Dear Mike,

I understand that, seeing as how you are six inches taller than me and in much better physical shape, not to mention blessed with a brand-spankin'-new bachelor's degree that is eight whole years younger than mine and therefore much more aerodynamic and svelte than my poor sad old degree, which is so helplessly buried underneath three master's degrees and the better part of a doctorate, clearly you must know better than me about almost any topic on the planet.

But when it comes to the psychiatric hospital system in the state of New Hampshire, my friend, my badge trumps your cell phone. You're welcome to call as many supervisors as you want, but I am not easily intimidated and your righteous anger will not convince me that I should lock a 40-year-old mentally disabled man up in the state hospital simply because he has an ear infection and needs some rest. I understand that he is acting out and has actually thrown things and hit people, and that's upsetting and sad for everyone involved. But he's in pain, and when you have an IQ of 65 it's a bit of a challenge to announce, "Oh, by the way, I'm feeling a touch of discomfort, might someone be willing to load me up with codeine before I get frustrated and angry?" Help him manage his pain better, in his own house, with his own care providers. Don't try to force me to send him an hour away from home to be surrounded by mentally ill strangers.

And don't suggest to me that I am punishing him in any way. If the word "punitive," which you might well have learned just this morning from your word-of-the-day toilet paper, escapes your lips in my presence once more today, you may end up discovering just how effectively a clipboard can be used to hamper one's train of thought.

You may now return to your regular life, and be superior to me in every other way. But you will not win this round, son.

With deep regret,
The Mean Woman in the ER