|"Good morning," the curtain was suddenly snapped back and
Robert was faced with a bearded man in a flannel shirt and blue tie.
He wore a pair of rounded lenses, and had a hospital ID badge clipped
to the front pocket of the shirt. He wasn't dressed like the other
doctors--a little casual-looking, even. But nonetheless, his badge
read "Dr. Phillip Kouran, MD-PSYCH".
"Hi," he said softly, in a voice that was the reflection of days and days of fatigue and anxiety resulting from sleeplessness. He was so spent, so exhausted, it was all he could do to stay here, in the moment.
"My name is Doctor Kouran--you can call me Phil. I'm the ER psych on call today. You're..." he quickly consulted his chart. "Robert?"
"Yes," he said, more softly.
"So, Robert," he casually folded his arms and gently leaned against the wall. "Why are you here?"
Robert took a breath. "I can't sleep...I haven't slept in about two weeks," his voice quivered, with him finally relaying his symptoms. "I'm so wound up...my thoughts keep racing around in my head and I can't sort them out anymore. All they do is keep racing and I can't stop them long enough to drop off to sleep...I can't even concentrate anymore...I don't know how to stop it. I just sit in bed and stare up at the ceiling and then I just start crying, but it doesn't even help...I think I need help..." he trailed off, waiting for the doctor to interject.
"So," the doctor said slowly, "Any thoughts of suicide?"
He'd never thought of it before, but he had to admit to himself now, the thoughts of ending this pain were starting to become more powerful in his mind, even as all other desires were fleeing. He spent at least a few minutes in the kitchen the previous day staring at the knife rack, contemplating the messy death the cut on the wrist would bring him. He even cursed the fact that he'd never considered it earlier, so that he could've had a better plan to end his life. The thoughts were not concrete, and did not last long, but the fact that he was even having them was enough to make him wonder how things could've gotten so bad.
"Well," he said carefully, "Thoughts...but not really anything I'd ever do. But I don't really know where I'll be in a few days if I don't get some help soon."
"Fair enough," commented the doctor, who wrote something down in the chart. His calm demeanor was somewhat reassuring against the chaos in the mind. Just another problem , just another case that had a cure, either in prescription or therapy...or a little of both.
"So," continued the doctor, "Any hallucinations or ...delusions of grandeur...things like that?"
"...No...nothing like that..."
"Are you on any medications?"
He took a breath. "have you ever been diagnosed as having a mental disorder?"
Robert tried to give some thought to how he wanted to answer this question. For a long time he thought he wasn't completely "right", at least not the way that other people seemed "right."
"Not yet...but I've been depressed for most of my life ...I guess....though it was never this bad before. It's never made me bail on work or anything. I pretty much deal with it and go on with my life. It's just this time I couldn't."
"What was different this time?"
Robert took a deep breath. "A lot. A lot is different this time. "
"So," said the doctor. "Can you tell me about it?"
Robert sat for a minute, closed his eyes, tried to cry but found he couldn't. It was just so awful. He couldn't believe he was sitting here. He couldn't believe things had gotten so bad. He just couldn't believe he'd finally snapped. He'd finally gotten to the point where he could not deal anymore. He was only 21, and already he'd reached the conclusion that life was just not worth living...
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