It’s 7:00 AM and I’m running late for work.
It’s my fault of course. I didn’t get much sleep last night and the snooze bar on my alarm clock was too tempting to pass up. When I finally achieved consciousness I realized I had only half an hour to shower, shave and drive to the hospital. No time for breakfast or coffee. Not good.
I jump into my car and slip onto the highway. One mile into my journey the “low fuel” chime starts ringing and waves of anxiety start rippling across my empty stomach. I don’t have time to stop for gas. Cursing, I think about making a quick stop at a gas station I know sells coffee so I can fill my tank and mainline caffeine at the same time. But the mature part of my brain says that I have an obligation to be at work on time. I grit my teeth and tell myself that I’ll have to be satisfied with the crappy coffee they serve in the staff room. Ugh, it tastes like warm water brewed through a brown crayon.
As I shift my car to the right lane to catch my exit I suddenly hear a car honking behind me. Looking in my rearview mirror I see a harried looking woman in a beat up old car on my bumper flashing her lights. She wants to pass me. That makes no sense since the exit is coming up soon. I ignore her.
But as we come up to the exit the woman honks her horn again. In my rearview mirror I lip read the woman’s mouth forming the words, “Motherfucker.” I shake my head angrily and keep going. Even if I wanted to there’s not enough room to let the woman pass. She’s just going to have to wait.
Suddenly the woman guns her rusted out shitbucket’s engine and tries passing me. That’s a stupid move. As she moves alongside I see a decrepit middle-aged woman with a head of greasy unwashed hair white knuckling the steering wheel with both hands. When we’re parallel she looks at me and the hole in her face starts screaming. The exit’s coming up so I step on the accelerator and force the woman to fall back behind me. Tough shit lady.
But the woman’s doesn’t let it go. When we reach the bottom of exit ramp we get stuck at a red light The woman takes this delay as an opportunity to stick her head out her window and treat me to full blown psychotic tirade. “You faggot!” she screams. “You fucking asshole! Who do you think you are? Fuck you!”
When you work on a psychiatric ward you have to have a tough skin. Being verbally abused is part of the job. Only yesterday an angry patient called me a “fat homo” while having an anxiety attack. I kept my cool and calmed the patient down. Was I annoyed? Of course I was. But I had enough experience and professional reserve to realize this woman was mentally ill and tailored my response accordingly. To be truthful being called a “homo” didn’t bother me – it was being called fat. I guess you can’t expect a psychiatric patient to care if you’ve lost twenty pounds.
Because I’ve worked with the mentally ill on and off for twenty years I’ve developed a very long fuse. That’s a blessing and a curse. When you work psych it’s an essential personality asset but on the street it occasionally causes problems. While reason, deescalation and a clear head will get you through 99% of the confrontations you’ll have with your fellow human beings, there are individuals out there who view a patient reaction as a sign of weakness and will exploit it to take advantage of you. When I was younger I discovered my “long fuse” was occasionally a liability. After getting into a few sticky situations by always being “a nice guy” I realized that every once in a while you have to look like you’re ready to kick the other guy’s ass. Hopefully that’ll always be a rare situation but it’s a sad truism that some individuals only respond to the threat of force. I see it with my patents all the time. Despite all our entreaties to calm down they’ll occasionally scream, yell and break stuff until five really big security guards show up and tell them to cut it out. The trick on the ward, as in life, is to know when it’s time to be nice and when it’s time not to be nice. It’s a delicate balance.
“Faggoooooooot!” the woman screams again, honking her horn loudly. “Faggooooot!” Then she rolls her car right up to my bumper and taps it. My fuse burns out. It’s time not to be nice.
I roll down my window and stick my head out. “Listen you crazy bitch,” I shout. “If you tap my bumper one more fucking time you’re going to be in a world of shit.”
The woman stares at me open mouthed, slumps in her seat and shuts up. Then the light changes and we drive off. When the road open up to two lanes the lady slowly passes me. Tears are running down the woman’s cheeks. I feel bad. This lady’s having a rough day and I probably made it worse. Maybe she’s poor and can’t afford a new car. Maybe her dog died or her kid’s sick. Maybe she’s late for work and didn’t get her morning cup of coffee either. As she drives out of sight I kick myself for trying to be a tough guy. There’s no honor yelling at a messed up lady. Next thing you know I’ll be roughing up Girl Scouts.
I pull into the hospital’s parking lot, race to the entrance, clock in and head towards the unit. The charge nurse chides me gently for being late. I apologize, grab a cup of bad coffee and head onto the floor. The woman who called me a “fat homo” the day before is sitting at a table eating her breakfast.
“Hey Steve ,” she calls out. “How are you?”
“I’m fine,” I reply. “How are you?”
“I’m sorry about the other day. I didn’t mean to call you names.”
“Thank you,” I reply. “I’m glad to see you’re feeling better.”
“I’m just glad you didn’t flip out,” the woman says. “Everyone one around me flips out. Thanks for being nice.”
As I walk around the unit I think about the crazy lady I encountered minutes earlier and compare it with how I handle the patients. I feel off kilter and guilty. But even though I’m second guessing myself, deep in my gut I know took the right approach. I got the balance right.
But that doesn’t mean I have to feel good about it.