by David Archer
"Prozac is a mood stabilizer, right?" Jade tapped the arm of her chair, and it looked like she was processing a lot more than she let on.
"It is, but when they began it, they were using it as a booster. There are a lot of medications that can aid antidepressants in low doses, despite the fact that their therapeutic dose would have a completely different purpose." Raymonds rested his elbows on top of the file and laced his fingers together. "Based on the amount of time Eric spent on the lower dose, I would say it was meant to be just a booster. It didn't work for him, and it caused some nasty side effects; however, instead of taking him off the medication or trying something else, they diagnosed the negative reaction as the appearance of mood swings and increased the dose."
Denny pointed to the table in front of him. "They did this several times? With several medications?"
Raymonds held a hand up and tilted it from side to side. "Well, they took very poor notes, so it's possible there's another explanation, but this is the one that makes the most sense."
Darren and Sam exchanged a brief glance, knowing the notes had probably been fine prior to redaction.
"Regardless of how it happened, Eric is overmedicated and overdiagnosed. In and of itself, being overdiagnosed isn't all that uncommon, but it's very odd for someone so young."
Summer frowned a bit. "Can you explain that?"
"If insurance is going to cover or help pay for the treatment of anything, there has to be a diagnosis, but consultants don't have insurance. Everything about their treatment is covered by government funding, so there's no need to grasp at straws for a diagnosis. If there isn't one, there simply isn't one, and it should stop there." Raymonds opened a folder and began leafing through the pages inside. "Here we have a diagnosis of Borderline Personality Disorder, and another diagnosis of Bipolar Disorder. I have diagnosed him with simple depression, which we can reevaluate once he's on a reasonable amount of medication."
Sam nodded a few times, focusing entirely on Dr. Raymonds. "So, what is the plan? How do we move forward from here?"
"Well, the first thing is to get all of you an updated list on what he can and can't have or be doing. You said he was on Dexedrine, yes?"
Sam offered a slight nod, somewhat tense.
"I have used the same thing for many of my patients with depression. It helps them get through a shift at work, stay awake while driving, or make it to an appointment they can't miss, like a wedding or funeral. However, it isn't supposed to be a staple, and it shouldn't be mixed with other stimulants." Dr. Raymonds looked at Denny then, seemingly changing the topic. "You said he likes music?"
Denny nodded. "Uh, yeah. He loves it."
Summer let out an almost incredulous laugh, a striking fondness in her blue eyes. "He's always listening to something, if he isn’t busy."
Sam shook his head. “I feel like an idiot, not realizing he was so doped up.”
Raymonds only shook his head, the look on his face unjudging. "It isn't your fault. It's not your responsibility to know how all of these drugs interact with each other. Eric should have come from North Forest Hospital with a list of warnings and any dietary limitations necessary. That's why our first step is to get us all on the same page." Raymonds took his glasses off and leaned back in his chair. "The Dexedrine he's on doesn't stay in his system, so there's no need to ease him off of it. Because of that, it'll be the first thing to get removed from his daily medications. If he needs it to stay awake, that's fine, but if he chooses to take it, he can't have any caffeine and sugar should be limited. On the other hand, if he doesn't need it to stay awake, he can drink coffee, take aspirin for headaches, and so on and so forth. If, for some reason, you absolutely must have the two mix, it won't hurt him, but it will leave him very, very agitated."
Darren stroked his chin, staring blankly at the center of the table for a moment, not entirely sure where his thoughts wanted to take him. "Eric would have access to medical textbooks, wouldn't he?"
Raymonds licked his lips and thought for a moment, eyes wandering upward. "I can't be completely sure, but I don't think it would have been censored by the program. If there were drugs that could be used to make bioweapons, then maybe, but there shouldn't be any harm in letting a kid have a few psychology and pharmacology textbooks."
Darren frowned a little deeper. "What are the chances he doesn't know he's overmedicated and overdiagnosed?"
Raymonds shook his head. "Non-existent."
Sam gave a sigh and turned his chair a bit, looking toward the office where Eric was sleeping on the sofa. "He told us several times that he was on too many medications, but we had no way of knowing whether he was being truthful until now."
Darren watched Sam for a moment or two. It may have been a fair statement, but Sam didn't seem convinced of his own words, and the way his gaze lingered on Eric's room implied guilt to Darren.
"It's understandable." Raymonds gave a shrug. "That's the entire point of the program, right? If we believe everything people like him say, they could talk us into just about anything. We're supposed to trust that someone is keeping an eye on them and taking care of them."
Jade scoffed and shook her head. "Yeah, well, they're doing a bad job."
"Agreed." Dr. Raymonds stood up and looked down at his file, sighing after a moment and closing it. "I'll talk to some of my associates who work a little more closely with North Forest Hospital. I would like to know how frequently things like this happen."
"If you could report back to us with anything you find, it would be much appreciated." Sam paused and cleared his throat. "Eric is usually adamant about being overmedicated, but a couple days ago, he asked for extra Dexedrine. I didn't give it to him because I was concerned about addiction. When he was still doing bad yesterday, I gave him a half a pill, and it appeared to help, but he insisted it wasn't enough. Did you get any sort of read on a possible addictive personality?"
Raymonds frowned and considered the question for a few seconds, tilting his head from side to side. "Ehh… inconclusive. Without full access to past medical records, it's hard to say. If he has a history of depressive episodes more severe than this, it could be a psychological addiction, but if it's most of the time milder, he could just be hitting his limit. There's nothing wrong with taking a stimulant to get through your day, per se, but they're supposed to be used for when you absolutely have to get up and manage. If you turn them into a staple, which North Forest Hospital has… it could very easily evolve into an addiction."
"He took one the night after Sam said no."
Sam's head snapped over to look at Denny—most of the table did, actually—both angry and concerned. "What?"
"When you guys were away on the case," Denny explained. "He asked me for Dexedrine when it was just the two of us. I said no, but later on his behavior began getting less sluggish and more… I dunno, wired?" He considered his words for a few seconds and then shook his head. "I woke up two hours later, and he was calming himself down to prevent a panic attack. I let him know I knew he took the medication, and he didn't deny it."
Raymonds responded to the new information before Sam had the chance, and Darren was secretly a bit grateful for that. Dr. Raymonds appeared to be a bit more mellow about the whole thing.
"That doesn't necessarily mean he's addicted. He has been dealing with these problems for a long time, and he could simply think the trade is worth it. You said he was preventing a panic attack?"
Denny nodded. "He said when there's no trigger, he can calm himself down."
Raymonds nodded back. "It's often easier to stop a panic attack when you know exactly what the cause is and how long it's going to last. It's possible your kid would rather endure a panic attack he has some control over than a depressive episode that is completely out of his hands. It wouldn't be the first time someone who wasn't an addict made that decision."
Raymonds left it at that and pointed to Sam. "You said you wanted to meet with me privately," and then he pointed to Jade, "and there is somet
hing Eric has for you."
Jade pointed to herself. "For me?"
Raymonds nodded with a small smile. "He'll explain it."
Jade blinked a few times and looked around the room, hesitating for another second or two before leaving the room.
Darren looked out the window and watched her go, tuning out the talk in the room.
* * *
Jade wasn't sure what to expect when she entered the semi-furnished bedroom, but she kept that uncertainty out of her eyes and body language. "Eric?"
Eric, who had finally managed to change clothes but remained in bed, smiled up at her. "Ms. Miller." He pulled an envelope from underneath the blankets, chewing his lip and carefully evaluating her.
Jade stood a few feet away, giving him space but showing that her involvement was voluntary. She stayed quiet, a light smile on her lips, and waited for him to explain.
"This is a self-evaluation." He tapped the envelope a few times. "Dr. Raymonds said I could write one up and give it to one person on the team. It can only be read by that one person, and that one person is supposed to keep an eye on the diagnoses being made by Dr. Raymonds. He said, particularly since he doesn't have my past medical records, that he expects them to run along similar lines, even if they aren't the same."
Jade nodded several times while Eric spoke, and when he was finished, she responded with the conclusion she had come to. "You want me to be the person."
Eric nodded his head with a little smile, holding out the envelope with a shaking hand. "Will you do it, Ms. Miller? I'll pick someone else, if you want."
Jade shook her head, taking the envelope carefully and holding it in her hands. She looked down at it for a few seconds, contemplating the decision Eric had made and trying to figure out why.
"Is there a reason you chose me?" she finally asked, looking up to see him still smiling at her. Briefly, she wondered if Dr. Raymonds had given him something.
"Out of everyone on the team, you spend the least amount of time with me, and I think you do it on purpose."
Jade opened her mouth to object, but Eric kept going.
"I think you know that if the team were to try and speak out on my behalf, they would most likely be disregarded because of their emotional attachment. You keep your distance, not because you don't care, but because you want to make sure you'll be seen as a credible, objective source of information. I know you care because you gave me cookies when I was fighting with the team. I know because you smile at me more than anyone else, because you don't want to hurt me while trying to help me."
Jade felt her eyes start to burn, and she pressed her lips together, looking down at the envelope again.
"I see other things you do, too. I read over your shoulder sometimes, and I know you're learning all you can about people like me and North Forest Hospital and its policies. I overheard you talking to an old friend of yours, too, trying to get the unredacted medical files sent in to Sam."
Jade swallowed, blinked the tears away, and kept her breathing level.
"I want you to have my self-evaluation because I know you'll be objective and fair, but also because I wanted you to know that I understand." Eric licked his lips and swallowed, glancing away before looking back at her. "Until a couple weeks ago, I haven't seen my mom since I was eleven, but I still love her more than anyone in the world. I understand that sometimes you can't be there for the people you care about, no matter how much you want to, and that it doesn't mean you care less than those who are able to get closer."
Jade approached the bed before she realized what she was doing, wrapping an arm around Eric and pulling him into a hug. She pressed his head against her chest and squeezed him, refusing to let a single tear fall.
"I was going to reach out more after your room was finished," she said softly, letting him go and taking a step back to put space between them. "I was going to start leaving cookies on a weekly basis. Maybe even slide a few notes under the door after hours."
Eric smiled up at her, sinking back into the sheets but looking brighter than he had in several days. "I would like that, Ms. Miller."
Jade smiled at him, tapped the envelope against her hand, and nodded toward the door. "I'll get back to the team. They'll be keeping you busy all day, I'm sure."
Eric nodded his head, the smile slowly fading as he sank deeper into the sheets.
Jade turned to go but stopped at the door, looking over her shoulder. "Eric."
"Yeah?"
"Just because you have the energy to smile, it doesn't mean you have to. I understand that sometimes you just want to smile on the inside."
Despite her words, his smile did return a bit. "Thank you."
"Just returning a favor." She offered him another smile and left, closing the door gently behind her.
Eric… She looked at the envelope again. You are something truly incredible.
THIRTEEN
"Indie just called,” Summer said as she walked into Sam’s office. “She was able to get into NFH’s computers, and pulled out an awful lot of information. There's a lot of budget statements, some requisition forms, and employee records, but there's also case summaries for cases people like Eric have helped with."
Sam tapped the end of his pen on the legal pad in front of him. "By and large, most federal contractors don't mind putting their summaries in the open archives. We can definitely use that to our advantage."
Summer nodded from where she sat on the arm of the sofa. "I already began sorting the cases by date, and I'm going to ask Eric to give me the numbers of his ward mates. I can get details from him, check to see if the details line up, and start making a timeline."
Darren chimed in from where he leaned against his desk, gesturing with his hand as he spoke. "We can use that to check for delusions, too. If we can prove the people Eric befriended in North Forest Hospital actually existed, we can tell Dr. Raymonds. He might be able to debunk the Schizoaffective diagnosis and get him off those anti-pyschs." He paused then, drumming his fingers on the desk next to him. "How's that working out, by the way?"
Sam gave a shrug and smiled uncertainly. "It's only been a week, so there isn't a lot of change. Eric is taking Dexedrine only as needed, but given how bad the fatigue has been, he's used it almost every day."
"Hey." Summer held up a finger. "That's still better than every day, sometimes several times a day. Silver lining, guys."
Darren grabbed his water glass from behind him and raised it. "I'll drink to that."
Sam smiled faintly, but he wasn't as convinced. Or maybe he was, he just couldn't tell because he was also drowning in feelings of helplessness. He wanted to do something.
"Yes, well…" Sam cleared his throat. "We are also decreasing the Prozac, so we'll have to keep an eye on his behavior and take notes. His next appointment is in two weeks."
"Is Eric going to start sleeping here?" Summer asked, and while she looked at Darren, her gaze remained on the obvious leader of their mission. "His room is basically finished, and we're going shopping for the finishing touches tomorrow morning. Denny installed a really nice, high-tech lock to help with the fear of no supervision."
Sam nodded a few times. "Good. I would like to, at the very least, get him to try it."
Summer looked at him, lips pursed a bit. "Be careful, though. If it's going to cause more anxiety, just let him keep staying at my place. He can try again when he's stable, after we've got all these medicines figured out."
"I know. I'll be very gentle about it." Sam scribbled down a few notes and began tapping his pen again. "I don't intend to get him a cubicle. I think the more time he spends in his room, even if he's just doing paperwork, the more it's going to feel familiar and safe."
Summer nodded emphatically. "Agreed. I'll have him look at desks when we go shopping tomorrow." She paused, glancing between them. "Is that everything?"
Darren finished the rest of his water and set the glass down, pushing off the desk and putting his hands on his hips. "We have to decide whethe
r or not he's allowed in the field again."
Sam frowned and contemplated the page in front of him. He tapped his pen a few more times and then set it down, leaning back in his chair. "I think we should take him along, barring unforeseen circumstances. If he's feeling exceptionally bad the next time we get a case, then we won't, or if we think the case will be particularly upsetting for him, but I think, at the very least, he trusts us enough for us to keep anything terrible from happening."
Darren pointed to Summer then. "How's that coming, by the way?"
Summer looked at him and blinked, taking a moment to process the jump in topic before replying. "Oh, you mean the caseload? It’s not as bad as I was expecting, considering that we’ve already solved four in eighteen days."
Sam rubbed his face. "We usually close about twenty cases in a year. We're almost a quarter of the way there in less than a month."
Steve sighed. "And here I thought this aching back was just me getting old."
Summer and Sam both smiled at that, and Summer got to her feet. "Now, are we done?"
Sam nodded and tucked his notepad into one of his drawers, pulling out an overdue report. "If anything changes, let me know."
"You got it." Summer left the office, closing the door behind her.
Darren looked at Sam for a moment or two, and then he jerked his head in the direction of the room. "We're still not bringing in Jade and Denny?"
Sam shook his head, not looking up from his work. "Eric is very fragile right now, and I want there to be at least one person on this team who is a hundred percent focused on being his friend. Having two people gives us the wiggle room we might need in case of an emergency."
Darren nodded in agreement. "I think that's probably in the kid's best interests right now."
Sam looked up from his paperwork, knowing he must have looked more tired than he felt. "Darren, we need to do something about this caseload. Do you know anything at all about the section chief replacing DHS?"
Darren shook his head. "Nope, but she's coming in tomorrow, so we're about to find out."
