Clinical rotation four.
Psychiatry.
I fear this rotation. The thought of sitting in an office from nine to five every day, listening to people drone on about their awful parents, inconsiderate children, intolerable husbands, bitchy wives, and boring jobs fills me with terror, the terror that as they reveal their innermost secrets and kinky fantasies, I will fall dead asleep.
“Happens all the time,” Shelly the gunner warns me. “You gotta watch yourself. Some poor schmuck’s whining about how much his life sucks and you nod off? You will be marked down.”
“Tim says shrinks call those people the worried well.”
“I call them cash cows. Whatever. Anyway, if you can stay awake, psychiatry is the cushiest rotation. Sign up early tomorrow, try to get Lindstrom, my guy. The best. We both fell asleep. So embarrassing. He snores.”
I wake up the next morning with a record-breaking dose of diarrhea. I spend the entire day in a fetal position on the floor of our phone-booth-size bathroom on Flower Street. Note to self. Never eat another bean burrito from a vending machine.
The next day, recovered, I arrive in administration eager to receive my psychiatry rotation assignment and prepare for two months of rest, if not sleep. To my horror, I have been matched with Dr. Levine, the only shrink left, a psychiatrist in private practice with whom I’ll be covering the maximum-security prison in Ionia.
This can’t be right. What happened to listening to the worried well and their boring problems? What happened to cushy? I have to get out of this. I try to get people to switch with me. I find no takers. For some reason they seem put off by the words maximum-security prison. I’m stuck. I resign myself. I will be traveling with Dr. Levine to administer antidepressants and provide therapy to hard-core prisoners, the worst of the worst—murderers, rapists, child molesters, and money managers.
“Word of advice,” Tim says. “Do not fall asleep.”
He smiles smugly.
DAY ONE.
I drop my car off at Dr. Levine’s condo, and we drive in his car to Ionia maximum-security prison, known as I-Max, thirty miles away. Dr. Levine is a runner, short, trim, and jittery, with a manicured orange Afro and a face flecked with freckles, a cross between Alfred E. Neuman and Carrot Top. But Dr. Levine is anything but a cartoon character or raving comedian. He wears thick horn-rims and speaks quietly and kindly and without a trace of humor.
On the drive up, he tries to put me at ease. “Basically, I listen, say very little, write medications. That’s about it.”
“Doesn’t sound bad.”
“It’s not, really. I ask how the prisoners are feeling, if they’re hearing any voices—”
“Wait. If they’re hearing voices?”
“Yeah. Pretty common. Among murderers, especially.”
“Uh-huh. I’m just going to be a fly on the wall.”
“I would. Oh, and avoid looking the murderers in the eye.”
We drive the rest of the way in silence. I look out the window and flash on a picture of Shelly and Dr. Lindstrom snoring away in their leather chairs while a member of the worried well whines about her difficult mother. And I have to worry about an ax murderer hearing voices?
How is this fair?
FROM A DISTANCE, you might mistake the cluster of nondescript buildings for a military barracks or boarding school. Closer in, you notice the fence that surrounds the buildings, and as you get closer still, you see not only the added mesh of barbed wire that sits on top of the fence but the mesh on top of that, consisting of rows and rows of ferocious, glittering razor blades. In my imagination, fueled by years and years of comic-book reading, I-Max looks like a lumbering, sleeping beast with a mane of gunmetal hair.
Once Dr. Levine announces our names into a call box, the first of what will be three gates clanks open. We drive to gate number two, manned by guards who inspect the car and wave us through to yet another gate, where more guards inspect the car again, even more thoroughly. One slides under the car, holding a taut vibrating wire attached to a small box. I hear him grunting and scraping at the belly of Dr. Levine’s dusty Camry. Eventually, he slides out and, from his back, waggles a thumbs-up.
Admitted onto the prison grounds, we pass through several more checkpoints, this time on foot, where we empty our pockets and various guards, male and female, search us, pat us down, feel us up, and electric-baton us. Each checkpoint requires us to show two forms of ID and our medical credentials. At last, searched, scoured, and plucked clean, we walk into an open area somewhere in the center of I-Max, where I feel watched, as if I’m prey.
We head to the medical center, walking across a prison yard where ten inmates play basketball, others lift weights, some play chess, and one lone orange-suited inmate with scraggly blond hair strums a guitar. If I hadn’t gone through eight checkpoints, been identified and searched, and seen the razor wire on the fence that surrounds us, I might think I had wandered into an urban park in any city in the United States. The idea that these basketball players, weight lifters, chess players, and guitarist have all committed heinous crimes beyond my imagination and yet are allowed this seemingly carefree time for relaxation, even fun, unnerves me. Their victims will never again play hoops, pump iron, play chess, or hear music. I have no answer and offer no moral judgment. It simply feels unsettling and out of whack.
We spend the bulk of the day in the medical center—a metal table and chair facing two more metal chairs, where Dr. Levine and I sit and talk to inmates. The day passes slowly. The inmates speak softly, sullenly. Most are heavily medicated, their conversations detached. Late in the afternoon, the nurse on duty leads in a slight, frail-looking guy, no more than five-six and 135 pounds. He wears leather restraints on his wrists and steps deliberately and lightly, almost on tiptoe. He twitches and smiles sadly, revealing a smattering of small yellow teeth and wide gaps in his mouth. His thinning hair lies like strings of hay across the top of his head. His forehead is long and goes on forever and is lined with what look like tread marks. He keeps his red face puckered tight, like a weasel’s. He sits down at the desk across from me and Dr. Levine. Dr. Levine flips through his chart.
“So, Raymond, how you doing?”
Raymond shrugs, twitches. “Doing fine,” he says. “Really well.”
“Good,” Dr. Levine says. “And the meds?”
“Fine.” Raymond twitches again. He pulls his leather-shackled wrists up above the table so he can scratch his nose. “Yeah, working fine since you changed them. I’m not hearing any voices.”
“That’s good,” Dr. Levine says.
“Yeah,” Raymond says. “It is.”
Twitch . . . twitch . . . twitch.
“Is there anything you want to talk about?” Dr. Levine says. “Anything on your mind?”
Raymond looks at me for the first time. His face goes dark, almost as if a cloud passes over him. His eyes flutter, then open wide. He keeps looking at me, unblinking.
“So, anything you want to discuss?” Dr. Levine asks.
A calm descends over Raymond like a window shade dropping. He pinches his eyes and looks at me, harder. He stares. I squirm. Look away. When I look back, he’s still staring.
What do I do? Where do I look? Don’t stare at him. Do I pretend to look up something in my notes? Do I flip through his chart and pretend I’m reading? Look away.
He keeps staring.
“Raymond?” Dr. Levine says.
He keeps staring.
“Raymond, what’s going on?”
He keeps staring.
“How are you feeling? Talk to me.”
He keeps staring.
“It’s okay, Raymond, you can tell me. What’s on your mind? What’s going on? What are you feeling right now?”
A beat.
Raymond lunges at me, leaping over the table.
“I’M COMING HOME WITH YOU, PRETTY BOY!” he screams.
I shoot out of my chair. “GAAAAA!” I shout, slamming myself back against the wall.
“I’M COMING HOME WITH YOU!”
I see then that his legs are chained to the table and the leather restraints hold back his hands so he can’t get close to me. The door flies open, two guards grab Raymond on either side, unchain his legs, lift him off his feet, and carry him out of the room. My entire body, flat against the wall, quivers. My throat is caked shut.
“How did you—?” I croak to Dr. Levine.
“Panic button. Under the table. You okay?”
After a moment I feel the blood return to my face, the quivering stops, and I nod. I stagger away from the wall and sit down.
“You want some water?”
“That would be great. Dr. Levine?”
“Yeah, Tony?”
“This is my first day in this rotation, and I’m just a medical student, but I’m not sure the new meds are working.”
For the first time—and only time—in our two-month rotation, Dr. Levine smiles.
Then the door flies open and Raymond, eyes aflame, stands in the doorway. He punches his shackled hands at me.
“I’LL BE WAITING FOR YOU IN THE CAR, CHINA MAN!” Twitch. Twitch. Twitch.