Lessons learned – Episode 1

This is the practical part of this blog - perhaps the only part you are really interested in.  Maybe you are wondering: what did you learn from your experience that will be useful to others? Or, Holy Moly I am freaking out and sailing without a rudder can you please share something that might help me?

Ok, fair enough. So here are some take-aways from the first episode, in no particular order:

1.     If a person you love is acting bizarre and is just not himself/herself (you will know this in your gut) then you need to get them a medical evaluation and most likely on one or more medications. Ideally, they will agree with you and go along willingly to a Psychiatric Hospital. However, depending on how far gone they are, they may be highly resistant to the idea. Psych hospitals can only do voluntary admissions (i.e. the person gets on the phone and says that they agree to come in). Alternatively, a Psych Hospital can do an involuntary admission with a 72-hour hold if the patient has been referred from the ER. So your best bet, if you are dealing with somebody who is completely uncooperative, is get them to the ER and then the “process” will take over. It’s unpleasant, and may involve your loved one traveling to the Psychiatric Hospital handcuffed to a gurney in the ambulance, but sometimes for their own safety you have go through this. 

2.     Do not take as final any opinion that is rendered on the spot by an ER medical doctor. They are not trained in diagnosing psychiatric conditions, and sometimes a definitive diagnosis takes many days of observation. 

3.     You will be your loved one’s advocate at the hospital. No difference here between a psychiatric hospital and a medical hospital. Staff are busy and looking at the big picture. You are focused on the well being of one person. Be pleasant, make friends with the staff, find out what is allowed and what is not, ask questions and if you don’t like the answer, research it. 

4.     Expect that they will have a stay of about 2 weeks (on average) as inpatient at the hospital. You will be able to bring them things that will make their stay more pleasant. Like a brand new pillow, favorite clothes or certain snacks. Everything you bring will be searched by the staff before it will be brought to your loved one. If you are bringing sweatpants or a hoodie, you will have to remove the drawstrings. This is not only for their safety, but for the safety of all the patients on the ward. 

5.     There is much to be said about the selection of the hospital. Based on our experience, I would suggest pretty much any of them other than the adult male ward at New York Presbyterian in White Plains. The Haven at NY Presbyterian was wonderful and I would definitely recommend it, however it comes with a really big price tag, which most people can’t afford. I know we can’t.  Plan on about $1K per day as your out-of-pocket expense (i.e. the portion that your insurance will not cover).  I will say more about our experience at other hospitals in later sections. 

6. Before your loved one is discharged from the hospital, make sure there is a plan in place for next steps. There should be a referral to a psychiatrist and a first appointment already made. Understand that they will be fragile and should not plan on resuming "life as normal" immediately upon discharge. 

A Deep Abyss (chapter 4)

Tuesday, August 10th  2010 - Noon 

My sister K. is with us as we pull into the parking lot of NY Presbyterian. It’s visiting hours. We have had no communication with the hospital since we were there last night to find Scott out cold. Parking proves challenging and because I am anxious to go inside to see Scott, my husband drops me off by the door while he goes with K to find a parking spot. Arriving breathlessly on the ward, I see that Scott’s room is empty. The hall is once again filled with men wandering around and there is a cluster of men in front of the nurse’s window, waiting to check out personal items for use during their free time. I don’t notice any other visitors but I am very focused on finding Scott. I see the nice nurse we spoke with last night. 

Where is Scott, I ask her. She is looking very harried and I am not surprised given the number of patients milling around. She gives me a sad look. He is acting a lot more psychotic today she tells me. My heart feels like it stops momentarily, and I get what will become a familiar sensation over the course of the next few weeks; I feel as if something cold and icy is dumped into my veins. But I remain outwardly calm – or at least I don’t collapse on the floor in fear or start screaming - and ask her what he has been doing. I don’t recall exactly what she said, but I think it had to do with punching walls and shouting threats, probably trying to leave again. He refused to take his medication. He may have been acting out sexually. She tells me he is in the “quiet room”, but I can see him if I want.

What follows next is what I have come to think of as my moment on the edge of the abyss. I feel that I looked down into a deep darkness and saw only pain. I walked the short distance down the hall to a room with a man standing guard by the door. The door is open and there is a blue plastic mat on the floor. The walls are covered with similar material, with padding under the plastic. There is nothing else in the room. Scott sat on the floor, on the mat, his back against the wall with his legs straight out in front of him. He did not hear me walk in. His tongue is swollen and sticking straight out of his mouth. He has a steeliness to him, which I can not tell if it is resolve or anger. He leans over and spit saliva on the floor, still without noticing me. 

I put down my purse and slip out of my black clogs preparing to sit on the floor with him. 

“Hi sweetheart”, I say to him. 

At the sound of my voice, he turns to look up me with a look of complete despair and suddenly collapses into sobbing. The sobs wrack his entire body and he lies down on his side. It is a terrible mixture of the mania, fear at having been left there, relief at seeing me, and medication. I lay down on the floor with him and hold him while he sobs. When his sobbing begins to subside I speak to him softy and gently, as one would speak to a small child. I tell him that he should take his medication so we can get out of this room. Then I say conversationally that I don’t really like this room and we should leave it. He nods his agreement. He doesn’t like this room. He is obviously addled, and is having a hard time speaking because of his tongue sticking out of his mouth, but he repeats after me: take medication, stay out of room. I smile encouragingly at him and stand up, giving him my hand to help him stand.

All this time we have been observed, first by the guard standing at the door, presumably through the camera mounted on the ceiling, and eventually by the nurse who comes over after I have cajoled Scott into agreeing to take his medication. The medication is produced in a small paper cup, along with some water. He mechanically swallows the pills and I say something inane about that not being so hard. 

Inside, my heart is shattering over and over and over again. An abyss has opened up. Peering over the edge into the darkness of the abyss I see a future of rooms with padded walls. I see a future with my beautiful son who is addled and needs to be spoken to like a child – jollied into doing what is required by the institution. 

At some point, my husband and sister have arrived. I am not sure exactly when. It must have been shortly after Scott took his pills and they agreed to let him leave the quiet room. Once he is back in his room, the blackness of the abyss recedes and a burning anger rushes in to take its place. I want to know what they have given him to make his tongue swell like that. I want to know what they did to try to keep him calm when he was upset at finding himself alone and locked on a ward with a bunch of older, clearly troubled men. Most look like they must be here on Medicaid and many look like they may have been discharged from a prison (which we later discovered was true).  I ask to speak with Scott’s doctor. We are told that we will get an appointment to meet with her before the end of the week. What?! 

Now, the squeaky wheel philosophy kicks in big time, and the three of us make a fuss, taking turns who makes it and whom we make it to. I am a little fuzzy on the details but as I recall it was not too long before we got a visibly angry doctor to sit down with us in a small room on the ward that has a door and some chairs. There was a social worker involved too, clearly she must have been assigned to our case, and she must have been the person we were put in touch with when we started asking to see his doctor. When we find out that the ‘audience’ is going to happen and are directed to the room, I ask if we can wait one minute while I run down the hall to get my sister who traveled here to provide help and support. This request is also met with disapproval but I leave anyway. I dash to get her, and find her in Scott’s room. He is sleeping again, laying on the twin bed and he has his head on her lap. She is stroking his hair gently and I see the tears in her eyes. I tell her of the meeting and she slips out from under Scott.

The doctor is female and Asian. My memory of her is that she was in her thirties and she was well put together; slim, well-dressed under her white jacket, polished. She is not pleased that we put our foot down about getting a chance to speak with her. That’s ok, because we are pretty angry too. K is to be the voice of reason during the meeting. She has a yellow pad to take notes, and manages to keep the anger out of her voice, even though I know she is as upset as we are. I ask about the medication and the allergic reaction. The doctor states that it is a drug that is commonly used, with very few side effects. She also says “they are very good at imitating others,” suggesting that he could faking his swollen tongue. Her antipathy for the patients is palpable. I am shocked at her suggestion, as if Scott could really manage to fake a swollen tongue, but everything that has happened since I walked through the door of the ward today has left me feeling like I am Alice tumbling in free fall through the looking glass and down the rabbit hole. Almost reluctantly, the doctor agrees to administer the antidote to combat the allergic reaction to the drug - as if it were not actually necessary. When we push on wanting to understand how things could have deteriorated so badly in such a short amount of time, she pushes back detailing his psychotic behavior. This is cruel, because we are his parents and the information is painful. The way she tells us of these things is to throw it in our faces. 

Scott shows up at the door and peers in through the window portion of the door. He looks anxious that we are having this big pow-wow with the doctor and social worker but have not included him. I get up to let him in, and the doctor is alarmed. She clearly does not feel safe with the patients. She requires a guard to be in the room with us, if Scott is to be there. Of course he needs to be there if he wants to be, we point out. The room is small and is crowded: the three of us, Scott, the doctor, the social worker, and now the guard. The conversation is not going well. We want to get him off that ward and out of that hospital. We want a diagnosis. We want to understand how they could have lost control of the situation so quickly as to need to put him in a quiet room.  Scott is confused and when he starts to mutter and mumble that “it could not have been all due to coincidences”, the doctor gets up and says, “we are done here” as she walks out of the room.

I recall saying to my sister as we were walking down the hallway after the meeting: “let’s get him OUT of HERE”. The anger is a respite, because it feels more comfortable than the terror.  Back in his room again, Scott is lying on his bed and I am rubbing his back to keep him calm. Or maybe it is to keep me calm. The antidote is working and the swelling in his tongue is almost all gone. This allows him normal mouth movements, including speech and swallowing.  He is very sleepy though and has drifted off.

While I sit with Scott, my sister and husband go off to make phone calls and discover our options. Four Winds Hospital might be an option, but they do not have a bed at the moment. They might have one tomorrow, and he would have to be transported by ambulance. They have another ward in NY Presbyterian, called The Haven, and they have a bed. This sounds promising, and K digs deeper to see if this option can happen this evening. 

We learn that The Haven is for men and women of all ages. They currently have a few patients (actually I think they refer to them as “clients”) close to Scott in age. It is not very crowded and they have a terrific ratio of staff to clients. Of course, there is a catch. There is an “amenity fee” of $700 a day, which is not covered by insurance. Thus between our co-payment for the daily fee plus the amenity fee, we would be out of pocket around $1,000 a day. They told us to expect a  minimum hospitalization of at least 2 weeks. We don’t have $14,000 sitting around. I point this out to my husband. He replies softly in a strangled voice that he would sell his arm or his kidney if it would help Scott. I quietly agree. 

At some point, through the magic of K pushing on our social worker and making phone calls, it is officially decided that Scott will be transferred to the Haven. A mental health worker shows up at the door of his room with a wheelchair. I am worried about how this transfer will take place. To say that Scott  has been behaving erratically would be an understatement. What if he gets up and makes a run for it while we walk between the buildings. I express this concern to the attendant, and he replies that “if he has to put his hands on Scott than he has lost the battle”. I try to put this in context of finding Scott in the “quiet room”. I also wonder what this has to do with him jumping up and running away, but it turns out that the walk over to The Haven takes place inside, through a series of connected hallways and elevators. Scott sits quietly in the wheelchair, his head lolling forward onto his chest. 

As they open the door for us to The Haven, a completely different energy greets us. Instead of men milling about in a mildly suppressed chaos with an institutional feel and a taste of despair, we walk onto a floor that is carpeted and quiet. There are sofas in the hallway, and the doors open onto to large rooms that have every appearance of belonging in a nice hotel rather than a psychiatric ward. Fluffy towels are stacked on the desk, waiting for the new occupant. His spacious room has a television, beautiful high ceilings, a private bath, three large curtained windows looking out onto the grounds, and upholstered chairs for visitors. 

Scott had completely collapsed into sobbing in the wheelchair as we waited for the paperwork and the nurse on duty at The Haven. I recall leaning over, wrapping him my arms around him and just holding him, not bothering to say goodbye to the attendant who had wheeled him over from the men’s ward. I am not sure why I was angry with him but maybe I was just angry with everyone associated with the previous ward. 

To our beleaguered psyches, that have withstood punch after punch since we lost track of Scott after he left for West Point on Sunday morning, The Haven feels like Heaven. Because it is late and he has missed dinner, they bring him the ‘special of the day’ on a tray. They apologize that he was not able to select his meal from the menu, but assure us that he will be able to for tomorrow’s meals. A menu? We practically chuckle in glee. The meal includes dessert, a Boston cream pie, and as we all sample it we agree that it is delicious. We have tucked Scott into bed - he is completely wiped out, but it feels safe and good to have him here. I am so relieved to have him out of that other ward and away from that doctor, whom we have taken to referring to as ‘the witch’, I feel almost giddy. 

Scott is dozing and I stay with him while K and my husband C. sit out on the sofas in the hallway, catching the duty nurse up on what has transpired so far. At some point I go over to them to ask about medication and inquire about “quiet” rooms. I tell the nurse with significant urgency that if Scott wont take his medication to just call me. I am practically begging. I think I am actually on my knees while talking to her since she is in a chair and C and K are in the sofa next to her. I assure her he will take them if I am there and I really want to avoid having him confined to the quiet room again. I find out that The Haven does not have a quiet room, that they don’t have to resort to such measures. She seems very competent and gives us a feeling of confidence. She calmly explains to me that she wants Scott to take his medication from whichever nurse is on duty, but she promises she will call me if there is a problem.

The rest of the visiting hours are passed quietly - Scott resting in bed, the three of us sitting in his room, talking softly. The Haven has an open dining area with snacks available at all times as well as drinks in a fridge and I believe we snacked and drank, since I don’t think any of us had actually eaten anything all day. Scott appears to be sleeping, but he comments occasionally on our chatter, and soon is awake enough to be sitting up. When we gather up our things to leave and I kiss his forehead goodnight, he is sitting comfortably in bed watching TV. A mental health worker is seated in a chair outside his room and, as per protocol, Scott will be watched 24 hours a day until they are sure he is safe. But the man seems kind and his presence is reassuring rather than intrusive. We exchange quiet pleasantries with him. As we leave for the night, it feels like Scott is in good hands and a safe place.

(continue reading) 

 

The Psychiatric Hospital (chapter 2)

Monday, August 9th 2010 - 9:00 am

We have decided to take Scott to New York Presbyterian Hospital. They participate in our insurance plan, are in White Plains which is only a 45-minute drive from our house, and these things seem like important considerations at the time. 

Returning home from the ER the night before around midnight we are dazed and tired, and decide it is best if we set Scott up to sleep on the sofa in our office. In this way, he would have to walk through our bedroom to leave. We want to make sure he does not drive away, and also we could not deal with getting rid of all the knives and sharp tools in the kitchen. 

Lying down to try to sleep, I face what feels like the worst night of my life. In the morning we will be taking our beautiful child - our handsome, smart, loving, funny, varsity-athlete, straight-A student – to the psychiatric ward. He is no longer the Scott we know and love. He is a manic, volatile, unrecognizable person from whom we have been told to protect ourselves and whom cannot be trusted not to hurt himself.  The pain is so acute and so vast that I cannot find the edges to grasp on to. It hurts to breathe and it hurts to be conscious. 

Amazingly, I eventually sleep. I know this because in the morning, Scott is no longer on the sofa in the den. In his mania, he slept almost not at all, and at some point went to his room. Fortunately he did not try to leave. He agrees to go to the hospital with us. With treat him with kid gloves because his reactions and responses are so alien that we are not quite sure whom we are dealing with, or what to expect. Apparently he is still under the impression that he is going to the hospital so that he can hook-up with a nurse. In his imaginary world where we are all actors to bring about what he desires - he feels he is playing a part, where we all pretend that he needs to go to the hospital because he is not well, but in reality, it is part of an elaborate scheme so he can get laid by a nurse.

We have called, and NY Presbyterian is expecting us. We were given instructions on how to find Admitting.  Still, it has not occurred to us to pack any clothes or toiletries for Scott. Like automatons, we get numbly in the car with him. We try to keep our voices calm and neutral. The hospital will be nice. I think they have beautiful grounds. They may even have a swimming pool … 

He does not notice, but we do, that the doors lock once you walk into Admitting. The process is very long and tedious. He is seen by many people, examined, interviewed both with us and without us. A woman has him fill in the paperwork for a voluntary admission.  She instructs him to write on the form: “I need help” and he complies. 

A doctor eventually shows up. We have been there for several hours already. He comes through one of the locked doors wearing a suit and is brusque, seemingly irritated to have to be interviewing Scott. His pager goes off several times during the short time we are in the room with him and each time he consults it. We feel like an afterthought. Our world is crumbling around us, and he can barely take the time to make eye contact with us. I am silently hoping that this man will not be Scott’s doctor once he is admitted. Scott asks if there is a swimming pool. The doctor is dismissive and tells him curtly that he has bigger things to worry about than the pool. He does not look up as he says this, but continues writing something on yet another form. A little empathy, compassion or even patience would have gone a long way that morning. But we are not to find any from the staff here. 

Sometime later a person comes to escort us to the ward. Since Scott is 18, he will be placed on the adult males’ ward. We are buzzed through various doors and eventually enter the ward. Linoleum floors, fluorescent lights, white plastic chairs, and a TV that is on at the end of the hallway greet us. Doors open to small rooms with twin beds. Some rooms have two occupants and I am happy to see that Scott has been assigned a room that is a single. The men seem to be passing the time by hanging out and walking back and forth in the corridor. They are all much older than our son. Most of them seem to have had hard lives and are not in a good place. Some have headphones, others are talking to themselves. Clearly this is a psych ward and the people are not here because they are doing well but still I am taken aback. So many men, some in hospital pajamas, some in sweats, shuffling up and down the hallway. Scott  will be under continuous observation initially, which is standard, since he is still deemed a risk. 

At this point we realize that he has no clothes or any personal items, so we decide to drive back to the house to gather these things. It’s not that we really thought he was not going to be admitted after he was examined at the hospital, it’s just that we were incapable of thinking further than what was necessary to put one foot in front of the other.  Our doctor had gently told us this morning on the phone that we needed to tell the hospital that we were looking for an evaluation and an admission. Yet in our automaton state we were operating mechanically and not really thinking about anything.

(continue reading) 

In the beginning ... the cataclysm (chapter 1)

August 8, 2010 – 11:00 a.m.

The handsome young man visible on the screen in the control room of the Military Police’s headquarters at West Point appears quite normal at first glance, but there is something very wrong with his grin and his posture given the circumstances. 

With his feet on the table and his chair rocking backwards, one has to look more closely to notice the handcuffs, the smirk or the occasional chuckle at some inside joke that only he is aware of. 

The Sergeant Major, an impressive man of imposing size and height, glances at the screen and turns away angrily, not realizing that my world is crumbling as I take in my son, aged 19, who is so far gone and out of character that he is clearly suffering from what I think of as a “nervous breakdown”. 

I had listened patiently, if fearfully, to the description of what had landed Scott here in handcuffs. I wanted desperately to just limit the repercussions, get him ‘off the hook’ and take him home. Then we could deal with whatever was going on with him. 

“Here’s one thing you should know,” the Sergeant Major had told us forcefully when he came out to speak with us in the lobby upon our arrival. “Your son was almost killed today. My men broke with protocol when they did not press the button that brings up the barrier capable of stopping a speeding truck. The barrier comes up in an instant and he would have crashed into it at 70 miles per hour: being killed on the spot.” Unlike the other officers who are in uniform, the sergeant major is dressed in sweats and had apparently been called in from the gym on his morning off upon being informed of the incident.

We make understanding, sympathetic noises. Thank goodness they used their common sense … I don’t know what has gotten into him … this is not like him at all … he hasn’t been himself recently. Our murmured reassurances continue, but we just want him to let us get to Scott; to take us back to where he is being held and to get him sprung with the least amount of damages possible. 

We simply have no idea that we have stepped through the looking glass and are entering a world so foreign and terrifying to us that we will be completely unprepared to deal with it.  

As my husband speaks reassuringly with the Sergeant Major and the others at MP Headquarters, I alternatively listen to their conversation, glance over at the holding room where they have Scott locked up, and walk outside to wipe away my tears. We are waiting for the New York State police to arrive, who will take custody of Scott. My older son is here too and he has been texting with a dear friend, who is also a wise attorney, to whom we had turned when we first found out the reason Scott had not returned from picking up a friend at West Point. ‘Admit to nothing he counsels’. Good advice. But there is nothing for us to admit to. We know nothing, and understand even less.

                                          ________

It will be months before Scott will be well enough to share with us what he thought was happening that day: a training exercise for the CIA. Driving the 15 minutes from our house to West Point, literally at 100 miles per hour, he believed he was part of some type of operation. Since he thought that all the other cars on the road were part of the training exercise and employed by the CIA, he knew that they would watch out for him and were timing his speed. Approaching the control point at the gated entry to West Point, rather than taking the path that requires cars to stop and hand over ID cards while the car’s trunk and underside are inspected for bombs, Scott took the lane that was open and is reserved for Army security personnel. He floored it and my BMW, which he had taken when he asked if he could give a friend at West Point a ride over to our house, responded accordingly. As he blew by the entry checkpoint, the MPs hit the alarm and quickly scrambled to pursue. When he pulled up in front of his friend’s house, the cars that had been in pursuit stopped as well, and his friend opened the door to find Scott being placed into handcuffs and under arrest. All part and parcel of the exercise he thought …

Same day – 7:00 p.m.
 

We are in the Emergency Room of the local hospital. It is Sunday and there are only a few other patients, but I hardly notice them. It is hard to ignore the man on the other side of the curtain from us, who appears to be a drunk and is quarreling very loudly with a family member over what has landed him here tonight, but my awareness of him fades in and out. My heart is beating so rapidly that my breath is shallow and a sharp pain somewhere in my chest seems to be causing my vision to malfunction. 

“Yes, he is hearing voices. Looks like schizophrenia.” The ER doctor tells us matter-of-factually. Scott has been taken for a cat scan of the brain and the doctor has stepped into our curtained hell after speaking with Scott privately, to share his medical conclusion with us. He walks back out. 

My husband and I are left staring at each other, at a loss for words, trying to grasp what we have just been told. I type schizophrenia into Google on my phone – but at first I can’t spell it. Google helps me and I scan the results, looking for something that will tell me he can have a normal life, even as a schizophrenic. What I find is less than reassuring. We wait for Scott to be returned and when he is, we try to act calm and normal. 

By the time the New York State police officer had arrived at MP Headquarters, we had had enough time with the Sergeant Major for him to understand that this was not a case of a kid acting like a punk. Scott was not drunk and was not on drugs. He had seen the doctor two days ago and clearly needed to be seen again. We promised him we would be in touch with our doctor as soon as we got Scott home. We shared the fact that we believed he had been abusing 5-hour energy drinks for many days. “Legal crack” is how the sergeant major referred to the drinks. Of course we also thought that he had been taking psychedelic drugs, but this we did not share. His behavior was too odd to explain otherwise.

We had needed to rush home two days ago from what had been a planned weekend getaway in the Adirondacks. Scott’s behavior on the phone had been so bizarre that I found myself wondering if he had a brain tumor. We asked his older brother to drive him to the doctor’s office, while we made the four-hour trek back to the house.

Once home, chatting with Scott, trying to keep him calm and dig a little deeper as to what was going on, he told me how incredibly good he was getting at Lacrosse. His brother had coaxed him into a game of catch as a means of distraction while waiting for us to return. He added that his coach would be very proud of him, which was out of character for Scott who is normally his own greatest critic, but nowhere near as odd as when he mentioned that he thought he was getting help from the “spirit of the house”. Who is the spirit of the house I asked. “Whomever is controlling the weather” he replied calmly. 

At that point I asked him if he was taking hallucinogenic drugs, and he replied that he would really like to know the answer to that question. He thought maybe somebody had been giving him some without his being aware. The doctor had taken blood and urine samples that morning but we would not have the results until Monday. We believed that all we had to do was keep an eye on him over the weekend, while we waited for the blood work to come back. If we kept him home and stayed with him, all would be fine. When he asked on Sunday if he could go pick up his friend at West Point so they could hang out together back at the house, this seemed like a safe thing to agree to as West Point is only a short drive from our home.

But these thoughts are far from my mind as we sit, frozen in uncomprehending fear at what is unfolding before us, in our curtained space of the ER on Sunday night. A call to our pediatrician after the debacle at West Point had landed us here. At first I get his service and when they ask if it is an emergency, I hesitate but then say yes. When I get the doctor on the phone and explain of Scott’s arrest and his charging the entry gate, he tells me in his calm and gentle manner that he agrees it qualifies as an emergency. Scott needs an emergency psychiatric evaluation he says. He recommends a couple of hospitals: Four Winds and New York Presbyterian. 

Since it is Sunday I can’t through to the latter, and the former tells me to take Scott to our local emergency room. We comply. It seems simpler than dealing with a psychiatric hospital anyway. We’ve been to the ER many times with Scott already for sports related injuries: X-rays, dislocated fingers, stitches … a trip to the ER with him seems almost familiar, and given how bizarre and scary life feels at the moment, familiar is good. However, it was a decision that turned out to be a big mistake on our part. 

                                          _______________

I lose track of the number of people who have asked Scott if he knows who the president is. The triage nurse, the ER nurse, the first doctor, possibly the attendant who came to wheel him away for the CAT scan. Scott thinks it is a lark and by the second or third time, he replies jokingly that he is not sure, but it might be Richard Nixon. At first alarmed, they eventually realize he is not serious. 

Once the doctor makes his pronouncement about Scott and the schizophrenia, they post a security guard outside our curtained enclosure, and refuse Scott the right to go to the bathroom. He might hurt himself, they say. What is he supposed to do, hang himself with toilet paper? He has to go so they roll in a potty and he has to squat. So much for preserving patient dignity. 

The security man standing guard is aged and looks like he would have a coronary if he had to break into a sprint. Given Scott’s six-foot frame, 180 pounds and speed on the field, he seems like a very unlikely person to provide security of any type. But during the long hours where we wait interminably for the next step in the process to happen I am surprised when I see the guard casually walk up to man who has entered the ER and quietly ask him for something. The man produces a large switchblade. Catching the guard’s eye, I smile tiredly, and he tells me he can spot them right away. Good for him, I think. I certainly had not noticed anything.

Time ticks slowly by. We are not sure what we are waiting for. But we wait. Scott has been medicated with tranquilizers so for the most part he rests fairly quietly. However, he is pretty amped up for somebody with that much medication in him. 

His ER nurse is sweet and well intentioned. She is also very pretty. She has a name like Mindy or Candy. I see an article on the wall that mentions her and her “high-energy competency in the pressure cooker setting of the ER”. I’m glad that they apparently have good nurses at this hospital, since so far I have been completely underwhelmed by the doctor in every way. 

As it turns out, Scott thinks that this trip to the ER is a ploy that we (or somebody) cooked up so that he could get laid by a nurse. God knows what type of things he has said to her when she escorted him off for an interview ‘in private’. Since Scott is over 18, they keep taking him away from us to question him. This makes us very uncomfortable since clearly Scott is not is his right mind, and we are not feeling very reassured by the medical staff and their decision-making.

At some point I speak with the nurse to ask her about her assessment of his condition. She looks sadly at me and concurs with the doctor’s evaluation. She sees that I am having a hard time processing this diagnosis, so she shares with me that her brother was diagnosed years ago as a schizophrenic, and it is good that we are finding out now about Scott. Now he is in a safe place she tells me. Looking desperately for straws to grasp onto, I ask her how her brother is doing now. I want to hear that he is doing fine. I want to hear that with medication he is living a happy and normal life; that he is married, has kids and a job that he loves. She shakes her head and glances downward. He’s no longer with us, she says with the tone of a person who often deals with fatal outcomes. He killed himself. Well, now I feel so much better. I am so glad she decided to share this life event with me. I walk away quietly.

We were told some time ago that we would need to wait for a ‘team’ from another hospital to come and do an evaluation of Scott. The ER doctor is a medical doctor and in spite of his pronouncement of schizophrenia, the hospital needs a psychiatrist to make an assessment. Apparently the hospital doesn’t have a psychiatrist on call. I find this hard to believe. Their procedure under these circumstances is to call for a traveling ‘team’ (they keep using this word, so we assume there is more than one person – how many people does it take?) from Westchester Medical Center. It is about a 45-minute drive, so we wait, and we wait. 

Hours go by. The wonderful, pronouncement-making, brusque ER doc has gone off-duty and is replaced by somebody else. The other doctor does not poke his head into our little enclosure. We see him sitting in the middle area in front of a computer, but he ignores us. We wait. 

Eventually I decide to call our pediatrician. It is by now 11 p.m. and we want his input on what is going on. We are a ship afloat without a rudder and it should have occurred to us to call him much sooner. He calls the ER doc on duty and speaks with him. He then calls us back to tell us that he is coming in and will be there soon. God bless him for leaving his comfortable home at this late hour of the night to deal with a crazy kid and his overwrought family in the ER. He gets there shortly and comes in to chat with our son. Scott appears overjoyed to see his doctor. He is grinning ear to ear. We are pleased to see him this happy since his mood has been volatile and we are trying to keep him calm. We don’t realize that his mood is completely out of line for the circumstances and tips off the pediatrician that something is seriously amiss.

Our pediatrician pulls us aside and fills us in that the ‘team’ was not dispatched. There was some problem getting them mobilized, and the ER is preparing to transport Scott down to the county hospital where he will be ‘housed’ overnight. Because he has been deemed a risk, he will be handcuffed during transport. As we try to process this information, he tells us that he has taken the responsibility for discharging Scott to our care, thus overruling the orders of the ER doc, with the promise that we would bring him to a psychiatric hospital first thing in the morning. He has his back turned to the central control area where the doc on duty sits, and tells us lightheartedly that the ER doc is offended, and most likely has his nose bent out of shape. 

Given that our pediatrician is on staff at this hospital and will no doubt have to work again with this doctor, it is wonderful and amazing that he cares enough to have taken these steps to make our lives and Scott’s experience slightly better.

Hallelujah! We feel reprieved, as if an angel has touched down and been embodied in this wonderful man, who has been our pediatrician for all of Scott’s almost 19 years, and for my older son’s 22 years. 

He speaks with us out of earshot of Scott, and cautions us to take the situation very seriously. We must remove all things that he could use to harm either himself or us. Kitchen knives, scissors, pills … Even these words of gloom do not dampen our relief at getting away from this ER and being able to take Scott home.

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