your sister?” I asked, withdrawing my hand and clasping both behind my back.
“Gone,” he said, following the flight of the gull before it disappeared around the bend. He turned his eyes toward mine, and the hopelessness I saw there nearly broke my heart. “She’s been gone for five years now, and alive or dead, I don’t think she’s ever coming back.”
The evening group session I ran in the Hinsdale Building on Tuesdays and Thursdays finished on time, but I had paperwork that I’d been putting off, and by the time I finally put that to rest it was almost 8 P.M. Full dark had settled across the campus, and although the hospital does a pretty good job with exterior lighting, the footprint of the place is still over twelve acres and unavoidably prone to large swaths of shadows. It’s for this reason that I don’t like leaving after dark. It’s not the patients I’m afraid of, although we house more murderers per capita at Menaker than they do at the closest prison, Brockbridge Correctional Facility in Jessup. And, yes, we’ve had our share of attacks—something the visitor brochures about this place will never mention. An experienced nurse was once killed here during the night shift, struck by a large television (this was before the days of flat screens) hurled at her by a patient while her back was turned. She’d fallen forward, the TV’s trajectory matching the arc of her fall, and the second impact had crushed her skull between the old Sony and the tiled floor. There are inherent dangers in working with people—many of them with a history of violence—whose self-control is tenuous at best.
But no, it’s not the patients I’m afraid of, but rather the dark itself that I find menacing. It’s been that way for as long as I can remember, and I can’t help but think that it has something to do with him, the way his mind turned the final corner that night when I was eight years old, the way I had to go looking for him, terrified that I was already too late.
The wide brick walkway from the physician offices to the front gate was well lit, but I could hear the April night breeze pushing past the oaks on either side, making their newly budding limbs shift and sway as if finally awakening from a long sleep and realizing they had someplace better to go. I could hear the trees whisper to one another, spiteful old men with malevolence in their hearts, the shadowy expanse of the grounds providing complicit cover for their furtive movements. A finger of one of the branches dipped down to graze my shoulder as I passed, catching on the slick fabric of my windbreaker, and for a moment I felt that it did not want to let go.
“Out for a walk, Lise?” Tony Perkins called out to me from the watchman’s booth near the gate, and the sound of his voice made me jump.
“Goin’ home, Tony,” I replied, but he held up a hand for me to stop a second.
“Let me get someone to escort you. Make sure you get there safe.”
I live in an apartment less than a quarter mile from the hospital, which enables me to commute by foot in all but the most inclement weather. Security here doesn’t like me to walk home at night unattended, and they often have someone accompany me on the trek if I’m leaving after dark. It’s sweet of them and reminds me how Menaker, for all its notoriety, can sometimes feel more like a close-knit community than a hospital for the criminally insane.
Tony spoke into his radio, listened to the response. “Matt will take you,” he advised me.
I only had to wait a minute.
“Headin’ home late, Dr. Shields?” Matt Kavinson emerged from a side path, flashlight in hand.
“Working hard, Matt,” I answered.
“You always do. You mind a little company on your walk?” he asked, and I smiled, telling him I was glad to have it.
We bid Tony a good night and left the front gate behind us, the stern silhouette of the hospital lifting its head into the night sky to watch as we descended the hill. The wind picked up and buffeted us from behind, making me wish I’d selected a heavier jacket this morning. It’s hard to know in April, as the cold gray tomb of March slams shut for another year and the hot, oppressively humid days of summer begin to rise like swarms of locusts from the Maryland marshes.
“How was your day, Dr. Shields?” Matt asked as we rounded the last corner and my apartment complex came into view. He was good company—quiet and unobtrusive—but there were times when you could almost forget he was standing beside you.
The image of Jason Edwards rose in my mind, those dark eyes looking out over the water below us, our mutual gaze following the gull as it disappeared around the bluff. Gone, I could hear him say … for five years now …
“One of my patients …” I replied, hesitating, as I stopped now at the entrance to my building. What more could I share? Confidentiality prevented me from discussing such things. It’s what makes psychiatry such a lonely profession.
Matt waited for me to go on. He turned slightly away, regarding the hedges hunkered like sentries along the front of the building. “You think you can help him?” he asked, articulating the question in my own mind, and I realized that I wasn’t sure if I could. There was something in the way Jason had looked at me today, his expression hopeless, his face defeated from the very beginning—as if I had already failed him, as if everything I had to offer was on the table, and in a cursory glance he could see there was nothing there to save him.
“I don’t know,” I answered honestly, wishing I felt more confident in my abilities. I certainly wanted to help him, but wanting and doing are two roads that may never merge. A gust of wind snatched at the words as they left my mouth, carrying them off into the night.
Matt was quiet for a moment. He clicked off the flashlight, now unnecessary as we stood beneath the glow of the streetlamps. “You’ll do what you can,” he said. “He believes in you.”
I looked at him, wondering whether there was any truth to what he’d said, and found it unlikely that he could know such a thing. “Does he?”
Matt nodded, his face a little sad, but he made an effort to smile nonetheless. “Of course,” he responded, turning to go. “You’re all he has left.”
I lay awake that night thinking about Jason. Matt’s words—He believes in you … You’re all he has left—had struck a chord with me, and I kept mulling them over in my mind. It was an odd thing for him to say. His role at the hospital would not grant him access to the background information of our patients. And yet, human relationships trump legal and professional boundaries all the time. If he was dating a nurse who’d been there during Jason’s intake, or even knew someone who worked at Jason’s prior institution, there was a possibility that Matt knew more than I did about my own patient. That bothered me, but his words weighed on me for another reason as well. It’s the nature of psychiatry—the role we’ve chosen to play. So often we are the only tangible thing anchoring our patients to their delicate perch above the abyss. It keeps me awake at night, contemplating that relationship, and when I close my eyes in the dark, edging carefully toward the elusive precipice of sleep, I can sometimes feel them slipping from my grasp—all of them. I startle awake, reaching out for a better hold, but find myself alone in the room with nothing but black and empty space above me.
I hadn’t commented on it today during our session, but it turns out that Jason and I grew up in
