The umpire whispers Please Play.
We sort of play. But it’s all hypothetical, somehow. Even the ‘we’ is theory: I never get quite to see the distant opponent, for all the apparatus of the game.
YEAR OF THE DEPEND ADULT UNDERGARMENT
Doctors tend to enter the arenas of their profession’s practice with a brisk good cheer that they have to then stop and try to mute a bit when the arena they’re entering is a hospital’s fifth floor, a psych ward, where brisk good cheer would amount to a kind of gloating. This is why doctors on psych wards so often wear a vaguely fake frown of puzzled concentration, if and when you see them in fifth-floor halls. And this is why a hospital M.D. — who’s usually hale and pink-cheeked and poreless, and who almost always smells unusually clean and good — approaches any psych patient under his care with a professional manner somewhere between bland and deep, a distant but sincere concern that’s divided evenly between the patient’s subjective discomfort and the hard facts of the case.
The doctor who poked his fine head just inside her hot room’s open door and knocked maybe a little too gently on the metal jamb found Kate Gom-pert lying on her side on the slim hard bed in blue jeans and a sleeveless blouse with her knees drawn up to her abdomen and her fingers laced around her knees. Something almost too overt about the pathos of the posture: this exact position was illustrated in some melancholic Watteau-era print on the frontispiece to Yevtuschenko’s Field Guide to Clinical States. Kate Gompert wore dark-blue boating sneakers without socks or laces. Half her face obscured by the either green or yellow case on the plastic pillow, her hair so long-unwashed it had separated into discrete shiny strands, and black bangs lay like a cell’s glossy bars across the visible half of the forehead. The psych ward smelled faintly of disinfectant and the Community Lounge’s cigarette smoke, the sour odor of medical waste awaiting collection with also that perpetual slight ammoniac tang of urine, and there was the double bing of the elevator and the always faraway sound of the intercom paging some M.D., and some high-volume cursing from a manic in the pink Quiet Room at the other end of the psych-ward hall from the Community Lounge. Kate Gompert’s room also smelled of singed dust from the heat-vent, also of the over-sweet perfume worn by the young mental health staffer who sat in a chair at the foot of the girl’s bed, chewing blue gum and viewing a soundless ROM cartridge on a ward-issue laptop. Kate Gompert was on Specials, which meant Suicide-Watch, which meant that the girl had at some point betrayed both Ideation and Intent, which meant she had to be watched right up close by a staffer twenty-four hours a day until the supervising M.D. called off the Specials. Staffers rotated Specials-duty every hour, ostensibly so that whoever was on duty was always fresh and keenly observant, but really because simply sitting there at the foot of a bed looking at somebody who was in so much psychic pain she wanted to commit suicide was incredibly depressing and boring and unpleasant, so they spread the odious duty out as thin as they possibly could, the staffers. They were not technically supposed to read, do paperwork, view CD-ROMs, do personal grooming, or in any way divert their attention from the patient on Specials, on-duty. The patient Ms. Gompert seemed both to be fighting for breath and to be breathing rapidly enough to induce hypocapnia; the doctor could not be expected not also to notice that she had fairly large breasts that rose and fell rapidly inside the circle of arms with which she hugged her knees. The girl’s eyes, which were dull, had registered his appearance in the doorway, but they didn’t seem to track as he came toward the bed. The staffer was also employing an emery board. The doctor told the staffer that he was going to need a few moments alone with Ms. Gompert. It is a sort of requirement that a doctor whenever possible be reading or at least looking down at something on his clipboard when addressing a subordinate, so the doctor was looking studiously at the patient’s Intake and the sheaf of charts and records Med-Netted over from trauma and psych wards in some other city hospitals. Gompert, Katherine A., 21, Newton MA. Data-clerical in a Wellesley Hills real estate office. Fourth hospitalization in three years, all clinical depression, unipolar. One series of electro-convulsive treatments out at Newton-Wellesley Hospital two years back. On Prozac for a short time, then Zoloft, most recently Parnate with a lithium kicker. Two previous suicide attempts, the second just this past summer. Bi-Valium discontinued two years, Xanax discontinued one year — an admitted history of abusing prescribed meds. Depressions unipolar, fairly classic, characterized by acute dysphoria, anxiety w/panic, diurnal listlessness/agitation patterns, Ideation w/w/o Intent. First attempt a CO-episode, garage’s automobile had stalled before lethal hemotoxicity achieved. Then last year’s attempt — no scarring now visible, her wrists’ vascular nodes obscured by the insides of the knees she held. She continued to stare at the doorway where he’d first appeared. This latest attempt a straightforward meds O.D. Admitted via the E.R. three nights past. Two days on ventilation after a Pump & Purge. Hypertensive crisis on the second day from metabolic retox — she must have taken a hell of a lot of meds — the I.C.U. charge nurse had beeped the chaplain, so the retox must have been bad. Almost died twice this time, Katherine Ann Gompert. Third day spent on 2-West for observation, Li-brium reluctantly administered for a B.P. that was all over the map. Now here on 5, his present arena. B.P. stable as of the last four readings. Next vitals at 1300h.
The attempt had been serious, a real attempt. This girl had not been futzing around. A bona fide clinical admit right out of Yevtuschenko or Dretske. Over half the admits to psych wards are things like cheerleaders who swallow two bottles of Mydol over a high-school breakup or gray lonely asexual depressing people rendered inconsolable by the death of a pet. The cathartic trauma of actually going in somewhere officially Psych-, some understanding nods, some bare indication somebody gives half a damn — they rally, back out they go. Three determined attempts and a course of shock spelled no such case here. The doctor’s interior state was somewhere between trepidation and excitement, which manifested outwardly as a sort of blandly deep puzzled concern.
The doctor said Hi and that he wanted to ascertain for sure that she was Katherine Gompert, as they hadn’t met before up till now.