I know how to care for my seriously mentally ill patients, while shielding myself from the pain of this work–how to let the ache go and not bring it home. But I’ve been away for a while, my guard has dropped, and there is no Star-Trek–like force field to keep my heart safe today.
My job as a psychiatrist in a large county jail provides some protections; cell doors and corrections officers guard my body. And unlike the young man I’m meeting with today, I started life in relative safety. I was not born with a congenital brain malformation giving me a speech impediment, an awkward gait, and a lowered IQ. I was not born with a predilection for schizophrenia, not adopted into a family overwhelmed by too many adoptees to be able to provide for a child with special needs.
My young patient and I can see each other through the window in his cell, but we have to use loud voices to hear one another through the cracks in the steel door between us. He’s been in jail for a few days, in town for a month, leaving homelessness in LA for homelessness in this city, to follow his destiny. He is in his late twenties but seems younger. Dirty and malodorous, he has been loud and disruptive, yelling vulgarities at the nurse this morning, too agitated to even take a shower yet. But now, he is telling me about his destiny–to design “cool clothes, but cheap, so everyone can have them.”
He doesn’t understand my attempts to explain bail and courts and competency. “You don’t understand!” he insists. “I was in placements for nine years…. Sometimes they burned me with cigarettes.” Tears begin to slide down his cheeks; my tears are backed up behind my eyes and in my throat. He wipes his face with the shirt of his jailhouse reds, revealing his skinny white chest.
He was arrested for trespassing while near a hotel, sitting on a grate with “the bums” for the warmth. All he asks is to get back to his life and go on. He doesn’t want medicine or any sort of help. He just wants to leave; he is totally frustrated that no one seems to understand the urgency of his need to be out.
But perhaps the knot in my stomach says that I do understand, that I need to be out as well, to follow my destiny.
Gail Kubrin
Pittsburgh, Pennsylvania



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