a tale of three psych patients

a recent conversation turned to the subject of abuse, to the dialog and community that exists for women who know what it is like to lose control of their bodies. since that conversation, my mind keeps drifting to the stories of these three people:

he presented in raging mania. i asked what brought him in. it was 15 minutes before his voluminous speech slowed enough for me to interrupt. we backtracked to where this story began, to where he found out his twelve year old daughter had been molested by a cousin. rage burned in his eyes in the re-telling. devastated, he had withdrawn the whole of his savings. he bought a gun, rented a hotel room, and spent the rest on crack to help him "get up his nerve." somehow the plan was severed, and he ended up sitting across from me in a small room of an inpatient psych unit. his anger toward the one who abused his daughter was overwhelming. no mood stabalizer would change that.

she was transferred from the emergency department after 26 staples were placed, holding her arm together. it was one of her alter personalities who did the cutting, she assured me. her mind began fragmenting after her childhood self was subjected to horrible abuse by horrible men. no staples could piece together that kind of trauma into a whole person.

he told stories of incarceration. his ex-girlfriend claimed he "stole the love." she wanted it, he promised me. he was angry at his months behind bars, at his court-ordered sex addition counseling, at her for blaming him. no words would convince him of any guilt.

these three, they collided into my world within days of each other. they passed each other in the halls of an urban psych ward, each carrying part of the story of abuse. the abuser. the abused. the father seeking justice. all carried anger and brokenness. all needed help that medicine couldn't give.

i try to weave their stories together in my mind, hoping they will bring meaning to the atrocities of abuse that exist in the world. hoping they will somehow shine light on the healing process. hoping there is hope for each of them in their own way.

things that give hope

i often imagine the worst for what happens to someone when they leave the hospital.  i wrongly assume the point where i meet them is part of an immutable broken path.  

16 year-old girl, second-time pregnant. rumors float that father of the baby is her father too. 

13 year-old boy, bullet-shattered shoulder blade.  step-mom comforts. birth-mom incarcerated.

45 year-old man, heroin-infected spine. discharged to homelessness and a "business meeting." 

i fill in the blanks of their futures along the trajectory of brokenness.  it's easy to do when you see others with similar pasts continuing to live in places of despair.


at covenant house i learned to imagine hope.  

i knew her from the children's hospital.  an infection left untreated too long.  we suspected abuse and neglect.  no family visited her.  i imagined single motherhood. minimum wage or welfare. domestic violence.  then i saw her at covenant house. a step toward hope.  safe housing. job hunting. educational support.  maybe a future of something other than the worst case scenario.  maybe a chance at life.

i knew him from the trauma bay. bullet in his arm; no major injuries.  i imagined another bullet would find him soon enough.  then i saw him at covenant house, struggling to begin a new life.

i don't know what happened after covenant house for either of them. i do know that because of their courage, i am able to imagine things other than destruction and downward trajectories when i see broken points in the lives of the people i care for. 

things that break us

slow steps up to the out-of-the way call room.  i will my pager to stop beeping so i can get at least three hours of sleep before morning rounds.  

danskos slide off my feet as i pull the blanket i stole from 3 West over my tired body.  out the window, i hear a siren.  it is brief, a quick cry, as if its operator isn't sure if the situation is an emergency or not.  my heart sinks, knowing what is next.  pager rings.  

feet slide back into danskos while i walk back down the stairwell.  i enter the code to enter the emergency room, and stumble into the trauma bay.  

beautiful athlete lies on the table.  a small hole in his chest, ringed with a black burn that can only be caused by a bullet.  the trauma protocol has already started as i pull plastic booties up to my knees.  i know the blood will flow soon enough.  

everything happens quickly.  a scalpel. a saw.  soon beautiful athlete's ribs are detached from his body.  blood pours onto the floor as skilled hands search for the source of the bleeding.  a hole in the heart.  staples quickly close the hole but the life blood of beautiful athlete is on the floor and no staple can reverse that.  a defeated trauma team calls time of death for beautiful athlete.  

a large needle is placed in my hand.  med student, sew him back together.  a baseball stitch will do.  impatient nurses hurry me along as i imprecisely reattach ribs to belly.  the skin under my stitches will never heal.  i stitch simply so his family can see him reassembled. 

a final knot is tied.  again i trudge back to the call room, again i will the pager on my waist to silence.  inside an open door i see beautiful athlete's family listening as trauma surgeon tells them the news.  i feel petty for craving sleep while beautiful athlete's mother grieves the short life of her 22-year old son. 

local newspapers never give details of the shooting.  simply name and age of beautiful athlete, and the cross-street where he took his last breath.  

at home the next morning, despite the overwhelming exhaustion, sleep will not come.  over and over i see my stitches, running like a baseball, across beautiful athlete's chest.  i wonder what hope looks like in the face of street violence. a fatigued grasping for meaning, i google some variant of hope, street violence. the first hit brings up words written by paul two millenia ago: i am convinced that neither death nor life...can separate us from the love of God.  my eyes flood with tears.  i hope desperately that this is true.  

in the retelling, a friend offers words of comfort. maybe your stitches were part of the redemption of the world.  maybe, if we believe our bodies are raised someday, it is your stitches that made him ready for that day. 

a chart review

i know her name.  
i know her age. 
i know she came to the hospital to have a baby, and she found out she had HIV.
i know they sent the hospital social worker to see her, to see how she handles the news.
the social worker's note documents tragedy. 
father of the baby died 4 months ago.  (street violence?)
two more little ones, ages 1 and 4 at home. 
year-old babe should get HIV testing.
patient's mom and stepfather died in the past year.
no other social supports. 
patient seems depressed...is she safe to take home this new life?

the babe's chart is somewhere else, but i remember the hospital's collective sigh of relief when he came back negative for the virus.  

i know all these facts. but i don't know her. 
i don't know the joy she feels when her new babe wraps his hand around her finger. 
i don't know the agony of figuring who gave her an infection science has only figured out how to suppress but not cure.
i don't know the guilt that builds, realizing she could have passed the virus to this new life.
i don't know if there is anything in life that has made her resilient, that gives her hope, that strengthens her in the face of these injustices, if there is a god she clings to.  

i hope for her.  
that someone would come alongside her in this now increasingly difficult journey. 
that year-old babe would be virus-free. 
that echoes of hope, bouncing off unknown walls, would strengthen her soul.  
that she would know she is loved. 

and, as always, that hiv would end.