The Flirt

When I thought about working with the men I was afraid they would flirt with me and I would blush. Or I would have to over compensate and be bitchy to set boundaries. Since I started at the jail last month this fear proved to be ungrounded, I was able to engage the men and give the same level of attention and care I would give the women without losing control of the interaction in any way. Most men showed gratitude with a simple thank you and went on their way out of respect. Then I encountered Mr. Cocaine-Bipolar Man for a physical. In my experience, mania usually does not feel all that good by itself. The excess energy feels very disorganized unless it can be focused in some way. Sometimes work or cleaning the apartment is enough, sometimes it's not and something more dramatic must captivate the mind like a new crush, using cocaine, a shopping spree, or walking across a dam. Using cocaine when manic is basically like pouring gasoline of a grease-fire in the kitchen, it burns hot and bright for awhile and leaves permeant damage to your home.

When they brought me Mr. Cocaine-Biplolar man he looked twitchy as he walked, raising his hand to rub his jaw as he crossed the high-polish linoleum floor. He was young and handsome, like someone I might have met at the local mountain bike club, someone I might date. "Do you work at Anna's Natural Foods?" he asked when he sat down in the molded plastic chair, cocking his head to the side. "No, but I do shop there," I replied. As soon as I heard my own words I knew I had blundered, like playing chess and allowing my opponent's knight to fork my queen and my king. I had given something away. He smiled. "I knew I'd seen you there a bunch, so much I thought you worked there."
"No, this place keeps me busy enough," I replied, strapping him into the blood pressure cuff and shoving the thermometer in his mouth. I doubted he actually recognized me from Anna's, he probably just thought I looked like someone who shopped at Anna's. For some reason people often guessed I was a vegetarian without ever seeing me eat, I could never figure out what gave it away. I decided to start shopping at the other hippy-crap co-op in town.
"Did you just get back from vacation?" he asked as soon as the bell rang to indicate the temperature was reached.
"No, why, so I look particularly relaxed?" I asked sarcastically, trying to erect a wall of humor as I wrote down his vitals.
"Your forehead looks sort of tan," he replied.
"Oh, that's a genetic hyper-pigmentation skin condition I have called melasma, it never goes away and gradually gets worse as I age, there's no cure. Thanks for bringing it to my attention," I replied. Even though the uneven coloring of my forehead didn't really bother me, I tried to sound embarrassed to make him feel bad. He was quiet as I began the dental exam. I communicated with him as little as possible, speaking only to give simple commands like "open your mouth," and "open your mouth again."

When we reached the mental health portion of the history he told me he was diagnosed bipolar and was in jail for possession of cocaine. I gave him my cocaine and bipolar is like pouring gas on a fire speech. "I know, I know, it just feels so damn good," he said, looking into my eyes. I felt like he was searching me, asking me to tell him something he didn't already know. "You're doing permanent damage to your brain each time you use, you're burning things away, you really need to stay on your meds and not use cocaine, and that's it," I told him as I turned the page and began the physical exam. "You're done," I said after I'd peered down his throat, felt for lymph nodes, and checked his lung and heart sounds. "I'm going to refer you to mental health, hopefully we can get your meds going again while you are in here."
"Thanks, and I'll see you at Anna's," he said, winking. I kept my poker face on and turned to fill in a few more blanks on the sheet.

The next week I was giving meds on his side of the jail, the trusty block. He had been started on a mood stabilizer and from the look of the medical record he had been compliant. When we reached the front of the line I handed him his pills in water in a little 30cc medicine cup, the sort of little cup that comes attached to the top of a bottle of Pepto Bismol. Most inmates gave the pills a little swirl with a flick of the wrist before throwing the cup back into their mouth. Some stirred the meds with their fingers or tapped the bottom of the cup to keep the pills from sticking. Mr. Cocaine-Bipolar man looked me in the eye and plunged his tongue down into the little cup, sweeping the sides of the little container. I wasn't embarrassed, it was so gross it was liberating. "Oh, he's working that cup!" I heard the man behind him say. "I hope that was for your benefit sir," I replied to the man behind Cocaine-Bipolar man in line and poured the next man's meds in water. I wondered if I had not given him that little in about shopping at Anna's, if that would have made a difference. Probably not, I decided as I moved on to the next block.