What's inside

Some of my favorite patients at the hospital are hard-bitten blue-collar guys on their first psych hospitalization.  They haven't processed their childhoods or their issues or anything - it's all been stored up in there, and when they finally start to talk, it's so raw.

Last week I worked with a man who moved to this country as a child.  As a young man he joined a gang and served prison time for shooting someone.  Now he's middle-aged and the stay-at-home dad of young kids.  More than anything, he wants a paying job.  He kept telling me, "I want to support my kids and my wife. I want to be a good father."

Today I sat with a working-class man whose decades-long depression finally got noticed.  He hasn't told his grandmother he's in the hospital, and that's the part he dreads most: "I just can't stand to do anything that would worry her."  Most people in hospitals get teary when they think of how hard their life has been.  These guys tear up when they talk about the harm they might have caused others.

I once saw an unemployed carpenter calmly discuss his plans for suicide and then break down when he told me how terrible he felt that he'd left his dog with a friend and hadn't provided money to buy dog food.  My ex-gangster showed the most emotion when he talked about his mother, who had flown across the country to see him in the hospital.  He hated to think of the money she had spent on the ticket.  "I want her to move out here so I can support her. I want to repay her for everything she done for me."

If I had gone into some other field, I wouldn't sit around talking with murderers, child abusers, addicts.  And I wouldn't get to be there when someone finally speaks about how much he loves the woman who raised him, or about the pain he doesn't show to anyone.  And every time I think, Holy shit, I can't believe you've been carrying that inside you.

"...the Devil hardly ever made anyone do anything. He didn't have to. That was what some humans found hard to understand. Hell wasn't a major reservoir of evil, any more than Heaven, in Crowley's opinion, was a fountain of goodness; they were just sides in the great cosmic chess game. Where you found the real McCoy, the real grace and the real heart-stopping evil, was right inside the human mind."

- Good Omens, Neil Gaiman and Terry Pratchett