take over for him and he doesn’t have to ask me.
“How would you like to proceed?” I’m not letting him off that easy.
“I think you should take him. I don’t have this kind of time to waste on someone who doesn’t talk, doesn’t want to be helped.” He is crossing his arms and shaking his head in fast, erratic twitches that make him look like a frightened woodland creature.
“I can’t make that call. You’re going to have to speak with Rachel.”
“Oh, come on, Sam, can’t you just take this one for me?”
“I’ve already taken Shawn for you.” I sigh. “But if Rachel signs off on it, I will take him. Until then, he’s yours.” I close my notebook for effect and open my door, allowing Gary to go find Rachel and deal with this.
We have a 9:00 a.m. staff meeting most mornings to discuss our patients and any administrative nonsense that needs to be addressed. Everyone usually drags ass in the meeting except for me and my boss, Rachel.
Rachel is a linebacker. She is a formidable presence, and her booming voice and sharp intellect scare the shit out of everyone. She was born to run an institution, and her lack of a private life really helps her excel at her job. Her stringy, mousy brown hair is pulled back with a velvet scrunchie and she is always wearing a sweater set and chinos that are too tight in the hips and it makes the slash pockets stick out like little ears.
Rachel likes me because she needs to believe that I really am always energetic and positive and a barrel of sunshine. Whenever I am out on the unit, I am a superhero. I am a troubleshooter, and a problem solver, and the go-to gal to get stuff done. My coworkers hate this about me. Until I cover their groups, or take their patients to the ER, or finish their case reviews/progress reports/treatment plans; then they love this about me. I make self-deprecating jokes as a defense mechanism. I always ask people about their weekend and how they’re doing because people are narcissistic and won’t ask me how I’m doing in response. This way I don’t have to lie to anyone.
“Frankie’s back in the hospital.” Shirley begins her report. “Apparently he was standing in the middle of the street trying to direct traffic. This was an intersection on Broadway, and it’s amazing that he isn’t dead. Supposedly, when the police tried to stop him and arrest him or whatever, he started running away from them, bouncing off of cars, running in between them… It was a mess. Eventually they tackled him, I’m not sure, and they brought him to the psych unit at Columbia University Medical Center. He is on suicide watch right now, and I keep getting calls from the docs telling me that he’s not cooperating. I’m not sure what I’m supposed to do about this.” Shirley is both disengaged and disenchanted and ran out of empathy years ago.
“You go to CUMC, Shirley,” Rachel responds, irritable, frustrated, possibly menopausal. “You talk to the doctors. You make sure they know you’re the point person in his continuing care. Eventually, Frankie is going to be coming back here for inpatient services once he is cleared to go, and he needs to be aware that he wasn’t abandoned in the psych unit at CUMC.
“Remember, all of you.” She is looking at us like bad kids who ate all the cookies. “We are the only resource for many of our patients here. We are their mothers and fathers, their caretakers and confidants…”
I didn’t sign up to work on this unit to be anyone’s mother or father and I resent her for saying this as she drones on with the lecture she has delivered so many times. I sip my coffee and stare out the only window in the conference room. There is construction going on across the street; I can hear it a little bit, but mostly I just watch the men in jeans and reflective vests glide up and down this building as they work the planks and rods of the scaffold, and I wonder what would happen if someone jumped off.
“In other news,” Rachel continues, “I’m announcing a caseload change this morning, as well. Gary has been working hard to reach our newest patient, Richard McHugh, but unfortunately, he hasn’t gotten anywhere. I met with Richard yesterday to discuss a change in his counselor, and he asked for you, Sam, by name. So, tag—you’re it. Good luck.” Rachel told me about this before the end of my shift yesterday, so this is nothing more than a performance for the rest of the staff.
Rachel pulls me aside and thanks me for playing along. I rejoice in being her golden girl, and whenever she has faith in me, it helps me to have faith in myself. She reminds me again that Richard specifically said he wanted to work with me, Samantha James.
Julie is waiting for me outside the conference-room doors. “No wonder Gary couldn’t handle that guy, I’m sure you’re going to do a much better job. I can’t believe Rachel even wasted our time assigning him to someone so incompetent.” Julie, always looking for someone to tell her she isn’t incompetent. She is huddling next to me like we’re girlfriends of twenty years, holding my arm and whispering her hot-coffee whisper into my hair.
“I just think it’s stupid to have these meetings at the ass crack of dawn when everyone is still hungover and can’t even read yet,” I say, trying to lose her.
“You’re hungover?”
“It’s a figure of speech, Julie. I am not literally hungover.” Lies. Lies. Lies. I would be much better off wrapped around a toilet right now, but Julie will offer me no solace.
“Oh—I know—I guess I just thought maybe you went out last night again. When are we going to go out together? Are you doing anything tonight?”
Julie likes me and wants to be my friend, but I find it impossible to like her. As much as I appreciate her for being an idiot who can’t get over high school, I still can’t tolerate listening to her inane musings and cotton-candy problems with her debutante friends and country-club life. David walks past us and gives me a knowing smile and chuckle.
“I never make plans this early in the day. I will let you know, though; we should definitely grab a drink sometime.” I smile broadly and disengage from her grasp as we are getting close to my office. I juggle my coffee and my case files to try to get the keys out of my pocket when I see that my door was left open anyway.
Nothing is amiss. I must have just left it unlocked. Maybe I’m still drunk. My iPod is still sitting tangled in the headphones on top of a stack of books on my desk. That wouldn’t be there if anyone had come into my office. My sneakers are in the corner where I leave them every morning. A couple of months ago, Shirley left her door open during one of her group sessions and the batteries got stolen out of all her electronics.
My initial meeting with Richard is already happening today, and I have been fixing my desk and my hair and my face and my office for the past hour to prepare for it. I am afraid of him, and I haven’t had this feeling since I started on my first psych unit nearly fifteen years ago. I was barely twenty-two. I never feel like this anymore. I’ve sat across from lunatics and psychopaths, diplomats and dignitaries; it’s all the same to me now. I haven’t been scared like this in ages.
My office is configured the way it’s supposed to be, with the desk chair closer to the front door than the patient’s chair. This is done just in case the patient gets violent and the therapist needs to escape, but we say it’s done so the clinician can obtain emergency services more quickly should the patient need
