I sit down for a minute, shaky, talking nervously, trying to make light of the whole scene, and the next thing I know one of the medical ER doctors has run over to check me out. It’s a good friend of Lucy’s, another lesbian with a down-home drawl I feel a special connection to, and I’m glad she’s on duty tonight. She helps me feel I’m in capable, caring hands as she masterfully palpates the cheekbones under my eyes to feel for a fracture, and recommends I get a skull X-ray just to be sure. I sit in the radiology suite like a patient, with a rubber glove filled with ice pressed against the bruise beginning to form on my cheek, and I try not to cry.
When the buzz has died down in CPEP, and my facial series has been cleared by the radiologist, I lie low in the nurses’ station, not willing to go home and abandon my shift, but also not fully willing to reengage with the patients or the paperwork.
Later Rocky comes by to tell me that Mr. Brown has been arrested and taken to the thirteenth precinct. He makes a point of relating to me the opening sentence on the arrest paperwork. Rocky has quoted him word for word, “I wanted to hit the doctor. I hope I got her good.”
I imagine it will be hard to plead innocent with a statement like that. When I speak to the assistant district attorney later in the week, I learn that the man has over twenty “priors.” They don’t even need me to come down to testify. I fax over some short forms and the deed is done. He will spend the next four months at Rikers.
Jeremy figures that this guy needed to be off the streets so badly, if he couldn’t be admitted to the hospital, he’d do his time in jail instead. Otherwise, why be so bold about punching me, setting me up with his quiet voice, confessing to it immediately? Or is it just that he is a bad guy? Maybe he’s simply a violent man who doesn’t care what the consequences are, he just wanted to “get me good.”
What I can’t stop wondering is, Did he get me good enough? Might he come looking for me when he gets out of Rikers to get me again?
Save Me
On Monday, I play a little game with Mary to see if she can see the bruise on my face. “Notice anything different about me?”
“Did you get your hair cut?” she asks, confused.
“Not exactly. Look at my cheek.”
“Ooh, how’d you get that?” she asks, getting up off her chair to examine my bruise.
“Funny story,” I begin, but of course, just hearing myself try to make a joke of it, I begin to cry. I cover my face with my hands to hide the ugly grimaces that typically accompany my tears.
“What happened?” she asks, so caring and concerned, so loving and open and able. She is standing right in front of me, not quite sitting back down in her chair, although I imagine she wishes she’d never gotten up.
Part of me wants her to hold me, and to comfort me. The more grown-up part, the psychiatrist in me, knows that this would be inappropriate, and that I need to soldier on, to talk about it so we can do our work.
“I got punched in the face by a patient.”
She sits down in her chair and waits. She’s not going to say a word until I completely unload. I could never be this patient with a patient. She has so much to teach me about being a good therapist. I need to remember to wait while I listen.
“I called him on his shit and he punched me. He whispered real quiet so I had to lean in to hear him and then he popped me, hard, right in my face. Have you ever been punched?” I ask, rhetorically. No self-respecting shrink would answer that, I imagine. “No, I haven’t,” she answers calmly.
“I hadn’t either. It’s really interesting, the physics of it. It’s like a cartoon caption. You know, the ones that say BLAM! There’s a big white jagged disc that accompanies the fist, that spins off of the impact. The energy of a fist and a face, when they collide, it creates a separate thing. It’s got heat. It vibrates. It actually pushed me backwards.”
“I think maybe you need to get beyond the interesting physics of the collision here, Julie. Can you tell me why this happened?” Mary makes it clear that I’m wasting valuable time.
“He was a malingerer. He was lying about his address and I caught him on it. I confronted him, told him I thought he was lying, and he punched me.”
“Is there more?” she asks simply.
“I’m sure he thought I was being a smug asshole.”
“And you think?”
“That he was probably right. I couldn’t wait to call him on it. Jeremy says it was emasculating. And that is obviously not therapeutic. He says I’m not helping these patients. Whatever is going on with them, whether they’re lying or telling the truth, the bottom line is they’re coming to me as a physician for assistance and then leaving empty-handed. I’m leaving them hanging. Dissatisfied. Only worse than that. They’re insulted.”
“It’s probably humiliating enough for them to be in the position of approaching the Bellevue psych ER asking for assistance. You don’t need to add to their shame.”
“So why did I do that? I think I get caught up in the cat and mouse of it. I get excited that I’ve figured out their game. I’m on to them and I want them to know they’re not getting anything past me. But that’s not what it should be about, right?”
“Right.”
While I’m talking, I’m also reviewing: First she hears about the razor man, then the transfer from Columbia. Last week I told her about the letter from Philly. This week I tell her about getting punched in the face. She must be feeling she’s got her work cut out for her. I hate that, feeling like a problem patient. Maybe she can’t fix me? Or worse, it’s too hard and she can’t be bothered.
“And then, the morning after I got punched, I came home and couldn’t leave the apartment again. I was feeling really twitchy. I couldn’t do my errands, but I also couldn’t nap. I couldn’t stop my brain. I finally left the house in the evening to meet Jeremy for a movie. When I went down the subway stairs, I kept flinching if anyone got too close to me. I had an increased startle response just like post-traumatic patients do. And then, during the movie, I couldn’t concentrate on the plot. I just kept seeing his fist coming into my face. The image intruded onto my mind’s eye, and I’d flinch every time.”
“Increased startle response, intrusive recollections. Classic PTSD symptoms,” says Mary.
“Exactly. It was actually fascinating for me to experience them, and to know that this is what patients really do go through after a trauma. I feel like I’ll be better able to warn people about potential symptoms after an assault having gone through it.”
“Great, Julie,” she groans. “Can we get to work here?”
“Yeah, I know. My behavior is totally humiliating and emasculating, which is therefore provocative and confrontational. Okay? I get it.”
“And?” Mary has not heard what she wants just yet.
“I have got to learn to rein myself in.”
“Bingo. You. Yourself. No one is going to do this for you, Julie. You can’t be all gas and no brake.”
As Mary points out, I could’ve gotten hurt much worse than I did. I’m lucky he reined himself in with just one exacting punch. There was a resident at Mount Sinai who was assaulted by a patient and he repeatedly slammed her head against the floor. She was never the same again. I still remember the stunned look in her eyes when I’d talk to her. It lasted for weeks after it happened.
I’m lucky it wasn’t worse.
Run for Your Life
After I get punched in the face, it’s pretty much business as usual for the next few weekends, except for one thing: I have become a bit gun-shy, like a skittish rabbit, quickly scurrying away at the first sign of trouble.
At sign-out I hear about a fifty-seven-year-old homeless man who came in by ambulance, grossly psychotic and disorganized. He’s coming off a seven-year stint in prison for homicide after beating a man to death with his bare hands, instead of using a gun like a civilized criminal. As usual, the Department of Corrections didn’t come up with any sort of game plan for how a man like this, with a psychotic illness and a vi
olent past, is supposed to fend for himself in the outside world upon release. A lot of these prisoners quickly end up at Bellevue where we try to put something together for them—a doctor who can treat them on an ongoing basis and a place to sleep.
I go to find my new patient in the observation room across from the nurses’ station. He has been placed on Hold status during the shift prior to mine, and he needs to be reevaluated for a potential admission. There are several patients in the observation room, all of them sleeping. I approach a patient who is curled up on a stretcher with his back turned to me, and I say, “Excuse me, sir, are you Mr. Taylor or Mr. Richards?”
There is no reply.
“Okay, now, I don’t know if you’re sleeping or just not talking, so I’m just going to take a look at your arm band here.” I slide the sheet off his clothed body to get a look at his right wrist.
He swings around, growls, “Don’t touch me!” and lunges toward me.
As fast as I can, I run out of the room and into the nurses’ station, locking the door behind me. I am quaking.
The nurses medicate him while I read his chart. Probably shoulda done this first. What would’ve been nice to know at sign-out is that the day before, he had required restraints and medication after threatening to beat up the staff and to rape any women in the area. He had also advised a female attending to “Wipe out your pussy.”
If I’d known this ahead of time, his explosion of unpredictable behavior wouldn’t have caught me so off guard. He’s lying in wait with his back to me one minute, awake and silent, and the next he’s pouncing like a tiger. But would I really have gotten all that from reading the chart?
I am now timid, to say the least, about seeing dangerous patients. I appreciate the nurses’ not giving me a hard time about it. I suppose that anyone would’ve backed away in that situation, but running into the nurses’ station and locking the door? I’m not so sure. It feels different now, like the stakes are higher; all of a sudden, pain is a real possibility, so it’s appropriate to be cautious. But I can’t let my fear stand in the way of being their doctor.
Then there is the issue of confronting patients who are lying and need to leave. I need to put into practice what I have been learning in my work with Mary.
Be kind. Be therapeutic. Be understanding. Don’t be a complete bitch.
Even the lying patients are still coming to the hospital because they are in need. Don’t send them away empty-handed.
I probably should’ve been reminded of these simple things earlier in the game. Stay safe, be gentle, deferential even. My tough-guy confrontational thing is so over.
It starts to come as second nature after a while, and as the weeks go by, I comfortably ease into my new role as Florence Nightingale.
And then things start to get weird.
About a month after the assault, and for the next several weekends, my pager goes off in the middle of the night. This is extremely unusual;
I never get paged. If anyone wants to find me, they call the CPEP. But now, at three or four in the morning, weekend after weekend, I wake to the shrill sound of my beeper. I press the button that backlights the numbers. It is always the same, or nearly the same: a variation on a theme. 69696969. Sometimes only a single 69. Someone is fucking with me.
Turn the Page
The mysterious stalker paging continues for nearly a month. I’m getting used to my beeper having multiple 696969s displayed in its memory. They come only on the weekends when I am at the hospital, usually while I’m sleeping in my office, and never when I’m at home or earlier in the day. It’s as if someone is telling me they know my schedule: when I’m at CPEP, and when I go to bed.
There is something eerie about getting paged like this. It is intimate, intrusive, and taunting. I am frightened, staring into the darkness, alone in my call-room at three in the morning, contemplating horror-movie scenarios. Who the hell is doing this? Am I supposed to think it’s funny? Could they possibly be thinking it’s sexy and I should be turned on or flattered? Is it Jude or Paul or one of the other AES attendings I flirt with?
Or is it someone trying to scare me? Because I am not turned on. I am scared.
I start watching my back as I walk around the hospital. I roam the deserted hallways afraid I will bump into a rapist or a barrage of fists as I round the corners. Remembering the episodes on ER where the attending Mark Green gets beaten up in the bathroom and ends up abusing painkillers, I start using the bathroom in the nurses’ station instead of the more secluded one near my office on the other side of the hall.
I feel especially vulnerable when I park my car in the garage coming to work in the evening. The fluorescent bulbs cast an ocher tint on the concrete and steel, and I run up the flight in the echoing stairwells, afraid to spend more than a moment in the desolate structure. I am relieved as I leave the garage and enter First Avenue, comforted by the sight of the homeless men and drunks that hang out around the front entrance, some of whom I know by name. Rocky’s patrolling the front walk, and I flash him a smile, truly glad to see him.
Fire in the Hole
It’s the usual Thursday morning staff meeting, July 1998, followed by the usual smaller faculty meeting. We’re spending way too much time talking about a proposed crisis residence—temporary housing with significant mental health support services. Anywhere besides a shelter to send a mentally ill person is inherently a good thing, so we all agree that this is needed. What we can’t seem to agree upon is the structure of the research project to prove its worth. If this is going to slow down the creation of a crisis residence, I’m going to need my own mental health support services. The bureaucracy of New York City is slowly driving me insane. At least it’s taking my mind off the stalker situation.
Disgusted, I get up to use the bathroom attached to the conference room, where the water in the bowl is perpetually brown, and I assume my colleagues can hear my every tinkle. A set of alarm bells begins to ring as I sit on the bowl. Three sets of seven blasts repeat at regular intervals. I can hear the doctors outside the door wondering aloud what the code means. All fire alarms at Bellevue are coded; a series of 7, then 1, then 4 (like the old Lemmon 714 Quaalude) signifies a fire in the CPEP. No one knows what 7-7-7 means, but I do.
“INTERNAL/EXTERNAL DISASTER!!!” I have to yell above the sound of the toilet flushing.
I know this because at the interminable staff meeting a half hour earlier, I was reading a poster while the head nurse droned on. The poster, on the wall above the crash cart, deciphers all the bell codes, and specifically mentions this disaster code.
The meeting breaks up as the bells continue to sound, and everyone seems stymied as to what’s going on. I call Jeremy and ask him to turn on the news to find out what disaster has befallen the city, and to page me if he hears anything.
Pam, one of the other attendings, calls the AES to see if they know anything, and is told that they now have twenty-six cases of anthrax in their ER. This is three years before anthrax has become a household word, and I have to look up the treatment in my infectious disease handbook. I immediately dial a pharmacy near Jeremy’s apartment to phone in a prescription for Cipro, enough for both of us, as I scream to the other doctors that anthrax is treatable; it’s a bacteria. Pam counters that she’s pretty sure it is immediately lethal, and there is no treatment. I repeat, in my most sure and doctorly tone, that it is treatable with antibiotics, as I am put on hold at the SoHo pharmacy. I fantasize there will be a run on Cipro as the news breaks, and I need to get through before the other people in the city learn what has happened.
Another doctor, who’s called his wife, says there’s nothing on CNN. “They probably don’t want to start a panic,” I surmise, projecting my inner state onto the network executives. I call Jeremy back and tell him calmly that there are twenty-six cases of anthrax in the ER, and I have called in a prescription for prophylaxis for both of us, and when it is safe to go outside, he should pick up the pills at his corner drugstore.
&
nbsp; “When it’s safe to go outside?” he asks, his voice tremulous. He sounds scared and I wish that he weren’t.
“I’ll call you back when I know more,” I say, as a way of saying good-bye but not leaving him entirely.
Pam and I go to the AES to investigate. As we walk over, I find myself worried that perhaps we shouldn’t be around people with anthrax. “Is it contagious?” I ask.
“I don’t think it’s spread by person-to-person contact,” she answers. This from the gal who says it’s immediately lethal and untreatable, and yet I opt to take her guess as fact. We go through a set of double doors where a hospital policewoman is sitting.
“Is it okay to pass through here?” I ask, thinking the AES may be quarantined.
She shrugs her shoulders in typical infuriating Bellevue fashion—don’t ask me, I just work here. We burst through the doors of the medical ER expecting a scene of chaos and fear: police, reporters, and extra staff pouring in due to the disaster alarms. What we find is a quiet and calm scene, no more people than usual, perhaps even fewer. Everyone is going about their business. In the corner, the Director of the AES is surrounded by people in suits, each one carrying a piece of typewritten paper, its heading: Anthrax Disaster Drill.
I am deflated, angry that no one told us ahead of time about the drill. Who answered the phone and reported twenty-six cases of anthrax to a CPEP doctor? Were they instructed to say this? Don’t they know how easily something like this can go from rumor to fact to widespread panic? I call Jeremy back to tell him it’s a false alarm, but he’s already called his two sisters who live in the city, fearing that they’ve been caught outside when the biological warfare was launched. I apologize strenuously, feeling sheepish, but we decide to get the prescription filled anyway.
If Bellevue is having a drill, we may as well be prepared for the real thing.
Weekends at Bellevue Page 14
