In a House of Dreams and Glass by Robert Klitzman

Author:Robert Klitzman
Language: eng
Format: epub
Publisher: Simon & Schuster

TALISMEN

In the ER, I was more personally vulnerable than in any other setting. Here at the entry point to the hospital, as a resident, I would be most exposed and most threatened—both physically and psychologically. Whatever patients walked in from the street and the wild night, the resident here confronted—unbuffered, and unsupported by a staff of nurses, other doctors, or mental health aides.

• • •

A few days after Susan’s M and M, I was again on call in the ER. Patients came and went all night without stop. No sooner did I finish one case when the next one arrived. I also had to see patients on medical wards who had psychiatric emergencies. No time was left even to get dinner.

Susan’s death hovered over me throughout the evening, shaking me up more than I would have expected: I was awed and terrified by how much of patients’ lives was beyond my control. Bad outcomes, even deaths, could occur. I was up against the raw harshness of mental illness, but had to keep going—another patient always waiting to be seen. I was driven by a schedule made weeks in advance, the ambition to do my best, and the belief that residency couldn’t get any worse.

At 2:00 A.M. I was finishing with my last patient, who was on a medical ward. I was eager to return home, when triage paged me. “You got another one down here,” she told me. “And he’s violent.”

“Put a security guard on him until I get there,” I said. I headed downstairs a few minutes later, and as soon as I walked through the automatic double doors to the ER heard a man screaming. As I neared the psych room, the voice rose.

“I’m not staying!” he was yelling. “It’s political. It’s all political! They’re putting me away for political reasons!”

A young man was standing in the doorway, his hands raised, pushing against the two sides of the blue metal door frame. John Tefferello was twenty-eight, with greasy long light brown hair tied back in a pony tail. The buttons of his plaid shirt were unfastened down to his stomach, exposing a hairy chest. He wore blue jeans, a wide leather belt with a big metal buckle, and work boots. “There ain’t nothing wrong with me,” he shouted. An indifferent security guard was leaning against the wall diagonally across the hall, at a safe distance.

I walked up to the patient, introduced myself, and held out my hand to shake. His arm didn’t move.

“Can we sit down?” I asked, gesturing to the empty room behind him which he was barring.

“I’m getting the hell out of here.”

“Why don’t you sit down and tell me about it?”

“Fuck you, man. I’m bolting.”

“I’d like to find out what’s going on first.”

“No way.”

“I think it’s best if you step into the room and sit down.”

“Fuck off, buddy.”

Suddenly, a cold, slimy glob smacked my face and rolled down my cheek. I was shocked. My finger reached up and touched the goop clinging to my skin, which had landed fractions of an inch from my eye.

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