Burn It Down

I barely know her.  She may not even know my name.  We are Facebook friends, but only as a result of the dozens of requests sent in August, when our class roster was released and orientation was a seething mass of trying to connect faces to names and backgrounds.  She is a blip on my radar, a classmate, a body in the room.  But today she has written something about starting her rotation with the "criminally insane" next week, while she and her friends leave comments about her "hanging on the hill," "Yikes!" and "LOL."

I do not know her, and my rage is a white hot torch inside me.  It makes my stomach roll, my hands shaking as I type this, my legs under the table tremble and I feel like if I saw her now, I would overturn tables, scream my lungs bloody and raw, my rage would set her on fire and she would burn to ash in an instant, flattened by the enormity of all I feel.

You do not know.  I want to tell her.  You do not even fucking KNOW.  I want to tattoo things like, They are people, too and They are not "insane," they are sick and have done terrible things because they have felt terrible things that you will never understand, onto her hands, leaving angry black lines that will mark her as indelibly as they are marked by their choices and actions and demons and fears.  I want to run back to the hospital where I spent the last two nights and I want to camp out on the stoop and block the door when she shows up next week, I want to put my flesh and blood between her prejudice and privilege and them, the vulnerable, the patients to whom we owe so much and from whom we have so much to learn.

I want her to understand what it feels like to have your medications handed to you in a paper cup and be watched while you swallow them.  I want her to know what it feels like to have all your phone conversations in a public room, on a dirty telephone with a 12 inch cord so short that you can barely even sit down.  I want her to know how it feels to see a binder, three inches thick with pages of reports, lab results, tests, and medication records that are all about her, the inside of her head, every bad choice she has ever made, every moment when she felt like she couldn't go on, every hurt in her heart, laid out in blue and black ink and filled with descriptions like, decompensating rapidly, poor response to medication, history of trauma, significant for sexual assault, rule out PTSD, poor self care, poorly engaged, continue fifteen minute checks.  Descriptions that once filled my chart.

I am overreacting.  I know this.

I know this, and yet.

My patients.  They have done terrible things, yes.  Killed people, threatened people, hurt their wives, their husbands, their children, their neighbors, the very people trying to help them.  Voices in their head, telling them to do this.  Psychosis so real, so impenetrable and unrelenting that it would be like me telling you, No, that's not your name.  You don't actually live where you think you do.  You are not a human, you are a drop of water.  Everything you believe to be true is false.  Everything.  Some of them are remorseful, some understand now what they did, they understand that they are sick, terribly ill and that medications and therapy may help and though they have helped, they don't remove the sickness and they don't change what happened.  Some show no remorse, yes.  It is difficult to see.  Reading their chart hurts the deepest part of your heart that believes the world is essentially good and worth saving.

But they are not "insane."  And the inside of their minds, the lives they have lived, and the things they have seen are more "Yikes!" than what you could ever possibly imagine.  I hope that when you start your rotations next week, that you will see this.  I hope for this with every torching, white hot fiber of my being.