I often tell my patients, “If you’re having an emergency, let custody know, and they’ll notify me.”  Once in a while, someone gets bad news or is feeling suicidal, and it’s important that they know they can ask for help and get it.

So today I was in between appointments, and one of the inmate clerks came by my office to tell me that a patient was requesting to see me.  The patient didn’t have an appointment for today.  His tier officer had written him a special pass to Psych Services.  I knew this particular inmate-patient; he’d come by my office for unscheduled appointments before, when he’d had some small crises.  I told the clerk to bring him in.

Mr. D arrived at my door, carrying a manila folder and a business-sized envelope.  He sat down and handed me the envelope.  “Here,” he said.  “I brought this to show you.”

The return address was an attorney’s office.  I pulled out a sheet of paper and quickly scanned the letterhead.  Oh crap, I thought.  Did this guy just get bad news?  Is this letter going to tell me that the court denied his appeal?  Am I about to deal with a shitstorm?  I braced myself and tried not to let my brain get too far ahead with planning the next intervention.

I read the letter.  In a nutshell, the attorney had checked a number of sources and was unable to find past legal documents that would have provided some important information that might be helpful to the inmate’s current appeal.

I handed the letter back to Mr. D.  “I don’t understand.  So what’s the emergency?”

“I have the documents that he needs right here.”  Mr. D held up the manila folder.  “I wanted to see if you would fax them over to his office for me.”