Shall We Dance?


46-year-old African American male presenting with suicidal ideation.

This is how I heard the nurse describe me to you over the phone.  My life with all of its struggles and victories summed up in less words than it would take for a person to describe their favorite movie.  Sitting on a bed in teh VA ER with a curtain pulled halfway around me, it doesn’t seem so out of place.  Neither do I.  You must have cringed when you got the call at 3:32 a.m. telling you to come and talk to me.  I almost felt bad for a second when I came to the hospital prepared to tell a lie.  Long, cold nights trying to find a place to sleep will make the lines between right and wrong blurry though.  I know you wouldn’t believe me if I told you that every time I do this, I feel like I am choosing the lesser of two evils.  It’s easier for you to believe that dishonesty is easy for me.

As you pull back the curtain and pull up a chair, I can see you trying to muster up the care you are supposed to have for me.  You seem to reach the level of pity, but can not progress beyond that.  It’s all right.  I don’t blame you.  You try your best to put on a show of concern.  It’s part of your job after all.  As for me, I don’t even try to play a role anymore.  I know what to say, I know my words will count for more than some false sadness and hopelessness I might enact.  I’m too tired to be depressed in my full glory tonight.  You’d see right through it anyway, and even if you didn’t, my chart would betry me.  So I make it easy on both of us.  I make it simple for you to write me off.

We shake hands.  We exchange names.  We begin the dance.  What brings me here?  I feel like killing myself.  Do I have a plan?  I think I might have swallowed a bottle of Tylenol on my way here.  When was that?  I’m not sure.  How many pills in the bottle?  I don’t know.  Do you feel hopeless?  Yes.  Have you had any alcohol recently?  Hell yeah.  I don’t hear voices laughing at me, I don’t see furniture bursting into flames, I don’t feel like killing someone else.  I am in the VA hospital, the year is 1998, and Bill Clinton is our horny president.  When someone says, “Don’t cry over spilt milk,” that means don’t regret something you can’t change.  When the cat’s away, I will play.

What will you do if we let you go from here?  I don’t know, Doc.  I’ll probably kill myself.  It’s up to you, but I think if I walk out of here I am going to hurt myself.  I don’t know for sure.  You can take that chance if you want, Doc, it’s up to you. You fidget because you are uncomfortable with me putting the responsibility in your hands.  And by this, I know I have won.  Despite my matter-of-fact tone and almost congenial demeanor, with these laswt couple of sentences, I have closed the deal.  I nearly had a smirk on my face when I spoke them, and I know you reached your final verdict concerning me right then.  I work the system.  But I do it because it’s all I have.  I have learned not to fear your personal judgment as long as your professional opinion allows me to stay in a warm place.

What do you want us to do for you?  I don’t know.  I guess I want you to know more about who I am.  I want you to ask me about my story, not just rely on your formatted questions to lead you to some diagnostic conclusion about what disease I am.  I want you to know that you can not understand me by merely reading a chapter in your DSM-IV.  And when you ask, be prepared to listen to my answers and share in the burden that goes along with catching glimpses of my life.  I was born poor.  Grew up even poorer.  I fought in Vietnam.  Saw men die.  Killed a few myself.  Got hooked on booze.  But I was also married once.  I have a daughter whom I took care of for a time. I went to school.  I had dreams.  Still do sometimes.  Most of all though, I want you to know I can not be encompassed by ten words.  But I know it is easier for you to believe the key to my state of being is within your grasp.  It is better for you to categorize me so I can be dealt with in the context of a protocol instead of a relationship.  It means you know how to handle me.  It means you can walk away from me with more answers as opposed to more questions.  It means life is a little simpler, and so sleep will come a bit easier.  I don’t begrudge you that.

46-year-old African American male presenting with suicidal ideation.

It doesn’t bother me to hear it anymore.  It is familiar.  It is my ticket to a few days of provision.  It is who I have become.

Thank you for the dance, Doc.  Maybe next time, I’ll let you lead.


Jane Choi, Class of 2000