Enforcement

Today....you know, it really wasn't awful, but, I'm still glad it's over.

My day started with a very nice lecture on adolescents and substance abuse and I was reminiscing a little about what a "good" group of kids I ran with in high school. I mean, we weren't self-righteous or prudes, and I know some of my friends did plenty of stuff (one of my softball friends, who was, like, the last person I would've expected it from, taught me the meaning of the word "kegstand"), and - believe me - we got into plenty of adolescent hijinks, but when it came to stuff that could be smoked/ingested/inhaled, we were sort of like, "nah, we're fine over here. That's what college is for."

I also was reminded of how one of my therapy kids came in a couple of weeks ago and said that her friends, to show their support in a difficult time, came over with "cookies and monsters." I, of course, being the ever suspecting doc that I am, was like, that has to be a drug reference, right? But I'll be damned if I knew to what. So I said, I don't know what that means, and she tells me, "Monsters, you know, they're these energy drinks." Oh!, I said. Monsters. Duh. Got it. And then she looks and me and says, "And cookies. You know, they're like....cookies."

Believe me, hon. I know cookies.

So then I go back to my office, and am talking to Peng, and I get this page, "The police are here and need to see you ASAP." I was like, what?? Peng says, it has to have something to do with your patient (there's history to that comment, just trust me). And I go up, and of course, that's why they're there. I talk to the officer, my patient and I have our session, she's safe, it's fine, I send her home. You know, via the police, because, well, it's not like she can walk. And I go into my next session, and get paged out because the officer that brought her is all, you let her go? Are you kidding? I say, no, it's fine, we did our thing, she's okay. She didn't give me any reason to petition her. And the officer says, "her phone call to me this morning is enough for an emergency commitment" (which is wrong, by the way. It's enough for an emergency petition and custody order). I shrugged and was like, sure, it's enough to petition her and bring her in for evaluation (because that's what a petition means. It's not a commitment all by itself. Anybody can take out a petition, but to get the commitment you need a Qualified Professional's Exam, which - guess what, lady? That's me). I evaluated her and let her go. Cop lady, although very nice, was clearly not pleased. The hospital police, who know me (and the patient), were like, are you sure? Well, okay, Dr. Kate! But then, to her defense, they (and I) see a lot more of this every day. There's a reason all the hospital cops know me, and it has nothing to do with my killer smile.

Look, folks, we deal with this every day. Involuntary commitment doesn't really prevent people who really want to hurt themselves from doing so, anyway, it just delays them. And with the type of therapy she and I are doing, and her personality disorder and current situation, this was what I was supposed to do. I understand, totally, where she's coming from. I happily gave her my name for her report. But, you can't keep all the crazy people locked up all the time. There wouldn't be anyone left on the outside...

So I went back into session with my next patient. Meanwhile, Peng, who noticed I'd been gone longer than the standard amount of time for a therapy session, went out to the front desk to find out if they really had come with my patient or if they'd come to take me away.

(I suspect that the men who do someday come to take me away will probably be bringing me a pretty white long-sleeved jacket...)

The rest of the day was largely uneventful, fortunately. We had a very sad but interesting M&M (morbidity and mortality conference, not the candy. It's a protected forum - i.e., nothing we say in there is legally admissible in court - in which we can discuss things that go wrong and how to keep them from going wrong again) which more or less involves a fubar on the part of another hospital service, and ultimately comes down to the "scary psych patient" syndrome. Which, unfortunately (although, thankfully not in this instance), can in fact be fatal.

I found out shortly after M&M that my coworker Eva is pregnant, with twins. She's seven weeks and they already have faces (that is one wicked ultrasound machine. I wish anything I'd ever worked with had that kind of resolution. But I digress). And, actually, tails (you had one too at that age). I'm excited for her.

My afternoon, fortunately, came and went. I have this one patient who's been in the clinic as long as I've been alive, and unfortunately it's now fallen to me to crowbar him out of the clinic, since I'm not going to be following him next year. I came up with a good plan for this, and he took it much better than I expected. He actually seemed to agree with the reasons I provided him with why he should be seen in a private clinic. I was pleased. One of my kids no-showed, the other was doing awesomely. And she was even early, so we ended a little early, and I got to leave with Peng.

All in all, not a bad day. But still leaves me shaking my head a little and thinking, my life is weird. Nobody else's job goes quite like this....