The entire ambulance ride to the ER, I was strapped to a stretcher and had my right index finger hooked to an oximeter. The paramedic who sat next to me apologized for having to restrain me and promised that as soon as we arrived at the ER I would no longer be strapped to the stretcher. I did not say anything back but I was counting back from a thousand just so I could focus on something else other than how uncomfortable it was to have my body restrained.

"Where are you from?" he tried to make small talk, undoubtedly to put me more at ease. 

"Jakarta, Indonesia. It is a big city like New York."

999, 998, 997, 996....

"I see. No idea where that is but if it's like NY then it must be wonderful," he said while checking my oximeter. "I am from Boston. Have you ever been there? Home to the best baseball team in the world. Oh wait, you're not into sports, are you? What are you studying?" 

"I don't want to talk about it, sorry. I study something stressful." 

"Hey, no pressure, kid. We can talk about something else!"  he smiled and I lost track of what number I was at and decided to start over in my head. When I got to 993, he was pointing at a building we passed by. It was starting to get dark outside and I could scarcely make out the words on a board in front of the building--a market of some kind? 

"We're now turning toward Lorain Avenue of Cleveland, kid, and that is West End Market. A lot of good food from different cultures. Daal curry, kebab, pho, takoyaki, you name it. Maybe when you get better you can make it a priority to visit the market, how about that?" 

"Do you think the market would have stir-fried shrimp and mango?"

"Never heard of that dish. Your country's signature dish?" the paramedic shrugged. "Is your country somewhere near Thailand? You mentioned mangoes so I'm assuming it's a tropical place. Thai mangoes are one of the sweetest mangoes." 

"Yeah, well, Indonesia and Thailand are both members of the Association of South East Asian Nations, so you get the geography correct."

The paramedic grinned and I resumed my silent counting. Where was I, 980? 

I did not even make it to 800 when the ambulance stopped moving and the back door opened. Two women, who I believed were physician assistants, hopped on to unbuckle the belts that kept me secured to the stretcher and, before I could protest, put me into a wheelchair.

"I am not physically disabled, by the way. I don't need a wheelchair." I finally spoke up as the women pushed me into what I would later learn was a triage area. 

"It's just standard procedure," one of them explained and the other one disappeared behind a curtain. "Anyway, I need to draw your blood. Please unclench your first for me."

I was not even aware I had clenched my fist.

"Would a blood test reveal the severity of my anxiety?" I asked as she was feeling around for my veins and rubbing the inside of my elbow with disinfectant. "That was my diagnosis, anxiety."

"Oh, no, anxiety isn't something doctors can detect via blood test. We're sending your blood to the lab just to make sure you don't have underlying physical illnesses we need to rule out before your new psychiatrist consults you on something to replace sertraline." 

"I don't want to be drugged. Please. I just want to go back to my dormitory and pretend that I wasn't that girl who almost killed herself."

"It is not for me to decide. That's between your new psychiatrist and the Chancellor at your college. I need you to cooperate, though, or I would have to forcefully tranquilize you." 

I kept my mouth shut and watched as my blood flowed from the syringe to the vials. I could only pray that the lab technician would see that I was high on sertraline and convince the new psychiatrist that the last thing I would need was being pumped with even more drugs. 

After my blood was drawn, I had to surrender my bag for inspection. My laptop and phone were confiscated because "they are distracting when you're supposed to focus on healing at the psychiatric ward" and my spare hoodie with strings was also marked as unsafe because apparently strings could be used to choke myself to death. I chuckled internally because it was so ridiculous--the strings were so short, how on Earth would I be choking on them?

The clock on the plain white wall showed that it was already 9.25 PM and I realized I had not had dinner. Usually, Hazel Licht and I would go to the dining hall down the hill a few feet from our dorm and grab tacos or burritos from the build-your-own-Mexican corner--mine would be filled with cilantro lime rice and spicy braised scrambled tofu a la Chipotle while hers would be filled with avocados and beans. God, I wondered if my roommate had been notified of my whereabouts. Was she frantically calling my phone right now and trying to figure out why I was nowhere to be found on campus? Would she be sad as she munched on her dinner alone? 

My rumbling stomach made me rise from the unnecessary wheelchair and approach a bald man typing on his computer. He must be the clerk in charge of organizing patients' files and records.

"Is there a vending machine nearby?" I asked him. "I only have 50-cent coins, though. I would have used my debit card but my wallet is in my bag, which has been taken away."

I emptied my jeans pocket to reveal a total of $3 in coins. "Got any Hershey or Kitkat?" 

"Kid, you look famished!" the man exclaimed. "I'll get you something better from the pantry." 

Does all ER have pantries or is this a Cleveland thing? Nevertheless, I was beyond thankful. 

The man came back with a plate of ravioli swimming in thick tomato sauce. 

"It's Chef Boyardee," he gave me a thumbs up. "Not gourmet food, I'm sorry, but I tried my best doctoring the canned ravioli. It's still warm from the microwave." 

I told him beef ravioli from a can was definitely better than tiny bars of chocolate. He seemed pleased with himself and returned to his post behind the computer screen. 

Not long after I wolfed down the ravioli, a nurse in green scrubs came to inform me the care team had found me a place at a psychiatric ward in South Euclid, about half an hour away. The reason I could not be admitted to the psychiatric ward directly connected to this ER was because they were already at full volume. I would be transported via ambulance again.

Wow, I guess today was a busy day for mental health professionals.

                                                             ******

South Euclid Center for Behavioral Health reminded me of a prison complex and for all I knew I could very well be a prisoner because there were layers upon layers of security to deal with. The weighted doors the paramedic wheeled me through had bars and deadbolt locks, although some doors required passkey authentication. Maybe the one with deadbolt locks led to units with patients who were deemed less likely to escape? 

"I'm leaving you now, but I'm wishing you the best in your recovery!" the paramedic said as we entered a spacious room full of long tables--the kind you would see in a school cafeteria. 

"Wait! Can't you stay for a minute more? I'm scared. What can I expect next?"

"Nothing to be scared of, I promise. In my experience, patients with anxiety disorder are given more freedom here than, say, patients with borderline personality disorder diagnosis. I gotta go now, but you really have nothing to worry about." 

The paramedic made his exit and a woman in her early forties emerged from what I would assume was a storage room where medical supplies like gauze and bandages were kept. 

"Ms. Rinjani Pratiwi? We've been expecting you. I'm Sarah Harrington, the head nurse. I would like to show you to your bedroom, but first, you need to fill out an intake form." 

The form was only two pages long, so I filled it out pretty quickly. The first page asked for stuff like birth date and year, blood type, address (I put down the address of my academic advisor's office), and phone number of trusted friends or guardians (I would have put down Hazel's number but I didn't have it memorized so I left it blank). The second page asked for my favorite foods and any dietary restrictions. Okay, my favorite foods other than shrimp and mangoes: fried rice with pineapples and grilled boneless chicken with honey soy sauce. Dietary restriction: none but would rather not drink milk--please leave milk for baby cows.

Sarah read over the intake form and laughed when she saw the part about baby cows.

"You have a sense of humor, eh, Ms. Rin? But I get it. We would make sure to substitute milk with fruit juice at breakfast. As for your favorite foods, we regret that we can't accommodate you but we do have pizza with ham on weekends--I could try to get you canned pineapples." 

"Hawaiian pizza. Thanks for not judging, Sarah. Usually, people hate pineapples on pizza." 

"Hey, if I were judgy then I wouldn't be working in a psychiatric ward!" she winked. "Let's get you to your bedroom. You're sharing it with three other female patients of varying ages. They are sleeping right now--it is way past light out--but you should introduce yourself in the morning." 

                                                                  ****

Day 1 of institutionalization

Sarah rang a bell around 7.45 AM to signal that it was time to wake up and wash up. There was a sink in the bedroom that all the room occupants had to take turns using. Sarah gave me a toothbrush and toothpaste along with a towel. I was about to ask for a change of clothes but it seemed she already anticipated all of my needs. 

"There's a laundry room at the end of the hallway, next to the communal shower. You can wash your clothes after breakfast. For now, you can wear this. It's a bit too big for you but we run out of the XS size." She handed me a set of striped white and pink pajamas. It wasn't the prettiest but it would have to do. I went to a bathroom stall (with Sarah guarding the door to make sure I wasn't doing anything dangerous like trying to eat a soap bar--apparently a few years back a psychotic patient chewed a lemon-scented soap bar because she thought it was cheese) and did my business. I disliked the lack of privacy but, I mean, this was a psychiatric unit.

Rocking my new pajamas, I sat down among other patients to wait for breakfast. 

"You're Rin, aren't you? Sarah told everyone to welcome you warmly." A girl who seemed to be no older than twenty-one patted me on the shoulder. She had beautiful green eyes and wavy blonde hair. "My name's Lindsay. I've been here for about three months. I was diagnosed with manic depressive disorder, so just a heads up don't be alarmed if I cry out of the blue for days and then laugh uncontrollably for the next few days and the cycle repeats." 

"Yeah, sure, crying isn't the worst thing to do here!" I assured her that I would be the last person to pass judgment. "If you can't even cry in a psychiatric unit, then where else would you cry?"

"I like you already," Lindsay giggled. "This is Kendall," she pointed to a girl next to her who had buzzcut hair and appeared to be fifteen or sixteen. "Kendall, say hi to Rin." 

"Hi," she waved shyly. "You seem nice." 

"Kendall has been here for two weeks and a half," Lindsay spoke on behalf of the shy girl. "She was admitted for PTSD and grief counseling. Her older sister passed away in a train accident." 

"My condolences." 

"I'll be okay," Kendall replied softly. "I see my sister in my dreams sometimes. I miss her but the care team here has been working with me to make sure I know how to continue living." 

"Enough chattering, ladies!" Sarah hushed us as she helped a woman whose hair was tied into a bun under a hairnet push a trolley full of food trays covered in cling wrap. 

The trays consisted of toasted white bread, butter, grape jam, a fruit salad comprised of apples and cut-up oranges and raisins, and a vanilla almond granola bar. Wow, sugar overload! 

"I hate white bread!" a tan-skinned curly-haired petite girl whose name I didn't know yet complained. I estimated her age to be anywhere from twelve to fourteen years old. "I want cereals. Why can't we have Cheerios and Frosted Flakes every morning?" 

"Because the menu is in rotation, Sashmita!" Lindsay rolled her eyes. "But you know what, if you don't want your white bread then I'll take it. You can have my granola bar." 

"I love you, Lindsay!" Sashmita squealed. 

I couldn't help wondering what someone as adorable as Sashmita was diagnosed with. Maybe ARFID? I learned about that condition from one of my classes last quarter, A Guide to Writing About Neurodivergence. ARFID made it so that someone would struggle with food of certain textures, smells, temperatures, or tastes. Sashmita being here might indicate that her condition was severe enough that she needed to be taught how to expose herself to more varied foods. 

Around 8.45 PM, Sarah marshaled us into a room with half-peach and half-beige walls. There were bookshelves, puzzle pieces,  crayons, origami paper, colored pencils, and teddy bears. 

"As always, do whatever you like until you're called for a session with your psychiatrist," Sarah gestured broadly to the items scattered throughout the room. "If you need me, just find me at the nurse station. Sashmita, I have pretzels if you're still hungry, so get them whenever." 

Once Sarah was out of the room, Sashmita stared at me with her huge brown eyes. 

"What?" I tilted my chin as a way to say hello. 

"You and I are the only non-white girls in our bedroom." 

"Yeah, so?" 

"Are you the child of an immigrant like me? Then we would get along splendidly!" her huge eyes seemed to grow bigger. "I am Afghan-American. My parents are from Afghanistan."

"I see. I'm not an immigrant's child but you're correct that I'm a foreigner here in America." 

"Does your name have a meaning? Rinjani. I like how it sounds." 

"It's the name of a mountain on the island of Java. My mother chose it because she hoped I would grow up strong, just like how a mountain is unmovable no matter how the wind howls." 

"Mulan reference!" Sashmita clapped her hands. "The emperor of China said to Shan Yu that he would not bow down to enemies because he has to be like a mountain in the face of big winds."

"Mulan was released in 1998. I was born in 1995, so no, my mom couldn't have gotten the inspiration from Mulan but yes, I remember the emperor of China versus Shan Yu dialogue."

"Sarah let us watch Disney movies each weekend. Mulan is the best!" Sashmita jumped up and down with giddiness. "But I also like Beauty and the Beast! You like Disney, Rin?" 

"Sure, but I prefer the non-princess movies. I like Wreck-It Ralph the most." 

"The one in which the characters live inside arcade games, right?"

"You got it. Anyway, mind if I sketch you?" I pointed to the colored pencils and a stack of paper.

"Ooh! Are you an art major? I heard you were a student at Anne Kitrinos College." 

"Not an art major, just someone who likes drawing and sketching." I started an outline of Sashmita's nose and lips. "Want me to draw you in Mulan's green armor?" 

"Yes! And do you think you can draw Lindsay in Captain Shang's outfit?" 

"I have to ask for her permission, no?" I started calling out to Lindsay but Sashmita put a finger on my lips. I raised an eyebrow and she bit her lips nervously.

"I want this to be a surprise," Sashmita whispered. "Lindsay acts like she's too old to enjoy Disney movies but I know she really likes that scene of Shang singing Be A Man." 

 I was about to start drawing Lindsay as a muscular leader of the saddest bunch of soldiers when Sarah beckoned me over from the doorframe to say it was my turn to see my newly assigned psychiatrist. Sashmita folded my unfinished drawing and hid it behind one of the bookshelves. I guessed we would pick up where we left off tomorrow. 

                                                                              ****

My new psychiatrist was an Italian man in his early sixties named Dr. Geoffrey Porcelli and he started our session by asking me why I was prescribed sertraline by Dr. Fisthammer if my challenges were mostly academic. I told him that academic challenges were just the tip of the iceberg--what Yunus did in the political science seminar indeed was triggering my insecurities, but he was not the whole story. I also struggled to adjust to life in a rural college town after living my whole life in an urban setting and I was under immense stress of finding a summer internship. My visa status allowed me to work off-campus during the summer, but only if my job had a direct correlation with my field of study. Since I was a political science major, most of the opportunities would be in Washington D.C. but I would be lying if I said getting an internship in the Capitol would not involve a cut-throat selection process in which I had to compete with thousands of many other equally eligible international students from around the globe. 

"Isn't the summer internship optional instead of an obligation?" Dr. Porcelli probed after listening to my venting. "Or at least that was the policy when I first came here from Italy."

"It still is optional, but my parents wanted me to do everything possible to get my career on track and a summer internship in the Capitol would put me ahead of the curve." 

"In one of the busiest centers of governance in the world? Isn't that extremely ambitious?" his eyebrows were knitted together. "That's highly competitive even for U.S. citizens." 

"Yeah, but isn't having ambition good? Otherwise, our lives would be purposeless." 

"Ms. Rin, there's a difference between having a sense of direction and setting yourself up against impossibly high expectations. You need to learn that. Your parents need to learn that." 

"Dr. Porcelli, you don't understand. My coming to study overseas means that I willingly subject myself to my family's high expectations. The United States has one of the best universities in the world, so why not make the best of the privileges I have and aim for the sky? Actually, the sky is not even the limit. Aim for the seventh heaven and then when we get there we'll aim even higher! If I am not aiming high, then sending me abroad is useless and Indonesia should be ashamed of me."

"Oh, I see what the root of your problem is," Dr. Porcelli started smiling. "You've been seeing yourself as an ambassador and representative of your country. You're afraid that if you fail to be great then it is like you're presenting your country poorly and bringing disgrace."

"Exactly. I need to show Ohioans, Midwesterns, and Americans in general that Indonesians are deserving of admiration for our work ethics, tenacious attitude, diligence, and ambitiousness."

"You're talking as if you were a diplomat on an important mission, Ms. Rin, but you do know that it's unfair to ask someone who just barely turned 19 to be the face of an entire nation, right?"

"If Mulan can have this fear of bringing dishonor to China, then why can't I have the fear of dishonoring Indonesia? We are the same deep down. We love our respective countries. We want our families and our countrymen to be proud of us. We want to uplift them." 

"But Mulan had to pay a high cost to accomplish that, didn't she?" Dr. Porcelli argued. "She had to hide her true gender identity while in the training camp and battlefields. And you, what do you ultimately have to sacrifice? Is a sense of accomplishment worth ruining your mental health for? Sacrificing your mental health for your country isn't heroic, it's foolish."

"What do you know about making sacrifices?" I snapped. "You've never been in my shoes!"

"I have. But I think you're not ready for deeper conversations, Ms. Rin, so let's end our session here for now and continue after lunch or once you have your afternoon nap. In the meantime, I am prescribing you citalopram."

"What are the side effects of citalopram?" I narrowed my eyes.

"Mostly headaches, stomachaches, and nausea."

"Well, as long as it won't take me to a dark place like Sertraline did then it's cool." 

"Good to hear, Ms. Rin, thanks for your cooperation. By the way, Nurse Sarah wanted me to relay a message to you. Your college had notified your parents already that you are being observed in this psychiatric facility. Your mom is booking a flight to see you and should be here in 36 to 48 hours. She has also requested to talk to me, with you present of course, about whether you should drop out of Anne Kitrinos College until you are one hundred percent healed." 

"N-No, no, no. I don't want my mom to see me like this. I don't want to have to face her and admit I've failed to be a good student. N-no, N-no, N-no. Get me out of here!" 

"I can't get you out of here until you show considerable improvement, Ms. Rin." 

"You don't understand. My mom would disown me. Get me out of here. Please. Please. Please!"

"Ms. Rin, your mom isn't disowning you. She just wants to take you home where you can continue to heal in the comfort of a familiar setting and build back the strength you need to one day return to university in a better shape. No need to panic." 

"I should have proceeded with my plan. I shouldn't have come to the Health Center. I should have swallowed all of the sertraline pills. Now it's too late."

"No, Ms. Rin," Dr. Porcelli gently stroked my back as I kept on sobbing hysterically. "You staying alive and not dying of overdose means you have a second chance to live a meaningful life."

"My life was already ruined when the college notified my parents of my admission to this facility. Whatever happens to respecting students' autonomy as adults and honoring their needs to keep some things private? My life is ruined, so get me out of here! I shall live on the streets!" 

"You don't want to live on the streets. It's such a rough way to live, trust me." 

"I don't care! It's gotta be a hundred times better than facing my mom's wrath! Let me go." 

"I promise you mom isn't mad at you and is just--" 

"LET ME GO!" I flailed my arms and squirmed in an attempt to escape Dr. Porcelli's tight hold on me. When it became evident that I was losing the fight, I dug my teeth hard into his hands. He screamed for the nurses to bring reinforcement. 

"Ms. Rin, biting isn't tolerated here. I thought you were old enough to know your manner!" Sarah pulled me from Dr. Porcelli with the help of her co-nurses. "If you don't release your bite, I'd have no choice but to bring you to an isolation room until you behave." 

By now I should have learned my lesson about doing something out of spite, but the rebellious side of me won over my milder and meeker side. I bit Sarah as if to say "You're bluffing."

A stinging sensation pricked my neck and I was overwhelmed with drowsiness. 

"Sorry," Dr. Porcelli's voice sounded so far away, "but you're practically asking to be sedated."