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The first patient he'd ever come in contact with was an older woman who liked to smile. He was fresh out of collegethen without a thought in the world related to his nursing license. He'd majored in psychology in school and done fairly well despite his penchant for marijuana and Jack Daniel's, consumption of both earned him consistent A's. Youth and innocence, resilience with a good heart. That's what he was about back in those days. Hell, that's what the whole world was about, as far as he was concerned. The sky was the limit, to coin an old cliche and why shouldn't he? For him, there was only upward movement when it came to his prospects for the future. He was a college graduate and he was working a professional job.

And so, there he was, walking the unit with the first patient he'd been assigned to since graduating. His first job. His shining star. They walked together around the unit. Sometimes he looked at her and for the life of him, she never looked back. No problem, though. What did that matter? He was there to make things ok, wasn't he? Psych counselor extraordinaire with a heart of gold.

Right.

Yeah.

That's a cheap shot at myself. Cheap and inappropriate. That's life.

Damn, I'm angry with myself, aren't I?

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edit: I don't remember what started this or why I got so down on myself. It happens sometimes. I remember that patient, though.

She was always sweet and pleasant, we'll call her Tina. She used to tell me about the clowns in her head, laughing. And I remember initially thinking that that wasn't such a bad thing until she told me about how they were laughing at her, with sharp, pointed teeth and they told her they were going to kill her. Or she had to kill herself. "They want me to die.", she'd said at one point - but she still smiled.

And I remember when she came into the ER one night, dead on arrival. Her liver had been failing for a long time and one night it and a lot of other things in her just quit. This was in the 90's. I stayed with her while the medical team did their work and straightened her out / cleaned her up when they called her time of death. And I remember holding her dead hand for a little while after and saying good bye.

My first patient.