Collisions 4

It's after hours and I am home sick today anyway, blowing my nose a zillion times and being grouchy about the fact that these germs got to me the day before the monthly infusion that is supposed to protect me from germs. I'm reaching for another tissue when a text message lights up my phone. I have never heard a text message before, but this one, just one word, tentative and searching, sounded like it had been spoken out loud in my empty room. "Kate?" it said. The message was from S., a client who is so polite she would not interrupt my personal time except for a major emergency. I immediately think of her two cats, who stayed with me until she got her apartment, and I wonder if something is wrong with one of them. But that's not it. The next message says "I'm dealing with some bad intrusive thoughts about my life and is there any help somewhere?" She doesn't have to get more explicit, we have discussed suicidal thoughts before. The answer to her question, even in a city as big as NYC, is that help is very limited. We have a handful of crisis residences, where peoople can stay and get support in a more homelike environment while they stabilize, but between the paperwork and the waiting lists, that won't help her now. Other than that, all we have is the psych ERs. I think of psych ERs as a last resort, most useful for people experiencing psychosis. Taking people away from everything that gives them comfort - friends,favorite foods, etc and keeping them in an environment that is prison-like at best and retraumatizing at worst, rarely helps my clients. But she had already decided. "I need to probably go to the hospital so I won't do anything stupid," she wrote. She lives in the Bronx, where the hospitals are underfunded to the point of being dangerous, so I follow our usual policy of suggesting that she get out of the Bronx. I give her the info for the hospital closest to our office, where I know they are LGBTQ friendly and we can visit easily. She's worried about leaving the cats, so I tell her to put out extra food and water and assure her with my cat lady expertise that they will be OK for a couple of days. She's worried about being admitted for a longer stay, so I promise her that if that happens we will come get her keys and take care of the cats. Even as I give her directions and discuss feline logistics, images and sounds are tunbling around the back of my mind, the clanging of the heavy metal doors, a patient screaming, a doctor saying "I can't let you leave tonight." I was going to go to bed early, but now I am waiting to hear that she has arrived and my mind is spinning back through time, to the day my own lawyer said to me, "you can go to the psych ER or I will call an ambulance." A conflict with my hateful neighbor had spun out of control to the point that he called the Dept of Buildings and an inspector showed up on my doorstep early one morning. This could have been a disaster because my house is 100 years old and I don't have a lot of money for repairs, but the inspector saw that I was in my nightgown and said, "you're not dressed, call to reschedule." I called my lawyer, who had been helping me deal with this neighbor, in full freak out mode. He's not a lawyer I hired, but someone I've known for decades, an activist who uses his skills to fight for our community. We know each other well, so I was shocked by his abrupt command to go to the hospital, but I also knew that if he said he was going to send an ambulance, he would and I couldn't have an ambulance show up at work. So I walked up 9th ave to Mt Sinai West, thinking to myself that I know what to say to talk myself out of this. That psych ER is small, and it was full so they stuck me on a molded plastic chair in the hallway that seemed to have been designed by someone who had never seen the human form. I made my way through question after question, form after form, while around me the doors clanged and people screamed behind closed doors. I know these forms and questions well from grad school and years doing this work, so I was not expecting it when the bearded gay psychiatrist came back and said "I spoke to your lawyer and he really loves you and he's concerned about you so I can't let you leave tonight." They brought me another uncomfortable plastic chair so I could stretch out a little, and I tried to apply my jail mindset - get as physically comfortable as possible and zone out. But I couldn't get physically comfortable, the odd position was causing increasing back pain, and sound of the doors clanging shut kept reminding me that I was trapped.

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