Over the next few days, George introduced me to my new administrative responsibilities: maintaining shift coverage, figuring payroll, calculating the daily census, and tracking statistics. I wasn’t crazy about these tasks, but I understood that they came with the territory. More important, George and I were hitting it off nicely. George was another seasoned veteran, and I hoped that with his guidance I would ripen into a competent manager. But it would never be. Less than a week into my new job, George called me into his office and shut the door.
“I need to let you in on something, Mary,” he said with a sheepish look. “I’m quitting. Yes, I know this is a terrible introduction for you, but I just don’t trust this new outfit. I don’t trust St. Barnabas. They don’t know what the hell they’re doing. I’m here close to fifteen years; I helped to create this Mental Health Center.”
“But they’re new!” I protested. “Montefiore was here for twenty-five years. You can’t compare the two—St. Barnabas is still learning. Things are going to get better.”
“No, they’re going to get worse. People are leaving here in droves.”
I was stunned. In an instant, all the good feelings about my promotion were gone. I knew that hospital staff was leaving, but I’d also assumed the exodus would taper off. My strategy was to duck and dodge the chaos until things settled down. But there was no more ducking and dodging. The reality of the hospital changeover was hitting me in the face. Suddenly, I longed for the pre–St. Barnabas days and the Rikers life I’d known. I was half-tempted to run back across the street—back to GMDC. But there was no turning back. And even if I did, St. Barnabas was making sweeping changes, changes from which even GMDC would not be immune.
But George had one more shocker. “I need time to job hunt. As of next Monday, I’ll be going out for a couple of weeks and you’ll be in charge.”
“But I just got here!”
“It’ll be okay. You’ll be able to reach me on beeper, and plus Karen will help out. We have a lot of systems in place. The place practically runs itself. It’ll be fine.”
I didn’t feel like it was going to be fine, but there was nothing I could do. Other than resigning, which I was not ready to do, I had no choice but to ride out the storm. Tough days were ahead. But as I numbly left George’s office, I never could have imagined just how tough they were going to be.
The following Monday morning arrived more quickly than I would have liked. One of the perks of my promotion was a coveted “Gate One” pass, which allowed me to drive directly to the jail, bypassing the parking fields and route buses. The small pleasure that I felt in passing the buses along the road vanished when I pulled into George’s empty spot, a reminder that I was on my own. Although I’d been given a crash course on the workings of the Mental Health Center, I didn’t know nearly enough to run the place with any authority. Nonetheless, I pulled the heavy door open and began the trek to our gate.
It was a busy morning in our wing; a long line of patients extended out of Hart’s Island awaiting medical treatment. Two others stood outside a dorm while an officer fussed with keys. One bore a simple, childlike expression and I surmised he was retarded. The other rocked back and forth, an eager look on his face. The officer hollered to his colleague back at the gate, “I got two nuts here who need to go to the barbershop!”
I winced when I heard it, but this was everyday jailhouse jargon.
I had just about reached our office, eager to begin the day, when a loud voice stopped me in my tracks. “maa–rryy!”
A blonde-haired woman in a white shirt—a captain—was furiously headed in my direction. How did she know who I was? More important, what did she want?
“Are you in charge?” she demanded, adjusting a flashlight in her holster. The nameplate pinned to her shirt pocket read Sikorski.
“Yes, for the time being I am.”
“Well, I’m the captain of the Mental Health Center, and I gotta tell you I’m not happy and the security dep’s definitely not happy.”
“What seems to be the problem?” I asked, a little less assertively than I would have liked.
“An inmate named San Filippo came in here last night. He’s in the new admissions dorm right now. This guy’s a major security risk! He’s gotta be moved to a cellblock. Right away!”
Since cells provide higher security than dorms, DOC assigns general population inmates with more serious charges to a cellblock as opposed to a dorm. But Mental Observation Units, which were comprised of both cellblocks and dorms, were under our authority. Especially where suicide was a concern, we weren’t going to place someone under our care into an isolated cell, high-security inmate or not. However, DOC highly resented our discretion in this area and challenged us every step of the way.
Because of George’s quick departure, I wasn’t prepared for dealing with DOC at this level. Regardless, this was my first challenge as an administrator, and I had to handle it. “I understand your concerns, Captain, and just so you know, our clinical team meets this morning to consider housing placements, and I’ll definitely bring this up.”
All things considered, I thought that sounded pretty reasonable. Besides, DOC was famous for perennially exaggerating security risks. But Captain Sikorski just rolled her eyes. “There’s nothing wrong with this guy. Nothing! He’s in a gang and just wants to get over. The deputy warden’s not going for this, I can tell you that right now!”
DOC was always pressuring us to do things their way, but if this inmate was suicidal—gang member or not—and killed himself inside a cell, I’d be the one left to explain why he was in a cell, not her.
She continued to gape at me, but I didn’t budge, and after a moment she backed off. “Well, all right—I’ll let him know you’re reviewing the case, but he needs to be in a cell,” she emphasized one more time.
“Well, we’ll see.”
Inside our office, I immediately found Karen.
“Oh, Sikorski! She’s always on the warpath. I mean, what are we going to do? Their mission and ours are completely different, and a lot of times they’re right, but we still have to go through our own procedures and not be bullied by them.”
Karen’s take on it reassured me, and I decided to put the Captain Sikorski matter aside and delve into my morning chores, suddenly grateful for these concrete tasks. As I studied logbooks and calculated the census, I watched the clock, anxious for the start of the clinical meeting.
At precisely eleven o’clock, I joined Karen and Dr. Marvin Gardiner, the Rikers chief psychiatrist, while we waited for the new admissions team. Gardiner, a longtime Rikers veteran, was beyond retirement years; yet even though he moved slowly, his mind was keen and he was frequently called upon as an expert witness in court situations. Shortly, another psychiatrist and two clinicians made their way in, carrying stacks of charts. Over the weekend, sixteen patients had been referred to us for a higher level of care. The admitted patients basically fell into two categories: the severely depressed (those considered at high risk for suicide), and the “SPIMIs,” those with severe and persistent mental illness such as schizophrenia, bipolar disorder, and dementia.
One by one, we read through the charts, making preliminary diagnoses and deciding on appropriate housing. Generally speaking, those in the throes of psychosis were better suited for a quiet cell, whereas dorms made more sense for the severely depressed. Finally we reached Jorge San Filippo’s chart. The new admissions team reported that San Filippo said his mother had recently died, that he was facing a lot of time upstate and saw no reason to live. His chart also revealed a history of self-destructive behavior. I relayed Captain Sikorski’s protests to the group, but given his mother’s death and depressed mood when he was interviewed, a transfer to a cell was out of the question. The possibility of suicide needed to be taken seriously. It was the team’s decision that he be transferred to a dorm for closer observation.
The remainder of the day was uneventful. If Captain Sikorski wanted to know the status of San Filippo, she never called to find out, and I was relieved to get out of the building without any further unpleasant encounters with DOC.