Will's Choice

by Gail Griffith

  I also gave her my cell phone number, but realized it was unlikely that Dr. Salerian would be able to do anything other than dump a message into my voice mail, given the hospital’s prohibition of cell phones. But maybe he could get through to the emergency room personnel.

  I scurried back to the emergency room and sat down on the floor of the crowded lobby with my back up against the cinder-block wall and waited for Will to return from the EKG. For the first time in two hours since finding him unconscious in his room, I had a moment to take stock.

  Hospital emergency rooms aren’t known for their esthetic touches. The colors are not subtle and the lights are invasive. For some reason the drinking fountain wasn’t working properly and crumpled paper cups piled up like contortionists all around the base of the cooler.

  Patients and their families were not faring much better in the inelegant environment, myself included. As a slice of humanity, we looked off-color and disheveled, haggard and insecure. A young man had been in a bar fight in the early morning hours and was still bleeding from a head wound that needed stitching; a Hispanic family was troubled by their infant daughter’s high fever and inability to swallow. You could have measured the anxiety level with a dipstick.

  I had not combed my hair or brushed my teeth since getting out of bed, and I had thrown on the clothes I’d worn the day before. I noticed a peculiar smell, something almost feral seeping up through my wool sweater and jeans. Fear. It must have been fear. As the day wore on, the smell intensified, but no one seemed to notice. It blended with the ambiance.

  Jack sat down beside me on the linoleum floor. We tried to make ourselves inconspicuous; if we appeared to be in the way, we would be ushered out. Every few minutes an officious nurse darted through the melee, announcing, “You people will have to wait outside!” which resulted in shifting postures and much shuffling of feet.

  I decided I would be better off taking refuge in the cubicle where Will had been examined, assuming that the staff would return him, gurney and all, to the same location. There was a worn-out plastic chair next to the heart monitor and I took a seat. The same overbearing staffer spotted me within minutes and cast a disapproving glance my way. “You’ll have to vacate this area.”

  Vacate the area? “I don’t think so,” I replied defiantly. “I’m waiting for my son to be returned from wherever they took him for an EKG.” She shot me a withering look, but I was starting to feel like a pack animal who had been beaten once too often and I was not moving.

  Jack was performing the dual role of anchor and emissary. In the fifteen years I had known Jack Brady, first as coach of my boys’ soccer team and as a fellow parent of children at Holy Trinity Elementary School here in Washington, D.C., I always knew him to be steely and clear-headed in emergencies. This was no exception. Because of the cell phone prohibition, he became liaison to the rest of the world, relaying news, calling family, and fielding queries about Will’s status, during repeated forays outside of the building.

  After one such trip, Jack returned to the nurses’ station inside the emergency room to see if they had an update. Initial blood work had come back from the lab, showing no opiates or alcohol in Will’s system. I suppose that was a good sign.

  “They’re in touch with the poison center to run some data on overdoses and interactions with his meds,” Jack reported.

  “What’s that mean? Do you think they think he overdosed on his meds?” I could not accept that line of reasoning and my irritation was careening into anger. This was simply not another tragic teen drug overdose and I resented the implication.

  “They have to look into it, as a precaution, kiddo.”

  The attending ER physician called for the hospital’s psychiatric resident doctor to come down and offer his assessment. The psychiatrist was a young man, intense, but kindly, clean-shaven, with dark curly hair. He began the standard query about Will’s mental health history. These guys were wearing me down like a water torture victim.

  “Look, this is not what it seems,” I told him. “I know my son and in just the past month, we’ve all seen a steady improvement in his mood. Talk to his doctor,” I urged. “He can confirm it. Will’s not the kind of kid who would try to kill himself.”

  “Do you know if he uses drugs or alcohol regularly?”

  “God, no. Why do we have to go over this again?”

  “No PCP, LSD, or Ecstasy?”

  “No. No. No. Wouldn’t you see that in the blood work? There’s nothing there! I really want you guys to look at what else might be going on. What about encephalitis or meningitis or some other kind of infection in the brain?”

  Will was gone from the ER for half an hour. When he returned, it was evident he was continuing to deteriorate. He was ranting an incomprehensible verbal stew and slogging at the orderly who tried to keep him supine on the gurney. He had never been a fighter, never agitated or violent. He had never been in a playground fight or landed a punch on his older brother. Consensus among teachers and family was that he was a peaceable, easygoing kid. Something dastardly had taken over his mind and body.

  A nurse screamed at him, “Lie down, William!” I dashed to one side of the bed to try to calm him, imploring, “Lie still, sweetie, please lie still.”

  I placed my head on his chest and hummed softly (but loud enough for him to hear, I hoped) a half-remembered tune about angels, which Will had learned in kindergarten. (“All night, all day, angels watching over me, Oh Lord…”) It was a cheery little children’s song and I don’t know if he remembered it; I’m not even sure why I picked it. Will quieted momentarily and brought his hand up to stroke my hair—just once—before lunging into a sitting position and frantically clawing the air, a look of sheer terror on his face.

  The resident psychiatrist bent over him and asked, “Will, do you know what year it is?” Will lay back down.

  “1999,” Will mumbled, head twitching from side to side.

  “What was that?”

  Will: “2000.”

  “Will, who is the president of the United States?”

  Will: “Grover Cleveland.”

  “Well,” I pondered silently, “we’re not in the right century, but at least we’re getting presidents.”

  As the psychiatrist and a couple of other clinicians tried and failed to elicit further verbal exchanges with Will, the chief ER physician pulled me aside to report: “Nothing showed up on the EKG. His heart rate and blood pressure are highly elevated. I want to do a spinal tap, but first I’d like to get some charcoal down him. It will counter the effects of any poisons he might have in his system—just in case he took something.”

  “So, what do you think is going on, doctor?” I prayed he had an inkling of an answer.

  “I don’t know.” The doctor looked down and momentarily avoided making eye contact. I detected a nervous uncertainty.

  “Have you seen anything like this before?” I was almost afraid to ask.

  “No,” he admitted reluctantly. I was stunned.

  “It’s a teaching hospital,” I tried to console myself. “These guys are young and they don’t know everything. There’s got to be someone here who knows what to do.”

  “Doctor, should I ask his father to fly out—he’s in California?” I was testing. If he said, yes, then I would know we were in real trouble.

  “I think he needs to get here as soon as he can.”

  “Oh, Jesus, this can’t be happening,” I thought. I began to shake uncontrollably. “They must be exaggerating. They just need to cover their bases. This just can’t be happening!”

  I covered my face and started to weep as a nurse shoved me aside so she could try to intubate Will, forcing liquid charcoal through his nose and down his throat. Will shrieked and flailed and swung at the nurse. An orderly pinned Will’s arms to his sides. He looked like a terrified animal—I had never seen anyone, let alone my child, look so frightened. I was beyond panic.

  The hospital staff went into overdrive. Everything was speeded up
, louder, more frenetic, and for the first time that day I was forced to consider the possibility that Will might not make it.

  The nursing staff insisted that I step out of the enclosure while they continued to struggle to get a tube down Will’s nose. Finally, after sounds of thrashing and stifled roars, I heard someone say, “William, you have another option here. If you drink this liquid, we won’t force it down your nose.”

  I held my breath.

  There was an eruption of gagging and spitting from behind the curtain. I wanted to know what was happening, but at the same time, I thought I might lose it if I had to watch the nurses force thick black fluid down Will’s throat.

  “Swallow all of it, William!” a nurse commanded. More sputtering and gagging. I peeked behind the curtain. What looked like tar was splattered all over the floor, all over the bedding. Some of it had hit the wall beside the gurney. It streamed down Will’s chin, neck, and chest and came out his nose. The gurney was now soaked with sweat and urine. An orderly propped Will’s head up as the nurse tried to force more of the charcoal down his throat. His eyes were closed and his skin was a ghastly shade of yellow-white, streaked here and there with black ooze.

  I ran outside and called Will’s father in California.

  “Bud, the doctors think you need to get here right away.” I delivered the news in a voice as calm as I could muster, but there was no mistaking the message.

  Momentary silence on the other end. I could visualize Bob’s face. We were thinking the same thing: “There’s only one reason for urgency.”

  There is a scene in the movie, Terms of Endearment, in which the mother, played by Shirley MacLaine (she is harried, wears no makeup, her dark roots are exposed), is outraged by the hospital staff’s inattentiveness to her daughter (Debra Winger), who is in excruciating pain and dying of cancer. MacLaine vaults over the nurses’ station and flies into the face of the head nurse, demanding immediate action. She screams at the nurse to give her daughter the painkillers she needs.

  That cinematic moment accurately portrays every mother’s clarion call. I identified with the instinct to throw some verbal punches on behalf of my kid. I was the Shirley MacLaine character—a mother who feels betrayed by a system that should be working with her, doing the best for her child. Were we moving closer to resolving the crisis? The medical team didn’t seem to know what to do. My confidence was sinking as my anxiety mushroomed.

  Will was hooked up to a monitoring system. Every few minutes he tried to detach the wires crisscrossing his body. The doctors were watching for the first signs of organ failure, possible cardiac arrest, or renal failure.

  I was anxious for them to perform a spinal tap, but the staff’s initial attempts to roll Will onto his side and lie still were exercises in futility. Whether Will was reacting to the cold of the cleansing solution applied to his back where the needle would be inserted, or the rough handling by the orderly who tried to keep Will on his side, he could not be stilled—at least not still enough for them to perform a spinal tap.

  I tried, once again, to calm him by whispering in his ear, “Willo, it’s your mom, sweetie. You need to lie still. It’s going to be okay.” This time he reared up and began swinging in all directions. I choked back tears and struggled to keep from becoming hysterical.

  At 2:30 PM, the doctor in charge decided to inject Will with doses of Haldol, assuming that once he was sedated, it would be easier to move him into position to do the spinal tap. One dose; fifteen minutes later, another. Half an hour passed and yet another dose of Haldol.

  “God, I hope they know what they’re doing.” I wondered how much sedation his system could handle in this state.

  Still no abatement in Will’s violent thrashing.

  A stranger stumbling onto the scene might have surmised that Will was possessed by demons and that we were engaged in a high-tech exorcism. Indeed, we had crossed over into a netherworld where reason and control were beyond our grasp. I was not quite ready to surrender my meager authority to a higher power, but I was getting close.

  The Haldol did not calm Will down initially. Despite the repeated doses he forcibly aborted two more attempts to do a spinal tap. Now we were stuck. It was 3:30 PM.

  The ER staff decided to move Will upstairs to the critical care unit as soon as a bed could be found. The medical team would attempt a spinal tap once he was settled on the unit.

  Bob boarded a flight for the East Coast at 11:00 AM Pacific time. He would transfer midway across the country and land around midnight in Washington. He planned to call when he changed planes in Dallas. Before he left San Francisco, Bob called our oldest son, Max, who was in his first year of college at Berkeley. Bob told Max that Will was in the hospital but did not let on that the situation was grave. Max, who was prone to worry and had always been close to his brother, sensed he wasn’t being told everything. But what was there to tell? We knew nothing for sure.

  But as the day wore on and no diagnoses were forthcoming, even I had to confront the possibility that Will’s condition was drug induced. I would accept the notion that he took an overdose intentionally. But a suicide attempt? No way. It had to be accidental. Still, the staff was resolute in their efforts to force charcoal into his system; the doctors assumed they were dealing with an overdose. Charcoal, with its toxin-absorbing properties, is standard fare whenever accidental or intentional overdoses turn up in emergency rooms. Another doctor on staff continued to scour the Poison Control database, researching the symptomatology and antidotes for all of the medications Will was taking.

  4:00 PM: A burly orderly transported Will to the fifth floor of the hospital. I trailed behind, hauling Will’s jeans and tennis shoes and the bag of his prescription medications.

  There was a minor flap when we reached the fifth-floor nurses’ station about which room Will should occupy; the staff wasn’t quite ready for him, but after five minutes he was rolled into a semiprivate room and onto the bed closest to the door. An elderly man lay unconscious in the bed next to the window, and his wife watched our arrival with disdain. She didn’t like what she saw—a ranting, writhing, out-of-control young man. I cannot say I would have welcomed this intrusion into the hush of the hospital room either, but her displeasure turned ugly. “Get that animal out of here!” she demanded of the orderly, rising out of her chair in protest.

  “Ma’am, calm down, we’ll handle this.” The orderly gestured her to stay away.

  “You can’t put that creature in here with my husband!” she glowered.

  The orderly tried to ignore her and struggled to bring some calm to the tumult by binding Will’s wrists and ankles to the bed railing with canvas restraints. Will, still flailing away attempts to hold him down, gyrated in every direction, blindly swatting away the attendant until both of his hands were secured by the side of the bed.

  “You take him and put him somewhere else!” the woman ranted. “He’s an animal!”

  The scene was too much for me.

  Every time I thought the day couldn’t get worse, it did. To see my son, his lips stained black from the charcoal, soaked in dirty linen, arms and legs tethered to a steel bed frame—to have a stranger charge that my child was violent or vicious—this was too much. I was living an unholy nightmare. The moment called for compassion, not a verbal barrage from a stranger.

  I stood in the hallway with my back against the wall and sobbed, while the orderly tried to usher the indignant harpy back to her side of the hospital room. A nurse, hearing the commotion, rushed in and rescued us from further abuse.

  “We’ll move him to a private room,” she directed the orderly. She put a hand on my shoulder as if to say, “I’m sorry. I know this is a lot to handle.” Her small kindness gave me a measure of hope: maybe we could get things back on a different track. At least now we were out of the chaos of the emergency room.

  But was I wrong.

  Will’s step brother, John, had been diligent in his investigations to determine whether there were any empty bot
tles of medication lying around Will’s room—any we missed in the hurried search before we left with the ambulance. John talked with Jack by phone late morning to report that all he came across was one empty container in the trash, but no pills.

  But, with his suspicions aroused, John looked further and discovered a slew of empty bottles under Will’s bed, and, lying next to them, a stack of handwritten notes—suicide notes.

  John drove to the hospital in a fury, not knowing where to find us and angry because we were not answering our cell phones. By coincidence, Jack was in front of the hospital just as John raced up in his mother’s car, the fistful of notes in his hand, tears streaming down his face.

  So Jack received the news before I did. He walked briskly back into the ER and approached the doctor in charge of Will’s case.

  “Could I talk to you for a moment?” The two men huddled in a corner and Jack reported, “My son found Will’s suicide notes; he left them under his bed.”

  The game plan shifted. Further attempts to do a spinal tap or other tests were abandoned. The doctors went to work ferreting out information on a massive overdose of the antidepressant drug Remeron.

  Jack waited until Will was moved from the ER to the critical care unit upstairs before coaxing me away from Will’s bedside.

  “Come out in the hallway, I have to talk to you,” he urged gently.

  I must have known what he had to say, because I refused to move or look in his direction.

  “Gail,” he said, placing his hands on my shoulders to steady me, “John found notes under Will’s bed. They’re suicide notes. Will left notes.”

  My world blew apart in an instant.

  We are so accustomed to witnessing the public grief of strangers that it is hard to adequately characterize that same emotion when you are at the heart of the catastrophe. I have watched scenes from a great distance of bus bombings in Jerusalem, or earthquakes in China, and wallowed in the instantaneous media transmissions depicting bereft widows and bloody victims.