If you haven’t read Part 1 of this post, go read that first here: Part 1. Tuesday was certainly the highlight of the week. But I guess if you think about it, few things can top an earthquake on the East coast. So, when Tuesday ended with a…rumble (literally…there was at least one small aftershock I felt), I was seriously grateful.
Enter Wednesday. Peak of the week, as my college professor used to say. Still feeling uneasy about taking the metro and going underground, I decided to drive to work. Sat in traffic, but I made it in with no problem. Everyone at work was pretty on edge, as if we were waiting for the proverbial shoe to drop—only this shoe was going to shake the ground we stood on. A ceiling tile fell out of the ceiling again when the door to the locked part of the clinic slammed, but other than that, all was well. We laughed every time somebody made a phone call and mentioned the earthquake (i.e. “Hi, this is Autodidact calling you from the behavioral psychology clinic. I am so sorry I had to cancel your appointment yesterday due to the earthquake, but I was wondering if you would like to reschedule?” or “Hi, this is Autodidact calling from behavioral psychology, how are you? Oh good. I’m sorry I didn’t return your call sooner, we had to close the clinic yesterday due to the earthquake, but I got your message and…”).
Wednesday was stressful only because I was trying to catch up from Tuesday, I had a bunch of scheduled clients, and my supervisor was going to be observing me with my clients. Then, a little after lunch, I got a phone call on my cell from a number I didn’t recognize. Answering the phone, it was a recording from my gas and electric company telling me everything they are doing to prepare for the impending hurricane, and letting me know everything I should do to ensure my preparedness. Make sure I have water, a full tank of gas in my car, canned food items…they are mobilizing extra people and resources for support…if they wanted to incite mass panic, I’m sure they did. Take a group of people who aren’t even 24 hours away from an earthquake and start leaving phone messages about a “dangerous storm” supposed to hit in 3 days, and you have a recipe for panic. No worries, though. It’s all good. So Wednesday, before I leave, I get a phone call from my 87-year-old grandmother who is in the hospital recovering from hip surgery, telling me to ask my dad to call her about why my uncle ordered a brain scan, and whether or not she has a brain tumor. This erupted into all sorts of family drama (but to cut a long story short, she’s fine, and there was never a question about whether or not she has a brain tumor. My uncle wanted a brain scan because of her increasing memory issues, but I didn’t know this at the time).
So I leave work pondering clients, supervision, hurricanes, and brain tumors, and am glad to get in my car rather than take the metro. I drive about 10 minutes, I’m not even out of the city yet, when I hit trouble. Or rather, someone else hit trouble. Or maybe we should just say the hit caused trouble, because a big SUV 3 cars ahead of me hit a pedestrian. I didn’t really see him get hit, but I definitely saw a person kind of thrown in front of the SUV, and the SUV and both cars in front of me slammed on their brakes. Several cars on the other side of the freeway stopped, two nurses got out of one car and started attending to the pedestrian, and a woman got out of the SUV, looking scared out of her mind, and already on her cell phone. About two other cars stopped, and several other pedestrians rushed over. I couldn’t see what happened beyond that and, honestly, I wasn’t really looking, as I was mainly sitting and praying for the man that got hit, and then attempting to get back into a moving lane of traffic once an ambulance and a policeman arrived. We can safely say that I was a little shaken up. (In case you’re keeping count, we’re up to 1 earthquake, 1 impending hurricane, 1 potential brain tumor, and a run-over pedestrian).
There was another aftershock that woke me up at 1:00 AM Thursday morning.
Which brings me to Thursday. I took the metro on Thursday, deciding that the drive is probably as risky as the metro at this point (or, more accurately, that I can’t win for losing with this commute and might as well do what’s the least painful). I got into work and prepped for my first client, who decided to no-show. Beautiful. I do some paperwork and then sit on hold with a kid’s school for 20 minutes when my pager goes off with a “411” page. I hang up the phone and call the front desk. “Hi Autodidact,” says Ms. Sherry* at the front desk, “do you have an appointment with Jeremy* today?”
“Jeremy?” I ask, pulling up my calendar. There is no Jeremy in my calendar. I go to the next week. Jeremy is definitely scheduled for NEXT week at 10.
“Yes ma’am. Jeremy, his mother, and his 5 siblings are here in the waiting room and they say they have an appointment with you at 10:00 today. Can you see them?”
“Well…uhhh…” I pause. Jeremy and his mother and his 5 siblings come from across town on the bus. Jeremy’s mother works the night shift. She probably hasn’t been to bed yet. “Sure,” I said. “I’ll see them.”
“Okay, I’ll let the family know.”
“Thanks, Ms. Sherry,” I say.
“Oh, and Auto?” she continues. “Jeremy is having a tantrum out here in the lobby, so you might want to come out soon.” We hang up. Super. I look at my schedule again—this means I will have straight back to back clients from 10-3. Fantastic.
So I go see Jeremy, and Jeremy tantrums for about 45 minutes of our hour. His five siblings are bopping around the treatment room like little balls in a pinball machine. I can’t even hear mom to talk, but we muddle through and get to the end of the session right as my pager goes off, informing me my 11:00 has arrived.
I see Jeremy and his family to the lobby, clean up the treatment room, and set up for my next client, Patrick.* Patrick is a 5-year-old with communication delays and behavior issues. Patrick’s family has been homeless on and off for the past couple years, but have finally found housing with a friend. This week, mom came in with a different set of problems: she suspects her friend’s son is being sexually abused, and is worried that he will start acting out and hurt her children. She didn’t think anything had happened with her boys yet, but with a toddler and a barely verbal 5 year old, we can’t exactly get a full report.
So, after hearing the whole story and circling around it a few times to get more information, I tell Patrick’s mom I need to go check-in with a supervisor, as this may be something I have to report. Both of my supervisors are at a different building for the day, so I try to find the supervisor-on-call from another clinic. She’s in session and another supervisor is in supervision. I decide to interrupt her. I explain the situation and ask whether I need to report. There are no clear answers, as the whole situation is a little fuzzy. We circle around the issue, she gives me her opinion on how to handle it, but tells me to interrupt the supervisor-on-duty. I do, we talk, and I go back into session. I explain things to mom, we’re wrapping up the session, and I get 3 pages in quick succession. Page 1: 911. Page 2: My 12:00 has arrived. Page 3: 911. I call back the extension for the first 911 page and there is no answer. I excuse myself from session again and go back to the supervisor’s office, which is who I suspected paged me, and it was. She consulted with a third supervisor, who had more recommendations for me. On my way back, I go to the front desk regarding the second 911 page, and learn that it was because my 12:00 was being aggressive towards other children in the waiting room. They just wanted me to hustle my butt along in case. I go back to the treatment room, talk to mom, and spend 10 minutes making sure she understands and is going to follow through with my recommendations. By the time I get her out the door, it is 12:15.
I clean up the treatment room, and get ready for my next session as fast as possible. “Getting ready” for this session involves taking all the furniture out of the treatment room, aside from a chair for mom, and 2 small chairs for me and client, because this client is the sort who will climb, push, and throw anything possible. Personally, I don’t feel like getting hit with a flying table. Into the treatment room we go, his behaviors start about 5 minutes later, and soon we’re into time-outs, restraints, screaming, kicking, hitting, and biting. Once he’s compliant (he had to sit in the chair for 10 seconds…which he did…after a 20 minute tantrum), I pull out 2 toy trains as I try to talk to mom. As soon as I turn my face away from him, he starts tantruming again…screaming, throwing toys, throwing shoes, and taking off his shirt. I take the toys and tell him he can have his train back as soon as he sits in the chair. Mom and I continue to talk, ignoring his behavior, which escalates every time we glance in his direction. Unable to get the attention he wants, and unwilling to be compliant, he decides to pull out all the stops: he pulls down his pants and underwear and looks directly at mom. I had seen this coming, and told mom we would ignore it, but mom just couldn’t. As soon as he made eye contact, she jumped up, exclaiming, “DON’T YOU DARE PEE ON THAT FLOOR!”
With a huge grin on his face, and laughter spilling out of every inch of his little body, my little friend promptly peed ALL over the treatment room. And I do mean ALL over the treatment room.
Another 20 minute time-out tantrum (followed by 10 seconds of compliance!), my little friend was finally calm and played nicely with trains. At about 1:15, my favorite client ever leaves, leaving me with a huge to-be bruise on my knee where he got me with his cute little galoshes, and another under my arm. I tell my good friend Ms. Sherry at the front desk that treatment room 1 needs to be cleaned, put the necessary “warning” and “out of order” signs on the door, and I get my next client.
Next client is a little cutie I hadn’t met before with a mother who wouldn’t give me any information. It wouldn’t have been so bad, as I’m rather used to that, except for the fact that I had not had breakfast or lunch, and I was utterly exhausted from my “sprinkling wonder” client before. Normally, conversations like this don’t frustrate me, but…well…I was tired. And hungry. And increasingly grumpy.
“His behavior is bad,” mom says.
“Okay,” I say. “Tell me what is bad about his behavior.”
“It’s bad,” she says. “Real bad.”
“Hmm,” I say. “Tell me more. Is he having tantrums, or not listening to you…”
“Oh yeah,” she says. “He does that.”
“Why don’t you tell me about the last time he had bad behavior.”
“Well…” says mom, “that’s hard to say…”
“Does he have bad behavior every day?”
“Most times. It’s a lot.”
“Is it multiple times a day?”
“Sometimes it might be.”
“Is there ever a day when he has a good day all day?”
“I can’t really remember.”
“So you said he has tantrums. What does he do during a tantrum?”
“Oh wow, Ms. Auto, you should see it. It’s real bad. He just get to acting bad and is just bad all over.”
“I understand that. Is he yelling or screaming?”
“Oh yeah.”
“How about kicking, hitting, biting, scratching…”
“Oh yeah.”
“What else happens while he’s having a tantrum?”
“Well…that’s hard to say.”
And so it goes. Really, not so bad. Pretty typical conversation, actually. But I was tired. And hungry. And frustrated. So I finish up with that client at about 2:15, and then see my last kid for the day, whose mother lies to me throughout the session. I call her out on her lies, she gets angry, but we work through it, all the while trying to stop this little 5 year old girl from eating the lint off of the carpet. This session also goes late, so it’s about 3:30 when I finally finish up. I go eat my lunch (or maybe it was breakfast…or dinner…who really knows at that point), return emails and phone calls, and decompress for a few minutes before my final client arrives.
After my final client, I sit down next to Matt in the office. “Was that your room clear-out I saw?” he asks.
“Yep,” I say, typing my progress note.
“Was that your room with the “out of order” sign on the door?”
“Yep,” I say, starting to laugh.
“Was that your client that screamed through the whole session?” he asked.
“Which of the 3 since 10:00 this morning are you referring to?” I ask, laughing.
“Why are you smiling right now?” he asks, laughing, “More importantly, what are you still doing here? Go home and have a drink.”
I go home that night and have two terrible dreams. I question why the heck I feel so stressed out and why I can’t just handle all this better. I get about 3 hours of sleep that night.
Friday! Thank heavens. I ride the train into work with the guy in the dress with the headphones selling perfume out of the bullet holder thing, see a couple clients, finish up some paperwork and come home. Everybody keeps telling me to go buy water and make sure I have food in the house for the impending hurricane, so I go to the store, which is of course sold out of water, flashlights, and batteries. I call my sisters, clean up a bit, and decide to decompress for a while. I take a shower, paint my fingernails, and watch a movie. I’m feeling myself slow down a bit when I get a phone call. It’s a sort-of friend calling with some very not good news regarding a mutual friend. She’s crying, we game plan a little crisis management to enact if the situation arises, and get off the phone. I turn off the movie, thoroughly grumpy, pour the remainder of my cup of tea down the sink, take 2 Tylenol PMs and go to sleep. Thank God whatever help-you-sleep magic they put in there prevents me from dreaming—or, at least, from remembering my dreams.
This morning, I woke up early, went to visit my grandmother at the hospital (always a trip…but that’s a story for another time), and came home. It’s raining, but not hard yet…but I guess I better go and finish washing my clothes before Hurricane Irene harrives. A perfect end to the week, no?
Yes, dear readers, as I stated way back at the beginning, all of this is 100% true and, believe it or not, abbreviated. Sometimes, real life is stranger than fiction.
*All names have been changed