O’Hara’s memoir, Ins and Outs of a Locked Ward, takes readers on a journey through this time as O’Hara reflects on his career, offering insights into mental illness and how treatments have changed throughout the years.
Zydalis Bauer spoke with O’Hara to learn more about the book and his sometimes-humorous experiences of working in the locked ward.
Hear O’Hara read an excerpt of his memoir in this digital exclusive.
Read the full transcription:
Zydalis Bauer, Connecting Point: Following in the footsteps of his mother, Pittsfield native and author Kevin O’Hara became a nurse and went on to spend three decades working in a psychiatric ward at Berkshire Medical Center.
His memoir, entitled “Ins and Outs of a Locked Ward,” takes readers on a journey through this time, as O’Hara reflects on his career, offering insights into mental illness and how treatments have changed throughout the years.
I spoke with O’Hara to learn more about the book and his experiences.
Kevin O’Hara, Author: I had written a book or two beforehand and my colleagues thought it would be a great story and a story that needed to be told. As many as our patients really don’t have a platform to do so, and I thought it was just a fine thing to end my career at doing.
Zydalis Bauer: And speaking of ending your career, your career was cut short after an attack from a patient which landed you in the hospital. And much of the book is told from that week-long recovery period.
Why did you choose this point of view to tell this story?
Kevin O’Hara: Well, it was for me, the perfect vehicle. See, I never really knew how to tell this story because it spans, basically, truly 50 years. From my days as an orderly in 1971, right through to 2010 when I was here, and then another 12 years for the book to come to fruition.
It was an on-and-off effort, but it did take me 12 years plus, I needed that space because of HIPAA concerns and privacy concerns.
Zydalis Bauer: So, let’s get to the stories, because I know that when we first talked, you said that you have numerous humorous anecdotes to share with us.
So, tell me some of the favorite stories you encountered, the personal moments you’ve had, and some of the experiences with — with patients that you had in the Berkshire Medical Center.
Kevin O’Hara: I believe 4,000 patients came through the turnstiles during my my tenure there. So, that’s hard to pinpoint. Many anecdotes, many of which took place when I was an orderly. They were the trying times.
I recall one event when we had this man who was forever felt as though he was constipated, though he wasn’t. And he was forever asking for the bedpan and always asking for the bedpan and say, “Did I go, Joe?” afterwards.
And of course, we rolled him off the bedpan, and of course it was empty. And he had gone twice already, anyhow. And there was no end in sight. And sure enough, I was outside in the hall after we drew the curtains and put the bedpan beneath him again, and there was a dietary cart there with a baked potato in it.
So, when I rolled them over, slipped in into the bedpan, he shouted his regular refrain, “Did I go, Joe?”
And I took the bedpan, I rumbled it over his head. I said, “My God, Mr. Reynolds, did you ever!”
And from then on, he said, “That’s the motherload I’ve been waitin’ on.”
And sure enough, I cured him. I cured him, you know. So, that was just one moment of many, many moments. But that one seems to come to mind. And of course, being an Irishman saved by a potato, that’s not a bad thing.
Zydalis Bauer: Much like the story that you just told, you take a humorous approach to a lot of these stories. I mean, when you hear psychiatric nurse or psych unit, psych ward, your mind tends to go to kind of a serious place, but you take a little bit of that seriousness out of it.
So, why do you take this approach when thinking about the stories and telling the stories?
Kevin O’Hara: Well, humor well, as they say, humor is the best medicine. And it was also a great barometer to how someone was doing. It made light of it. It was trench humor, you know, foxhole humor, more or less. But it got you through difficult times.
There are many, many things. They called me Nurse Lite, all right? That was my nickname, Nurse Lite, because I had only done my 30 years as a psychiatric nurse. I never went to ICU or CCU or the medical unit, so I was absolutely hopeless in a mayday situation. In fact, to be honest with you, I didn’t know the difference between a cardiac paddle and a ping pong paddle, you know?
So, I was I was desperate, but I was also called a Pez nurse because one thing I could do well was pass medications, although in the book I do talk about three or four of my mistakes. Fortunately, they never sent anybody to room 500, and that’s the morgue. But I had a couple of close calls. But we figured out that over the years, I had dished out over 250,000 pills.
Zydalis Bauer: Oh, my God!
Kevin O’Hara: Yeah, that’s a lot. You know, that’s a walloping number! That’s a quarter of a million pills, and I think I only made three or four mistakes.
Zydalis Bauer: Hey, that’s pretty good. I think that’s a pretty good job. Track record, right? We’re all allowed a couple of mistakes.
Kevin O’Hara: That I know of anyways, right?
Zydalis Bauer: Right! Well, and I want to also talk, because this book covers a lot of medical treatments that have happened over the years. It tells more than just the stories, but we can actually see the change in medical treatments happening over the decades.
So, in what ways will readers witness this throughout the book? Is there anything shocking that we might encounter that we’re like, “Whoa, I can’t believe they did that at some point in time”?
Kevin O’Hara: One thing that I had noticed in my — my reign was ECT, electric shock therapy. Now they call it electroconvulsive therapy. In the early going, jeeze it was horrendous, much like Jack Nicholson in “One Flew Over the Cuckoo’s Nest.”
I mean, people would break teeth, you know? I mean, the jolt was severe. They flop around like fish out of water and they had great headaches and amnesia.
Now, that’s really settled down. And the only thing that actually moves, basically, in the ECT treatment today is a big toe. That’s about it. I don’t know why the big toe moves, but you know, they’d have a seizure, but it was controlled and they’d give you muscle relaxants beforehand. So, it wasn’t as vivid and a horrific as it had been in the seventies.
You know, over for 40 years or so really, you do see a lot. Now it’s medication, though, medications the way it goes. And some medicines are fabulous, but many have side effects. But the old ones, like Thorazine and Haldol, as horrific as sometimes the side effects can be, it emptied out Northampton State Hospital because patients would be living unmanageable lives without these, what they call chemical straitjackets.
Zydalis Bauer: Some of the stuff that, you know, you’re talking about, we’re laughing because, as you said, humor is great medicine, but it’s really some serious and heavy stuff.
What did you learn about yourself during these three decades as a psychiatric nurse?
Kevin O’Hara: Nothing. Absolutely nothing. I’m back to the starting point!
Jeeze, I don’t know. Just a whole wash of different emotions. I learned that patients generally tell the truth, like children, especially chronic patients. But I saw all sorts of emotion. And in the book, it’s a real, I suppose, roller coaster of emotion because some stories just aren’t happy and they’ll never be happy, right?
But, you know, there’s a nice lining behind it and you get a sense — people who have read the book say it gives a great humanizing to a patient and that they’re just like us and everybody’s just trying to get by as best they could. And that’s evident in the stories, not the way I wrote them, but the way they — the way they were, you know?
So, I tried to be as truthful as I could on the page when I spoke and wrote about, you know, people’s struggles, everyday struggles, things that we take for granted.
Quick example, we had a patient who was very paranoid, took her out on a pass just to see how she was doing. She was with us for about eight or ten days, but it was time for her to test the waters. And she seemed very good indoors or in the courtyard, where we spent some time. But when she was outside out of the building, a fellow walked by us with a Bum t-shirt, it’s a name brand. It says Bum on it. And — but she started, you know, wallowing and had to go back because she was convinced that he wore that sweatshirt to mock her because she didn’t have a job. So, that’s how sensitive people can be.
Then of course, we had another guy and I saw him with the shoes on the wrong feet and I pointed it out to him. I said, “Look, you had your shoes on the right feet.”
He said, “I know. I just wanted to know what it was like to wake up with your shoe on the wrong foot,” you know?
So, I said, “Okay, got it.”
Zydalis Bauer: That completely reminds me of a child, right? It’s just like, I just want to try it quick experiment.
Kevin O’Hara: Right.
Zydalis Bauer: So, Kevin, this is your first — fourth memoir to date.
What do you enjoy about documenting your life through writing and storytelling?
Kevin O’Hara: When it’s done! When it’s done! Believe me, it’s a struggle. My “Donkey Travels,” I walked the donkey around the coast of Ireland back in 1979. My “Donkey Travels” took me 25 years to write, on-and-off effort. But then again, I was raising a family with my wife Melita, and I was working full time and so, I dabble at it.
But I knew I had to do it, because my journey around the coast of Ireland with the donkey was tremendous. And it would be a failing of mine if I could never put that on paper.
Zydalis Bauer: So, 12 years for this book to come to fruition.
What would be the ideal takeaway that you hope readers have after reading this book?
Kevin O’Hara: A greater understanding, perhaps, of the struggles of these folks. I mean, you pass them on the streets all the time. Most people don’t acknowledge them. It’s just a tough old go, and to be aware of that. But that would help.
In fact, just to give you an idea, we had a patient, and he was stopped by the police because he kept crossing, hitting a red light to cross — a pedestrian red light on North Street, here in Pittsfield. And when he was asked why he was doing it, I guess he had been doing it for an hour or two, you know, back and forth, traffic everywhere, right?
And when he asked why he did it, he said, “It’s the only time in my life I feel like I get respect.”