“Okay, now please explain how a 5150 patient ends up here when there’s nothing else going on.”
“I don’t see why that’s relevant. She’s in distress, she asked for you, I liaisoned.”
“With who?”
“I told you. Ravenswood University Hospital. Networking with local caregivers is one of our primary mandates.”
“The U. punted to you.”
“We were considered ideal for the situation.”
I looked around at a thousand square feet of nothing. “I’m here because I evaluated Zelda Chase’s son five years ago and his welfare concerns me. Where is Ovid now?”
“No idea. The only reference to him is his name in Sherman’s transfer document.”
“What did he say about the boy?”
“Just that he existed. Now can we get going—”
“I’d like a copy.”
“It’s mostly dates — onset of providership, termination. You have never terminated.”
Making that sound like a felony.
I said, “I’d still like a copy.”
“I don’t have one. Everything’s e-filed at headquarters.”
“Where’s that?”
“Boston.”
“Should be easy enough to get.”
“Fine,” she said. “But there’s nothing in there.”
“What about your copy of Ravenswood’s chart?”
“No need for us to get that, she wasn’t treated there, just inputted. And furthermore, I don’t see how any of this—”
“Since Ms. Chase got here, she hasn’t mentioned Ovid at all?”
“She hasn’t talked at all.”
“You said she asked for me.”
“At Ravenswood,” she said. “How else would I know? Now can we proceed?”
“Once I’m oriented. I still don’t get why she was sent here when you’re a shell operation.”
“We are not a shell, we are fully operational.”
“Doesn’t look fully to me.”
“We are totally prequalified and authorized by the federal government and cooperating local governments to offer comprehensive mental health services and we’d be meeting our goals if getting things done in this city wasn’t the way it is.”
Pale eyes fluttered. So did pale hands.
Welcome to L.A.
I said, “Bureaucracy, huh?”
Without a trace of irony, she said, “It’s the worst.”
“I sympathize, Kristin. Wikipedia says you’re into the second year of a three-year grant, meaning you’re feeling pressure about your next NIMH site visit. Your mandate is primarily outpatient but for that you need to develop a ‘network of community referrals,’ and so far that hasn’t happened because it’s as if the city wants to make your life miserable. But don’t feel picked on, anyone trying to start a business in L.A. deals with it.”
“We are not a business, we are—”
“Same difference, Kristin. Let me guess: You leased this property only to encounter the building department, the zoning department, a whole list of ad hoc community boards and committees, the assessor, the health department — I’ll bet you’re getting lots of input from the health department. Because at some point you’ll need to feed staff and patients so they classified you as a restaurant and are making you jump through all kinds of hoops. How’re you handling nutrition in the meantime? Takeout?”
“High-quality takeout.” Her foot tapped. “What-ever. Now, can—”
“Because of the delays, you’re limited to ‘short-term crisis admissions’ and the best way to accomplish that is to take in 5150s because they’re not lucrative, meaning that local practitioners who you’ll need as referral sources don’t feel threatened.”
And with all the competition for NIMH money, if you don’t come through by the time the feds send in their savants to review you, you’ll lose the high-titled job you snagged because of your mother’s contacts with the congressman who got you the HUD position.
Kristin Doyle-Maslow said, “If you’re refusing to provide service, let’s terminate this, here and now.”
“I’ll provide, let’s go.”
Looking at me doubtfully, she resumed walking. When she reached the second door, I said, “What’s the name of the doctor who transferred her to you?”
“Nehru.”
I looked at her.
She said, “What?”
No room for world history in urban studies?
I said, “Thanks for the info, Kristin.”
The restricted area was wide but shallow and quartered into a nursing station and Inpatient Rooms A, B, and C, each bolted shut and equipped with miniature flaps over peep-spaces. I listened for sound, trying to figure out which room housed Zelda.
Silence.
The station was more homey than clinicaclass="underline" wooden desk in place of a counter, a couple of upholstered chairs, end tables, and a black leather couch that still bore plastic wrapping around its stubby legs. A white metal cabinet with a red cross in the center took up the right-hand wall. To the left, a man in a white uniform sat behind the empty desk reading a paperback. He gave a small wave that I returned, though Kristin Doyle-Maslow didn’t.
She said, “He’s finally here. Her doctor.”
The nurse got up and walked toward us. Thirty-five or so, balding, lightly mustachioed, nondescript. His badge was half the size of Doyle-Maslow’s but gave out real information.
Kevin Bracht, RN.
We traded names and handclasps.
Bracht said, “Happy to see you, Doc. She’s sleeping, that’s all she’s been basically doing.” Eyeing Door A.
Kristin Doyle-Maslow made her exit while talking. “In terms of billing, talk to Yvette out front. Your patient’s due to be released tomorrow morning, remittance should arrive within sixty days. If you need to extend the 5150, it can’t be here.”
“Why not?”
“That’s our mandate.”
“And she’s already been here for two out of three days.”
“One and a half days, it’s a forty-eight-hour hold, not a seventy-two.”
“That’s different.”
“Overall, she’ll be held for seventy-two but part of that was allotted to Ravenswood, which is fine, we’re only authorized to do two-day holds in line with our position statement emphasizing transitioning to comprehensive outpatient services.”
Which you’re not set up to carry out. Thank you, Joseph Heller.
Kevin Bracht’s eyebrows arched.
I said, “No prob, Kristin. Mr. Bracht and I will now liaise.”
The sound of the door slamming bisected the sentence. Bracht laughed and said, “Just Kevin’s okay. So now you’ve had the privilege of meeting The Hyphen.”
“Must be fun working for her.”
“Almost as fun as a sharp stick in the eye. Soon as Ms. Chase is discharged, I’m out of here.”
“Quitting so soon?”
“Not quitting, never hired. It’s a temp deal, the agency didn’t exactly explain things accurately.”
“You’re a freelance?”
“I’m a guy who needs to moonlight, Dr. Delaware. Three days a week I work at an applied behavioral analysis home for autistic adults. The wife and I just bought a house, so I do extra hustle. Mostly that’s taking care of old folks who need watching for a weekend when their regular caregiver’s away. Also some terminals at home and some hospice care.”
“Tough stuff but better than this,” I said.
“Death I can deal with, Doc. It’s normal, it’s expected. This, on the other hand, is a weird setup. The Hyphen has no clue about psychiatry or anything else for that matter. Once I realized I’d be stuck here by myself the thought of some crisis coming up began scaring the hell out of me. I mean I’m authorized to call the referring physician but what’s that worth? Stuff happens fast, no way am I going to bear responsibility if God forbid there’s a situation.”