Lost and Found (ONC2024)✅

Chapter 1

"No. It's Judah, but people call me Jude."

The session was already off to a rocky start. "Have a seat," I said, pointing to one of the armchairs. Sitting behind a desk was never my style. I always preferred face-to-face meetings with clients.

If I had to guess, I'd guess that one of Jude's parents was white and the other was of Asian descent, probably Cambodian or Laotian. Holding a clipboard, I re-examined the intake paperwork and realized he'd checked off white/non-Hispanic. He plopped down in the chair and sighed deeply. Before I asked him 'what brought you here today,' he yawned and said, "I'm soooo tired."

I suppose his exhaustion partly explained his disheveled appearance and odd behavior.

"I haven't slept in over a year. I can't take it anymore. I just really need to talk to somebody. I need to talk to you."

"Have you spoken to your primary care doctor about your insomnia?"

"Yeah, a few times. He's useless. He told me to take melatonin, then he recommended I see a psychiatrist when it didn't work. The psychiatrist prescribed medication and sent me here for therapy. I've tried all kinds of antipsychotics: risperidone, Abilify, Seroquel, Geodon, Latuda, even Haldol as a last resort. Nothing worked."

Jude offered a lot of information without me prompting or prodding, making my job much easier. It was frustrating to have sessions with clients who simply sat there, offering only one-word responses, frequently filling the room with an uncomfortable silence. They rarely wanted to be there, court-ordered or forced by family members. I chose not to see children or teens for those reasons. Working with kids and teens required a set of skills and patience I didn't possess.

"You see, I was in a car accident a little over a year ago," Jude continued. "I was in the hospital for weeks. I was in the car with my mother when a car ran through a red light. I'm lucky to be alive... or am I? I don't remember much of it. My mother was there, too, in the passenger's seat. I can't even remember where we were going. It's not fair. She only got a few cuts and bruises. I got a big gash on my head and a broken arm. See the scar." He lifted the front of his hair, showing off the faded scar across his forehead. "I kinda wish I died in the crash. Life was simpler before it."

Uh-oh... now I had to assess for suicidal ideation. Again, Jude continued speaking without me opening my mouth to assess safety.

"But I'm not suicidal. I don't want to kill myself. I just wouldn't be sad if I died in my sleep... if only I could sleep. Melatonin did nothing because I fall asleep with no problem. It's what happens to me after I'm asleep."

"What happens after you fall asleep?"

"I wake up somewhere else. This is why I need help."

As Jude spoke, I was already trying to come up with a diagnosis. Was it bipolar disorder? Schizophrenia? If all else failed, I'd use the adjustment disorder diagnosis.

"What's going through your mind as you're trying to fall asleep?" I asked.

"Before the accident, my mind was blank, but now things are different. When I go to bed, all I think about is where I'm going to end up and whether or not I'll make it back. Sometimes I load up on caffeine so I won't go to sleep, but eventually I just crash. I've been to Cambodia so many times I can speak the language."

"But don't your parents speak the language?"

Jude rolled his eyes, replying, "My mother's white. My dad's from Cambodia and I've only seen him a handful of times. He's a useless drunk."

"Okay... let's talk about your parents. It sounds like your father has an issue with alcohol."

"Yeah, he has wet brain. He's in a nursing home because he's totally lost his mind. It's alcohol dementia or something."