“That’s true.”

“So, here’s the thing: I have a feeling that your blood pressure elevation and headaches are stress-related. Now, I don’t want you to think I’m minimizing the importance of your high blood pressure by saying that. But we know there’s a powerful mind-body connection. Stress can lead to heart attack, stress can lead to stroke, stress can lead to infection. You get the idea. Because of this, even when I feel your symptoms are due to stress, we should check your blood to take a look at your kidneys, do a chest X-ray to take a look at your heart and lungs, and an EKG as well to look at your heart. Let’s do a head CT, too, to make sure there’s no bleeding or other abnormality, given your new headaches in the setting of elevated blood pressure. This may seem like overkill, since I’m pretty confident they’ll all be normal, but I still think we should check to be safe. Make sense?”

“It does. I have a feeling they will all be normal, too. I think it’s just stress. I don’t want to take up any more of your time. But since I’m already here, I might as well get checked out, because goodness only knows when I can come back. You’re right. I definitely can’t afford to get sick now, so better to play it safe.”

I nodded. “And you could even practice that meditation you mentioned while we’re waiting for your results.”

Ms. Hernandez reclined on the stretcher, and her face softened into a smile. “Good idea.”

“Excellent. Just relax. Do you want the lights on or off?”

“Off is good. Thank you.”

I flipped the light switch and as I left the room, I heard Transportation calling to take Ms. Hernandez up to radiology. Perfect timing. After refreshing my computer screen, I saw that all her labs, as expected, were normal.

Next, I moved on to Abraham Wade, a tall, muscular white man who’d come in for alcohol detox and depression; his repeat vitals were normal. I tapped on the door and completed the routine introductions. His hair looked as if it had been recently cut, and it was dark and slick with the same sweat that ringed his collar. Although he had told Angela he’d just been drinking, he appeared sober. He didn’t seem to have any acute medical issues. He explained that after being in the military, he had had a bout of prescription drug abuse: He’d been prescribed oxycodone for the chronic back pain he developed during his deployment overseas. His mental health care notes explained that his primary care provider and pain management specialists had worked together to get him on a non-narcotic pain regimen. When I asked him about this, Mr. Wade agreed that it was partially true, but added that it was truer to say that he had simply decided he didn’t want to be addicted to narcotics anymore. He had stopped taking them and started working out more, which had alleviated his pain.

I completed the required history and exam and then prepared to get back to my coconut coffee.

“Well, Mr. Wade, my part is done. I just do the medical screening. Your labs are all cooking, and I’m pretty confident they’ll be fine. The other parts, the depression and alcohol use, you and the psychiatrist will discuss,” I stated as I began to back out of the room.

“Doctor, do you know who the psychiatrist is? Do you think he’ll send me home? I mean, I’m not suicidal or nuthin’. I was just so desperate. I want to live. I want to be better. I’m a good guy,” he said, pointing at his chest. “I’m really a good guy. You might not know that from all the shitty things I’ve done, but I am.”

“I believe you. We all do shitty things sometimes,” I said, unable to stifle some knowing laughter.

“Yeah, right?” he said, nodding.

“As for who’s on, it’s Dr. Masetti. I really don’t want to speak for him. He’s super nice and thoughtful. A really sweet man. I know he will do whatever he can for you. Anything else before I go?”

“Ma’am, I just really want to do this,” he continued. “It’s time. I never talked about my drinking when I was here before,” he pleaded as he kneaded his hands.

I took a couple of steps toward him and rested against the sink to show that I was listening.

“Ever since I got out, I’ve been drinking. Come to think of it, I was drinking before the military. I remember I would drink when I was a kid. When my father wasn’t home, which was always—thank God, because he was a tyrant—I would break into the liquor cabinet and take a bottle out for me and my friends. I did stop drinking when I enlisted. I mean I only drank between deployments. I liked to say that I would only have a drink with dinner or socially.” He frowned and wrung his hands. “But I was pretty social, Doc.” He laughed. “Come to think of it, ma’am, I was always a mess. Ever since I was little, I tensed up when men yelled. So, what do I do? I join the military, of all places,” he said, throwing up his hands. “When I got back, I was always wound up. I’d start sweating in crowds—markets, malls. God forbid a car would backfire. I didn’t even realize until recently that that is not normal.” He paused. “I’d just go home and have a drink.

“Ma’am, I had a good job. I was the foreman at a big construction company and ran my own side business, too, doing floors, some painting. I was doing great. But then I started drinking more and more. I didn’t know what was happening. I mean, I literally didn’t know because I would black out. My business was the first to go. Then my wife left with my son, just last month. She did the right thing, too, Doctor. I was an asshole.” He paused, frowning again. “Look, I’m sorry. I know you don’t have time for all this. I know you have other patients.”

I was listening to him, taking it all in. “It’s okay. I have a minute before I have to scoot.”

“Thank you, ma’am. I just wanted to ask,” he said, clearing his throat. “Well, I’m sorry. I mean, first, do you even know how I ended up here? A couple weeks ago I somehow called my wife—or ex-wife; I don’t even know what she is now, but I called her. I don’t know what happened. I was drunk. She had left to stay with her parents and stopped taking my calls the week before, so she didn’t even get my voice mail until the morning. She checked it and heard me spewing craziness. She tried calling me at home; I didn’t answer. She called work, but they said I wasn’t there. She was too afraid to come home, and I don’t blame her.

“I woke up to men in SWAT gear breaking down my door. Meanwhile, I’m curled up in a fetal position on the floor with my guns laid out around me. Next thing I knew, all these armed men rushed the room. They got a call from my ex saying she had to flee the house the month before because her husband, who’s ex-military, is a depressed alcoholic and he just left a message screaming about how he’s gonna kill himself. To tell you the truth about it, I was really embarrassed, but I was also more than a little pissed off that they busted my doors. The police took me to the closest ER, but I refused treatment. Instead, I went home to fix my fucking doors.”

Realizing he’d used an expletive, he interjected, “Oh, I’m sorry, Doctor. Please excuse my language.”

He continued: “Yesterday I blacked out and woke up this afternoon with my bedroom door on the floor—I don’t think I ever fixed it right. Two empty bottles of vodka were on the floor from I don’t know where. I had a voice mail from work, since I was a no-show, and one from my five-year-old son, who I haven’t seen in three weeks. So today, I drove myself in. There really isn’t much left for me to lose. I have to do this. I know this isn’t your decision, but I just want everyone to know. I want everyone to know now that I need help. I’m a good guy under all this bullshit. Oh, sorry again for that.”

I studied his ruddy face. I felt the determination in his voice. “No worries, I get it,” I said. “You’re a good guy, and you’ll get through this. You are getting through this. I’ll let the psychiatrist know what we spoke about.” What I meant but couldn’t say to Mr. Wade, for fear of implying a promise that was not mine to make, was that I would beg Dr. Masetti to admit him to the hospital today.

“Ma’am, again, I’m sorry to keep you. I just wanted to ask you something before I went off on that long tangent. I want to ask you how hard will this be? How hard is detox?” His tone seemed to convey even more sincerity than before. He was a strong man, a smart man, one who right now was desperate and open. In this moment, he was a man who wanted with every fiber of his being to transcend this part of his life.

I looked at him, wanting that transcendence for him, too, wanting it with every fiber of my being. “That, my friend, is a good question. I’m going to tell you the truth because I think you want it, I think you deserve it, and it will only help you get through this so you can live the life you want, which is the life you deserve.”