The Day the Wit Hit the Van

I received an email the other day from a young woman whom I had supervised in a cllinical therapy internship.
She had written and asked what had made me so certain I would succeed as a mental health counselor. I replied,
"Well, I have only been at it for 30 years so write me back in another ten years. Perhaps by then I will know the answer".

Truth be told the early days of my "practice" were fraught with ambivalence and uncertainty. None better illustrates my wavering dedication than the following tale from my early days.

I was three years out of graduate school and working for a local New York State community mental health center in Port Chester, NY. For reasons unclear to me now, I had worked my way up the civil service ladder in a brief period to the position of Cooridinator of Geriatric Day Treatment Services.

Our offices, and my Day Treatment Program, were located in the back of and basement of a local church in this NYC suburb. Port Chester was a relatively middle class commuting city in Westchester County. The next village heading south toward the city was the wealthy and comparatively upscale, Rye, NY.

I had done well designing, implementing and eventually coordinating the Geriatric Day Program. Approximately 55 clients, all over the age of 55, were enrolled. I had a few resources: a van driver, an open expense account to purchase lunch supplies for the group, and a few staff members. I relied heavily on the largesse of the Port Chester community especially the large and dedicated group of senior citizens who volunteered their time several hours per week.

I approached the project with youthful zeal and enthusiasm. The program was active and full of life and laughter. My clients were improving with their mental health issues, gaining support and friendships and most importantly having a great time. Some of those follks lived with their families in their own homes in Port Chester, while others, recently discharged from large institutions lived in what were then called "group homes". One group home in particular, located in Rye, sent about 7 clients daily to the program.

It was my first experience as an administrator and I was careful to treat both supervisees and volunteers respectfully and well. I would never ask anyone to perform a task that I would not perform. I was a "hands on" administrator who would often roll up her sleeves and get going when things got busy. I was never afraid of hard work.

Our van driver was a genial, and for the most part, reliable fellow, who also happened to be a client in our mental health clinic. I liked Henry a lot especially because he treated the geraitric clients with such care. He felt proud and important to be "helping with the oldsters" and it was a pleasure having him working along side us.

One day Henry called out sick. It was my job to take over as van driver and I jumped into the vehicle and began the rounds of collecting the clients for the program. After shuttling everyone in, we had an uneventful but pleasant day .At the close of the program, I jumped back into the van to bring everyone home accompanied by a sweet senior volunteer from the church.

Now back then, using the NY State van was a relatively easy job. You "signed in" on a sheet attached to a clipboard in the van, noting your mileage and time departed with time returned and condition of van when returned.. You were careful to observe all the rules of the road and inside the van, but especially the "Clean up your mess before you turn in your keys" sign just over the console. Usually this meant disposing of coffee cups and making sure the ashtrays were clean and butt free. Easy enough and I had done the clean up drill a hundred tiimes before while making trips to the main hospital campus in Duchess County or traveling by state vehicle to other clinics.

Seven clients piled into the van while my senior volunteer rode shotgun in the passenger seat. I prepared to set off completing all necessary paperwork, checking the mirrors and adjusting the drivers seat to accommodate my small size. I could barely reach the gas pedal without standing but was satisfied I could make the brief trip to Rye and back.

"Everyone buckled in?" I shouted.

A chorus of "yeas" returned and I slowly navigated out into King Street en route to Rye via the Boston Post Road.

A few moments after we had left, client Andy raised his hand and inquired?

"Miss Cathy? Aren't you going to ask us about our day?"

"Ah? Okay...", No one had left me a script, but I quickly deduced that it was a daily routine for Henry to ask the clients about their day at the program. It mattered not that I had just spent the whole day with everyone currently sitting in the van. I was proud of myself for handling the question so promptly and seamlessly.

"How was everyone's day?"

"Great"! the clients shouted back. "We ate sandwiches and played cards"

"We had dance therapy and had social group"!

"Well that sounds terrific" I replied. I glanced over at my senior volunteer who had a look on her face as if I were simply not trying hard enough.

"Okay'! "Look everyone we have hit a little patch of traffic here and lets roll down all the windows, so no one gets over heated". We were sitting on the Post Road in midtown Rye on a beautiful but hot summer day. The sidewalks were filled with mothers and children headed to the pool or the ice cream shop. Traffic had slowed to a crawl and I was hoping the van would not get too hot. The air in the unairconditioned van was getting stale.

Just then another client, Bill, called out to me. "Cathy, we have to turn around and go back to the program".

"Okay, Bill, we are stuck in a traffic jam here and I don't think we can turn back just now. Is there an important reason for us to return?"

It seems Bill had left his half uneaten sandwich in the refridgerator back at the clinic. He had started to think about that sandwich and worry about it. I assured him that I would take care of the sandwich and insure that it would be there for him the next day. Bill was calmed by my reassurance. My senior volunteer shifted her weight in the passenger seat. Clearly I had to speak with Henry, upon his immediate return, as to how to handle van issues, in the clinically appropriate way.

The van began to get hot and I felt the sweat beading on my forehead when Sarah raised her hand and said.
"Cathy, we have to turn around and go back".

I looked into the rear view mirror and asked

"Why must we go back?"

Because, she said.

"I gotta go".

Up ahead there were five cars between the van and the traffic light, Beyond that the road was clear and I believed I could make it to the group home, within a few minutes, while observing the speed limit.

"Sarah'", I called, "We are almost home, do you think you can hold it?"

"Yes" she called back. "I am holding it".

I breathed a sigh of relief and inched forward toward the light.

Thirty seconds later, as we were second on line to the traffic light, Sarah called out to me again. "Cathy we have to turn back, because I gotta go"!

"Oh, Sarah! I thought you said you were holding it." I nervously scanned the streets nearby for a gas station or restaurant where I could stop and bring Sarah to the restroom. I was headed into residential Rye and even had there been a place to stop, there were no gas stations or restaurants, or any other options.

The light turned green and I pressed the pedal to the floor. "Okay Sarah", I shouted, "I will have you home in two minutes, just hang on". I said a silent prayer and began speeding down the road as carefully as I could.

"Don't worry Cathy. Its okay, don't rush" Sarah called back. "I held it until it came out and its out now"! I slowed down and peered into the rearview mirror, Sarah was sitting quietly as the other client's stared stoically forward.
Soon enough the vehicle was filled with a malodorous feces like scent. Never one for body fluids (and this was instrumental in my decision to not attend medical or nursing school), I began to violently gag.

With all the professional demeanor I could muster I began apologizing to Sarah and reassuring her that "accidents do happen". I drove the next mile with one hand on the wheel and the other hand over my nose and mouth, begging God not to let me vomit and add to the damage already done.

Soon we were "home". I led the clients off the van and escorted Sarah inside where a nursing aide was poised to help her. I surveyed the van noting a large gooey puddle in the back seat and on the floor. I knew better than to check in with my senior volunteer who had not been amused in the very least by the events that had occurred on our journey.

Driving home I took a lesson from family dogs I had known and drove the entire route with my head out the window. I continued gagging which greatly impacted my accelerator skill. Every time I would heave, my foot would jump the pedal and the van would jolt. We returned the six miles back to the clinic this way bumping and jolting and heaving all the way.

Finally back, I headed back inside and gathered up a bucket and some rags and cleaning agent. Left alone I succeeded in cleaning up the mess while taking brief time outs to vomit into one of the many plastic bags I had brought.. I began crying at some time during this task and my face had became filthy, coated with runny mascara, sweat, tears and dust. My breath was unspeakably bad. Before heading back into the clinic I paused and composed myself. I was, after all, a professional. Satisfied that the job was done, I headed back to work to put away the cleaning supplies.

I had not seen my face or hair in the mirror but I suppose some of what I had endured showed. My supervisor, a look of concern on his face, approached me and asked what had happened. Just then the tear floodgates let loose and I sobbed and and choked out my van story. He listened patiently until I stopped crying and sent me on my way to clean up myself and head home for an early day off. Just as I walked away he called out to me-

"Cath?" I turned around to face him, as he continued, "Look its not so bad. Just think one day you can tell everyone you know, that you were there, The Day The ____ Hit The Van".