"Stand Off At The Detox"

Weekends were usually laid back at the detox and this one was no exception. It had been a warm, beautiful, summer day when I came in to work the evening shift. After listening to report until around 3:30, it was time to check everything out around the detox.

On the weekends we ran with one counselor and one nurse (for 28 beds). Usually by late Friday afternoons we would have a full-house so additional staff would not be needed to do admissions. Once in a while we would have an open bed or two and we would do a couple of admissions however.

After getting supper out with the aid of a couple of patients that were waiting to get their beds at a half-way house, I kicked back in the main area of the detox to chat with a couple of them and watch the BoSox on the tube.

After a while I went down to the basement to check on the patient laundry. The counselors and the nurses were responsible for everything around the detox; from admissions, to doing the laundry, to making the beds, helping to serve meals, aftercare placement, etc.

When I came up from the basement, Margaret my nurse partner for the evening was nowhere to be found. I figured she was probably in the woman’s dorm chatting with the new female patient.

That morning we had gotten a new woman patient in from the local emergency room that had asked for detox. We had two rooms for the women; one was a four person room, the other, a two person room. This new admission was solo in the two person room.

These two women’s dorms were inside a larger dorm room that housed six of the sickest male patients and was overlooked by the med room window.

I went back to the main room and hung-out with several of the patients. It had not occurred to me to take a stroll through the detox to check-up on Margaret. We were an open-unit, meaning that a patient could ask to leave at any time. We would grant their request, after a chat to try and get them to re-consider their decision.

So there I was in the main room playing cards when Ray, one of our male patients came stumbling towards the table where I was. He was one of our patients that would be with us every other week from the local shelter. When he came in we would wait for him to sober up before doing his admission; usually the next day.

Ray had just come in that afternoon from the local shelter and was still exhaling the cheap vodka that he drank when hanging out with other alcoholics down by Harvard Square. “Hey, what’s up Ray,” I said as he came near the table.

He was trying to tell me something, but his speech was slurred and almost incoherent. He said something about Margaret. I said yea Ray, Margaret is working tonight, and he shook his head.

“What you don’t believe me?” I asked him. “No, no, no,” he said back to me.

Then what is it Ray? “Maagareeet wants meeee to get yoooou!” Suddenly, I noticed the seriousness of his eyes. Oh Christ I thought, “Where is she Ray?” “Sheeee’s in the Dooooorm.”

As I raced into the dorm that housed the women’s rooms I began to wonder how long had it been since I had last seen Margaret; probably a good hour or so.

Margaret called out to me in a firm, controlled voice, “Willy, can you come in here please.”

As I entered the dorm room Margaret had our new female admission from that morning pinned to the wall. I could see that Margaret’s left hand and arm were pinning the patient’s right arm and hand high up on the wall. In the hand of the patient was a razor blade.

I raced over to relieve Margaret’s hold on the woman’s arm. As I took over the pin, Margaret was able to carefully pry the blade away from her without any of us getting cut.

“Jesus Margaret, how long have you been in here holding her?” She figured it had been roughly an hour or so. "I kept calling out to you, but between the door of the room being almost closed, and the main door of the dorm being closed you couldn’t hear me." "I was finally able to get Ray up after yelling to him numerous times and told him to find you and get you in here."

"I came in here to give Sarah her medication and found her about to cut herself, she jumped up and told me not to try and stop her or she would cut me also. That’s when I pinned her to the wall."

Margaret was a strong woman, but this patient was also. As Margaret came down from her adrenaline rush, she was exhausted. We became much closer after this incident. We also started to check in with each other much more frequently when working shifts together, about every ten to fifteen minutes.

We called the hospital we were affiliated with and Sarah was transferred to their inpatient psych unit. Being an open unit we would not have been able to provide her with the supervision and help that a case like hers required.

This could have turned into a really ugly incident. Thank God for my little stumbling buddy Ray. Drunk or not, he knew he had to get me to help Margaret.