Intensive Therapy

by Jeffrey Deitz

  “Torn them apart, no doubt,” Dr. Breckenridge said.

  “Do you think Gregory will make it?”

  “I think so,” she said. “It was good that we got to him early. Your heads-up saved us precious time. The first forty-eight hours will tell. As long as he doesn’t develop intractable seizures he should live. What he’ll be like is another story.

  “I won’t forget this night, will I?” she said.

  “How did it feel?” Jonas asked.

  “I was surprisingly calm. Even though I’d been in ORs for years, when they shut the doors tonight, I felt I had entered another world. I knew exactly what to do.”

  Jonas smiled. “I played violin. I used to feel that way when I had a big solo. I couldn’t wait for my turn.”

  Dr. Breckenridge said, “I learned to sculpt in elementary school. I made my first model of the brain out of Play-Doh when I was in second grade.”

  Jonas smiled at her. “It’s late, Dr. Breckenridge. I’ll let you get some rest. Thank you for giving Gregory a chance.”

  She hesitated. “Just so you know—it was a bloody mess in there. The bone fragment nicked an artery. The clot and the swelling were as bad as anything I’ve seen. If he had been anywhere else, he wouldn’t have had a chance. Still, it could be a very long vigil. And even then, who knows what there’ll be on the other end.”

  “Good luck with your future, Dr. Breckenridge. You know, cracked skulls aren’t going away anytime soon in the Big Apple. We could always use a hand.”

  “Call me Anna. Say, did anyone ever tell you you’re easy to talk to?”

  Jonas grinned and produced his card. “Pleased to meet you, Anna.” He took a step back and smiled at her. “Jonas Speller. Call anytime.”

  Anna’s eyes welled up. “Thanks,” she said. “I see some awful stuff. It would be good to have someone to talk about it with.”

  Jonas looked into the woman’s eyes, shook her hand gratefully, and then departed.

  45

  Jonas was returning to Martin and Victoria when Dr. Meninas caught up with him. “Do you have a moment?” he asked.

  “Sure,” Jonas managed feebly, his vision blurring from fatigue.

  “Word has it that you saved Melinda’s life by helping her mother keep her from jumping off the Strawberry Mansion Bridge.”

  “Where did you hear that?”

  “The neurosurgical attending pieced the story together from the police. How does it feel to be a hero?”

  “I don’t feel much of anything except the overwhelming need to sleep.”

  “I won’t keep you long, then.” Dr. Meninas said. “Lately, I’ve been thinking about psychiatry, but my peers say child psychiatry is a waste of a medical education; that I’ll spend my life writing Ritalin prescriptions and battling school boards to get kids into therapeutic schools. They say I should go into pediatric oncology if I want to save people’s lives.”

  “That’s absurd!” Jonas said. “Look at tonight. One child with uncontrolled mania winds up on death’s doorstep after nearly killing another. Tell me psychiatry’s not about life and death.”

  “Just so you know, a police inspector named Ruby Pale is here someplace.”

  “If it wasn’t for her, we wouldn’t have found Melinda.”

  “Also, a Dr. Milroy called. He is …?”

  “Melinda’s psychiatrist. He’s on his way in. We want him to meet Melinda as soon as he can. He’s terrific with teenagers. Her transfer to the Pennsylvania Hospital psych unit will be a lot smoother if she feels good about her doctor.”

  “I can see you’ve done time in the ICU,” Dr. Meninas said.

  “My first job in New York City was running the consultation-liaison service at Mount Sinai. That was before Prozac, when patients died all the time from antidepressant overdoses. What a horrible period!”

  “I know about those days,” Dr. Meninas said. “My Uncle Umberto was a revered pediatrician in Brazil. Whenever he lost a patient, he took to bed for days. His psychoanalyst got the family doctor to prescribe an antidepressant. My uncle hoarded the pills and then took an overdose after his best friend’s child died of leukemia. Umberto barely survived.”

  “How’s he doing now?”

  “Fine. Turns out he was manic-depressive. He’s on Lamictal and Seroquel and is doing well. I have a lot of respect for your profession, Dr. Speller. Imagine what would have happened to our family had my uncle died.”

  “‘Save a life, save the world,’ I tell my residents. Look us up. Mount Sinai has excellent psychiatry programs. I’d be happy to put in a good word for you. Lots of pediatricians pursue child psychiatry. Knowing child development puts you miles ahead. Our chairman was a pediatrician, and he’s a wonderful teacher.”

  “I’ll think about it. Thank you, Dr. Speller.”

  “Just give me a minute with Mr. and Mrs. Braun, Dr. Meninas, and I’ll be out of your hair.”

  Jonas turned to Martin and Victoria. “Dr. Meninas and the staff have the situation well in hand,” he said. “It’s been a long night for all of us. I’m going to crash at my in-laws’, but I’ll stop by in the morning. I’d like to catch up with Dr. Liddle.”

  “I can’t tell you how grateful we are,” Martin said, extending his hand.

  Victoria squeezed Jonas’s arm firmly as he turned to leave. “Thank God you were here. I don’t know what I’d have done without you.”

  As they walked down the corridor toward the elevator, Martin extended an arm around Victoria’s waist as if he wanted to comfort her. She responded with indifference, which made Jonas wonder even more about what was happening between them, and inside her.

  46

  Ten minutes later, Dr. Milroy, still in his parka and galoshes, knocked gingerly on Martin and Victoria’s door. Martin seemed grateful. For the moment, Victoria wasn’t. Despite her venomous stare, Dr. Milroy did not avoid Victoria’s eyes.

  He said, “I’m so sorry, Mr. and Mrs. Braun. I thought we could wait to admit Melinda. I was wrong. I’d like to see her now, but I’ll understand if you want someone else to treat Melinda.”

  Satisfied with the sincerity of Dr. Milroy’s apology, Victoria’s anger dissipated. “No,” she said, looking toward Martin, whose body language was conciliatory, as well. “None of us wanted Melinda locked up against her will over Thanksgiving. Fortunately, both the children are alive. We’ll visit them soon. If Melinda’s awake, I’ll tell her you want to see her.” She noticed Dr. Milroy’s tousled hair and salt-stained boots. “Thanks for being there tonight. Your advice about how to talk to Melinda made a difference.”

  “I’m glad. Where’s Dr. Speller?”

  “He just left. He was exhausted. Martin and I are going in to see Melinda and Gregory. The nurse said they’d let us in for fifteen minutes each hour.”

  The sight of Gregory attached to a respirator with a plastic tube coming out of the side of his head overwhelmed Victoria with helplessness and rage, alternating with periods of such absolute dissociation she felt as if her emotions had been deactivated. Even though it made no sense, Victoria’s first thought was that Martin could have prevented the disaster.

  While Martin hovered about Gregory, Victoria went to Melinda’s room.

  Melinda regained her faculties gradually as her body temperature climbed, her wild eyes searching for clues to what was happening.

  As soon as she saw her mother, she spoke. “It really happened? Please tell me it was a bad dream.”

  “I wish it was,” Victoria said.

  “Where’s Gregory?”

  “He’s two doors away.”

  “He’s still alive?”

  “Yes.”

  “You promise he’s still alive,” Melinda said.

  “I promise. I wouldn’t lie to you.”

  “You said he needed an operation. They operated on his brain?”

  “It’s all over now.”

  “On his brain? I can’t believe I did that to my brother. It makes me sick. Give me that thing,”
she said, pointing to a lavender basin on the window sill. “I feel like throwing up.”

  “It’s all right, honey,” Victoria said. “It’s all right.”

  “What did the doctor say? Will he be okay?”

  “The doctor said we were fortunate we got him here as soon as we did. They won’t know for a long time how well he’ll recover.”

  Melinda tried to sit up in bed. She seemed confused by all the wires connecting her earlobes, fingers, and chest to a computer monitor across the room. “What are these for?”

  “For a while it was touch and go with you. The doctors have to watch your heart and temperature carefully.”

  Victoria helped Melinda maneuver her legs over the bedside, whereupon she dissolved into her mother’s arms, crying, “I’m sorry. I’m so sorry.”

  “I know. I know,” Victoria said tenderly, holding Melinda with more affection than she ever had before.

  After she cried herself out, Melinda said, “Before you came, there was a strange woman over there. Who is she? Where did she go?”

  “The doctor wanted a nurse here in case you got upset. I asked her to step outside to give us some privacy.”

  “I don’t like her. She looks like she’s angry with me.” Melinda pointed to her hospital gown and made a face. “I hate this thing,” she said. “I feel so naked with nothing on underneath.”

  “I would, too. But it’s hospital policy,” Victoria sympathized.

  “Did you mean what you said at the bridge?”

  “Every word. I promise.”

  “What happened to your arm?”

  “I broke my wrist when I slipped in front of the house,” she said, looking down at her swollen purple fingers. “I must have reinjured it when I pulled you off the ledge. I should go back to the emergency room.”

  “You’re coming back, aren’t you?” Melinda said.

  “Of course.”

  “What did you mean when you said you understood what was wrong with me?”

  “That I know what it’s like to have thoughts and feelings so jumbled that you can’t think straight—that make you want the world to go away.”

  “That’s exactly how I feel. That’s why I don’t want that woman in here. It’s one more thing to deal with. Can’t you make her go away?”

  “I’ll try. She’s here because one of the doctors taking care of you was afraid you might hurt yourself. Your body temperature got so low the doctors worried that your heart might stop, but I don’t think we have to worry about that anymore. There’s another doctor, too. Dr. Milroy.”

  “Who’s he?”

  Victoria took a slow breath. She wanted the words to come out right. “He’s the doctor who’s going to help with your moods and thoughts.”

  “He’s a psychiatrist, right? You think I’m crazy, don’t you?”

  “Not at all. Dr. Milroy works with lots of teenagers. You’re probably just like me. My doctor says I have bipolar disorder and that I’ve had it for years and didn’t know it. My mind got so jumbled from all the thoughts racing through it I thought it was normal.”

  Melinda looked relieved. She got out of bed and pulled her IV pole to the vinyl chair where the nurse had been sitting.

  “Here,” Victoria reached over to her, covering Melinda with a hospital blanket. “Before long, you’ll be in your own warm bed at home.”

  “Ugh. My room is such a mess; I don’t want anyone to see it. It’ll take forever to clean it up.”

  “I’ll help you,” said Victoria, putting her good arm around Melinda.

  “It’s been so awful,” Melinda said, tears streaming. “Everyone at school hates me. Whenever I speak in class, they laugh behind my back. I’m afraid to say anything. I went to my English teacher, because I couldn’t do the reading—no matter how hard I tried nothing stuck in my mind—and she accused me of being lazy. It wasn’t always that way.” Melinda sighed. “I used to like reading.” She pointed at her forehead. “Something bad happened. I did it to myself.”

  “What do you mean?”

  “It’s too … too … I’m so ashamed. I’d rather tell the doctor.”

  A nurse entered the room. “It’s time, Mrs. Braun,” said Melinda’s charge nurse, a comely woman whose name tag said ‘Robin.’ She was sympathetic but businesslike. Robin turned to Melinda. “It’s so nice to see you up and out of bed. How are you feeling?”

  “Are you talking to her or me?” Melinda said.

  Robin smiled. “I guess I meant both of you. You both look like you could use a cup of hot tea and a piece of honey cake.” Victoria started to knead Melinda’s neck with her good hand.

  The pain in the other one was becoming unbearable.

  “God, that feels good,” Melinda said.

  “Rough night?” Robin said wryly.

  Melinda and Victoria laughed.

  “Dr. Milroy wants to introduce himself to you, Melinda,” Robin said. “He may talk with you later, Mrs. Braun. We’ll let him decide.” Robin’s jaw dropped when she saw Victoria’s hand. “Mrs. Braun, your fingers look like they’re about to explode. Let’s get you down to the ER. We’ll get you back up here as soon as we can.”

  Victoria gave her daughter’s neck one last squeeze and left, passing Dr. Milroy on his way into the room. Martin walked her into the elevator and accompanied her to the emergency room.

  “You know what, Martin?” Victoria said as they entered the last of a set of swinging doors. “I’d rather you went back upstairs in case something happens.”

  “I’d like to be with you,” Martin said.

  “I know,” Victoria said, disconcerted that she found such little consolation in Martin’s presence—which brought to mind talking to Jonas about feeling dissociated from Melinda.

  Martin looked hurt. “Are you okay?”

  “I’ll be all right. You know where I am if you need me.”

  47

  Victoria returned to the emergency room in time to vomit; the pain had become that intense. A technician ushered her directly into the treatment area, where an aide removed the cast seconds before a lead-aproned woman re-X-rayed Victoria’s wrist.

  The orthopedist walked in holding two enlarged radiographs, which he affixed to a light box. “This is before,” he said indicating the one on the left. “This is now,” he pointed to an area circled in red. “You didn’t break anything new, Mrs. Braun, but you pulled the bones out of alignment. I can give you the same local anesthetic as before and reposition the bones. You’ll need something for the pain after the nerve block wears off though.”

  Although the injection into her armpit felt like being impaled by a fireplace poker, the nearly instantaneous relief from the pain was divine.

  “What did you do to your hand?” the doctor asked while waiting for complete numbness.

  Victoria replayed the scene at the bridge in her mind, shuddering at how close Melinda had come to falling. “Will it change what you do?” she said.

  “Not really.” By then, the doctor was starting to manipulate her hand and arm, pulling down, away and then up. The crunching sounded like someone stepping off a gravel road onto bubble wrap.

  “I did what any mother would do to save her child,” Victoria said quietly.

  “I’m sure you did,” the doctor said. He and Victoria were silent until he finished the procedure. “What do you say, Mrs. Braun, no more heavy lifting tonight? Seriously though, I hope everything turns out well.”

  “Thank you,” Victoria said as he left to attend to a screaming child.

  Victoria returned to the ICU waiting area in time to catch Dr. Milroy on his way out. He and Martin were at the doorway talking. Victoria accompanied Dr. Milroy down the hallway toward the elevators.

  “I was just telling your husband that Melinda and I had a good talk,” Dr. Milroy said to Victoria. “She promised she wouldn’t hurt herself, so I sent the psychiatric nurse on her way. There’s a lot Melinda wants to talk about, which is a good thing. She also agreed to come to Pennsylvania
Hospital. It’s late,” Dr. Milroy said, stifling a yawn. “Let’s all get some sleep and reconnoiter when we can think straight. The doctors here want to monitor her over the weekend to make sure her heart remains stable. See her as much as you want this weekend. After she’s moved on Monday, visiting will be restricted for the first week. We’ll start family sessions when the time is right. I’ll stop by on Saturday to talk with Melinda, and I’ll keep you in the loop about what’s happening. Any questions?”

  “Not for now. I’m glad you came,” said Victoria.

  When she returned to her waiting room, Martin was dozing lightly, reminding her of Morris drowsing in front of the television the nights he’d had an extra martini. She wandered down the hall to the pediatric ICU intercom and asked to visit. Once inside, she passed an empty corner room with two orderlies in hazmat sealed suits, complete with helmets and faceplates, scouring the floor and walls.

  When Victoria returned to Melinda’s room something didn’t feel right. It was the absence of noise. The ‘drip, drip, drip’ from the IV had stopped, and the cardiac monitor displayed a continuous flat line. Alarmed, Victoria approached the bed only to see that Melinda’s bed covers were scrunched together; there was no movement or sounds. Victoria shouted, just as Robin came into the room.

  “She’s not breathing,” Victoria screamed. “She’s not breathing.” Robin quickly pulled the covers back. No Melinda; just an empty bed.

  “Where is she? Where is she?” Victoria yelled. “Not again!”