Page 4 of Love and Other Mental Health Concerns
It’s been two days since I made my stunning first impression with Nick, the consultant, who seemingly holds my future in his hands. Or at least my somewhat immediate future. My desire to die of embarrassment after my swan dive during the company meeting was apparently outweighed by my need to get paid, so I did make my way back to work the following day. My anxiety has been in a bit of an overdrive since the arrival of the consultant, but I decide to try my best to push that aside and stay focused on my patients.
“Fuck you, Marcy! I am…gonna go. Jus’ have Cindy get me. She will! Call her!” My patient slurs his request, reeking of booze and cigarettes. Let’s just say some patients make it easy to stay distracted.
“I know Jax, and I will call Cindy. First though, can you chat with me for a minute about how you got here?” I had already read the notes from the paramedics but wanted to hear his version of events. Jax is here every month or so because his drinking gets out of control, and he ends up in some dangerous scenario that he believes is perfectly reasonable. Unfortunately, he is one of many patients we have in a similar pattern.
“Yeah, I got here in an ambulance.” He groans. Jax is sweaty, disheveled, and his complexion is ruddy. A gash near the top of his forehead is bandaged, but blood is starting to seepthrough, and his over-sized flannel shirt is stained with it. He clearly hasn’t been showering and was brought in without shoes.
“Right, but come on Jax…”
“Alright!” through his almost garbled speech he explains, “I just needed a couple things, stuff, ya know? And I don’t have keys to my car anymore. Cindy tell you that last time? No keys, like I’m a child. So, I have to ride a bike. I ended up in the fucking ditch, no fault of my own. Was just about side swiped by one of those college douchebags! Fucking fucks.” He growls out the pathetic insult, eyes heavy and exhausted looking.
“Okay, so you took your bike to the store, staying on the bike path?”
“No, I was on the side of route ten, but plenty of space for everyone there!” He’s explaining that there is plenty of space along a four-lane highway for him to drunkenly ride his bike toward the grocery store. Shockingly, he found himself in a ditch along the side of the road, with a head injury from hitting a guardrail as he fell. Given the danger of this latest venture, I am about to tell him he is on a seventy two hour psychiatric hold so we can get him detoxed and stable before he will be discharged.
This won’t be his first hold, and as I begin to explain to him that this is the plan, his agitation increases. “Marcy, you know me! I am safe! I am just having a good time! No harm!” I keep my calm, which I can do within the confines of my work with my patients, but often find difficult to do outside of this space.
“Jax, your head is still bleeding. Dr. Roberts is going to need to stitch you up. Your blood alcohol level is a new record for you at .32, and you nearly got yourself run over on the highway. So, you will be here to detox safely while we try and figure out your next steps. You and I have been through this before, and when you are feeling a little more like yourself, I want us to come up with a recovery plan for you, together. How does that sound?” I keep my tone firm but warm. I need him to want to work with meso we can get him the best care, but also need to be clear that we have some expectations for his treatment.
“Sounds like a bunch of bullshit Marcy, but thanks. When’s the Doc coming? I want some meds to take the edge off all this.” He clumsily leans back on his cot, hopefully ready to get some rest.
“Soon Jax, just hang tight.” I exit his bay and head toward the nurse’s station.
Dr. Roberts, the emergency department physician during days, had been paged to the ED when Jax got brought in but still hasn’t made an appearance. He is gorgeous, all thick black hair and tan skin, but aloof and cold in his interactions with pretty much everyone. His bedside manner with the patients is decent enough, but he often seems like he is just counting down the seconds of each shift. Even if that is true, a little more feigned enthusiasm from him would certainly boost staff morale during his shifts.
“Hello Lauren, I met with Jax.”
“Yeah honey, the whole hospital heard. Thanks.” She gives me a wink.
“I paged Dr. Dipshit but it’s been crickets. I need to get the paperwork signed for Jax’s seventy two hour hold before he tries to escape.” I explain.
“Before which one escapes? Dipshit or Jax?”
“Great question, either would be a problem for me right now.”
“I’ll give him a ring with a little SOS energy Marcy, and then start making threats to his family if that doesn’t work.” Everyone listens to Lauren. She is the charge nurse, and no one messes with her. I watch her pop some more nicotine gum in her mouth before dialing Dr. Roberts again. I decide to take the opportunity to duck into a small staff eating area nearby to get my notes done.
“Can you also let me know if his sister, Cindy, calls the unit? I am trying to get a hold of her.” Jax has had trouble following up with the most basic of aftercare suggestions, so his family may need to be more involved with next steps. If they are willing of course, not a guarantee. As a surprise to no one, they are getting a little tired of trying to manage his behavior.
“You got it, Marcy. I’ll page you if I hear anything.”
With space in the hospital limited, and only one social worker employed, I do not have my own office. My worn leather satchel has become my mobile response unit as I tote around my laptop, notebook, a tiny portable printer, and some brochures for services offered by the county and other local agencies. I grab a seat at one of two café tables in the glorified pantry space and try to focus on getting my notes from the day into the electronic medical record. I’m not working more than five minutes when I am interrupted.
“Marcy, right?” A deep but warm voice catches my attention from the coffee machine. Two ocean blue eyes staring down at me, paired with a bright smile and a warm energy that envelopes the space.Of course I am Marcy, you watched me eat shit and then waved my tampons around like a baton in the middle of a staff meeting less than forty eight hours ago, is what I really want to say. I try for something a little more socially acceptable.
“Yeah, that’s right, hello Nick.” I try to return his smile, but compared to his it feels lacking. In this less frantic introduction, I can appreciate some of the fine lines at the corner of his eyes. Just the smallest bit of gray hair is starting to show in his sandy colored hair and beard. Why is that so attractive on a man?
“Sounds like you have quite the patient in the ED at the moment. I hope you don’t mind but I heard your conversation with him. You did great work; he responded well to you.”
“So, you were eavesdropping? Isn’t that a privacy violation?” I’m not actually concerned about this; I know Nick isallowed access to the ED and my conversation with Jax wasn’t private behind the flimsy bay curtains. I am a little curious to see how this golden retriever would manage a little bit of pushback though, at least while my anxiety medications are still working.
His expression flattens a bit. A curious eyebrow raises at my attitude toward him. I’m sure he is used to everyone around here kissing his ass. My insecurity is showing, determined to make sure he knows that my roll, and myself, deserve some level of respect. I am not sure that this is the right time or way to try and assert my backbone, but here we are. I’m trying desperately not to be a victim to the bottom line and spinning the rings on my fingers with abandon.
“I think you and I both know that the entirety of the emergency department could hear that conversation Marcy, but you’re right. I should show some more respect, and I offer you my apologies for that.” His smile back on his face, and energy reserves restored. His Aura kind of hums, like he’s just itching in his skin to chat, which I assume is how he approaches most of his interactions.
But no argument or quip…he just apologizes? This feels like a trap.
“Well…Okay,” I counter. Good one.
