Monday, May 18, 2015

What Happened?

Nearly a year has passed since my last post on this blog. After two suicide attempts during the first four months of 2014, Parrish’s mental health declined. As hard as I tried to convince myself that things would be better, his manic episodes became more frequent and severe. He asked me to stop blogging about our life. He was ashamed and embarrassed about his illness, so I agreed.
In spite of his brain syndrome, schizoaffective disorder, there was a palpable goodness about him. He was kind and gentle and generous and had impeccable manners. He was a Southern Gentleman plagued with a mental disorder that sometimes masked his goodness. Everyone who knew him as a child remembers him as the happiest little boy imaginable. Nonetheless, his illness was progressing.
He used alcohol to treat his manic episodes, and for a while we used a breathalyzer to discourage drinking. Before long, though, when I asked him to blow into it and he had been drinking, he exploded with paranoia and began railing against me for all my past sins, real or imagined. I spent too much energy being angry, not just at Parrish but at his disease—the unfairness of it, it’s intractable hold on him, the toll it took on me. I am ashamed of how many times I lost my temper.
I resorted to putting a deadbolt lock on my bedroom door and wearing the key on a plastic spiral bracelet in order to make sure he didn’t get his hands on any unauthorized medication. All this I did in an effort to protect him from himself, to throw roadblocks in the way of his efforts to treat his pain, his unrest, his feelings of guilt and unworthiness. But I was as powerless over his bipolar symptoms and his drinking as he was.
The summer was hard. Parrish took long bike rides around The Island, trying to burn off some of the energy, the manic force that filled his head with racing thoughts and the desire to drink. Sometimes he got relief, but at others he arrived home in the same state of unrest and confusion he had tried so hard to overcome. 
He saw a therapist and an addictionologist every week. There were medication changes and short periods of improvement, but his internal battles continued. When we moved into this house, he often told me it gave him a sense of belonging. I thought he would stabilize and feel grounded, and have a sense of permanence, and for a while, it seemed to be. 

There were good times. Often we drove to The Village Pier to see Lawrence, his father, the senior active harbor pilot for the port of Brunswick, board the pilot boat and go out to sea and bring in a ship. One day in July, we rode 12 miles out with him and watched him climb the ladder to the ship’s elevator, which would take him to the wheelhouse to assume command of the ship. Parrish was very proud of his dad, but it was a bittersweet pride. He felt guilty because he wasn’t able to become a harbor pilot, a profession that is traditionally passed down from father to son. While in college, he was a boatman for his dad, but he wasn’t emotionally equipped for the dangerous job. We were never able to assuage his feelings of not having measured up.
We frequently drove down to The Village for yogurt and ate it on a bench overlooking Saint Simons Sound. We had supper at a restaurant overlooking the water at least once a week.  I have always believed in the healing power of the ocean, it’s steadfastness, the negative ions it produces that soothe our souls and calm our minds. Every now and then, this sweet and tortured man’s spirit could be lifted by the salt air.

There were also periods of dark depression when he spent days in bed, sleeping almost around the clock, arising only to eat a bowl of cereal or some other snack. And there were angry outbursts, periods of confusion and days without sleep. I armed the security system at night in case he got up and left the house without realizing it. It sounded at 4:00 AM one morning early in September, and when I found him standing in the carport, he had no idea why he was there. 
October was a sine curve for us—extreme episodes of angry mania graphed against low troughs of depression. By the third week of that month, Parrish’s behavior was so erratic, I was afraid for his safety. So, his doctor admitted him to a private behavioral health facility, where he stayed for nine days. At first he was heavily sedated and monitored carefully. Then the sedation was gradually lifted, and he came home more in control, more himself, though he continued to struggle.
One day soon after he got home, when he was sober, he sat down in the chair across from me in the sunroom, where I was reading the paper. Manic, his heels worked furiously against the floor and he shifted in his chair.
“Mama, I know you get mad when I drink. I don’t blame you, but you just don’t understand. It’s not about you. I love you more than anything in the world, and I never want to hurt you, but I end up doing it anyway, because I am so sick!”
He took a long pull on his cigarette. I remembered other times when he told me much the same thing. Maybe he was right. Maybe I just didn't get it.
“Nobody wants to feel the way I do—nobody. When I’m manic, I can’t concentrate long enough to read a book or watch a TV program. Who would want this? I feel guilty that I live at home with my mother at age 45 when I should have a decent job and a family of my own. All I want is to be halfway normal. When the noise in my head gets so loud I can’t think or hear or focus, I will do anything to make it go away, even for a few minutes. I can’t smoke a whole cigarette without putting it out and looking for some other distraction. I can’t sit still or have a clear thought about anything because of the tornado in my head.”
I sat across from him and watched helplessly as he knuckled tears of frustration from his handsome, tortured face. 
“That’s when I drink. At the risk of damaging my relationship with you and Daddy, even at the risk of my own safety, of going to jail, I drink because for a little while—just a little while—the noise in my head goes away. Even if it only lasts a few minutes, it’s worth it. But then I can’t stop drinking, and you know what 
happens next. I’m just drunk and angry and sad and sick and manic, and the noise is back. Sometimes I want to die; I really just want to go to sleep and not wake up. You think if I just don’t drink, everything will be okay. If everything was okay, I wouldn’t need to drink! Don’t you see? My brain is broken in a million pieces.”
I got up and walked over to where he sat, heels still pounding the floor. He stood and gave me a halfhearted hug. It was the best he could do.  
“I’m so sorry, P. I’m so very sorry. You’re right. I can’t know how you feel. But I can accept what you say. It’s your reality, your truth, and I’ll try to be more patient. I know it’s unfair for me to get mad at you and lose my temper when it’s your illness I hate, not you. I couldn’t love you any more than I do, but I’m beginning to understand that loving you won’t make you well. We can’t give up, though, we have to keep looking for a plan that will work. And you know I have to ask, are you feeling suicidal now?”
“No,” was his reply, and he dismissed my suggestion that he call his psychiatrist. 
There is something so wrong about not being able to help one’s own child. I was overcome with helplessness and, yes, guilt. Earned guilt? No, I didn't make my son sick, but the mother in me grappled with the notion there was something I was missing, something more I could do to make Parrish’s life better. I never stopped believing if I just loved him enough, there would be a miracle.
There were a few weeks, from mid-November until mid-December, when P was sober and focused and calm. Always attractive, he was even more so without alcohol in his system. He dressed every day in crisp khakis and colorful shirts and sweaters that made his blue eyes sparkle. On cold mornings, he delighted in building a fire for us to share. I can’t explain why we were given that time, but I will forever be grateful for it. He was on a new medication, and maybe that’s why we had that incredible, peaceful reprieve. Our friend Marnie came for Thanksgiving. Friends from high school, they fell in step and really had a good time. We had friends over on Thanksgiving night, and they were taken by Parrish’s charm, his impeccable manners, his sense of humor and his obvious intelligence. It was the best Thanksgiving for me in many years.
I was hopeful we had found the answer, the right medication, but in mid-December, he started drinking and was soon in crisis again. So, he went back to the hospital on December 20, for three nights. He was little improved when he was dismissed, but we all wanted him home for Christmas. His dad came over, bringing gifts (which were carefully chosen by his incredible wife, Melissa), but Parrish was unsettled, unfocused, suffering an inner turmoil that was visible on his face. He couldn’t enjoy the day, the time together or the gifts. When the paper and ribbons had been stuffed in the trash and the gifts organized, he excused himself and went to bed. 
On January 5, Parrish rode his bike across the Torras Causeway, a four lane road that spans the salt marsh between Saint Simons Island and the city of Brunswick on the mainland. Motorists routinely exceed the 50 MPH speed limit, even when crossing its five bridges, one of which arches a half mile across the Mackay River. It’s a dangerous ride, even with the bike path that’s provided. He presented himself at the hospital emergency room and asked for help to calm his extreme mania. 
He was released to me after an inadequate dose of medicine and was just as sick when he got home as when he arrived there. Two days later, having not slept since returning from the ER, he had a manic episode that once again sent him for impatient stabilization. That time, he was admitted to the state-run facility in Brunswick.
We spoke on the phone every day. He was deeply sedated and thick-tongued, but he could organize his thoughts a little, and with some effort, I could understand part of what he was saying. He never hung up without telling me he loved me, and I always told him back. It was something we did, even when things were at their worst. I was concerned about his level of sedation, but when his doctor called me to report on Parrish’s progress, he assured me he was decreasing the medication dose and Parrish would soon be more alert, and he could start thinking about letting him come home.
On January 17, ten days after admission, his doctor called to say Parrish’s respirations were rapid, and he was sending him to the ER for evaluation. It was a little after 11:00 in the morning.  Going to the emergency room had become part of our life, and I wasn’t alarmed. It’s not uncommon for bipolar patients to have rapid and shallow respirations, even hyperventilate. I waited a reasonable length of time for the staff to get him settled, then called to check on his status. His nurse said couldn’t talk; she was busy taking care of him. 
There was no trace of urgency in her voice, but as I hung up the phone, my breath caught in my throat. Something was wrong; I could feel it at my very core. Anxious, adrenaline pumping, skin prickling, I grabbed my purse and drove to the hospital and repeated to myself, He’s okay, he has to be okay. He’s always okay, not matter what happens, he’s always okay. He survives, always survives. 
I arrived at the ER to find my son in a coma, a tube snaking out of the side of his mouth, taped to his cheek and connected to a ventilator. Monitor wires and cascades of IV tubing cluttered the space above him. His wrists were tied to the sides of the bed with thick brown leather restraints, and his abdomen was grossly distended and hard. He was completely unresponsive, even when I climbed under the tubing to kiss is sweet face and put my lips to his ear and assure him everything was okay.
“I’m here, P. It’s Mama. A machine is breathing for you so you can get better. You’re going to be just fine.”
As a nurse, I could see from the numbers on the monitor his blood pressure was barely enough to sustain circulation and his oxygen saturation was too low to support his vital organs. A chill shot through me. I opened his right eye and saw a spark of hope when the pupil reacted to the light in the room.
“What happened?” I looked at the nurse who stood on the other side of the bed, eyes fixed on the bedspread. “What in the name of God happened to him?”
She looked up. “He has severe pneumonia and an intestinal obstruction. I’ll get the doctor for you.” Her face was kind and sad.
I climbed back under the tubing and reached for Parrish. I held his tethered hand and leaned close to tell him how much I loved him. It didn’t occur to me to ask why he was tied to the bed when he was clearly unconscious.
The doctor stepped into the room, his expression solemn and drawn.
“What is this? What could possibly have caused this shutdown?” I croaked.
“Mr. Gray’s lungs are completely filled with pneumonia, so we’re breathing for him. He has an intestinal obstruction, but he’s too critical to operate. We’re going to move him to ICU and see if he can rally. It doesn’t look good, though. He’s a very sick man.”
The voice in my head chimed in. He has to be okay, he’s always okay. He’s been near death before.
“But how did he get so sick so fast? I just talked to him yesterday.”
He just shook his head and said, “We really have no way of knowing at this point.” 
Shoulders sagging, arms dangling at my sides, I stood and stared at this man who offered me so little hope. My stomach lurched at the wave of realization that this time could be different. Parrish might not come back from this sudden and devastating medical emergency.
“But what happened?” I repeated. I was too stunned to formulate the questions that would give me meaningful answers. Did Parrish stop breathing in the ambulance or after he arrived at the hospital? Was he conscious when he  got there? Did he say anything? Was he in pain? What caused the obstruction? Utterly alone and terrified, I stood mute, paralyzed. I cradled my face in my hands, then looked back up at the doctor, whose voice had become distant and faint. What was I hearing?
“Should I call my family?”
“Yes.” he said. “I’m very sorry.” Then he was gone.
I stood in the doorway of Parrish’s room and punched Lawrence’s number into the pad on my phone. I told him where we were and about the ventilator, but I didn’t say I thought P was dying. I wasn’t sure I believed it myself. He came right away, and while I waited for him, I called my brother and some other family members who all repeated the question that was whirling around in my head. What happened? 
While the staff moved Parrish to ICU, I waited in the parking lot for Lawrence. When I saw his car pull into a parking space, I ran to him and all my resolve to stay calm melted away.
“He’s not going to recover this time,” I blurted into his shoulder. “His lungs are so full of pneumonia he can’t breathe and he’s going to die.” My heart was swollen with fear and shock and disbelief at my own words. My breath came in short spurts punctuated by deep sighs.
In his gentle way, Lawrence said, “There’s probably something they can do for him.” His face was pale, and I could read the same fear in his eyes that I am sure was in mine. 
“You should call Melissa and tell her to come,” I squeaked.
“Maybe they can do something . . .”
“You’ll understand when you see him,” was all I said.
We went to the waiting room to sit and wonder. We spoke in whispers as though saying it all out loud would make it true. I tried to prepare Lawrence for the sight of his son, completely unresponsive, skin dusky, belly distended, tubes everywhere. Melissa arrived, kind and comforting, the strong one we both needed. Time passed, I don’t know how much, but I finally got up and walked down the hall and rang the bell of the intensive care unit. A nurse responded and said we could all come in. Lawrence stopped in the doorway of Parrish’s room and a sob, almost a keening, rose from his throat, and I thought he might collapse. 
“Take a breath,” I said. “Go over and take his hand. Talk to him, tell him you are here. You too, Melissa. He needs to know we are all here.”
And we took turns talking to P, assuring him that he would be okay. I know he heard everything we said. I am absolutely certain of it. Every time one of us talked to him, his blood pressure and oxygen levels improved marginally, then returned to their unpromising baselines. Yes, he knew we were there.
Denial is a powerful emotion. I could not process the truth and instead began to prepare for a long siege in ICU after which P would be coming home. Melissa drove me to my house, and I gathered a toothbrush and my medicine and dropped them in my purse. I sat down on the blue loveseat in the den and smoked a cigarette, made a couple of calls, caught my breath. It never occurred to me that Parrish might die before we got back to the hospital.
We had been home for about 45 minutes when we started back to the hospital. Five minutes into the drive, my cell phone buzzed. It was the nurse, urging us to come back quickly.
I rushed into the room to find P still alive but with monitor readings indicating he was fading. We continued what was by then, undeniably, our death watch, taking turns with Parrish, doing everything we could to comfort him and one another. The nurse came in and untied P’s hands. Why were they tied in the first place? Was he struggling in the ambulance or after he arrived at the ER? I sat at his side and used the tail of his hospital gown to blot my tears and wipe my nose.
We tried not to weep, but we did, our faces stricken with shock. We held one another. None of us could sit down for more than a few minutes. The three of us shared one Coke, and we never finished it. I couldn’t keep my eyes off the monitor. I wanted to throw a blanket over it, or better yet, hurl something at it, break it. But I kept staring, thinking I could will the numbers to change.
I have never missed Clint as much as I did that night. I wanted him there to wrap me in his arms and protect me from the unthinkable reality of P’s dying. I wanted to cry on his shoulder, bury my face in his neck, feel the incredible warmth and love of him. Even with the love and support of everyone in the room, I felt hopelessly alone.
A few minutes after 9:00, face buzzing with fear and feeling as though my head would explode if I didn’t get some air, I took the elevator downstairs to the cold air of the parking lot and lit a cigarette. After two puffs, my cell phone sounded, and I knew. 
“Come quick,” Lawrence whispered. His numbers are worse.”
I scrambled back upstairs to find that Parrish’s heart had stopped beating at 9:15. I wanted to crawl in bed with him, put my ear to his chest, listen for any sign of life. The nurse lowered the side rail for me, and I kissed his beautiful face, lay my head on his silent chest, felt as though my own heart would stop beating. Overcome with a sadness so profound I almost forgot to breath, I felt as though I would melt into him.
How could he be dead? How could he possibly be dead when he was alive this morning, when I talked to him yesterday?
I went to Lawrence and we wept into one another’s shoulders, barely able to stand. Melissa embraced us both, but there was no comfort, only shock and despair. 
We stayed with Parrish until the staff was ready to move him to the morgue. Not wanting to see him transferred to a stretcher, covered with a sheet, and wheeled out by people who knew nothing about him—who had never seen him smile or laugh, people who didn’t know he once won $500 in a trivia game because he knew the zip code of the Pentagon, and he could name every county and county seat in Georgia. They didn’t know that underneath all his sickness, he was a sweet and generous soul. We didn’t want to see him carried away by strangers.

I didn’t sleep that night. Four months later, I am still awakened in the night by the vision of my only child on an ICU bed, dying before my eyes. We still don’t l know why he died the way he did. We finally got some professional help to look for answers, but the question remains, “What happened?”