Observations

  One of the many ways our healthcare system is broken is the difficulty of finding a psychiatrist who takes insurance.  The combination of low reimbursement rates and burdensome paperwork makes many of them opt out.  With such limited options, I wound up at a training clinic, where the doctors are residents.  Once they finish their two years of residency, they move on.  They finish up in June, and I don’t meet the new one until September, which would have been fine except that the leaving doctor only gave me two refills, not the three I needed to cover the gap.   I didn’t realize this until I ran out and my assistant called the pharmacy to request a delivery.  The training clinic, like so many hospital systems, is impossible to reach by phone, and since I have not yet met the new resident, I can’t message her on the portal.  My assistant and the pharmacy went back and forth trying to figure out this conundrum, but in the meantime days were goin...

  I was waiting for the elevator in the blast furnace heat of the 95 th   St station next to an older woman in denim shorts and brightly painted nails.     She was closer to the elevator when the doors opened, releasing a blast of even hotter air, like it was coming from hell itself.     She cringed but got on and I followed.     “You’d think they could air condition these elevators,” I said. “This is the worst station for heat,” she replied. “I moved here from Bensonhurst.” Before I could joke that I wouldn’t be able to leave the cannoli, she added“little Chinatown.” I know many older people miss the days when Bensonhurst was all Italian, but there aren’t many new immigrants coming from Italy, and many of the second generation ones have moved to Staten Island or New Jersey. The same thing happened to Carroll Gardens. But you can’t blame the new immigrants for that.     “And now look what’s happening here,” she says.     I’m no...

8/6/27       I came home after a truly marathon day - 11 walk-ins, one intake, and an absent social worker - with my brain feeling like warm jello, not fully set.     I was gathering cardboard to put out for recycling when I suddenly noticed a large hole in one of the terrace side first floor windows. I can’t really imagine what would take out almost half of an 6” by 8” window pane. There is no tell tale pattern of a rock impact or a bullet. I’m familiar with bullet holes in glass because I grew up in Red Hook in the 80s when gangs were battling it out for drug territory. There was often shooting, and a stray bullet hit our bathroom window, luckily while nobody was in there.     Since I went to the school 8 blocks to the north in the entirely different world of Carroll gardens, my 5th grade teacher was alarmed by the phrase “bullets in the night” in one of my classroom poems and dragged my mom into it who confirmed that it...

        Another new intake today made four in two days. Today it’s a trans man in his twenties who happened to meet one of our staff. Our staff member heard he was having trouble getting Medicaid and food stamps and told him to come see me.  It sounded like he got denied because of the work requirements that are part of Trump’s Big Ugly Bill. They assigned him to one of the workfare agencies, but when he showed up they told him his appointment was cancelled but then the City considered him out of compliance. I told him that if he had something he was interested in I could find him a much better training program than the workfare ones, but he told me he doesn’t feel up to it right now and his story came spilling out. He is grieving the loss of his younger brother, who at 21 was murdered by his on again off again g irlfriend. His grief about his brother’s loss is being complicated by the memories of his father, who was also murdered, years ago.  I t...

  I woke up at 5:30am because Gretchen has decided it’s time to eat.   The rest of my cats used to be good at waiting for my alarm, but Gretchen is a bad role model and once she starts demanding food, the others join in.   It was pouring outside, raining cats and more cats, as we say in my feline-centric household.  When I went into the other bedroom to fill Gretchen’s dish, the leak I noticed recently was a steady drip. I don’t know what the hell I’m going to do about it, there’s no way I can come up with money for a roofer. If I could get up there, I could put a tarp over it at least but I can’t.   Mary, the elderly Irish butch next door, used to walk from her roof onto mine but by now she must be 80, seems deaf and another neighbor just told me that she could not have been the person who buzz cut my front yard and left bits of greenery all over the walkway because she has pneumonia.   I decided not to think about the roof right now.  Before I could ...

  The thing about depression is that usually it’s portable - something heavy, like an extra book in my bag that I lug around with me.     But sometimes it morphs, liquefies and soaks me, and then sets into a thick, impenetrable coat of cement.     The natural inclination of cement is immobility, which is fine if you can stand in a sculpture garden growing mossy over centuries, but I still have all the responsibilities of the busy, bustling world.   The cats, who spend their days making detailed observations and then calculating the correlations between human behavior and the food in their bowls, know something is wrong when the ringing alarm gets no response.  They deploy a level one response - Marley staring intensely at me from her perch on my chest.  Then they escalate, Connor joining her on my chest, not just doubling the stare power but also adding bulk that skinny Marley can’t achieve on her own. Finally, as a last step to stave of...