I'm a medical family therapist working with other medical professionals in family medicine and emergency settings. My "office" is just as likely to be an emergency room, trauma unit, or hospital ward as my quiet consulting room. In the large metropolitan hospital system where I work, I deal with interpersonal violence, sexual abuse, attempted suicide, death, and every imaginable emergency—often while the emergency is unfolding. My job is to stabilize these crises, help patients calm down enough to ensure their short-term safety, and set up a counseling schedule with them if possible. If I do end up counseling them, I usually see them for from six weeks to six months. Every day in "crisis land" brings its share of jolts to the nervous system, and often I'm pushed beyond the boundaries of my baseline clinical training and personal comfort zone. A day almost never unfolds exactly according to schedule, and there aren't many days when I don't feel like I'm walking on a swaying tightrope without a net.

Monday

My cell phone rang as I was driving to work. "When are you going to get here, Dr. Mendenhall?" one of my nurses asked anxiously.

"I'm on my way." I always arrive about 30 minutes early, so I can raid the coffee machine and look through my first few patients' charts.

"We cancelled out your morning appointments. Heather Shutters is in the ER with her son, Adam. The police said he could come here and see you or go to Juvenile…