Songs from the Black Chair


2006 Connecticut Book Awards finalist

2005 Pushcart Prize

An excerpt:

A thousand men a year come and sit in the black chair next to my desk. They are between eighteen and eighty years old, usually black or Hispanic, usually with a psychiatric condition and a substance-abuse history (crack, heroin, and alcohol), often with a forensic history (usually released from prison that day), and quite often with a major disease. At some point, I always end up asking: “Are you hearing voices?” “What do the voices say?” “Have you ever seen things that other people didn’t see?” “Have you ever tried to hurt yourself?” “Are you having thoughts of hurting yourself now?” A few times a month I hear responses like “I thought for about an hour today about jumping in front of the subway,” or “I want to die,” or “I can’t tell you whether I’m going to hurt myself or not,” or I am shown wrists that have recently been cut, or bellies and limbs and necks that have long scars in them. When I hear or see these things, I calmly tell the person in the black chair that I think he needs to go to the hospital in order to be safe. Almost always he agrees without complaint. I call 911 and write a note addressed to the attending psychiatrist, Bellevue Hospital emergency room, detailing my observations and an assessment of their mental status. Fortunately the hospital is only a block away. Within ten minutes, the police and EMTs arrive. “Good luck,” I always say to the men as they are taken away. To my amazement, they almost always say, “Thank you.”

For the records the staff and I are instructed to place the men we see into one or more of the following official categories of disability or distress, as promulgated by the city’s health department:

SPMI (seriously and persistently mentally ill)
MICA (mentally ill chemical abuser)
Axis II (personality disordered)
Forensic (released from jail or prison)
Over 60 Years Old
Mentally Retarded/Developmentally Disabled
Physically Disabled
Vocational Problems
Domestic Situation

It’s a nice list of bureaucratic categories, and it means nothing, really. I’ve created my own list. These, I’ve learned in my two years of sitting next to the black chair, are far more descriptive and pertinent descriptions:

The Travelers and the Wanderers
Guided by Voices
Vietnam Vets
Waylaid Tourists, Usually Recently Robbed
“No English” and No Papers
Various Persons Destroyed by Alcohol, Crack, Heroin, or Other Substance
Alzheimer’s Patients and Other Victims of Senility
Manic in America
People Who Choose to Live Underground and in Darkness
The Truly Weird, for Whom We Can Find No Category That Fits

But I keep all this to myself. I sit at the computer and duly check off the city’s official list.

Of course, they are all travelers and wanderers. They come from Jamaica, Georgia, Colombia, Kuwait, Poughkeepsie, Italy, Oregon, Taiwan, Wyoming, Poland, Detroit, and Bosnia. And it is Manhattan—not Brooklyn, Queens, or the Bronx—that they want to come to.