Chapter 2
2
I stayed in the conference room a minute longer, breathing in the stillness before opening the door. Thudding music and piercing basic cable news blasted from the nearby TV room. Halfway down the hall, a patient shouted at full volume, but as I approached he went back to muttering. Several other patients paced the hall, two of them silent, one laughing to himself. While the art therapy patients were pretty lucid, many others—because of medications or difficult diagnoses—were not.
At Diane’s office I knocked, pausing in the open doorway. She motioned me in, setting down her phone. A Black woman in her fifties, Diane was consistently poised, her raspberry lipstick always perfectly in place. Her ability to stay regulated sometimes amazed me.
“Thea. You have time for a new patient?” She watched me expectantly.
I cleared my throat. “Yes, of course.”
“Good. I have a new admission; she just came from observation.” Diane handed me a folder. “Jane Doe. Found wandering the Brooklyn–Queens Expressway three days ago; police brought her to CPEP for eval. No drugs or alcohol in her system. But really no other info.”
“What did she say?”
“Nothing.” Diane paused. “She’s mute.”
“Selectively?”
“We don’t know. But so far, she hasn’t said a word.” Diane smoothed her braids, which were twisted into a low bun. “That might change; we’ll see. She’s a 9.39 for now; we set her up in Block D. One milligram of Ativan TID. I want you to keep an eye on her.”
9.39 meant that we could involuntarily hold Jane Doe for up to fifteen days. Diane often asked us to watch out for the younger female patients, though for the most part they were able to hold their own against any SAO (sexually acting out) by other patients.
“Of course,” I said crisply. I often felt like I had to prove myself to Diane, though I suspected that tendency came more from my own insecurities than her expectations.
“Bring some paper.” Diane shrugged. “Maybe she’ll write something down for us.”
I glanced through the intake form and psychiatric evaluation notes as I headed to Block D, one of the female-only rooms. The notes were carefully handwritten and more descriptive than usual.
White female
Age unknown (20s/30s?)
No drugs/alc in system according to tox report
Arrived wearing new clothes—sweatshirt still had Target tag
Fingers scraped and scabbed—one fingernail half torn off
Scratches and bruises along arms + legs
PT refuses to make eye contact or speak
PT can do basic functions (eat, urinate) when prompted
Working diagnosis: Psychosis Not Otherwise Specified
Differential diagnosis/Rule out: substances not showing up in tox report, organic etiologies, schizophrenia vs bipolar/MDD with psychotic features, acute stress disorder
The back of my neck prickled. The unit was always full of a variety of patients cycling in and out, but the root causes of their issues were normally pretty straightforward: untreated disorders, lack of housing and resources, drug use, often connected and exacerbated by a societal lack of support.
This case seemed less obvious. What had happened to this woman?
Lonnie stood motionless in the entrance to Block D, hands pressed to the sides of the doorway.
“Lonnie. You know you’re not allowed here.”
He turned slowly, then smiled. “Hello, Thea.”
“Time to go.” I tried to say the words with authority, like Diane would. But he just watched me, eyes narrowed. “I’m serious.”
“I know her.” He nodded with his chin. “I think we dated.”
“I think that’s probably unlikely. But whatever the case, you can’t be here.”
Femi, one of the nurses, strode by, watching us openly. Lonnie pushed off the door, gliding in the opposite direction. I exhaled, relieved he hadn’t dug his heels in.
It smelled ripe in here: stale sheets tinged with metallic sweat. Three of the beds were filled with sleeping women, their bedding gently rising and falling. The meds and boredom meant many people were sleeping at any given time, despite the noise pouring in from the hallway.
At the back of the room, Jane Doe was on her side facing the wall. When I skirted the bed, I found her eyes wide open and staring. It made my stomach dip with eerie unreality, like I was looking at a doll or mannequin.
Her pale face was bare of makeup, her hair greasy, but she was conventionally attractive: big green eyes, sharp cheekbones, full mouth. I found my hand going automatically to the back of my head. She had the same thick copper hair as me.
That was weird. Had Diane assigned her to me because we looked kind of similar?
Of course not. It was just a coincidence. I wasn’t the only redhead in the world.
But it was more than that. Beyond the similar features, she looked—she felt —familiar. Crouching down, I studied her. Where had I seen her before? Maybe a party?
Her eyes stayed trained on the wall behind me. I followed her gaze to the scribbled-over wall, where bubble letters spelled out EAT SHIT . One hand was curled by her side, bandages covering several fingers, which jarred me back into my role.
“Hi there,” I said in a soft voice. “My name’s Thea. I’m the social worker who will be working with you. Diane told me you just got here today. If you need anything, you can let me know.”
No response.
“In the meantime, if there’s anything you want to tell me, I’ll leave this… shit.” The word popped out, unbidden, as I realized I hadn’t brought paper or a pen. “I’ll come back with some writing supplies.”
“Be careful.” The sharp words came from the next bed. Another patient, Shana, propped herself up on one elbow. “I don’t trust that bitch one bit. And you’re giving her a pen? She might stab me in my sleep.”
“No one’s going to stab you,” I said.
Her forehead creased, but then she just rolled her eyes. Her head dropped to her pillow. “Whatever. Maybe she’ll get you first.”