The night started out just fine, all were happy in the home and tired. Medications were taken at the appropriate times and my children, sometimes nick-named "The Bickerson's" were actually at peace and I had hope for a peaceful and easy Saturday night. Last week in the middle of the night we had a suicidal process stopped mid plan and I chose not to take my son to the emergency room. His psych doc asked why I had not brought him to the ER when he was so acutely suicidal and I told her of my huge frustration in the process.
My son gets to the ER and looks just fine, calm, compliant, polite and the mental health workers look at me like I am nuts to say he is suicidal. It is her insistence that his suicidal ideation is very serious and not to be taken lightly so she told me that if it happens again to tell the mental health worker that SHE was his doctor and that his diagnosis was very serious and his suicidal threats were to be taken at the highest level of intensity. She told me that if I needed to tell him that I want to speak to the psych doc on call and go over his head and worse comes to worse simply state that I am not leaving the hospital with my son, they are to keep him. Well, my hope was that I would not need to use these tips for better service but I was wrong.
I had just gotten comfy in my bed, feeling safe and happy enough to actually sleep in my bed fo the first time in a week instead of sleeping contorted on the couch to stay on hyper vigilant suicide watch. My bed felt so so good to stretch out and just sink in. Sure enough, as sleep began to take me over I hear the door to my son's room opened which always makes me nervous. I heard him come down the stairs and walk straight to my room. "What's up?"...he answered, "Mom, I want to die and I rpomised you I wouldn't but I don't want to live anymore and I can't control it." Good bye comfy bed, our five minutes together was precious and sad all at the same time.
I sat up and tried my best to distract him, think of hopeful thoughts, the potential service dog, his short films, his art work and poetry, his aspiration to have a job at a golf course driving golf carts. He said that none of it mattered and was all a waste because he was too much work and not worth any of it and he couldn't go on trying. After about a half an hour of my full blown efforts to distract and lighten the mood he continued to weep and stay in his deep darkness and I asked the million dollar question, "If I fell asleep tonight, could I trust you not to harm yourself in anyway?"...answer, "no." CRAP.
We agreed it was time to go the the ER. I hate that trip. In the middle of the night we gathered our things and head to the ER, in the dark and cold. We went in to the front desk and told them that he no longer wanted to live and they processed his insurance card, gave us his bracelet and we went back to triage. I pulled the triage nurse aside to tell her my son's form of Bipolar includes hallucinations and such and that I just wanted it on record in case it happens so that everyone would know how to treat him if he started talking to his demons or voices.
Upon this information, the doctor on call comes in and sits in front of my son and starts talking to him like he was a stray wild dog. "How are you feeling tonight?" he says in a soft high pitched tone. I looked at him like he was an idiot. "Are you feeling stressed tonight?". DUGH, would we be here if he wasn't??? "Are you hearing voices right now?" My son looked at him with disgust and said, "no" and rolled his eyes. I tried to clarify to the doctor that he doesn't hear them all the time, just on occasion and that he was not hear because he hears voices, he's here because he wants to die. He smiled at me like I was crazy too and said, "Ok, no problem, do you want some medicine to take the edge off of your stress tonight?". My son said he was fine and the doctor apparently frustrated and still looking for his sense of understanding left the room.
We were walked back to the back of the ER where the nurse and the doctor were mocking people who hear voices. They were discussing how funny it is that people say they hear this or that and that the only voice they should hear is the voice of God. I sat in the hallway for a second staring at them wondering how they could possibly be so insensitive or stupid and feeling grateful that my son did not hear them.
Next the nurse who was just engaged in mockery of my son's condition comes in and without looking at my son or myself grabs his arms and starts cleaning his fresh cuts. He's rolling his eyes and says, "you know these aren't that deep, they don't need to be stitched up." I answered, "We aren't here for the cuts on his arm, we are here because he doesn't want to live anymore." He sort of froze and finally looked at me and said, "Oh, really?" He looked at my son and said, "Is that true?" to which my son answered int he affirmative. Then comes another brilliant patronizing statement delivered almost with a sense of laughter to it, "You are a good looking guy with your whole life ahead of you, why would you not want to live anymore?" I wanted to kick him in the head but still haven't gotten around to taking those kick boxing classes that would have been so helpful at this moment.
He drew the blood and took a urine sample and then we wait for an hour for the results to come back. Once the results come back then the mental health worker can be called. Until then, I sit in an awful hard plastic chair and my son sits on a gurney and we wait. Finally, the doctor who still insists on speaking to my son like he is a lost dog comes in to tell us that all the tests were clean so now we will call the mental health worker to come assess him. I muster up a smile of gratitude for the forward mtion of the process and he leaves.
We have always had women mental health workers, even had one lady twice, she was nice, I liked her. Tonight we got our first guy. He looked like he was 19 but professed later to have a 20 year old kid so I'm not sure what he's doing to stay so young looking but he seriously looked like he walked otu of an abercrombe andFitch ad with his clothes and cologne. I pulled him aside when he arrive after waiting for him for an hour and told him what my psych doc told me to tell him. He said, "Oh, wow...okay, I understand." We walked back into the room with my son and he pulled out his paperwork and said, "So, what is better or worse then when you were here last time" I was a bit stunned, I had just explained the progression of my son's mental illness and the serious intensity of his suicidal actions and the concerns of his psychiatric doctor and he was comparing today to last time.
He asked all the questions on his form and then showed us his score sheet. No, seriously, there is a score sheet. It is apparently like a quiz in a magazine. You know those quizzes, the ones that tell you if you are compatible to an executive or a hippy or if you are supposed to vacation in a motor home or on a tropical island. He tells us that my son lost points on the suicide scale because he is not a 45 year old white male and the fact that he has such a great Mom. He showed us his arithmetic and declares that my son is borderline suicidal. I was speechless. Borderline suicidal. His chart said so. We only added up to borderline. Nothing I said to him mattered, only his happy arithmetic.
He then turned to me and said, "Do you think you could take him home and keep him safe tonight?" I was stunned at the question because it seemed so stupid. I gathered myself after a few seconds and said, "Do you think I would come to the ER in the middle of the night asking for help if I thought that I could do this at home? My son told me that he could not guarantee that he would stay safe if I fell asleep, does this not warrant help beyond myself?" He stuttered for a moment and said, "but you guys have made it through before, he seem quite calm and compliant, I'm not sure he would really benefit from a psych hold." Then he said the words that were most dangerous for him, "unless you are just too tired." WHAT?!?!?!
I stopped breathing for a minute and my eyes went blurry. He offered to fax the forms to the psych hospitals around and see if anyone would take him. He said he'd get back to us in a bit. He got up and walked away. My son laid back in his gurney and closed his eyes and I started plotting ways that I could learn kick boxing in five minutes or less. My adrenaline started to race and I was working up the strength to tell this idiot that I was not leaving the ER with my son that night when he announced that the psych hospital will take him. They were saving him a bed and they would process his paperwork. I remember hearing a long exhale leave my body.
Now, we have done this several times already and the 3am shift almost never processes the incoming paperwork, they wait for the 7am shift to come and in a dump it all on them. I told the mental health worker that I had a daughter asleep at home that I wanted to go check on and since i figured it would be several hours I would go home and come back. He warned me not to leave because it could be processed very quick. I went back to the room and waited for 45 minutes for him to come in and tell me that they will not be processing his paperwork until the next shift and it could be several hours. Um...yah.
My son was sound asleep. I asked if I could write out his medications so that they could make sure he would not miss any medicines-missing meds is very very bad these days. The doctor did a "tshtpft" sort of sound and gave me a paper and a pen and stormed off-to no other patients in the whole damned ER. I left dizzy and exhausted and drove home where I finally fell asleep around 5am only to be awoken at 7am to a nurse calling to find out what medications my son needed in the morning. We finally came to the conclusion that they did not have one of the medications so I needed to bring it. I went back to the ER with my son's meds to find a fantastic nurse on the morning shift. She was friendly, compassionate and sharp as a tack. We finally got everything together and my son's transport came for him only 11. 5 hours after entering the ER...our fastest process yet. We've been there up to 26 hours before.
The likelihood that they will keep him for the full 72 hour hold is minimal. He hates it there and knows what to say to the doctors and nurses to convince them that he is no longer suicidal. Because he went in on a Sunday morning and the staff on the weekend doesn't really make those decisions, I am pretty much guaranteed one day of peace but there is no telling what will happen on Monday. My hope is to have him stay in there for at least two days to give the new medicine more time to help him stabilize without me being on hyper vigilant 24/7 watch in order for my daughter and I to breathe out for a few minutes, my adrenal glands to come back from their afterlife for maybe a day and know that he will be relatively safe.
The psych hospital is not exactly the greatest place but it is the best we have. He has been uncomfortably harassed in violent and sexual ways by some of the other kids, Being on suicide watch means he has to sit in the lobby all day long except for when he goes to group therapy which is four times a day. All the kids in there remind me of characters from "Girl Interrupted" and I think they can teach him more harm then good sometimes. When he gets home, he will need to decompress a bit and eventually he will ask me all of his questions trying to make sense of what he saw and what he heard. I just pray that I will be able to put those pieces back together enough to help him get on to a safe and healthier track. No guarantees, ever.
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