Saturday, December 03, 2005

After Lisa: Chapter 13

Ritchie's suicide attempt gets him hospitalized. Deborah goes to AA

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The morning after his suicide attempt Ritchie walks down the corridor of the ward nodding to other patients. His neck shows scrape marks where the rope had been. He catches the eye of another patient approximately his age.
“Hey man.”
“Yo. What’s happening?”
An aide goes to the main locked door of the ward and unlocks it with a giant key. Michael and Deborah enter. He is wearing a tie and sports jacket, Deborah has on a dress. They are shy in any new surroundings, but the inside of a psychiatric ward? It isn’t something they ever imagined they would see. They don’t know what to expect. They’re not sure what they are supposed to do. They look around. So far so good. A lot of teenagers. Not that different from Ritchie. They are relieved. They thought it would be full of very strange people, like the woman last night in the ER. Apparently not. Apparently the really crazy people are sent somewhere else.
They spot Ritchie off to the side shyly trying not to eye a group of girls. One of the girls in particular is petite and cute. Deborah and Michael relax. They wave to him. Deborah smiles wanly. She mouths “I love you”. They follow Dr. Agnew into his office. He is a young cocky man who clips his words as if to exaggerate that he is succinct.
After a perfunctory greeting he points to two chairs then wastes no time getting started, “How long has he been on Prozac?”
“He was supposed to begin it this morning. He…”
Dr. Agnew cuts Michael off, “So he never got it.” He writes that on a form then looks up again at them.
“How long did he see Dr. Stern?”
He just had one visit, yesterday.”
“Did Richard…”
Deborah intervenes, “Ritchie. He likes to be called Ritchie.”
Dr. Agnew’s voice takes on an irritated tone. “Did Ritchie give any indications that he was thinking about suicide?”
Michael answers, “Not really.”
Deborah disagrees. “ Once, I think two years ago he talked about dying. He wanted to know whether his sister Lisa—she died 5 years ago from a lymphoma- might really be alive in heaven. We talked about that. I was surprised. He believes in it. Michael I guess he got that from you. He really misses her. We all do. Immediately after Lisa died, Ritchie would bring things home from school that he said he was saving to show Lisa when he went to heaven. He’d speak about that a lot, And then he stopped talking to us about those kinds of things. He’s become our mystery teenager.”
Dr. Agnew makes his impatience unmistakable, “I mean actual suicide threats.”
“What do you mean actual?” Michael asks
“Threatening to do it.”
“No nothing like that. But you know…”
“Any family history of suicide?”
“No.”
“Dr. Stern told me he saw you for depression several years ago. He kind of hinted that you also are depressed Mrs. Russell. So there is a strong family history?”
“I don’t know. Not before Lisa’s illness.”
“Lisa?”
“My daughter.”
“Oh right, the one with the lymphoma. What about his grandparents? Did they get depressed?”
“They were okay.”
Michael cuts in, “What about your mom during menopause?”
he asks Deborah. “She was pretty crabby?”
“Well that was only a few months. I…”
“So the answer is yes. There’s a strong family history.”
He marks it on his chart
“Well I’m not sure. I…”
“Listen, I have a patient scheduled in a few minutes. I’m all set. I got what I need.”
“That’s it?”
“You’re supposed to see Mrs. Franklin next. She’ll answer your questions. She’s in charge of disposition…”
“What do you mean? Who are you disposing of?” Michael asks sarcastically.
“She’s in charge of discharge planning. She’s an important part of the treatment team.”
“Why? Are you thinking about discharge? He just got here!”
“Hospitals are not the proper place to treat patients. It causes regression. Patients begin to like it here a little too much.”
“And you think that could happen with Ritchie?”
“I don’t know Ritchie, but yes, very possibly. Let me talk to Ritchie some more and talk to his therapist…”
“Who is his therapist?”
“I already told you. Mrs. Franklin. She’ll meet with you later. Let me see what time.”
The doctor picks up his phone and dials her extension. He mumbles something into the phone, then looks up.
“In about an hour. Why don’t you see if you can find Billy out there”.
“Billy?”
Dr. Agnew sneaks a look at his chart.
“Sorry…Ritchie.”
Dr. Agnew shows them the door. They go into the corridor. Many patients, including Ritchie, are in a common room at a lecture. Michael and Deborah catch Ritchie’s eye, take a seat towards the back. A young pollyannish woman, Ms. Allison is in front of the screen where slides are being projected. A large picture of a nerve junction is depicted. Her pointer moves to what appears to be bubbles.
“This is serotonin. Depressed people don’t have enough of it. Who is on Prozac?”
Five patients raise their hand. Ritchie doesn’t. Michael signals him to do so. Ritchie ignores him.
“What about Celexa, Zoloft, Paxil, Effexor?”
Almost all of the rest of the patients raise their hand.
“Good. These drugs fix your chemical imbalance. They are miracle drugs like antibiotics. If you take your medication you will feel much better. Although sometimes they don’t work, we have other medicines and the chances are they will work. It’s very important that you take your medication… Religiously!”
A patient raises her hand.
“So our problems aren’t what’s bumming us out?”
“Well I’m sure you think they are, but it’s really your chemical imbalance. Well… that and one other thing…Anyone know what that is?”
No one raises their hand.
“Come on Connie. You’ve been here before.”
Connie gives her a look of disgust. Ms. Allison isn’t the least distracted.
“Negative attitudes. I have this booklet for you that I want you to study about how to think more positively.”
A new person pipes in, “When do we meet with the doctor about our medication? I’ve been here 5 days and I’ve only seen him once for 15 minutes.”
“ Well, he makes rounds every day and the staff reports to him. Exuding cheerfulness she continues, “He’s very, very busy.”
“Do we get to meet with him about medication problems?”
“Well, in special situations. But we encourage you to bring up any medication problems in medication group. For those of you who are new-you’ll meet together once a day with the nurse and that’s where you are supposed to ask about any side effects that bother you.”
“I’m not going to talk about no side effects in front of every one else.”
“Sometimes you just have to find the courage.”
“Are you serious? You know lady. This serotonin thing. It sounds like one size fits all.”
“Well you can look at it that way, but that is just negative thinking.” Very cheerfully she adds, “You’ll see. Very soon you’ll feel fine.”
“How do you know that?”
“I know it because I used to get depressed. Just like you. And now I am on medicine and… well…can’t you tell how positive I am? That can be you.”
“So now you have no problems?”
“I didn’t say that. Now I look at my problems differently… with a positive attitude.”
“You is one drugged lady.”
“Well, any other questions?”
Ms Allison looks around the room. No hands are raised.
“Very good. For those who don’t have one of these (holding up the booklet) come up to get your copy. Seriously, there is a lot to learn about a positive attitude. It works.”

Most of the patients do move forward to get the booklet. Ritchie conspicuously moves in the opposite direction towards Michael and Deborah. He hugs his mother.
“You okay mom?”
“I’m good. I’m good.”
Michael addresses him, “Are they treating you okay?”
“Well, no one’s coming at me with needles like they did last night.”
“You should get a copy of that booklet.”
“There’s so much bullshit up here.”
“I’m going to get a copy. I’ll be right back.”
Michael leaves them.
“Is dad pissed at me?” Ritchie asks his mother
“No, he really isn’t. Can’t you tell?”
“Not really.”
“He wants to help you. You gave us a big scare. She moves her fingers through his hair as she talks, “Are you feeling better?”
Ritchie shrugs…
Michael returns. Deborah and Ritchie greet him with an artificial smile. Michael hands him the booklet.
“Read it over tonight. What have you got to lose?”
“Yeah right, Dad.”
“Ritchie what is it you want? Just tell me because we aren’t playing a game here.”
“For starters, I want out of here. Right now.”
“What if we can find a different place?”
“Like where?”
“I don’t know. I’m seeing Dr. Stern. He’ll have some ideas.”
“It’s got to be a place where they don’t take away your shoelaces.”
“You seem to have forgotten why you are here. Any place is going to do that. He tries to soften a bit, ”Look let’s see what Dr. Stern has to say.”
Michael looks at his watch, “I have to call in to the office; then I want to see Dr. Stern. Deborah. You want to see Dr. Stern with me?”
“I’m okay staying here.”
“Dad. Could you check the ER? I’m missing my ring-the one Lisa gave me.”
A visual image of the ring flashes through her mind “Really? The ring?”
“Okay. I’ll check it out.” It is on his to do list “See you guys later”.
Michael leaves. Ritchie and Deborah stand together, speechless and awkward. A psychiatric aide appears. He can’t be more than 23-24 but his voice has deepened into a commanding staccato.
“Russell. You’re supposed to be at community meeting.”
“I’m with my mother”
“Doesn’t matter. You have to attend the community meeting.”
“And what if I don’t?”
“In our house visitors go by house rules. You have to go now
“What are you going to do? Give me a bad grade? Am I going to get an F in patient cooperation. ”
“You want it? We’ll be glad to give you an F. A good, good F.
Deborah intervenes “You know I noticed on one of the bulletin boards that they have AA meetings at the hospital. There’s supposed to be one today.” She looks at her watch, “actually, in about 10 minutes. Ritchie. Listen to this gentleman. Go to your meeting. I want to go to that meeting. It’s been a while.”

Ten minutes later Deborah is in a large hospital conference room used twice a week for AA meetings. Several members surround a large coffee maker. A tall angular man fusses over preparing his coffee. He carefully pours a teaspoon of sugar, turns his spoon over, then repeats it for another teaspoon and a half. Next comes the powdered creamer. Carefully he sips, smacks his gums, It is still too hot. He studies the donuts. He picks a circular cinnamon sugared one from the supermarket box. He tears the donut in half. He hasn’t looked at another person in the room.
There are clearly regulars, old friends. Deborah is also not paying attention to anyone. She overhears small talk all around her, somewhat like the buzz you hear at the beach when you are trying to fall asleep, a buzz without details, soft mumbled conversations fading in and out. She waits her turn at the coffee maker feeling awkward, trying to be invisible. For the most part she succeeds. She takes a seat alone. Several of the younger divorced men, as always looking for a girlfriend, steal glances at her. She is pretty, which is numero uno for the younger guys with active hormones but Deborah is oblivious. She has been since she met Michael. She quickly reverts to her usual companion Lisa. Memories replacing memories, then another, then all over again.
The very first time they went to their camping site, a sunny amazing day. The whole family is excited to have discovered this place. Michael grabs one-year-old Ritchie and swoops him into the air. He catches him effortlessly, then sets himself for another toss Michael throws him high, high into the air. When he played baseball, he preferred a homerun swing to a controlled bat . Ritchie is terrified but just as quickly he lets out a happy squeal as Michael gently catches him.
“Gain!”
“Again?”
“Gain!”
“Again?”
Deborah confirms his translation. “ Yes, Again”
He throws him up again, perhaps ever higher. Ritchie squeals with laughter.
“Gain.”
Lisa pulls at Michael’s leg. He looks down at her. She points straight up. Michael hands Ritchie to Deborah and picks up Lisa who looks up at him excitedly. He throws her up almost as high as he threw Ritchie and catches her the same way. He’s delighted with himself. She doesn’t seem happy.
“No. As high as Ritchie!” she demands.
“That was as high!”
“It wasn’t. I saw. You threw Ritchie into the sky.”
“You want to go into the sky?”
“Higher than that!”
“Okay. I’m going to send you higher than the sky”.
“To God.”
“I’m not sure what kind of catcher he is.”
“The best”
That memory does it every time. A tear forms. She dabs lightly with a Kleenex.

Another memory: earlier in their relationship; she and Michael are still wildly in love. They are dancing. They go to the punch bowl. She is tipsy. Michael finds her silliness absolutely wonderful. They dance and dance.

Deborah fingers the back of her neck, squeezes the muscles, trying to loosen them. She looks around the room. A speaker is talking about his life when he drank. Her memories continue.

She opens up a book where she has hidden a joint. Michael comes in to the room. She tries to hide it.

Another: A demonstration against Reagan’s support for the contras; Deborah has a flower in her hair. Michael has a beard and long hair. A hundred of them stand strong holding hands as policemen close in on their crowd. Some one, not far from them, screams at the lined up policemen, “PIGS” Suddenly the police charge. Everyone scatters. Fear, real physical fear, the first time she has ever felt it. She watches at a safe distance as one of the policemen throws Michael to the ground. He lifts his nightstick but then thinks better of it and chases another demonstrator. It was at that moment, the moment she suddenly felt terrified for Michael, that she decided she wanted to spend her life with him.

A new speaker is before the group, a black man in his 50’s wearing a bow tie.
“ I want to say, right out, the bottom line. AA saved my life. AA saved my life. That’s the truth. AA saved my life. You new people tonight. I know you probably think that’s bull. Probably all of it sounds phony. Higher power. Give me a break right? Well you’re right. It is bull. Some people like to talk a lot of bull. AA lingo. It’s annoying. But you know what? The people that talk like that are right about all of it.
When I first came here I had to convince myself that there was something wrong with me. Like, what is an alcoholic? So what if I get drunk every once in a while? What gives other people the right to tell me how much I should drink? Fuck them. I will decide for myself.
It’s my life not theirs. They just want to judge, judge, judge. Yeah they say they are trying to help me because they care. Yeah right. Fuck them. FUCK them.”
A couple of brothers chime in, “Yeah man.”
He continues, “But you know what? I’m here and you’re here because we know damn well they’re right. Doesn’t matter what their reasons are. They’re right. First time I came here I waited for AA to do something for me, to prove it was going to work.
It didn’t work. I screwed up for two more years. Kept cheating. Until I fucked up one too many times. Lost my job. My wife said she had had enough. I knew she meant it. I got desperate. That is what it took to get me serious, when I fuckin’ decided I was a goner. Couldn’t stop myself before that. I couldn’t stop drinking. That’s when I stopped caring about you jerks at the meeting. I had to stop. That’s all that mattered.
Took me a while but now I know. Getting wasted is a wasted life. Getting all cocked and telling off people feels good. Absolutely right except for the next morning. You wake up with this fear. How you made a fool of yourself, how you made a new enemy. How your wife’s feelings aren’t going to recover for weeks. Maybe never.”
“ Man. Okay maybe occasionally you have a good time just because you are high. And you can’t get that feeling any other way. Partying is the best. Telling people off is the best. Right?”
He hesitates.
“Feels good right?”
He hesitates again
“Wrong.”
“You need to get things fixed another way. You gotta keep half your brain. Or you are going to be in deep shit. Because if you couldn’t do it while you are sober there’s gotta be a reason. There has to be a reason why you have to shut off your brain in order to get there.
Okay without a little help you are too afraid to do anything. You are in prison. I ain’t got no easy suggestions how to fix that. See a shrink? Find out what is wrong? Find out how to change. Learn how to have a good time without getting high. Take a medicine that helps you to enjoy yourself without having to be drunk. That is if there is one. Okay there isn’t. Okay maybe the very best times you’ve ever had were when you were drunk.
There is a reason for that. The devil always throws the best party in town. Man nothing beats the devil.”
He hesitates for effect then continues. “ He also is the way to hell. As high as you get from booze and marijuana, and heroine and cocaine, that is how low you will get from being high. You are here today, and you will come back here because your low has made all the highs you got, all of them together times ten thousand, all that great time you’ve had is worth shit now. It is the shit.”
“AA is bullshit, but man it’s saved me. Because when you finally know that getting shit- faced is for shit that’s your only chance…
Knowing it and remembering it and living by it. That’s exactly what will save you.”
“Yes,” calls out someone in the audience. Then a lot of “yeses” and “yeahs.”
“Yeah you know it is good. Real good. So what do you do? Just in case you forget, you come here.”
“Yeah some people have to come here again and again. And yeah some of them sound like robots. So fuckin’ what if the real reason they repeat it, the reason they have to convince others so often is that they have to convince themselves. Continually. They preach and preach to anyone who will listen but especially they preach to themselves. So fuckin’ what. You do what you have to do. If I don’t preach I’m going to be in trouble.
I am Larry and I am an alcoholic.”
“I am Larry and I am an alcoholic. Somewhere else I am a father, a son, a husband. I am the boss on my factory floor. Other people think about me other ways. But you know what? I am an alcoholic. I almost blew it all and I still can. Because I want to get high. I can almost taste it. I am Larry and I am an alcoholic.”
“I need help from anything that makes even a little bit of sense. Whether I say it or someone else says it. Any phrase that I can repeat. It’s gold.
Gold. One day at a time. Hell for me it’s one hour at a time. Right now I want to have a drink. Right now. I am Larry and I am an alcoholic. I haven’t had a drink in seven years.”
Applause. Deborah has left Lisa for a moment. She is listening.

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