Brooklyn Zoo (20 page)

“What mistake do you think you made when you wrote in Mr. Roy’s chart the other day?” she asked me, her backside pressed against the door as if to prevent me from leaving. Her tone made me nervous, and I couldn’t for the life of me remember what I’d written. I didn’t have it in front of me, because Mr. Roy’s chart had been missing from the nursing station when I’d collected the others.

“Refresh my memory?” I asked reluctantly.

“Hospital police, getting in his face, calling him a bitch.”

“Oh.” I began to sense where this was going, and I felt a little dizzy. I explained, “But obviously that didn’t happen. I wrote it down because he agreed it was a hallucination. I thought that showed he was making progress, like you’ve been teaching me.” My voice tapered off.

T. moved away from the door and sat down in the chair next to her desk. “Dr. Amony just read what you wrote. He was reviewing the chart because it’s on its way to administration because Mr. Roy’s mother is threatening to sue over the blow job. Do you see what the problem is?”

I did not want to, but I did. She continued.

“A lawyer reading that chart does not understand psychosis. He does not understand delusions and hallucinations and paranoia. He only understands that his client made a serious allegation against the hospital police and that the staff dismissed that allegation without even bothering to ask anyone who’d been on duty the night before what might have happened.”

“Oh,” I said. I was an imbecile. There was no way around it. My contributions to CPEP were meager, especially compared
with the price the hospital might ultimately pay for inviting me to complete my training there.

“Would you like to know how you should have handled the situation?” T. asked.

I did.

“If you were ever again to note something like that at all—and there are many reasons you might decide it was better not to—but if you did, you have to investigate. To follow up and see whether there was anything to what Mr. Roy was claiming. I agree with you that it’s unlikely that this happened. The hospital police are not sadistic, and it’s hard to believe that they are arbitrarily waking patients in the middle of the night to call them names. But you cannot record such a thing in a chart, which is first and foremost a legal document, without following up. And by the way, you should have followed up on this whether you chose to record it or not. Maybe something happened with another patient. Who knows? Whatever the reality, it needs to be clear to us.”

I nodded again. “I’m so embarrassed,” I told her.

She nodded. Her face relaxed, and she softened her tone. “Yes, but you are here to learn, and you certainly won’t forget this. Anyway, for the rest of your time here you still need to write notes, because you need the practice, but you will no longer be writing them in the charts. Neither will any of the other interns when they rotate through here, Dr. Amony’s orders.” I wondered if it would be possible to pass what remained of my time in CPEP without seeing the man. I took some comfort in the fact that he might not connect my face with my crime. T. continued. “Everyone’s on edge around here these days. You know about the big lawsuit?” I nodded.

“Mostly just what I read in the
Post
,” I told her.

“The hospital’s own legal service is suing. Basically, one
of their lawyers got paranoid and started busting in on patient interviews to ask questions and make demands. Dr. Amony kicked him out. The lawyers he worked with got angry and suspicious in return and started actively soliciting ER patients for complaints about their treatment. The most sociopathic patients. The Department of Justice has been called in to investigate. There’ll probably be some helpful changes around here as a result, but the staff are on eggshells, trying to make sure everything is in order.” T. paused and brushed her hands of the whole matter. “Who should we see first?”

“What’s the date?”

It was not an extraordinary question, but its asker made it so: the young and handsome and well-groomed Mr. Rumbert, from Barbados, had not uttered a syllable since he’d arrived in CPEP three days earlier, and now here he was with a complete sentence. We’d spent several groups together, and I hoped that his attendance had contributed at least a little to the end of his mutism or at least to the fact that he had chosen me to speak with. “Mr. Rumbert! You’re talking today! You must be feeling so much better.” My enthusiasm was intended to impress upon him, as Dr. T. had taught, what it meant for him to improve. I told him the date was October 26.

“I thought it was some—” He stopped abruptly and stared at me with concern. We were standing in the hallway outside T.’s office.

“What is it?” I asked.

“It’s your eyes,” he said. “I’m not sure if maybe they could zap me.” I assured him they could not and asked him to come into the office to chat. As we were getting seated, T. arrived. I began the interview.

“You’re so much better today. Do you have a sense of why?”

T. cut me off with her hand. She looked at me. “Too complicated,” she said. She turned to Mr. Rumbert. “Did you get breakfast?” she asked. “You haven’t been eating.”

“It’s hard to eat because I can’t leave. It’s like I’m in prison,” he said.

I started, “This isn’t a—,” only to be cut off by T.

“Does he know where he is?” T. asked me quietly. I asked him.

“It may be a prison. I’m not sure,” he said. His accent was refined. Slightly English sounding.

“You’re in a hospital, sweetie,” said T. He pondered that information. “Why don’t you go out and have a seat and think about that?” she suggested, but Mr. Rumbert stayed where he was. T. began to do paperwork, and he sat and watched, trying to figure out if she warranted his trust or his suspicion. T. left with some papers in hand, and Mr. Rumbert and I remained in the office. He turned to me.

“You remind me of a character on a show on the Sci-Fi channel,” he told me. “The guy on the show is trapped in this village, and people try to convince him of things. You look like one of those people.”

“You’re worried that I want to convince you of something that’s not true,” I interpreted. “Me and Dr. T.”

He laughed. I looked at him, puzzled.

“It’s her name,” he said. “It’s funny.”

I woke a woman named Ophelia for morning group, and she was not pleased. “You woke me from my sunder,” she kept repeating in an angry voice. She followed me into the dayroom
anyway. A man named Juan was dancing in the hallways, and I corralled him, too. There was a third patient, a woman, she looked a little slow. And Mr. Rumbert again. I asked them to speak about why they were in CPEP.

“I came for a bed, but I was double-crossed,” said Ophelia.

“My fiancée called 911 after Shabbos dinner,” Juan said, which sounded funny because he was clearly Mexican.

“Why did she call?” I inquired.

“You’d have to ask her,” he replied.

The woman who looked slow said she’d done crack for the first time and was full of regret. She began to cry.

Rhoda walked in to get Ophelia. She needed her help with some paperwork.

“You can come back when you’re finished,” I told the patient as she left. She turned and gave me the finger. Juan told those of us who remained that he wanted to read to us from a book called
Recreating Your Self
. As we listened, Ophelia returned, and she was worked up. She marched up right close to me.

“You double-crossed me,” she yelled. Her body looked tense, poised for a fight. For the first time in the ER, my fear of being physically threatened was being realized. I made my way toward the door, encouraging Ophelia to come with me, not wanting to leave her alone with the other patients. She was taller than I was, and wiry. I imagined her rage would give her fists great force. I had never learned how to protect myself from a punch, and cowering seemed like my best defense. I remembered what T. had told me weeks earlier about being soothing.

“It’s okay. Come with me. We’ll find you some juice, something to eat,” I said. She followed me as I walked backward into the hallway, which for once was deserted, the guard
having abandoned her post. Ophelia remained too close, still menacing, insisting on my alleged crime, taunting me. I continued walking slowly, my body facing toward her as I backed away sideways. “Hello, hello,” I said loudly, turning my head toward the adjacent halls, trying to get the staff’s attention without alarming anyone, but someone was always yelling, if not screaming, in the ER, and no one was likely to heed my cautious cries. Calling for help seemed overly dramatic, and I thought it might set Ophelia off besides. Shit.

But Rhoda came out of her office and saw us. She rushed over, inserting her solid body between Ophelia’s and mine. She managed to calm her down while also explaining to me that Ophelia had slammed out of her office two minutes before. “I’ll take care of you,” Rhoda said firmly to Ophelia, shepherding her off to another hallway. I went back to the group room, concerned that the patients might have gotten spooked. Juan and the other woman were now seated side by side. She was choosing passages from his book, and he was reading these aloud. Mr. Rumbert sat across the room, silent but calm. I entered and closed the door and sat to listen and get myself back together. Ophelia was back soon, standing outside the windows of the group room looking in. I saw the guard was back at her post, and I opened the door. “Would you like to rejoin us?” I asked Ophelia, because wasn’t that my job?

“Don’t talk to me,” she said. “You look like a canker sore.”

Afterward, I did not have much left in me, but still I brought Juan into T.’s office for an interview. His chart said he had a long history of bipolar disorder. He told me he was an attorney and a converted Jew and there was no reason for him to be in a psychiatric emergency room.

“Have you been hearing voices?” I asked.

“Yes,” pause, “Guided by Voices,” pause. “Get it? The band?” Guffaw.

“Are you worried that someone is watching you?”

“Yes,” pause, “the Police,” pause. “Every breath I take, every step I make.”

He kept insisting there was no reason for him to be there, and when T. came in, she’d quickly had enough and told him we were done. He got up and walked out, turning off the light as he made his exit.

“That’s so symbolic,” T. said. “Lights out.” I told her about what happened with Ophelia because I thought the staff might want to assign her an assault level. T. asked if I was okay. I was still shaken, but I said yes. Then it was time to go, and as I left, I saw Juan the converted Jew lying on his stomach on one of the reclining chairs. I waved, and he thrust his hands back to catch his ankles in a resplendent yoga bow pose.

All the way to work the next morning I debated whether to bring Ophelia to group. I hadn’t thought to ask T. about that. With a higher-functioning patient—someone who was not psychotic—I thought it would have been important to bring her in, to demonstrate implicitly that her aggressive impulses were not as destructive as she likely feared. I was not sure that the same thinking applied to a psychotic patient, especially a paranoid one, since paranoia reflects a projection of aggression—that is, Ophelia experienced the hostility not as her own but as directed toward her by those around her (in this case, me). I decided I would invite her if she was up but that I would not wake her from her “sunder” if she was still asleep. It turned out not to matter, because when I got the
census she was no longer on it—moved to the list of people waiting for a bed upstairs. I was relieved. I found Juan and Mr. Rumbert—who was continuing to speak—and a new woman who was attractive and looked with-it. But then she told me she did “sortation” for a living, which made me suspect she had a thought disorder because I knew, thanks to my month in the psych ER, that use of neologisms was often a symptom of schizophrenia or mania. T. called in sick, and Dr. Brink was my official supervisor for the day.