After midnight

In a dark mood, I went to bed early. Figured I’d sleep it off or at least get some sleep before my double header of hematology and rheumatology tomorrow. I didn’t realize my phone ringer was off, I’ve been leaving it on in case of hospital calls, but I must have turned it off for the Rise and Resist meeting. At five past midnight, I woke up suddenly for no particular reason. The cats were all snoozing quietly in their spots, the heater was humming along softly, making a hopeless effort to keep up with the night’s bitter cold. It felt like I had been awakened by an invisible disturbance in the energy. Confused, I reached for my phone and saw a missed call from my Very Sick client. I called him back and found him distressed. “I want to go home, I’m tired,” he said, with no understanding that his life literally depends on the heart and blood pressure medications flowing into his veins. I tried to explain, “your heart needs the medicine.” “They already gave it to me,” he said, unable to understand that it’s a continual drip. “How are you going to get there?” I ask, hoping that the concreteness of logistics might bring him closer to reality. “I’m going to get a Lyft and go,” he insisted. “You can’t walk,” said his nurse, “you’ve been in bed for too long.” “I can walk,” he insisted “I walked all day today.” He’s meandering in and out, closer and farther from reality. He starts pleading and wheedling, trying to convince his nurse to take him downstairs. My impression that he is thinking it will be easier to escape from lower down is reinforced when he says “I’m not going to do nothing,” in his most innocent tone, which I recognize from his days as a teenage force of chaos in the shelter. When that approach fails, he starts reaching for his lines. “You can’t pull that out,” says his nurse calmly but firmly. “If you do there will be blood everywhere and a big risk of infection.” “I want to talk to my providers, I want my papers,” he says having left against medical advice so often he knows the procedure even in his confused state. “They’re going to keep fucking with my ass,” he says with the suspicion of medical providers that has contributed to his becoming so sick. “They should send me back to my original place because this is bullshit. It’s crazy. I can’t deal with it.” I knew he wouldn’t be able to deal with it, that was part of why I made him DNR. “I just went with Cage to McDonald’s,” he says, taking another detour in his mind. “Cage came to visit you,” I say. “Everybody was there,” he says. “You mean the group?” I ask, thinking of the HIV+ group Cage runs at New Alt. “My aunt,” he says, “and everybody” and I realize he is thinking of his family who have been visiting. “Your family has been visiting,” I tell him. “Yes,” he says, sounding aggrieved “but they never come at night.” “What is that!” he cries. “your pain medicine “ says the nurse although he said no when I asked him if he was in pain. They’re trying to chill him out. “I’m not going to make it through this shit because they don’t believe in me,” he says, “I can’t make it on my own. I really want to go home, this is crazy.” Suddenly he gets agitated. “Miss!” he says loudly “I can’t walk up these stairs. I can’t walk up these stairs!” The nurse takes the imaginary stairs in stride. “That’s why you can’t go home right now,” she says. I recognize that she’s entering the delusion like I used to do with my Dad. I remember stopping him from getting out of bed when he had pneumonia, thought he was at an expensive resort and wanted to go for a hike in the woods. “We can’t go hiking right now,” I said. “Why not?” “It’s raining,” I said, and he settled back down to wait for better weather. Next he starts freaking out about roaches. “No! No!” he yells in panic. “There’s roaches here!!!” “Where?” asks the nurse. “In the corner! There’s roaches!” “are you seeing roaches?” asks a doctor walking in. “I swear to God,” he says “I can’t sleep here.” “I’m sorry,” he says abruptly. “What are you sorry about?” I ask. “They’re going to do what they’re going to do to me. I tried to tell you guys, we’re being bothered, especially in my case, it was horrible,” and I wonder if he’s remembering being molested as a child. There’s a long silence, then he says, “I have shit to do, good-bye.” He hangs up the phone and I feel certain that whatever he has to do is not in this universe.