Another day at work

He's six feet and two hundred pounds of pure muscle. Professional looking tattoos all over his bare arms, sharp looking dimples in both cheeks which turn out to be cheek piercings.

I've always been an adrenaline junkie. Stealing, drugs, piercings, violence.

He's been to prison sixteen times, once for deadly assault.

I feel powerful when I hit people.

He keeps running out anxiously to check on his infant kid.

My biggest fear is hitting my daughter. She's the only person I've never hit.

He's charming. I've learnt with experience that its a red flag.

Everything I value is here. My wife, my daughter, my work.

He recently put his wife in the hospital and ended up in jail.

I want to be fixed, fast.

He has no insurance.

We troll the four-dollar lists for the cheapest medicines. I don't trust him, yet a drug screen would cost him too much. We learn all about medication profiles, side effects, drug studies. Yet so often it boils down to one question.

Is it too expensive?

We nix my first choice, a safe but expensive medicine especially useful with aggression and pick an old, cheap one.

One more question, doc. Why me?

I give him the standard story about genetics and environment. Satisfied, he leaves. I finish up and walk home, torn between despair at the cards we are dealt and thankful that it wasn't me in his shoes.

*All identifiers changed to protect privacy*

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About purplesque

Psychiatrist, cook, bookworm, photographer. Not necessarily in that order.
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20 Responses to Another day at work

  1. Nancy says:

    Wow. This makes my problems feel really manageable. I can't imagine being in his wife's shoes either.

  2. jaklumen says:

    Damn… just… damn.

  3. Waterbaby says:

    that'd be a tough job. and, for him, a tougher road; for those in his circle, the toughest.

  4. Aubrey says:

    Do you see any hope in this, purple? Any hope in his working through this misaligned violence? Given this situation, do you think his wife and daughter are safe with him – do you have the clout to advise that they move out?
    I've said it before: you are so brave to face other people's problems, especially when they themselves are unable to.

  5. some people do have a gard road to walk. Is the fact that he wants to do something a good pointer for real change?

  6. Emjay says:

    I agree with WB – this is tough on everyone. Was he there voluntarily or was this a result of his time in jail or court imposed? That might make a difference to the outcome.

  7. Purplesque says:

    Yes..what made it worse was that it was clear he loved this woman, but can't control the aggression when it hit him. Can you imagine, hurting someone you love in a blind rage and then facing it..

  8. Purplesque says:

    Sometimes thats all that comes to my mind, Jak.

  9. Purplesque says:

    You're so right, Wbaby..families are so often hit the hardest, yet they get the least help.

  10. Purplesque says:

    I see..some hope, Aubrey. There's always some hope. (Or maybe I'm just a novice.) He's smart. He's managed to successfully kick drugs. He's here for help. He has a family he cares about and who care about him. Thats more than what most patients of mine have.A safety assessment is the first thing I do. His wife and daughter have moved out temporarily. If they hadn't, I would have asked his permission to talk to them separately, find out how safe they feel and made a crisis plan with them as well. With adults, unfortunately, you can't do more than that. With kids, we can call Child Protective Services, but we have to weigh in if the situation is worth the kid being taken away and possibly placed in foster care.

  11. Purplesque says:

    Oh, absolutely, FD. With situations that are at least partly ego-syntonic (drugs, violence), the person wanting to change is the first, biggest step.

  12. Purplesque says:

    Absolutely..he was here voluntarily. Basically scared to death that he might hit his daughter. For what its worth, I think thats the best incentive for this guy..so I have hope.

  13. He's charming. I've learnt with experience that its a red flag. This could be the subject of a book……. fascinating.Oh, gosh……it's good he's trying and that he has some support in his effort……and you.

  14. Purplesque says:

    This could be the subject of a book.I didn't mean that all charming people should raise flags. Just my personal downfall. When I find someone charming, they're probably sociopathic, or at least have a major character disorder. Sigh..

  15. Oh, I didn't think you meant that. But I've experienced a similar "trend" (although not to the degree that you're encountering because of what you you're work is) — and been fascinated by it."Charmers" is a word that was used to describe many of my family members, people who were a delight to be with for a short time, the life of the party, good politicians, etc., but absolutely "broken" in some ways or sadly lacking in others. I also did a bad job hiring people when I was working, because I always selected the "charming" ones and they were the worst employees by far. It's an interesting thing to think about.*waves*

  16. Purplesque says:

    🙂 I know exactly what you mean. 'Charm' comes from being able to give people what they want, being able to make people feel delighted, the center of your universe. Most people who are charming have an ulterior motive in making you the center of their universe. Again, this isn't universal, but sociopaths are usually charming. So are people who often lack something essential, and must make up for it with charm. That said, I do know people who are charming and otherwise 'normal'. Still, it is an interesting thing to think about, like you said..

  17. This is really sad. There are many, so many of them in Jacksonville. That's really down and out city. Cheap drugs and beggars who haven't seen a meal for 3 days everywhere. I often wonder with the technological advancement, why we are more and more troubled inside. Maybe eating sugar and drinking too much already caused more problem than we imagined. Maybe we are just too lonely in this world full of people. Maybe we just don't know how to handle our emotions because we are still children underneath the big responsibilities and big titles.

  18. JD says:

    Wow….good stuff! It's been a while since I've been on here other than to simply post a few things here and there and today, I spent time reading and you got my attention with this story. I know that we all have something we must compensate for in one way or another. Most of us are fairly well balanced, but that's only to the world we don't let see our true selves. I'm speaking from personal experience in my past, but also I know folks who are like this, my ex who was emotionally abusive (and didn't even know he was doing it – or if he did – it didn't register as wrong). The mind is truly an incredible thing. Thanks for sharing! BTW, how are you doing? It's been too long!

  19. Purplesque says:

    Hey..good to see you! And you're right about the compensation..all of us do it, but its pathological for some.I've been good, and sorta busy. Must find time to visit everybody soon. Thank You for dropping by.

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