Life, Death, Madness - Page 7


Listening to Chopin

My encounter with Dorothy brought back intense memories. When I'd first come to the hospital, four years ago, I'd been assigned to the psychiatry unit. Having spent the previous decade in prison social work, I'd celebrated the move to a hospital setting. I'd no longer be the lone clinical practitioner in the brutal, hardened world of incarceration; instead, I'd be part of a bright, nimble medical team, working with diverse families and helping shape transformative hospital care for the mentally ill.

A neighbor of mine—a psychotherapist well acquainted with the hospital—joked that I must be a masochist to jump from a prison yard to a psych unit. Her comment still burns. I can't help but wonder what continues to draw me to these extremes of psychotherapy.

I do have a sense of what led me to the work. Growing up in middle-class New Jersey, I felt loved and cared for, but carefully protected from major upsets. My gentle parents edited out the raw footage of life; I have no memory of seeing a dying person, or real rage, or raw grief. I was kept safe but spared the experience of being fully alive.

Consciously or unconsciously, crisis social work has delivered me to the walled-off side of life—to the heart of human suffering. When I step into the hospital in the middle of the night, it's as though curtains are drawn back: the actual curtain to the treatment room and the figurative curtain hiding the wounded world from me. I'm a first responder. I feel myself waking up, growing up.

It's tough work. The river of grief, rage, and fear of those I work with runs so deep and wide that I sometimes can't imagine how I can help them navigate it. The stakes are high; what if I blow it with this desperately fragile individual? Unlike office-based therapy, I may not see this person next week, or ever, to follow up. But if I'm honest, I'd say that the hardest thing about my work is what I'm forced to see each time I accompany my clients in their devastation. A part of me doesn't want to know that life can get this bad. My illusions of life's safety are smashed, daily.

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