Free Weekends at Bellevue by Julie Holland Page A

I know that’s how a good screenplay would read; but in truth, my growth came in fits and starts, and I had to learn the same lessons repeatedly before they’d sink in. One step forward, a couple back, a couple more forward: Eventually I inched my way along the path, growing and changing, but the process wasn’t pretty.

To Protect and Serve
    I usually start off my Saturday night shifts by cleaning up the trash, throwing away all the used coffee cups, pen caps, and progress notes. Once the area seems a bit neater, I get to work on “clearing the rack.” Tonight, there is a backlog of patients who have been seen and put on Hold. This means the doctor on the shift before mine couldn’t make up his mind about what to do with them, or else the patients were too drunk or high to be released. Most Holds get discharged once they’re sober (they’ve “cleared” in medical terms), but other times we admit them to a detox bed, or, if they look psychiatrically sick enough, to the dual diagnosis ward upstairs for the MICA patients—mentally ill, chemical-abusing—an acronym that efficiently describes most of our patients.
    I grab the first chart from the Hold bin: a guy who was wandering the hospital’s hallways last night, high on cocaine. When HP tried to escort him out, he made only enough sense to convey that he felt suicidal. Now, nearly twenty-four hours later, he says he feels better; he’s come down off his high and is eager to put his Bellevue detour behind him. That makes two of us, but he won’t let me call anyone to confirm that he isn’t a suicide risk or an axe-murderer.
    “Mr. DiCarlo, I can’t let you go until I can speak with someone who can vouch for you. I need a phone number of a friend, a cousin … anyone.”
    He sits and stews for a while, not willing to give up a number. After acouple of hours of waiting, he realizes I’m not kidding. The number is his only ticket out.
    “Okay. You can call my mother, but she doesn’t speak much English.”
    I approximate Italian using my meager Spanish, and she manages to communicate two things to me:
1) Don’t send him here.
2) He beats his girlfriend.
    She gives me the girlfriend’s phone number slowly in her native tongue.
    I know I have to call the girlfriend. Somehow, I sense I can’t release him unless she gives the go-ahead. He’s in a hurry to get discharged and is pressuring me to let him go, and if there’s one thing I’ve learned in my few months at CPEP it’s this: If they want to stay, they need to leave; if they want to leave, they need to stay. It seems to hold true ninety-five percent of the time. If someone walks in saying, “I am hearing voices telling me to kill myself and others,” or “I am a danger to myself and others,” then I know he is relaying verbatim what he’s learned on the street, in the shelters, or in jail. He believes this will get him “three hots and a cot” in the hospital for a few days. If a patient is trying his hardest to be released, but won’t give up any phone numbers that can make it happen, then I have to assume something is amiss.
    “Mr. DiCarlo, I need to talk to your girlfriend.”
    “I want out of here,” he grimaces. “I’m done with your phone calls.”
    “You cannot leave here until I talk to your girlfriend.”
    “That isn’t going to happen.”
    He doesn’t know I have her phone number already. “Fine,” I reply. “You can rot here all weekend for all I care.” I’m being a bully, and for some reason, he is eating it up. He doesn’t bolt for the door, he doesn’t escalate to the point of being restrained. He wants the conflict to be drawn out.
    Eventually I get in touch with his girlfriend and ask her if she will feel safe if he is discharged.
    “Don’t let him out!” she begs me.
    She tells me she has an order of protection against him which he’sviolated continually for the past two weeks, and the police are looking for him. Two weeks ago, he busted down her door,