by Torey Hayden
A heartbeat’s length of silence.
“When I want to,” she added.
“I think maybe that was the five-year-old inside you, coloring that picture. Which is maybe why, when I look at it, it looks like it was colored by someone who felt very scared and angry.”
“Or maybe just five,” Cassandra said. “Maybe that’s just how things look to you when you’re five.”
“Maybe,” I said.
She rose from her chair. “I’m going to go now.”
“All right. I’ll see you tomorrow. Good-bye.”
“Good-bye.”
Chapter
18
In the afternoon I had a couple of errands to run that involved leaving the hospital for a short while, so I decided to get clearance to take Drake with me. I still worried about the effects of hospitalization on such a young child, and it was now apparent that he wasn’t going to go home after a week. I was also concerned about the occasionally stressful atmosphere of our sessions. The chance to take him out, to interact with him in a less pressured way, to do something friendly and fun seemed like a good idea to me.
Drake was delighted. Friend had to come, too, of course, and by this point Friend had his own fan club on the ward. While I helped Drake into his jacket, one of the young aides came and tied a scarf around Friend’s neck “to keep the chill off.”
Not that there was much chill. It was very late winter, yet nonetheless bright and sunny outside, full of the promise of warmer months to come. In fact, inside the car, it was actually hot.
I strapped Drake into a car booster I’d borrowed from the ward. He loved everything we were doing, waving and gesturing, his head swiveling this and that way in the parking lot. My knowledge of signs for outdoor things was quite limited but I knew “car” and signed that.
Drake observed my sign and then looked up at me. It was an odd little moment, because I was very aware of this “observing” quality. Here was a sign he didn’t know. But then he looked at me, made eye contact and, in an equally observing manner, took in my mood.
“You worry about making signs, don’t you?”
He regarded me, his expression solemn.
“Has somebody told you it’s wrong to sign?” Because suddenly I was thinking of Mason Sloane. Perhaps the staff at the preschool or somewhere else had tried to teach Drake sign language to help him communicate and Drake’s family hadn’t approved. Had he possibly been punished for signing?
Drake didn’t indicate one way or the other, but his sudden seriousness made me fairly certain the answer was yes. Everything then fell into place. This was how he knew signs, but also why he became upset when I had called attention to his using them, even though my comments were not meant to be negative. To him, I was catching him doing something bad.
It then occurred to me how confusing my own behavior must have seemed to the poor little boy. On one hand, I was teaching him signs and, thus, actively indicating that this was okay to do, but then I was also calling attention to the fact that he already knew signs, which he had gotten into trouble for knowing. What a bewildering world he was living in, trying to please all the adults, even when they sent such contradictory messages.
I dropped off some notes at a nearby clinic and picked up some photocopying. Then I went over to another medical facility, where one of our former patients had been transferred, in order to hand in some folders. As a treat, I then stopped at an ice cream shop. Of course, there was no leaving Friend in the car during this visit, so there was much unbuckling and lifting in and out before the three of us finally managed to go into the store.
It was a Baskin-Robbins franchise with all thirty-one flavors, but it was just a small one, the premises long and narrow and not much bigger than the therapy room. Because it was midafternoon on a weekday, no one was in there except us and the girl who was serving.
Enthusiastically, Drake went up and down the counter, looking at the various tubs of ice cream. He kept lifting Friend up to see, too, and pointing at different ones. The girl behind the counter was charmed by his excitement and kept handing over little taster spoons full of the different flavors Drake pointed to.
“Okay, we can’t stay forever,” I said, “so it’s time to choose. Which flavor do you want in your cone?”
Another few minutes were spent going up and down the display. Finally he pointed to a very bright ice cream of green, white, and orange.
“All right. A cone of that,” I said to the girl. “Just one scoop, please.”
She took down a cone from the display. Suddenly Drake became agitated. He grabbed my arm and tried to gesture something about what the girl was doing. He ran along the counter to where she was, back to me, and gestured again.
“What do you want?” I asked.
He gestured again.
“I’m sorry. I don’t understand,” I said.
He gestured again, frantically this time.
“This is where words would be helpful,” I added, “because I do want to understand you, but I’m afraid I don’t, Drake. I’m sorry.”
The girl leaned forward to hand him his ice cream cone. “Here you go,” she said.
He wouldn’t take it. He shook his head.
“What’s wrong?” I asked. “Isn’t that the flavor you wanted?”
Drake was going to cry. Mouth turning down, he pointed along the counter.
I came down on my knees. “Honey, I’m sorry. I really don’t know what’s the matter. Is it the wrong flavor? If so, that’s okay. I’ll take that ice cream cone and you can get the flavor you want. Show me which one you want.”
He pointed. It didn’t actually seem to be at a different flavor of ice cream. He just pointed in the general direction of where the girl was.
Frustrated, I tried to comfort him. The girl leaned farther over the counter and tried to help, too. She said reassuringly that neither of us had to take the flavor if it was the wrong one, that she could just put it aside.
Steadfastly refusing to take the ice cream cone, Drake screwed up his face. Tears spilled.
I rose up. Not knowing what else to do, I opened my purse, paid the girl for the ice cream cone, and took it myself. But this was hardly satisfactory. Here I was with an ice cream cone I didn’t really want and Drake had nothing. The treat had been for him, not me.
I licked the ice cream. It tasted funny. Definitely not a flavor I would have chosen. Quietly, I waited for Drake to regain his composure. The girl stood behind the counter and nervously watched the two of us.
“Okay, sweetie,” I said gently when the tears were just snuffles, “can you try again for me? Can you show us what you want?”
He hesitated a moment, assessing, I think, if this were some kind of pressure for speech and how much genuine patience I was likely to have. Then he approached the end of the counter by the cash register again and pointed.
I followed the line of his finger, which was upward, so not really at the ice cream. I looked at the clutter of stuff at the top of the counter—straws, napkins, plastic spoons, small paper tubs—and just behind them, the holder for the cones.
“You want a napkin?” I queried. This much fuss over a napkin seemed obsessively neat for a four-year-old, but I hadn’t actually seen Drake at mealtimes, so perhaps he was fastidious in a way I didn’t know about.
He shook his head. He kept pointing.
“A straw?” Which seemed even more unlikely, given we were not having drinks.
His mouth was starting to drag down again as I failed to understand.
“A cone? Do you want a different cone than the ordinary one?” I asked. “Is that it? Do you want one of the waffle cones?”
He was teary again.
The girl was going along the top of the counter. “This?” she tried, tapping the spoons. “This?”—she tapped the napkins. “This?”—she tapped the straws. “This?”—she tapped the little individual-portion tubs, stacked upside down.
And that was it. Drake almost melted with relie
f. Too near to crying to be able to register any happiness at finally being understood, he just kept nodding.
“A tub? You didn’t want it in a cone? You want this kind of ice cream, but in a little tub?” I asked.
He was still nodding frantically.
And so we finally managed success.
I left Baskin-Robbins perplexed and thoughtful. For an otherwise cheerful and reasonably accommodating little boy, he had seemed unusually insistent on the tub. Why not a cone? I hadn’t ever come across a little kid who wouldn’t accept an ice cream cone.
It also brought home how important it was to get this child communicating effectively with those around him. This had been a surprisingly upsetting episode, not only for Drake but for the girl behind the counter and myself. And truth was, Drake probably had far more important things to communicate even now than whether to have his ice cream in a tub or on a cone.
Perhaps most of all, however, this event made clear how much I had failed with my usual method of intervention for elective mutism. My method relied on being able to intervene as a newcomer who had no previous nonspeaking relationship with the child. That certainly wasn’t true now. I too had sacrificed words in preference for understanding. If I had been following my very own rules, I should have left him without the ice cream unless he made some effort at asking for what he wanted. Instead, I too got sucked right into the drama of trying to find out what he meant.
For the first time manipulation crossed my mind. With his merry smile and his charismatic manner, Drake didn’t seem like a manipulative child; on the other hand, perhaps this was the perfect method for controlling situations. Beguile everyone. Because who can resist doing what a cute, smiley charmer wants? Could that be possible? Had he managed to dupe me as well?
I had one more stop before returning to the unit. Joy Hansen had asked me for further information on elective mutism. I had intended to drop off some reading material in the morning when I stopped to see Gerda at the rehabilitation center, but I’d forgotten it in my car. As the center was so near the hospital, I thought I’d stop on the way back and drop it off. And since I was there anyway, I thought I’d peek in on Gerda just to see what she was like at a different time of day.
“We’re going to make a really quick stop here,” I said to Drake, as I unbuckled him from his car seat. “We’re going to see a lady who has trouble talking. Just like you. She’s very old. She used to talk but now she doesn’t. So I come to see her, just the same as I come see you.”
Drake was the center of attention from the moment he entered the front lobby of the rehabilitation center. Several elderly people sitting in the chairs called out to him. Given his long hair and cherubic features, they all thought he was a little girl, but Drake being Drake, he still responded good-naturedly, waving to an old woman and old man sitting by the window.
Indeed, in this tabernacle of the old, everyone who saw us rejoiced in his youth. “Well, look here! Look who we have here!” each person remarked as we passed.
One of the nursing staff paused, as we came down the hall. “Is this your daughter? She’s beautiful!” Which, of course, meant I had to delicately explain that not only was he not my daughter, he wasn’t even a girl.
An old lady had stopped as I was speaking with the nurse. She bent forward and stroked Drake’s cheek. He didn’t shy away from the withered hand. Indeed, he smiled beatifically back at her.
“You’re so cute, I could just eat you,” the old woman said, which to me seemed a rather alarming comment to make to a four-year-old, but Drake just kept smiling.
In her room, Gerda was lying down. She turned her head when we entered, and for the first time I saw her smile.
“This is Drake,” I said. “He’s one of the children I work with at the hospital. He and I are out for the afternoon. We’ve just had an ice cream and now we’re stopping by to see how you’re doing.”
Gerda struggled to sit up, so I leaned over and helped her into a sitting position. She reached a hand out toward Drake. It was hard to know exactly what she intended, whether she was wanting to stroke him the way the other old lady had or whether she was gesturing about something. He smiled but was too far from her to touch.
With Drake in the room, Gerda was much more alert and animated than I’d previously seen her. For the first time, she seemed to want to communicate, because she then gestured to me. I didn’t immediately understand, but then she stretched back toward the bedside cabinet that was just beyond her reach. Thinking she must be seeking something in the cabinet, I opened the drawer. In there was a small bag of the flat red-and-white swirled peppermint candies that are wrapped individually in cellophane. She nodded fervently, so I lifted it out and gave it to her.
Gerda opened the bag and picked out one. This took considerable effort on her part, making me more aware of the extent of the damage done by the stroke. I was tempted to help but I didn’t. We just waited. When she had finally managed it, she held out the candy to Drake.
A winning smile on his face, he took the candy and unwrapped it, popping it in his mouth. There was unexpected poignancy in this moment between silent child and silent adult, both struggling to bridge the gap as best they could.
“Drake finds it hard to speak,” I said. I looked down at him. “Can you say ‘thank you’ with your hands? Like this?” I showed him the sign.
Drake imitated it.
“Now, can you say that to Mrs. Sharple? Can you tell her thank you for the candy?”
Drake signed “thank you” and then “candy.” He smiled broadly.
Gerda smiled back.
Chapter
19
How to proceed with Cassandra?
If I looked back over our sessions together, they had been very chaotic. My well-thought-out, coherent plans inevitably ended up in tatters by the end of the session, and Cassandra herself provided very little consistency. In typical therapeutic sessions, activities are either guided by the therapist’s experience and knowledge of how to deal with a specific problems or guided by the patient’s needs. In our case, the sessions had been a miasma of events that seemed to change randomly from day to day and left me “coping” much more than “guiding.” I couldn’t tell if this was because there were so many problems fighting to come out in Cassandra’s case that no single pattern was yet emerging, or if she was simply so fearful of dealing with deeper problems that she had actively avoided revealing any pattern.
Certainly trust was a major issue and I hadn’t achieved it. And forcing a child to color a rag doll according to my wishes wasn’t going to have given it to me. I hadn’t really been proud of the previous session. The teacher in me had responded to Cassandra’s repetitive efforts to control our time together. Once out of the situation, I wasn’t convinced it had been appropriate of me to respond that way as a psychologist. Possibly it was a necessary confrontation, particularly in light of the fact that I didn’t want her institutionalized any longer than was absolutely necessary, but I did not want to repeat the experience. Nor did I want domination to be what that session was remembered for. I wanted it instead to be seen more as a delineation of our roles, an understanding that she could explore and deal with the traumas of her past, because I was strong enough to keep her safe while doing that.
On the unit, Cassandra was continually in trouble for telling outrageous lies. Most involved graphic sexual abuse and were often so outlandish they would have been laughable if they weren’t so sick, or if we on the staff were not so worried that someone might mistake what Cassandra was saying for the truth. As it was, for our own protection, none of us was allowed to be alone with Cassandra. We always had to work in public locations, in pairs, or with a videocamera recording us, and preferably all three.
Then Selma arrived on the unit. She was eight and had very serious problems that included auditory hallucinations and a tenuous grasp on reality. This meant Selma often heard voices telling her things. After a day or two on the unit, Selma became increasingly agitated.
All of a sudden, her voices started to say things to her like “Nurse Nancy put her finger in your butthole. When you were in bed last night, I heard her say she wanted to feel you.” This was understandably distressing to Selma, who wasn’t always able to discern if such things had really happened or not; and, of course, to us staff it was downright terrifying, because one kid making allegations of sexual abuse was serious enough and now we had two.
We all knew Selma’s fretting was being fed by Cassandra, as there had been no sexual content to Selma’s hallucinations before she came onto the ward. Moreover, Selma’s words were all verbatim the same tales Cassandra had been telling about virtually everyone in authority. Thus far, however, Cassandra had been so covert in priming Selma that no one had caught her at it, until the morning after our coloring book session.
When I came for her, Cassandra was in lockdown. For such a serious offense, it was common to leave the child to serve his or her time in seclusion and reschedule classes or therapy sessions for another time. With her malicious lies and continually provocative behavior, however, Cassandra had become deeply unpopular on the ward, both with staff and other children. As a consequence, they were always desperate for a respite from her. Moreover, I really didn’t want to lose a session, which I would do, because I had no time later in the day to reschedule. So it seemed better to take this opportunity to tackle things head-on.
Cassandra was sullen, almost surly, when I said she could come with me. Rising reluctantly, kicking the seclusion room door frame as she left, she did not give much impression of being glad for a reason to go. However, by the time we reached the therapy room, she was her usual self. Indeed, she seemed downright chipper once we were inside.
“I want to draw pictures today,” she said.
“Perhaps later. First, can you tell me more about what went on out there?” I said.
“Went on where?”
“Out there. On the ward. I’m interested to hear your side of it.”
“I don’t remember.”