Monday, January 4, 2010


The concrete rooftop is shrouded in shadows and reflections from floodlights under the stars. Six adolescents engage in a half-hearted game of volleyball.

"Hey! Watch your position! You could have caught that one!"

An anorexic blond with short, mousy hair and a pointed angry face appears to be drowning in a large ski parka and baggy jeans. She yells at a tall, muscular 15 year old boy who towers over everyone, staff included. It's a warm summer night - he is in shorts and a t-shirt.

"Watch it skinny. You don't know what the hell you're talking about. Shut your mouth."

"Don't you talk to me like that! I'm a girl. You can't talk to me like that. Didn't your mama raise you any better?"

"Don't you talk about my mama. You don't know my mama." I think I remember that his mama is dead.

A staff member, who appears to be in his late twenties, wanders between them. His bronze skin and long, shiny dark hair suggests American Indian ancestry. His angular face has a permanent smile. He always looks stoned, and his easygoing manner and slow, rambling walk reinforce this impression. I was mildly surprised, once, when he asked if I had any leftover pain medication at home, from minor surgeries. I told him I didn't think I did. We were supposed to be the staff. When did people grow up? Maybe if I got into med school, I decided. I was wrong. Maybe when we're doctors. Nope. Maybe never.

"Hey, guys, take it easy. It's just a game. We only have ten more minutes, before we have to go down to our last group. Let's have fun."

The anorexic blond steps back and smiles in wicked satisfaction. The 15 year old pounces, screaming obscenities. I shrink back in horror. He has easily twice the bulk of any single person on the roof, and the staff's just me and perma-smile. I'm barely twenty, fresh out of college, skinny myself in an over sized Lollapalooza t-shirt and baggy shorts. I've only been working in adolescent lock down a week, but instinctively know that a basket hold is not going to work in this situation.

Skinny girl runs to the corner of the chain-link fence that borders the rooftop, and hides in the shadows. Smiley rushes to restrain the mountain of uncontrolled testosterone. It's like watching a train wreck. I quickly quell the urge to help, knowing we would lose handily, and instead grab my keys and rush to unlock the gate and run down the concrete steps to the floor for help.

When I return with two men, one bearing a shot of Haldol, I can see, but not hear, what is going on. It's like being in a vortex. The 15 year old is trying to gut-punch the staff member, who is in turn trying to pin at least one arm down behind the large youth's back. They are both down on the ground, in constant motion and battle for control. Five 11-15 year olds, skinny included, are standing in various positions on the volleyball court, open-mouthed. The two staff members rush in to help and suddenly, the youth's scream of fury and defeat pierces my silence with the insertion of the antipsychotic. The men hold the youth until he is calm, and when I realize the situation is under control I escort the other patients down to the ward.

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