61 pages • 2 hours read
Teddy isn’t sure how to talk to Mia after what happened. He is angry that she didn’t talk to him about everything sooner, but Bernard—Teddy’s best friend—assures him that she might have not known how to. Bernard reveals that he might have to move back in with his mom soon since she needs his “check” to help pay for her own medicine (157). Teddy doesn’t want Bernard to leave and knows that Bernard’s mom’s house isn’t wheelchair accessible, since he lives on the third floor. They fantasize about living as roommates in the future.
Ricky takes a small, shy patient—Cleo—to the time out room because she isn’t participating enough in P.E. class. Ricky is outraged at the substitute teacher but can’t do anything. On the way to the room, he reminisces about his time working as an unloader, a physical but fun job. Once he reaches the room, he places Cleo in there, and after making her comfortable, he accidentally falls asleep for 10 minutes. When he wakes up, she has drawn in purple marker all over herself, “even her teeth” (163). He feels bad and has been feeling worse because of how often he has to take kids to the time out room. He confesses his anger and shame to Joanne, but she assures him it’s not his fault and that he should consider finding a new job. He doesn’t want to because he fears they’ll hire another “gorilla” like Jerry, and he would feel responsible. He tenderly considers Joanne’s situation in her wheelchair, and he imagines bringing donuts the next day to the patients.
A patient dies at Riverwood, another Whitney-Palm owned “institution for mental diseases” in Illinois. Michelle recounts how the patient was tied to a wheelchair, even though she could walk and how it was “weird” but common to tie up patients who have strong meds. Michelle admits that the situation isn’t uncommon and that the employees most likely didn’t care about the patient: “I guess they thought she was sleeping. I don’t know what they thought. Honestly? I wouldn’t say this out loud but I don’t think they cared” (166).
In a corporate meeting, Tim tells Michelle that she should consider adding more beds to ILLC to increase revenue. She doesn’t think an extra bed will fit the rooms, but Tim insists that she can think creatively and calls her a “good girl” when she agrees. When the meeting ends, Tim shares another incident at a facility in which a boy was raped and then hung himself. Michelle believes her company should pay a fine for this but is afraid to tell Tim. After his talk, Michelle approaches Tim and informs him about Joanne’s question regarding patient outcomes. He says he will personally look into it, but Michelle isn’t convinced.
Cheri—Yessie’s roommate—has moved. Cheri was having issues and feeling uncomfortable at ILLC, so she attempted to run away and was caught twice. Yessie thinks they have taken her to the “nuthouse” and fears for her friend. She observes the emptiness of the room and feels alone, then looks at the photo Joanne gave her of the young crippled man at the protest. The photo inspires her to feel better.
Jimmie is feeling bad about what happened to Mia. Jimmie helped her shower and brought up her vaginal smell out of concern, but never took the responsibility of following up on it and feels guilty for knowing that Mia was being sexually abused during that time. She visits Joanne’s house to decompress, and they talk about how the system is flawed and that what happened to Mia wasn’t an isolated incident, but the outcome of institutional misbehaviors. Jimmie isn’t sure how she can help and is deeply concerned for the safety and wellbeing of Yessenia, but Joanne assures her that Yessenia is capable of taking care of herself. Joanne’s support comforts Jimmie, and she decides she will talk to Yessenia.
Teddy’s voice shows how he is merely a young adult trying to understand his world. Like many young adults, he is bracing himself for independence and is unsure about his future and about how to handle the emotional complexities between him and Mia. He functions as a symbol for the innocence and ordinary adolescence of youth. Even though he is viewed as a troublemaker, he is caring and looks out for his friend, showing that there is more to his character than surface characteristics suggest: “Bernard, when I get my own place, you gotta move in with me” (159). Teddy’s sense of caring and looking out for others is overshadowed by the fact that he is a disabled youth who is labeled as problematic. He isn’t the only person who is struggling to cope with his situation at ILLC. Ricky, a supposedly mature adult, also struggles with his place and relationships there.
Ricky’s internalized guilt begins to overwhelm him. He clearly has a soft spot for the patients and wants them to be happy and well-cared for, but instead, they are tossed into “stinky” boxes instead of being allowed to enjoy themselves, and he feels angry and helpless:
Here’s a kid, she’s not doing a damn thing, so what do they want? They want to stick the kid, by herself, into a stinky room, size of a doughnut hole. Kid is either—either doing too much of something or too little of something. Fuck you, Mrs. Velasquez (160).
His character’s sense of supporting disabled people of all backgrounds is sincere, and Joanne’s influence on him is helping him grow more aware and capable of making small changes for those around him.
Joanne’s influence has also started to impact Michelle, as she becomes more conscious of the devious occurrences at various IMDs. She reflects on various things she sees at her job, including political visits: “[T]he company donated $765,000 last year to politicians. […] Whitney-Palm must give money to their campaigns so the politicians won’t do anything that would be bad for companies that run nursing homes and IMDs” (168). Though she hasn’t outright mentioned her reservations to Tim, she is starting to question her company’s actions more, while sharing her personal doubts and concerns. The recent neglect and deaths of multiple patients may have stirred her more into awareness about how things need to improve. Her mention of Joanne’s concern suggests that Joanne, once her foil, has had a positive influence on her.
In a keystone moment, Yessenia looks at the photo Joanne gave her of the crippled young man at a protest, and she feels empowered. The lack of care and respect she receives—highlighted by how she wasn’t able to say bye to her best friend—amplifies her frustration and desire for independence. Meanwhile, Jimmie is feeling shameful about not being able to help Mia sooner, and she knows Yessenia is in an extremely vulnerable position; Jimmie wants to help them both. The idea of the “institution” or “system” is made literal during a conversation with Joanne, and Jimmie wonders what her place is within it. The bigger picture of how not just individuals like Mia or Yessie—but many people—are affected by the flawed nature of privatized healthcare begins to take shape: “what happened to Mia is not, like, an isolated incident. It happens in a lot of, or Joanne said all, institutions. Her idea is it’s the System” (178). The exploitation of disabled people is intentional, systemic, and targeted; since it yields profit for others, no one steps up to defend the disabled community, making them ideal victims for these social crimes.
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