“When I got to her house, I saw her walk behind it, but when I went back there, she was gone. There was no one there. I yelled and yelled. There’s a pond behind her house and for a second I thought maybe she’d gone into it.”
I didn’t want to talk about this anymore. It hurt to remember.
“What do you think is wrong with me?” I asked.
She looked up from her notepad. “We’re trying to figure out what’s going on.”
“But you said symptoms. You asked me what other symptoms I had, so you must think that it’s symptoms of something. I know you talked to my dad. He told you everything.”
As if on cue, there was a knock on the door and Janet was back with my parents in tow.
Dr. Keels nodded for them to sit next to me.
“June and I were just getting to know each other,” she said.
My dad was all business, shaking her hand before taking a seat. My mom let out her breath when she saw me, like she’d been holding it for a long time. She scooted her chair closer to me.
“June has been telling me about the things she’s experiencing,” Dr. Keels said to them. They stared so intently at her face, like they expected to find answers there. My mom leaned forward in her chair.
“June, would you mind if I shared with your parents the things you’ve told me?” Dr. Keels asked.
“I don’t mind.”
“It appears that June has experienced some periods of psychosis.” She looked each of us in the eyes one at a time, to make sure we were all paying attention. “There are a few things that can cause such episodes,” she said. “I was just telling June that we’re trying to figure out what may have caused hers. In order to do so, we have to rule out the possible causes until we land on one that is the most likely. All of your tests came back normal,” she said to me. “Your drug screen came back normal, too.”
She saw the surprise in my face. I didn’t know I’d been screened for drugs.
“It’s normal procedure to determine if you’ve taken anything psychotropic that might be causing these symptoms.”
I had smoked weed once at a party in Brad Henderson’s backyard, and I had taken some of Nick’s aunt Linda’s sleeping pills that had made me wake up feeling like my brain was full of cotton, but nothing else.
“I’ll establish a working diagnosis and we’ll proceed from there, but we can go ahead and treat your symptoms and make adjustments as needed.”
“What’s your working diagnosis?” It was my dad.
“It’s too soon to assign names. The first thing we want to do is help June establish normal sleep patterns.” She looked at me. “Regular sleep is crucial to your mental health. Exhaustion from lack of sleep can cause hallucinations.”
“Could that be it?” I asked. “Could I just be tired?”
“Possibly, but sometimes not being able to sleep is a symptom of something else.”
“Like what?” my mom asked.
“We’re not assigning any names yet,” Dr. Keels reminded her.
“But if you had to give it a name? Today, right now. What would you call it?” It was my dad again. He stood now. He wore his demanding face, his I’m-ready-to-fix-this-problem face.
“Steve…,” my mom said.
Dr. Keels looked like she was weighing her options. She opened the bag she had come in with and pulled out pamphlets, passing them out to us.
“This is some background information that you all might want to read.” She rambled on, words rolling off her tongue as she laid out the information. “There are mental illnesses that can cause symptoms like you’ve described.” She used words like bipolar disorder, schizophrenia, schizoaffective disorder, major depressive disorder.
My mom put her head in her hands like she was devastated, like someone had told her I died.
Dr. Keels leaned closer to me. “The fact that no one in your family has ever reported experiencing periods of psychosis makes a good prognosis more likely,” she said. She looked to my parents for confirmation and they both nodded. “It’s also a good sign that you’re aware that something is wrong. People who are aware that what they’re experiencing is abnormal respond much better to treatment. The technical term is insight.”
I had insight into what was wrong with me. I just didn’t know what it was called yet. And neither did she.
“So what do we do about it?” I asked.
“Since being admitted, you’ve been given small doses of an antipsychotic. Initially it makes you sleepy, which is why you’ve been taking it at night. But it’s not a sleeping pill. Over time that effect will wear off, so we’ll introduce a sleep aid, just until you can develop normal sleep patterns on your own.”
“But I’ll keep taking the other one, too?”
“Yes,” she said. “And we’ll continue to monitor you and treat any symptoms as they come up.”
“How long will I be in the hospital?” I asked.
“At least until a working diagnosis can be made. It really varies from person to person. We’ll need to regulate the medications, tweak the dosages as needed. I’ll need to observe you and we’ll continue to chat. In the meantime, the medication has helped a lot of people with symptoms similar to yours. It can help you think more clearly, slow down those racing thoughts, help you remain able to discern reality from not.”
“Will it get rid of the voices?” I asked.
“The antipsychotic likely won’t reach peak effect until about three to four weeks after starting it, so you may still experience some symptoms until that time.”
She must have seen the panic in my eyes, because she continued. “But you should feel the calming effect immediately. So while you may still hear voices or see things, the drug will impact how you react to them.”
“They’ll be less scary?”
“I hope so,” she said.
“So in a few weeks, they’ll be gone? It’ll fix them?”
My dad leaned forward, waiting. It might have been the first time he was in a room with someone who knew more than he did about something.
“This can be a waiting game, June, and it’s important to understand that a lot of these illnesses are lifelong conditions, and so is the treatment. But many people live full, independent lives. You can read about some of them in the literature I’ve given you. You had a psychotic episode, but that doesn’t mean you can’t recover from it.”
“Lifelong?” I asked. It felt like my throat was closing.
“Yes,” she said. “Like a lot of illnesses.”
I’d woken up something inside me that was never going back to sleep.
“Think of it like asthma,” she said. “Your dad has asthma. I remember from med school. He had an asthma attack one semester. He said it was the first one he’d had since he was a child.”
This was true. He’d told me stories of rushed car trips to the emergency room, with the windows down so the wind in his face would keep him awake, all because he’d gotten too close to the neighbor’s cat. He’d been worried I’d have similar problems, but I never did.
“If he takes his medication and avoids those things that trigger an attack, he’s less likely to have one,” Dr. Keels said. “It doesn’t mean he won’t ever have another one, but he knows what to do when he does and then he recovers from them. I don’t want to oversimplify it, but I think the analogy could help explain things a bit in terms of this being an illness we can treat.”
My dad avoided cats at all costs and never went anywhere without his inhaler.
“But there’s no inhaler for this,” I said.
What would I use to help me breathe?
“You’ll have medication and me, or someone like me. You’ll have other coping strategies to help you. You’ve already developed at least one.”
She saw the confusion in my face.
�
�Your notebook,” she said. “Writing down what happened, how it made you feel, helped you. Right?”
I nodded.
“And you have a good support system in your parents. Those things will be vital to establishing successful recovery strategies. Before, you were coping the best you could, with the tools you had. My goal is to diagnose you and help you build more tools.”
“So what do we do now?” I asked.
“We watch and wait and we adjust the treatment accordingly.”
My dad hardly ever told my mom that he loved her. It wasn’t that he didn’t love her. He was just never comfortable with that word in the room. She stopped saying it after a while, too. Maybe because he almost never said it back. She pulled away from him a little more every day. I didn’t know when he noticed. She sent him divorce papers during his second week in prison.
“You don’t love him anymore?” I’d asked.
“It’s not about loving him,” she’d said. “It’s about letting him go so I can have a life, too.”
That was something I didn’t know how to do.
* * *
It was visiting day at the Varner Unit of the Arkansas Department of Correction. The prison was about an hour and a half’s drive from Creed and it usually had visiting day on the weekends. Unless Aunt Linda was working, she came every time. I couldn’t come unless she did. They didn’t let minors visit without an adult. Even so, I only came with her about once a month.
I wasn’t claustrophobic, but every time I walked through the metal detectors, it felt like the walls were closing in. We made it through the line in record time. There weren’t a lot of people visiting.
The visiting room was divided by a glass partition, with cubicles set up all along the glass. There was room for two visitors on one side and the inmate on the other, with a phone on either side of the partition.
There was a loud buzzing sound and the door opened and my dad walked into the room. I used to think he was the biggest man in the world, but every time I visited, he was smaller. I was taller than him now.
He sat in the chair across from us and picked up the phone. I picked up mine. Aunt Linda always let me go first. She’d bring a book or magazine, something to pay attention to, so that I could have some sort of privacy.
“Son,” he said. He usually called me “son” instead of saying my name, like he was trying to remind me of my role.
“Dad,” I said, returning the gesture.
I didn’t know how thick the glass between us was. I used to wonder how much strength it’d take to break it. I’d imagine being able to do it. The times he was in county jail, they’d let us visit in an open room with tables and chairs. I could touch him. I didn’t, but there was the option.
Looking at him was like looking in a mirror, only this mirror aged you twenty years. John looked more like my mom’s side of the family, like Hank. I used to be jealous of that, because I thought that made it easier for John. He could pretend that he was Hank’s son. I couldn’t, because my dad was in the mirror every time I looked in one.
“Have you heard from John?” he asked.
It was always the first thing he asked.
“Not in a while,” I said. “You?”
He shook his head. “You still with June?”
He thought he was asking another question he knew the answer to, like his first one. He didn’t know that I’d betrayed her, that she was in the hospital and might never speak to me again.
“I don’t know,” I said. “It’s complicated.”
I didn’t add that she might hate me now.
He leaned back in his seat. “It always is,” he said.
He waited for me to explain, but I didn’t trust myself to talk about it yet and there was really only one thing I’d come there to say.
“I got a letter from your mom,” he said, interrupting my thoughts.
“Really?”
“Yeah, she married Larry.”
He could tell this was news to me.
“I’m sure she was going to get around to telling you.”
“Yeah,” I said. She probably wanted my dad to know first.
“I guess Larry makes her happy,” he said.
“I hope so.”
He nodded.
“I’m quitting Benny’s,” I said. “I’ve got one more job to do and then I’m done with him.”
He shifted in his seat, like he couldn’t get comfortable, and then he leaned closer to the glass.
“You’re gonna be an upstanding citizen now?” he asked. His look was a cross between proud and sad, like he knew this was the moment he’d lost me to Hank.
“I’m gonna try,” I said.
“What will you do for cash?”
“I’m going to Hank’s this summer,” I said.
He nodded. “You always go to Hank’s.”
“I don’t think I’m coming back.”
His face changed. He leaned back in the seat, like he was chewing over the idea. Aunt Linda didn’t look up from her book but she put her hand on my leg.
“I think that’s a good idea,” he said finally.
There was a twinge in my side, a tiny part of me that hurt, because I wanted him to ask me not to go. I wouldn’t be able to see him once a month.
“You’ve got options I didn’t have,” he said. “If you’ve found your way out, then you should take it.”
“And it’s not like I have much in Creed to stick around for,” I said.
It was a jab at him for not being around to raise me.
“It wasn’t my choice to leave you, kid.”
Not like my mom, he meant. I hated being put in the position of defending her, but I would do it and he knew it. And he was wrong. Somewhere along the way, he did make a choice.
He sat up straighter in his seat, like he was preparing for the fight.
I hung up the phone and stood, surprising both of us.
“Bye, Dad,” I mouthed. “I’ll see you.”
My birds were gone. A nurse had made me take a shower earlier and I couldn’t find a trace of one. I’d been careful with them since being admitted, only showering when forced and then trying to save one or two. I’d wanted to keep the birds. I liked the idea of them wearing off over time.
Lifting the gown I’d been given over my head, I stood bare under the fluorescent lights of the bathroom and stared at my body in the mirror. I searched for the birds, just in case I had missed one.
Wait.
There on my left hip bone was a black smudge, a disappearing feather. I put my hand over it. It’d be my secret.
It felt good to have one.
My face was almost healed from the scratches. I didn’t know how I felt about that. The scratches were a clue that something was wrong inside my head. I imagined the “misfires” in my brain that Dr. Keels had talked about that made me see and hear things no one else could.
My eyes were sensitive to the light and my head felt fuzzy, both side effects of my medication. Dr. Keels had upped the dosage. She told me to expect the fuzzy-headed feeling for a while but she didn’t say anything about the light. I had to remember to talk to her about it. I saw her every day and we talked endlessly about everything. She dissected my symptoms until they were cut into their smallest pieces. She’d been crossing possible causes of psychosis off her list.
Severe depression.
Bipolar disorder.
Lack of sleep.
I’d been getting regular sleep lately with the help of a sleeping pill, but my symptoms still persisted. I hadn’t heard a voice since being admitted, but there were the other noises. At night, after everyone was asleep and the halls were dark, I’d hear someone walking down the hall. They always stopped outside my door. For a while they wouldn’t knock, just stand out there breathing heavily. Then the kn
ocking would begin. The first time it happened, I opened the door unaware, just like when I’d answer the door back home after hearing the doorbell. I thought maybe it was one of my parents coming to tell me good night. They were spending more time at the hospital than home lately. No one was there, and I didn’t take it well. Dr. Keels prescribed a stronger sleeping pill after that.
There was one cause of psychosis that Dr. Keels hadn’t crossed off her list yet. We’d been dancing around the idea during our sessions, both the ones with just me and her and the ones with my parents.
Schizophrenia.
I was preparing myself for it to be that, reading everything I could, asking Dr. Keels a million questions. She told me not to get ahead of myself, that it had to be at least thirty days before a diagnosis was made. That was what she was leaning toward, though. I could tell. Unless my symptoms changed. My symptoms drove everything.
I asked her a million questions and she answered every one. She said that for some people, the onset of schizophrenia was like a slow burn, a gradual decrease in functioning over a period of time. For others, the onset could be sudden—something could happen to trigger the illness.
“Typically, the symptoms increase in frequency and severity until there is a break from reality,” she said.
I’d had a break from reality.
“If this is schizophrenia, then it’s a good sign that you’re experiencing more positive symptoms than negative ones,” she said.
“What’s positive about my symptoms?”
“Positive means something different in this context. Hearing voices and seeing things are occurrences you’ve never experienced before. They’re added characteristics, positives. Negative symptoms are the absence of your normal characteristics. Not sleeping is a negative symptom. Others would be lack of motivation, social withdrawal, inability to maintain relationships, problems with speech and movement. Negative symptoms impact quality of life more so than positive ones.”
“So what do we do about it?” I asked.
“What we’re doing now,” she said.
“But you still don’t know for sure.”
Nick and June Were Here Page 10