Chapter 2 – Admissions

Let’s just call him Izzy.

After an eternity in college, changing his major countless times, and running out of money, Izzy had switched his major one final time, to psychology. A counseling internship was required, so he took himself to the Iroquois Regional Medical Center, and started his assignment at the outpatient chemical dependency clinic. 

He left the thin man and his warning and joined a crowd funneled towards an automatic sliding door. It swallowed great mouthfuls of humanity, and transformed them into workers, patients, and visitors. When he came to it, he took a deep breath and stepped inside with the rest. A blast of overheated air assaulted him and a tongue of a carpet runner captured the debris of autumn from his shoes.          

A tri-colored map of The Iroquois Regional Medical Center was fastened to the wall. The Center was a three-block-long Leviathan of interconnected buildings. Outpatient Behavioral Health was at the far end, including the Chemical Dependency Clinic in the basement, and Mental Health a floor above. He had a long walk ahead through a maze of hallways. They called it the behavioral health wing at the Medical Center, but it was really a tail, tacked on as an afterthought. The real business of the Medical Center was in the units leading directly off the lobby. Oncology, Gynecology, Dermatology, Radiology, and the rest were the true medical specialties, having to do with muscles, blood, nerves, and bone. But Izzy had finally made up his mind. He would work in nothing other than psychology. 

Izzy, like many blue-blooded Americans of a post boomer generation, was a natural at psychology. The good war had been won, Vietnam lost, and they put their little flag on the moon and never went back. On the TV news, between the famines and the wars, were advertisements for Prozac and Zoloft. In the courts, criminals who were once placed in the stocks were put in anger-management classes. Schools taught self-esteem alongside trigonometry and biology. As if there were no more churches and clergy, the troubled swarmed to AA meetings and therapists. There were no frontiers anymore except the one within. Instead of going westward, they went inward. Instead of butchering Indians and enslaving Blacks, they blamed their parents and called their shortcomings a disease. Instead of herding cattle across the Texas plains, Izzy, like his peers, kept a journal and rounded up every impulse in a two-toned composition book. It’s what he did for perspective. It was his substitute for the gas, noose, or gun. Just as a Samurai guts himself with his sword, Izzy eviscerated his psyche.

Of course, Izzy didn’t intend to go into therapy as a patient, but as a therapist. Patients have to wait for appointments and cram sixty minutes into a fifty-minute hour. They thumb old magazines in waiting rooms where they worry about who will see them there. They tell their secrets to strangers. They take strong drugs that don’t get them high. They have to pay, rather than be paid.

Therapists, on the other hand, get paid, not well most of the time, but comfortably. They wear nice clothes and sit out of the wind and cold. They give people the same advice that they need, but would not take; nonetheless, they work out all their issues vicariously through their clients. They get to prop up their names with letters after, and, if they’re the right letters, they get to prop the other end with doctor.

Izzy had to resign himself to starting his career as an un-paid intern. Of course, they’d give him the crap jobs and he’d have to make coffee and copies, as if Denny’s moved into Kinko’s and hired him to work the counter. An internship might affront his dignity, accustomed as he was to lording it over the night shift as a security guard, strutting around with a ring full of keys. The transition was particularly keen one, considering that internships were regarded as college courses and full tuition was charged. 

Change is hard, that’s for certain, but doesn’t everyone take a turn as an intern? Even if his nose were up someone’s butt, in time, someone else’s nose would be up his until they all form a long, hunched over train. There’s always some small satisfaction in that.

Izzy might’ve stopped at the gift shop to pick up a greeting card for his new supervisor to start things off on the right foot, but there were none appropriate, nor any suitable Mylar balloons to tie to his desk. There was a shortage of optimism at the medical center, and so he passed by the store, thinking the college cheerleaders should be on hand for the start of new internships.

In the first corridor, instead of a row of short-skirted, pompomed lovelies, a gauntlet of grim portraits of the board of directors guarded the passageway. They looked as though they could use a greeting card or a Mylar balloon more than most. It was as if they proclaimed, as he passed by:

“The Iroquois Regional Medical Center is a 300-bed health care provider serving the four county Finger Lakes area of New York State. We are fully accredited by the Joint Commission on the Accreditation of Hospitals and Health Care Organizations. A wide range of specialty programs and services, both inpatient and outpatient, are available at the Medical Center.”

“The Iroquois Regional Medical Center was recently purchased, with five others in the state, by Medco, a for-profit medical service corporation, based in Scottsdale, Arizona. We will continue to operate as a physician-focused, comprehensive provider, striving to provide optimal satisfaction to an urban, suburban, and rural area. Our pledge is not only to continue to provide you with the service and support you’ve come to expect, but also to bring additional value-added opportunities for all.”

“We are pleased to announce the appointment of Dr. Benjamin Ahern as Director of Behavioral Health. Dr. Ahern is a leading figure in the field of psychology and the author of many important books.”

Izzy hastened away from the stares of The Board. His eyes glazed over by their proclamations, he got lost, crashed through a set of swinging doors, and found himself in ICU.

ICU seemed like an electronics store for all the monitors mounted by the nurses’ station. Surrounding it, the patients slept in their rooms, crowded with machines that hovered around their beds like anxious visitors. Izzy stepped up to the counter, populated by a squad of preoccupied medics huddled around a chart. Each wore a stethoscope around her neck like a rubber and stainless steel scarf. The intern stood open-mouthed and studied a monitor. Portentous line graphs raced across the screen, jumping at intervals like a heat of Olympic hurdlers.

There was sublimity about those line graphs that froze him. They were clearly labeled blood oxygen, heart rate, and so forth, but he knew they signified much more. It was as if they’d drilled a hole and installed a peephole in the locker room of the Fate sisters and he was watching them undress in front of him.

He would’ve liked to stay there until he had captured the meaning of those line graphs. If he could not determine fate, then at least he could understand it, and, if he couldn’t understand it, then he could clean up after it. Go on, he said to himself, get out of ICU. You’re blocking the way with your humanities degree. They only want high GPAs working here. He turned, without needing to consult a map, down the darker, less urgent hallways, for there, without doubt, would he find the chemical dependency clinic.

One response to “Chapter 2 – Admissions

  1. What a splendid description of life in the health care field. This is a refreshing look into the role of psychiatric care in a big medical center. I enjoyed your writing style and am looking forward to reading the next chapter.

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