John Burley - THE HIDING PLACE

I pushed through the door. The patient looked up as I entered, smiled tentatively at me. His handsome appearance was the first thing that struck me about him: the eyes pale blue, the face lean but not gaunt. He had the body of a dancer, slight and lithe, and there was a certain gracefulness to his movements that seemed out of place within these walls. A lock of dark black hair fell casually across his face like a shadow. He was, in fact, beautiful in a way that men rarely are, and I felt my breath catch a little as I sat down across from him. I gauged him to be about thirty, although he could’ve been five years in either direction. Mental illness has a way of altering the normal tempo of aging. I’ve seen twenty-two-year-olds who look forty, and sixty-year-olds who appear as if they’re still trapped in adolescence. Medications have something to do with it, of course, although I think there’s more to it than that. In many cases, time simply does not move on for these people, like a skipping record playing the same stanza over and over again. Each year is the same year, and before you know it six decades have gone by.

“I’m Dr. Shields,” I said, smiling warmly, my body bent slightly toward him in what I hoped would be perceived as an empathic posture.

“Hello.” He returned my smile, although it seemed that even my opening introduction pained him in some way.

“What’s your name?” I asked, and again there was that nearly imperceptible flinch in his expression.

“Jason … Jason Edwards.”

“Okay, Jason.” I folded my hands across my lap. “Do you know why you’re here?”

He nodded. “I’m here to see you.”

“Well … me and the rest of your treatment team, yes. But can you tell me a little bit about the events that brought you here?”

His face fell a little at this, as if it were either too taxing or too painful to recount. “I was hoping you’d already know.”

“Your records haven’t arrived yet,” I explained. “But we’ll have time to talk about all this later. For right now, I just wanted to introduce myself. Once again, my name is Dr. Shields and I’ll be your treating psychiatrist. We’ll meet once a day for a session, except on weekends. I’ll review your chart and medication list once they arrive. Paul will show you around the unit and will take you to your room. Meanwhile, if there’s anything you need or if you have any other questions, you can ask Paul or one of the other orderlies. Or let one of the nurses know. They can all get in touch with me if necessary.”

I stood up, but hesitated a moment before leaving. He watched me with an expectant gaze, and despite my better professional judgment, I leaned forward and placed a hand on his shoulder. “It’s going to be okay,” I told him. “You’re in a safe place now.”

He seemed to take my words at face value, trusting without question, and in the weeks and months to come I would often look back upon that statement with deep regret, realizing that nothing could have been further from the truth.

I had to ask him for his name, Charles. I don’t know the first thing about him.” I was in Dr. Wagner’s office, trying not to let my irritation get the best of me. It was two days later and the paperwork for the Edwards patient still hadn’t arrived.

“Don’t worry about the paperwork,” he was telling me. “It’s not important.”

“I don’t see how you can say that,” I responded. I’d declined to take a seat, and now I shifted my weight to the other foot, struggling to maintain my composure. Don’t worry about the paperwork, I thought. He was the administrator, not me. He should be worried enough for the both of us.

Dr. Wagner had been the chief medical officer at Menaker for as long as I’d been here. He’d hired me right out of residency, although he’d actually suggested during my interview that I consider working elsewhere for my first few years of practice. The conversation we’d had didn’t seem that long ago, and standing here today I could picture that younger version of myself sitting in my black skirt and double button jacket—my interview attire, as I’d come to see it.

“The job’s yours if you want it,” he’d told me, “but you should give it some extra thought.”

“Why is that?” I’d asked.

He reached forward and slid an index finger along the top of the nameplate near the front edge of his desk, scowled at the dust gathered on the pad of his finger during that single pass. Then he looked at me. “Right now, you want to go out there and make a difference. You’re ambitious, enthusiastic, full of energy. You want to use the medical knowledge and skills you’ve obtained to change people’s lives.”

“I feel I can do that here,” I replied.

He nodded. “Yes, yes. In small, subtle ways, I’m sure you could. But big changes, the kind you wrote about in your application to medical school, for example—”

“You read that?” I hadn’t included it in my application for this position.

He chuckled and shook his head. “They’re all the same,” he said, throwing up his hands. “Tell me something.” He cocked his right eyebrow and extended his index finger in my direction. The layer of dust still clung to it, displaced from its previous resting place after who knew how many months or even years. “You didn’t use the word ‘journey’ in your essay, did you?”

“Excuse me?”

“Seventy-six percent of medical school application essays have the word ‘journey’ embedded somewhere in their text. Did you know that?”

“I didn’t,” I admitted, although I wasn’t sure what this had to do with—

“I used to be on the admissions committee at Georgetown,” he said, “so I should know. I’ve seen enough essays come across my desk.”

“Seventy-six percent, you say?”

“It’s a mathematical certainty.” He brought the palm of his right hand down on the table with a light smack. “Granted, there’s some slight fluctuation from year to year, but on average it’s seventy-six percent. The word ‘difference’ is in ninety-seven percent of medical school application essays. Ninety-seven percent ,” he reiterated. “Can you believe that ?” He chuckled again. “We did a study, tracking the most common word usage in application essays over a ten-year period.”

I returned his gaze, not knowing how to respond. The man was eccentric, I had to admit.

“Which means,” he continued, “that almost all prospective physicians want to go on a journey and to make a difference . That’s the prevailing dream.”

“And?” I prodded, still not clear where he was going with this.

“And you won’t do that here at Menaker. There is no journey. Patients are here for the long haul and, for the most part, they’re not going anywhere. And although you might make a small difference in the lives of some of these patients, that difference will be played out slowly over the course of ten or twenty years. It’s not something you’ll notice from month to month, or even from year to year. Young doctors come here because the place has a reputation of housing the sickest of the sick. I get that. I can understand the allure. But within a short time, most of them move on—because this is not what they wanted. Not really.”