Home for the Holidays

I’ve gotten chastised a couple of times lately for neglecting my readers. It’s true, I have neglected you and I apologize. I’ll try to be more attentive, but honestly, things are nutty for me here in the Nuthatch.

For some weeks now, I’ve been splitting my time between my regular inpatient duties, and a partial hospitalization program. Partial hospitalization is basically groups all day for outpatients. For me, shifting between programs is a little jarring.

For one thing, the pace and rhythm of the day is completely different. With inpatients things are often fast and unpredictable. With outpatients, you can sometimes be crushed by the stunning sameness of the patients day after day. I spend a whole hour in group with the guys in partial, twice a day, and am rarely surprised by what happens. Inpatients, much less stable by their nature – well, you just never know one day to the next.

The holidays can be particularly dismal, especially for the inpatients. They fall into two categories: the ones who are scrambling to get well enough to leave, and the ones who are scrambling to remain sick enough to stay. Either way, it’s hard to say no. On the one hand, if they’ve got a place to go, and loving people to be with, it feels cruel to not help them get things together to be discharged, even if in your heart of hearts you just don’t think they’re ready. And if they don’t have the comfort of a hearth and home waiting for them, well, it feels equally cruel to tell them they really are fine and off you go.

At least the patients just leaving the hospital – or those still in the hospital – don’t have the pressure to be all normal and happy and festive that the guys in the partial will have to face over the coming days. They’re pretty much free from the burden of doing the hopeful and positive routine that loved ones need sick people to perform at holiday time, so that they can go on with their own supportive and grateful performance. If everyone doesn’t play their part just right, the whole show is ruined. And these outpatient guys really need the show to go well – they need to know that they can still play the part of someone who can function – even if their heart isn’t really in it – because the successful performance will show them the way back to themselves. For the inpatients at the holidays, survival is really all that’s required.

We haven’t really talked about it in these terms, but I suspect that the others who work here are, like me, a little disoriented these days by the contrasts between our lives outside of work and our lives in it. I’m sitting with a patient who isn’t sure whether he’ll try to beat himself with something heavy if he leaves today, while my own mind is drifting to projects to finish, presents to wrap, weather and traffic reports and the sweet, sweet smell of evergreen. Hey, I’m busy and I’ve got lots of important, important stuff on my mind, so are you ok to go or not?

Happy holidays. I’ll be back soon.

Madeline