Lisa Jacobs, in her nonfiction piece, March Manic (Intima Spring 2019) describes a long shift on a psychiatric unit. She is “beyond exhausted” to the point of having questioned her own grasp on reality.

As a case manager in a Baltimore City hospital, I once spent hours attempting to find placement for a homeless 19-year-old addicted to heroin who needed long term IV antibiotics. When I asked if I might call her mother she replied “I don’t give a fuck” but retracted her permission as I was leaving the room. I pretended not to hear. The next day I was told she had signed out AMA (Against Medical Advice). a colleague said, “Get over it. She was a waste of time and resources.”