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Friday, April 29, 2011

Baby Skye

Disclaimer: This series in no way represents real patients. It is a compilation of many different patients and many different situations. Any resemblance to actual patients is purely coincidental. There is no such thing as a typical day in hospice care. Some are busier than others and each individual patient has his or her own special needs.


Skye is 15 years old. In fact, we share birthdays, and I will remember her every year for the rest of my life. She has brain cancer, gleomastoma multiforme, and she has been fighting it since she was 11. We have her now for end of life care after a series of palliative operations and radiation. It has been along four years for Skye and her family.

She cannot talk or use any of her extremities, her arms and legs as flaccid as cooked spaghetti. Occasionally she opens her eyes, but it is impossible to determined whether or not she sees anything. Probably not. What is certain, however, is that she responds to the closeness of her mother. When Amanda climbs into bed with her, or even when she sits at her side and holds her hand, Skye’s face visibly relaxes. Even though in a coma now, she knows when her mother is near, and I believe she hears her voice, in spite of profound hearing loss brought on by the aggressive tumors in her brain.

Why Baby Skye, you may ask? When her cancer was diagnosed at age 11, her growth stopped, due in part to the radiation treatments meant to shrink her tumors and relieve her of the headaches that attend this kind of cancer. She has an infantile demeanor, a round face which was caused by all the steroids used to relieve her symptoms. She stopped swallowing before she came to us and was getting tube feedings, and she continued to get them until her system could no longer tolerate them, was too tired to process nutrients. The skin on her hairless scalp is mottled from the same radiation that stunted her growth. She indeed, looks like a baby angel as she moves toward her passing. As always, Simba, souvenir of her trip to see "The Lion King" on Broadway is tucked under her left arm.

It has been my honor to care for her, advocate for her, support her parents through Skye’s inevitable passing from this world. We, her parents and I, have prayed for her, for a peaceful passing. We have prayed that our hands be blessed as we minister to her final needs. We have cried together, laughed together, and loved this precious child together.

Back at their home, Skye’s younger sister, Mia, waits. Her grandmother is with her, trying to make her life as normal as possible, packing her lunch and sending her off to school every day, helping with her homework. Mia is afraid of Skye’s cancer. She wonders if it will happen to her. Cancer affects everyone close to it and some who aren’t. It is a monster with a long reach.

I am going to climb up on my soap box for just one paragraph.

Last Tuesday, when I first met her, Skye was suffering with a harsh death rattle, sounding as though she were drowning in her own respiratory secretions. She had mucous draining out of her nose and the corners of her mouth. The night nurse didn’t work on them as hard as she should have. She tried to suction them out, but to no avail. Suctioning secretions is, for me, a last resort. It traumatizes the patient and never produces the desired result because it does nothing to dry the secretions at the source. Believe me when I say that I would never hand a patient over to the next shift in that condition. We have a plethora of standing orders to treat pain and secretions. If they didn’t do the job, then the nurse should have called our medical director, even if it was the middle of night. (End of rant).

I spent 12 hours working to dry those secretions, giving her something about every 30 minutes for the first 6 hours of my shift. When my shift was over, I handed her care over to a wonderful nurse in whom I have complete confidence. Skye was breathing easy and her secretions were almost gone. I knew Hannah would finish what I had started.

When I arrived at work the next morning, I found Skye at peace and breathing without difficulty. Amanda and her husband, Keith, were asleep in the daybed in Skye’s room, so I quietly checked on my Baby Skye and tiptoed out of the room, breathing a sigh.

Before being downsized, I was to have worked yesterday. Instead I found myself at home and thinking about Skye and her family. So, I dressed to do my errands, loaded my dogs into the car and went to see her. I found her peaceful and breathing easy, actively dying, her angelic face relaxed and her eyes closed. The ever present Simba was tucked under her left arm, just like always.

I spent about an hour with Amanda, and she didn’t stop talking the whole time. She showed me pictures of Skye before she got sick. She talked about how brave her little girl is, what a tough fighter she is. We shared stories about our pets, about men, about parenting and about death. Amanda is ready to let Skye go. All she asks is that she be comfortable.

Likely, Skye will be gone when I return to work next Wednesday. She came into my life just a few days ago, but she will never leave. She is the first child I have cared for, and though I knew it would be hard, I never dreamed it could be this beautiful.

© cj Schlottman

Wednesday, April 27, 2011

Downsized

It happened yesterday. After being in budget meetings all day on Monday, my manager came in and immediately started toying with the schedule. I commented that she looked as though she were struggling with it, and she sheepishly looked up at me and said, “We need to talk when you have a free minute.”

I have known since I began working in hospice care that our facility is overstaffed. We, the staff, from time to time have bantered about the idea that, if the patient census did not grow and maintain itself a near capacity, some or all of us would eventually be asked to cut back our hours. The entire staff has been asked to take PAL (Paid Annual Leave) when the patient census is low. I have not accrued any leave yet, so I was spared that - until now.

So, I was not surprised when I met with Frances and she asked me to drop one day a week from my schedule. The old “First Hired, First Fired” rule. Only I was not fired, thank God. I was almost relieved, concerned only about my benefits package. She assured me that I would not lose my benefits, and I breathed a sigh. At 63, it would be impossible for me to find affordable health insurance. Scary, very scary.

Interestingly, lately I have been thinking about my job in terms of what it is taking out of me. Just last week, I entertained the idea of talking to Frances about not working three days in a row any more. I am 63, and on my third (12 hour) day in a row, I am not at top form. It is hard on me because I push myself to my physical and mental limits to make sure my patients don’t suffer because I have brain and body drain. The first day after my three shifts is lost to sleep, a little writing and in general, taking care of myself.

Now, allow me to back up for a moment. One of the biggest problems with our facility is lack of public relations. We are a nonprofit subsidiary of one of the largest health care systems in the state, and they have failed to promote our services. Period.

We have been open for six months, and still there are doctors in this town who do not know we exist. There have been no mass mailings to the medical community, no pens with our name on it to give away, no business cards, no refrigerator magnets, no television exposure, not a single billboard. They have TV ads for their physical rehab facilities, their heart center, their emergency room, and they have billboards all over town promoting the hospital, but none for us.

There are three local television stations. Each one of them has a spot on their early morning programs and on their noon programs that is dedicated to community affairs. Our so-called PR person has not taken advantage of this free publicity. We could promote our facility by calling and asking for time on one of those spots, send our Medical Director or one of the upper management team or one of us nurses to be interviewed. That’s so simple, I thought it up all by myself.

I can survive this draconian cut in pay, I think. A pay cut of one-third my salary is significant. It will mean changes in the way I live, but I can do it. What worries me is those on our staff who, like me, do not live in two-income households. They need their jobs to keep food on the table and clothes on their backs and those of their children.

I can barely make it with a pay cut, but most of them cannot. And all the while, we could all have job security if our parent company had just told the world that we are here.

Wednesday, April 20, 2011

Friends

Just the other day, while reading some of my favorite blogs, I ran across and very thought provoking post at Lauren Moderly’s very stylish and refreshing blog, Hipstercrite. Her blog keeps me tuned in to the younger generations, and she is a talented writer. I am linking you to her post, "The Definition of Friendship."

Her post made me think of our age difference and how it might color our ideas of friendship with a two completely different pallets. She is 27, and I am 63. You can do the math.

I have written about friendship before, but since reading Lauren’s piece, I have been examining the friendships I have had and how they happened, how some of them ended, how some of them have survived the tornados that periodically ravage my life.

I don’t have many friends, don’t really like or understand many people, which, to me, has to be at the core of a friendship. Understanding. A simple word when you write it down, but when you try to take it apart, it carries great weight and is buttoned up tightly, difficult to access. In the understanding at the heart of a friendship is also forgiveness, sacrifice and truth. You cannot have a friend unless you are willing to accept their flaws, forgive their sins and be open to hard truths.

So, how does it happen, this understanding that leads to friendship? Is it a chemical thing? Are we congenitally programmed to seek out people we can understand and that understand us? I believe so, but then, I believe in love at first sight. It happened to me. And all of my friendships have been at first sight also.

In her blog post, Lauren chronicles her friendships from early childhood. She, in a real sense, categorizes them.

The thing is, I don’t believe there are categories of friends. A friend is a friend, not an acquaintance or someone you network with online. I love my blogging friends from afar, but if we ever met, would that attraction hold up, make us friends, make us trust and understand one another? Think about it.

What about work? Do I have any friends at work? I don’t. I like and respect and admire the nurses and doctors and techs and secretaries with whom I work, but they are not my true friends. They will never “understand” me. They are my comrades, which isn’t the same thing as being my friend. Our differences are a large part of why we are an effective team. We share experiences every day and each, in his own way, processes those experiences differently. My true friends understand my reactions and responses, but that is not necessarily true in the workplace. There is nothing wrong with that. These are, for the most part, decent people who are valuable as human beings, but I don’t want to buddy up with my coworkers. I need to leave them at work, where they belong.

I’m friendly with my postman, the guy from Federal Express, my nail tech, my hairdresser, the pharmacist who fills my prescriptions, the cute girls who run the cupcake shop, the guy at the bank, my doctor, my insurance people and countless others, but they are not my friends. They are pleasant acquaintances and I enjoy seeing, speaking to and smiling at them.


My late husband I shared only three good, solid friends, the kind of friends you can call at four in the morning and confess that you are in jail for DWI, and they would haul themselves out of bed and come bail you out. On the other hand, we each had our own friends, just ours alone, and it worked for us. I didn’t try to get him to go out to dinner with my best friend, because he couldn’t stand to breathe the same air as her husband. That friendship belongs to just us girls.

They are disparate in nature, these friends, but we both loved them dearly, and two of them are still here for me now that Clint is gone. These people are my friends. What happened to the third one is a post in itself.

I was once invited to join a garden club, but when I discovered that I had only one friend in the group, I declined. Those organizations are for people network, get in with the right crowd. One doesn’t go out and look for friends. They just happen. At least the real ones do. Besides, I detest yard work.

I have been in relationships that I thought were friendships, but they were not. Either I stopped understanding them or they me, or maybe we never did understand one another. There’s nothing wrong with that. It happens. It hurts. But you move on.

Childhood friends rarely make it past seventh grade. Lauren skillfully illustrated that in her piece. I only had one childhood friend and one high school friend who survived the changes in our lives. My best friend from fourth grade, Mary Ellen, remained my friend through two of my mother’s marriages and all of the moves she put us through in order to satisfy her own needs. We landed back on Saint Simons Island the summer between ninth and tenth grades, and Mary Ellen and I fell right back into step. She was still my friend when she went off to school and I stayed home to go to nursing school. Marriage and work and living in different area codes did not chip away at our friendship. We were still close and understanding when she was diagnosed with lung cancer and died two months later. (I loathed her husband, a self-aggrandizing egoist writer who was also a drunk). And, yes, when I walked into Mrs. Medlin’s fourth grade class, Mary Ellen and I looked at each other and by first recess we were friends.

And then there is Don, first cousin of Mary Ellen’s husband, Jim. In an incredible example of synchronicity, Clint and I met him when she died. I had heard about him for years, a visual artist without a day job, talented watercolorist, who lived in Valdosta Georgia, but we had never met. It turned out that he disliked his cousin as much as I did. The night of Mary Ellen’s visitation, I was manning the phones at the house when Don walked in. We were instantly “in friend.” Amazingly, he and Clint were, too. We all fell into step, and Don , “Cuz,” as I like to call him, became part of the family. He got me through Christmas the last two year by coming to stay with me.

I am still very close to my friend from tenth grade, Shirley. We all called her The Squirrel, and we were friends at first sight. Fortunately, she was fond of Mary Ellen, too. Our friendship survived her five marriages and my two. She is now on number six. We may not talk but once or twice a month, but I know she is there, and she knows I am here. Our friendship survived my marrying a physician and her being broke all the time.

My best friend here in town, Nancy, recruited me to work in the Medical Intensive Care Unit shortly after my move to Macon - trying to escape my mother and my former husband. We had an interview and came away from it, well, friends. This friendship has had its ups and downs, but it is solid and has survived things like my husband not liking hers and her pulling away from me for several years back in the 80’s, then coming back into my life. We never discussed what happened or why, and at this time of life, who gives a rip? It happened, it un-happened and that is that.

I didn’t mean for this to turn into an essay about my friends, but it seems wrong not to include my other real friend. Her name is Fonda, and she is the strongest woman I have ever known. She lives in Augusta, Georgia, but we became friends when she lived in Macon. We worked together, but before that, we fell in friend at a conference in Vail, which I was attending to learn to teach people now to stop smoking in a program that she would manage at the hospital. She was my boss. I don’t have friends at work now, but she and I were friends before we started working together. By the time the conference was over, we were swilling champagne and telling stories about ourselves while our husbands were playing golf or fishing. She is one that I can call in the middle of the night.

So, friends, friendship. I don’t believe my ideas about it are different from Lauren’s. At the end of her piece, she had come to the conclusion that, “....being selective doesn’t necessarily mean bad.”

I believe, as wise as she already is, that her friend filter will become as well developed as mine. (Even if I am 36 years older than she).


© cj Schlottman

Sunday, April 17, 2011

Relapse

When I returned from work on Thursday night, I thought I would be spending today with my son, Parrish. We had plans for him to fly to Atlanta yesterday and meet me there for a short two-night visit. I called his best friend, Michael, and made dinner plans with him and his wife, Ashley, for tonight.

The call came just as I was peeling off my scrubs and running a hot bubble bath. Fortunately, I had a drink in my hand, and there were no cigarettes in the house.

“Mama? I have news that is sort of bad and sort of good. I could lie to you and pretend nothing happened, but I have to be honest with you. Mama, you are all I have left in the world. I relapsed on Tuesday and got stoned on a handful of pills.”

“Oh, Parrish, I sighed. Are you still using or was it a one night thing?”

“It was a one night thing and I am back in outpatient rehab. I can’t come to Atlanta this weekend. My doctor says I should not be around you right now. I hope you don't see this as rejection. It’s me, for once, doing the right thing. Please don’t think I don’t love you.”

I have known for years that I am not good for Parrish. A painful truth, for sure, but in my own therapy, I have learned that it is so. He has an enormous amount guilt and shame about the way he acted over the years, and being around me, especially here at my little cottage, boils those feelings to the surface. We do better on neutral ground, but it is still a struggle for him, making him manic and bringing out his schizoid characteristics. When he was here in December, he was as manic as I have ever seen him, perseverating and inappropriate and unable to sleep and having the occasional hallucination. We were both miserable. My emotional energy was nil by the time he left, and he was just this side of blubbering.

“Aren’t you proud of me for doing the right thing? Don’t you think I’m taking responsibility for my own mistakes and working to clean up the mess I have caused? Please don’t have hurt feelings. I love you more than I can say, but I can’t come to Atlanta this weekend. I’m sorry about the airline ticket. Maybe you can get some credit towards another flight in the future. I hope you’re not disappointed in me. I think I’m doing the right thing, don’t you?”

Manic? He went on in that vein for a few minutes, until I interrupted him to say I was proud of him for owning his mistakes and trying to get back on track. I said not to worry about the plane ticket. I told him to take care of himself, that I was okay, that my feelings were not hurt, that I was very proud of him.

The miserable truth about this thing is that, far from being disappointed, I was relieved. And guilty. And sad. And hurt.

What kind of mother is relieved that she will not have time with her only child? How damaged does a relationship have to be for her to feel that way and say it out loud? I know what my therapist would say. She would say it is healthy to be honest with one’s self, that it is a marker of strength and willingness to own my feelings, no matter how negative they may be. She would be right, I believe, but that knowledge in no way makes this easier.

Parrish is 41 years old, and every year he becomes more childlike and needy. The medications that keep him precariously balanced on a tightrope of semi-sanity are also eating away at his liver, his kidneys. Before his disease finishes ravaging his brain, he will have regressed to the mentality of a preschooler.

He, college educated (BA, History), blessed with an eidetic memory, his good looks now ravaged by homelessness and self-abuse, has the mind of a 12 year old.

And he must start from the beginning - again - to get clean and sober. I am not so naive as to believe that Parrish slipped only once. Lately, he has not sounded sober, and when I have questioned him, he has blown it off as side effects from his medicine. Maybe this rehab experience will be the one that works - for good.

I don’t really believe it will, though. I’ve been down this road before.


© cj Schlottman

Saturday, April 16, 2011

The Ginormous South

I have been on the road again. This time in Atlanta with my beautiful and talented and brilliant and athletic granddaughter, Addie, for The Big South Volleyball Tournament, from April 2 through April 4.

The Packing Thing went pretty well as I had a full day to devote to getting the job done without losing my mind. It was nonetheless a difficult thing for me.

I stowed Mr. Palmer in his travel bowl, then packed his glass bowl and food in the box with him. I could tell he was excited by the way he swam in circles so energetically. He does love to travel.

We arrived, Addie and I, at our hotel at around ten in the evening, after an uneventful handoff from Charles Cheeseman at the Chick Filet in Macon. They all live in Savannah, so Addie hitched a ride with them as far a Macon. Then I took her on to Atlanta. I love having her all to myself!



In all their wisdom (and I am sure in an attempt to keep the trip as cheat as possible), whoever does these things for Coastal Volleyball chose hotels on the top end of the perimeter (I-285). The tournament was held at the World Congress Center, which is in the heart of downtown Atlanta. Quite a commute.

We considered going in search of a late supper, but the room was cute and cozy, and by the time we got Mr. Palmer settled on the lamp table and my things unpacked, we changed our minds, deciding we had enough healthy stuff in the room to hold us over. The truth of the matter is that we were both bone tired. So, we ate apples and bananas and a few pieces of chocolate and some chips. I also ate a granola bar, thinking it would counterbalance the chocolate.

The Big South is a misnomer. It should be called the Ginormous South. Inside the World Congress Center were - count them - 144 volleyball courts. Now think about it. There are 12 players on each court, presumably a coach, a few players on the bench and an official. Then there were parents and siblings and friends, grandparents and the ubiquitous venders. I am sure I am leaving something out, but you get the idea. Hands down, it was one of the loudest places I have ever been. No, check that, it was the loudest place I have ever been - and I have been to the NCAA Final Four as well as in Italy when they won the World Cup. The players were cheering for one another, and so were all the members of their entourages. The sounds echoed and echoed some more in that incredibly large building. Then there were the screeches of the officials' whistles.

But I digress. Addie was scheduled to play at 4 PM on Friday. We slept late and grabbed some breakfast/lunch, then took a test ride to the World Congress Center to be sure we knew where we were going and how long it would take us to get there. I turned on the GPS loaded into my Blackberry, and off we went. We did well, found GA 400, which pretty much goes straight down to the I-75/I-85 connector. We even made the correct exit. Addie was navigating, and doing a good job of it, but I was having trouble determining which lane I should be in. I missed a couple of turns, and each time I did, the robotic voice of the GPS system started to squawk “as soon as safely possible, make a legal u-turn,” or “rerouting.”

I was insane. It was Friday in downtown Atlanta, a city famous for it’s traffic woes, and a robot was telling me where to go. There were horns blaring - at me and at dozens of other vehicles. There was the lady who rolled down her window and called me a name. Addie was laughing so hard, she was about to cry, and I began to talk back to the robot. I began to call it names. Addie laughed harder.

After we had been in the car for about an hour, we found the bleeping World Congress Center. By then, we were cutting it close to get back to the hotel and back downtown in time for Addie’s first game.

So, with Addie’s help, we (sort of) retraced our route and got back to the hotel just in time for her to jump into her uniform and grab her gear. We almost made it on time. By then, the infamous Atlanta traffic was snarled into its Friday afternoon insanity, everyone making a beeline for the suburbs.

We found the parking lot for our building, not knowing it was about a 15 minute (uphill) walk to the courts. Addie ran ahead, and I came along as fast as I could. Naturally, I had on the wrong pair of boots for hiking. I followed her, not taking my eyes off her in the distance. She overshot the entrance and we ended it going in the back way, sort of.

I have often heard it said that God takes care of children and old people. Believe it. It’s true. We arrived court side at 4:15, and the previous match just finishing up. We both took in a long breath and blew it out slowly.

Addie’s team played four matches - winning a few games but no matches - and we got out of there about 9:15. We found some delicious Mexican food at a place called Uncle Julios right up the street from our hotel. It was after 11:00 when we got to bed.

Saturday was basically a replay of Friday, only we knew where we were going, and there was no Friday Afternoon Madness on the streets and expressways of Atlanta. I had so hoped to take Addie shopping for a birthday present. She turned 16 on April 11. But there was no time for anything except volleyball and eating and sleeping.

There was one glaring difference on Saturday, though. After playing their matches, each team is required to “ref” the next match, and I, of course, stayed in my seat to watch the match while Addie kept score. The next two teams arrived. One of the mother’s sat down beside me and said it was time for me to give up my seat. I looked up and down the row of folding chairs that lined the court, and there was one empty seat next to me and three or four adult men and a bunch of children taking the other seats.

“You are being very rude taking a seat while our team is playing.”

I politely told her that I was there to watch my granddaughter keep score.

Plop! The chair beside me was taken by another woman, and an ample woman at that. She and her friend began to shout across me about how rude I was.

“I’ll be happy to trade seats with one of you ladies if you want to chat.”

“We want you to leave.” This from the plump plopper on my right.

I looked into her eyes and said politely, “Bless your heart. I don’t know where you are from, but in The South, grandmothers do not stand while men and children are sitting. If every man and child leaves his seat and there are not extra chairs, I will stand, but not until then.”

So they went to Plan B, and the heffer to my right stuck her left leg out and pulled her jeans up to reveal what looked like the worst case of poison ivy I ever saw. The scabs were enormous, and they will covered by some sort of pasty looking cream. Gag.

“Look here, I have this highly contagious disease, and it’s not smart for you to sit next to me. It is very, very contagious.”

“Then, bless your heart, you should cover it up and in the interest of public safety, leave this building filled with over 2000 people. You wouldn’t want to start an epidemic, would you?”

I turned to the woman on my left, looked straight into her eyes, and said, “Bless your heart, this little plan will not chase me away. I am not afraid of your friend’s rash.”

Then they fell back on Plan C and tried to run me off by whistling and screaming at the tops of their lungs. The one to my right leaned over in her seat, and her butt crack was clearly visible. No scabs there. Now, THAT might run me off.

When their team lost it’s first game, they both shut up and the butt crack/rash woman got up and rumbled away.

On Sunday morning, we packed up our things and Mr. Palmer and made our way to the tournament on time for Addie’s team to play their final matches. By previous agreement, I stayed for one match, then I left to go home, worried that Mr. Palmer might be too hot in the car.

Addie and I exchanged “I love yous” and hugged for a long time.

I did not want to leave. I wish she lived next door to me. I love her so. Her team, which was pretty much cobbled together at the last minute and suffered from poor coaching, didn’t win even one match. She was very mature and philosophic about it all. Though intensely competitive, she is not a sore loser.

She is the finest gift my son, Parrish, has ever given me.


© cj Schlottman

Tuesday, April 5, 2011

The 48 Hour Day

03/25/2011


At work, about 8:30, my cell phone vibrated. It was Danny, the owner of the ALF in Miami where my son Parrish lives. He called to tell me Parrish was missing, had been for two days - 48 hours - and that he was going to call the police and have him officially declared a missing person.

My throat tightened as though my head were being twisted off, and my breath came in short gasps. In the past when Parrish went missing, the news was never good. I had visions of him vanishing for months without a word. I instinctively saw him drunk and/or drugged, reeling down some sidewalk somewhere, homeless and in physical and mental anguish, his possessions stolen or traded for drugs or alcohol. I even envisioned him dead, either by his own hand or that of another.

Danny said he called all of the local hospitals. Parrish periodically checks into hospital when he feels as though his disease is out of control, usually when he feels manic, but recently because he was having suicidal thoughts. Danny even called the police to see if Parrish had been arrested.

I turned away from the others. In spite of myself, I melted down to a pool of pathetic, gelatinous disquiet, tears flowing over the rims of my lower lids in spite of any attempt on my part to make them magically melt away.

I stumbled into the locker room, balancing myself on the counter, only just able to stand, listening to Danny’s voice, which had gone muddled and slurred in my ear. I stood still, tried to process this news and keep my head afloat in the tsunami of emotions that flooded my brain, made my body prickle, almost buckled my knees.

I had to ask Danny to repeat himself twice before I could hear what he said. He sounded calm, reassuring. He promised to call me with any news. We rang off, and I squeezed my phone as though I could will it to ring with good news.

This could not be happening again - not after all the months of sobriety, all the efforts to regulate his medicines, to keep him in a sheltered environment because he cannot function without an external support system. As much as he complains about assisted living, he cannot function without it.

I stood frozen in place as though my feet were nailed to the floor, unable to move or speak, wanting to open my mouth and scream but unable to utter a sound. I labored to organize myself, affect some sort of composure.

When I emerged, the others looked at me with great concern, wanted to know if I were okay.

”No,” I said. “My mentally ill son has been missing for 48 hours.”

I turned and walked back to the locker room, not knowing whether to go home or try to function at work. After some thought, I concluded that going home would be the worst thing I could do. I envisioned myself lying in bed with the covers pulled over my head, or maybe sitting in the floor of my closet with the door closed, poisoning myself with worry, weeping and pulling down one of my shirts and screaming into it. No, going home was not the answer.

So, I went to my manager’s office, closed the door and spilled my guts all over her. The tears returned. She sat and listened, a look of compassion on her face. There was a period of silence broken only by me blowing my nose.

“What do you want to do?” she asked. “What will help you through this? Do you want to go home? No, you shouldn’t be alone now, not like this. Take all the time you need to gather yourself together, and I will give your patients to Janet, let her handle the drugs, and you be her assistant. Stay with us, at least until you have some word.”

The hours dragged on as I tried to be half a nurse. It’s not easy to be half a nurse, and without thinking, I medicated one of my patients. I should have gone to Janet and let her handle it, but I forgot all about
being half a nurse. The woman needed medicating, so I did it.

Janet was not happy.

“You are confusing me,” she snapped. “Do you want to take your patients back or leave them with me? I can’t deal with you and me both taking care of them.”

She was right, of course. I apologized, said I wasn’t myself, that maybe I should have gone home.

“Just tell me what you want me to do.”

“I want you to keep the patients, and I will help at the desk or just go sit with one of my little ladies, keep her company while she no visitors. “

“Are you sure? I can’t be half a nurse any more than you can, and you are compromised. You really are not yourself.”

“Okay, I mumbled,” stinging from her tone but knowing that she was right.

Time continued to creep along, and finally, at 6:00, I left to go home - an hour early. When I reached my car, I called Danny for news.

“We found him. He’s in hospital in Hollywood.”

“That’s so far from you. How did he get there? What is wrong?” I croaked.

“He is on his way back here, so I will get him to call you when he arrives. Don’t worry. He is okay.”

I rang off, put my head down on the steering wheel and sobbed myself dry, feeling twisted and distorted, a black hole, completely at the mercy of my much wounded heart. Afraid to drive, I went back inside and sat and drank a cup of coffee and waited for my heart to stop skipping and shuttering, taking my energy with it.

As the night nurses came in, I got up and went back to my car, cranked it and crept home in the twilight, focused hard on the road which stretched out in front of me forever. I finally saw my house.

Home. My bed, my dogs, my stuff.

I was undressing when my phone vibrated in my pocket.

“Mama? Did Danny call you? I’ve been in the hospital in Hollywood for two days, but don’t worry. I went up there to eat supper with my friend Carlos, and on the way back to the train station, I passed out, woke up in the emergency room. My lithium level was three times the therapeutic level. There were IVs going into my arms in three places. I didn’t have my phone card, so I couldn’t call anyone, but I’m okay now. Finally, they called Danny late today. I’m back at the ALF, and everything is okay, really it’s okay. I don’t want you to worry.”

I sighed.

“Danny called and told me you were missing. I knew you would turn up. I didn’t worry. Really, I knew you were some place safe. Now go and get some rest. We’ll talk tomorrow.”

My dogs were already in bed, giving me that worried look they get when they know I am in trouble. I peeled off my scrubs and underwear, left them in a pile on the floor, fell into bed naked and slept the sleep of the dead.


© cj Schlottman

Author’s note: This event took place nearly two weeks ago, but it has taken me this long to distance myself far enough from it to write it down in a coherent fashion.