RGD was brought in to the emergency room on May 14, 2017, at 7:43 p.m. after ingesting as many as one dozen fluoxetine. Gastric lavage was performed in the emergency room, and patient was stabilized by 8:32 p.m. and admitted to Mercy.
When asked the reason for the attempted overdose, RGD said she was trying to help her son (deceased, April 15, 2017) find his way to heaven.
Samuel Davenport and Ruth Glass reported that RGD has been suffering from severe depression following the death of her son (Jonah Davenport, age 5). RGD has been unable to function, refuses to get out of bed, refuses to perform normal tasks, no longer plays a parental role to her daughter (Eden Davenport, age 10), avoids personal grooming, including bathing, and eats only when forced or coerced.
Ruth Glass reported to Dr. Lahey that RGD claims to have seen her son on the day of the overdose.
RGD was extremely thin, her skin had a grayish pallor to it, her eyes were sunken in their sockets. She was slow to react to my presence, had difficulty focusing her vision and stabilizing her gaze, appeared not to understand many of my words, refused to answer most of my questions, although not with hostility, only with ambivalence.
I informed RGD that she was getting better and that she would be released from the hospital in a day or two. RGD became visibly upset. I informed her that I would be helping her and her family get through this difficult time.
RGD was unable to calm herself and reported that Jonah (son, deceased) had found her at Mercy and she couldn’t leave because she didn’t know if Jonah knew the way back to their home.
RGD became increasingly agitated, started to thrash her arms, nearly pulling out her IV. I depressed the call button for the nurse, who entered within twenty seconds and immediately administered 4 mg lorazepam through IV.
Follow-up Scheduled: ___X____Yes____No if so, when: _Monday, _May 22, 2017__9:30 a.m.___
TWENTY-FIVE
MADDIE
Grief is my business.
Sometimes I feel ashamed that I profit from the tragedies of others. But most of the time, my guilt is tempered by the knowledge that I am helping people to heal.
I treat young and old, in various stages of grief and at various levels of grief. I once treated an elderly woman who lost her husband and her parakeet in the same month. She was fine with the loss of her husband—“He was a jackass”—but her parakeet’s death left her inconsolable. I treat children who’ve lost their parents and parents who’ve lost their children, spouses who’ve lost the loves of their lives and husbands and wives who don’t know why they’re grieving because they couldn’t stand their partners, siblings with survivors’ guilt, best friends unable to go on without their touchstones, people who’ve lost limbs or jobs or the ability to do the things they were able to do before.
There are those who don’t understand why I do what I do, who can’t comprehend why I would make the choice to surround myself with so much loss. But I remind them that every person on the planet is surrounded by loss. Life itself is a series of losses, is it not? In this world, happiness and fulfillment are products of successfully dealing with our losses.
Aside from the various race- and gender-related challenges I’ve faced over the course of my life, I have also suffered numerous tragedies, and those compelled me to do what I do today. When I started the psych program at university, my goal was to be a high school guidance counselor. I wanted to work with inner-city kids at that dubious stage when they can either embark on the path to success or careen toward mediocrity or failure.
Just before I got my degree, my parents were killed in an auto accident, and suddenly I was an orphan with no brothers or sisters and no family to speak of. At the time, I suppressed my grief, compartmentalized it, buried it where I thought it could do me no harm. I threw myself into my schooling, graduated with honors, and found comfort in the fact that my parents would have been proud.
Two years later, when I was midway through my doctoral program, my fiancé was one of the many victims of a shooting spree in a local restaurant that involved a disgruntled employee. My professors allowed me to take a sabbatical, and for six months I couldn’t leave my apartment, could barely get out of bed.
It was through the kindness and compassion and determination of one of my fellow doctoral candidates, my friend Jessa, that I was able to work through my grief and become a functioning human being again. She counseled me every day, in between forcing me to do my laundry and make my bed and eat my meals. She offered me tools to help me step outside into the sunshine and accompanied me when I finally dared to go to the restaurant where Paul had been killed, holding my hand tightly and monitoring my heart rate and reminding me to breathe when I forgot. She told me that happiness was not some elusive force that only showered down upon the deserving, but a choice we all make despite the fact that life is hard.
A year later, Jessa died from an undiagnosed brain tumor. Her death, but more importantly, what she did for me in life—giving me back mine—inspired me to do what I do. Helping others through their grief not only fulfills me and helps me deal with my own loss, it is a way for me to honor Jessa’s legacy.
I have been married for seven years and have a good, if somewhat unorthodox, marriage, not only because I’m black and my husband is French-English. My husband works three hours away and keeps an apartment near his firm where he sleeps Monday through Thursday. On Friday, he works a half day then takes the train home, and we spend the weekend together. Our friends often question this arrangement. Secretly I think they’re jealous. But it works well for us. I don’t know that our marriage would survive if we were to live together full-time. My days are long and emotionally charged, and because I must remain stoic for my patients, I require a lengthy decompression period at night, and it is impossible to decompress with an audience. Peter, my husband, FaceTimes me every night, but only after I text him that the coast is clear. Sometimes I talk to him about my day, after the intensity has faded, either through a hot bath or yoga or a run. And he is always an active and compassionate listener, asking questions when appropriate and occasionally offering insight. But most nights, I steer our conversations to lighter arenas and enjoy the sound of his voice as he tells me anecdotes from work.
Madelaine Meyers Grief Support and Counseling Services is thriving. I have a good reputation in my field, and I work hard to earn it. My practice occupies the ground floor of a brownstone, and I am proud of the comfortable, welcoming, and nonclinical space I have created. My sessions are longer than most therapists’, because I don’t believe that fifty-five minutes is enough time to get to the root of an issue, introduce a new tool, or analyze a particular memory or dream. These things take as long as they take, and I would never want to cut short a patient on the brink of a breakthrough. I don’t charge exorbitant fees—I am midlevel at best—and I take insurance. My patient roster is full, every day, every week, month, and year. Tragedy happens daily, and grief is ever present.
When Archie, one of my old professors from university who now works in family practice, called me with a referral, I told him I couldn’t take any more patients, especially not a family. We talked for a long while, and he related to me the story of the Davenports—the death of five-year-old Jonah and the failed overdose of his mother—and by the end of the conversation, I was going through my calendar to see if there was some way I could work them into my schedule.
“Ruth, the mother’s sister, is an old dear friend of mine,” Archie said. “She’s been through some difficult times, and now this. I care very deeply for her, Maddie. These are good people. If there’s any way . . .”
And because Archie helped me establish myself when I was first starting out, and because he’d never asked me for anything in return, I made a way.
TWENTY-SIX
SESSION ONE
The Davenport family is waiting in the reception area when I arrive at my practice on Monday morning. They are early. Rachel Glass-Davenport is seated on a chair, her sister beside her, her head lowered and h
er shoulders hunched over. Samuel Davenport stands with his hands in his pockets, gazing at a print on the wall, not really seeing it, I suspect. The little girl—Eden, I recall—sits apart from her aunt and her mother, her nose in a book, her knee bouncing up and down rapidly.
My assistant, Nadine, stands and smiles at me from behind her desk.
“Dr. Meyers, the Davenports are here for their appointment,” she says in her calm, melodic voice. Aside from her impeccable credentials and sterling character references, I hired Nadine Walters for her voice. In a room that is often filled with heightened anxiety and emotion, a voice with certain characteristics—a nasally pitch or a high squeak—will only make things worse. A helicopter could crash through the front door of the practice, and Nadine would inform me with the same intensity she might use when telling me I have something in my teeth.
“Thank you, Nadine.” I look from face to face, hoping to meet eyes with each family member, but the only person looking at me is Ruth Glass. She wears an expectant, almost desperate expression.
“Good morning,” I say. “Nadine, why don’t you show the Davenports to the family room. I’ll be there in a few minutes.”
Nadine nods and moves around the desk. She is full figured but moves with lightness and grace. Her long black hair is shiny without a trace of gray, despite the fact that she is well into her forties. “Please come this way,” she murmurs, then makes a slight sweeping gesture toward the back of the brownstone.
I watch Ruth get to her feet, then turn and lean toward her sister to help her up. Samuel moves to help, but Ruth waves him off. He turns to his daughter and puts his hand out to her, then lifts her out of her seat. She keeps her hand in his. They follow Nadine to the second door on the left.
I go to my office, stow my purse, and boot up my computer. Check my schedule for the day and charge my phone. Three minutes later, I walk into the family room.
As per its name, this space might be found in any home—comfortable couches with plump pillows, a couple of easy chairs, a coffee table stacked with magazines and children’s books, a toy chest in the corner, and a television on the wall. In the far corner is a kitchenette with a small refrigerator full of various nonalcoholic beverages, a countertop with a sink, a coffee machine, an electric kettle, and a basket with an assortment of herbal teas.
Rachel is seated on one of the couches, eyes cast down. Samuel is pacing, and Ruth is investigating the tea bags. Eden sits on the floor by the toy chest, carefully perusing its contents. All eyes, save for Rachel’s, turn to me when I enter.
“Again, good morning,” I say. I cross to one of the easy chairs and sit. I carry nothing with me, no notepad or clipboard, no recording device. When I perform a group intake, I like to be unfettered and rely solely on my senses and intuition. If I’m busy taking notes or checking to make sure the session is being recorded, I miss too much. I have found that this method allows my patients to relax and open themselves up more.
“I’m Dr. Madelaine Meyers. You can call me whatever makes you most comfortable, including Maddie. It would be nice if we could all sit down together.” I stop speaking and wait. After a moment, Ruth crosses to her sister and sits beside her. Samuel looks at the two women for a moment, and I can’t decide whether his expression is one of longing or resentment. Possibly both. Finally, he sits on the other couch. Eden gets to her feet and wanders over, gives me a doubtful look, then slowly lowers herself into an easy chair next to me. She sits on the very edge, as though she wants to be ready to spring up at any moment, and clutches her book to her chest. I can’t make out the title, but the cover picture is dark, with clouds and lightning on it.
“First, I want to say how sorry I am for your loss. I didn’t know Jonah, and I’m not going to pretend that I know exactly how you all are feeling. I have experienced the loss of a loved one. Several loved ones. I’m telling you this so that you’ll know I can empathize.” I turn to Eden. “Do you know what empathize means?”
She nods solemnly. “It’s like when you can understand something because it’s happened to you, too.”
“That’s very good. If I ever use a word that you don’t know, please feel free to ask, or if I ever say anything that doesn’t make sense, let me know, and I’ll try to do a better job of explaining. Okay?”
She nods again and I smile at her. “Good.” I look around the room. “That goes for everyone. Okay?”
Ruth nods. Samuel clears his throat. Rachel doesn’t move.
“I’d like to talk for a few minutes about why you’ve come to see me and what your expectations for our time together are. After that, I’d like to meet with each of you individually . . .”
“How long is that going to take?” Samuel asks. He isn’t angry, just impatient.
“I think about twenty minutes per person.”
“I have to go to work.”
“How about I meet with you first? Does your family have a way home?”
“I have my own car,” Ruth says defiantly. “I brought Rachel.”
I nod. “Good. Is that acceptable to you, Mr. Davenport?”
“I suppose.”
“Do you mind if I call you Samuel?” I ask, and he flinches at my question.
“I would prefer Sam.”
“Fine. Thank you, Sam. So, let’s begin. Why don’t we talk about the reason you’ve come to see me.”
No one speaks. Sam turns his head away from me. Ruth sits forward and pats her sister’s hand. “Well, we—”
“You’re going to help us feel better,” Eden chimes in. “Because we’re all so sad, and it’s kind of like we’re trapped in the sadness, like it’s quicksand or really thick mud and our feet are stuck and we can’t get out, and you’re going to give us a really strong rope and pull us out.”
“That’s a very good explanation, Eden. Is it okay if I call you Eden?”
“That’s my name, so I guess it’s okay.”
“Would anyone else like to add to Eden’s explanation?”
“I’m worried about my sister,” Ruth says. “As well as the rest of the family. But I think Rachel needs the most help. I mean, obviously, considering what just happened. And yes, you can call me Ruth.”
“Thank you, Ruth. What about you, Sam?”
“What about me?” He looks at me, then pointedly checks his watch.
“What are your reasons for being here?”
“I’m sorry, Dr. Meyers, but that feels like a useless question.”
“Please don’t be sorry about expressing yourself.”
“My son died. My wife is in trouble. We’re all grieving. That’s why we’re here.”
“Would you agree with Eden that you feel stuck in your grief?”
I watch him ponder the question. He glances at Rachel. “Yes.”
“Okay. Rachel? Would you like to tell me why you’re here?”
She doesn’t look at me. When she finally speaks, her voice is a monotone. “Because we’re stuck.”
“Thank you, Rachel. Thank you all. Each of us are individuals, and we all deal with our grief separately. But a family is also a unit. And it’s important for all of you to be on the same page as to why you’re here as a family. What about your expectations for our sessions? Would anyone like to comment?”
Sam chuffs, much like a dog. Ruth shoots him a glare. Eden kicks her feet out, and Rachel just sits there, motionless.
“Sam, I understand that my questions might seem rhetorical or, perhaps, irrelevant. But I ask them for a reason. What are your expectations for our sessions?”
“I don’t have any,” he says. “I don’t believe in therapy. I believe in moving forward.”
“And are you?” I counter. “Moving forward?”
He throws up his hands. “I’m trying.”
“That’s good,” I tell him. “That’s very good.”
I glance at Eden, who is concentrating on her feet, and Ruth, who is shaking her head, and Rachel, whose head is down, and I decide not to push them further. I h
ave seen this kind of resistance countless times. Pushing is counterintuitive and can lead to a total shutdown. Patience and persistence are far more effective.
“Why don’t we begin the individual sessions? Ruth, Rachel, Eden, help yourself to anything. If you’re hungry, there are snack bars and crackers in the cupboard. And the remote control for the television is in the drawer of the coffee table. Sam, if you’ll follow me?”
I walk to the door of the family room. Sam looks at Rachel for a long moment, then smiles at Eden. “See you later, piece of pumpkin pie.”
The girl jumps from her seat and throws her arms around Sam’s waist. He gives her a brief hug, then pats her back.
“’Bye, Dad,” she says. “Have a good day at work.”
“I will, honey. You take care of your mom and Aunt Ruth, okay?”
Eden gives her father a dubious look, and he chucks her under the chin. She reaches up and pulls at his tie, forcing him to bend over, then she whispers in his ear. I can just make out her words.
“Do you think Dr. Meyers can help us?”
I force myself to look at the floor. Sam glances at me—I feel his gaze upon me—but I pretend I didn’t hear his daughter’s words.
“I hope so, honey,” he says to her. “I really do.”
TWENTY-SEVEN
SAMUEL DAVENPORT
“Am I supposed to lie down?” he asks, jerking a thumb in the direction of the couch. We are in the room I use for my private sessions, a small space with good light from a south-facing window. On one wall is a couch, and catty-corner to the couch is an easy chair. A straight-backed chair faces both, and a desk sits in the corner, out of the way.
“You’re welcome to lie down if you’d like,” I tell him, and he snickers. “You can lie down or sit or remain standing. Whatever makes you most comfortable.”
He paces the length of the room in three seconds, turns and gazes at the Kertész print hanging over the couch.
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