The Invisible Black Woman

In addition to ruling out all sorts of heart conditions, there was still the matter of the longer intake assessment after my lovely visit with Petra. Well, maybe not lovely, but I’d definitely call it meaningful and memorable. So now I had to go to another center to see what was what. Getting approved for IOP—the outpatient program I was “auditioning” for—was apparently not automatic. I would soon learn why it was that everyone who wants these treatment program doesn’t automatically qualify.

I’d gone ahead and scheduled my IOP assessment for a Friday morning. It was very early, so I spared hubby the trouble of having to stay up to tag along. Since Petra mentioned this could take up to 90 minutes, I didn’t want him to have to hang out that long waiting for me to come back.

When I arrived to the center, it looked like an unassuming house in the middle of a quiet neighborhood. I pulled in and found a parking space right away, so I considered myself lucky—ish.

I walked in and what looked like a quiet home on the outside transformed into a full-fledged hospital: a waiting room, several doors that required badged entrance, and a front desk to check in. I walked up to the front desk and was greeted by a friendly fellow, Carlos.

“Good morning. Here for an assessment?”

I nodded my head yes.

“What’s your name, date of birth?”

I gave him both and once he confirmed I was in fact, “in the system,” he asked me to have a seat. The waiting area was notably large, all things considered. There were only three other people there. Two who looked to be father and son and an older woman who I presume was waiting on someone else. She was slumped over fast asleep. I picked an empty corner and waited.

I began to imagine what the son was there for. He couldn’t have been any more than 12. The gentleman was affectionate and I definitely got the sense it wasn’t their first time here. A little bit after, a nurse came out and called him by name. He got up to go and his father said, “I’ll be right here, buddy.”

It gave me secondhand warm and fuzzies to see that display of affection. I quickly looked away and busied myself with a game on my phone. Then my name was called. I looked up to see a Filipino gentleman with glasses smiling at me. His accent reminded me of comedian Jo Koy when he perfectly imitates his mother. I immediately felt at home and relaxed.

He escorted me to another room and closed the door behind him. He told me he would be verifying my details then the nurse would be stopping by to do my assessment. There were—shocking—a slew of forms I’d have to fill out.

He handed me a stack of forms, mentioning something about no biological samples and no non-FDA approved meds—you know, typical procedure stuff. I did a double take when he mentioned the bit about closed-circuit TVs in common areas. “Just for safety,” he said. Huh, so I was being watched. Mmkay.

Manuel’s voice was soothing, almost melodic, as he explained each consent form and questionnaire. He joked about the lengthy paperwork, lightening the mood. I appreciated the breather between the formalities. There was a form about releasing information to other doctors or family members, and another on treatment and billing. Manuel was thorough, ensuring I understood every bit of it.

Then came the mention of advanced directives, again, which I didn’t have. I checked the box, indicating my current status and moved on. Manuel then assured me about the insurance coverage and the possibility of getting discounted medications if needed.

As I initialed and signed where indicated, Manuel pointed out a red button to press once I was done, signaling I was ready.

“For safety reasons, the doors to these rooms are locked, so you won’t be able to get out,” he said.

I wasn’t sure how exactly I was supposed to respond or react to that.

He left the room, leaving me alone with my thoughts and a heap of paperwork. I felt a mix of anticipation and anxiety, wondering about what I’d gotten myself into.

After what seemed like a proverbial eternity, I finished my paperwork then pushed the red button as instructed. I found it a tad amusing that this was one of the rarest of occasions when pushing the red button wasn’t a bad thing. A few minutes later, the door opened. The nurse, Odette, walked in.

“Hi, my name is Odette. I’m one of the nurses.”

She took a quick glance before deciding where to park herself and the laptop she was wheeling on a mobile cart.

I thought maybe I was in her way, so I offered to move. “I can sit over here if that’s better?” I said, while gesturing toward the opposite chair. I assumed she would be escorting me to another room, but I was mistaken.

“Oh, no, no, no. You’re good. Are you okay if we meet in this room?”

“Yep, that’s fine by me.”

“Okay. So, yeah, unfortunately, we’re a smaller facility.”

Noted.

Odette began walking me through PHP, how it was Monday through Friday, 9 AM to 3 PM, packed with group therapy sessions. Lunch was squeezed in between, and the doctor did rounds three to four times a day. I’d have a personal therapist for weekly one-on-ones and the option for family meetings.

She must have seen the look of confusion on my face.

“Any questions?” Odette asked.

So many.

“When I spoke to the therapist at the preliminary assessment, she indicated that there was a step-down option?”

“Yes. So we do have an intensive outpatient program, IOP. And, when you work with your therapist on the discharge, you can mention that, that you would like to step down to the IOP.

Houston, we have a problem.

If I was understanding her correctly, to get to IOP, I’d have to first go through PHP. Not at all what I had in mind. So I tried again.

“So do I need to do the inpatient first? Is there no way for me to go through IOP without doing PHP?”

“Oh, yeah, if you don’t need medication, you can just do the IOP. The only thing is that you don’t do the IOP assessments here.”

Welp.

“Oh, she didn’t tell me that. She referred me here to do the—I thought I was coming here to do the IOP assessment. I didn’t realize that it was only PHP here.”

“Ohhhhh,” she said.

“Yeah, I’m going to school right now, so I need to do the outpatient rather than the inpatient program.”

“Okay, so we just do the PHP assessments here. Because this is the second highest level of care. And we’re just assessing, like, are they safe enough? Are they stable enough, to be in the PHP program?”

Ah, now the closed-circuit TVs and locked rooms made so much more sense.

Odette was being very nice, so I did my best not to overly show too much disappointment.

“Okay, I’m going try to help you,” Odette said.

“One thing to note is that it is ultimately the doctor’s decision whether you do IOP or PHP. You may be more appropriate for the inpatient program. The intensive outpatient is a small team and the therapists do their own assessments, so I can give you their phone number.”

“That would be great, thank you.”

“I’m really sorry,” Odette replied.

“Oh, that’s okay! This is all very new to me. I have no idea what I’m doing and you don’t have anything to apologize for.”

She smiled and relaxed a bit. “Okay, so I’ve just written this out—how far do you live?”

I told her where I lived.

“So what we can do is, I can get you their phone number and you can try to call them and see. Because it’s a Friday, they might be catching up on documentation, so they might be able to squeeze you in.”

“Yeah, that’d be awesome.”

“Okay. Alright. So I’ll be back then.”

“Okay.”

As she was heading out, she asked again, “so we definitely don’t want to do the PHP?”

I resisted the urge to say hell to the naw, naw naw, and just shook my head no. I then immediately felt guilty, so I apologized—as if this was some sort of rejection of her.

“Okay, no worries. You’re good. You’re good. I’m glad you brought that to my attention.”

“Sorry.”

“No, no. I’m glad that we kind of—we worked this out. We hashed it out before this became,” she stretched out her hands wide in what I imagine was meant to represent a flustercuck.

I nodded in agreement.

“Yeah. No, I appreciate it. Thank you.”

“You’re welcome. My pleasure. So, hold on. Let me get that number for you. And then I can try calling over there myself.”

“That’d be awesome.”

“Yeah. I’ll try to do something.”

“Thank you so much. I appreciate it.”

“My pleasure. I’ll try to do what I can.”

“Awesome. Thank you.”

“You’re welcome.”

She asked me to sit back in the waiting room just so I wasn’t taking up one of their three assessment rooms. I had no problem going back to an area that didn’t have me locked in.

A few minutes later, Odette came out and asked me to come back to the assessment room.

I followed her inside and she motioned for me to have a seat.

“So I have good news and bad news.”

Great.

“So I did call IOP and their nurse is out sick today.”

Clearly, we’re doing the bad news first. Got it.

“But, I talked to the doctor here and he said that if you are open to it, we can do your IOP assessment here, so you won’t have to wait to reschedule again. Would you like that?”

I’d have given her a bear hug if I wasn’t calculating the odds as extremely high that she had at least a taser in her pocket.

“Yes, yes, of course, that would be great!”

Odette smiled warmly. “Okay, I’m just going to grab my laptop. So, I’ll be right with you.”

“No problem,” I replied, still processing all the information. A small dark corner of my brain wondered if what I shared during the assessment would upgrade me from IOP to PHP. I wondered to myself, on a scale of, you’re not doing great to there is no way she’s leaving this facility, just where the hell will you end up today?

I had no time to answer, as Odette returned. “So, we’ll do the assessment today. They’ll either reach out to your insurance today or Monday, and they’re hoping you’ll be able to start on Tuesday. Does that work for you?”

“Yeah, 4:30 to 7:30 works for me,” I said, relieved that things were moving forward.

Odette nodded. “Great. Okay. And then they’ll call you. Normally, like I said, this is a bit out of my usual routine, so I’ll make sure everything’s set in your account.”

I expressed my gratitude, impressed by her dedication. “I appreciate you doing this.”

“Oh yeah, my pleasure,” she replied with a reassuring smile.

As we discussed insurance matters, I mentioned both of my insurances, wondering how to manage them. Odette advised, “Usually, once the primary stops, you might want to provide your secondary.”

“I did list them both,” I confirmed.

Odette noted the details and reassured me that the IOP therapists would help with the authorization process. The conversation then shifted to my primary care provider and any psychiatric assistance I might have had. I shared the details, feeling an odd mix of vulnerability and relief as I spoke.

Odette listened attentively, jotting down notes. She then asked about what brought me to IOP, her tone gentle yet inquisitive.

I delved into my recent struggles—the palpitations, breathlessness, the chest pain, and the overwhelming sense of anxiety and dread that seemed to radiate from my work environment. As I described my job responsibilities and the mounting pressure, I felt the weight of the past months resurface.

“Work is definitely a factor,” I admitted, feeling the familiar tension rise at the mere thought of my job.

Odette nodded sympathetically. “Are you sure you don’t want to take some time off just to focus on treatment?”

I explained how I had already taken some time off, but my job security felt—well, insecure. The conversation shifted to my love for my studies, balancing my health and education, and the complexities of managing FMLA and short-term disability along with—oh yeah—my health.

As Odette continued with the safety risk assessment and medical history, I found myself opening up more than I anticipated. I’m sure her very pointed and proctologist-like questions had a lot to do with it. Much as with Petra, the floodgates opened once again, and all my fears, anxieties, and struggles poured out—along with the tears.

Odette offered me tissue and asked if I wanted some bottled water. I declined. I just wanted to get it over with.

She inquired about my sleep, medications, and any history of abuse or trauma. Each question felt like a step deeper into my psyche, and Odette handled it with such care and professionalism that I didn’t feel overwhelmed.

The session concluded with a discussion about my daily activities and work life pre-FMLA. I shared the details of my role, my team, and the challenges I faced with my supervisor.

“You did great,” Odette said as we wrapped up. “I know it’s hard to talk about these things.”

“It’s okay,” I replied, feeling a sense of relief and exhaustion.

Odette promised to get me the form for my short-term disability and reassured me that the IOP staff would contact me soon. As I signed the final forms, she reminded me to stay strong and explore my rights regarding my job situation.

“Thank you so much,” I said, genuinely grateful for her help.

“You’re welcome, my pleasure,” Odette replied with a smile. “I’ll be back in just a few minutes. You can wait here.”

I nodded, taking a deep breath as she left the room.

Soon after, Odette returned with the final paperwork. “So this states that today you’re going home, and the continued treatment recommendation is intensive outpatient,” she explained, crossing out irrelevant sections meant for PHP.

I nodded in understanding, signing where required. Odette assured me that the therapist, although out sick today, would contact me by Tuesday.

“Thank you so very much,” I said, feeling a mix of relief and anticipation for the next steps. I also felt a debt of gratitude that my mere words didn’t seem to convey, but I thanked her just the same.

“You’re welcome,” Odette replied. “Take care, and call if you have any questions.”

As I left the center, I felt a mix of apprehension and hope. The journey ahead was uncertain, but the good news was I was heading home. The doctor didn’t deem the need to lock me up and throw away the key. That was already a step in the right direction.