Maria Yang, MD

The rows of fluorescent bulbs formed an indoor sun. Its cool rays illuminated the windowless psychiatric emergency room. This sun never rose and never set. Only the clocks betrayed that it was nearly three o’clock in the morning.

His left shoulder held the telephone receiver against his ear. The drone of the dial tone filled his head. His right hand floated above the keypad, then dropped back to the table.

He looked at the clock. A quiet sigh escaped from his lips. Lifting his right hand again, he willed his fingers to dial the number that was scribbled on the torn sheet of paper before him.

Instead, he hung up the phone.

He silently rehearsed what he would say if someone answered his call. Would he leave a message if no one picked up the phone? If yes, what would he say? If no, how long should he wait before calling again? Should he even call again? What if someone did answer the phone, but would not stop talking? Could he just hang up?

He shook his head, took a deep breath, picked up the phone, and listened to the drone of the dial tone. His fingers quickly punched in the phone number.

Please answer the phone.

Two rings. Three rings.

Please don’t answer the phone.

The ringing stopped.

“… hullo?”

He finally took another breath.

“Hello. My name is Dr. A and I’m calling from Big City Hospital. May I please speak to Mr. B?” Standard greeting.

“Yeah… that’s me.”

“I’m sorry to disturb you at this hour, Mr. B.” Standard disclaimer between the hours of 10:00pm and 7:00am.

“It’s okay.” Mr. B yawned.” “I was expecting this phone call.”

Dr. A frowned. This isn’t the first time he’s gotten a phone call at 3:00am about this.

“I’m calling about your sister. She’s here at the hospital, in the psychiatric emergency room. She’s okay.” Standard remark to prevent panic. People usually assumed the worst.

“Oh, that’s good.”

“Would you mind telling me what happened this evening?” Standard open-ended question to elicit a history.

“Sure.” Mr. B sounded bored, numb. Most people did at that hour.

His sister tried to open the door to her room. It was still locked.

At three o’clock in the morning, peace eluded them all.

Does it ever bother you to listen to people who want to kill themselves?” the medical student asked.

The attending psychiatrist glanced at the whiteboard.

The whiteboard was divided into five columns. The first showed the patient’s age; the second indicated the patient’s sex. A last name was in the third column. The fourth held the chief complaint, the reason why the person was in the psychiatric emergency room. The disposition—admit to or discharge from the hospital—occupied the fifth column.

Nearly a third of the patients had a chief complaint related to suicide.

“Yes; there are days when I feel exhausted from listening to people who say they want to die. That’s part of the work, though,” the attending said. He paused, then clicked through several screens on his computer. Pushing his chair away from the table, he said, “Come. Let’s take a walk. We’ll learn why we’re fortunate to listen to those who want to kill themselves.”

The attending unlocked the solid, windowless door. A camera attached to the ceiling watched them retreat down the hallway.

They walked through two sets of double doors into the medical emergency room. The attending paused in front of the whiteboard there. His eyes scanned the list.

“Follow me,” he said to the medical student.

They passed through hallways lined with occupied gurneys. A young woman with dark hair gingerly touched the intravenous line that was taped to her arm. An elderly man with rasping breaths gripped the side rails of his gurney. A man peeled bloody gauze away from his leg. Several people had curled their bodies underneath the thin white sheets, their eyes closed and their bodies still.

As the medical student and attending passed by the trauma bay, they slowed down. The attending pointed inside. Several nurses stood around a man lying on the gurney. Blood was splattered all over the floor tiles. Plastic bags, tubes of various sizes, and soiled white towels littered the room. Layers of gauze, some of it stained red, were wrapped around the man’s head. A mechanical ventilator heaved breaths into him. The heart monitor reported each beat with a hollow chirp.

While walking out of the room, a nurse greeted the attending with a nod. Upon seeing the medical student, the nurse murmured, “Gun shot wound to the head.”

“When people tell us they want to kill themselves, we have the opportunity to intervene,” the attending said as they walked away. “Some people, like that man, never give us that chance.”

In her right hand was a white plastic bag marked with a smiling yellow face. “Have a nice day” and “Thank you!” were printed on the front.

She had tied the handles of the bag into a square knot. The resulting loops dangled from her hooked fingers. The bag swung with each step she took while walking north on Park Avenue.

Her destination was an apartment between 73rd and 74th Streets. As taxis, cars, and delivery trucks raced past, she caught glimpses of the short grass, leafless trees, and stunted bushes that grew in the median of the avenue.

The plastic bag bumped against her leg and she reflexively extended her arm. Though she knew that the contents inside would not break or spill, she did not want to jostle the bag.

The doorman looked up when she walked into the building. Pewter stripes adorned the lapels and sleeves of his navy blue suit. The knot of his black necktie was crooked. He smiled at her in recognition.

“How you doin’ today, miss?” he asked, wrinkles appearing at the corners of his eyes as he smiled.

“Fine,” she said. “I’m here for apartment 13X. He’s expecting me.”

“Go on up,” the doorman said. Glancing at her plastic bag, he asked, “You got any lunch for me?”

“Not today,” she said, smiling.

“Next time, all right?” He winked at her.

She walked across the black and white checkered floor, underneath the chandelier that resembled a glass jellyfish, past the single pink orchid in the white ceramic vase, and stepped into the elevator. She felt the bag tap her leg again.

That was the portable flip-top sharps container that nudged her thigh. The brown paper sack inside the plastic bag also held a 3cc syringe with a 21-gauge by 1.5-inch needle, a pair of bright blue nitrile gloves, several small squares of gauze, one band-aid, three alcohol pads, and one container of hand sanitizer. The vial of antipsychotic medication waited inside its small box.

After exiting the elevator, she turned left, walked across the wooden floor of the hallway, and stopped in front of apartment 13X. She rapped on the black door three times.

“Who is it?” a muffled voice immediately responded.

“It’s Dr. Doe,” she said.

“Dr. Doe! Are you here to give me my injection?” he asked.

“Yes,” she said.

The locks on the door began to unlatch.

When she was sixteen years old, she said, “I wish old people would stay inside. They walk so slow. They take up too much space on the sidewalk. Who wants to see them with their canes and walkers, anyway? It’s so depressing.”

When she was forty years old, she said, “I like to see old people out and about. It’s nice to see that they are still active. When I’m that old, I hope I can still walk around like that.”

When she was seventy years old, she noticed that the youth walked impatiently around her. She said, “I used to make fun of old people when I was younger. I thought they were so slow and weak. Now I guess I am one of them.”

After crossing her arms in her lap, she looked up at the cloudless sky before glancing over her shoulder.

“Thank you for pushing my wheelchair,” she said.

I have instructed my bridesmaids to wear Alfred Angelo dress number 7174 in sapphire. The groomsmen will wear periwinkle windsor ties with their chalk stripe tuxedos. They must wear vests. I’ve never liked cummerbunds.

The three year-old boy said nothing when I asked him about the burn on his shoulder. Its shape looked like the hot, steel surface of an iron. He also said nothing when I asked him about the purple-green bruise that stretched from the side of his neck to his right ear. When I asked him about his parents, he looked away.

My bouquet will have orange circus roses, apricot roses, and miniature calla lilies. A lavender bow will wrap them together. My maid of honor will have the same bouquet, except orange freesia blossoms will replace the calla lilies. Her bouquet will be a third smaller than mine.

Her oncologist sent her to the hospital again. Last month, her five-foot, six-inch frame weighed 108 pounds. This time, her weight was 91 pounds. She gasped from the effort of sitting up in bed. The stomach cancer was winning. Her husband pulled me aside and asked, “Do you think she will make it to her 26th birthday?”

The wedding invitations will have dimensions of five inches by seven inches on 110-pound cardstock in eggshell white. The swirls at the top will be plum in color and the charcoal text will be in serif font to provide contrast to the flowing lines. I’ve ordered 100 purple “pansies in the basket” LOVE stamps from the post office.

“I’m going to be late for work!” the 73 year-old woman screeched. “Why won’t you let me leave my own home? I’m going to be late for work!”

Her daughter, her eyes red, wiped her nose and looked away.

“Who is she?” Mother screamed at me while pointing at Daughter. “Why won’t she let me leave? I’m going to be late for work!”

Daughter put her hand over her mouth. Her shoulders quivered.

My wedding dress will be ivory in color and satin in material. It will have a dropped waistline and an A-line silhouette. The gown will be floor-length and have a chapel train.

My wedding will be perfect.