This is how my morning began:

I had a new arrival scheduled for his initial intake. We were about fifteen minutes into the interview when the sergeant came by my office and knocked on the door. I waved for him to come in and asked the new arrival to step outside. The sergeant came into my office and said, “Hey, Doc, we got Inmate XYZ in the holding cell. He’s saying he’s suicidal.”

We both knew the drill. “Thanks, Sarge,” I said. “I’ll talk to him after I finish up this appointment.”

“Great,” the sergeant said. He turned to leave the room and just as he was walking away, my phone rang.

“Dr. V,” the person on the other end said when I answered. It was one of the mental health administrative office technicians. “We received a call from the clinic regarding one of your patients. He’s not saying that he’s suicidal, but they have some concerns. They need you to go over there as soon as possible and talk to him.”

I said, “I just spoke to the sergeant, and he told me that they’ve got one of my patients in the holding cell right now, saying he’s suicidal.”

“This is a different inmate,” the office tech said.

“Give me a few minutes,” I said.

I got off the phone and turned to the new arrival who’d returned to his seat across my desk. He was casually looking at the posters on the wall and acting like he hadn’t heard anything that had been said in the last three minutes.

I looked at the day’s schedule of appointments and silently said goodbye to any remaining bit of free time I may have had left.

“Listen,” I said. “Can you come back this afternoon? I’ve got a couple of emergencies to take care of.”

I’d seen all of my patients for the day and was typing up progress notes on the computer when one of the inmate doormen/clerks knocked on my office door. He held another inmate’s ID in his hand and showed it to me. “This individual is asking if you have time to see him. He says that he desperately needs to talk to you.”

I took one look at the name and photo on the ID and immediately knew what was up. “Sure, bring him in,” I said.

This particular inmate-patient was a 53-year-old lifer who had committed his crime at age 17. He’d been incarcerated since 1979. In June of this year, he’d attended his umpteenth parole board hearing. This time the board found him suitable for parole. Since then, he’d been waiting to hear whether or not the governor would oppose and reverse the board’s decision. I had a feeling that he just got his answer today.

Mr. M walked into my office, and he didn’t have to say a word for me to know that my hunch was correct. I let him talk and cry and express all the things that he needed to say.

After a while, he looked at me sadly and said, “You know, this had been the first time that I actually let myself start to dream. I let myself daydream what it would be like to live outside of prison, out in the community, maybe have my own place, a job. Now…”

He didn’t finish his sentence, but I knew where he was going with this. I was also aware of his history of clinical depression and suicide attempts. He looked so heartbroken and hopeless and dejected that I knew it was time for one of my personal unconventional interventions.

“Listen,” I said. “Let me tell you a story. You know how you get to a place where you’re just feeling like it’s all hopeless, like there’s no point in trying any more, everything is just fucked?”

Mr. M nodded his head and smiled a little through his tears, and I could see that I was getting through to him.

“I’m going to tell you what a good friend once told me when I was feeling that way. I don’t remember what I was doing at the time—I think I may have been trying to make something, or fix something around the house, but I just kept messing up and I was getting frustrated. And I was like, Man! This is just fucked! This is a lost cause!”

“I hear that,” Mr. M said. He leaned forward a little to hear the rest of the story.

“This friend of mine came along,” I continued, “and he said, Relax, this is not a lost cause. It’s not fucked. Nothing is ever fucked.”

Mr. M sat back, and his small smile broke into a laugh. “You’re funny, Doc,” he said. “I like that. Nothing is ever fucked. I’m going to write that down. Thank you.”