New Year's Eve and I'm riding shotgun with a street medicine psychiatrist, ostensibly to deliver a mattress but mostly holding the Oh Shit handle while she relates, in detail, how much worse her life was as a trauma surgeon.

We barely know each other. Likes and retweets mostly, with a single in-person interaction in a homeless camp where she flew in to administer psych meds for a particularly unstable female after she'd been arrested and discharged in the space of a few hours (amazingly, even if you're clearly hallucinating, police will cuff you if you start confessing to homicide).

Like the street medicine nurse, she too was the Doctor Barbie every little girl aspired to be---blonde, french manicure, weighed a buck ten, dating a studly brain surgeon---if dolls spent a hundred hours a week in the ER, only quitting when they finally looked down at another human and thought, "I wish this dude would die so I could sleep for thirty seconds."

The car conversation went back and forth about humans vs. animals, as clients, as medical research subjects, as companions, and the general vibe I gathered was, though she clearly cared for people's well-being, animals were a thousand percent easier to love because they didn't want to fuck with her. Being a psychiatrist wasn't about making people feel better, it was about dislodging the garbage from their brains to allow them greater autonomy, but even at their best she found humanity to be a dim prospect.

At some point I went into work mode and began listening for red flags. During a comparison of Worst Places to Lose Cell Signal While Camping Alone, she flippantly used the phrase "the last few times I tried I tried to kill myself" to describe dangerous roads out west. Probably nothing. Still, she was neither a comedian nor a poet, and there's a non-zero chance she and I will come across horrors with seismic consequences, so something to file away.

It's hard to know the right answer when friends ask about street work, whether they come out of concern, oily curiosity, or the fierce hope that you'll smile with a "my job is gross, tell me about your vacation" hand wave. For me, it's mostly the second. I once had a depressed pal complain when her friends said, "Stop trauma dumping on us and get a shrink", as if therapy were a paywall to emotional expression, but sometimes it's fun to warm your hands on another woman's rage, to be the robber shining a flashlight on the murder cabin in her head.

She went on listing horrible things (I won't share them here, seeing it printed makes it worse for me). You never get used to this part of the job, even though women tell me horrible things all the time, and not just the homeless. Hotel clerks, sales girls, lawyers, scientists, the tide of small talk rolls back and you find their ships anchored to the abyss. Like Doctor Barbie, they have been served chaos all their lives and have convinced themselves that delegating order is impossible without their immediate intervention. I asked her if she'd read "House of God" (she stopped after page thirty), and encouraged her to finish it, if only to reach the bit where the young surgeon, in an effort to upstage Death, manually pumps a patient's heart long after brain death.

Later I visited a dude whose girlfriend had died. I averted my eyes, checking his dogs for ticks, and offered him a blanket. He thanked me and never brought it up again. Homeless men are so much easier at emotional distance. Like removing a bullet, the amount of effort it would take for them to open up, and the subsequent days of screaming and therapeutic drinking, is rarely worth it, especially when they're under a bridge and have so little to sustain them. Better to keep it inside.