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BOOK REVIEW: 'INS AND OUTS OF A LOCKED WARD. MY 30 YEARS AS A PSYCHIATRIC NURSE'

Book review: Kevin O'Hara's newest book 'Ins and Outs of a Locked Ward' is edgier than his usual tales, but still filled with heart

Pittsfield-based author Kevin O’Hara is known through his books and decades of Berkshire Eagle columns for his warm, witty and whimsical tales. There are plenty of all three in his newly released book, but the title, “Ins and Outs of a Locked Ward: My 30 Years as a Psychiatric Nurse” tells readers that they are on much different turf than usual.

Book cover

The locked ward of the title is Jones 3 at Berkshire Medical Center, a mysterious place of local myth and legend. O’Hara lets us in to visit the colorful collection of patients living with mental illness, some destined to regain their place in society, however tenuous, and some not.

The parallels to the book and movie “One Flew Over The Cuckoo’s Nest” are apparent, as are to a lesser extent, the parallels to the movie and TV series “M*A*S*H.” The distinction comes from the presence of the narrator, who portrays himself as an idealist with feet of clay, his good intentions regularly clashing with harsh reality.

O’Hara relates his origin story for becoming a nurse, which is in part because of his mother’s career as a nurse in Ireland, and also a desire to “do penance” for not what he did while serving in the Vietnam War but for what he witnessed there. His nursing philosophy, specifically in Jones 3, would be based on, of all things, the donkey, Missy, who accompanied O’Hara on his trip around Ireland chronicled in his book “Last of the Donkey Pilgrims: A Man’s Journey Through Ireland.” Noting that gentle donkeys are often penned with high-strung thoroughbred horses to calm them down, O’Hara decided he would be a calming, humorous influence on his similarly high-strung charges.

While O’Hara as the weekend charge nurse on Jones 3 saw himself as the Donkey Nurse, the common nicknames for him seemed to be Bearded Nurse, Nurse-Lite and Kevlar, for his ability to escape trouble, sometimes of his own making. The latter proved ironic when a large, angry, probably steroid-addled patient newly arrived in the locked ward body-slammed the slightly built O’Hara to the floor with a thud that could be heard on Jones 2.

This incident provides the structure of the book, as the chapters are labeled after the days of the long week O’Hara spent at BMC recovering from a fractured pelvis, broken ribs and internal bleeding. At about the same time O’Hara was injured, a burly, red-haired biker crashed his Harley head-on into a tree in Pittsfield in an apparent suicide attempt. Left instead with debilitating injuries, Ollie, aka Fat Boy after his Harley, became O’Hara’s hospital roommate and companion on an imaginary bus trip to Ollie’s former home town of Yuma, Arizona.

It is within this format that O’Hara tells his stories of both the ward and the larger hospital to readers as well as Ollie. He meets his future wife Belita, a medical technology student from the Philippines. Called on to help treat a burn patient, O’Hara delivers a harrowing tale with an unexpected denouement. The sprightly Holly (patient names are changed because of HIPAA regulations) brings joy to a depressive patient in a real-life O. Henry story. O’Hara accidentally switches the pills between two elderly patients and sweats the outcome with medical allies.

“I’ve been known to live and die by the tongue,” writes O’Hara, and offers examples. And he notes poignantly, so many of his patients “had wrung my heart like a sponge.”

We also meet many selfless nurses and kind doctors, all referred to by their real names. There are exceptions, O’Hara’s Nurse Hatchet — a reference to the cruel Nurse Ratchet of “Cuckoo’s Nest” — is a composite figure of the nursing supervisors who didn’t care for O’Hara’s Donkey Nurse strategy and reliance, along with his colleagues, upon foxhole humor to deal with the stress of the job.

Many of O’Hara’s long-time readers may be taken aback by this far edgier book with its mordant humor and occasional raunchiness (there is a sexcapade that is a familiar tale and doesn’t quite jibe with the other stories). But this book about largely unseen people, troubled but human nonetheless, written by an accomplished storyteller, should attract some new readers for O’Hara as well.

Bill Everhart reviews books for The Eagle.

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