The Blind

by A. F. Brady

  “I didn’t realize how much I needed to talk about this.” Rachel sighs.

  Looking around her office as she says this, I can see the results of the turmoil. It’s in a state beyond disarray. There’s a dark stain on the carpet in the middle of the floor, and it seems to be growing fuzz of some kind. Several umbrellas have dropped between the wall and the filing cabinet, none properly closed. The plants that line the windowsill are long dead, even succulents and cacti that are supposed to be unkillable. Under her desk, there are numerous pairs of shoes crammed into a plastic bag. From woolly winter boots all the way to sandals—obviously unattended for months.

  “Well, I’m right here to listen to you. I have a group in forty minutes, but I could have David cover for me if you need to discuss what’s been going on.” Now’s the time to solidify my status with Rachel.

  She nods somberly, defeated, and I pick up her phone to buzz David on the intercom. He agrees to cover my group and doesn’t bother to ask why.

  “Covered,” I say. “What’s happening?” I feel like I should be uncomfortable; it’s not normal for Rachel to allow professional boundaries to fall, and it’s certainly not normal for her to confide in me. But instead this feels like an opportunity.

  “It’s not just us—it’s all the publicly funded facilities. The money just isn’t there anymore. The city doesn’t have it for us, the state, the federal government—no one. The money just isn’t there. The mental-health-care world never recovered from 2008. Things were redistributed, and we got the short end of the stick, as we usually do.

  “But now we have the same yearly decline in staffing because people can’t exist on these wages. We’re losing administrators who can’t stand to live without a six-figure salary, and the workload and influx of patients is going in the opposite direction.” Rachel isn’t looking at me. She’s facing away, with her head lolled back on her desk chair, her feet stuck straight out in front of her, and she’s gently twisting left and right.

  “How long has this been happening?”

  “Months. Or, I suppose, I’ve known about this for months, but it’s been building for longer than that.” She abruptly spins back to face me and pulls a tin of something from her desk drawer. She plucks out a sour candy and offers the tin to me. I politely decline, as I still have the taste of toothpaste in my mouth.

  “The suits came for a meeting before it got really cold, maybe September or so; let me know that the wheels were coming off at Typhlos. Long discussions of staff loyalty and capabilities. Who would be able to handle a heavier caseload, who would maintain employment with us, despite increased work and no increase in pay. It’s always such a pleasure to hear them commiserate with us as they take away the last crumbs of our survival. And preach the importance of patient care. I’m the captain of a sinking ship, and they’re constantly calling me to remind me that they’re fighting the good fight, and they’re down in the trenches with me. They propose these preposterous solutions to keep team morale up. Team morale? They don’t even know our names.”

  I’m looking at Rachel’s desk. She has files and notes and binders stacked haphazardly all over the place. There are takeout containers underneath piles of documents and used tissues shoved into corners.

  Her desperation is evident, not just in the fact that she’s talking to me at all, but her voice, her office, her demeanor; everything about her suggests an air of madness.

  “They don’t even begin to comprehend that I’m alone here.” She’s nearly sobbing. “I’m alone in managing this crisis, I’m alone in knowing the crisis even exists, I’m alone in performing the bulk of the managerial duties. I even asked! I asked if I could promote one of the psychologists to a managerial position, so I could at least talk to someone about this! I had you in mind, by the way.”

  “And what did they say?” Am I getting a promotion?

  “‘We would prefer if the staff didn’t get wind of the financial setbacks. We imagine it will be temporary, and we would prefer to have as few people aware as possible.’” She uses a nasal, cartoon voice to impersonate the higher-ups and pulses animated finger quotes at her temples. “Same nonsense as always. So, they’re lying to everyone. Lying by omission.”

  “Well, I’m glad that you told me. Obviously, you need to get this off your chest and have the opportunity to share with another staff member. I don’t expect any kind of promotion or change in title, but if you need my help, or some kind of backup while you’re going through this, I am right here. Very happy to help. And I won’t tell anyone what’s happening.” Doesn’t seem worth it, but I might as well keep up appearances.

  “I can’t—I can’t ask that of you. I’ve already put so much on your plate. I’ve given you all the impossible cases, you’re running the most trying groups, and I can’t risk pushing you to a breaking point. If I lost you, this whole place would go under, believe me. And Jesus Christ, I just accused you of being pregnant.”

  “Rachel, this is my job, and I love my job. And I’m good at my job. It would be impossible for me to know that this is going on, and to know that you need help, and not provide any. Give me something. Let me shoulder some of this burden for you.”

  I can see in her eyes that she desperately wants to accept my offer. She’s been thinking about it. She’s been waiting for an opportunity to come talk to me. The shine is back on me, and it’s nearly brilliant now.

  “I haven’t been doing monthly med meetings with all the staff. I’ve been outsourcing supervision sessions, as you know. Sam, I haven’t even reviewed the staff evaluations.” She holds up the pile of folders. Still with the OMH seal tied over the stack like an unopened Christmas present.

  So that’s why I’ve been flying under the radar; the evaluations were never reviewed. “I should have had these finished and the report submitted to OMH as soon as Dr. Brooks and Dr. Young gave me their summaries. But the Office of Mental Health has the same problems we have—they’re overworked, underfunded, understaffed. We’re all in the same sinking ship.”

  I have never been so lucky as to have a golden opportunity to save my own skin fall into my lap like this. “Rachel, please, let me take something off your hands.” Give me the evals, give me the evals. Give. Me. The. Evals.

  “I’m just so overwhelmed, and I look at the patients every day, and I can’t let them down.” She’s getting misty-eyed and a faraway look. Give me the evals.

  “I can help with administrative tasks if you need. I can take over the intake responsibilities. I can cover your groups if something comes up—” give me the evals “—or I could even do the OMH evaluation summary for you.” My heart is beating in my throat, and I can feel the blood and adrenaline pumping all the way down to my fingertips. The veins in my hands are starting to come to the surface, and the sweat is pooling at the back of my waistband.

  She looks down at the handful of evaluations, but there is some disconnect between what she sees and what she’s thinking. “I—I can’t have our patients suffering because of financial issues. I can’t have them losing out again; they’ve been through enough.” Her voice gets smaller as her thoughts tangle and crash. Seemingly without consciously deciding to, her hand slowly extends in my direction, and she looks to me, slack-jawed and wide-eyed, opens her fingers and drops the evaluations into my outstretched hands. “I can’t have the patients feel these changes. They need support…” Her voice trails off; my ears are full and ringing. My stomach is creeping into my mouth, and I’m elated and terrified that she may be giving me the ticket to my liberation. I run my hands over the smooth face of the top file folder with my sweaty palms and feel the weight of the package.

  “What else?” I ask, my eyes glued to the stack of evaluations in my hands. I can’t believe this is happening. Rachel is in a trance of anxiety and self-pity, and I’m not sure she can hear me.

  “Here’s what you can do for me.” She’s staring into the middle distance, as if she took acid and it just kicked in. “Don’t tell anyone that I’m dro
wning. Don’t tell the rest of the staff, not even David, that we’re in trouble. Keep up the facade. Please, don’t let anyone see the man behind the curtain, so to speak.” She refocuses her eyes onto mine and clamps the outsides of my hands with hers as she says this. Her hands holding my hands; my hands holding my salvation.

  I slowly stand up; I need to get out of this room with these evaluations before she sees right through me and takes them back. Rachel straightens up and meets my eyes again with a confused and tenuous look.

  “I won’t tell anyone if you won’t.” We shake on it; a pact. A pact between two drowning women to pretend that the other can swim.

  DECEMBER 20TH, 3:46 P.M.

  I have the package of evaluations tucked under my arm and I feel as if I know what it’s like to be a heroin dealer concealing a shipment. The excitement is tremendous, but the fear is overpowering. Rachel has lost her damn mind and decided that the best person to review the evaluations and prepare a summary report for the Office of Mental Health is me. Mentally unstable, self-annihilating, awe-inspiring superhero Dr. Samantha James.

  I have to work as quickly as I can because there is no way she will remain this brain damaged for long. Just because Typhlos is in trouble doesn’t mean she needs to stoop to this level.

  I tear the OMH ribbon from the package, and the files spill out like an open accordion. They’re organized by department, and even though curiosity immediately sends me to read the files of my clinical colleagues, I restrain myself and create an organized and cogent system for summarizing the findings. I have to get something down on paper in case Rachel were to come check on me, so I start with the boring ones: the maintenance staff and the kitchen workers. I’ll follow those with the security staff, then the orderlies and nurses, and finally I will dig into the clinical staff.

  My head is filled with the notion that Travis and Dr. Brooks gave us all a free pass and I’m not going to be found out. I don’t know what I would do if I opened my file and discovered I was wrong. I place the folder with my name on the tab down at the bottom of the pile.

  David is still covering the group I asked him to cover, so I could talk to Rachel. I imagine he will come in and tell me how it went when he finishes. I’ve got ten minutes, maybe fifteen, and after that, my schedule is clear for most of the afternoon. I should be having individual patient meetings; I should be working on case files and reaching out for continuing care. Instead I hang an In Session sign on my door, turn up the white-noise machine to full blast and clear my desk of all other work and debris. I pull out my phone to find a text filled with suggestive emojis from AJ. With a smile, I turn it off; can’t have distractions now. I take out two pens: a red one for notes, a black one for the summary. I lay a white Typhlos legal pad next to the stack of evaluations, and it’s off to the races.

  Each folder contains the results of the assessments and inventories that were given to the staff member, as well as a brief summary of the findings. Then there’s a separate synopsis of the interviews. For the OMH doctor’s reference, there is a copy of the Typhlos employment history and each individual’s résumé.

  After Travis and Dr. Brooks complete the probes and turn in their findings, it’s Rachel’s job to review their conclusions and make employment decisions for every employee. This is now my job. The actual OMH reviews go back into everyone’s staff folder in the administration office, probably never to be seen again, and it’s Rachel’s final report that gets submitted to OMH. Now my final report.

  I open the first folder—Salvatore Valbuena, maintenance worker. Employed with the Typhlos Psychiatric Center for eleven years. Education level? High school equivalency diploma. Assessment and interview conclusions? Unremarkable. Verdict? Fit to maintain current employment. I jot down some quick notes, carefully close his folder and place it upside down on my windowsill.

  As I continue, I see that nearly all the maintenance staff has the exact same result, with the exception of Carlos, who showed erratic and unreliable responses on all his inventories, and the interviews were inconclusive. Clearly, this is because he doesn’t speak English, and neither Travis nor Dr. Brooks spoke any Spanish. Instead of doing their fucking jobs, they decided to assume that his bizarre responses were due completely to the language barrier and despite the inconclusive results, they pronounced him fit to maintain current employment. To show that I am scrupulous and careful, I make a large red note on my pad requesting that the next time these evaluations occur, a Spanish-speaking doctor is available to those who are not proficient in English. See? I’m perfectly capable of doing this.

  As I read through the evaluations and review the results of the assessments, I wonder if these things are being graded on a curve. If I had to guess, I would say that at least half of us are fucking crazy, and if we didn’t come in here crazy, we went crazy while we were here. Look at Rachel—she was the poster child for being sane, and now she’s beginning to come apart at the seams. Did the OMH clinicians give us some leeway? Did they take into account the stress levels that this environment produces? I wonder if they took it upon themselves to give some of us get-out-of-jail-free cards, just to keep us employed here while the seas of financial uncertainty swell around us.

  I’ve gotten through the monotonous and uninspired evaluations of almost all the ancillary staff. My shift is technically over, and I could go home and open a bottle of wine now. A cold one. Maybe two cold ones. And I could smoke cigarettes in peace. Before I decide to fully pack it in, curiosity prickles my neck.

  I flip to the bottom of the stack, shimmy my evaluation out and place it on top of the pile. I stare at it for a moment, wondering if I have faith enough to open it. I let it sit there, at the top of the pile, next on the list, waiting for me to gain the strength. Stashed somewhere is a giant Ziploc of nips. Where the fuck did I hide that thing?

  I put my unopened folder back beneath the rest of the clinical staff and kick off my shoes. I can’t bear the thought of finding out yet. I bring the remaining evaluations onto the floor and pull my coat off the hook. I make a little nest for myself, using my coat as a pillow. From what I’ve gathered so far from the other evaluations, this is going to be more entertainment than anything else. As I’m gearing up to get a good laugh, starting with Julie, there’s a knock at my door.

  “It’s me. You still in there?” I reach up from my station on the carpet and open the door for David. “Hi. What are you doing down there?”

  “Hi. Just some extra stuff that Rachel asked me to help out with.” I can’t even tell David that I’ve been given this opportunity to save myself. I can’t admit what I’m planning on doing with my evaluation. “What are you doing?”

  “I was heading home. Just wanted to let you know that your group was totally uneventful. You might want to check on Shawn’s meds, though. He was super out of it.”

  “Will do. Thanks, David.” I wave at him as he closes my door, and refocus on Julie’s evaluation.

  I pull out her résumé, and scan over any bolded information. Upper East Side address, high floor, 10021 zip code. Obviously. She included her GPA on her résumé. Jesus Christ, what a kiss ass. Graduated from college when I was defending my dissertation. She’s only twenty-eight years old. Master’slevel clinical staff, employed with Typhlos for two years. Her last three jobs before this were in residential programs. None of them lasted longer than six months. I see copies of two performance reviews. The first was completed just after Julie’s six-month probationary period, and the next one a year later. Everything looks good; she gets three and four out of five-point ratings on most items. The comments section is what I’m interested in.

  Lacking professionalism in patient interactions.

  Inappropriate use of hugging and physical contact.

  Energy levels distractingly high.

  Nonclinical language used in clinical paperwork.

  Can benefit from observing other clinical staff members during group sessions.

  Note: Please do not use smiley-face symbo
ls on any clinical documentation.

  Ha! I can’t believe these things were addressed with her over a year ago, and she still behaves like a cheerleader, sorority slut on the unit. What a joke.

  Her assessment summary states “unremarkable.” Just like the rest of her. Nothing notable, nothing pathological, other than pathologically irritating. The interview summaries indicate her bubbly personality may not be suited to this particular field, although it concludes that she is fit to maintain her current employment. Maybe I should grab a fat black Sharpie and change that conclusion. At the bottom of her interview summary, I find another golden nugget.

  Axis 1 Diagnosis: None (rule out anxiety)

  Axis 2 Diagnosis: None (elevated histrionic response)

  The psychiatrists think she’s got anxiety and a tendency toward hysteria. Freud would love this shit. I toss Julie’s evaluation aside and continue through the counseling and social-work staff. I keep running notes in case I encounter anything interesting, but Travis and Dr. Brooks seem to have kept everything perfunctory and professional. Now and again there is a small blurb about a foible or personality trait that could be problematic, but no one has been deemed unfit so far.

  Before starting in on Gary’s file, I pop into the staff lounge for another coffee and a pack of peanut M&M’s. Gary is the last in my master’s pile, then I’m moving on to the psychiatrists, then the two PhDs: David and me.

  I skip over Gary’s résumé and give a superficial glance to his employment history and performance reviews. He has mostly three-point ratings. Average. Nothing special. I get to his assessment and interview summaries, and now it gets interesting.

  Intense discomfort and anxiety related to completing psychological assessments and inventories.

  Profuse sweating and heavy breathing noted during each assessment and interview session.