The number one thing which haunts me as a therapist

All that we see or seem Is but a dream within a dream -edgar allen poe

***

I have dreams about clients. From time to time tiny doppelgangers of clients roam around my head at night. It’s understandable. Because we’re working with clients all day therapist spend more time with clients than co workers, so naturally clients roam the hallways of our minds. Not to long ago I had a client, Kyla, roaming around my mind. I’d not seen Kyla for a few months. She’d discharged from the Medicaid funded treatment center where I worked and within in a week relapsed. Her dad found her in a car cradling a bottle of vodka. I had to go to a training the week she was discharged so I missed seeing her off. The week before she was discharged she and another client gave me a gift.

After I got the call from Kyla’s dad telling me what happened, I looked up Poe and the poem. Something about it haunts me.

***

I stand amid the roar on a surf-tormented shore and I hold within my hand grains of the golden sand how few, yet how they creep through my fingers to the deep. while I weep, while I weep. Oh god, can I not grasp them with a tighter clasp? oh god, can I not save one from the pitless wave is all that we see or seem but a dream within a dream?

***

After I’d heard about her cradling that bottle I was a man possessed by doubts. Maybe if I had been there working with her instead of at the training … maybe if I had requested an additional week of treatment from her insurance company…. maybe if I had known then what I know now… maybe if the Medicaid system wasn’t designed to fail…