Safe, Wanted, and Loved: A Family Memoir of Mental Illness, Heartbreak, and Hope

by Patrick Dylan

  “What are you talking about? That stuff doesn’t matter when it comes to your career. Take the class. End of story.”

  I listened to her, and it forever changed my life. As part of the course, we completed several personality and behavioral tests. We also answered a number of priority questionnaires. We would be asked countless times and in different ways to rank various aspects of our lives—wealth, health, marriage, family, influence, free time, et cetera. After doing dozens of these, it became obvious what mattered most.

  Health was my first priority. Without health, as I had found with Crohn’s disease, other parts of life became harder for me to enjoy. After that, the most important things to me were marriage and family. In fact, wealth and prestige, and the other trappings of a business magnate, weren’t anywhere near the top. Suddenly, those high-paying jobs that demanded constant time away from home lost their allure.

  One of my college roommates, Sam, had started a software company and wanted me to join him. He made a compelling offer, but there was a catch: I’d have to leave business school early. It was the late 1990s, and things were moving at internet speed. For my classmates, the idea of abandoning the MBA program four months before graduation would have been unthinkable. For me, it sounded like a fun way to try working at a startup. And Harvard would let me finish my degree so long as I did so within five years.

  Mia didn’t hesitate. “If you want to go work with Sam, do it.”

  “Really?” I asked. “I’d be taking a pay cut from what I was making before business school. If the stock does well, that’d be one thing. Otherwise, it could be a huge waste of time.”

  “So what if you don’t make a lot of money? We don’t need it to be happy. What we need is for you to wake up every morning excited about your day.”

  I was so thrilled at the thought of joining Sam, and so grateful to Mia for supporting me, that I made an impromptu vow. “Tell you what,” I said, “if this startup is in any way successful, we’ll take a shot at living in Florida. I promise you.”

  “Deal. I’d bet on you any day, Pat. I’ll look forward to our move.”

  Many spouses would have been upset if their partners had dropped out early or spurned lucrative job offers. But Mia never complained; instead, she guided me to exactly the right decision.

  Her support for me never wavered.

  ***

  Although I was relieved to have Mia home, a sense of gloom descended over the house. Moody and snappish, she kept to herself. We tried to avoid her anyway, apprehensive about setting her off.

  One of my first priorities was to get Mia in front of Dr. Rojas again. He was eager to see her, and I was desperate to prevent any more bouts of psychosis.

  “So, how is Mia today?” he asked when we sat down.

  “Why do you always ask me that?” she snarled. “Why don’t you say ‘How are you doing today?’ like a normal person?”

  Dr. Rojas sat looking at her, smiling pleasantly.

  “Did you hear me? I don’t like when you ask me that,” Mia spat. She continued in a mocking voice, “‘How is Mia today?’”

  “Would you like me to greet you in a different way?”

  “Yes, I would.”

  “Okay, we’ll try this again. Mia, how are you doing today?” he asked. Mia gave short answers to his questions, remaining surly and brusque. She still had paranoid thoughts, and she admitted them, but she wasn’t psychotic.

  Near the end of the appointment, Dr. Rojas turned to me. “Do you have enough of everything but Zyprexa?”

  “Yes, that’s right.”

  “Good. Now, would you like me to write the script for Zyprexa or the generic form?” he asked.

  “I don’t know.” We had been using his samples before the crisis center. “What do you think?”

  “The brand-name version is expensive,” Dr. Rojas said, “and your insurance probably won’t cover it.”

  “Is there a difference in the medication itself? We finally have things under control, and I don’t like the idea of switching.” Even slight changes, I feared, had the potential for serious repercussions.

  “There shouldn’t be, but I can’t guarantee it.”

  “Then let’s stick with what’s working,” I told him.

  I went to pick up the prescription later that night. When I gave Mia’s name and birth date, the pharmacist looked up at me uneasily.

  “Sir, are you sure you don’t want the generic form of this?” she asked.

  I expected to pay more than usual. “Yes, I’m sure.”

  “Okay.” She started ringing it up. I knew Dr. Rojas had written a script that would last about ten days. “Your total is $1,053.68.”

  “Um . . . I’m sorry, what?” I asked, trying to digest it.

  “It’s $1,053.68,” she repeated. “There is a generic form.”

  “Uh, no, that’s okay,” I said, forcing myself to speak through the shock. As I handed over my credit card, my mind started racing through the math. At $3,000 a month, this wasn’t tenable, but I couldn’t risk anything that might send Mia back to the crisis center.

  I decided to discuss the generic with Dr. Rojas later. And I threw the receipt away inside the store. If Mia had seen the price tag, she never would have taken it.

  As the days passed, the family continued to tiptoe around Mia. When she wasn’t present, life proceeded on a semi-normal basis. The kids were kids, with homework and their outside activities. And I played the role of single parent: making dinners, fixing school lunches, and trying to keep track of their many appointments and responsibilities.

  But when Mia was near, the mood changed. We became quiet, worried about saying the wrong thing. And our altered behavior didn’t help the situation; Mia remained highly perceptive. She could sense the abrupt change whenever she joined a conversation. It made her feel as though we were excluding her, and that only exacerbated the resentment.

  We couldn’t recapture the joy that had defined our family interactions before the illness. I knew the medications were to blame, but it was hard not to take her dour attitude personally. Dinner conversations were especially difficult to manage. Will, older and more reserved, was relatively easy. He mostly watched in silent acceptance. Jamie, on the other hand, couldn’t contain herself.

  One night, Jamie shared with the family a new theory she was developing. “I figured out something today,” she declared. “Vampires are real.”

  Sudden silence. I looked from Jamie to Mia, whose startled eyes and gaping mouth were frozen in terror.

  “That’s great, babe.” I put my hand on Jamie’s shoulder. “But you know that vampires are just make-believe. It’s fun to pretend that they might be real, but we know they aren’t.”

  This threw Jamie off, because normally I would have answered with something like, Oh, is that right? Why don’t you tell us the steps in your thinking that led to that conclusion? She gave me a puzzled expression, but then charged on with her dissertation.

  “Well, really, we have no way of knowing that they’re not real. Because what are they going to do, tell us they’re vampires? Of course not. And if someone gets bit, they become a vampire, so they’re not going to tell us, either!”

  An uncomfortable pause as Jamie waited for feedback.

  “And how are we to know that they’re staying up all night? We’re sleeping, so we wouldn’t know.”

  She waited again. This was the part where we would throw out contradictory evidence, debating in a lighthearted way the case for and against vampires.

  But Mia was now staring at me with a look of absolute horror. As far as she was concerned, Jamie actually believed that vampires were living among us.

  I shut the conversation down at that point. Nevertheless, I still had to spend a half hour before bed persuading Mia that Jamie didn’t need to see a psychiatrist immediately.

 
But I finally did have Jamie seeing a counselor, a therapist named Maureen Jenkins. She had a PhD in psychology and considerable experience working with adolescents. Overall, I thought the match was a good one, and I was hopeful that Jamie might open up over time.

  Their first meeting didn’t amount to much. I escorted Jamie to Dr. Jenkins’s office, which included a small table where two people could sit together. After a ten-minute introduction, I left them alone. I knew that Dr. Jenkins’s plan was to have Jamie do art as part of her therapy, and it seemed like a great approach. Afterward in the car, Jamie didn’t want to talk about it, but I took heart in the fact that she finally had professional support.

  With all of the activities and therapist meetings, Luke and I were basically running a taxi service. Mia hadn’t been home for long before the fight for control of her car keys reignited. She remained livid that her independence had been curtailed. Plus, she wanted to start contributing again with the kids, and no one could fault her for that.

  I discussed it with Dr. Rojas. He advised me that although the Zyprexa blunted her personality, it wouldn’t prevent her from safely operating a vehicle. The real culprit was the Ativan, but we had already cut that dose in half, and our plan was to cut it in half again within a few weeks.

  Given that Dr. Rojas wasn’t overly concerned, the decision came down to trust. For six weeks, I had known where Mia was every moment of every day. The idea of letting her drive off, potentially alone or with the kids in tow, made me nervous. In her current condition, I knew things would be fine; but, as I had seen too many times, her mental state could deteriorate quickly.

  I did have one advantage. When it came to technology, Mia wasn’t the most sophisticated user. And she took her iPhone everywhere. I secretly enabled Find my iPhone on her cell. It made me feel disingenuous, but it also provided tremendous comfort.

  As for Luke, he continued to entertain. At some point, I asked him to take Will to a Saturday-morning golf lesson. Luke wasn’t a golfer, and the club had strict rules on etiquette. Before they left, I pulled Will aside. “Try to keep him in line,” I begged.

  They arrived home hours later, and I asked Will how it went.

  “Oh, it was fine,” he replied, a grin spreading across his face. “The last green got a little dicey, though. I had to plead with Uncle Luke to keep his shirt on.”

  “Oh jeez,” I said, rolling my eyes. “Can you imagine if people would have seen him walking around the course without a shirt?”

  “Yeah, well, he didn’t take his shirt off, but I thought I better get him out of there when he started climbing the palm trees.”

  “Are you serious?” I exclaimed. “Those trees are like twenty feet high!”

  “I know,” he snickered. “Uncle Luke shimmied up easily, like a monkey or something. He wanted fresh coconut.”

  This wasn’t the only story that emerged from that month. In mid-November, a big fight with Manny Pacquiao was taking place. Luke found a bar that was showing the fight, borrowed our car, and drove off after dinner; I didn’t wait up.

  Mia woke early the next morning. I heard her rise and walk to the kitchen. Two minutes later, she came back into the bedroom.

  “Luke is dead,” she announced without emotion.

  “What?” I sat bolt upright. “What do you mean, ‘Luke is dead’?”

  “There’s blood all over the porch, and I just checked on him. He’s not breathing.” She was reciting facts, with no trace of distress in her voice.

  Immediately, I suspected that she was suffering another delusion. “Mia, I’m sure Luke isn’t dead,” I said with as much confidence as possible. As I stood to throw on a T-shirt and shorts, I mentally started reviewing the medications she had taken the night before.

  “Yes, he is,” said Mia matter-of-factly. She shuffled into the bathroom to wash up; Luke’s demise didn’t seem to be bothering her much.

  Walking into the foyer, I scanned the porch and noticed drops of blood on the tile. I went out to inspect the scene. Sure enough, I saw evidence of an open wound of some type; blood was splashed everywhere. Red droplets led down the sidewalk and onto the driveway, where they disappeared.

  I strode quickly to the back room and looked in on Luke. He was sprawled on the floor and didn’t appear to be moving. My heart skipped a beat.

  I leaned down to examine him. His face looked fine; I saw no bruises or cuts. Stooping lower, I put my ear to his mouth and could hear faint breathing. At least he isn’t dead, I thought. And then I realized how ridiculous it was. Dealing with Mia’s illness over the past six weeks had me fearing the worst.

  I shook his shoulder. “Luke,” I whispered. “Hey, Cubano. Get up.”

  His blue eyes opened slowly. “Patricio? Everything okay?”

  “That’s what I was going to ask you.”

  “Yeah, aces, amigo.” He smiled groggily.

  “Then why is there blood all over the porch?”

  “Oh shit,” he said, more energy entering his face. “I thought I cleaned that up.”

  “Mia saw it just now. She’s convinced you’re dead.”

  “Ah, damn,” he groaned, clearly upset with himself. “Sorry, man, I thought I got it all, but it was pretty dark.”

  “Luke,” I asked in a steady voice, incredulous that he hadn’t yet clarified the situation, “whose blood is it?”

  “Mira, I was driving home after the fight, and I hit a rabbit.”

  “That would explain why there might be blood on the car, but there’s blood all over the porch.”

  “I wasn’t going to leave that rabbit on the road. That’s good eats, bro.”

  I closed my eyes in disbelief.

  “But I didn’t skin it in the house,” he continued. “That would have really made a mess, yeah?”

  “You skinned a rabbit on our porch?”

  “Deboned it, too. But like I said, I thought I cleaned it all up.”

  “You didn’t.”

  “Sorry, man.” I could hear the remorse in his voice.

  “Luke, where is what’s left of the rabbit?”

  “It’s in the fridge, Patricio. I figured I’d make us rabbit stew tonight,” he said proudly, smiling.

  No one in the family would want rabbit stew. Jamie loved the little bunnies in our neighborhood and never would have forgiven her uncle, and Will would have been grossed out, too. Mia probably wouldn’t have minded, but she wouldn’t have eaten it, either.

  However, Mia’s eating habits weren’t what they used to be. She was consuming fried chicken by the bucket, along with loads of bread, chocolate, and candy. She could sit down with us for dinner, partaking heavily of Cuban food, and then a half hour later I’d find her secretly raiding the kids’ Halloween candy by the handful.

  This behavior was anathema to the Mia I had known. Together, we had prioritized our health, not only with diet but with exercise. Our first date had been a four-mile run together. But Mia had discontinued all forms of exercise, too. I knew it was the medication. Still, it didn’t make it easier to witness such a drastic change.

  Mia had been petite—five feet two and weighing no more than 110 pounds. But after weeks on antipsychotics, she had started gaining weight. After she had come home from the crisis center for the second time, the bulk accumulated even faster. By mid-November, she had added at least twenty pounds to her frame, probably more. And it came on so fast that it mostly affected her belly.

  I knew better than to mention anything about it, but it led to awkward conversations. Periodically, someone would come up to her and exclaim happily, “I didn’t know you were expecting!”

  “I’m not,” she would reply, devoid of emotion and without further explanation.

  “Oh, I’m sorry,” the person would respond uncomfortably, their embarrassment painful.

  With her changing appearance, Mia was moving further awa
y from the person that she had been. She had gone from being caring and kind to selfish and mean, from fun and happy to gloomy and sad. Someone who had been a role model for healthy living was now confusing the kids with terrible dietary choices. It was hard to accept, but it was our new normal, and we each had to deal with it in our own way.

  I dealt with it by doubling down on finding the cause of her illness. All of my free time was consumed with research, which included reading everything from scientific papers to random blog articles. Her brother Mark did the same, and we regularly compared notes, but we didn’t uncover anything.

  As Thanksgiving approached, I began dreading the holiday. The worst times at home were the weekends, with the kids around all day and Mia poisoning the mood. Thanksgiving would be an extended weekend, and we would be adding more people to the mix. I didn’t know how Mia would respond, but I knew she would be especially upset if we skipped it altogether. I made plans for us to spend the holiday with my parents and the weekend with Mia’s family.

  My brother, Brad, and his wife, Jen, along with their boys, would be at my mom’s place. I was worried that so many people in a small house would stress Mia’s limited patience. I warned the adults, sending an email describing her demeanor and preparing them for potential problems.

  Issues began to surface during our drive across the state. Luke was traveling separately, and the kids probably wished they had gone with him. Mia was in a particularly sour disposition. She insisted that I drive, choosing instead to sulk in the passenger seat. But she also demanded that I take a relatively new route. This was before driving apps, and I wasn’t entirely sure of the directions.

  “This is the exit to 95 that I want, correct?” I asked Mia after two hours, knowing that if we missed our turn, we would have to drive a half hour out of our way.

  Silence.

  “Mia,” I repeated, certain that she had heard me the first time, “is this the correct exit?”

  No answer. The exit was approaching fast.

  “Mia, it’d be great if you could answer.” I wondered what to do if she didn’t.