I used to work in in-patient psychiatry. The patients I worked with were incredibly ill. I had internships for the two years I was in graduate school and I often asked my supervisors how they could tell if they were actually having a positive impact on the patients. Drastic changes were rare; a patient actually getting “better” was even rarer. I learned to scale back, way back, what I perceived as change. We spoke about building relationships and creating connections as the meat of the work. In my first year of actually working one of my colleagues shared that she viewed the work we were doing as seed planting. We might not be able to water the seeds or watch them grow, but we can plant them and have faith that someday they might grow, or not.
Over the years I would often run into former patients on the street or on the subway or bus. The golden rule of therapists is that the patient must initiate the interaction outside of treatment. Some would acknowledge me, some would say hi, some would want to talk, some would pretend they didn’t see me – I learned to cope with all of these different reactions, I also learned that I was making connections with the patients I was working with. I have not worked in in-patient psychiatry for two and a half years now. It has been awhile since I ran into a former patient. Last night that changed. As I was walking through Union Square I saw a former patient coming toward me. He looked crazy compared to everyone else walking about, but in actuality he was about as stable as he gets. I realized too late that he was coming straight toward me, my quick reflexes to dodge people coming at me are not as sharp as they once were. A good foot taller than I am he towered over me and grabbed my shoulders. I felt my heart stop and people around me gasp. He then shook me violently, let me go, and kept walking in the direction he was going as if nothing had happened. While the incident has left me feeling far more than just physically shaken it has left me with the confirmation that all those years of wondering if I was actually making a difference were for naught. This man was not cured of his mental illness, nor was he able to interact with me in a healthy way, but I had connected with him enough in our work together for him to still remember me over two years later. Blessing or curse? I’m not sure yet.