Elephant in the Sky

by Heather A. Clark

  “Are you in the same class?”

  “No, but I see him sometimes at school. Mostly we just hang out at home. He lives on my street.”

  “What types of things do you do with Noah?”

  “I don’t know.” I am getting bored by my conversation with Dr. Aldridge.

  “Well, how about we start with today. What did you do when Noah was here visiting you?”

  “We watched a movie. And played some video games.”

  “I see. Do you do anything else with Noah? When you’re not in the hospital?”

  “Yeah. We play outside. We go swimming. And ride bikes. And we play hockey. We are on the same team, but sometimes he’s not there.”

  “How come?”

  “He only plays when we need the help.”

  “Makes sense.” Dr. Aldridge scribbles on her paper again. When she finishes, she looks up. “The nurses told me you had quite the scare today, Nate. Can you tell me about that?”

  I stop and wait. I watch Dr. Aldridge for clues to see if she’s been sent by the nurses who wear the bad clothes.

  “Nate?” Dr. Aldridge asks again. She keeps smiling. I decide it is okay, so I tell her all about what Spider-Man told me. What I needed to be careful of. Why I couldn’t take the pills from the nurse wearing navy blue because it would have killed me.

  “That sounds pretty scary.” Dr. Aldridge stops for a minute and then asks, “How do you feel when you think about dying, Nate?”

  I don’t say anything. I don’t want to talk about this.

  “Do you want to die? Or do you ever think about hurting yourself?”

  “No. Of course not. Why would I want to do that?” I shake my head. Sometimes doctors are so strange. They are supposed to be smart, but then they go and ask stupid questions like that.

  “I’m happy to hear that. I wouldn’t want you to hurt yourself.” Dr. Aldridge stops talking. It’s like she’s waiting for me to say something. But I have nothing to tell her.

  “How about school? Can you tell me about that? Do you like it?” Dr. Aldridge asks.

  “I guess so.”

  “Do you like your teacher?”

  “Yes.”

  “What’s her name?”

  “Mrs. Brock.”

  “What do you like about Mrs. Brock?”

  “I don’t know. She teaches me stuff. And she’s nice to me, I guess.”

  “Do you have a favourite subject?”

  “No.”

  This is a dumb conversation.

  “What about the kids in your class? Do you like them?”

  I shrug again. I don’t want to talk to her about Tyson or any of the other mean kids in my class.

  “Who are your friends in your class, Nate?”

  “Can I play a video game now?”

  “No. Not yet. I’d like to talk about your friends at school first. What are their names?”

  “I only have one friend.”

  “Okay, what is your one friend’s name?”

  “Noah.”

  More writing. “But Noah isn’t in your class, Nate. Do you have friends in your classroom?”

  “But I told you … I still see him at school sometimes, even though he isn’t in my class. I don’t need any more friends.”

  Dr. Aldridge smiles at me. “Okay, then, why don’t you tell me more about Noah? What is the best time you’ve spent together? Any favourites?”

  “Yeah. Definitely. This summer, he came with us to the cottage. It was fun. I liked swimming with him. And fishing, too.”

  “Anything else?”

  I shrug. “I’m tired. Can we stop, please?”

  “If you’d like. But I do have a few more questions for you. Do you think we could keep going? Just for a little bit?”

  I look down at my hands. “I guess so.”

  “Okay, Nate. That’s good. We’ll talk about a few more things, and then we’ll stop. If you feel too tired, let me know and we’ll wait for another day.”

  I wait for her next question.

  “Can you tell me about any of the kids in your class who might not be so nice to you?”

  “No.”

  “Why not?”

  “Because I don’t want to talk about them.”

  “Okay. I understand that.”

  Dr. Aldridge waits. She says nothing. I stare at her and cross my arms.

  “Nate, I want you to know that if you ever want to talk to someone, I’m always here to listen. No matter what. And don’t forget what I told you last time. Everything you tell me will stay just between the two of us. I won’t tell anyone. Not even your mom and dad. Not unless you want me to.”

  I think about this for a moment. I wonder if I really can trust her.

  “Do you remember how you told me the last time we met that you sometimes don’t eat your lunch? That you throw it out when your dad isn’t looking?”

  I nod my head. I feel scared. I’m going to get into trouble for doing that.

  “Well, I didn’t tell anyone about that. Not one person.”

  “You didn’t?”

  “No, I didn’t.” Dr. Aldridge looks me straight in the eyes when she says it. It makes me believe her.

  We sit quietly.

  It feels like a really long time.

  If I tell her about Tyson, will she let me go to sleep sooner? Or play video games?

  “His name is Tyson. But there are others too. They are mean to me like the kids at my last school”

  “Tyson? Who is that?”

  “The kid in my class who is always mean to me.”

  “What does he do, Nate? Can you tell me about it?”

  “I don’t know. Stuff, I guess. He calls me names all the time. Like weirdo and cuckoo. And he tells me I’m ugly.”

  “That isn’t very nice. It must be very hurtful.”

  “Yeah, I guess. And sometimes he steals my snacks, when he likes what I bring for my recess snack. Especially if it’s Fruit Gushers. Those are his favourite. And a few times he punched me when I wouldn’t give them to him.”

  “He punched you? Where?”

  “In the cheek. Or in the stomach. One time it really hurt. He did it so hard. I felt like I couldn’t breathe, and I fell to the ground. Then he took my apple juice and Fruit Gushers and ran off.”

  Tears fall down my cheeks and I am surprised. I didn’t think I was going to cry. “But the worst part was that he didn’t even eat it. Even though I know he loves Fruit Gushers. He threw them in the garbage and screamed at everyone in the playground to never eat a snack from a weirdo. That I probably do weird things to my food.”

  “That must have been very hard. Did you tell anyone?”

  “Yes.”

  “Who did you tell?”

  “Noah.”

  “Anyone else?”

  I shake my head. I never tell anyone things like that, except for Noah.

  “Why not?”

  “I don’t want them to know, I guess.”

  “Thank you for telling me, Nate. I know that must have been hard to do. And I’m here to help you, if you want me to. With Tyson or anything else that’s going on in your life. You now that, right?”

  “Yeah. I do.” I scratch my head. It feels itchy. “Dr. Aldridge?”

  “Yes, Nate?”

  “Are you going to tell anyone about Tyson stealing my snacks and punching me?”

  “No, Nate. Not unless you want me to.”

  “Okay, good. I don’t want you to.” I look down at my arms. They look funny for some reason. And I’m starting to feel like I’m going to throw up.

  “Dr. Aldridge? Can I ask you something?”

  “Yes, Nate. Anything you’d like.”

  “Can we stop now? I don’t feel good.”

 
Dr. Aldridge snaps her book shut and puts her pen in her bag before smiling at me and giving me a hug. “Of course, Nate. We’ll start again the next time we meet, okay?”

  I nod and crawl into bed. I don’t remember falling asleep.

  49

  Ashley

  “I think Nate’s ready to go home,” Dr. Aldridge said to Pete and me from across her desk.

  “Really?” I asked cautiously. Nate had been in the hospital for just over two weeks and although I was desperate for him to return home to our family, I was also nervous to be without the constant support of the medical team at the hospital.

  “I will still treat him, as an outpatient. And I should see him regularly. Twice a week to start, and then less frequently as Nate gets better. You should all continue to go to your support groups. But Nate’s delusions have really started to diminish. He isn’t showing signs of paranoia. And he’s certainly not agitated like he was when he first came in. He’s stable. I think he can handle it.”

  “What about school?” I asked hesitantly, my protective instincts kicking into high gear. I knew Nate would need to return to school at some point, but I was dreading the moment he would go back to the bullying.

  “I have a suggestion for you about school. It’s fairly new, but there’s a solution that I think will work well for Nate. A new type of school has recently opened not far from here, called the Henry Lewis School Hospital. Basically, it’s a child and adolescent day program that also offers schooling. It’s a really great transitional program for kids like Nate who no longer need to be a part of the inpatient unit but still require more intensive treatment and would have a tough time being integrated back into a regular classroom. Nate would spend the day involved in individual and group therapeutic activities. There are teachers on site, and he would attend school at the hospital, and then return home each afternoon.”

  “Are there doctors on site as well?” Pete asked.

  “Yes. Including me. There are three psychiatrists who work out of the day hospital. I could continue to work with Nate there.”

  “It sounds too good to be true!” I replied with a sense of relief. “It really sounds wonderful.”

  “It is. I strongly believe in this program. It focuses on combining things like individual therapy, family therapy, behavioural interventions, and medication management to facilitate keeping the child at home, in school, and in regular outpatient treatment. Nate’s a perfect candidate.”

  “When would he start?”

  “I’ve looked into availability, and we can get Nate in the week after next, if you’d like. Starting on Monday.”

  Pete and I both nodded eagerly.

  “If Nate is to go home, there’s one big thing we need to all be aware of,” Dr. Aldridge continued. “The Risperidone has started to work, and is doing a good job of shifting his brain from an unbalanced world of mania and psychosis to reality. As we talked about before, though, every patient is different and it could take weeks before Nate sees the world for what it truly is. Nate doesn’t need to be in the hospital anymore, but he is straddling the fence between the delusions he’s experienced and what’s actually happening around him. He’s on middle ground right now, and while the psychosis has really been minimized, Nate still believes some of the things that are not true.”

  I nodded. I knew exactly what she was talking about. Beside me, Pete took my hand.

  “We have no way of knowing when that will change,” Dr. Aldridge continued. “It would be better if I were with him when he starts to realize everything for what it is. Because when he does … when he realizes things aren’t as he’s thought, it will be a very tough adjustment period. And he will likely mourn them, like a real-life loss.”

  “Is that why you asked us to bring in the pictures? To help get him to realize all of this?” Pete asked. Dr. Aldridge had sent us both an email the night before asking us to bring in family pictures from the past year.

  Dr. Aldridge nodded, pursing her lips. “If you’ve got them, let’s go to Nate’s room. There’s no time like the present to see if my idea helps …” Dr. Aldridge stood from her chair and we followed her into the elevator.

  When we got to the room, Nate greeted us with a big smile. He was just finishing his session with Payton, the art therapist whom he had been working with for the past two weeks. He loved it, and Dr. Aldridge felt it was one of the treatments that was helping him the most. During her daily visits, Payton used various materials to get Nate to express his inner images, feelings, and needs.

  “I was just leaving,” Payton said. “I’ll see you tomorrow, okay Nate? You can finish your clay project when you have some more time today. Sound good?”

  “Okay!” Nate responded.

  Once Payton had left, Dr. Aldridge pulled up a chair. “Your parents brought in some of your photo albums from the past year for me to take a look at. I loved seeing them. You’ve grown so much taller over the past few months …”

  “I know, right?” Nate grinned. He looked proud.

  “Want to see?” Dr. Aldridge opened the first album to a section about halfway through. The pages revealed pictures of our street pool party from over a year before. All the kids were in the pool, and Nate was jumping off the diving board, hamming it up for the crowd.

  “Look what a great jumper you are!” Dr. Aldridge said, pointing to another picture of Nate. I remembered him jumping off the diving board and doing an impersonation of a frog like it was yesterday. “And here you are with your hockey team that fall. Lots of pictures of you scoring goals … you must be a very good hockey player.”

  “The best — right, Nate?” I said, smiling proudly. “He’s the leading scorer on his team.”

  “That’s great,” said Dr. Aldridge. She slowly flipped through the photos.

  “And here you are this past summer, Nate, riding your bike.” Dr. Aldridge grinned, pointing to the pictures of Nate racing up and down the street.

  Nate nodded his head, examining the photos. Dr. Aldridge continued to flip the pages, until Nate took over. He stared intently at the pictures, as though he was seeing them for the first time.

  “Ah. Your trip up north from this past summer!” Dr. Aldridge said, pointing to a picture of our family sitting in front of the cottage we had rented. “You look like you’re all having so much fun.”

  “Yeah. I guess.” Nate’s voice was very quiet. When Dr. Aldridge didn’t respond, the room fell still.

  “Nate?” Dr. Aldridge asked quietly. Pete and I remained silent. We did not move an inch. “Is there something you’re noticing in these pictures?”

  Nate shrugged, looking very sad.

  “Anything you want to talk about?” Dr. Aldridge asked in a voice barely above a whisper.

  “It’s Noah,” Nate said almost inaudibly. Tears formed in his eyes. “He’s not in any of these photos.”

  Dr. Aldridge waited for our son to continue.

  “He’s … he’s not real, is he? My best friend Noah … he doesn’t exist in real life. That’s why he’s not in the photos. Even though he was there with us. On my hockey team, at the cottage … he was there with me. I remember him standing beside me when we took the group picture in front of the cottage. But now … he’s not in the photo.”

  “That is right, Nate. He isn’t in the photos,” Dr. Aldridge said quietly. She sat down on the side of Nate’s bed, and looked my son straight in the eyes. Her voice was calm and clear. “I know Noah has been very real to you for a very long time. And this is likely difficult for you. But you need to know that your mom and dad and Grace … they are all very real. They do exist in real life. And they all love you very, very much.”

  Hearing Dr. Aldridge’s words, Nate started to cry openly. I was desperate to go to him, but didn’t want to interrupt the doctor’s progress. Instead, I watched from the sidelines, my heart breaking a little bit more with each tear that
fell down Nate’s cheeks. I took Pete’s hand, and he squeezed it tight.

  “But … if Noah isn’t real, then how do I know that? How do I know Mommy and Daddy and Grace are real? What if I find out tomorrow that they aren’t real either? And I’m all alone?”

  I couldn’t take it any longer. I rushed to his bed, and pulled my son into my arms. Tears were coursing down both of our cheeks. “Sweetie … oh honey. Mommy and Daddy, we’re right here. Feel my face. Give me a hug. I’m so very real, and I will never leave you. I promise you. We all love you so much, and we will always, always be here for you.”

  “Nate,” Dr. Aldridge said softly. “You knew that Noah wasn’t real because he wasn’t in the pictures. Is that right?”

  Nate sniffed loudly and wiped his wet cheeks with his hand. “Yes.”

  “But who was in the pictures with you? Who has always been in the pictures with you?” Dr. Aldridge asked.

  “Mommy. And Daddy,” Nate responded. “And Grace too.”

  “That’s right. So you know that they are real. It isn’t like Noah.”

  “But … but I’ll miss Noah. He was my best friend in the whole world.”

  “I know, sweetie. And whenever we aren’t with people we care about, it’s very sad,” I said, squeezing my son more tightly.

  “Do you know what the good thing is, Nate?” Dr. Aldridge asked, gently interrupting me. “You’ve told me exactly what you like about Noah. Right? You like that he’s fun. And that he likes hockey. And that he keeps your secrets. Well, the next time you make a new friend, and I know you will, you can use all of those things to help you figure out exactly who you want to be your absolute best friend. Does that make sense to you?”

  Nate nodded but didn’t stop crying.

  “Why don’t I give you some time?” Dr. Aldridge asked Pete and me quietly. “I know one of you will need to get back to Grace at some point, but I’d suggest you stay as long as you can with Nate tonight. We can plan on discharging him in the morning, after he’s had a good night’s sleep and I talk to him one last time. Does that work?”

  I nodded. I was so grateful that between her and the medication, she had finally been able to get through to Nate and convince him that Noah wasn’t real. He’d been talking about his made-up best friend for months.