by Ava Conway
“I wouldn’t drink that if I were you.”
I jumped at the low baritone voice and spilled hot coffee over my hand. Cursing under my breath, I put down the cup and grabbed a small stack of napkins.
“Sorry. I didn’t mean to frighten you.”
I finished cleaning up and turned to face the large orderly next to me. Mischievous hazel eyes stared at me with interest from beneath a crop of dirty-blond hair. The man looked more brawn than brains, especially in his formfitting white uniform, and his features were so open and innocent that it made me feel like an old hag. His lopsided smile was infectious and made him stand out from the sea of sad faces. He was so friendly, so damn happy, that it made me wonder what he was doing here. Probably crowd control.
“Why shouldn’t I drink the coffee?”
“It’s decaf.” He wrinkled his nose. “And it tastes like it came from a sewer.” Before I could grab my cup, he dumped it into the trash. “There’s much better stuff downstairs in the visitors’ area.” He considered me for a moment. “Although if you wanted the strong stuff, I’d go over to the outpatient building. That stuff works better than those energy drinks.”
With the words “energy drinks,” an image of the handsome thug from the hall flashed through my mind. That gaze was enough to bring a woman to her knees. In fact, just thinking about that hungry look in his eyes made me feel too weak to stand.
“Are you okay?” he asked.
“Yes. Why?”
He shrugged. “I don’t know. You looked a little distracted.”
“I’m not distracted.” That was a lie, but I wasn’t about to let the handsome stranger get to me. I had a purpose, and that purpose did not involve ogling the very people I was here to help. Frustrated, I rubbed my hand until my skin turned bright pink and tossed the napkins into the garbage. It was then that I noticed the coffee spots on my sleeve. “Damn it.” I glanced down at my chest and found matching stains on my lapel and camisole. Lovely.
“Sorry,” he said as I inspected the spots on my jacket. There went my five-hundred-dollar suit, painstakingly chosen to create a lasting impression. Now instead of projecting the image of a young professional who had her act together, I looked like a Rorschach test. Patients were going to try to pick out pictures in my coffee stains.
“No, it’s fine.” It really wasn’t, but I didn’t want to create waves on my first day. Maybe I could run to the ladies’ room and take out the worst of the stains before group therapy began.
“I’m Elias, by the way.” He held out his hand. “I’m one of the orderlies here at Newton Heights. Dr. Polanski asked me to speak with you before the therapy session so you could feel more comfortable.”
Just my luck. Thanks to this gorilla of a man, I wasn’t going to get a chance to clean up.
I adjusted my glasses and took Elias’s hand. It engulfed mine, and made me feel small and insignificant. “I’m Mia.”
“Mia, nice name.” He tilted his head to the side and studied my face for a moment. “You look familiar.”
I removed my hand from his grasp. “Yes, well, I used to visit my friend here. Lucy.”
“Ah,” he said, straightening. “I know Lucy well. She was very bright and seemed to have a lot of potential. How’s she doing?”
“Fine,” I snapped, irritated that he didn’t seem to care that he had just put a bazillion coffee stains on my designer suit. “The receptionist said that you had my first assignment?”
“It isn’t much.” He flashed me an apologetic grin. “I’m supposed to answer any questions you have about this place. I’ve been working here for about two years and know everyone here.” He grinned. “Patient relations are my specialty.”
“Specialty?”
“Well . . .” He shoved his hands into his pockets. “It isn’t an official title or anything. I just think it’s important to establish relationships with the patients here and gain their trust. That way, if any of them run into problems, you’ll be one of the first people they turn to for help, instead of falling into old patterns and destructive behavior.”
“But we aren’t here to be their friends. We’re here to help them.” Nothing in any of my textbooks said to become their friend. In fact, it was quite the opposite. One of my professors last year went on and on about the dangers of psychiatrists becoming too emotionally involved with their patients. “Emotional distance is critical for people like us.”
He considered me for a moment before responding. “But emotional distance would only make them feel more isolated.”
“Getting involved will only make you ineffective as their doctor.”
He pressed his lips together as anger flashed through his features. “You talk about these patients as if they aren’t human.”
“That’s ridiculous, of course they’re human, but Dr. Polanski herself said in her paper in Psychiatry Annual that it is critical for doctors not to become emotionally attached to their patients, or they risk becoming ineffective and irrelevant.”
“I don’t know anything about papers, but I do know about people. If you treat a person like an animal long enough, they’ll begin to act like one.”
I snorted. “I’m not treating them like animals. I’m treating them like patients.”
“Patients who are beneath you.”
I opened my mouth to retort but changed my mind. This was getting me nowhere. Elias was only an orderly. He had no idea what he was talking about. I cleared my throat and lifted my chin, hoping that the serious expression I plastered on my face would silence this meaningless conversation.
“You have my assignment?”
“Yes, well.” His tone seemed to change, and his shoulders relaxed. He glanced around the room as he spoke. “You’re to just observe this group therapy session and see how things work. After that, the doctor will explain more of the rules in detail and show you around.”
“That’s it—just observe?” I was at the top of my class and had come highly recommended by my adviser. Surely Dr. Polanski had more for me to do than just watch?
Elias shrugged. “That’s what I was told.”
“Are you sure that was all you were told?”
He scowled, as if my words offended him, but quickly smoothed his features into his normal, easygoing nature. “She said to take lots of notes. You’ll need them for your semester project.”
“Notes?”
He grinned. “Yup.”
“Anything in particular I should be paying attention to during the session?”
Elias shrugged. “Dunno. She didn’t say. It seemed like she just wanted you to get to know the patients. The rest would come later.”
“Get to know the patients.” I tried not to roll my eyes. This man was as dense as he was big.
“Hi, Elias!” A Hispanic man strolled up and gave Elias a high five. Elias immediately brightened and they exchanged some idle chitchat. As I listened to their conversation, I took in the patient’s tattooed arm, long ebony hair, wife-beater T-shirt and sweatpants, and tried not to let my irritation show. From the way he spoke, it sounded as if this guy didn’t have a basic high school education, and yet Elias had dismissed me to chat with him about the movie he saw in the common room last night. Don’t these people have any manners?
“I’m tired of all of these girlie movies,” the patient said. “They need to show more action flicks. Blood, guts, that type of stuff.” The patient pounded his fist into his palm and swayed from side to side as he spoke.
“I’ll check on it, but don’t hold your breath. You know that Polanski frowns on that sort of thing.”
“Just trying to keep it real, man.” The patient clasped Elias’s hand. “There’s too much touchy-feely stuff around here. There’s no place for a guy to be a guy, you know?”
I cleared my throat, hoping to put an end to this pointless conversation.
“Oh, sorry.” Elias flashed me an apologetic look as he let go of the patient’s hand. “This is Nesto. Nesto, this is Mia.”
> “Ms. Horton,” I corrected and nodded at the patient. “Pleased to make your acquaintance.” I turned back to Elias. “About that thing we were talking about.”
The patient rolled his eyes and dismissed me. “I’ll talk to you later, amigo.” He started to walk backward and pointed both fingers at Elias, as if he held a gun in each hand. “Remember—more action flicks.”
“Got it.” Elias’s grin seemed genuine as he mimicked the patient’s hand gestures.
I waited for Elias’s attention to return to me. Part of me wanted to ask him what he thought he was doing, talking about action movies. These patients were here to learn and grow, not watch violence and sex. Dr. Polanski would never approve of such a thing. I wanted to tell him that, but there were more pressing things on my mind.
“During this session, should I take notes on how the patients answer questions, or their behavior while the doctor is talking?”
“Dunno.” Elias shrugged. “Both, I guess.”
“Both?” I ground my teeth in irritation. “Do you know anything?”
Elias grinned and nodded to the rest of the room behind him. “I know that you’re going to be in for a wild ride. These sessions can get kind of rowdy sometimes. If you feel uncomfortable or anything, just give a shout and I’ll come over and help you out.” He winked. “These patients listen to me. Most of the orderlies need to use restraints of some sort, but I find that most of the time a kind word and some understanding—”
“Okay. Thanks for the tip.” God, what a terrible day. This guy obviously wasn’t going to be any help, so I just wanted him to shut up and go away. The sooner I got rid of him, the better.
“I’ll be standing over there if you need me.” He pointed to the entrance where a second orderly stood, waiting for him. Elias’s friend had hair the color of dirt and eyes to match. He was tall and broad, but instead of Elias’s good nature it appeared as if this one had a chip on his shoulder. He had crossed his arms and scanned the room as if he were looking for an excuse to start a fight.
I shivered and picked up my things. “Okay. Thanks.”
As Elias turned to go, a new question popped into my head. “Do you know why there are no women here?” I knew that Newton Heights took female patients; not only had my friend Lucy been here but her roommate, Iris, as well. It was odd that there were no women in the session, however.
“This is group therapy,” he said, as if that explained everything.
“I know that,” I said as I slipped my oversized tote over my shoulder. “You already told me.”
He studied my face for a minute before responding. “Didn’t they teach you about group therapy in school?”
“Of course.” Duh. Group therapy was a pretty basic concept. I had learned that my first year in Psych 101.
He shook his head and chuckled. “I’m not sure how they do it in other places, but here, group therapy is segregated by sex.”
I felt like a fool. “Of course it is.” Segregation by sex would decrease the stress of socially dysfunctional patients and help them to speak more freely. It was a brilliant way to get patients to open up, and in my research I had learned that Newton Heights had been doing this for years. I mentally kicked myself.
“Personal therapy is one-on-one,” Elias explained. “Group therapy takes place in the morning and is done in small groups of the same sex.”
I nodded and waved my hand between us in dismissal. “While recreational therapy is coed. I know.”
“Sometimes,” Elias agreed. “It depends on the patient and why they’re here.”
“I see.” I dropped my hand, feeling a little defeated. It didn’t sit well that I was outsmarted by someone with such a thick skull. It was probably just nerves, but I made a mental note to study more, just in case.
“Well, thanks,” I said, desperate to be rid of him. “I think I can take it from here.” I turned to move away.
“Wait a minute.” Elias brushed his hand across my elbow, stopping me from leaving.
“Yes?”
The large orderly glanced around, moved closer, and lowered his voice. “Be careful when talking to the patients.”
I narrowed my gaze. “Why?”
“Most of them are really nice. But some of them . . .”
“Some of them, what?” I asked when he didn’t continue.
“Some of them are more damaged than others. They might seem to have it together on the outside, but underneath they’re struggling with real issues. Oh, they’ll be charming at first, and that’s how they drag you into their world. Once you succumb to their charm, they’ll try to use you to get what they want.”
Now, this was why I wanted the internship. Things like this weren’t written in textbooks and would make for a fascinating paper to conclude my work-study program. Information like this made a difference between graduating cum laude and magna cum laude. More than anything I wanted to be at the top of my class. It would be putting the nail in the coffin of the old, directionless Mia and burying her for good.
I leaned in closer. “And what would these patients want from someone like me?”
Elias parted his lips to speak, but a strong female voice stopped him.
“Good morning,” Dr. Polanski said as she swept into the room. “Sorry I’m late. There was a last-minute meeting and—” She shook her head. “Never mind. Why don’t we all come forward and take a chair in the circle?”
The doctor was petite, much shorter than most of the patients in the room, but she had a presence about her that demanded everyone’s attention. I took in her olive-green business suit, which matched her shoes, and the flowered clip in her shiny, salt-and-pepper hair and guessed that fashion sense wasn’t a prerequisite to becoming a doctor. Still, her outfit looked better than my disheveled, stained blazer and skirt. Grimacing at my coffee stains, I vowed to go shopping that evening for a coordinating wardrobe in olive—sans coffee stains. And perhaps with a little more modern touch. If I wanted to be successful, then I had to dress the part.
“Better do what she says,” Elias advised. “If you need anything, I’ll be with Johnson over there. Talk to you later.” As he went to his spot by the entrance, I adjusted my glasses and made my way over to the circle.
“Excellent,” Dr. Polanski said. “Now, we’ve been discussing anger—how it feels and what it can do to us if we don’t release it. Can anyone tell me what anger management is?”
“It’s when your anger is put to a committee for review,” Nesto said as he tightened the leather strap along his long, inky hair and slid his arm along the back of the chair next to him. He stretched his legs into the center of the circle and winked at me as I pulled out a notepad and pen from my briefcase. I think he was trying to be charming, but instead it came across as creepy. I opened up my notebook to a fresh page and put the date at the top. Perhaps if I ignored him, he’d leave me alone.
“In a way you’re right, Nesto.”
“I am?” he asked as he shoved his tattooed arm up his plain white shirt and scratched his washboard abs.
“Yes.” Dr. Polanski glanced around the circle. “Anyone else care to elaborate?”
The room fell silent. I wrote down the words “anger management” and underlined them. After a brief hesitation, I wrote down the definition I had learned in class and then reread what I had written. Pleased with my note taking, I glanced around at the rest of the patients and realized that no one was volunteering to answer Dr. Polanski’s question. How odd. This wasn’t the first class, and according to the doctor they had discussed this last week. Surely someone remembered what went on in the previous session . . .
“Carter?” Dr. Polanski asked, meeting the gaze of the man sitting next to Nesto. Carter ran his hands through his bushy hair and turned away, muttering incoherently to himself.
“Harris?” Dr. Polanski shifted her gaze to a thin, pasty-skinned man in camouflage pants and a gray shirt. He had many more tattoos than Nesto, covering both arms and his neck. He also had a ring
in his nose and diamond studs in both ears. Black hair stood up from his head at all angles. He looked vaguely familiar, but I couldn’t tell where I had seen him before.
Harris crossed his arms and stared at the floor.
Unable to take the uncomfortable silence any longer, I raised my hand.
“Nesto?” Dr. Polanski met the gaze of the Hispanic man across from me.
Nesto shook his head. “No idea, doc.”
I raised my hand higher.
Dr. Polanski sighed. “Can anyone here tell me anything we talked about yesterday?”
She was ignoring me, I could tell, but I really wanted to help. Answering her question would be the perfect opportunity to show everyone how prepared I was for this internship, and how much I had worked to be there.
“I can answer your question, Dr. Polanski.”
The doctor turned her sharp, hawk-like gaze toward me. “Very well, Mia. Why don’t you tell us about anger management.”
I ignored the tightness around her eyes and twirled my pen in my fingers, a nervous gesture I had picked up since the night of Lucy’s accident. “Sure. Anger management is the process by which a patient recognizes that he or she is feeling angry, and then takes steps to defuse the anger and redirect the energy in a positive way.”
“Very good.” Dr. Polanski nodded.
“Jeez, we have a regular Freud,” Nesto murmured from across the room.
I stopped twirling my pen and frowned at his all-knowing grin. “The idea of displacement came from Freudian psychology, sure, but displacement is only one way of dealing with anger. There are other ways for a patient to manage—”
