Tag Archives: child psychiatry

Committed – Chapter 3

Once Upon A Time...

I’m usually pretty good at giving advice.  When my friend Tracey was dying of cancer at the age of forty-two, she once asked me why something so awful was happening to her.  This was a real stumper; why would God, or Whatever Higher Power Is Out There slap an organ crippling, bone breaking, tumor growing disease onto a mother of three whose big dream was a quiet, simple, family life?

“What if,” I said to Tracey, my voice cracking as I scrambled to make sense out of the senseless. “What if what’s happening to you is somehow changing the future?  And what if changing the future will someday save one of your kid’s lives?”  Tracey smiled, intrigued by the thought that her death might have purpose, even though I sounded like a fake fortune teller.

But when Ivy walked out of Lila’s room, her suicide threats echoing like small screams in the pale, empty hospital corridor, my mouth felt broken.  I wanted to tell Ivy to bring on the tough love.  I wanted to say that Lila was manipulating her and she had to quit rewarding the behavior.  But then I imagined it was Griffin who was trapped in a cage of his own fear, grasping through the bars with little hands and begging me not to leave, and I knew I could never walk away.  So I just hugged my friend, her eyes raw from a barrage of tears, as we took the elevator from 3 East to the ground floor where we could see Ben and Adrian trying to catch snowflakes outside, pink cheeked and laughing.

“I don’t want him to see me like this,” Ivy said, and then headed for the bathroom to pull herself together.  Ben needed her too so the luxury of falling apart would have to wait.

Strong And Fragile

Lila spent nearly two weeks in the psych ward before her slight, soft-spoken doctor–the Mr. Rodgers of child psychiatry–granted her a four-hour pass.  Before she left,  he asked Lila to name four things she worries about–and to rate the fear level they might cause on the outside:

1.)   Riding in the car with Ben — 8

2.)   Being around trash cans (because people throw up in them) — 6

3.)   Going to the mall – 4

4.)   Eating at a restaurant – 7

Using deep breathing techniques learned in group therapy, Lila made it to the mall with her mom and Ben.  They shopped at Nordstrom Rack and had lunch, the looming, lurking trashcans scary but manageable.  But the breakthrough that fanned hope like gasoline does a fire came during the drive back to the hospital.

“Hey Ben!”  Lila exclaimed suddenly.  “I’m in the car with you and I’m a zero! The significance of this milestone settled into her face.  “It’s been a long time since I was a zero,” she said softly, as the world, both beautiful and terrifying, rolled by outside the window.

“Who would have ever thought that a trip to the mall would be such a momentous triumph,” Ivy told me later on the phone and then took a long, cleansing breath.  “I love Nordstrom Rack.”

Layers

The battle with mental illness is not fought on a level playing field.  Physicians and therapists have varying skill levels, philosophies, and personalities.  The system is jammed, with open beds awarded to those most in need.  Arbitrary decisions are made such as who gets treated first: the boy who chews his fingernails to the quick and refuses to speak, the girl who hides food and cuts herself, or the one who sticks her head in plastic bag?

After a five-day wait, Lila was moved from 3 East to the CBAT ward (Community Based Acute Treatment) where she would get intensive therapy.  Now, while Lila is in session, Ivy lies on her daughter’s bed, researching obsessive-compulsive disorder and drug side effects.  Some days Lila makes progress (I can see her being herself again for the first time!) and others, she falls back into to the abyss of rage, frustration, longing and fear (I hate you!  If you loved me you wouldn’t put me here!  Don’t touch me! I’m scared!).  Both Ivy and her husband, whose financial situation has deteriorated to the point where they must sell their house to pay bills, hold on tightly to keep from falling in along side her.

“The other day, one of the moms at school asked me what I did over Winter Break,” Ivy said.   “I told her I spent it in the looney bin with my daughter to the tune of five grand!”  Even though there is nothing funny about a child with mental illness, our brief burst of laughter gave Ivy a much-needed reprieve.

And there is hope—for Lila and the millions of other children who suffer from anxiety disorders.  Some kids who experience episodes of mental imbalance end up stronger and better adjusted than others who sail through adolescence.  When Lila’s pediatrician told me his sister had attempted suicide by downing a bottle of Tylenol at the age of fifteen, I asked him how she was doing now.

“She’s awesome!” he said, and then smiled.  “The sanest one in our family.”

But it will likely be a long time before Lila’s emetophobia recedes to a point where it becomes just another grown-up sounding word; OCD is much more tenacious than any cold or flu.  In the meantime, her parents drive back and forth, and back and forth, from home to hospital each day, re-structuring their lives around the reality of a troubled child.  One of the hardest things about this is having faith that the steps they’re taking to help Lila are right.

“I’m just a rookie mom doing it without a dress rehearsal,” Ivy emailed me on the seventeenth day of Lila’s hospital stay.  “Sometimes when I come to a complete stop in my brain and really think about what’s happening to my baby, I double over with nausea (cruel, that, no?).  Hold on, I think to myself, hold on.”

Foggy Day