Emergency Room Messiah

It's April now. Four months ago, my actions made a mockery of the ethical codes of psychology, something I never imagined I'd do. Because of this, I am writing under an assumed name with care taken to avoid using last names or true facility names. To this day, my brain refuses to draw any conclusions about what happened that night, but I've kept it inside for too long to deal with by myself. If I keep it much longer, it will devour me from the inside out. So, I give it to you now. I give it to you and allow you to draw your own conclusions.

Christmas Eve was a financially rewarding day to be Jewish. The psychiatric crisis center that I worked at part time paid time and a half for the big holidays. With the great mystery of Y2k looming only one week into the future, I wanted to pile up some extra cash... just in case!
For most of the night, I had flipped over virtual cards on the computer solitaire game while listening to every version of every Christmas carol through a single speaker radio in the agency’s waiting room. I would have changed the station except that this particular radio protested with unbearable static if you even went near the tuning knob. At the agency, some nights were dead and others were wild. It was the kind of job where you really just never knew what was in store for the next eight hours. Your greatest crisis could be losing ten hands in a row of solitaire and resisting the urge to toss the computer through a window. Sometimes a crisis call was dealt with right there and then. Other times we had to go out and do evaluations at local emergency rooms. This night had been uncharacteristically slow for a holiday. My partner had gone home three hours earlier with the understanding that if I really needed him, I'd page him. The first call in four and a half hours came in exactly two minutes before 11:00 PM when my shift was supposed to end. I groaned and let it ring a second time, convincing myself that by doing this, the caller may change their mind and hang up. It rang again and I reluctantly picked it up. I recognized the voice on the other end of the line as the one you least wanted to hear at the end of a shift. Mary Ann was the emergency room psychiatric nurse at North Central Community Hospital. As nice a woman as she was, her calls almost always meant an impending trip to the emergency room to evaluate a suicidal or psychotic patient.
"Hi Maryann. Can ya hold this one til the morning?"
"Sorry Dave," she replied. "We need you to come out."
I sighed loud enough for her to hear me over the phone. "Okay. Give me a run down."
"Well, this one's a little different. I think you'll actually enjoy it Dave."
"Yeah," I replied sarcastically. "Slim chance. Not at 11 p.m. Give me the scoop."
"Well," she paused, trying to construct her thoughts into words. "I guess simply put, we have a guy who thinks he's Jesus."
"He thinks he's Jesus?"
Maryann was suppressing laughter on the other end. "Yeah. I told you this one was different."
"Well, what do you need me for? Is he suicidal?"
"No," she replied. "But he may be gravely disabled."
This was term we used to describe anyone who might be at risk for getting hurt or dying simply because they were unable to cope with reality. "How so?"
"Well, he came in with the police who picked him up down on 7th Avenue. He was walking along the sidewalk just kind of looking around at everything and everyone. They figured if he stuck around that neighborhood for much longer he wouldn't make it through the night. So, they brought him in, wearing this long white robe, no coat, no shoes, no ID, no insurance card. He claims that his home is everywhere and that he is just here for one day."
"Does he say where he's going after that?"
"Well, he said it depends on what he finds out and that he plans to return to...well, heaven. Dave, this guy is completely convinced he's Jesus and I'm worried that he's going to get himself into all sorts of trouble. I think he needs to go into the hospital for his own safety."
I knew that I had no choice but to evaluate him. "Okay Maryann. I'll be there in five minutes. I just have to close up here. Where is he?"
"He's in 105. You'll know him when you see him. He actually kind of looks like Jesus."

I shook the snow flakes off as I entered the hospital lobby. Even though I was Jewish, I was hoping for a white Christmas. There hadn't been one in way too long. I actually considered asking my hospital room Jesus if he could help me out with that wish. As I passed by the receptionist's desk, a woman was lying on a hospital bed, bandages on her forehead and her leg propped up on a pile of pillows. As the receptionist called Maryann to notify her of my arrival, my eyes met those of the woman in the bed.
"Merry Christmas," she said weakly, her voice hoarse and crackly like an AM radio station. "I am going home tonight. I saw Jesus and he said I would be healed."
I smiled at her. "What happened?"
"Car accident. I have a concussion and a broken leg. They want to keep me but Jesus said I will be able to walk out tonight."
I mustered up a sympathetic smile. "Well, good luck and Merry Christmas."

Maryann came into the lobby. "Hi Dave. Happy Chanukah. Have fun with this one." She motioned towards room 105. "This guy is fascinating. I don't remember meeting anyone like him before."
I smiled at her and thanked her for the opportunity to personally interview Jesus.
Room 105 was the size of a large closet. Its walls were hospital scrub green and shiny enough to insult the eyes. Along the right side wall was a small desk and chair with a 60 watt desk light. That was it. There were no paintings, no pictures, no fluff or frills. When I opened the door, the man was sitting on the bed, cross legged, back flat against the wall. He slowly looked up at me. I felt a chill as I noted how much the man resembled the image of Jesus I'd seen in paintings and churches.
I smiled as I entered the room and extended my hand to the man. I always tried to put clients at ease by making the evaluations seem more like an interview of equals than that of a clinician and a presumably crazy person. The last thing I wanted to do was to make them think that I was just some nose in the air, aristocratic Doc who didn't see them as a person. There were plenty of others who did that job well enough! To me, each one was just another human with issues of their own.
The man stretched out his hand to me. His skin was unusually pale, warm and soft, like that of a child, untainted by work or weather. He looked directly into my eyes as our hands met.
"Thank you for coming David."
I just smiled, taken off guard by his greeting. "Yeah, well, uh...no problem." I withdrew my hand and sat at the desk. "We'll get started in just a minute," I chirped as I shuffled some papers around, making it look like I was locating the needed forms as I gathered my thoughts. It was unnerving how uneasy his presence was making me. "I just need to get some stuff together here."
I readied the clip board with our agency's crisis evaluation form. "Stick to the format," I reminded myself. At times, I had a tendency to be so interested in the patient, I would stray from the format and miss some information. After filling in the date and time that the evaluation request came in, I asked the man his name.
"Jesus."
"Okay. Do you have any other names or aliases?"
"I am Jesus, son of Mary, also known as Jesus of Nazareth, Jesus Son of God, Jesus the Messiah..."
"How about a last name?"
"No."
"Okay. Date of birth?"
"December 25th."
"I should have guessed," I replied smiling. "An early happy birthday to you." I looked at the man. He had a very calm look, with a half smile. He gazed at me through icy blue eyes. Avoiding his gaze, I looked back at my papers. "What year?"
"Zero."
I left it blank.
"Do you have a social security number?"
"No."
"Insurance?"
"No."
I took a deep breath. As if the demographic section wasn't hard enough, the real questions were still to come.
"Okay. I need a statement of the presenting problem from your perspective. I have what the nurses believe to be the problem but I would like to hear from you about why you think you are here."
The man stared straight into my eyes. It wasn't a threatening stare but the intensity made me jittery. "I am here because another millennium is passing. My Father has sent me here to determine the readiness of the world to accept the second coming of the Messiah."
"Okay. Well, why do you think you are in the emergency room?"
"Because those who brought me here were not yet ready to accept me."
I shifted in my chair, and took a semi-conscious deep breath. "Right, right. Okay, let's see. Do you have any past psychiatric history or psychological treatment?"
"No."
"Substance abuse?"
"No."
"Are you employed?"
"Yes."
"Oh? Where do you work?"
"Wherever people are ready to listen to the word of God."
"Mmmm. Who is your boss?"
"My Father. The Lord."
"Ah. Got it." I stared at my paper and hastily scribbled down some notes, thinking about my boss reviewing the evaluation the next week. He'd either laugh or fire me. I thought about asking Jesus for a job with his boss.
"Do you take any medications?"
"No."
"If you leave here tonight, where will you be going?"
"That will depend on what happens while I am here. It is my job, David to determine whether the Lord's children are ready for me. If they are not, I will return to my place next to my father and come again in one thousand years."
"I'm just curious," I began, veering from the format, "where were you before you got picked up tonight?"
"I came to earth in the form of man at midnight and will return to the heavens in the form of spirit at midnight. While here, I have spoken to the masses one by one. Sadly, very few seem ready to accept me. But some do. The woman in the waiting room that you saw coming in believed in me. She will be healed. There are only 6 minutes left David. Midnight is coming. I must make my judgment soon."
"How do you know she saw me coming in?"
The man simply smiled a soft, knowing smile.
"How do you know what time....Oh, never mind." I was rattled, a rarity for me. I had experienced sweat drenched, screaming madmen, brandishing hand guns in the air or holding them to their heads. I'd seen a woman throw herself from a seventh story window and a boy bleed to death from his wrists in this very emergency room. But, for some reason, this was rattling me. I stood up and looked at the clock on the wall behind me. Five minutes to midnight. I watched as the second hand passed the twelve as I realized that this interview wasn't uncovering the information I needed. Without looking a the man, I began to explain the next steps in determining his fate.
"Okay. What I am going to do now is to go out and speak with the nurse and I will be back in a few minutes to let you know what's going to happen from here." I turned to the man, my hand outstretched. His eyes were closed and his head was once again down. The man looked up so slowly I barely even noticed his movement. He stood and took my hand in both of his hands. His grasp was firm but gentle.
"David. I have made my decision. I will return to my Father's side. You are a good person. You are doing good for this world and are on the right path for yourself. But the world as a whole is not ready to accept me. Continue to bring peace to those around you David. That's how the world will change, one by one." The man slowly let my hand slide away from his own and sat back down. He allowed his hands to fall into his lap as he lowered his head and closed his eyes. I let my gaze linger for a moment before I turned and left, the door locking behind me. It was a minute shy of midnight when I found Maryann.
"So, Dave, what did you think?"
I shook my head and laughed. It sounded forced even to me "I don't know. That was really..." My words trailed off as I reflected back on the experience.
"Dave?"
"I don't know. I don 't know what we can do with him. Did you do a tox screen?"
"No, but we will if we decide to keep him. He didn't seem high, just delusional."
"Yeah. I guess that's right. Delusional. Any ideas for DSM diagnosis?"
"Maybe just defer it or rule out delusional disorders and schizophrenia."
"My boss is going to love this one. The guy is oriented, calm, not paranoid, denies any hallucinations but completely believes he's Jesus. I think you're right. I'm going to defer the diagnosis. I think we should keep him Maryann. I worry that he's going to get himself into trouble out there. Maybe his delusion will break at some point and he'll let us know who he really is."
"Sounds good. I'll get going on our part of the paper work and find a Doc to sign off." She glanced at her watch. "Hey! It's officially Christmas day!
I glanced down at my watch, confirming her statement "Yeah. Merry Christmas, Maryann."
"Thanks. I gotta go take care of the paperwork. I'll talk to you soon Dave." I watched as she headed off down the hall leaving me to finish my own forms. By 12:15, my forms were complete and I pulled my coat on. As I headed towards the lobby, I stopped by room 105. The man I'd interviewed was no longer there. It amazed me that on Christmas, they were processing clients that quickly. The woman who had been lying in the lobby was also gone, a freshly made up bed stood by the receptionist's desk. I drove home laughing at the thought of Maryann calling to get acceptance from the State agency to hospitalize a man who only went by Jesus with a birth date 2000 years ago. I didn't envy her!
Once I got home, I tapped the play button on the message machine. The last message left me frozen.
"David, this is Maryann. I got all the paper work done and went to 105 and the guy's not there. No one saw him leave, no one can find him here. The weirdest part was that the door was still locked from when you left! This is bizarre. Call me on extension 1412 when you get in."
My hands began to tremble as I dialed the phone. "Maryann, it's Dave."
I could hear her cupping her hands over the mouth piece as she whispered intensely.
"Dave. The guy is gone! I have two maintenance guys looking all around for him! He definitely didn't go out the front door and all the other doors are inaccessible from the psych unit unless you know the codes!"
"Maybe it was one of your bosses playing a joke, dressing up and trying to freak you out."
"On Christmas? No shot. Dave, I never saw that guy in my life. No one here would even dream that one up. Dave, this is really bizarre."
"Okay, okay. Let me think a minute." I paused, turning back the mental pages of the evening's events. I worked to push the words the man's words about leaving at midnight out of my thoughts but couldn't do it.
"Maryann, do me a favor. Go to the receptionist desk and check out what happened to the woman who came in with from the car accident around 11:30."
'What woman? Why?"
"Don't worry. Just find out."
"Ok, hold on." I listened as the clicking of her shoes on the tile floor faded away. In a few minutes, she was back.
"Dave, there was no woman in an accident tonight. Just some drunken kid who'd fallen off a ledge. The last accident victim we had was here this afternoon and he left by dinner time."
My heart thundered against my ribcage as the possibilities raced through my head.
"Dave? You still there?"
"Yeah Maryann. I'm here. I think you should lose the paper work. Just shred it and don't say a thing to anyone else. Did you call the doc yet?"
"No, I was going to do that after I told the guy our plans. Dave, I can't just bury this! How can I do that?"
"Maryann, how can you not? The guy is mysteriously gone without a trace after we'd determined he needed to be hospitalized. Neither of us will have a job if you don't burry this!"
"What about the security guys looking for him?"
"Lie. Tell them he showed up and everything is all set."
The line was silent. "I don't know Dave. I don't think we should."
"Do you have a better idea?"
"What if something happens to him?"
"Look, Maryann. That's a chance we have to take. This whole thing is so bizarre I can't even think about it. Let's just bury it and let it go."
"Fine. I'll do it but you better get out here and meet me for a drink. I need one!"

I felt some relief but knew that I'd experienced something I couldn't explain. We never saw or heard from or about the man again. Even now, 4 months later, I won't really let myself think about what happened that night too much. Only the facts. No interpretation, speculation or conclusions. I still work at the same agency and Maryann still works at the same hospital. We spoke about it that night but never after that. I haven't told anyone else what happened that night and I know she hasn't either. But, I will never forget it. Whatever really went on that night, I still try to remember the man's words about living in peace and changing the world one person at a time. It's what I have always tried to do and will continue to try to do. Sometimes, our life lessons wait for us in the most unpredictable places, at the most unusual times and from those we least expect it from.