Our theme for the month of November is “firsts.”
My supervisors all tell me you never forget your first patient. My first training placement on my journey to clinical psychology began in a juvenile detention center, where my job was to perform psychological evaluations for children and adolescents prior to their court appointment with the judge. After a week of orientation, it was time for me to meet for my first patient.
Trembling, I began to wander down the hallway to the secure portion of the facility, where I would request to see my first victim. My eyes darted wildly, searching for the right door. I bumbled with my walkie, finally uttering, “Master control from mental health, door one.” Silence. Alone with the rambling hum of fluorescent lights, the musky odor of grime unseen—yet still sensed—I stared at the door, convinced I had angered the person operating the locks. At last the door buzzed and I darted through. All moisture had long evacuated my mouth as I requested the guard to meet with the youth. I had always heard people say someone “looked right through them,” but I had not experienced it until that moment, when a singular look, an exaggerated chomp of stale gum, and a whooshing, eternal sigh all combined in an instant to communicate how much of a nuisance I was to this man. His finger depressed a button whose label had long worn away, and out wandered an exhausted looking teenager, a tall African-American boy with expressive eyes that gazed at me with apprehension. We’ll call him Steve.
We wandered back down the hallway to the visiting area, where the mental health team typically met with the teens. Sitting in plastic chairs at table with a crude chess board printed on it, we sized each other up. Steve leaned back in his chair, pulling his arms through his sleeves to fold them across his chest beneath his scrub-like outfit doled out to him by the county.
“So, what is this?”
“The judge has asked that we do an evaluation.”
“Do I have to?”
“Yes. Well, no, I mean, uhh technically I can’t force you, but, you have the right to refuse, but it would be really great if you—“
“Whatever, it’s fine.”
I pulled out my clipboard with the structured interview questions, and I asked them one by one. This, of course, was protocol.
“Put those questions away, man. I’ll just tell you how it is.”
“Ok, well, there’s a lot of specific info I need to get from you.”
“Yeah, but I can give you all that. I’ll just tell the story.”
And off he went. Me, feverishly scribbling, trying to re-direct him to relevant topics. I was paralyzed, confused, and exhausted. Steve was running the show in that moment, and I was just trying to catch up. Discouragement washed over me, as I couldn’t feel any connection developing between us.
“Look, Steve, this will go much better if we just go question by question, okay?”
Steve went on to say he recently began hanging out with some gang-involved guys in the neighborhood. He messed around with weed, alcohol, and this caused a significant rift between Steve and his stepfather. The longer he spoke, the more animated he grew, and he got up from his chair and attempted to pace back and forth in the six-foot space.
“Why don’t we dive in with the first test?”
“Yeah, okay, let’s do that!”
I pulled out the materials for a standard IQ test, figuring it would give him a good outlet for his energy. This did nothing to curb my anxiety, however. These tests require precision and exactness, since they were developed to be delivered exactly the same way every time, if possible. Any deviation from protocol could jeopardize the validity of the results. So, naturally, I clammed up like a middle schooler at a school dance when Steve began asking a question after everything I said.
“I can’t tell you whether or not you got it right.”
“Can’t I get a hint?”
“No, just give it your best guess.”
“Man, this is bullshit. I’m done.”
“You’re working really hard.”
“I don’t wanna do this anymore.”
“This will help us know what you’re good at, you know? What you’re smart at.”
“That’s the problem! You don’t understand!”
He was nearly in tears now. I sat quivering, my clipboard fluttering between my sweaty fingers.
“My stepdad keeps telling me, ‘How come you can be so damn smart and act so stupid!?’”
I slid the test materials away, put my pencil and clipboard down, and leaned back. I was so stuck on protocol, so tied to my methods and exactness, that I hadn’t even let Steve be Steve. Like the guard, I was looking through him, so focused on my forms and tests, preoccupied by appeasing my supervisors and adhering to perfect protocol.
I’ll never forget the way those guards stared through me. I’ll never forget that dreary musk that saturated those halls. And I’ll never forget Steve, the kid who was my first lesson of forgetting about the doing and turning instead to being.