Dr. Ager has read through everyone’s charts and files and records by now, and she’s noticed something different about Hannah’s treatment.
No one is paying for it.
Health insurance companies pay out big for ICU visits, ER physicians, and surgeries. But they don’t like loosening the purse strings for psychological treatments. So every single dollar in revenue matters, even at a private, endowed hospital like Belman.
Dr. Ager pushes her glasses up onto the top of her head and gazes around at the gathered staff.
Why, she wants to know, when there are so many young people in need of care, does one person in particular gobble up so much of Ward 6’s resources?
She doesn’t even have to say Hannah’s name. Everyone knows who she’s talking about.
Nurse Amy takes this question, leaning forward with an ingratiating look on her face. She says she knows it’s weird—anomalous, she corrects herself—but that’s how it’s been for years. “Delia Belman’s granddaughter took a special interest in Hannah,” she explains. “She stipulated that care should be extended to her, without expectation of reimbursement.”
Jordan looks at Amy like, Where did all those big words come from? But the fact is that everyone is trying to impress Dr. Ager, who has been carefully monitoring staff dedication and performance.
“And has she seen the amount of resources that this particular client uses?” Dr. Ager asks. She always says client instead of patient. That or service user.
“I don’t imagine she’s looked at the numbers,” Amy says.
“Well, she will,” Dr. Ager replies.
“Hannah has no resources herself.”
Dr. Ager nods. “As I assumed. But the majority of people with mental illness get neither treatment nor medication. She isn’t the only young woman in New York who needs help. The world is full of Hannahs.”
No it isn’t, Jordan thinks. There’s never been anyone like her.
Dr. Nicholas tentatively clears his throat. He didn’t use to come to these meetings, but that was before Dr. Ager came on board. “We can’t discharge her,” he says. “She’s too enmeshed in her hallucinatory world.”
“No one’s talking about discharging her,” Dr. Ager says. “Not yet. But I think we should encourage her to leave the ward voluntarily. Just for a few hours. Half a day. Didn’t you tell me she suggested that herself recently?”
“She suggested it, yes. But she didn’t end up leaving the grounds.”
“Hannah has no record of self-harm or suicidal ideation. She’s never tried to run away. I believe she can be trusted.”
Amy and Jordan look at each other. “It depends on the day,” Amy says.
“We’ll wait for a day when she’s lucid and cooperative.”
“Will staff go with her?” Jordan asks.
“We don’t have anyone to spare.”
And so it’s settled. Hannah’s going to be sent out into the big wide world. Alone.