Friday, January 31, 2014

Hyper-Mania Reigns

Monday, January 27

Since his return from Savannah last Wednesday, Parrish’s mania has escalated exponentially.  I keep thinking back to his admission lab work when he went to hospital because of his overdose.  His lithium level was negative.  Given that, it’s hard to believe him when he says he takes it every day as directed.  Not taking it guarantees instability, even with his other meds. 

Though he had been in hospital in Savannah for a week and was supposed to be properly medicated, Parrish was manic on the day he was dismissed, a fact that I pointed out to the social worker and the discharge nurse. 

When released, he barreled  through the door to the waiting room, actually an anteroom with a couple of chairs in it, and was trying to push open the outside door before I could get his attention.

“Whoa!  Slow down, P.  We have to meet with the nurse and the social worker before you can go.”

“Let’s just go.  I can’t take any more of this bullshit.  There’s a patient in there throwing chairs around.”

He was loud and could not focus or hear what I said unless I repeated myself.  When I looked at him I saw a sick little boy, out of control and not knowing why he felt so bad inside.  His eyes danced with anxiety and fear and false bravado, and I wanted to swaddle him and bundle him close to my chest and sing to him and make all the crazy go away. 

“Take a breath, Son.  Take a breath and sit down while we go over your discharge plan.”

“I don’t need a discharge plan!”  I’m going to see my own shrink in a week.”  

He was up and down, in and out of his seat, pacing around the space.

“Can we get something to eat?  I’m starving.  Pigs shouldn’t have to eat the food they serve here.  This place is a travesty!” 

My observation that he was unstable and manic was met with blank looks from the social worker and the nurse. 

“The doctor has decided he is stable and can go home.”

“Look at him, please!  He lives alone!  He cannot sit still, and when he does sit down, he works his heels against the floor so fast that they are a blur.  He can’t stay on topic.  He has scattered thoughts.  What is stable about this behavior?”

Our “counseling session” was taking place in the anteroom.

“He’ll be more relaxed when you get him home.”

The nurse proceeded to give Parrish a five-day supply of Abilify, Valium and lithium, carefully explaining to him that he should take them exactly as ordered.  She sat there and told a psychotic man that he should follow the rules!  But it gets better.  She then handed him printed prescriptions for another month’s supply of the drugs.  They included one for 60, count them, 60 Valium tablets, 10 mg each, more than enough to kill him.  

“You’re going to send this man, a patient who has been under suicide watch for 12 days, out of here with a prescription for enough Valium to kill himself?  Is this your idea of a discharge plan that will work?”

“The doctor thinks he can handle his medicine.”

Deciding to take control of the Valium myself, I got us out of there as fast as I could, knowing all the time that P was not stable and should be in a controlled environment but also knowing that Georgia Regional would not or could not meet his needs.  He received no therapy and never saw a doctor, only a nurse practitioner, if you can believe what he says.  I am going to request the records and find out for myself.  At that moment, I held fast to the knowledge that he had an appointment on the 29th with a private psychiatrist here on Saint Simons.  

Parrish’s mania escalated on the drive back to Brunswick.  He obsessed about coming to live with me.

“I can’t live alone, Mama.  You should have figured that out by now.”

“And you know as well as I do that living with me is not an option, Son.  Is there any real need for me to go over all the things that went wrong when you lived with me?”

“But now you have control of my money!  You’re responsible for me because you are my guardian.  If you can’t make yourself take care of me, your guardianship over me is going to be revoked as soon as possible!”

I chose to ignore that remark, not bothering to remind him that he has no voice in whether or not I am his legal guardian.

Conversation was spotty, and there was an undercurrent of anger in his words.  He demanded that I give him some money, said he couldn’t walk around without money in his pocket.  I reminded him that, when we were giving him money to eat and wash clothes, he spent it on alcohol and God knows what else.  Every item of clothing he owns was dirty when I cleaned out his efficiency, and there was evidence of alcohol use.  

“No, Parrish.  I will not give you any money.”

“But how will I eat and wash clothes?”

“I will wash your clothes and your daddy and I will make sure you are supplied with groceries.”

“This guardianship thing has got to go!  As soon as I get out from under it, I’m leaving this town.”  

When we arrived in Brunswick, he insisted that we stop at CVS to fill his prescriptions.  Since he had a small supply medication, I didn’t think it was necessary, but in view of his mania decided to humor him.

On the way to the drug store, I told P he would have to let me keep the Valium and that I would give him enough for two days at a time.

He bristled.

“I am fully capable of handling my medication!”

“No! You are not.  I gave you a bottle of Elavil and less than two weeks ago you took every one of them in an effort to kill yourself.  You will have to give me control of the Valium.”

“But I’m fine.  And I need some money.”

“You were fine 8 hours before your suicide attempt.  I will not let you have enough Valium to try it again.”

Sulking, 

“Okay, Mama, have it your way.  You always do.  I have never won an argument with you, so do what you want to do.  I need some money, though.  I can’t walk around without any money.”

P was only in the store a few minutes before he returned to the car and got it.

“The drugs won’t be ready until day after tomorrow.  They have to order some of it.”

“They don’t have Ability and lithium and Valium?  I find that hard to believe.”

“Well, that’s what the man said.”

Something seemed wrong, unsettling, but I couldn’t put my finger on it, and as long as he didn’t have the medicine, I decided not to worry.

“We’ll come back on Friday.”

I checked P into a decent hotel, helped him unpack and put his things away.  His mania subsided and we made plans to go to the grocery store on Friday.  Before I left, I promised to order a pizza for his supper.

I called his father and left a message that P was back in town and installed in a hotel, but I didn’t speak to him personally.

I talked to P several times on Thursday, and I was concerned that his tongue was thick and his speech was a little slurred, both signs of alcohol use but also signs of mania.  I knew he didn’t have any money, so I encouraged him to get out and walk, work off some of the extra energy he was producing.  That night, I called his father to tell him I was concerned that Parrish’s mania seemed to be escalating.  I left a message.    

On Friday morning, I got a call from Lawrence thanking me for the message and promising to call me later when he had time to talk.  I took Parrish to the grocery store and we went shopping for a new winter jacket for him.  His jacket was one of the several things, including his Kindle, that were not in his efficiency when I cleaned it out.  He was manic but not extremely so.  I could tell his anxiety level was high, despite the Valium he took in the morning.  I was uneasy about leaving him alone and even considered going back and spending the night with him.

Shortly after I arrived at my flat, Lawrence called.  

“I’m concerned, too,’ he said.  “A little while ago, I got a call from him demanding that I bring him some quarters for the washing machine.  He was very insistent and his speech wasn’t right.  I hesitated because I was there earlier to take him the medicines he asked me to pick up at CVS, but I went anyway and his room was empty.”

“My God!  He has 60 Valium pills!  That’s enough to kill him if he takes them all!”

“I’m going back over there right now,” Lawrence wheezed.  I can get there faster than you can, and I’ll call you from there.”

I held the phone and stared at it for a few minutes before the tears welled up and the sobs began.  Had he done it again?  I felt as though I might implode, fall in on myself and get lost in the darkness.  Paralyzed with dread, I sat and stared and smoked until the phone rang about 20 minutes later.

“He’s not here.”

“Look around and see if you can find the Valium, the other drugs, too.”

“There’s nothing here except a full bottle of lithium.  What are we going to do?”

“You go home and rest up for work in the morning.  I’ll go over there and wait for him in his room.  If he doesn’t return within a couple of hours, I’ll call the police.”

I arrived at the hotel at about 7:30 and searched the room thoroughly.  The only suspicious thing I found was an empty 24-ounce can of an alcoholic beverage that was 12% alcohol, roughly twice the potency of beer.  Everything else was in order.  I worried and tried to write.

Lawrence arrived a little after 8:00 to wait with me, and we decided that we would give P until 10:00 to show up before contacting the police.  At 9:30 he staggered in.

“What are you doing here?”

“Your daddy and I have been waiting to see whether you would show up or be found dead somewhere.  No one has been able to get in touch with you since you called him this afternoon.”

“I’ve been out.”

“How much have you had to drink?’

“I haven’t been drinking.”

“Of course you have.  You reek of beer and can hardly stand.  Do yourself a favor and don’t embarrass yourself by trying to convince us that you have been out for a stroll in the cold for several hours.”

“I haven’t been drinking.”

“Look at me, Parrish.  Look into my eyes.  This is me, not some doctor who knows nothing about you, not your daddy whom you used to get all the Valium that is now missing from this room.  Where is the Valium?”

“I don’t know.”

“Where is the fucking Valium?”

I didn’t look at Lawrence, but I could feel him cringe at my language.  At that moment, I didn’t give a shit what he thought about it.

P pulled the bottle out of his pocket, and I jerked it out of his hand and opened it.  There were seven tablets left out of the 60 that were dispensed just the day before. 

“Did you sell these or trade them for alcohol?”

“No.”

“You are lying.  Tell me what happened to all of these pills.  If you took them, we need to take you to the hospital.  Did you sell them or trade them or take them?  Do not play with me, P.  This is not some game.”

In a whisper, “I traded them.”

“To whom and for what?”

No answer.  He tried to change the subject.

“What are you doing here, Daddy?” 

“Son, I’m here because I love you and I’m worried about you.  If you keep this up, you won’t have to kill yourself.  Somebody’s going to do it for you!”

“Why in he name of God did you think you could drink, Parrish?  You know you can’t drink.  What is wrong with you?” I asked.

Lawrence kept trying to defuse Parrish’s crazy rantings, so he talked him into trying on a snow suit he brought him earlier.  Yes, a snow suit.  He thinks P should wear it when he is out walking in the cold.  Parrish was so impaired, his daddy had to put the suit on him. 

After laughing like a hyena, P started weeping openly and lamenting his situation, trying to convince us that his life is essentially a piece of shit, that he has nothing.

“You have two parents who love you.  You say that’s all you ever wanted.  Here we are, both involved in your life and trying our best to make it better.  Where would you be if your daddy and I weren’t paying for this hotel so you have a place to live?

Finger to his temple, “I’d be dead!”  If you two think you can keep me from killing myself, you don’t know shit.”

“Don’t play the suicide card with me, Parrish.”

“I’m no playing anything.  I’m telling you the facts.  You’re going to kick me out on the street again.  You’ve done it before and you’ll do it again.  I’ve never been right since you divorced Daddy and took me away from him.” 

“That’s enough, Son!  Your mama has never been anything but a good mother to you.  There is nothing more precious than a mother’s love, and you have repaid her by giving her more hell than any woman deserves.  Now you just stop that kind of talk.”

And so it went until Lawrence took his leave.  I assured him that I would stay with P until he went to sleep.

“I’m not tired.  I don’t want to go to sleep and I don’t want you here.”

“I’m staying.  Get used to it.”

I lay down on the day bed under the window and started watching Modern Family.  P came over and sat on the side of the bed and pushed his face next to mine.

“I need to tell you something, need to be honest with you about what happened tonight.”

“I’m listening.  You know you can tell me anything.”

“I walked to his hotel to see The Famous Writer.”

I waited.

“I told him I had some Valium and I would give him some if he would buy me some beer.”

“You went to The Famous Writer?”  

I was incredulous, unable to understand why P would seek out The Famous Writer for any reason after their confrontation last month.  I suppose there are no extremes to which a mentally ill person will not go to quell his urges.

“What in the name of God made you go to there?  Did you go there with the idea of trading Valium or did you go there to pick a fight with him?  This is hard for me to process but I can believe it.  Why?  You could have sold that Valium to anyone.” 

Out of left field, “Did you know he has a car now?”

“I heard it through a mutual friend.  Did you get in the car with that drunken madman?”

“He was going to the island to get a hair cut, and he took me with him.”

I didn’t believe him.

“Where does he get his hair cut?”

“A place in Redfern Village.”

“And he took you with him?”

I know where The Famous Writer gets his hair cut.  I took him there myself once, and it’s in Redfern.

“What did you do while he was getting his hair cut?”

“I sat there and waited.”

“And where did he buy you the beer?”

“He went to the liquor store across from the airport and bought himself a case of wine and me a six-pack of beer?”

“One six-pack?”

“Maybe he bought more than that.”

“I see.  You didn’t get in this shape by drinking one six-pack of beer.  I’m surprised that you think I might even consider believing that.”

“I took some Valium, too.”

“How much?”

“Two 10 mg tablets.”

“Really?  Two?”

“Maybe more.”

"Then what happened?"

“He drove us back to the his hotel and started telling me all this stuff about music.  His wife kept calling him and he shouted into the phone and called her a cunt and hung up on her.  Then he went psychotic and started ranting and raving about how much he hates everybody and how he has no use for you.  He told me you owe him fifty dollars.  I said if he called you another bad name, I would hurt him.  Then he told me to give him the Valium and get out.  I asked him to bring me back here, but he said ‘no’.”

“And you actually gave him the Valium?  How much?”

“All but what’s left in the bottle.”

“We’ve talked about this long enough.  You need to get some rest.  Let’s get ready for bed.

A look of utter amazement crossed his face.

“You’re going to stay with me?  You've never done anything like that for me.”

“Of course I have, P.  I let you live with me last year until it became clear that the arrangement was bad for both of us.  I will be happy to stay over.  Honey’s in her kennel and should be fine.”  

P was calmer, and we went out by the pool in the freezing cold and smoked a cigarette and shared a Dr. Pepper.  Over and over, he thanked me for staying with him.

“I’m in crisis, Mama.  I need you.”

“I am here and will spend the night, so stop worrying.  And stop thanking me.”

Once back inside, I convinced him to eat some of the vegetable soup I brought him earlier in the day.  Then he heated up some chili and ate that.

I tucked him in, wondering how we got to the place.  He was one of the happiest little boys who ever lived, the kind of kid who loved everybody everybody loved him back.  He made friends with the garbage men, for goodness’ sake.  In a moment he was snoring.  

I settled down with a cup of tea and some Ibuprofen and a crossword puzzle, then went to sleep myself.  I woke at 4:30.  My bones were aching so I took some more Ibuprofen and tried to sleep.  At 5:50, I woke P and told him I was going home.  He roused momentarily and thanked me and dropped back off to sleep.

When I arrived at my flat on Saturday morning, Honey was barking.  She never barks when she's crated up, but she chose last night to start.  I could tell she was in great distress.  She had pushed the tray completely out of the crate and was wet around her mouth and chin from anxiety.  After a quick bowl of food, she was asleep at my side.  We went for a walk in the park, and as exhausted and sore as I was, I didn’t want to go to sleep.

The weekend was nothing if not hellish and I am tired in my body and in my soul.  I haven’t felt rested or completely relaxed since Cuz died on the fifth of this month. Parrish’s suicide attempt followed seven days later.  Writing is hard for me when I don’t get proper sleep so it may take all week to write down the events since Parrish’s release from Georgia Regional last Wednesday.  The only helpful thing the staff there did was make Parrish an appointment at Gateway, the local public mental health center, so this morning I was up 
early to get him there for his 8:30 time slot.  I knew the day would be hard but never expected it to be so torturingly draining.

To be continued…..


© 2014 cj Schlottman










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