I met Justin when he was 6 years old, in 1995. He was in the Pediatric Intensive Care Unit (PICU). I had been invited by the PICU staff to come and, using that-psychiatric voodoo-that-you-do-so-well, try to stop him from throwing feces and food at the staff. The PICU was almost always full and was typically busy 24/7. Nurses, physicians, aides and families crowded the unit. The noise from medical machines, phones, and conversations kept the large room filled with a non-stop buzz. There were always lights on, people were always moving around and, although each individual moved with purpose and each conversation was focused, the overall effect was chaos.
I walked unnoticed through the din to the nurses' station and studied the board to find the boy I'd been asked to see. Then, I heard him. A loud, odd shriek made me turn immediately to find a bony little child in a loose diaper sitting in a cage. Justin's crib had iron bars and a plywood panel wired to the top of it. It looked like a dog cage, which I was about to discover was terribly ironic. The little boy rocked back and forth, whimpering a primitive self-soothing lullaby.