Dawn came and, with it, uncertainty. 

Now that Aaron was facing the imminent reality of going to a mental hospital, doubt was starting to creep in. A bit of research on the internet told him he could check into a hospital fairly easily, but the prospect of being deemed a danger to himself or others was daunting. He could lose his freedom entirely, winding up locked away for a very long time.

Will they make me wear a paper robe with my ass hanging out? he wondered. Or lock me in a room that’s a little too similar to a prison cell? 

It would be so easy to sit at home and hope that whatever was happening to his mind would pass. But this wasn’t a little thing like putting off doing the dishes or waiting for a sprained muscle to recover. Ignoring this problem would be wildly irresponsible; there was a real chance he’d hurt someone if things kept on as they were and that was unacceptable.

An overnight bag sat by the couch, filled with a few changes of clothes and some toiletries. He didn’t know what he’d be allowed to keep in the hospital so he erred on the side of optimism. He even had charging cords and his cheap tablet in the bag. Maybe he’d be able to pass the time with music, videos, or reading.

Just after seven o’clock, he got his bike out of the building’s garage and started on his journey. His first stop was the bodega a block from his apartment, where he added several bottles of soda, snacks, and a couple packs of cigarettes to his bag. He exchanged pleasantries with Jack, the middle-aged Indian man who owned the store and ran it with his kids, but didn’t hang out to hear what crazy stories or gossip Jack had to share. 

Really pushing the limits of optimism thinking they’ll let you keep cigarettes at a hospital, he told himself.

Aaron rode east. His next stop was a bit of extravagance in the form of comfort food. He stopped at a place he knew opened at 6 a.m. right on the border of Midtown and East Sac. It was early enough that the brunch crowd would still be sleeping it off, so he expected a fairly quiet breakfast.

The bar was, indeed, quiet. The only people he found inside were a bartender, waitress, and, presumably, a cook. He sat out on the back patio where he could smoke and read until his breakfast — an omelette with hash browns, bacon, and toast as well as a side of biscuits and gravy — arrived. The food was good, the atmosphere quiet, and he felt relatively at ease.

The meal wasn’t entirely peaceful; there was a moment that set his nerves jangling like car keys dangled over a baby. A loud shout erupted from a room behind the patio and Aaron bumped the table when he startled a bit. He settled down quickly enough; the shout had been a cheer and it reminded him the place also had a small card room attached.

When he was done, he got back on his bike and headed south. The hospital he was going to, the Bidwell Center for Psychiatry, was a small private hospital on Folsom Boulevard. It was right near his alma mater, the state college, and was twenty or thirty minutes away by bike at a comfortable pace. It would be much longer if he took the trip at a leisurely pace… which he did.

He wasn’t procrastinating, not even a little bit. He was simply enjoying the ride. It’s not like he was in no hurry to rush through what could turn out to be his last minutes of freedom. Not at all. He was just enjoying the scenery. Eventually, even his sedate speed got him to the hospital.

Maybe I should’ve walked, he thought. What’s a little five mile walk when you haven’t exercised for over a year? 

The Bidwell Center for Psychiatry was a wide, one-storey tall building, two to three hundred yards across. The walls were light green with gently-sloping white roofs. Two broad wings on either end formed a recessed courtyard in the center, with the entrance in the middle. Several benches lined the courtyard, covered in white trellises hung with vines and a number of young trees were planted around the courtyard, as well.

Aaron lingered by the bike rack at the edge of the courtyard. He lit a cigarette and stared at the building. A constant, low-grade hum of anxiety had been hanging at the edge of his awareness all morning, gnawing at his resolve to check himself in. Now that he was standing in front of the hospital, the hum had escalated to a rattle.

Why did it have to be such a pleasant morning? he lamented. Not that I’d wish for more paranoid hallucinations, but they certainly would make this decision easier. 

It took Aaron three cigarettes, but he finally went inside. The lobby was surprisingly small, not much larger than Aaron’s living room. A narrow reception desk sat across from the glass doors and there were four spindly chairs that served as a waiting area. The lady behind the reception desk gave him a small stack of papers to fill out and told him someone would be with him shortly.

Most of the paperwork was standard for any visit to a new doctor — medical history checklists, insurance information, and the like — but it included a lengthy questionnaire about his mental state. Aaron had decided to downplay the severity of his symptoms; he wanted help, but he didn’t want to be committed long term. It was also hard not to feel like he was blowing things out of proportion after a calm morning of no imaginary knife-wielding assassins. 

An orderly came and called for Aaron before he finished the questionnaire. The orderly, who introduced himself as Joseph, was average height with a sleek, muscular build. He led Aaron into a small interview room that was barely big enough for a table and two chairs. Oddly, one of the chairs was placed so it would block the door when it was closed.

“Excuse me,” Joseph said, stepping into the room and pulling the door closed behind him. “Please, set your things down and have a seat.”

The layout of the room basically forced Aaron to take the seat farthest from the door.

A subtle way to make it easier to trap or restrain someone in here, Aaron thought. That might just be the anxiety and paranoia talking, though.

“If you didn’t have time to finish filling out your paperwork, you can do that now or wait until later,” Joseph said with a smile. “There’s never an end to paperwork and I’ll have even more forms for you when you’re done, so don’t feel like you have to rush.”

Aaron plastered a smile on his face that he hoped was friendly and continued filling out the questionnaire. Joseph took the seat across from him.

“So, what brought you to the hospital?” he asked.

This is it, Aaron thought. Time to thread the needle. He took a breath, steady but not deep.

“I’ve been feeling really on edge the past couple days,” Aaron said. “I’m used to anxiety but this has been different. I feel like people are about to attack me. Not, like, shouting at me but more like coming at me with a knife or something.” He paused. “A few times I even felt like there were people hiding in the bushes or shadows, about to jump out at me.”

Joseph nodded along, expression sympathetic. “That must be hard. Periods of heightened anxiety aren’t unusual for people who have to cope with it regularly. Why do you feel coming to the hospital is the right choice for you at this moment?”

Aaron used the last question on his form to cover a pause and consider how to answer. He only took a couple seconds so it wouldn’t be obvious he was measuring his words.

“I don’t think I’d attack anybody, but these feelings have been so strong that I’m starting to question myself. It seems like a professional would be in a better position to assess my situation than I am. Just the thought of lashing out in panic, thinking I’m defending myself, has me freaked out.”

More sympathetic nodding from the orderly. “I can understand that and our staff would certainly be glad to try to help. I do want to make sure you’re aware of the potential ramifications of a hospital stay. People who spend time in a psychiatric hospital, for any reason, often aren’t prepared for the long-term consequences. For instance, former patients are often surprised to find they’re barred from buying a gun after treatment.”

“I don’t have any real interest in owning a gun, so that’s okay. Even if I did, I’d have a hard time justifying choosing the chance to maybe buy a gun someday over the risk of taking a swing at someone because my brain is telling me they’re about to stab me.”

Joseph made a note on his own clipboard, nodding. “I think that’s a sensible outlook. So, if I’m understanding you, you’ve been feeling on edge and like you’re about to be attacked. Have you been seeing or hearing anything that isn’t there?”

Aaron had thought about how to answer this question a good deal in the long hours of the night. He shrugged. “How could I know? I don’t think I’ve had any hallucinations, but the sense of danger has been so strong it’s practically the same thing.”

“Can you tell me more?” the orderly asked, taking more notes.

Aaron sighed. “I had a bad dream last night, so I went for a walk. To clear my head, y’know? This guy was following me and I was convinced they were trying to sneak up and attack me. It turned out it was a friend from the neighborhood who was drunk and trying to invite me to hang out. I totally misread the situation.”

“What did you do before you found out who it was? When you thought you were about to be attacked.”

“I tried to shake them off, but that didn’t work out. Eventually I ducked into an alley and confronted them when they caught up.”

The orderly nodded. “Can you tell me more about how you confronted them?”

Aaron rubbed his chin. He definitely couldn’t say he’d lifted a fully grown man clean off his feet like he weighed as much as a box of cereal. That was the weirdest part of his recent delusions and would definitely be a red flag to the doctors.

“I hid behind a dumpster and when he came up to the alley, I twisted his arm behind his back and pushed him into a wall.”

Joseph scribbled a few more notes. “What if you hadn’t known them?”

“I’d like to think I’d have come to my senses, but I’m here because I might not. What if I thought some random person was trying to kill me and beat the crap out of them?”

“That makes sense to me,” Joseph said. “So, just for clarity — this anxiety you’ve been experiencing lately is more specific and more severe than you’re used to. And you’ve reached a point where you’re worried you might attack someone thinking they mean you harm. Is that right?”

There it is, Aaron thought. The lynchpin in any case for an involuntary hold: ‘are you a danger to yourself or others?’

Reluctantly, Aaron nodded.

“I think we can admit you for a 72-hour hold, which gives us time for observation and you a chance to speak with a doctor at least once a day. Does that sound alright?”

Again, Aaron nodded.

After a bit more administrative paperwork, Joseph led Aaron back into the ward. It was much nicer than Aaron had expected.

The first room was a large communal area. A long nurse’s station ran nearly the entire length of the wall with the entrance. The bulk of the communal space was occupied by large round tables with plastic chairs. A small bank of payphones — actual payphones, like from an old movie — took up a small section of the wall near the entrance.

The corner across from the entrance had high windows looking out on a small, walled courtyard. Flower planters with attached benches ran along the walls and a large sycamore grew from a central planter. The windows were tinted to limit light coming from outside, which was fortunate because that corner was also the communal television area, with a wide TV in the corner and several small couches and plump chairs. The other far corner had a small reading area, with squat bookshelves against the walls and a few more comfy chairs to sit and read.  There were also two wide hallways flanking the courtyard corner. They were both thirty or forty feet long and had three doors on each side.

Joseph walked Aaron to the nurse’s station. Three other staff members were busy with various tasks behind the counter, but they all said their introductions to Aaron and one handled his intake, making a folder with his documents and placing a plastic band on his wrist. The plastic was soft and flexible and plump with edges that didn’t cut and chafe. 

“Let’s get you set up in your room,” Joseph said.

He led Aaron through the common room and down the hallway to the left of the television corner. There were several people in the communal area, but Aaron had no idea which ones were patients; all but one of them — a rail-thin, tiny old woman with flyaway hair the color of pure cotton in a long gown — were wearing either staff uniforms or street clothes.

“These are the men’s rooms,” Joseph explained as they walked down the hallway. 

They went into the middle door on the right side. Aaron realized the walls of these rooms — and probably the women’s rooms on the other side — formed half the walls of the little courtyard. Sadly, the rooms didn’t have a door or window to the small outdoor space.

I never cared much about trees and nature and all that, but it might have been nice to go sit out there, Aaron mused. Maybe I still will.

The room itself was quite spacious, but rather spartan. It was bigger than the average motel room and furnished much the same — two full-sized beds with a small end table between them and a long, low dresser with two sets of wide drawers on the wall across from the beds. 

The room even had a little bathroom in the corner near the door, with a toilet, sink, and shower. Each of the fixtures was rather unusual, having been designed in a way that minimized their potential to be used for self-harm. The showerhead, for instance, was a small, angular metal protrusion that stuck out of the wall only two or three inches. The bathroom had a door, but it was a flimsy little thing made of balsa wood or something similarly delicate that folded up and couldn’t be locked.

“This will be your room while you’re with us,” Joseph said. “You’ll be bunking with another patient, but he’s very personable and good about giving people their space. If you find it’s causing you anxiety or discomfort and you don’t think you can manage it, come see us at the nurse’s station and we’ll see if we can work something out.”

The orderly gestured to the far bed, which was obviously the unused one. “Set your things down over there and we’ll do an inventory.”

Aaron set his bag on the bed and they began to go through everything. Joseph sorted them into three piles. The first pile contained Aaron’s toiletries and most of his clothes, the second all the snacks, cigarettes, and electronics, and the third just two things — a pair of pants and a hoodie.

“You can keep all these with you,” Joseph said, indicating the first pile. “We’ll have to store these,” he added, indicating the second. “The last we’ll have to check.”

It turned out the clothes in the third pile had drawstrings in them, which weren’t allowed in the hospital. Joseph was able to pull the drawstrings out without needing to cut anything, so Aaron got to keep them and the drawstrings went with the prohibited stuff.

“No snacks, no electronics, and no smoking,” Aaron observed. “I’m guessing we won’t have the opportunity to step outside, like into that courtyard, for something like a cigarette?”

“Afraid not. We have a wireless radio headset you can check out from the nurse’s stations, dozens of books in the reading corner, and pretty good cable,” Joseph explained. “I’ll need you to empty out your pockets, too, and then I have to pat you down.”

Soon, Aaron’s keys, phone, lighter, and the remains of his emergency pack of cigarettes were added to the prohibited pile. After Joseph gave him a quick pat down, he wrote down all of Aaron’s prohibited items on an inventory and put them in big plastic bags. 

Those sodas are going to be lukewarm and probably explode with fizz if I ever get out of here, Aaron thought with a sigh. At least I only picked up smoking again yesterday, so I shouldn’t fiend too bad.

A woman in scrubs carrying a clipboard stepped into the room from the hallway. When Aaron noticed her, she just smiled and said, “Rounds.”

“We check the rooms several times an hour to make sure everyone’s doing okay,” Joseph explained. “So, in terms of what you’ll be doing while you’re here — we offer three meals and at least two group sessions every day. You can participate as much or as little as you’re comfortable with, but being active is encouraged. Other than that, a psychiatrist will speak with you at least once a day to find out what your needs are and how we can best address them. Everything sound good?”

Aaron nodded. He wasn’t confident he could really say anything right now around the bundle of tension in his throat.

“Cool,” Joseph said, packing all the plastic bags with Aaron’s stuff into the bag he brought from home. “Lunch is in a couple hours; you just come out and get a tray from the cart, then you can eat anywhere in the ward. The next group session is at three o’clock, if you’re interested, and the doctor will probably speak with you this evening around dinnertime. Do you have any questions for me?”

“So that’s a definite ‘no’ on the smoke breaks?”

Joseph chuckled. “I’m afraid so. This is a hospital, after all.”

Since Aaron had no other questions, Joseph picked up the bag with most of his belongings, said goodbye, and left Aaron alone in the room.

Aaron sat down on the neatly-made bed that would be his for the next three days — and hopefully no longer — and stared at the floor.

Well, he thought, here I am.