After a breakdown in her therapist's office, my sixteen year-old daughter Alice ends up at Sutter Psychiatric on a 72-hour hold for the third time in a year and a half. It's mid-afternoon the day after her admission, when the doctor calls asking a lot of questions and answering few.
“When Alice arrived, she was in benzodiazepine withdrawal.” she says, matter-of-factly, “We were able to stabilize her with Klonopin and we'd like to continue that course with your consent.”
“I'm sorry, she was what?”
“Alice has confirmed Ativan use. It doesn't show up in tox screens, but we estimate significant usage due to the dosage of Klonopin needed to relieve her withdrawal symptoms. We would also like your consent to begin treatment with an anti-depressant and I'd like to keep her under observation for a couple of weeks until the effects of the anti-depressant kick in. That will also give us a little more time to manage her detox.”
I consent to everything the doctor asks for and hang up the phone. There are a hundred questions and fears running through my head. Where did she get the Ativan? How long has she been using it? How the hell did I not know?
On Saturday, I drive up to Sacramento to visit Alice. Both Jay and Max say they'll go with me if I need them to, but I can tell that they're exhausted and frayed so I leave them with pizza and a couple of movies, promising to be home before dark.
Two blocks from the hospital, I stop at a Burger King and pick up a couple of spicy chicken sandwiches. I add them to the bag filled with clean clothes, lip-gloss and mascara, all of which pass inspection at the front desk which makes me realize that for what it's worth, I'm getting good at this. Unlike the hospital in Fremont, the adolescent unit is sprawling and visits are less controlled. We are allowed to sit alone in the day room.
“This is the only thing I've eaten in two days.” Alice says after, devouring both sandwiches. Then she grabs the bag I brought and disappears into her room for a moment, returning with fresh clothes, a brush of Cherry Blossom gloss and a thick coat of Maybelline Great Lash. She curls up in the crook of my knees like she did when she was a toddler, and leans into me with a great sigh.
I can't help but notice how subdued she is. When we visited at Fremont and on the first stay here, she was always animated and occasionally agitated. Today though, she reeks of sadness. We sit for a while in silence and then she asks the big question.
“When can I come home?”
“They want to keep you for a couple of weeks until the anti-depressant starts working.”
“They gave me Zoloft yesterday,” she says, “I got all panicky and told 'em I wouldn't take any more, so they switched to Remeron.”
“And you're still taking the Klonopin?”
“It feels foggy, like being stoned, but without the fun.” She turns and looks up at me, “Weeks?”
“Yeah, but they'll go fast. Your dad said he could get Wednesday off and come up with Max to visit. Then we'll all come next Saturday and I bet Grandma & Pops can come some time next week too.”
She starts to cry, not silent tears but mascara-running, gut-wrenching sobs. Her nose runs and she wipes it on my sweater. All I can do is hold her. Nurses and patients walk past, peering into the Day Room but immediately averting their attention once my eyes meet theirs. We sit like that for half an hour, until she's all cried out and half-asleep in my lap. Finally one of the nurses pauses in the doorway and taps her watch.
“I have to go, kiddo.”
She sits up and rubs beneath her eye, smearing the mascara across her cheek. I brush her hair back off her forehead.
“I'll try and get the afternoon off so I can come with Jay and Mouse on Wednesday, ok?” I say it knowing full well that I shouldn't take any more time off from work, but also knowing that I will because the guilt of leaving her here alone is intense.
“I love you, mom.”
“Right back atcha'.” I say, choking on the words as I disentangle my body from hers and head for the door.
There’s something sad and hollow about returning home without Alice. She's always been the biggest, loudest personality in the house. She's also the only one who will hug me out of the blue. Sure, half the time she's got an agenda, but still, I miss it. Her absence somehow blankets us in silence. Max goes about his business, happy to pop his head out and greet me, but just as happy to curl back into the little world he's built for himself, with his art and music and now June. Jay goes about his business too, working long hours, putting himself to sleep with a six-pack of Tall Boys, here, but not HERE; present but not PRESENT so much of the time.
I can't remember when I started withholding details and keeping so much of the emotional turmoil to myself but when I get home from Sacramento, I take a hot bath and settle in with a good book and a half-pint of whiskey. I don't tell Jay how Alice wept. I don't tell anyone. And it reminds me of this Bible verse where the apostle Luke writes “Mary held all these things in her heart”. I always thought that was a lonely verse and I feel how lonely that is now.
Sunday is quiet too. Jay and I spend much of the day indulging in a Zombie movie marathon and when Max comes home from a trip to the river with friends, he joins us. It seems as if we're just settling into the relief of normal family life and each of us is working to take up a little of the slack.
By Monday I'm feeling better, trying to talk myself into being ok with the doctor's timeframe. I'm even considering how this might be the reprieve the rest of us. Then I get the call.
“I'm calling to schedule Alice's discharge.” an unfamiliar voice says, “What time will you be here to pick her up?”
“Pick her up? The other doctor said they were keeping her for a couple of weeks.”
“Treatment plans are subject to change. Basically what Jordan needs right now is to continue her detox at a good in-patient rehab program rather than a psychiatric hospital.”
“Is this an insurance thing?” I ask.
“I couldn't say. Now she'll come home with a prescriptions for the Remeron and a Klonopin taper. You can pick her up any time.”
“A taper? What's that?”
“The nurse will explain it when you get here, but basically it's a process for weaning her off the medication slowly so she doesn't experience seizures.”
I can't even wrap my head around what he's saying. We already know that our insurance won't cover in-patient drug treatment and I was very clear with the first doctor about that. So now they're just tossing her out and I'm supposed to walk her through this alone?
I leave for Sacramento straight from work. It's an hour and half each way if I don’t get caught in the commute. By now, I don’t even need the Mapquest directions crumpled on the passenger-seat. I chain-smoke the whole way and scroll through talk radio stations hoping to find something to take my mind off the nagging questions, same as always; what have I done? What should I do? What didn’t I do that got us to this point?
Her discharge goes much the same as before. Quick, efficient and complete. Woefully unprepared for what lies ahead, I pack up my still-foggy sixteen year-old and drive home in the midst of a sluggish commute.My husband Jay knows I'm bringing her back, but I forgot to let her brother Max know and he just heading out the front door when we arrive.
“You're home.” He is visibly surprised.
“Mom broke me out.” Alice grins.
“Really?” He looks to me for confirmation and I shake my head.
“You shoulda seen her, like the chick in Resident Evil.”
Happy to be home and mellowed by the Klonopin, she's reasonably good company all evening. When I give her the Remeron before bedtime however, her speech becomes slurred and her legs threaten to give out so that her journey down the hall is becomes a zombie walk.
Jay helps her into her room, telling her “If you eat my brains in the night someone else is going to have to pay the rent.”
I have to help her with her pajamas and get her settled into bed.
“Why is it good medicine when they give it to me and suddenly bad medicine when I take it myself?”
“Because you're sixteen and you don't always know the dangers involved.”
“I read things. She says, working hard to get the words right, “I know things. Like did you know that the chemical compound of Ativan is C15H10Cl2N2O2?”
“I did not.” I say, pulling the bright pink sheet up under her chin. Did you know that this house is awfully empty when you're not in it?”
“I did not.” She closes her eyes and pats my hand. “Don't trip mom. I'm gonna be just fine.”
[Note: The final year of my daughter's life was a revelation and I wouldn't trade it for anything. I tell her story in bits and pieces as part of my own therapy, but also to let others who may travel some piece of the same path; You are not alone. This piece and previous diaries about Alice are cross-posted at Laurustina.com.]