Chapter One Mother Nature's Son On a warm day in early spring, two New York City cops and two EMS workers roll a gurney down the hallway, escorting a man to the entrance of Bellevue's psychiatric emergency room, where I work. Lying on the stretcher underneath a white sheet, with a head of dirty blond hair beaded and dreadlocked, he is naked, sunburned, and screaming. I walk out to greet my new patient as the drivers hand me his paperwork to sign. "What'd you bring me?" I ask eagerly. I can see he's a live one. I love the live ones. Over the shrieking, one of the EMS guys gives me "the bullet," the few pieces of relevant information when introducing a patient to a doctor: age, chief complaint, pertinent history. "This is Joshua Silver. Twenty-three. No significant medical history, no allergies, no meds. Also, he denies a psych history," he says archly, shooting me a look. "And how'd he get to you guys? Who called 911?" "NYPD called in an EDP." This is cop-talk for a psychiatric patient: emotionally disturbed person. "He'd taken off his clothes in Times Square and was parading around, barking like a dog. And growling," he adds. This gets the patient's attention, and he interrupts the driver to clarify, "It was my way of showing them that I was not an animal. I am not a dog!" Barking and growling to prove he is not a dog? His logic is lost on me, but at least he's stopped yelling and started communicating. "You can talk to me," I say, turning my full attention toward him. "See, there were some guys from Nation of Islam preaching on the corner, and they told a woman who was arguing with them that she was just a dog--God spelled backwards--to which I took offense." He then explains to me, as he did to them, that all people are art. " 'Thou art art,' I told them. 'Once you accept that all people, all objects, are art, you will live in heaven as I do.' " "You know what, Joshua?" I ask, having decided it is time to move out of the triage area and into the locked area. "I think you and I should go talk about this inside." I want us to sit in an interview room so I can try to get some more history, and I don't feel like standing over him while he lies on a stretcher. I can already tell he's an admission and will need to be in the detainable area for patients awaiting beds upstairs. I let EMS and NYPD know that they are free to leave, and I grab my new patient some hospital pajamas. I help him off the stretcher, wrapping his sheet around him, and walk him into the larger, locked part of the ER. As I escort him through the entrance, the door clicks definitively behind us, and I hope he doesn't notice that he is now locked in. Because he is naked, we can dispense with the contraband search, which is good. The search is often the point where people become uncooperative and agitated, ending up restrained and medicated. Prior to entering the detainable area, a patient must remove his belt, shoelaces, rosary beads--anything that can be used to hang himself or choke a fellow patient. Inevitably, the patient will insist that he is not suicidal or dangerous, but it doesn't matter; these items are not allowed in the detainable area. Neither are cell phones, crack pipes, backpacks, knives, pens, wallets, and the list goes on. The patient has to give up just about everything along with his freedom. Luckily, Joshua is oblivious. I show him to the bathroom where he puts on the pajamas quickly. I alternate between keeping an eye on him and setting up the interview room. There are several windowed rooms wi Excerpted from Weekends at Bellevue by Julie Holland All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.
