[This tape was transfered from a 16mm film original by Colorlab
for the National Library of Medicine, January 2006, NLM call number HF 1414]
[Distributed by the International Film Bureau, Inc., Chicago, Illinois]
[The Mental Health Film Board Professional Education Series]
[Man to Man, An Affiliated Film Production, Copyright MCMLIV by M.H.F.B.]
[Sponsored by the Mental Health Authorities of Michigan, New Jersey, Alaska]
[Mental Health Film Board: K. Appeal, M.D., L. Baumgartner, M.D., C. Binger, M.D.,
J. M. Bobbitt, Ph.D., M. R. Kaufman, M.D., R. T. Morse, M.D.,
T. A. C. Rennie, M.D., H. P. Rome, M.D., L. Saul, M.D.,
E. D. Swann, H. I. Weinstock, M.D., Alberta Jacoby, Exec. Sec.]
[Written by Irving Jacoby and Jack Neher
Photographed by Richard Leacock
Edited by Aram Boyajian
Consultants T.A.C. Rennie, M.D., William F. Green, M.D.]
[Directed by Irving Jacoby]
[Music]
[Narrator:] Sanctuary, refuge, hospital.
This is no snake pit.
The doors are locked, but it's not a prison that we enter.
For these locks are meant to protect patients.
They open as though by magic,
when the sick no longer need the safeguards of hospital care.
In the meantime, those who carry the keys are not guards.
Joe Fuller, psychiatric aide, is no man's keeper but his own.
This is his job.
His living.
This ward is his work world.
It's a strange world, to us.
[Men mumbling and speaking incoherently]
[Joe Fuller:] What's this, Mr. Jordan?
[Mr. Jordan:] I made a notee.
[Joe Fuller:] Very nice.
[Mr. Jordan:] Do ya want one?
[Joe Fuller:] Fine. Thanks a lot.
[Mr. Jordan:] That's right, throw away those chains.
We don't like chains around here.
Do we boys?
[Other men:] Nah, no.
[Joe Fuller:] Well, thanks a lot, Mr. Jordan.
[Mr. Jordan:] You're welcome, I gotta go now.
I got one of these for the night man and Frank.
[Mumbling in the background.]
[Mr. Mills:] Hey, Jordan is a lot easier to take
since he started occupational therapy.
[Joe Fuller:] Yeah, it gives him a chance to work off a lot of steam.
[Mr. Mills:] Nice cord, ain't it?
[Joe Fuller:] Yeah.
[Fuller lights Mr. Mills' cigarette]
[Joe Fuller:] I hear you're going home this weekend, Mr. Mills.
[Mr. Mills:] Yep, and maybe for longer than that.
[Joe Fuller:] Good.
[Mr. Mills:] I'll be glad to go home.
It's been almost a year now.
And you know Joe, I was as bad as that guy over there
when I first came here.
[Mills points out man sitting in chair leaning forward with hands hanging between his legs]
[Joe Fuller:] Yeah, I remember.
[Mr. Mills:] Now that reminds me.
I found a pipe in his locker.
I wonder if he'd like to smoke it?
[Joe Fuller:] Maybe he would.
[Joe Fuller moves towards man in the chair.]
Sit up, Mr. Rusk.
Come on.
[Joe pulls Mr. Rusk to the upright position.]
How'd you like to smoke?
This is your old pipe.
[He places it in Mr. Rusk's hands. It clatters to the floor.]
[Joe picks it up and places it to the side of Mr. Rusk's chair and walks away.]
[Narrator:] Perhaps later.
Perhaps next time.
Of all the tools in Joe's work kit, time is the most useful.
The ability to accept time as an ally is usually called patience.
Joe has learned to be patient.
Patient as a mother.
Patient as a nurse.
At times it must seem to him, as patient as Job himself.
[Someone knocks on the class window.]
For Joe's charges, like children, have many conflicting needs
according to their personalities.
Their states of illness,
their physical conditions,
their momentary whims.
The aide is the only constant human being
in an environment marked by inconstancy.
When one man delights in harmless mischief,
another must be protected from his antics.
Sometimes one can help another,
a sign of his own improvement.
But more often it's Joe's personal attention that's wanted.
His word, his touch.
Sometimes a bemused patient merely requires a little prodding,
a gentle reminder of where he is,
while others seem to have lost all memory of the simple tasks
they learned as children.
No longer able to take care of themselves,
they depend on others to help them live from day to day.
Joe helps.
Without resentment.
Without contempt.
This is his work.
[Nurse:] Dr. Brand, this is Mr. Harve, a new psychiatric aide.
I'm bringing him up on this ward because you're so short-handed.
[Dr. Brand:] We sure can use him.
Glad to meet you.
This is Miss O'Malley.
She is the nurse in charge in this ward.
And this is Mr. Fuller.
He's a psychiatric aide like yourself.
Have you ever worked in a mental hospital before?
[Mr. Harve:] Oh sure.
I know all about looney bins.
[Dr. Brand:] We prefer to think of this as a hospital
where we treat sick people.
[Mr. Harve:] Well, I didn't mean nothing.
[Dr. Brand:] No, I realize you didn't.
You see these are all special patients
who are getting the best that the hospital can offer them.
There's electroshock,
there's recreational therapy,
there's occupational therapy...
and the companionship of other men.
[Mr. Harve:] I usually work on a back ward, where they don't have that.
[Dr. Brand:] Yes, I know,
but for the time being I'd like you to work here with Mr. Fuller.
He has more than he can handle.
[Mr. Harve:] Anything you say.
[Dr. Brand:] Well, Mr. Fuller will explain your duties to you.
[Joe Fuller:] Well, like the doctor said.
On our ward, we try to give a lot of time to each patient.
It's kind of a new idea.
The more treatment they get,
the better chance they have of going home.
[Mr. Harve:] I don't go for stuff like that.
I like a ward where the doctor comes through once a day and spends five minutes.
How did you get into this racket in the first place?
[Joe Fuller:] My wife.
This was Helen's hometown.
She used to work over in the administration building
before we were married.
Then I opened a small radio repair shop downtown.
Only it didn't pan out.
Then she got her old job back, and I took this job.
How about you?
[Mr. Harve:] I guess I just needed a job too.
But I ain't doing this kind of work for fun.
And if the doctors and nurses ride me too much,
well, I'll just move on.
[Joe Fuller:] Sometimes I think of moving on myself.
Might not be a bad idea.
[Narrator:] On a job like this,
you learn not to consider yourself judge and jury.
Joe usually takes people as they come.
On the other hand, he doesn't have to like everything he sees.
[Bill holds a music session with a group of men singing "Sweet Adeline."]
[Mr. Harve:] Cut that out!
[Mr. Mack:] Try and make me!
[Mr. Harve is scuffling with a patient.]
[Joe Fuller:] What's your trouble, Mack?
[Mack:] I don't want to sing.
[Joe Fuller:] Okay then, don't sing.
Go ahead, Bill.
[Bill:] All right, men. I've been working on the railroad.
[Choir starts singing "I've been working on the railroad, all the live-long day."]
[Fuller beckons Mr. Harve over]
[Joe Fuller:] Take it easy.
[Mr. Harve:] What that guy needs is a good beating-up.
[Joe Fuller:] Look Frank, that stuff doesn't go around here.
[Mr. Harve:] And I thought you were a right guy.
[Joe Fuller:] I'm okay,
but you can't go around hitting guys.
McGarrick wouldn't hurt anybody.
Besides, he's in here because he's seriously sick.
[Men sing "Dinah won't you blow your horn...someone's in the kitchen with Dinah."]
[Mr. Rusk is holding his pipe, running it through his fingers, while singing continues.]
[Narrator:] Dr. Brand usually confers with the nurse
and the aide after his morning visit with the patients.
[Dr. Brand:] I'm afraid I'm going to have to transfer
some of your men off the ward.
How about some of those who haven't responded to treatment?
[Nurse O'Malley:] Well, doctor, there's old Mr. Noven.
He has had over 50 electric shock treatments
and there's no change at all.
[Dr. Brand:] Well, all right, we'll transfer him.
How about Rusk?
He hasn't improved much.
[Nurse O'Malley:] Well, you were telling me about him this morning,
weren't you, Mr. Fuller?
[Joe Fuller:] No, it was just a little thing.
[Dr. Brand:] Well, tell us anyway, Mr. Fuller.
[Joe Fuller:] Well, I had been trying to get Mr. Rusk to smoke his pipe,
but he's never shown much interest in it.
And the other day I saw him holding it.
Today when I offered him a light, he accepted it.
[Dr. Brand:] Well, let's keep him around a little while longer
and see what develops.
I'm glad you persisted with that pipe, Mr. Fuller.
You know we depend on you for the little things.
They can be mighty important.
That just shows you what you could do with more help around here.
How does that list look now?
[Therapist:] Underhand!
[Narrator:] In mental hospitals nowadays,
exercise is a prescribed activity.
For not only does it keep bodies in good shape,
it involves the patients with each other.
and provides a normal, familiar outlet for feelings.
The leader is usually a trained recreational therapist.
[Therapist:] Strike one!
[Narrator:] Not all of the patients are capable of taking part.
Some of them can't coordinate sufficiently to throw a ball.
Others are unable to maintain interest in anything outside themselves.
But the games bring the men out of the wards and into the sunshine.
There's something relaxing in just the sounds
of people enjoying themselves.
[Ball rolls over to the bench where Mr. Rusk sits with Joe Fuller.]
[Joe Fuller picks up the ball and gives it to Mr. Rusk.]
[Mr. Rusk:] Thank you, Harry.
[Joe Fuller:] Harry?
[Narrator:] Mr. Rusk had talked.
Joe was so surprised and perplexed that he never
knew who won the game that afternoon.
A few days later,
he was attending one of the classes that are part of an aide's training
in the care of the mentally ill.
Dr. Brand was discussing the dynamics of identification.
[Dr. Brand:] Even our rules for living are designed to reach the patient
with what for him is an unbelievable idea:
that he can trust us.
Common sense suggests you begin by always behaving
in a way that makes you his friend, not his enemy.
Even when you think he is incapable of understanding what you're doing.
You can also try to know the patient as a human being.
Liking what is likable about him.
Understanding what is not likable about him.
If we remind him of someone who made him suffer,
he'll mistrust us.
And if we remind him of someone he liked,
he may come around to trust us.
Yes, Mr. Fuller.
[Joe Fuller:] The other day one of my patients,
a Mr. Rusk down in recreational therapy, he fumbled a ball.
And when I picked it up for him,
he thanked me and he called me Harry.
I was wondering who Harry was?
[Dr. Brand:] Does anyone have any ideas?
Mr. Jackson?
[Mr. Jackson:] It's possible that this Harry is someone
that Mr. Rusk had played ball with in his younger days.
[Joe Fuller:] But he's in his 50s.
That would have been a long time ago.
Although maybe he was thinking back on happier times.
Sometimes they do that.
[Dr. Brand:] They do indeed.
You can check with one of the social workers, Mr. Fuller.
Find out if there's a Harry in the family.
But no matter what you find out,
I suggest you spend a little more time with him.
[Social Worker:] Mr. Rusk has a son named Harry.
An only child.
Wait a minute, the boy was killed in action in the Pacific.
[Joe Fuller:] That's it.
[Joe Fuller and Mr. Rusk sit at a table with a checkerboard.]
[Narrator:] Now that Joe knew something about the pain
that Mr. Rusk had been unable to bear,
the patient became a real person for him.
Waiting for still more to emerge would be easier now.
[Joe Fuller:] How about a game, Mr. Rusk?
[Narrator:] For Joe often found it difficult
to live and work among the masks that the
mentally ill use to protect themselves from pressures they can't stand.
They like the formal relationships of card-playing or checkers
because the rules don't change.
Each act does not become a problem involving feelings.
Yet Joe is aware of suppressed feelings.
How else could one explain the fits of odd behavior
that seem to have nothing to do with the game?
[Joe Fuller:] It's your move, Mr. Rusk.
[Narrator:] Feelings that have been pushed down so deep
may take a long time to come
to the surface.
It was taking Mr. Rusk months.
Communicating is apt to be frightening.
It must be tenderly encouraged.
The feelings may give rise to thoughts that are so confused,
they must be reshifted,
straightened out,
reordered,
constantly,
continuously.
There is no time for anything but endless rearranging
in the vain hope of finding a
sequence that's satisfying.
There are many ways to talk without using words.
There are many ways to connect with another human being.
We use our manner.
Our eyes.
Our smile.
Long before we learn to use words.
Joe, like a person working with children,
has come to understand the wordless language.
[Joe reaches over to light Mr. Rusk's pipe.]
Many of his patients never talk, but they will express feeling.
Many of his patients seem not to understand,
yet Joe must find a way of getting them to do
what is necessary for their health and welfare.
Patients can be handled physically without violence.
The kind word, the explanation,
may be understood hours or weeks after it's been given,
for no one knows what such patients hear and remember.
Mr. Rusk took three months to make his first move.
Another three was spent in getting up the courage
to play hard enough to win.
By now Joe doesn't find the games
as one-sided as they used to be.
The miracle of a man coming to life is slow,
but no less wonderful for that reason.
One by one he regains the little skills
by which a human being moves towards relative independence.
It can be a delicate, difficult process.
We can only follow it from the outside.
We learn to notice small changes,
but their why and how remain a secret.
Growth is always wonderful.
[Joe Fuller:] Mr. Rusk, this is our clothes room.
This is where you'll be working, if you like it.
Now this will be your job,
folding trousers.
Just let the legs hang down like that and fold it over on itself.
And each one is marked.
There's a size 34.
Over here, it's all marked off, 32, 34, 36
Now, this would go in there.
Do you think you can do that?
Does that look easy?
[Mr. Rusk:] 34.
[Joe Fuller:] That's right.
[Mr. Rusk proceeds to place the pants on the shelf.]
[Joe Fuller:] That's it.
[Narrator:] It was almost a year before Mr. Rusk
could venture out of his shell.
[Mr. Rusk:] You know when I called you Harry the other day.
[Joe Fuller:] Um hum.
[Mr. Rusk:] You must have thought I was crazy.
Well, I must be crazy or I wouldn't be here.
[Joe Fuller:] You just mistook me for your son, that's all.
I must look like him.
People make mistakes like that at times.
[Mr. Rusk:] Yeah, but I'm crazy.
I can see now you don't look like Harry.
[Joe Fuller:] Well, from what you told me about him,
he must have been a fine fellow.
[Mr. Rusk:] The best!
I can't understand why he had to be...
Nothing much mattered after that.
[Joe offers the lighter to light Mr. Rusk's pipe.]
[Joe Fuller:] The war took a lot of nice guys.
Must have been hard on your wife, too.
[Mr. Rusk nods.]
She's all alone now, isn't she?
[Mr. Rusk:] I guess so.
[Joe Fuller:] She'll certainly be glad to have you home again.
[Mr. Rusk:] Nah, I'm finished.
[Joe Fuller:] What do you mean,
look how you've improved in the last few months.
The doctors will help you get well.
[Mr. Rusk:] Not me.
[Joe Fuller:] Why not?
Look at Jordan.
The one who used to talk so much.
He has ground privileges now.
He can come and go around the grounds as much as he pleases.
And look at Andy Bower.
He's working down on the farm.
[Mr. Rusk:] Yeah, but look at Wilmer.
He's as lonely as ever.
[Joe Fuller:] Well, sometimes I think Wilmer
would rather stay here than go home.
He likes to play the clown too much.
[Wilmer, with a paper bag on his head, bows, and Mr. Rusk laughs.]
[Joe Fuller:] That's the first time I've heard you laugh!
[Mr. Rusk:] Well, feels good to laugh.
I guess I haven't had much to laugh about lately.
[Joe Fuller:] Aw, you're coming along fine, Mr. Rusk.
You're getting better everyday.
[Mr. Rusk:] You really think so, Joe?
[Joe Fuller:] I certainly do.
[Mr. Rusk:] Well, it was good talking to you this way.
[Narrator:] Then Mr. Rusk went back in.
He'd need time to think over, to comprehend, his big step forward.
His wife.
His home.
He'd have to think about them.
[Mr. Harve walks up to Joe Fuller in the locker area.]
[Mr. Harve:] It's 5:30 Joe, going to supper?
[Joe Fuller:] Not just yet Frank, I want to finish this job first.
[Mr. Harve:] I guess they told you, I'm leaving next week.
Got a swell job in a factory downtown.
[Joe Fuller:] Well, some people get all the breaks.
[Mr. Harve:] Well, I think it's about time
I got away from these people.
How about you?
When are you moving on?
[Joe Fuller:] Well...won't be this week.
[Mr. Harve:] Better hurry up.You aren't getting any younger.
[Joe Fuller:] Haha, you're not kidding.
[Mr. Harve:] Well, I'll see you at supper.
[Joe Fuller:] Mr. Rusk, what's the matter?
Here, Mr. Rusk, you dropped this.
Say, I didn't mean what I just said to Frank.
I was only trying to be friendly.
I'm not even thinking of leaving.
[Mr. Rusk stops working and walks away.]
Mr. Rusk?
[Narrator:] Regression is the technical name for Mr. Rusk's medical condition.
For Joe, no technical word could describe the situation.
After a year of patient, careful work, day by day, hour by hour,
he's back at the beginning.
The elaborate bridge over which Rusk has been moving toward health,
the bridge of which Joe himself was part, has come crashing down.
All that day, he worried about Mr. Rusk.
[Nurse O'Malley:] Hello Joe. What's for dinner?
[Joe Fuller:] Huh! Oh, I forget.
[Nurse O'Malley:] You forget! It must have been real good.
By the way, Mr. Rusk seems to have had a relapse.
He hasn't eaten anything all afternoon.
Try and get him to take something.
See you later.
[Narrator:] Try to get him to take something.
Try to pick up the milk you spilled.
Try to remake the statue you dropped.
It was even worse than it had been at the beginning.
Then Mr. Rusk had been angry at the world.
Now Joe felt that the anger was all focused on him.
What's more, he felt he deserved it.
What to do about it?
He could go home and try to forget about Mr. Rusk,
or he could tell Dr. Brand the whole story.
[Joe Fuller:] No, it was my fault all right.
I should have known how he'd react to the idea of my leaving.
[Dr. Brand:] None of us are perfect.
I wouldn't blame myself too much for an accident like this.
Have you been thinking about leaving?
[Joe Fuller:] No! Well, I must admit that I have thought about it off and on.
But you know how it is, doctor,
You get to know some of these patients...
you get to like them,
some of them.
Patients like Mr. Rusk, a few others who get better.
I thought I was in on something real big for awhile,
something where I was doing some good.
Then I messed it all up.
[Dr. Brand:] Don't worry sO'Much, Joe.
This might be the most important thing
that's happened on your job here.
Do me a favor. Forget Mr. Rusk tonight;
take your wife to the movies.
Mr. Rusk will still be here tomorrow when you come on duty.
[Narrator:] Joe hung around the hospital that night
after his shift was over.
Something had happened to him, too.
Something that needed to be thought over, to be talked out.
Kate O'Malley was the kind of girl you could talk to.
Besides, this sort of thing was her profession.
[Joe Fuller:] What did he mean,
the most important thing that ever happened to me?
[Nurse O'Malley:] I don't know...
but when I first started in mental hospital work,
I used to get pretty discouraged when a patient become upset.
I used to feel like giving it all up
and going in for surgery, or pediatrics, or something else.
But now I realize that every serious illness has its ups and downs.
[Joe Fuller:] Mostly downs, it seems to me.
[Nurse O'Malley:] Listen Joe, you have a lot to give these patients.
I probably know more about Rusk's illness than you do,
but you probably know more about Rusk.
[Joe Fuller:] That's what makes me feel so bad about all this.
Rusk was the one I was counting on to come through.
[Nurse O'Malley:] You had a man-to-man relationship
that was the right medicine for him.
You have a knack for doing that.
That's why you were able to help him more.
[Joe Fuller:] I guess I didn't think of it that way.
[Nurse O'Malley:] Someday Rusk will come to realize you're a man
he'll have to give up,
and he'll accept that too.
You deserve a lot of credit for reaching Rusk when the rest of us failed.
It's no easy job.
[Joe Fuller:] No, and it's not a bad one either.
[Nurse O'Malley:] Depends on who's doing it.
[Narrator:] The world of the mentally ill
is not very unlike the world we know.
The things in it may appear distorted to us
because of the special point of view from which they are seen.
What makes the point of view special
is the particular pattern of feelings of a particular person.
Each pattern is different, as each person is different,
depending on what he was and what happened to him.
Joe has come to recognize these differences and live with them.
He has learned to accept surprising or even silly behavior,
as long as it's not destructive.
He has really come to like what is likable.
And to try to understand what is not likable.
He doesn't feel threatened by patients who express their needs directly.
He doesn't feel contempt for grown men
who act with the exuberance of children.
He takes them as they are.
And this acceptance, this liking,
is what Joe can contribute to the process of therapy.
For hospitals like this one are places where sick people
are being helped to recover from serious illness.
Joe is part of a team, headed by a psychiatrist,
that is constantly trying to speed this recovery,
which might otherwise take a lifetime, or might never occur at all.
Along with some psychotherapy and physical therapy,
along with the occupational, recreational, and industrial therapy,
there is also the simple therapy of being treated with respect,
day in and day out, by the one sane person in the ward.
Time and patience.
Joe has them to give.
The bridge is beginning to be rebuilt on an even firmer base.
It may be easier for Mr. Rusk to move over the second time.
But he cannot be pushed.
[Joe Fuller:] It's your move, Mr. Rusk.
[Climactic music playing]
[This picture was made possible through the cooperation
of the professional staff of the Fairfield State Hospital,
Newtown, Connecticut, who played their own roles
as well as those of their patients.
The understanding which they brought to these performances
bespeaks the sympathy and respect that they feel for the mentally ill.]
The End