Observations Reflection

It’s Okay to Get Angry.

It was my first job as a physician. I was 32 years old.

In that job I functioned as a psychiatric consultant. Thus, while I had clinical expertise, I didn’t have formal authority at any of the places I worked.

I can’t remember now what exactly happened: Someone said or did something that vexed me. It made me worry about how staff might (mis)treat patients. But who was I? I didn’t work for that agency; I was only there two days a week.

“I don’t feel like I can say anything,” I sighed to my boss.

My boss took a sip from his drink and leaned forward on the table.

“Maria, it’s okay get angry,” he said. “Sometimes you need to let people know that you’re angry.”

When we’re young, we often don’t believe that we can contain our anger. And, in some ways, that’s true: We don’t contain our anger because it is unfamiliar to us. There are different flavors of anger: Sometimes it simmers just beneath the surface of our skin while the flames roar in our ears. Sometimes it explodes and tears, words, and fists fly from of our bodies. When we’re young, these flavors are novel and strange: What is happening? What am I supposed to do with this? It’s empowering and overwhelming and frightening all at the same time.

We also don’t believe that we can contain our anger because we often don’t know how. It’s a skills deficit. Our anger propels us to do different things because anger is uncomfortable. We say (or scream) things. We break things. We cry. We bury it within us. We focus the energy of anger into other things. We avoid it.

As we age, we get to know our anger because it keeps coming around. There’s no way to avoid it, though that doesn’t stop us from trying. Most of us recognize the different flavors over time; we even learn what flavor we prefer.

Many of us also learn that our anger won’t destroy us. The sharp edges of anger cause us pain, yes, but we know that the edges will become dull and the pain will recede. That never happens as fast as we wish; we grumble with annoyance and impatience as the days, weeks, months—maybe even years—pass. The anger burns, but its flames do not kill us.

We also learn that when we share our anger with others, whether we intend to or not, we often make ourselves vulnerable. Those who must work or live with us learn what our buttons are and how we react when they press them. Sometimes our distress makes them laugh at us. Indeed, there are people who will use the vulnerability within our anger against us. Many others, particularly those who care about us, learn more about who we are and appreciate us more, despite our anger.

Not only does our anger let other people know who we are, but it also tells us who we are, too. Sometimes we don’t like what we learn about ourselves when we’re angry. Other times, our anger reminds us and reaffirms what we value.

And sometimes you need to let people know that you’re angry so they learn what matters to you.

Informal-curriculum Nonfiction Reflection


“I’ve been alive for too long,” he sighed. “I will be 200 years old in two months and four days. I was born in 1817, you know.”

“200 years is a long time,” I replied. While he wasn’t 199 years old, the wrinkles around his eyes, the knobbiness of the knuckles on his hand, and his slumped posture made him look older than his actual age.

“I’m an angel,” he continued. “I do what I can to help people, as that is my mission from God.” His thin frame quivered as he coughed into the crook of his elbow. “God sent me down from heaven 200 years ago. People are drawn to me. Animals are drawn to me. They know that I can help them. I give away my food, I give away my cigarettes, I give away my marijuana. God gives me instructions about how to best help people.”

“Would you miss God’s voice if it went away?”

The Angel bit his thin lip before responding. “Maybe.” He looked worried.

“You seem to appreciate the guidance,” I said, though we both recognized that I was actually asking a question.

“Sometimes God says helpful things,” the Angel answered. “Sometimes… not.”

He shared that sometimes demons speak to him, too. They whisper and shout amidst his thoughts, pointing out how his efforts are useless, that no one cares, that there is no value to his life.

“What has stopped you from killing yourself?”

The question had barely left my lips before he answered, “It’s a sin.”

The cases of beer helped to mute the voices of God and the demons, which often became a cacophony when the light of heaven was gone. No, he didn’t think that the beer was hurting his liver; maybe it was even helping it.

“I didn’t get the hepatitis from drugs,” the Angel offered. “I wasn’t feeling good, I was sick. The doctor tested me and said I had hepatitis. He told me that I had to tell anyone I was having relations with. When I told the lady I was seeing at the time, she said, ‘You got that from me.’ I wish she had told me that sooner. I would’ve used protection if I had known that.”

The Angel didn’t know when he was getting out of jail. We discussed what treatment would best help him. When I asked if he had any questions for me, he shook his head.

“Feel free to come back any time to talk,” he said with the same polite manner he showed for the half hour we spoke. He bowed his head.

You can look up an inmate’s charges on the internet. It’s public information. You won’t learn what specifically happened that resulted in the arrest, but you will learn the alleged reason for why the person is in jail: Robbery. Assault. Failure to appear for court. Theft. Domestic violence.

I don’t seek that information before I meet my patients in jail. If patients start sharing their understanding as to why they’re incarcerated, I stop them. My duty is to the patient, not to the court or the attorneys.

When I first started working in the jail, I looked up the charges for all of my patients, as that information has the potential to help with clinical care. What I saw quickly dissuaded me from doing this on a routine basis.

It is uncommon for a man of the Angel’s age to be in jail. Yes, he was reporting and demonstrating psychiatric symptoms, but they alone did not explain why he captured the attention of law enforcement. Why would a man with his gentle manner and feeble condition be in jail?

Failure to report: sex offender.

The Angel had two convictions: One for Rape, the other for Indecent Liberties With Forcible Compulsion. These occurred years apart.

“Sometimes God says helpful things,” the Angel answered. “Sometimes… not.”