Posted by: Kate | July 6, 2012

A Choice of Realities

She refused to go to the hospital, insisting nothing was wrong. But after days of seeing proof otherwise, her daughter called for help. So rather than meeting her in a hospital room, I met her in her own bedroom.

She was courtly, both in appearance and in behavior. It was somewhat of a surprise, considering her evident poverty and recent losses and changes, but she had a certain way of holding her head and a certain way of looking at you that made you remember your pleases and thank yous; even if you typically used them, you were extra-careful to mind your manners around this lady.

She bore up under the onslaught of invasive, demanding questions with aplomb, and accepted the indignity of the situation with grace. She admitted to hearing things other people didn’t hear, seeing things other people didn’t see, and experiencing ongoing conspiracies on the part of her children, the government, and possibly alien agents, all with such gravitas and simple belief that it was easy to start to believe her version of events, to fall into her reality for a while. When it came time to step back into my own reality – the one that (I hope) most other people share, and therefore we consider it correct, even though we really can’t ever prove one version or another. We can just offer pills and therapies that pull other people’s reality closer to our own, as this lady has experienced many times in the past.

“Frankly, young lady, I don’t want to be on those pills right now. I know what they will show me. I know what they will make me feel. And I don’t want to feel like that right now. It’s too much. It’s too hard. I can’t handle it,” she pleaded with such dignity that tears came to my eyes. Because I knew she was right: the reality that those pills would bring her was horrible. It contained the untimely death of her partner of over 30 years, the abrupt move to a different state, the awareness that her primary caregiver is gone and there is no one left who truly wants to take his place. Her children will do it out of duty, but not out of open-heartedness.

We formed enough of a bond that I was able to tell her – gently, I hope – that even though her world felt better right now, it truly was dangerous to her at the moment. She was taking walks in the middle of the night, in an unfamiliar and not particularly safe neighborhood. She was accusing her children of horrible things. She was engaging strangers in uncomfortable interactions. It was time to return her to the medication regimen she had been on for so long, to return her to the more generally accepted reality, even though it was a more painful one.

She trusted me. She asked me to follow her to the hospital, and I did. She asked me to stay until they knew where she would be admitted,even though that meant staying hours after my shift, and I did. After her daughter left, she asked me to sit and hold her hand, just for a moment, and I did.

There are rules, and suggestions, about not getting too close to clients, about not touching, about not getting involved. And sometimes those rules are broken, I believe to everyone’s benefit.


  1. Kindness and compassion go a long way in this world. She was lucky you were the one who answered the call.

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