All the Things We Never Knew (22 page)

The muted, bland colors on the couches would make anyone depressed. A couple of families sat with patients—you could tell which ones were the patients because they were dressed in cotton scrubs. One man shuffled past, disoriented and mumbling. He took tiny steps, a couple of inches at a time, as if he were recovering from a stroke.

My throat tightened. I couldn't swallow. What kind of place was this? How could someone possibly get better here? The lighting was horrible, artificial, dim. The staffers sat behind heavy shatterproof glass laced with wire. They were completely walled off from the patients. After they'd taken my purse, no one had even attempted to show me where to go, or let me see David's bedroom, or even tell him I was here. My palms were sweating.

Breathe, breathe, and breathe
, I told myself.

A young woman, who looked like she weighed about eighty-five pounds, eyed me from the corner. She was curled in a fetal position, her mouth slack-jawed when she looked my way. The scrubs hung on her emaciated body, and her feet showed bones covered by thin, dry skin. She growled as I walked past.

I looked to the other side of the room: there was David rounding the bend. He was completely shaven again and clean, cleaner than I'd seen him in months. His wrists were bandaged, but his arms were still tan from gardening. He stood across from me awkwardly, as if we were strangers meeting in an airport. He swallowed. His mouth sounded dry.

He wore blue scrubs with black slippers and a plastic tie around his waist that replaced his leather belt. “Yeah, I've always wanted to be an MD,” he said with his hands turned up, showing off the outfit.

I laughed, confused. I hadn't expected this. Could David be better already? His eyes were clear again. He wasn't shaking. It was as
if he'd come up from a long slumber and looked and felt better. His hair was combed back, and even though he was thin, he looked like he might survive.

He led me to a furniture grouping, four chairs divided by a low table. He sat, clasped his hands between his knees, and hung his head.

“How are you feeling?” I asked.

“I don't know anymore.”

“Have you seen a doctor here?”

“Not yet.” He shook his head. “Sometime tomorrow afternoon.”

I wondered what he would do until then, in this bare and dismal place. He hated to sit still; it made him antsy and nervous. He was used to handling a dozen jobs, flying around in his truck, juggling two cell phones and the demands of clients. Hospitals are always boring, but this was even more so. There were no books or magazines and no recreation room. There appeared to be
nothing
for him to do here. This place looked like
One Flew Over the Cuckoo's Nest
, only smaller.

“Is that for the kids?” I asked, noticing a table in the corner set up with crayons and coloring books.

“That's for us.” He raised his eyebrows. “They invited me to color this afternoon.”

Tears filled my eyes. I remembered my friend Claudine telling me once how she'd never asked a question David didn't know the answer to. Whether it was politics or religion or history or mathematical theory, David was a walking encyclopedia. Full of stories. Full of life.

“This won't work,” I said, unable to control my tears. “This place is horrible, David. You are not as sick as these people, David. We have got to get you out of here.” I was protecting myself again. Denial.

He grabbed my arm across the table and looked me straight in the eye. “I am these people,” he said. “This is where I belong.”

“No, no, you aren't!” I objected. “David, you are not doing a shuffle and talking to the sky. You are not so emaciated you can't think. Well, you are skinny, but you are not . . .” I broke down crying. “You are not
as sick as they are
.”

David had always been different—and I'd finally accepted that he was mentally ill, but the full impact of what that meant was now making its way into my consciousness blow by blow.

David kept his voice measured and low. “Yes, I am,” he said. “I am, Sheila.”

I rambled, desperate to reframe his story: “You do not know that, David! You just lost your dad; we're going through a really terrible time, you and me. But that doesn't mean you can't get over this. With medication and rest, you can repair yourself, David. But not here, not here.”

He sighed, suddenly looking tired again. It was as if I'd caught him at his best for a few moments, and now that person was gone, replaced by someone who needed to go back to bed. I tried to reach him the one way I knew I always could.

“Sophie misses you, David,” I said. “She misses you so much.”

“Ah, the Sophster,” he said, as if he were being reminded of an old friend. “How is she?”

“She doesn't understand, of course. But she needs you, David; she needs you home.”

“Yes.” Suddenly he stood, even though I was nowhere near finished talking. He clearly was. “Please give her my love.”

Then he shook my hand. We might have been complete strangers.

“Thanks for coming,” he said politely, and then he turned and walked into a bedroom several feet away.

I followed him. I couldn't just walk away without reaching him, without telling him that I'd help him to get better, that Sophie would, too. That we'd find a way to make him healthy and whole again. But could we?

The room was bare—there were no windows. It was the size of a prison cell. There was a bed and a chest of drawers. He lay down facing the wall.

“I'm really tired,” he said, without turning over. “Maybe you could come back another time.”

I sighed, tension building in my throat. I was the imposter in a
world he'd already accepted as his own. Did he know something about the interior of his mind that I didn't? Had he really left the world—my world, Sophie's world—so far behind?

“Okay, David,” I said, patting his arm. “Okay, I'll see you tomorrow.”

I wandered through the room back to the security area and knocked on the window. A couple of people behind the desk talked to one another. I knocked again. The dark-haired woman looked up, annoyed, and then continued her conversation with another nurse.

I knocked a third time, annoyed. Being a nurse in a psych ward had to be tough, but these two nurses were taking complacency to a whole new level.

“Are you leaving now?” she asked, looking up from her conversation.

“I'd like to talk to David's doctor first, if that's okay.”

She looked at a book below her. “David? What's his full name?” she said.

“David, David Krol.”

“How do you spell that?”

I sighed. Of course they don't know who their patients are. Of course they don't know who the patients' doctors are. This was a high-priced holding cell for people hell-bent on killing themselves. My blood pressure rose. My chest rose and fell quickly.

“How many clients do you have here tonight?” I said.

“Twelve,” she replied.

“Then would it be possible to learn their names?” I asked. “They have names, you know. They are hurting out there. And here you all are locked behind your glass cages. David has been here since nine o'clock this morning and hasn't seen a doctor? What am I paying for, anyway? Imagine him in the emergency room for nine hours without seeing a doctor!” They were underpaid and overworked, I knew. But they had stopped caring, letting the system
turn them into cogs, to the point at which they were hurting, not helping, their patients.

The woman straightened her back. “The doctor will be on tomorrow,” she snapped. “If you want to come back during business hours, you are welcome to talk to her then.”

She clicked the glass door closed. The other nurse came around with my purse.

“Visiting hours are over,” she said, coldly. I suddenly realized the fatal error I'd made. In showing how angry I was over what I realized was inept and callous care, I made the staff my enemies when I needed them most. But I was too tired to try to fix my mistake, and I walked quietly out the door, hearing it shut with a firm swing behind me.

 

INVOLUNTARY HOSPITALIZATION

When a loved one needs immediate psychiatric intervention or help, but they don't agree with that decision, caregivers may come up against the issue of involuntary commitment, also known as civil commitment. Involuntary commitment occurs when a judge decides that a person is mentally ill and mandates treatment, which can include psychiatric hospitalization. If a loved one resists outpatient care and cannot agree upon a plan for his or her safety, sometimes involuntary commitment may be necessary; David's second suicide attempt triggered an involuntary commitment.

Dr. Xavier Amador, Ph.D., has devoted his life and his practice to understanding mental illness. He has a brother with schizophrenia and knows the trauma of mental illness firsthand. Amador's book
I Am Not Sick, I Don't Need Help!
outlines techniques to prevent involuntary commitments for people with psychiatric disorders. Among those techniques is a four-step process for creating a treatment agreement that keeps the patient out of the emergency room and out of an unwanted court-ordered hospitalization:

               
1.
 
Listen.

               
2.
 
Empathize.

               
3.
 
Agree.

               
4.
 
Partner.

“Finding common ground with a person with mental illness can be very difficult. She doesn't think she needs medication or therapy. You think she does.” Amador says that common ground can exist even between the most entrenched oppositions. When faced with the frustration of trying to convince your loved one to get help, remember, “the enemy is brain dysfunction, not the person.”

Amador says there is no universal checklist you can use to tell you when you should call for help. However, there are certain circumstances that always warrant commitment. When someone
is obviously about to hurt himself or endanger someone else, the imminent danger of harm signals the need to call in outside help. In fact, this is the most common legal standard for committing someone, against his or her will, to a hospital.

Then, there are three ways to seek a commitment for a loved one: go together to an ER, call your local crisis team, or call your local police. Many police departments and psychiatric emergency rooms work in partnership to keep mentally ill people who commit minor offenses out of jail.

Chapter Sixteen

The next morning, as on so many of these recent mornings, I dropped Sophie at school and drove home in a fog. My blood sugar felt perpetually low, my body heavy with fatigue, dulled to the piles of work all around me. The dogs were hungry; at least I could feed them. I pulled the huge bag of dog food from the bin, and it felt like it was going to overwhelm my body, crush me underneath it.

I sat in front of the bin and let grief wash over me. I forced myself to crawl to the hand-woven carpet David had given me for my birthday four years earlier, and I let myself lie down.

He'd bought the rug when we were in Costa Rica, and he tromped all through the streets with that thing lugged over his shoulder. We couldn't locate a place to mail it, so he carried it everywhere, into little shops, to the beach, back to the hotel. We finally found a place to ship it home. It probably cost us more than if we'd bought it in the States. He was so headstrong in everything he did.

That reminded me of Jody, the divorce attorney. The divorce had been the last thing on my mind that week, but now I sat up and considered my list of “Crucial Things to Do.” Jody had told me to find a copy of David's company charter. I dragged myself up from the carpet and willed myself upstairs. David's office was on the top floor of the house, where the heat rose, and I stayed out of his space
as much as I could. I couldn't think straight with all his crazy piles, piles, and more piles. He never threw anything away. Sometimes, I'd find files that were fifteen years old, dated back to when he first started building.