My job can be life and death

My job can be hilarious at times. It can be frustrating at times. Sometimes it can be frightening. Today though I was reminded of how it often involves a person’s life or death.

“Hi John, how you doing?” I was speaking to the coroner on the phone. “Not bad for a Monday,” I replied matching his small talk. “Say, have you all ever had a patient named Anne Smith in your hospital?” (Anne Smith is a fictitious name) “Her name isn’t familiar” I said, “but let me check the master list.” As I turned to the “S’s” on the master patient list, I found Anne’s name. She had been a patient at our hospital for a three day stay about six months prior. “Yes she was here” I said, “what’s up?” “Well,” he said, “she’s dead.”

When you work at a psychiatric hospital and you learn of a former patient dying, one of your first thoughts is - “Will I be blamed or sued.” Unfortunately, people attempt to “cash in” on any little scratch, slip and fall, and certainly suicide. I am not faulting law suits with merit, but I have seen a lot without merit. Families who have nothing to do with a person when they are alive may be quite active once their “loved one” commits suicide.

Now the fact that I could not recall Anne or her circumstances did not help. I went to medical records and pulled her chart. The coroner said he was going to send a request for records so I needed to get it anyway. As I browsed the chart, Anne’s case began coming back to me. Her husband brought her to the hospital as a walk in one afternoon. He was concerned she might be suicidal. To get to the point, Anne was admitted. As often happens, she wanted out of the hospital as badly as she wanted in. We call it a flight into health. Stress and circumstances drive a person to the brink of suicide. They seek help in a hospital. Once in the hospital, they often get restless and want out. “I feel better now,” they will tell you. “I want to live, I have so much to live for.”

Of course we agree with the “I have so much to live for” statement. “Be patient,” we tell them, “a day or two ago you were going to kill yourself - what has changed?” In Anne’s case, she was able to make the argument. She promised she would come back if she had any problems. She said her husband was very supportive. She promised to attend outpatient therapy once discharged.

Anne had a 9 month old baby and she was still mourning the death of a child one year earlier. Her response to that tragedy was an attempt on her life one year ago. This time though, Anne was discharged and that is the last we heard from her or about her until today.

I feel bad for Anne and her family. Her child will never know her. She will grow up with the stigma of suicide. She may wonder if suicide is her destiny. It won’t be a good thing. Suicide impacts so many people.

As for me, it was a reminder. What I do is important. What I say to someone may be the last advice they get. I am not so grandiose to believe I have to say the exact right thing or people may die. I do believe that I can give people hope with my words. And I believe my indifference may keep suicide on their menu of ways to handle problems.

Although saddened because of Anne’s unlived life, I am energized to make a difference in the lives of those I work with, because it is life and death.


My Monday routine:

The weekend is a memory and I have a full week staring me in the face. As I sit writing I can smell the dark roast coffee dripping in the kitchen. Hobo is laying next to my chair in his familiar pose. When I complete this post I will go outside and water my plants. I have to give them some Miracle Grow this morning. I have a wheel barrow in the front yard full of impatiens - really beautiful with the lucious green foliage and multi-colored blooms. The morning is quite humid - normal for a Louisiana July. Sounds of man are mostly quiet and the birds are singing at their peak. Very peaceful and soothing - a good way to start a busy day.

Man, that coffee is good! When I went to pour my fresh cup of joe I noticed the condensation on the kitchen window. My AC bill is going to be up there this month. Just another July thing in Louisiana and evidence I have poor insulation.

So after I water the plants, I need to haul butt and get ready for work. Barbara and I both work at the local psychiatric hospital and we have been getting to work later than we would like. Today we are shooting for 7:30 AM or so.

When I get to the hospital the first thing I do is go back to the unit. We have a capacity of 15 patients and usually have close to that many. I am in charge of the intake function at the hospital as well as functioning as a social worker. The intake person answers the calls of people requesting admission or people referring patients for admission. Many admitted to our little hospital are coming against their will.

Once on the unit, I say hi to patients and staff. I am usually greeted from across the unit once I come through the locked double doors. 99% of the time it is a friendly greeting. I get the usual small talk and many times requests to pick up a carton of cigarettes or to make a phone call. Especially on Monday, it is like they have been waiting for me to walk through the door. Sometimes I am bombarded with requests from two or three patients at once. I fend them off as best I can and check the census. I have to keep up with who comes and goes and who is staying in which room.

After gathering the necessary info on the unit and exchanging a few laughs with the staff, (I will write more detail about these exchanges in future posts), I head back to my office in the front of the hospital and update the spreadsheets and print the reports for the 9:30 AM intake meeting. I love the intake meeting. It is where several staff meet to go over the list of patients and discuss any needs / problems and to coordinate our day. These meetings should be recorded. A lot of funny things are said at the intake meeting. (More on this later too.)

The social service group is conducted from 9:15 to 9:45 AM every day. This way we have had a chance to get a feel for what is going on with each patient before the meeting. The rest of the day I take intake calls and work up admissions, work on discharging patients, continue workups for those recently admitted, talk with the patients or their families.

I go home anywhere from 4:30 to 7:00 PM depending on what I have to do and whether I can get a ride home. As I mentioned earlier I do not drive because of my poor vision so I have to figure out how to get around. I have a lot of folks who help me out in this area so it is rarely a problem.

After work today, I will attend the Covington Planning and Zoning meeting. I am on the Planning and Zoning Commission and have been for about 8 years.

Hopefully, by 8:00 PM I will be home. I will probably spend the rest of the evening on the computer or listening to Fox News.

Sounds exciting, my Monday huh. I hope yours is too.

Until the next time.

John Strain




I was awakened by thunder. Not the distant rolling thunder, but the loud crackling kind of thunder that gets me moving to unplug anything not hooked up to a surge suppressor. My dog Hobo hates loud noises. When we are not home and a storm comes up he winds up in the corner of our bedroom closet. I can always tell if it stormed and how severe the storm was by the size of the pile of shoes on our floor. It has been raining a lot this year. Tropical storm Bill hit us and there have been almost daily heavy rains. Oh well.

It makes me think of control. I cannot control it (the weather). I have to adjust my plans if the rain comes. This statement may sound obvious, but many of the people I work with or oboserve to be in distress are often not accepting a similar fact. We cannot control what other people do, think, want, say, feel, dream, love, hate, and crave. Only the most disciplined of us can control ourselves most of the time.

If you are looking to raise your stress level or depress yourself try to control something you cannot. To stay sane and calm we must practice "acceptance". Here are a few examples of how acceptance is our best course. Think of an NFL game (or any game for that matter). We have all seen bad calls by referees. When players do not accept the injustice of it and continue to complain and feel cheated, they are at risk of botching the next play. Think. I am sure you can think of several good examples. The announcers always allude to this fact, "He better get back to the huddle or they will get penalized for delay of game . . . He needs to get his head back into this ball game . . ."

Acceptance does not mean to "like it" or to "condone what happened just to "acknowledge it as reality". If I accept a problem as a fact of reality I can begin to address it. If I refuse to accept a problem as a fact of reality it will continue.

The Serenity Prayer covers all of this in simple eloquence:


Grant me the serentiy to accept the things I cannot change,

The courage to change the things I can,

And the wisdom to know the difference.

So ask yourself what you need more or less of. Control, acceptance, wisdom, or God.

Until the next time,

John Strain


Introcucing Me!

This is it. My entry into "blogging". In the past I have done some writing of poetry or short pieces. It has been a while though since I have engaged in the discipline of sitting down and writing my thoughts. Feel free to look in on my journey and give me your opinions, thoughts, and feelings about my words.

Who am I? I think I know, but to describe myself to others is a challenge. Usually one describes or even defines themself by what they do or what they have done. They may talk about their relationships to other people, institutions, or philosophies. All of this at least gives people a starting point of understanding. This is the short answer of "who I am", the long answer will be revealed day to day in my writings. Maybe I will gain a better understanding of "who I am" in the process and maybe you will too.

My name is John Strain. I was born in Kansas City, Mo on March 2, 1957. Today I live in Covington, Louisiana where I have lived for the past 12 years. I was married February 19, 1983 (20 years). My son is 18 and will enter college this fall 2003. My dog Hobo is a black lab and is 12 years old.

I have a BA in religion and psychology. I attended New Orleans Baptist Theological Seminary and earned a Master of Divinity in biblical studies. Later I returned and worked toward a Doctor of Education in counseling and psychology. I never completed the degree. All but dissertation.

I work at a psychiatric hospital with the chronic mentally ill. I am a Licensed Professional Counselor. My profession overlaps with my interests in religion, psychology, sociology, philosophy, and current events. People and what they do fascinate me. I am a people and I sometimes fascinate myself.

I am legally blind so I often see things differently. I don't use a cane or dog, but I can't drive a car either. Still I get around just fine. I can do everything I need to. I am interested in computers especially Macs. Presently I am dabbling with creating videos and DVD's. I have run marathons and consider myself a runner, but lately I have been lazy. I need to hit the road again.

Friends are important to me and I have some good ones. I particularly enjoy getting together to eat, drink, and talk. I love to laugh and make others laugh. I value laughter highly - it is an elixer.

The above should serve as a general introduction to me. In the following days my words will reveal more. I have no noble purpose in this or grandiose expectations. I simply feel compelled to write my thoughts. I do hope these posts cause you to think or laugh. Please let me know what you think in response to what I think.

Until the next time,

John Strain

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