for a short walk in the garden. She had arranged for morning tea to be brought for

them both to a corner of the garden. Gary seemed excited to be outside. Nor did he

object to returning to the unit. Gradually he was allowed stay outside longer, then be on

his own, though morning tea was brought him each day. Julie began taking his lunch out

to him and eating with him during her lunch break. By now Gary had settled on a

favourite spot, a corner far from the door. Here he set up a camp space and was

allowed to bring bits and pieces from round the garden. There were a few problems we

had to manage, but we were rewarded with a new Gary.”

“Gary’s improvement was not unnoticed by the relatives. They insisted he be dismissed

from the unit. Eventually the Director of Nursing was forced to give in. Gary managed

for a while, but the grog got him again. He was returned to us helplessly drunk. He

urinated round his room, too drunk to find the toilet. For several days he lay in bed, just

as when he had first arrived. Sober, Julie took him in hand again. Again there was the

recovery, again we were forced to release him to the care of relatives.”

“Did I say ‘care’?” Williams shook his head angrily. No one replied.

“Well, this occurred twice more. On the last occasion the relatives were warned that

should it happen again, we could not be responsible for his rehabilitation: the other

inmates must be considered.”

“The inevitable happened. Of course we were roundly abused for not taking him back.

Occasionally, we’d see him around town. If he were not drunk he would come and hug

us or shake our hand. We would shout him to a hamburger and coffee.”

“One day one of us happened to say: ‘Haven’t seen Gary round for some time.’ A week

later Julie told us: ‘It seems Gary has gone off with relatives up Brewarina way. I’ve

contacted some of the hospitals to let them know we have his medical records if he

shows up. I think that’s the best we can do, short of dobbing him to the police. Gaol

would be the last place for him.”

Williams paused and sighed, frustrated. “You see my point? We opened Gary’s

physical door only to release him into the cultural imprisonment of his tribal ties. And for

him this last state was, arguably, worse than the first.”