Читать книгу THE HIDING PLACE - John Burley - Страница 10

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.”

“Some of them must want it,” I countered.

He only sighed. “A few, yes. But most don’t. I’ve read enough essays to know.”

I’d gone home that night and managed to unearth my own medical school application essay from eight years before, and goddammit if he wasn’t right. I’d used the word difference twice, and the essay’s last sentence read, I look forward to the journey on which I am about to embark. Pathetic, I thought, standing there in my kitchen. But at the time I’d written it I’d meant every word. The next morning I called him up to accept the position. Maybe my expectations had changed since applying to medical school. Maybe I just wanted to prove Wagner wrong.

“Did you look?” he asked, and we both knew what he was referring to.

“Yes,” I admitted.

“And?”

“And I must be in the minority,” I lied. “When would you like me to start?”

That was five years ago, and despite his predictions at the time, I’ve been relatively happy here. The nursing and support staff at Menaker are dedicated, and the faces of those I work with seldom change. There is a sense of family, and for someone like myself whose real family has been splintered in numerous ways, there is a certain nurturing reassurance in that stability. Wagner had also been right about the patients, who are clearly in it for the long haul. Practicing psychiatry in a place like this is like standing on a glacier and trying to influence the direction it will travel. It’s difficult, to say the least. But sometimes, despite all the forces working against us, we are able to effect a change—subtle, but real—and the victory can be more gratifying than one can possibly imagine. But all jobs entail occasional days when you feel like banging your head against the wall, and for me today seemed to be one of them.

“Am I missing something here, Charles?” I asked. The volume of my voice had ratcheted up a notch. I made myself take a breath and exhale slowly before continuing. “We cannot admit a patient involuntarily to this institution with no court order and no patient records. It’s false imprisonment, tantamount to kidnapping.”

If Wagner was concerned, he didn’t show it. “I think you should leave the legalities to me,” he advised. “Focus on the individual before you, not his paper trail. Talk to him.”

“I’ve been talking to him. For two days now. He doesn’t say much—doesn’t seem to know what to say.”

“It can be difficult.”

“It’s frustrating. I have no patient history or prior assessments to help me here. I don’t even have a list of his current medications.”

Wagner smiled through his goatee. It was a look, I suppose, that was meant to be disarming. “I think you have everything that you need right now. Talking to him is the most important thing. Everything else is secondary.”

I turned and left the office without a retort, deciding that whatever response I might muster wasn’t worth the price of my job.