Chapter 26
Chapter Twenty-Six
T here is a frenetic energy in the city all week as people bounce from event to event, anticipating the big awards show on Sunday. Two weeks ago, I set up a meeting at UCLA to check out their pediatric behavioral health emergency department while I am in town. I want to get a feel for how they run it, especially after what I saw in Houston. It will be a key part of my presentation to the board at the end of the month—the last big thing I have to do to convince the hospital to provide a portion of the start-up costs for the unit. I’m feeling confident about it because I recently found out I have secured two out of the three grants.
The chief medical officer of the unit at UCLA is Dr. Ernest Williams, a pioneer in pediatric behavioral health. He also happens to be a former professor of mine and a longtime mentor. No matter how many times I hear him lecture to a group or even one-on-one, I'm blown away by his knowledge, and more so by his warm disposition and empathy. He is easily one of the best in the business, beloved by patients and colleagues alike. He greets me in the lobby with a giant hug.
“Julia! I worried we’d never see each other again in person after the pandemic.”
“Me too. I’m so glad to be here. Thanks for taking the time to show me around.”
He walks me through the unit and explains that before this existed, any child experiencing a mental health crisis in Los Angeles and the surrounding area was directed to regular emergency departments. They were being screened by nursing staff, followed by emergency department doctors, and then were briefly evaluated by a rotating psychiatrist. They usually wound up with a laundry list of meds and ultimately left in a similar holding pattern as I’d seen in Texas—one that both Dr. Williams and I considered barbaric. There are so few acute psychiatric beds and residential treatment centers for kids in the state—so again, they were being housed in ED hallways and waiting rooms, their parents hoping and praying that a bed might open somewhere—even if it was eight hours away by car.
“We have our fair share of frequent fliers, but during and after COVID it seemed like a tsunami of them. Some would decompensate so badly in the adult ED that their parents would take them out AMA only to return less than twenty-four hours later and wind up in the same exact situation,” Dr. Williams explains.
When I walk onto the unit, I'm elated by what I see. The entire space is done in bright, cheerful colors. Individual patient rooms rim the outside of the wall, and in the center is a giant hangout area. I assume it's used for group, based on the colorful beanbags scattered in a circle, feelings charts on the wall, and tissue boxes scattered throughout. Beyond that is a separate space outfitted as a classroom, equipped with all the newest technology and bright desks bolted to the floor, a typical safety precaution. The unit is staffed with three full-time child psychiatrists, four full-time therapists, and fifteen full-time rotating RNs who specialize in psych. I have a brief meeting with one of the psychiatrists and one of the therapists and sit in on a group therapy session. In that time, a therapy dog comes onto the unit and makes his rounds, transforming the kids instantly into more carefree versions of themselves, if only for a few moments.
Dr. Williams takes me to lunch afterward, and I pick his brain, asking about the more logistical concerns and most importantly, how they secured funding.
"Partly state grants and party very generous private donors who contribute at an annual gala the hospital hosts every spring. There are a lot of deep pockets in LA; I imagine they are even deeper in New York. If you do it right, you can cover your costs for the year and beyond."
He catches me up on his life, sharing that he and his wife recently downsized to a condo in Santa Monica and his daughter is halfway through her sophomore year at Stanford. I brief him on life in New York, leaving out any mention of Matt.
As we wait at the valet, Dr. Williams says, “I know I made this offer years ago, but it still stands. If you ever want to try out life on the West Coast, there is always a spot for you at UCLA, Julia.”
“Thank you. That is such a generous offer.” I am genuinely flattered. It would be a once in a lifetime opportunity to work with Dr. Williams in this inspired new unit. But New York is home.
* * *
I climb into Matt's giant Land Rover and drive to meet him for an early dinner. I'm bursting with energy and inspiration, feeling more confident than ever that I can make this entire thing a reality at New York Grace. Even the jam-packed 405 can’t bring down my mood. I breeze into the restaurant and find Matt at a table to the right near the front door. He doesn't notice me walk in, but I very much notice him. Namely, that he is surrounded by three exceptionally beautiful women. The one sitting to his right, a petite brunette with icy blue eyes, is laughing at something he said and has her hand on his forearm. I feel the hairs on the back of my neck stand up.
"Jules!" Matt exclaims when he sees me. He pushes back from the table abruptly, coming over to wrap me up in his long arms. If I had any doubts about what may have been going on at that table, they disappear a second later when Matt kisses me full on the lips in front of the other women.
He turns to them. "Alex, Jessica, Kara—this is my girlfriend, Julia."
The shock on their faces is very satisfying.
I can now see that these women seem to be some obscure age between twenty-five and fifty, but it's hard to tell because of their distorted, overfilled faces. The three of them offer me polite hellos, but I can see right through the veneered smiles—they are sizing me up. Hard. The excitement I felt five minutes ago evaporates, and I am transported back to high school, walking through the lunchroom, trying not to shrivel under their gaze. I do not like the feeling.
"If you ladies will excuse us, Jules and I have a date that I've been looking forward to all day."
"Bye, Matt. See you on Sunday," one of them says.
He grabs me by the hand, and we walk out to a back patio, finding two seats in the corner overlooking the Pacific. Before I say anything, Matt reaches across the table and squeezes my hands in his.
"They are friends of friends—they saw me waiting for you at the table and came over and sat down."
I nod. I can accept this. It makes sense. I trust Matt. I believe him. But feeling this level of insecurity is not something I've dealt with in a very long time, so I'm surprised and confused by how easily it floods in and stings. I wonder if my reaction is a combination of the nerves I feel about Sunday, the pressure of being in LA for the first time, meeting Matt's friends and colleagues, and ultimately just feeling out of my element. Like I can't quite find my footing here. And even though it's only been a few days. I have a sudden pang of homesickness.
"How was your meeting? I want to hear all about it."
I fill him in, my excitement returning ever so slightly. When I mention Dr. Williams’s offer, Matt's face lights up. "So, you could move to LA?"
"No, no. He said it very casually. He said the same thing years ago. I didn't actually consider it."
"But you could." He gives me his megawatt smile.
I laugh. "I don't think LA is for me."
"What's not to love? It's January! And we're outside. In short sleeves. Look at that beautiful Pacific Ocean. I know you’re an East Coaster, but there is a whole lot to love here." He points to the right. The sun is starting to set, and it is mesmerizing.
"It’s beautiful." I can't disagree.
"Even more so because you're sitting next to me. You know I always imagined it'd be like this. I wasn't sure if it could be real. But it is." He rubs the inside of my wrist with his thumb.
I kiss him across the table and change the subject. I don't know why but I have a very strong feeling that I don't want to be here permanently.