11/14/2009 05:12 am ET | Updated Nov 17, 2011

Best Laid Plans

That which is mind-boggling always entertains. The story I have to tell is truly mind-boggling, so stay with me, that you may get to the "Huh?" at the end.

Several weeks ago, I received a request, via e-mail, "from" Michelle Obama, to volunteer. It was a national day of volunteering, the e-mail said, so I exhorted myself: do not just leave the good deed to others, get out there and do something useful for someone. I scrolled through the list of good works to be done locally (I live in Sarasota, Florida), searching for something I was competent to do, and lo and behold, I found a low-cost health clinic in an area that is more or less our local version of Harlem. The clinic is called Genesis and serves both the community and returning veterans. Those who are poor, who have lost jobs, who have no health insurance. Some who are homeless.

Returning Vets, I thought. Now, surely, they need and deserve all the help we can give them.

I am a clinical psychologist (PhD, 1976) and a psychoanalyst (Psychoanalytic Certificate, 1982). And I was on staff, as a psychologist, for seven years at New York University Medical Center's Institute for Rehabilitation Medicine, which cares for severely physically disabled patients of every sort. And for fifteen years, I was in private practice as well. So, I have experience with both psychological and physical distress.

A tall, lean, black man named Jim runs Genesis and seemed glad to get me.

"You're a mental health counselor?" he asked.

"A clinical psychologist," I nodded.

"You licensed here?" he asked.

"Only in New York," I told him, ruefully.

"Not an issue," he reassured me, "We'll get you a Limited License; since you'll be volunteering and not charging anything, it won't be a problem. Fill out these papers," he handed me a few sheets posing questions of the name-address-telephone number sort, asking that I affirm that I have practiced for at least ten years in the United States, that I was indeed licensed and that I am retired and have no intention of charging anyone any fees.

I did as required, had the papers signed by Jim and notarized, and sent them off.

Meanwhile, assuming this license business was pro-forma, I began to work. On day one, I discovered--this was in early August--that there was a waiting list stretching out until the end of September, of people who needed to complete written intakes before they could see the one volunteer psychiatrist available to prescribe medication and/or begin some talking therapy with one of the three counselors who were, by the way, already booked up. The situation was unacceptable. Picture people in anxiety panics, people weeping, people contemplating suicide. Weeks? They had to be seen now. So I said (thinking oy, what am I getting into...) "let's get through these intakes. I'll do them."

We scheduled them one after another, day after day, any hours I could be there. People had disappeared, moved, lost phone service, but we got through a slew of those who were still available, still waiting.

When done, I informed Jim that I would give the clinic one day a week.

I have patients scheduled tomorrow.

Now comes the brain-curdling part.

Over the weekend, I received a letter from the Florida Department of Health, signed by one Robin McKenzie, Program Administrator. She thanked me for my licensure application and told me that I needed to submit further documentation, which papers she enclosed with her letter. Then, she added, "If we receive the signed affidavit, your application file will be complete." And then the astounding words, "I'm sorry to inform you that your completed application would then be presented to the Board with a recommendation to deny."

"Please let me know if you have any questions," she wrote.


I try calling Robin McKenzie, but an answering device tells me she is out of town until tomorrow. I am told to press 0 for immediate assistance. I do so and am told--also by a recording--that no one is available to answer, that I should try again at a later time.

I don't know whether to laugh or cry. Do I charge forth to work without the state's approbation or do I allow myself to be hog-tied by red tape and cancel the patients who expect to see me tomorrow?

Florida has me on hold.

And people say we don't need health care reform?