A profession that recognized me

My transition from graduate student to therapist happened quickly.

By the time I graduated in May 1996, I had been offered a position at Brynn Marr Psychiatric Hospital in Jacksonville, North Carolina. I was assigned to the adult unit as one of two therapists.

The speed of the transition mattered.

Years earlier, after earning an engineering degree from Georgia Tech, I had struggled to convince employers that I belonged in engineering. I had tried. I went to interviews and wanted the independence that employment would provide. But interviews required me to perform enthusiasm and confidence about a professional identity that never felt natural.

At Brynn Marr, I did not have to manufacture an explanation for why the work suited me. My education, internships, direct-care experience, and years of preparation formed a coherent story.

I had become qualified for work I genuinely wanted to do—and an employer saw it.

Responsibility

Half the patients on the adult unit were assigned to me. The other therapist received the remaining half.

Being assigned a patient did not mean that I performed every aspect of care. Psychiatrists prescribed medication. Nurses monitored medical needs. My role included assessment, therapy, treatment planning, communication with families and other providers, and planning for what would happen after discharge.

I became one of the primary people responsible for understanding each patient’s story.

That was the work I had pursued since deciding that engineering was not where I belonged. I was no longer volunteering, observing, or working in a paraprofessional position. I was practicing in the field for which I had trained.

Victoria

Victoria was initially assigned to the other therapist, but she soon asked to work with me.

Her diagnosis was borderline personality disorder, a label that often caused staff to interpret distress as manipulation. Victoria could be volatile, sarcastic, and difficult to reassure. Beneath those behaviors, I recognized terror of abandonment.

When her Medicare coverage ran out, the language surrounding her care changed. Her needs had not disappeared, but the hospital was no longer being paid.

Staff arranged what they called an intervention. The treatment team sat together on one side of a table. A single chair was placed opposite them for Victoria.

The arrangement communicated the meaning before anyone spoke: the professionals were united, and Victoria was the problem being confronted.

When she entered, I could not remain seated with the group.

I moved my chair beside hers.

The discussion eventually turned to her failure to attend the therapy groups conducted by the other therapist and me.

“Fine,” Victoria said. “I’ll go to Bruce’s groups.”

Her refusal was not a refusal of therapy. She was distinguishing between environments in which she felt controlled and one in which she felt safe enough to participate.

Karen

Another patient, whom I call Karen, sat through groups with the stillness of someone who had withdrawn deep inside herself.

She was a thin Black woman in her twenties. Something in her expression made me wonder not What is wrong with her? but What happened to her?

An intern brought her to my office after completing the intake. Karen did not want the intern to remain. She carried shame about experiences for which she was not responsible.

I moved closer without crowding her.

“You’ve been raped,” I said gently. “I’m so sorry someone did that to you. I can help.”

She eventually revealed that the recent assault had not been the first. She had also been sexually abused within her family.

I explained that we could approach the memory from a position of safety, almost as if she were watching it on a screen rather than being forced to live through it again.

“Will you come with me?” she asked.

“My voice will go with you. I’ll be right beside you.”

During the exercise, she reached for my hand. I let her hold it while I reminded her that she was in my office, not back inside the traumatic experience.

Her breathing gradually slowed. When she opened her eyes, something had returned to her face.

Later, the intern saw her and immediately recognized the change.

The woman leaving my office did not look like the woman who had entered it.

Hurricane Fran

By early September, Hurricane Fran was moving toward the North Carolina coast.

The warnings intensified on September 4. On September 5, Fran made landfall near Cape Fear as a major hurricane.

I was at Brynn Marr with Victoria when my telephone lit up with Lynn’s name. She did not ordinarily call while I was working, so the interruption immediately carried weight.

“What are you doing?” she asked.

“I’m working,” I answered, initially amused by the obviousness of the question. Victoria laughed.

Then I heard the fear in Lynn’s voice.

The storm was coming, and I was not an unattached person who could decide that my own safety mattered only to me. Someone was waiting for me. Someone needed to know that I was coming home.

“I’m leaving now,” I told her.

The drive became more dangerous as the weather worsened. Rain struck the car, water collected on the roads, and at one point the engine sputtered.

A realization moved through me with unusual force: if something happened to me, Lynn would be devastated.

Childhood had taught me to experience my safety as a private matter. With Lynn, my life belonged within another person’s emotional world. Protecting myself was also an act of love toward her.

She was waiting when I reached home—frightened, relieved, and angry that I had remained away as long as I had.

We stayed together while Fran battered the area around us.

I had spent the day helping patients understand that their lives mattered. The storm reminded me that mine mattered too—not in the abstract, but to the woman waiting for me to return.

What the storm gave me

Hurricane Fran frightened Lynn, but something about her fear made me feel good.

Not because I wanted her to be afraid. I wanted the opposite. I wanted to reach her, protect her, and let her know I was coming home.

What affected me was the knowledge inside her fear:

I mattered to someone.

She was not calling merely because the weather was dangerous. She was calling because I was in danger. The possibility that something might happen to me affected her. She needed me to return because my life existed inside hers.

That realization warmed something in me that childhood had left cold.

Growing up, I had learned to experience my safety as a private concern. No one seemed frightened by what might happen to me. No one communicated that my absence would tear something essential from their life.

Lynn did.

When I reached home, she was waiting. Her fear, anger, and relief all arose from the same source: love. During the storm, with the wind battering the house around us, I knew that I belonged somewhere.

I was needed.

And I needed her.

More importantly, I was valuable and my arrival at home was crucial.

Lynn becomes the patient

Not long after the storm, Lynn’s cough worsened. It sounded deeper and heavier, as though something had settled in her lungs that she could not clear.

We called the cystic fibrosis clinic in Chapel Hill. Her appointment was scheduled earlier than usual, and both of us understood that the doctors might admit her.

We left Wilmington before dawn for the drive to Chapel Hill.

At the clinic, the examination eventually confirmed what we feared. Lynn needed intravenous antibiotics. She would have to remain in the hospital.

What I remember most clearly is the waiting: sitting near the clinic while decisions were made, watching people move through hallways as though this were an ordinary day, and trying to hold myself together for Lynn.

At Brynn Marr, I could sit with people who were frightened, traumatized, or overwhelmed. I could help them slow their breathing and locate the part of themselves that remained safe. I could listen to experiences of abandonment without being pulled beneath the feeling.

With Lynn, there was no professional distance.

I was not standing beside a patient whose life would continue somewhere beyond my own. This was the woman with whom I shared my home, my bed, my plans, and nearly every day of the previous four years.

When the nurse prepared the IV, I struggled to watch. The antiseptic smell, the equipment, and the needle made me queasy. Still, I wanted to remain close.

I held Lynn’s hand.

“What is that?” I asked when fluid began moving through the line.

“Just saline,” the nurse explained. “The doctor will send the medication orders.”

After the nurse left, I sat beside Lynn on the bed.

“Do you want me to get you a book?” I asked. “Or cards? What can we do?”

She asked for one of Anne McCaffrey’s books that she had not yet read.

“I want to stay with you,” I said.

“I know,” she answered. “I’m glad you’re here.”

Those words mattered.

During Fran, her fear had told me that she needed me to come home. Now, in the hospital, she told me directly that she was glad I had come with her.

She remained there for approximately a week to ten days.

I stayed as close as the hospital allowed. At night, when I could, I lay beside her carefully, making sure not to disturb the IV. I rested an arm across her body so I could feel her breathing.

A nurse entered once and saw us together. She did not ask me to move.

I could help Lynn with percussion therapy—the rhythmic tapping intended to loosen the mucus in her lungs—but the responsibility frightened me. The same hands that held and caressed her were now supposed to help her breathe.

Had I done it often enough?

Had I understood how much she needed?

Was the mechanical vest sufficient, or should I have been doing more?

I wanted illness to be something visible that I could confront. A creature I could find and destroy. But cystic fibrosis was written into her cells. There was nothing outside her body for me to fight.

My only powers were presence, tenderness, and whatever practical care I could provide.

Eventually, the antibiotics worked well enough for Lynn to return home. Her color improved. Her breathing became easier. Our familiar life resumed.

This was not yet the end of life as we knew it. The hospitalization frightened us, but it passed. Lynn came home. We returned to sleeping together, making plans, and assuming that our shared life would continue.

Still, something had changed in me.

Hurricane Fran had shown me how much my safety mattered to Lynn. The hospitalization had shown me how completely her safety mattered to me.

I had become the therapist I had worked so hard to become. But no amount of clinical training could teach me how to stand beside the person I loved while something inside her threatened the life we shared.