A Day in the Life....

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I don't like posts that take looooooong to read. I am sensitive that when I do that I ask for too much time when there is not enough time to go around already. So don't read this if the very length of it is a turn off.

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This is about a day at work. I have a demanding interesting challenging affirming good job. I am not bored, rarely disappointed. But sometimes it's not easy:

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I had a hard day.
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I work two long days each week usually seeing seven or eight clients. Today by 8 am I had 3 phone messages from my 18 year old client "A" who I trust and who has agreed to a contract with me that before she would ever harm herself she would call me or the Crisis Center.
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She kept her promise. When she called this morning, she needed help, probably a hospital admission (her first) to help her understand why she cries so much and feels so sad and so alone that she wants to cut herself.
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I have been a psychotherapist for not yet two years. I consider myself a counselor but I have done many other things in my career too. This is the first time I have been a therapist per se, and one who mostly sees clients where they live, not in an office.
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So accompanying my client to the Crisis Center meant that I had to cancel my first two appointments with other clients. I was glad to do it, had to do it, but from there my day was a windstorm:
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9 am Call A's mother, pick up A at school, head to crisis center, arrange for her sister to stay with her, meet with intake counselor.
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11 am See J. for weekly session at her house except no one was home. J is usually there and reliable. I don't have her new cell phone number. Damn. I know she will call me, she will feel bad about standing me up.
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11:10 am I call L's new foster mother and ask if I can stop by. L is Angelina's 6 year old brother and he along with their 3 year old brother are in a new home where there is an expressed interest in adopting them, and maybe Angelina too.
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New Foster Mother tells me that she and her husband cannot decide yet to adopt the boys, that they need more time to think. She is kind and warm and she runs a daycare center in her home. But she says the boys are sometimes out of control, especially N. the 3 year old. I tell her a little about Angelina who she has not met and ask if sometime she might come for an hour or two to play with her brothers. She says of course. She walks me to the door and she hugs me genuinely. I like her and I will pray.
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12:00 I drive to the middle school of my 10 am client, who I missed earlier this morning. She is 13 and the office cannot find her: she is not in the class she is supposed to be in. I meet with her guidance counselor and (politely) ask why some one doesn't go looking for her if she doesn't show up for her 7th grade class. The counselor tells me bluntly, "We don't have the staff to do that. There are a lot of kids who don't go to class." Not a good school, I knew that, but I am not pleased.
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12:30 I drive to M's apartment building. She is not there. Two no-shows in one day, by two reliable clients. I am mad at myself that I cannot find M's new phone #. I leave a note.
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12:35 I sneak into Burger King, relax for a few minutes.

1:00 I see M. for the first time since she had her baby. I have been nervous about this. M. has significant problems with her three children ages 6, 8, & 12 and she has just given birth to a premature daughter against all medical advice. Plus there are three dogs stuck in crates most of their lives and I am pained to see that, to not be able to rescue them.

M is sitting on the couch feeding the baby a bottle. The baby is very clean and dressed in warm cotton onsie. I comment that M seems happy having a small baby and she says yes. I ask how her two daughters are doing and she says, "They try to get my attention." I suggest she let them sit on the couch with her and the baby, perhaps put the baby in their laps. She looks at me like I'm crazy.

2:00 I drive ten miles or so to an elementary school where 11 year old D. and I have our therapy session sitting on the floor in the empty Anger Management room. The room has carpeting on half of each wall but it is not thick so if someone were angry enough to slam into one of the walls, they would not be spared. D and I play two games of Old Maid and one game of War while I ask her about her favorite things (people, colors, places, subjects) and then she asks me back. We laugh our heads off every week about being in the Anger Management room. I see D. because she is overweight, is very aware her father does not see her very often, and was being bullied in school last year. She is much happier this year. She doesn't talk about her feelings much but I'm glad she knows she can.
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3:00 Another school, this time a middle school where 13 year old L. and I sit in the cafeteria and I can see how depressed and miserable she now is. Two weeks ago her mother lost all parental rights and L and her younger sister are now in a permanent foster home until she is 18. This is with a man she loves who has been a surrogate father to her for years, but his wife cannot seem to give the kids some time and space. This is a child whose history has been a disaster, and yet she is so bright and spirited. She wants to be a Mechanical Engineer in Japan. I keep telling her she will get there but there are 3 important rules: no drugs, no gangs, no babies. She laughs but I make her say that with me at least once a month. I am worried about her now. I make a note to ask my supervisor for some advice.
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4:00 I have a new client, another teenager who is in trouble in school and with the courts. She calls my cell phone and cancels at the last minute. Normally that is not acceptable but I cut her a break this one time because I don't know her and don't think it's a good idea to start off with conflict. I tell her I hope I can help her and I look forward to meeting her. She asks me if her foster mother told me that she dislikes people.
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What? I ask. "I don't like people" she says. "All people?" I ask. "Most," she replies. I like her honesty. It will be interesting to meet her.
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4:15 I make a few phone calls from my car. I call my friend (you know I mean you!) and we chat away, a nice break for me. I organize my appointment book, call back the client I stood up this morning.
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4:45 I see A's mother at the clinic. She loves her daughter, she wants to help her, is worried about her, but she is at the end of her own rope. She does not easily share her vulnerabilities, this is hard for her. I agree to see her again next week. I'm hoping if I help the family this will help A. But I tell her I strongly recommend she have own therapist and she agrees to call her insurance company. I tell her 'why go through this alone if you don't need to?" and she seems to agree.

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6:30 I walk in my kitchen door. My emotions are on overdrive. I had very little problem with all the juggling today, and I was thoughtful and deliberate with everyone I saw, but my emotions are drained.

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Walking into the Crisis Center this morning, A asked me if I liked my job. "Very much," I said.

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"How do you do it?" she asked me. "All those problems you have to help with and what do you do if you have your own problems?"

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I smiled at her. "I'd see someone to help and listen to me." We smile together and I stay beside her while she checks herself in. I'm glad I'm there with her. She is courageous to be handing herself over for help. I am proud of her. It makes a difference....