Where Empathy Overrides Power on Any Given Day

Have you ever thought about how powerful a simple pen is? I’m sure there are customized pens made for government spies and while that is cool, the strongest asset is the pen’s ink. As a medication-technician in the psych unit, your pen becomes all that you have. I’ll tell you more about this later.

For nearly two years, I worked alone overnight and was responsible for over a hundred psychiatric patients. Schizophrenia, bipolar, and borderline personalities; I spent forty hours of the week with. That’s 160 hours a month, you can continue the math.

Many have said to me that it should be easy since it’s late at night when all the patients are sleeping. Many have also not had the pleasure. For the most part, I don’t look at anyone with a mental disorder any different than I look at myself. Little does anyone know, I am outpatient. Disclosure, voluntary.

That’s something I learned about myself after being attacked by something I could not control or be fully prepared for. The way I react externally to any crisis will bleed onto the sheet of my internal and often astute, hidden truths. Be mindful, calm, even more creative, I tell advise.


If I truly desire to be a thought leader then my target must be to hustle and motivate without being ignorant of the current situation happening right before our eyes.

A patient has been cheeking their meds for well over two weeks. I begin to see a change of personality. This change is subtle and takes one to know one. Their family decides to take them home during the weekend to spend some quality time with their beloved. Social distancing is ironically not their thing, I guess. I would prepare two days and two nights of their medication and stuff them into small ziplock bags. They should be back by Monday morning to take their meds during the first roll call.

Almost always, they’re back the next day. As they hand me Sunday’s meds, I say, “Back already, huh?” as I examine their eyes, posture, mood, and tone. Pupils fully dilated, response time quick, attitude; insolent.

Red flag, the patient is high, but don’t make such assumptions out loud. As I process all of these thoughts, I start documenting on the laptop. The next shifts would need such data. I check for any signs of abuse or injections.

I ask the patient if there is something wrong or is there something I should know so I could better assist and provide them the service they needed to promote their right to a “quality of life.”

They tell me, no, but their behavior screams the opposite.

I take out my pen and give them an offer;

“Listen, I can protect you but you gotta play ball with me.”

Works every time. “I used it again, I’m sorry, I’m going to bed.” Thought so, I don’t write them up, I don’t report it. I ask, are you ready to come down or still chillin’?

Regardless of the answer, I say drink some water before you leave and bring some with you. If they were ready to come down and sleep, over the counter omeprazole and Benedryl did the trick if they didn’t have a script for quetiapine fumarate (Seroquel)[.] Methamphetamine, the suspect as usual.

I live in Los Angeles, California, where the first imagery that comes to mind is that of Hollywood, the American Dream, and home to the dankest strains mother nature produces by the evergreen. You don’t automatically think about the homeless, the domestic violence, the easy access to drugs, retail and recreational marijuana.

No, I’m not discriminating against anyone or making assumptions without clear circumstantial evidence. I have to know my patients and better, create mutual respect. Without either, you could not last in this position. I learned this early in my career and this is nothing you can learn ‘textbook.’

The political system in the mental health field is one-sided, “the patient is the priority. This is their home, you have a job because they’re paying to be here.

You’re getting paid to be here.” If there is a fire, you’re the last one out (if your lucky), no exceptions. Remember these thoughts as someone who probably brings home at least fifty grand a year.

As I question why I only make the city’s minimum wage. Which grosses to around twenty-six grand tops, no benefits, no 401k, no health insurance, no paid time off, and no fucks given, at-will. Since I took the “harder way” it’s always difficult to find a job that truly invested in me for the long run.


I take out my pen.

I sign all the documents stating that I’ve read all the above and understand what it means to be an at-will employee. Upon my termination, I take out my pen once more and sign that I acknowledge the termination and would like to receive my $700 check. If we didn’t sign, we wouldn’t receive our check. I look at my check and I start to cry because this is two-dollars short of my rent.

That pen I used could have got patients kicked out of the facility. That’s why I didn’t write them up if they were honest with me. It’s accountability.

Be real with me and I’ll be real with you.

I don’t want to take away your home and I am not nosey. I just need to know who to look out for in case there’s screaming, fighting, overdosing, and court orders. I’m that medication-technician that will tell your caseworker that you get better every day, but every day doesn’t get better. No one is perfect. As long as there are no signs of abuse, we coordinate to keep people out of jail.

Even when we give out so much empathy, I learned that empathy will not earn someone’s respect. It takes sacrifice, going against the grain, but not to my benefit at all. It’s career-suicide for me, but as an at-will employee, I need it like the flowers need the light of day and water as the fountain of well-being.

Respect might not matter to you. I remember saying that the first time I got my ass beat by a patient for “having no respect.” Respect is not an entitlement, I learned that it’s a survival skill. Just as these people knew that they could beat me down if they wanted to, they knew that I could put them back on the streets if I really wanted to. I can orchestrate the entire scenario, but I don’t.


They say the more you learn, the more you earn. It’s quite the opposite in this environment. The more you earn respect, the more you’ll learn how to adapt to an environment where a crisis is normal and silence becomes suspicious. I earned my respect because I learned to use my pen wisely.

You have to take into consideration what kind of trauma these people have been through. Not to add what they are currently going through with overcrowding and serious disregard for the housing and cleaning of the facility.

The smell of broken homes, the scent of someone selling everything but their soul, and reek of the life that used to be; laid dormant without wanting to shower or eat. Could you write anyone up?

Imagine taking away the last thing someone had. Like the scent of someone who sold everything but their soul finally lost her last possession. She’s back on the street and God only knows what’s going to happen to her.

Your pen all of sudden is a lot more powerful than you thought. But, it’s alone. It needs you to use its power. In a time of crisis, it needs you to (see picture above, limit or practice virtual hugs for now).

I’m well aware of what is happening today, but that doesn’t need to be the only conversation we are having. In fact, it should be the last conversation we have. Okay, that sounded scary, I didn’t mean it that way. I meant — you get me.

There is a solution to every problem. Problematically, solutions being hard to come by, are sometimes the most inconvenient, scary, unimaginable, hardest “pills” to swallow but we have no choice.

We only have to trust. We must continue to write these letters to the future. So they can learn from our mistakes. 

They can pick up where we left off, as their future will pick up their’s.

It’s time, you’ve been here long enough. You know what you have to do. Finish that book. Publish that article. Look back at all your drafts that you never had the inspiration or will to complete.


You have all this time now. Publish that. You’re running out of money to pay your bills, you’re afraid your credit report is going to show your irresponsibility during a global pandemic? Tell them to piss off. You’re good for it, dispute it and it’ll be removed later, trust me. Let’s do what we do, writers and amateurs (like me). Do so, “to a T.”

Stay safe. Health is wealth. The social distance over social ignorance. Listen to the professionals that step in when the commander in chief doesn’t have the answer. Then disregard his following, opposite, and often optimistic snarks. Frontliners, we cannot thank you enough.