Brooklyn Zoo (36 page)

When I returned two days later, Nicholas was restless and alone. I’d been expecting to find his brood, to work with the family in the wake of his indifference. But away from the company of his mother and brother, Nicholas looked desperate, like a caged animal in his eyes. I didn’t want to get too close, but he was paralyzed, so I moved next to the bed.

“I’m trapped,” he declared, scratching mercilessly at his thighs through the white sheet.

“Can you feel that?” I asked, watching his hands. He shook his head. He had a furry boot on each foot. He asked for some water. I went into the hall, where there was a drinking fountain and small plastic cups. I filled two and brought them to him, and he grabbed them and guzzled. A Jamaican nurse came in looking full of all that might comfort a boy. She gave him a shot in the leg that he also couldn’t feel, and he was irritable with her.

“Baby, don’t get frustrated,” she cooed. “Everything happens for a reason. Trust in God.” She put a pillow behind his head, and he asked her to stretch his legs. “Your brother should do this for you,” she said, standing at the foot of his bed, bending
his knees while holding his flaccid calves. The television had been turned—by whom?—to FitTV. A muscular Israeli jumped up and down on a step, exhorting morning viewers to follow along at home. From under Nicholas’s bedclothes a tube poked out, yellow with urine. The nurse left, and I turned off the hateful set. Nicholas started right in talking.

“I had three nightmares,” he told me, staring at me intently. “In the first one, I got out of a car with a friend. He gave me a gun, and then I got shot. In the second one, I got shot, too. But in the third, I was at my grandmother’s house, and there was no gun. I fell backward and hit my head and was bleeding all over the place. Once I woke up, I was afraid to go back to sleep.” He stopped talking and waited. I often felt dreams were presented by patients like challenges, material for me to sculpt something out of, buttery maple cookies or Disney figurines.

“What do you make of all that?” I asked. We are the authors of our own dreams, our associations to them as valuable as any therapist’s.

He answered, “That I shouldn’t be alive. I’ve done a lot of very bad things in my life. I don’t want to tell you about them. Yet.”

The “yet” chilled me. But how many very bad things could a boy of eighteen actually have done? And what happened to the kid who didn’t particularly want to talk?

“I never let my guard down,” he said.

“Makes sense,” I said. He’d entered witness protection around the time he’d learned to talk.

“My family expects too much of me. They think I should be up and running around already. I’m going to let them down. People keep saying, ‘Don’t worry. It will be fine.’ But I’m not okay. It’s not fine.”

With that he immediately fell to sleep. It was strange actually. I felt weighed down by his vulnerability and all that he’d intimated so quickly, rapid-fire. I went to Dr. Singer.

“Eventually, you want to be future oriented with him,” he instructed. “What are his plans, and how can he actualize them? Acknowledge what he’s struggling with, and help him to envision a better future. I’ll go see him, give him some Seroquel to help with the nightmares.”

The next day Dr. Singer reported to me on his meeting with Nicholas. “He’s still delirious,” he told me. “What he said to you yesterday may or may not be true. No point doing therapy with someone in a delirium.” He gave a little laugh, not at me, but with me, and I joined him, only a little abashed. I’d learned what addiction looked like, schizophrenia and mania. Here was delirium now, feverish and abrupt.

When I returned to Nicholas’s bedside, he greeted me in a friendly way. His mother and brother were back. I asked if he remembered our talk.

“Not really,” he admitted sheepishly. “Well, maybe a couple things.”

I could tell he was embarrassed, and so was I, and I didn’t press the issue. I listened as his mother and brother plotted strategies to get the witnesses to talk. The brother would testify the next day. “Good luck,” I told him before I left.

“I like her,” I heard the mother say as I hit the hallway, which made me feel guilty because what was I really doing for her son?

At my request Dr. Singer and I started spending more time together. Tamar had really raved about him, and doctors and nurses from A Building to C obviously shared her regard. He
was the Bruce Springsteen of Kings County Hospital, and walking the long, dreary corridors with him was slow going and magnificent. Everyone wanted a minute with the man, to ask a question or to shake his hand, and I basked in his limelight, important by association. In whatever misguided ways the physicians tended to use psych, they obviously valued it, or at least him. It seemed he had helped everyone, at one recent point or another, with a difficult case. One morning we headed toward 7D North. Between exchanging metaphorical high fives with passing physicians, he briefed and then quizzed me.

“Eighty-one-year-old woman. Cancer all over her body. She was in the hospital for two months, very confused. She was discharged to a nursing home, but now she’s back after just one week with pneumonia. She’s not eating. What was the consult called for?”

I thought: not eating.

I said: “Depression.”

“And what are we actually most concerned about?”

I thought: confusion.

I said: “Delirium.”

Dr. Singer nodded. “Good,” he said. “Now, how’s your French?” Our patient was Haitian and spoke Creole, which I’d learned was similar to the Romance language I’d chosen to take up in high school. We entered the hospital room, and in my twelfth-grade French I introduced Dr. Singer and myself to the elderly woman there. Then I translated his English instructions for her. Lift your left hand. Lift your right. Show me one finger. Show me two. She did as I asked, so we moved on to questions. Are you at a museum? Are you at a school? When she answered both affirmatively, Dr. Singer said we really needed a Creole interpreter and went into the hallway
to find one. (In all of the United States, perhaps only at Kings County Hospital could one find such a person simply by popping one’s head into the corridor.) He was back in a flash with a janitor. Still, our patient had already fallen asleep. Dr. Singer roused her. The janitor introduced himself.

“Ask her if she’s in a museum,” Dr. Singer instructed.

The janitor looked at him dubiously. “She’s not in a museum. Why would I ask her that?”

The two of them tried to reach a mutual understanding, but the janitor’s English was not as good as his Creole, and explaining proved cumbersome. Never mind, Dr. Singer finally told him.

“I think she’s been delirious for a couple months,” Dr. Singer said to me. “Her son reported she’s been in and out. We’ll do an EEG to determine for certain.”

“Why do the doctors order a consult for depression with a case like this?” I asked.

“They feel helpless, so they call us. If it’s depression, we give her meds; she eats; they feel better. We’re who they call before they call in the priests.”

He went on: “Do you know this old psychiatry joke? A psychiatrist is called to see a patient. He gets there and the patient is dead. The psychiatrist goes to the physician and says, ‘The patient is dead.’ The doctor looks horrified and replies, ‘What did you say to him?’ ”

If Alisha’s doctors began treating her better, she seemed only to be working harder to come up with reasons to be livid with them. I couldn’t blame her. The real things she had to be enraged about—an incurable disease, so many impossible systems—were for her purposes insurmountable. But the doctors,
available and now inclined to help, them she could take on, fists at the ready. And also, there was me, another passerby she could lash out at. Reframe her problems as challenges, give her choices, Dr. Cherkesov had counseled. But so far I’d only managed to become one more in a series of nameless, faceless receptacles for her hate. She barely looked at me as she seethed, in forty-five-minute stretches.

“My doctors are lying to me. They say my bones are still growing and so they can’t do the hip replacement,” she said for the third time in as many visits. I asked what I thought was an innocuous factual question in response, trying to remain engaged, only to have her spit at me, “That’s a dumb question. I’ve told you this story three times!”

“I’m glad you’re bringing that up,” I said, speaking slowly to give her rage time to work its way out of me. “I must admit I’ve been wondering why you tell me the same thing every time I come to see you, all these times in a row.” If she moved past her paranoia, what awaited her was worse. I knew that and she knew that, but we had different ideas about what to do with that knowing, with her preferring to stay stuck like a needle in a scratched record, and my hoping to keep her company as she acclimated to reality and its tragic limitations. I hated that this was the best I could do for her—anything short of a cure and a winning lottery ticket felt insufficient—but at least one of us had to move past our infantile grandiosity, our certain hope that we could conjure all we needed from the magic of our minds.

“Right. Fine. Well, I’ll never tell it to you again. Obviously, I should be keeping it to myself,” she huffed.

“It’s not that,” I said. “I’m here to listen to whatever you need to tell me. But our time together is limited, and I was just thinking we could use it more productively.”

“Well, I’m sorry I spoke to you at all. To any of you! I came to this country when I was twelve because my mom said I could get better medical help here, and look how I end up!”

“Uncured and insufficiently cared for,” I said.

Alisha’s anger broke like a felled horse, and she cried then. I sat quietly until she asked me to go. Too spent now to hiss, she said it almost gently.

In between talking cases I was still going around with the doctor on the pager. On the irritable Dr. Jonas’s days this was trying, as she was in a perpetual rush and three months in she was still acting as if I didn’t exist. One morning I arrived on the fifth floor early only to find her already dashing out with her resident, Alvin Wang. Alvin smiled and waved toward me as he tried to keep up with his mentor’s driven march toward the stairwell. Though by then she must’ve known it was my assignment to follow her, she did not slow when she saw me. A psychology trainee wasn’t worth acknowledging, let alone waiting for. I went into the meeting, and after it ended, I decided to stay in the cool of the Kings County room rather than track her down across the street, but then I felt as if I were playing hooky, and also there was the nagging disappointment of possibly missing out on one valuable lesson or another. I crossed over to Downstate and found her and Alvin leaving their sunny suite of CL offices. They were on their way somewhere, and I fell into step alongside.

“Seventeen-year-old Hispanic female,” Alvin told me as we moved along the shiny corridors. Downstate was as sparkling as Kings County was dull. “Raised in the projects. History
of multiple rapes. Her doctors can’t find a reason for her headaches, and they want us to determine if they’re psychosomatic.”

“If the psychology intern had been here earlier, she would have known that,” Dr. Jonas said to Alvin, not looking at me still. I was taken aback, mostly surprised that she’d noticed both my current presence and my earlier absence.