While working at the psychiatric hospital in admitting, I was sent to speak with Lacey, a girl who came in with her mother. It was up to me to fill out the interview form, do the mental status exam, and decide whether the girl would be admitted to the mental hospital or not. Of course, I would present the case to my attending, who would check my work and (hopefully) catch my mistake, but I still felt like I was being handed a lot of responsibility.
I went to the waiting room and called the girl's name. A middle-school-aged girl and a young woman, baby on hip, stood and followed me to a room. After introductions, I asked Lacey what brought her in. She did not answer, but only looked out the window, away from me. His mother began to speak, and told me a long and convoluted story about marijuana, bad crowds, running away, and fights.
As the mother spoke, I looked at Lacey, who skillfully avoided eye contact with everyone. I had just finished two weeks on the alcohol and drug dependence ward, and so my soul was full of stories that began like Lacey's and ended with hard street drugs, divorces, dead loved ones, and dead dreams. I looked at her and wondered: will you go down one of those paths, or is this just a slightly-more-serious-case of teenage rebellion? And another possibility: is your mom the crazy one? She's the one doing all the talking.
The baby had fallen asleep on Lacey's mother's chest by the time the story was finished.
"Thank you so much for helping me understand," I told her. "I know it's been a long wait for you, but would you mind stepping out so that I can talk to Lacey?"
She left, and I turned to the silent teenager in front of me. She still gazed out the window. Was that a grave silence or a nonchalant silence or a hurt silence or a panicked silence or...?
"Lacey," I said, "I want to hear your side of the story."
"What your mom told me...does that match what happened?"
Nothing. I tried one or two more times. Still nothing.
"Well," I said, taking a new tack, "pardon me while I fill out some paperwork." And so I sat there, across the table from her, checking boxes on the mental status exam. I wanted to show her I wasn't afraid of silence. Several minutes passed.
"You know," I said at last, trying to speak like one seventh-grader to another (or one medical student to another), "I can't make you stay. Finally, you decide whether we can help you or not. Do you think you need help? Do you want to stay?"
A few more seconds of nothing, then Lacey's eyes moved from the window to his lap. Then she nodded. My heart soared, partially with elation at successfully communicating and partially because I thought she really could use the help.
"Okay," I said softly. I didn't follow Lacey after this, but I won't forget this interview soon. Pray for her if you read this.