The Intruder (5 page)

“Be that as it may,” says Mrs. Baldridge primly, “his coverage does not provide for thirty-day hospital stays.”

Dana looks over and sees Mrs. Lee has somehow gotten up on the windowsill and is standing there grinning like an aging Broadway starlet on the verge of a triumphant comeback.

“Excuse me, I’m going to have to call you back,” Dana says into the phone.

She hits the panic button under her desk, calling in security. Then she gently approaches Mrs. Lee the way she’d approach a wounded sparrow on a porch railing.

“Mrs. Lee, please come down from there,” she says softly.

“Kay!” says Mrs. Lee cheerily, somehow breaking the word into two syllables.

She turns toward the window and squints at the sun, basking in its warmth. The light catches a purplish bruise under her right ear.

“Mrs. Lee, I’m afraid you’re going to hurt yourself.”

By now, Eduardo, the nervous young hospital cop from the front desk, has come in accompanied by Mr. Lee, a bristle-haired bull in a pink Lacoste polo shirt.

“Kay, lo-kay,” says Mrs. Lee, as if she’s happy to see both of them.

Mr. Lee mutters something short and harsh and his wife steps down from the sill, daintily taking his hand. The bowling ball and the pin, Dana thinks when she sees them standing together. He must knock her down twice a day.

“We go now,” he says, starting to lead his wife out.

“I really don’t think that’s wise.” Dana follows them out into the waiting area. “There are things we need to discuss.”

A homeless man in a Yankees cap and an MTA shirt sits there watching them, with an empty baby stroller at his side. A woman from Honduras, in four-point restraints on a bed down the hall, is cursing out the nurses in Spanish. Mrs. Lee whispers something in her husband’s ear and her hands flutter like pieces of paper caught in a sudden updraft.

“She say she wasn’t going to jump,” Mr. Lee tells Dana. “She was looking at the view.”

They are on the first floor and there are bars over the windows.

Dana asks the couple to wait so one of the unit psychiatrists can talk to them, but she knows Mrs. Lee will probably just end up getting discharged because she’s there on a voluntary basis. She starts to leave a message for Dr. Miller, and for the 147th time in the 147 days she’s been working in the ER, she asks herself if she’s really helping anyone this way.

“Excuse me.”

The homeless man with the baby carriage is staring at her as she puts the pink slip in Miller’s box.

“Yes?”

“I was wondering if you had a minute.”

She checks the in box at the nurse’s station to see if there are any other patients waiting. The one face sheet is for a John Gates. A momentary lull. The only other people in the waiting area are a Muslim woman in a white headdress and black basketball shoes and a Puerto Rican man whose lips are still blackened from the charcoal they pumped into his stomach to absorb an overdose. One way or another they’ve been taken care of.

“You’re Mr. Gates?” Dana looks at the homeless man and tucks a couple of stray hairs into the bun behind her head.

“Yeah, uh, well. Last I checked.” He smiles ambiguously within his beard.

She shows him into her office. He stands in the doorway for a moment, studying the bare walls and the anonymous furniture, as if he’s looking for clues.

“I’m Ms. Schiff,” she says. “Have a seat.”

He takes off his cap and starts to sit. But then he suddenly stops, stands up straight, and slowly lowers himself into the chair. With his left foot, he carefully pulls the baby stroller close and puts his right hand on the back, like he expects someone to try stealing it.

“So what brings you to the emergency room?”

He looks at her for a long time.

“Some kids tried to set me on fire the other night.”

She’s not sure whether to believe him. In the five months she’s been on the unit, she’s talked to dozens of homeless people with hundreds of problems. Not that many were white, though. She wants to be careful here. Not just because she’s heard white homeless people tend to be crazier than the others, but because she doesn’t want to make a leap of empathy based just on skin color.

“So somebody tried to set you on fire,” she says. “Why didn’t you call the police? What makes you think you want to talk to someone here?”

He lowers his eyes and stares at the empty baby carriage. “Up until that happened, I think I kinda wanted to die,” he says. “Now I’m not sure.”

He hums and rocks the stroller with his foot. Though he smells and his clothes are dirty like other homeless people’s, there’s something a little different about him.

“You’re not sure you want to die.”

“I think I want more life.”

“All right.” She sighs and rubs the space between her eyebrows. Here comes another one. “I guess I need to get a little more pedigree information from you.” She looks over the face sheet and swivels in her chair to get a twenty-page yellow form off her desk. “What was your last address?”

“Central Park.”

“I see.”

She notices the way his chin seems to be drawn down to his chest, as if by magnetic force.

“Are you currently taking any medication?”

“Haldol, five milligrams,” he says in a deep, froggy voice.

“Anything else?”

“Well, I guess you wanna know about the crack ...”

“How much?”

“Ten, twelve bottles a day. It offsets the Haldol.”

“Well, that’s honest.”

“I never lie.” He licks his ragged lips and starts tapping his foot. “The nuns taught me that in Catholic school. It makes things easier to remember.”

She looks down to complete the first page of the form. He’s definitely beginning to interest her. So many people who come in are disorganized and have no real hope of recovery. Maybe it’s just the blue Transit Authority shirt he wears over his other layers of clothes. But she has the feeling that he was once connected to something in the real world and now he wants it back.

She’s aware of him shifting his weight in the plastic seat as she runs through some of the other standard questions. But then he interrupts.

“Look, can I say something to you?” He stops her with a bold stare and she notices he actually has beautiful green eyes.

“Of course.”

He pauses to take time with his words, like a man trying to figure out how to lift a grand piano by himself.

“I know you’re gonna ask me all these questions on your form about previous employment and other treatment I’ve had. But none of that really matters. Okay?”

“Why not?”

“Because,” he says, squeezing his hands between his knees, “none of it can ever make up for the death of a child.”

Silence. He hunches over, looking at the empty baby stroller again. His face seems older. The net of lines around his eyes tightens.

“Is that something you’d like to talk about?” Dana asks, putting down the form.

He releases his hands and sits back. She hopes her voice hasn’t betrayed too much. Countertransference. She’s been warned about it since grad school: don’t identify too much with your client’s problems.

“No,” he says quietly. “I don’t think so. Not right now anyway.”

He wraps his arms around himself and begins to pulsate in his seat.

“So are you thinking you might like to be admitted to this hospital?”

He shakes his head
no
vigorously without looking at her. She peeks out the door and sees patients are stacking up in the waiting area like planes on a runway.

“Then I’m afraid I still don’t understand why you came here today,” she says. “You don’t want to talk about your problems. You don’t want to be admitted. What is it that you do want?”

“Things have come apart,” he says, crossing his legs and examining the sole of his left shoe. “They need to be put back together.”

She watches him a few moments, trying to decide how to describe him in a write-up. White male in his mid-thirties. Once married, according to the information sheet. Reasonably sequential in thought process. Diagnosis unknown.

“I’m still not quite getting the picture,” she says.

The gnarled scabby fingers of his right hand begin to play across the top of his knee like it’s a piano. Index finger, thumb, pinky, ring finger, middle finger. “See, being out on the street
like I am, it’s changing me.” The fingers start to play faster. Thumb, pinky, index. “There are things in my mind that shouldn’t be there.”

“What kinds of things?”

“I don’t know.” He half smiles shyly: if only you knew.

“Well, are you hearing voices?”

“Just yours and mine.” He looks at the hand lying on his lap. Ring finger, index, pinky, thumb.

“And are you still worried you might hurt yourself?”

“I’m worried that no one is taking responsibility.” The fingers stop moving.

“What do you mean?”

“I mean, I know I am not in complete control of my faculties.” The fingers close into a fist. “Being out on the street like I am . . . It’s like every day I wake up and I’m afraid of what I’m going to do.” He stops and gives a little shiver. “And I don’t think God meant for me to end up this way.”

The mention of God is usually enough to make her scalp prickle. In this office, people attribute all kinds of things to God’s will. God wanted me to cover my body in peanut butter. God wanted me to go to Atlantic City with the union pension fund. God wanted me to stand in line at D’Agostino’s without any clothes on. But John Gates seems perfectly sober and serious mentioning the Lord even as his left knee does the crackhead jiggle
^le
-

“So you mentioned the idea of responsibility before,” she says, turning to the evaluation page. “Who are you suggesting take on all this responsibility?”

“You.”

“I beg your pardon?”

The air becomes very still between them.

“You.” He leans forward on his elbows and looks up with his lost-little-boy green eyes. “You seem like a nice person. I can talk to you. I’d like you to be my regular doctor.”

She looks at the empty extra-strength Tylenol bottle on her desk and wonders why she didn’t get a new one this morning.

“But I’m not a doctor,” she says. “I’m a social worker. And this is an emergency room. Nobody sees regular patients here.”

From down the hall, she can hear Mrs. Berkowitz in the waiting area. That demented old lady from Cherry Street who always shows up waving the empty prescription bottles her late husband was given in 1951. He must have died a happy man.

“See, that’s the problem with the whole system!” he says loudly and then catches himself. “No one takes any responsibility,” he says, trying to modulate his voice. “Everyone’s giving me the run-around. Every time I get a new caseworker they either get transferred or they lose my file. And somebody’s going to get hurt!”

She looks at him. Eyes clear, left knee still trembling. He’s not completely paranoid or delusional. At least not yet. He’s a man on the cusp.

“So you want to get your life back in synch?” she says, testing his resolve.

“Yes.”

“And you want to get off drugs?”

“Yes, Ido.”

“And you want to get off the street?”

“Yeah, and I’d like to get another apartment.”

“Well this isn’t a real estate office.” She rubs her eyes. “Do you have any insurance?”

A slow mournful headshake. “I lost all my benefits with the TA, ‘cause I failed the drug test. And then I fell off the rolls because I missed my face-to-face.”

“You’re going to have to reapply,” she says, taking out a card and writing down some numbers on the back. “You need to start at the Emergency Assistance Unit office.”

At least he once had a job. From the room next door, the Honduran patient in restraints is shouting. “I want
puta
music!
Puta
music!”

Dana notices John Gates staring past her, looking at something in the hallway. “Hey, what’s that mean?” he says.
“Be careful when opening doors; risk of elopement. ”

“It means they want to be careful about patients escaping.”

“Oh. I thought maybe they were worried about patients and doctors eloping.”

“No. I don’t think that happens very often.”

“Well you never know.” He starts to smile.

Dana feels her chin sag and her ears get hot as she looks through the rest of her papers. The rumble of voices has grown louder in the waiting room and the mix of accents has become more dense. There must be a half dozen of them out there by now. Just the thought makes her tired. She’s going to have to move him out soon.

“Look, give me a call in a couple of days,” she says in a frazzled voice, adding her office number on the back of the card and giving it to him. “Maybe we can work something out so I can see you at the Mental Health Clinic at the hospital. I’ll talk to my supervisor.”

A major headache, to be sure. She can already see the sullen, heavy-lidded look on Rod Walker’s face when she brings it up at the next staff meeting. “If you do this, you’ll be setting a bad precedent for everyone else ...” She hopes John Gates will be worth the effort.

He gets up and starts to push the stroller out the door. But then he stops and takes her hand, an almost courtly gesture. “Thanks, Ms. Schiff. You’re good people. I knew I was right about you.”

His fingers feel like sandpaper blocks as they brush hers. She takes her hand back and sucks in her cheeks. She wonders what she said to make him feel so trusting. Maybe it was just the look on her face when he mentioned the death of the child.

Probably she has to learn to put up a colder front, as Jake’s been telling her. Or learn not to care.

5

Who was the ...” Dana’s fork pauses in midair.

“... the guy.” Jake finishes the sentence for her.

“Yes, your old client. The one who ...” Her face pushes up, straining.

“The one who threw his mother out the window? Al V. Strang?”

“Right. Didn’t he . . .”

“... cut off his penis and try to take a bite out of the patrol car when the police came to arrest him?”

“Well.” Dana lowers her fork.
“He was
a hopeless case, wasn’t he?”