“That’s a nice watch,” Mr. A said to me today during his routine follow-up appointment.

“Thanks,” I said. “It’s a Swatch. You know, like the kind that was popular in the 80s?”

“Nah,” he said, slowly shaking his head to indicate that he didn’t know. “I’m not that old.”

Riiiiiggght. Because this was a kid who was born in 1994. The year I graduated from U of R.

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.”

So the most exciting thing that happened at work today was this:

My no-make-up-and-bland-hair-pulled-back-because-I-work-in-a-men’s-prison face.

I don’t know if you can tell from the photo, but I had a pretty huge goose egg on my forehead.  It didn’t come from anything scary or dangerous like an inmate elbowing me in the head or a correctional officer accidentally hitting me with a baton.  No, it happened because I was in a huge hurry to use the restroom.  I quickly locked my door, swung around to race out of there, and ran right into the corner of a shelf that was protruding from the wall next to my office door.

I had to be escorted to the clinic by a correctional officer, and medical staff looked me over to make sure I was okay.  I probably could have requested to go home afterwards, but I stuck around because I had three patients scheduled this afternoon.  The funny thing is that each one of them noticed the goose egg the moment they sat down across the desk from me and immediately expressed concern for my safety and well-being.  Which is kind of heart-warming when you consider that they are convicted felons in a prison.  At least I know I’m not working entirely with cold-blooded sociopaths.

First bit of news I learned this morning when I got to my office:  There had been a suicide on our yard.  Second bit of news:  As mental health staff, we would have to go on the tiers after yard recall this afternoon and conduct one-on-one cellsides with each inmate to make sure he was doing okay and to see if he wanted a follow-up appointment with his clinician.

It had been a while since I’d done a cellside.  For those of you unfamiliar with the term, it means going into the building where the inmates are housed and talking to them at the cell door.  You’ve got to be okay with walking down the corridor while 50 pairs of eyes watch you from behind their glass windows and 49 pairs of ears are listening while you talk to one inmate.  If you are fearful or uncomfortable, they’ll know it.

I’d done enough cellsides to know what to expect.  This time, I stood at the end of the hall and loudly announced who I was, what I was doing there, and why.  Then I went knocking door to door.  Most of the guys said, “I’m okay.”  A handful of them requested to see their clinician.  A lot of them just gave me a thumbs up to let me know they were fine.  Every so often, someone would say, “What?  What happened?”  Here and there, someone would say, “No comment.”  One guy said, “I don’t know nothing about it.”  And then there was the one guy who said, “You talking about the dummy who hanged himself?”

I was doing fine until I moved on to the next door, and the window was covered with paper so that you couldn’t see inside the cell.  I scanned the glass to find the narrow label that told me the name of the individual who lived there.  It belonged to the man who had cut his throat and then hung himself.  I felt a wave of sorrow, and my heart went out to him.

I had just gotten to my office and was sitting at my desk checking email when an alarm went off overhead– literally above my head on the second floor, in the chow hall.  A fight had broken out and it was barely 7:45 AM.

The rest of the day was full of craziness and crises.  I don’t even want to get into it now because it’s better to just leave it behind me and move on to my three-day weekend.

Anyway, when I got home and pulled into the driveway, I saw one of the neighborhood kitties just chilling in our front yard.  That cat had the right idea.

This is how I started my morning:  Within half an hour of sitting at my desk, I was handed an inmate request for mental health services.  The inmate clerk who gave it to me said, “He’s waiting outside.  He just wrote it.”  I looked at the form.  It read, “Ergent!  Emergency having problems need to see my doctor ASAP!!!”

Naturally, I had to get him into my office right away and find out the nature of his emergency.  I didn’t know what to expect, but once he started talking, I really had to start thinking about all the different ways to do my job properly.  Because what he was telling me was that, last night, someone took advantage of him in a sexually inappropriate manner, and it wasn’t another inmate.