A few minutes after I arrived at work yesterday a coworker informed me that a recent graduate of ours had just overdosed and died. I was strangely unresponsive, unaffected by the news. A short while later I was called over to another part of the hospital to assist in a “psychiatric crisis.” A boy–thirteen or fourteen years old maybe–was threatening to punch a nurse in the face. The hospital is woefully understaffed on the weekends, and I was the only male in the building. Although all employees are trained to deal with these situations, the hospital culture is such that the males are expected to do the “dirty work” of physical restraint. Still processing the tragic news from earlier in the day, I keyed in to the locked hallway, approached the angry young man, and calmly talked to him. I spent about thirty minutes with this kid, who eventually broke down in tears about being institutionalized and kept from seeing his family. He said he had not seen his little brother and sister in over a year.
When he was settled down, we parted with a fist-tap and I returned to my unit. The nurse informed me that the kids were rowdy and disrespectful in my absence. I called them out to the group room and coldly meted out consequences (some written assignments and snack privileges revoked). Throughout the evening the kids kept asking me if I was alright. “You look mad” one said. I said I was fine. And I really didn’t feel mad. I didn’t feel much of anything, really.
As the kids were getting ready for bed, a girl pulled me aside to have a word with me. She had been passed a note by one of the boys while we lined up to go to the AA Meeting earlier. She wanted to turn it in to me to avoid getting in trouble (she had seen other patients get busted for such things). This girl was close to the young man who had just overdosed. They were from the same town, had gotten high with each other many times. I asked her how she was doing with the whole thing. She said, “It doesn’t seem real.”
The whole evening seemed unreal to me, like I was an android going through preprogrammed motions. I’ve known from the beginning that the “success rate” (however that’s defined) is painfully low in psychological treatment of any kind. Most of the kids that go through our program return to the drug abuse and criminality they’ve known much of their lives. Many end up in detention centers. Some die. The young man who left us, he often said, “I’m scared of going back out there and dying.” He had a two-month old son. The lasting image I have of him is the big smile he had on his face when I asked him how his visitation with his little boy went. “It was great.” he said.
I’d like to believe he was sincere about his treatment, and that he left us with the intention of trying a different way to live. He left the treatment center before he was ready, due to a lack of insurance coverage. This hurts. Today we’re sending another boy home for the same reason.
Whatever happened, happened. Whatever will happen, will happen. This afternoon, I’ll clock in again and do my thing. It all seems so unreal.
