The Art of Psychotherapy

Before being admitted to medical school I worked as an orderly in a psychiatric unit of a prestigious university hospital headed by an internationally known shrink. The unit was directed by an associate professor with a full complement of residents, interns, psychologists, social workers, nurses, medical students, allied therapists, and menials like myself. Once a week we all gathered in the solarium for patient government, an exercise I never understood or enjoyed. The pipe smoking residents in their white barber's outfits did impress me by their understated comments, clearly pregnant with meaning.

The patients were a democratic mix of white folk: involutionally melancholic retired executives; involutionallly melancholic wives of successful executives; unsuccessfully rebellious co-eds; aimless scions of the malefactors of great wealth; and lost souls of all sexes with money or insurance. I learned the important skill of restraining the dangerous for needed injections. And I followed the lead of the other orderlies, most of whom were black. There were also invisible staff members who brought the meals, scrubbed the floors, and did the laundry.

As I reflected on my experience later, I remembered how it had been clear to me that only one staff member had helped everyone. Dignified, professional, careful in tailoring her always honest approach to the needs of either patient or staff member, she left the sad smiling and the agitated, calm. This was Mrs. Clemons, the black orderly. I long aspired to be her equal.