“Two o’clock, everyone! Medication time!” Julie consults her clipboard and calls the first name.
“Melanie?”
“Here I am,” she calls out cheerfully.
“Okay, Melanie. You know the drill. You’re aware of what you’re taking, right?” The nurse asks perfunctorily—like a flight attendant mechanically reciting the passenger safety instructions, knowing no one is paying attention. Three Breezes prided itself on its medication regimen.
“I know, I know,” Melanie says before tossing the pills into her mouth as if she is gulping down a shot of alcohol.
“Crystal Light or Hawaiian Punch?”
“Hawaiian Punch, please.” Melanie’s mouth is full of pills so it sounds more like “H’wine Pun, peaz.”
She thinks she’s so cute, that’s what kills me. She thinks everyone thinks she’s adorable. News flash, Mel: You ain’t all that.
Julie hands her a small Dixie cup, watches carefully as Melanie gulps that down, checks another box on her clipboard and calls the next name.
“Sukanya?”
Sukanya shuffles forward.
“How are you today, Sukanya?” Julie asks as she hands over the tiny cup of pills.
“Are you aware of the medication you’re taking?”
Sukanya blinks and the nurse continues.
“Crystal Light or Hawaiian Punch?”
Sukanya casts a glazed glance at the pitcher containing the unnaturally red beverage.
“Here you go.”
Sukanya takes the Dixie cup in one hand and the pill cup in the other and starts to turn away. Julie grabs her arm. “Sukanya,” she sings in a mock-friendly tone, “you know better than that. You need to swallow the pills here, where I can see you.”
Sukanya stares at the fingers wrapped around her forearm until Julie releases her grip. Then she slowly places the pills on her tongue and swallows them down with the punch.
Can we move this thing along?
“Good job. Okay, let’s see, who’s next? Isabel?”
Isabel moves forward. Like a model patient, she takes her pills in front of Julie and moves away from the doorway of the tiny pill closet. After ECT, this is nothing to her.
“Kristen? You’re on deck!” Julie is back to her clipboard, checking away. She does not know that when Kristen pops her medication into her mouth the pills nestle under her tongue. After Kristen turns away from the medication checkpoint, she spits out her medicine.
Isabel has taken only two steps into the group therapy room. There, facing the double doors, is Lark, neatly tucked into the wing chair, enveloped by the jacket.
We have to look at that damn jacket for the entire session?
“Let’s start off this group session by checking in with everyone,” Larry announces. “Let’s go around the room and each of you can let the rest of the group know how you’re feeling or what you’d like to work on or, well, I’ll leave it to you. Whatever each of you would like to say. Isabel? Let’s start with you. How are you today?”
Isabel breaks her stare at the jacket and tries to focus on Larry. Thirty seconds later she looks back at Lark, who appears to be fighting to keep her eyelids open.
“Isabel?”
“Yes?” Focus.
“I asked how you were doing?”
Focus.
“I’m not doing too well, if you must know. I hate this fucking place. I don’t want to be here. I think this is all a bunch of shit…sitting here, talking about ‘what’s going on with us,’” she says, mimicking Larry’s slow intonations. “I’m sick of it. Sick of it all. I want to get out of here.”
“Hmm.”
“And furthermore, Lark’s sitting in here in that thing and it’s a little hard to concentrate.” She stops and looks back at Lark.
“And?”
“And nothing.” She pauses. “Actually…I thought this place trumpeted the fact that all patients are in charge of their own treatment regimens, or however you put it,” she challenges Larry.
“Meaning what, exactly?”
“Meaning I have been subjected to a treatment that I didn’t necessarily agree to. I thought we were supposed to be able to agree to what kind of treatment we received.”
“You’re referring, I assume, to ECT,” Larry says.
“Yes. I’m referring to ECT.”
“What’s she talking about, Larry? What’s ECT?” It is Ben, who seems slightly agitated.
Great. Just fucking perfect. I’m getting electroshock therapy and Ben the I’m-gonna-blow-up-my-school guy isn’t? Great.
“They shock you,” Melanie jumps in. “They put a thing in your mouth and they shock you in the head.”
“No they don’t,” Isabel cries defensively. “They don’t put anything in your mouth.”
Isabel feels her cheeks reddening.
Get those smug looks off your faces: I am not like you, you goddamned nutcases.
“ECT is a very effective form of treatment,” Larry intercedes on her behalf. “It’s been very successful in the past and I’m sure Isabel’s therapist feels it will best suit her needs. Isabel, I hear that you feel upset about this, but I do know that Dr. Seidler has repeatedly tried to talk to you about it.”
“Wait a second. Wait just a second. You guys talked about me?” Isabel is horrified, picturing a coffee klatch of doctors swapping stories about their pathetic patients. Five bucks says mine’s more screwed up than yours.
“Now, hold on,” Larry says, trying to calm the now unsettled group. “We work in tandem, your therapists and I. I speak constantly with all of your therapists to ensure that we are all up to speed on the issues you’re dealing with. It’s imperative that we maintain an open dialogue…”
Open dialogue my ass.
“…to better serve your recovery.” Larry stops and takes an exaggerated deep breath.
“Let’s move on. Lark?”
“Wait! What am I supposed to do?” Isabel is infuriated. “Seidler told me I’m having ECT again tomorrow—I don’t get a choice? That’s not okay. I am not doing it again.”
“Have you told Dr. Seidler that?”
“Yes.”
“What did she say?”
Isabel shifts in her seat. “I don’t remember,” she says sheepishly.
“I think what she might have said was that it is not uncommon for patients to experience anger following their first treatment, but we’re confident—” Larry hurries past the word we’re “—that another session will enable you to achieve the maximum benefits of ECT.”
“But…but couldn’t there be another way? Couldn’t I just promise to work on myself more actively or something? Please? Isn’t there any way I can get out of this?”
“Let me talk with Dr. Seidler after this session and see what she has to say.”
“Thank you, Larry.”
You catch more flies with honey.
Larry takes another exaggerated deep breath to emphasize a subject change.
“Okay. Now. Lark?”
Lark slumps farther down into the tall chair.
“Do you want to tell the group what your situation is, Lark?” Larry asks this while surveying the nervous faces around the room.
“Why don’t you do the honors, Larry.” Lark slurs her words through the hair that had fallen into her face. She does not try to shake it away, it just hangs there like a veil.
“Lark is in restraints today because we believe she could be a danger to herself and maybe to others,” Larry addresses the group.
“And a danger to you, Lar, right?” Lark challenges through her mask.
“Well, if you’d like to talk about that, we can.”
Lark’s beady eyes dance as she tells the group she bit Larry before being carried away to the soft room. She appears proud.
“Do you think you’re a danger to yourself, Lark? Will you sign a contract?”
“What the fuck’s a contract?”
“A contract is basically a written agreement between you and your doctors that you will not try to take your life. We write it up in whatever language suits you, but it boils down to a promise that you will not harm yourself for a certain period of time. Feel like signing one? If you do, and if we believe it’s in good faith, we’ll remove the restraints.”
“Fuck you.”
“Why are you so angry, Lark?”
“Fuck you, Larry!” Lark has shimmied to the edge of the seat and is struggling to stand up. The jacket ruins her balance and the anger ruins her equilibrium. The combination keeps her tumbling backward into the seat.
“I’m going to have to get an orderly if you cannot control your temper.”
“Fuck you, Daddy!”
“Lark?”
“Don’t hurt me anymore, Daddy.”
Larry stands and quietly moves toward Lark.
“Get away!” Lark spits as she whips her head from side to side until her hair has completely covered her face.
“Lark, what do you want to say to your daddy?”
Lark’s breathing becomes forced and shallow, and from behind her hair, she starts to wheeze as she tries to take in air. “Please don’t hurt me, Daddy…I can’t breathe. Get off. It hurts.”
“Do you need your inhaler?”
“Yes,” she gasps as Larry reaches for the device tucked beside her in her chair. He holds it up to her mouth and gently calms her down enough to get her to take several inhalations. As Lark’s breathing returns to normal, Larry moves away.
“Are you back with us?”
Lark nods, still slumped.
“I want you to know we all support you.”
“Yeah, we do,” Melanie interrupts. “I know how you feel. I know you hate your dad—I hate my father-in-law. I thought about getting him a gift for Father’s Day this year but I blew it off. Screw him. He gets me the cheapest presents for my birthday, so screw him. I love the Sharper Image catalog. That’s where I usually got him something but I didn’t this year. Besides, I was here. I mean I am here,” she laughs, “so I said to Elwin, I said, ‘if your father—’”
“Melanie? I’m sure Lark appreciates your support. Now, maybe someone else has something to say?”
“Lark?” Kristen practically whispers. “I know we’re not close friends or anything, but if you want to talk you can come to my room. I’m not having visitors this weekend so I’ll be around.” Kristen begins to cry.
“Why are you crying?” Larry moves toward Kristen.
Boy does he have his hands full today.
“I don’t know. I don’t know.”
“Are you sad that you’re not having visitors?”
Isabel feels envious. Her parents are visiting for the first time, and while part of her is excited about it, the other part dreads it immensely.
Kristen blows her nose. “It gets so lonely here on the weekends.”
“Yeah, and the food’s not as good.” Ben nods in agreement.
“I hear that,” Larry says. “Things are slow on weekends on purpose. We feel time off from group sessions and individual sessions can be useful for patients. Sometimes it can give you time to think, time to write in your journals, time to process everything.
“Getting back to Lark, though. Isabel? It looked like you wanted to say something.”
With Kristen sniffling, Melanie seething and Lark bandaged up in restraints, Isabel can think of only one thing to say.
“Hey, Lark, if you want to inhale my secondhand smoke this weekend, I’m all yours.”
She hopes that behind the wall of dirty hair Lark is smiling.
“Isabel, Dr. Seidler and I spoke on the phone a few minutes ago and I wanted to talk to you about our conversation.”
Isabel’s heart is speeding up as she searches Larry’s face for clues.
“What’d she say? Do I have to go in again tomorrow? Because I’ve got to tell you, I’m just going to refuse it. I’ll get on the phone with my attorney and I’ll sue this place for malpractice if I have to—”
Larry is holding up his hands as if to say “I surrender.” “Hold on, hold on. Let’s not get ahead of ourselves here. Calm down.”
Isabel’s stare is unblinking.
“Now. Dr. Seidler told me that you and she talked about this—that electroshock is one of the most effective forms of treatment—”
“Blah, blah, blah,” Isabel interrupts. “I don’t fucking care how effective it is. I’m not doing it again.”
Don’t cry. Do not cry.
“What you’re experiencing here is a common side effect of the treatment—wait! Before you interrupt me again, let me tell you that many patients experience aggressive irritability following their first treatment. That’s precisely why Dr. Seidler is recommending a second round. To curb the irritability and to therefore receive the top benefits of the treatment.”
“By irritability you mean belligerence,” Isabel shoots back. “You, this place, no one allows any of us to stick up for ourselves. The minute we do it’s off to the soft room.” Her arms sweep a large arc of frustration in one direction and then another. “Or it’s ‘Hey, have some more ECT. It’ll shock the irritability out of you.’”
Suddenly Isabel is overcome with exhaustion. Larry is watching her carefully.
“You know what? I give up,” Isabel says as she collapses into a nearby chair. “You and Seidler…you know I don’t have the energy to fight…so forget it. I give up.”
Larry moves a chair close to hers and sits forward in it. “It’s fear you’re really feeling, isn’t it? Not irritability. Not anger. Fear. Am I right?”
Silence. Isabel looks down at her lap.
“I can imagine you’re scared.”
“You can imagine? What? You can imagine what it’s like to go from having everything to having nothing? To being treated like an infant sometimes and an inmate others? I can’t even count how many times I’ve traveled, alone, mind you, to foreign countries to cover pretty dangerous stories—wars, even. And yet I can barely take two steps out of the unit without someone telling me to sign myself out.
“I’ve interviewed heads of state, presidents, CEOs, you name it—all of whom treated me with dignity and respect—and now I can’t even shave my legs without some lesbian nurse ogling me.
“I’ve had to become an expert on dozens of subjects, different cultures and a handful of medical breakthroughs, and yet I am not allowed to request that electrodes not be taped to my temples. Don’t tell me you can imagine what I’m feeling, Larry. You have no idea what this feels like.”
It is Larry’s turn to look at his lap.
“You’re right,” he says without looking up. “You’re absolutely right. I have no idea what it’s like to be in your shoes.”
Then he looks up, straight into Isabel’s frightened eyes.
“But I think, then, that it’s safe to say that you, Isabel, have no idea what it’s like to be in my shoes.”
Isabel tilts her head ever so slightly. Touché.
“You probably don’t realize how frustrating my job can be. How tough it can be to see patients suffer, to not be able to reach them, help them. And yes, it is equally difficult to see some patients make significant strides—” he gives Isabel a knowing look “—only to sabotage themselves by refusing the very treatment that is helping them.”
Silence.
“Just give it one more shot, Isabel. Then, if you don’t want to do it anymore you can take it up with Dr. Seidler. One more time.”