Brooklyn Zoo (39 page)

The vestibule by the elevators was deserted. The sixth floor was Friday empty, and without any heavy metal to bang for the elevator, I hit its blue door with my house keys instead, producing a less than satisfying racket. There’s something about leaving a place for the last time. I slowed down to take in the afternoon sunlight as it struggled through the dusky paned windows and hit the linoleum. I thought to remember the smell. When the elevator came, I got on. Two floors down a janitor boarded, and the operator showed him one of several Coach bags she’d stashed under her stool to sell. “Two hundred dollars,” she said. “In the store they go for five hundred, but I get them stolen!” He bought it. There was a young lady he was trying to impress.

Outside on the street with a bursting feeling in my chest and nowhere in particular to be for a while, I was not sure what to do with myself and I called George. They were training him up to the last minute at his fancy private hospital, and my call went to voice mail.

“I’m done!” I cheered into the phone as I walked toward the subway that would spirit me away, but I didn’t get the tone or the words quite right.

THERE IS VERY LITTLE DEMAND FOR NOT-YET-LICENSED PSYCHOLOGISTS
, and so I spent the summer after internship’s end writing my dissertation, fact-checking at a soon-to-be-defunct magazine, and looking for a job, any job, in my field. (George had beaten me out for the one job we both interviewed for, screening applicants to the NYPD. I hated to lose any competition to my touched-by-the-Ivy-League husband, always so certain of the supremacy of his final training year, but at least I got health insurance out of the deal.) By October, I’d successfully defended and was ensconced at a public mental health clinic not far from home, being paid still very little to see outpatients by the dozen, putting in the hours I needed to fulfill my postdoctoral requirements for licensure.

It felt good doing long-term therapy again—what my training and interest best suited me for—and with people who usually wanted my services. The place was shabby but well run, with an attendance policy that made me think about Carmen Thompson and what kind of time we might have had
together had Kings County’s clinic maintained such a basic thing as that. (Maybe they’d expected too little from their charges, who then managed barely anything in return.) I did intake interviews as well as therapy at that clinic, and during those I realized this: no one who sat down across from me felt entirely unfamiliar. I could isolate, at least in broad strokes, what was going on with the most disturbed patients simply by sitting with them for a while and paying schooled attention, a not unnecessary skill for a clinical psychologist no matter the setting. In one of my few good moments with Caitlin Downs, around the middle of my internship year, she had said this, and it stuck with me: “At some point after you leave here, it will crystallize for you, what you got out of the experience.” She’d been right and then some, as other lessons would become clearer as well, as time went by and I got around, learning again and again that graduate school had only been a very good beginning.

There were no such easy satisfactions for the G Building. Six months after I left, the Department of Justice issued its final report, which asserted that “significant and wide-ranging deficiencies exist with respect to Kings County Hospital’s provision of care to its mental health patients.” Among other things, it cited inadequate clinical leadership and understaffing, “a system that has neither clear, specific standards of care nor an adequately trained supervisory, professional, and direct care staff.” The hospital set out to hire a psychologist for each unit, though filling those positions proved difficult. G Building—a pointed threat for generations of neighborhood children—had a reputation.

The Justice Department made its suggestions, each quite reasonable on paper. Still, it was hard to imagine things getting better. Public hospitals are famously dysfunctional and
stubborn places for dozens of social, political, and economic reasons well documented by others with much greater understanding than mine. But there are also the psychological impediments to better treatment—at least as intractable and crossing socioeconomic lines. You can’t call an orange an apple and then make a pie of it. Psychological problems are not simply medical ones (though I am hardly the first to observe this either). To mislabel the former the latter—in what has proved a failed attempt to obviate discomfort—results not in better treatment but its opposite. Ideally, we’d live in a world with less shame surrounding the sometimes-outsized travails of being human. Realistically, research will continue to confirm that medication, even when it helps, is no stand-alone panacea, and the pendulum will swing back toward a wider valuing of the harder-won bounties psychologists offer.

After our year at Kings County Hospital, my fellow interns moved on to other things. Jen went to work with children in foster care. Alisa had a baby. Leora moved back to Israel. Zeke took a job in college counseling. Bruce left the field altogether, opening a beautiful mid-century modern furniture gallery on the East Side of Manhattan. Every few months Jen and I meet him there for dinner. We order Indian takeout, and talk eventually turns to the G Building, where in our wake Scott put Caitlin in charge of the externship program and then soon after got promoted himself.

Me, I would gladly work in a hospital again. In my fantasies, it’s the hospital of my book, where interdisciplinary teams work together effectively, with respect for each other and a knowing certainty that patients who come for care will leave—as I did—having taken in some things worth knowing.

With great appreciation for my dear sister, Cori Carr, who suggested I write this book, and then was also my perfect reader during the arduous process of writing it; and then, too, for Megan Abbott and Nana Asfour, for generosity with their thoughts, resources, and most of all friendship over many years. With gratitude to my parents, Michael and Helene Lockman, for many things, including their grace in the face of being undisguised subjects in their daughter’s memoir. Thanks to Joe Reynoso, for going over this manuscript with a psychologist’s eye. With love everlasting to my husband, George Kingsley, who, when this book began to feel like a quagmire, offered the best advice a nonfiction writer could get: “Write what happened.” I feel incredibly lucky to have gotten the chance to work with both Dan Conaway—my agent and favorite cheerleader—and Gerry Howard, an editor whose wisdom always felt like that of a good therapist: ethereal, pragmatic, and exactly what I needed to hear at any given time. Finally,
but not least, to my lovely fellow Kings County interns and the dozens of patients and professionals I had the opportunity to work with during my internship year. I was lucky to have known them all, even when that good fortune sometimes felt like something else along the way.