a crazy quartet – the women on my ward today


she has been looking down her body

below a knobbled knee

and isn’t sure she likes
what’s down there

after a time of study
she decides

down she goes

and wrench
to get it off

eat it

with relish
but no sauce

she studies what she’s left behind
through piggy eyes
that seem set
a little too close

watches the way the red
is swabbed away
without flinching

the toe
now cleaned
is a mis-shape
in white bandages
but she seems
somehow more contented


this is just me
I’m not actually
at all

I work all the time
in the arts
you know


and I do openings

I wouldn’t expect you to know
there’s no room for dull
in the arts

you have to know
how to

ha ha ha

how to

yes I know

and I find you nurses
are offensive

I find the doctors
second rate

I am not
repeat not
at all high maintenance

I require
only a normal amount of time
a normal degree
of due consideration

get me another yoghurt

and do you happen to have a razor
so I can
sharpen the trim
on my pubes


she’s been all right

not too bad you know

the change in just two weeks
is amazing

but she still dishes it up
to her mom

you know
when she was getting sick she went
from wanting to kill herself
to being jesus christ
in just a day or two

it was the weed
I think

and she says she won’t smoke it
but I don’t know

talk is cheap
and anyway you look at it
she’s still got a way to go

I mean
while she was on leave with us
she went out to church
with her gran

which was lovely
but she only went because
she claimed that she
was the special one
and she owed it to the congregation

I think she might
still have a way to go


she went missing
after dark
but we found her at last

behind the persimmon tree
and some scrappy bushes

she said there were men
there was risk
and threat

but when we had a look
there were none

she said she was in danger
that she might die

but we’d locked everything down
there was just us and her
and the something
in her head

but I don’t know
what goes on there

we had to carry her back inside
three of us nurses

a bad moment
in a mad mad day

that’s the way they go
these mad days
that I get caught
in the middle of

© Frank Prem, 2009



over rocky ground

today started with screaming

intellectually disabled girl
telling me
fuck you
a phrase she’s learned
since she got admitted

the guy in the h.d.u.
wanted to see me
wanted to use the phone to call
the federal police

something about
a girl he didn’t know
hadn’t ever met
but she was at risk

he knew in his heart
she was in danger

young man craving smokes
that he couldn’t have today
made a fist at me
tipping into rage until he spat
with each word he spoke
before he burst into crying

prison wasn’t pleasant
he was used
he said
like it was my fault

one time today
there were three of them at me
bearing down and making gestures
I should not survive

cathy rang to say
was I okay
she was worried I might over-react
do something …


then I had a session with my boss
about the job
and about him and her and them
and they and me
and when is it all going to change
and should I stay
or go or

what the fuck

what am I supposed to do
I wonder

I’m not sure
looking for a happy landing

© Frank Prem, 2007

the futility of triple words

Psychiatry 4: Acute Observations

sitting in the dining room
the back corner where he won’t get disturbed
he’s got a book of rules out
dictionary thesaurus and words
a world of words

he does so many pages a day
a genius at the triple-word plays
because he practices moves and combos
knows a little-used term to describe
a master scrabble player
that includes a q tile or maybe a j

he’s scored five hundred
he’s scored five-fifty
he’s scored on every play
in this game of ours
while I’m stuck
looking for a way to turn my tiles in
try to find better letters
maybe find a triple word he hasn’t claimed yet

but then
he really ought to be good for the big scores
he’s got the dictionary open
at eight in the morning and anyway
it’s time for me to make my way to the meds room
to line up anti-psychotics in plastic cups
a thesaurus won’t keep his eyes open
he’ll be sleeping
dreaming about big scores
about jousting in tournaments

about victory

in his room
before a result is declared

© Frank Prem, 2009

teenage girl in the psych ward lock up

hey hon

what you doing
did you work today

they just gave me some fruit
cut up for a snack
and a can of cola

you know we can’t pay
all the rent by thursday
unless you can borrow some money
from your dad

do you think he’ll give it to us

oh well

what are you doing
what are you drinking

jim beam and coke!
well that sounds just fine

I wish I was there
I’ve got a thirst up just talking to you

they’re going to make me see a psychiatrist
a bit later
but they haven’t made me have any meds yet

just some valium when I start to shake
or get jumpy
it’s always the same
after a big drink

don’t forget to call your dad

I’ll talk to you tonight
but I need to have a cigarette now
and go back to bed

goodbye goodbye

don’t forget to call your dad

hey nurse
could I get a light for my ciggy

© Frank Prem, 2009

meandering journey

Psychiatry 4: Acute Observations – Poem 61

this one’s a story
about traveling
and never really knowing
until arrival

only to find
that it’s time again
to keep moving on
in a restless way
that’s littered with small
shining gems of meaning
waiting to be stumbled upon
if your eyes
stay fixed
firmly on the ground

pick a day

pick any shining day
you like
you might choose the one
we just had
why not
it was bright
and the sun rose

there was a woman in my hands this morning
I had to tell her
that she was welcome here
but that there really wasn’t much
I could do

her ills and ails
were beyond my reach and ken
but I would do all that I knew how

she smiled

it took away her pain
for the moment that we shared
and my incompetence
was a thing we could both laugh about

the light of truth
was more palatable
than the darkness
of yesterday

sometimes I think
the only thing there is
that keeps us hanging on
and clinging to the shining thread
is the laughter
that emerges from the night
when we speak honestly

I’m sorry
I’ve meandered
but this is still a traveling poem
and I am moving to another place

today it’s true
I stopped awhile
but it was temporary

© Frank Prem, 2016

Next – Psychiatry 5: Hostel Life -Introduction

This is the final poem in the Psychiatry 4: Acute Observations section.

nursing theory

Psychiatry 4: Acute Observations – Poem 61

well alright
if you really want to know
I’ll tell you the theory
my theory

a few eons ago
they stopped making people like me

I’m a relic from another time

I rubbed shoulders
with madness and eccentricity and violence
and plain nuttiness
for three full years before they licensed me
to be a psychiatric nurse

if they give students two or three weeks
it’s a luxury

back then
they figured that
if we could treat really sick people
in their homes or in the community
they wouldn’t need to come to hospital
we could go to them

fair enough

so what happened
was that all the nurses who had a few runs
on the board
skills and experience
went off to work in the community

well you would
wouldn’t you


except that the result
and you don’t need to be a rocket scientist
for this bit
the result
is that we started getting the sickest people
the ones that couldn’t be managed in the community
coming into the inpatient units

bloody near impossible

at the same time
we stopped training people
in the way they’d created nurses like me


no wonder it’s a bloody struggle
for the poor buggers working in the acute units

no wonder it’s hard to find staff
you can’t blame them for not being interested
in learning on-the-job in psychiatry

no wonder the system is stuffed

I don’t know if there’s a place in the game
for an old fart like me

I’m too cynical
jaded maybe
but that’s my theory
some other bugger might tell you different
but one thing’s sure

it isn’t right

© Frank Prem, 2016

Next – Psychiatry 5: Hostel Life Introduction


alzheimer’s in the twenty-first century

Psychiatry 4: Acute Observations – Poem 58

didn’t christ say

what you do
to the least among you
you might as well be doing to me

I always thought
he was supposed to have said
something like that
I thought it might have meant
something real


I follow things
that politicians say
I listen through the newspapers

they all sound like such god-fearers
every one of them has faith
sometimes they fight about
who’s got the best

it seems a strange thing
to me
a kind of phenomenon


today I read another hard-luck tale
a follow-on
from the one about the mad-woman
they put in detention
then forgot about for a few months

they were going to send her
I believe
to some other lucky country

turned out she was one of us
all along

oh well
I guess sometimes
shit happens that way

but today I read
there’s another
this time they deported her
four years ago
and nobody’s seen her since

god only knows where she is now
or if she might be dead

she was one of ours too
slipped through
a safety net
meant to protect us
from the dirty unwashed
these boat refugees
who might be some kind of terrorists
except that most terrorists
I hear
arrive by aeroplane these days


when I cast my eye
over the headlines
I feel despair
wonder why I’m battling the odds
to make my small shred of difference
when it hardly seems that anyone cares
about what happens to the least of us

making a difference
is no longer a measure
of what sort of people we are
or of who our parents were
before the alzheimer’s of this
terrorising twenty-first century
drew a veil
across our vision of justice
our sense of right


I believe tomorrow
I’ll stay home from work

it’s not that I don’t care
it’s just that
I can’t find the heart
to face it

© Frank Prem, 2016

Next – weary

raising the pride

Psychiatry 4: Acute Observations – Poem 58

today they’re okay
on this day at the start of october
I’m proud

this crew of mine
a random rag-tag of workers
has pulled together
to make it through the shift

it wasn’t without drama
sickness left their numbers down
experience was light on the ground
and there was madness in the air

hallucinated voices insinuating

hooch smoked out of sight of everyone

trouble brewing behind brooding looks

and a young guy rocking non-stop

he’s out the back in the high-dependency
with a head full of trouble
so f____d
that we don’t know what to do
and maybe there’s nothing we can do

I’m not sure what will become of him

but today the shift held up
they worked for each other
for the people they’re here for
and it went okay

I feel proud

© Frank Prem, 2016

Next – alzheimer’s in the twenty-first century

between ridiculous

Psychiatry 4: Acute Observations – Poem 57

it’s a fine line

we’re saving a woman
from killing herself
because her life
is a form of dying

she says if she has to go on
it’s not worth it
she might as well pull out the PICC line
that delivers liquid nutrients
to feed her
and just bleed for a couple of minutes
till it’s over

a very fine line

sometimes it makes sense
to be thinking in terms of
an ending
I can understand that
yes I can

no really
I can
when life is reduced
to never tasting food in your mouth again
never being allowed
to bounce a grandchild on your knees
lest you start bleeding again
and always always having the bloody PICC
to remind that you’re an invalid
I can understand

and the anger too
to have your life destroyed like this
through simple mishap in a routine procedure
in the operating theatre

I know about the anger

it’s just that
before you can decide
it’s not worth it
and that you want
to pull the plug
you have to be sane

and if you’re miserable
because your life seems to be
in a terminal state
of appalling
that’s not sane
it’s a depression we have to treat
before you can do
what you have to do

you can’t be allowed to kill yourself
unless you’re of sound mind

the line doesn’t get any finer


the medication
and the shock treatments
have shaken her memory to the foundations
she’s started making little written notes
just to try to catch up on
the place where she was
before treatment

her husband helps
reminding her of what has gone before

and she may be no better
how can we choose any better
between what’s rational
and what’s mad
even when I might think
that I too would rather die
if I were in the same position

I can’t imagine
never being able to eat real food again
or living the whole of the rest of my life
through an intravenous drip

and in the meantime
the treatment has to go on

I wish she and her husband
would remember that
and not hold us responsible
for shooting her memory
to such very small pieces

or blame us
for not letting them act
on understandings they’ve reached
about what to do
when it becomes intolerable

it’s no good pointing the finger
we’re only trying to help her
to be rational
when deciding

it’s a terribly sublime line


one of the nurses told me
that there was a murder
a double suicide
up in the hills

the details were in the local paper

in the end
sanity prevails

© Frank Prem, 2016

Next – raising the pride