Conflict

I seldom engage in the kind of conflict upon which the angry and aggressive thrive. I listen with absolute astonishment to professional football players talking of "taking out" other players as part of their job. I am equally astounded by the pride with which military leaders talk about "service" which has entailed killing civilians on the other side of the world.

 

I find conflict with the aggressive to be very draining and mostly a waste of time. Many people, especially heterosexual men, are invested in picking fights. This accounts for much of the lack of human progress throughout our history.

 

There are programs in urban ghettos which treat violence as a disease, perhaps an addiction. While I believe people can be habituated to violence in violent environments, I also believe a violent act in most cases is still a choice. I assert this as a psychiatric nurse who spent years working with violent people who were psychologically impaired by genetic illness, such as schizophrenia or bipolar disorder.

 

In 1977, I said "No." to an alcoholic schizophrenic man who was particularly childish and manipulative. He demanded to be allowed to leave a locked psychiatric unit, over which I was in charge. He wanted to go to the street to beg for money for alcohol and cigarettes. This would have led to another arrest and readmission at his state of recovery at the time. He had a long history.

 

I withstood his usual tirade of abusive obscenities, spat into my face from centimeters away. He had a habit of leaning into people to get his way. His lack of personal hygiene and lack of any dental care tended to get him results with this method. I was inured. "No." I persisted. I was twenty-seven and less cautious.

 

My patient kicked my shin with full force with his steel-pointed construction boot, which he had salvaged from the donated clothes closet we had in this impoverished state facility. I collapsed to the floor. I thought my leg was broken. Luckily, some of my staff witnessed this. They took him off to isolation before he could apply the boot to my head.

 

My leg wasn't broken, just sore for weeks. However, I was perhaps the first nurse in the employment of the Commonwealth of Massachusetts to assert my human rights under the law. I pressed charges against the patient. This was not an easy decision. I was harassed by police, psychiatrists and social workers all the way up to the Director of Mental Health Services for the Commonwealth, a stern psychiatrist of Viennese origins, who tried to convince me I had no legal rights as a psychiatric nurse. I was not convinced or dissuaded.

 

My peers were very supportive. They, like myself, were used to being injured by the truly out-of-control. We all knew when an injury was intentionally inflicted, as in this case.

 

The hearing occurred just blocks away at the county courthouse. The patient had been arrested after my criminal complaint and was held in the county jail. I was terrified, since I had to take the witness stand in open court. After all the criticism and shunning by supervisors  I had endured at the hospital since filing the complaint, my confidence in my decision was somewhat eroded.

 

I was sworn in. The judge asked me to describe the incident. He inquired about my injury. The court-appointed defense attorney made a brief declaration that I was, in essence, unprofessional in bringing charges against a patient. There was derisive laughter in the courtroom at one point during his statement.

 

The judge, who was quite well known in the media for his no-nonsense character, looked angry. After the case was presented, he narrowed his eyes in my direction. I felt like I was being x-rayed. Then he looked at the patient, who had been cleaned up and was playing the cutesy, imbecilic darling. The judge made a brief statement that no professional person sacrifices his civil rights when performing his duty correctly. His statement had a shaming effect on some who had been snickering at the defense attorney's subtle defamation of my character.

 

The patient plead guilty with the qualification that he did not know what he was doing. The judge accepted the guilty plea and sentenced the patient to six months in a high-security facility for the criminally insane. In his sentencing remarks, the judge looked at me and said he could imagine what pressure I had encountered against my asserting my civil rights. He commended me for using the legal system in this case.

 

Over the subsequent decades, I have had my share of challenging situations, in which I have been aggressively approached in and out of mental hospitals. This is part of urban life, especially as an openly gay man. Part of my practice is to avoid conflict. If avoidance is not possible, I seek to neutralize it. If neutralizing it is not possible, then I will engage to the extent that my person and human rights are defended.

 

I have found that being intentionally peaceful (not aggressive or competitive) has very much reduced the incidents of aggression in my life. I do not participate in situations which are prone to bring out human aggression. If confronted with aggression, I always look to the higher issue involved. Most people who are aggressive are also needy in some fundamental way. I ask myself, "What is the need behind the aggression?" Most importantly, I do not engage in aggression by countering it with more aggression, unless physically threatened. Being patient and addressing the aggressive behavior later through legal or institutional channels is a more effective way of avoiding damaging conflict.