Just In Time

by Joan Lindstedt Jackson

  Sylvia doubted the circumstances were similar enough to make the comparison but got her point.

  “I think I hear Steve coming in—yep, and Dr. Nora. I’d better go,” Nancy said.

  After they hung up, Sylvia tried to pin down what she felt, but her thoughts were all over the map. Relief that Dr. Nora had jumped in and taken charge. Anger with Dr. Pandi, who never called her back and left Steve to fend for himself. Helplessness living so far away and unable to attend the session with the new psychiatrist. Mostly she felt unsettled about the future. Then she thought of Scott. She needed him now—his calm voice of reason to settle her down, his innate ability to prioritize, much like her dad always seemed able to do. Sylvia could count on Scott to be there for her whenever she asked. So used to handling everything herself, being in charge and taking control, sometimes she simply forgot to ask him. She picked up the phone.

  Helping Steve recognize that his thinking was confused, that his perception was distorted, and that he needed immediate help was a tricky endeavor, even for Dr. Nora, akin to helping a functioning alcoholic recognize his drinking was out of control. But Steve couldn’t get “sober” and reflect on his own behavior. Without the proper balance of meds, his reasoning ability would worsen, until all sense of reality and time were blurred. Increasing paranoia usually set in, heightening his distrust of others and his fear they were conspiring against him. Dr. Nora knew it was critical that Steve’s medication be adjusted as soon as possible.

  With Sammy in tow, dancing around her feet, Nancy greeted them as they entered the house, introducing herself to Dr. Nora. “You sure are a lifesaver, I’ll tell you that.”

  “What do you mean?” Steve asked. “Lifesaver? She’s not a lifeguard, you know.”

  Dr. Nora chuckled at Steve’s misinterpretation and looked warmly at Nancy, who was obviously doing her utmost to be positive. “We’re just taking it one step at a time. If you’ll excuse us, Steve and I need to take a look at his meds.”

  “Of course you do. I’ll just duck into my bedroom, get back to my video game. Holler if you need anything,” Nancy said scuttling off, Sammy on her heels.

  Steve guided Dr. Nora to the dining room where his med vials lay scattered across the table. She gazed at the disarray, wondering how he could ever make sense of them.

  “Steve, I have an idea. You know I don’t prescribe medication. I’m not qualified for that.”

  “Because you’re not a psychiatrist, right?” He stared over her head at the old sorority photo of his sister. “Sylvia doesn’t look like that at all anymore. When did she get so old?”

  Dr. Nora chuckled. “We all get old, Steve. But you’re right, I’m not.”

  “You’re not what?” he asked.

  “I’m not a psychiatrist, so I can’t prescribe meds.”

  He rolled his eyes and sounded indignant. “I know you’re not. That’s why I have to see Dr. Pandi.”

  “Exactly right. Since your meds are a little mixed up, and Dr. Pandi is out of town, I thought we might visit a psychiatrist I know who could help us sort them out.”

  “You mean right now?”

  “The sooner the better, don’t you think?”

  “Not much, I don’t,” Steve chuckled, thinking he’d made a joke, but she wasn’t laughing. “It’s kind of sudden. I don’t know.”

  “Do you agree that the changes in your meds have become confusing?” she asked.

  He looked down at the floor, as if disappointed in himself. “Yeah. I don’t know what to take.”

  “And you know how important it is for you to take them, don’t you?”

  “Yes, so I can stay out of the psych unit,” he said.

  She didn’t want to make him nervous by explaining that psychiatric hospital stays needn’t be threatening. While some mentally ill people learn to identify their symptoms themselves and actually inform their doctors when they feel they need a few days in the hospital, Steve was still far from that mindset.

  “Mostly, your meds help you lead a more normal life. That’s been your goal. Why don’t you get a plastic grocery bag to put these in so you can show them to my psychiatrist friend.”

  “Friend?” Steve stood a moment trying to sort it out, as if wondering who would want a psychiatrist for a friend. “Are you going with me?”

  “Of course. I’ll drive and stay right by your side, Steve.”

  “I guess it’s okay, then.”

  He turned toward the kitchen when Nancy suddenly appeared. “Let me get the grocery bag for you. I’m not sure you know where I keep them, Steve.”

  Steve scowled, bothered by Nancy’s sudden appearance. “They’re in the drawer under the stove where mom always kept them.”

  “You do know!” She rushed past them to the kitchen. When she grabbed a bag from the overstuffed metal drawer, ten more came spilling out. She just let them lie and handed Steve the grocery bag. “Do you need anything else?”

  Dr. Nora said they didn’t and started dropping the vials into the bag while Steve held it. Relieved, she watched in awe that Steve was so consistently cooperative with her. But in her heart she sensed that he could trust her. And that’s all that counted.

  “I’ll have dinner for you when you get back,” Nancy said. She just stood there, acting as if she didn’t quite know what to do with herself. Sammy came bursting into the room and she scooped him into her arms. Dr. Nora smiled at her then, saying they were all set. And they left.

  The psychiatrist sat behind an ornate, imposing wood desk that seemed to fill half of the room. Sitting opposite him, Steve figured the desk must make him feel important. The doctor stared at Steve, drilling him with questions. Avoiding eye contact, he stumbled through the questions, trying to remember the doctor’s name. Was he able to sleep? How many hours a night? (Does during the day count?) Did he have any friends? (Only in high school. I’m too old for friends anyway.) Did he hear voices? (I can’t tell him about the little boys.) Had he ever been violent? (I don’t think so. I don’t remember.) The doctor was talking too fast. Steve couldn’t keep up. His brain was too tired. Then Dr. Nora was talking about what happened at Friendly’s today. The police. I thought she was on my side! The doctor kept going. Did he imagine other people were talking about him or watching him? They are! Steve was on the hot seat, scared he wasn’t giving the right answers. When the doctor asked what medication he was taking, Steve mixed it all up. Dr. Nora handed the doctor the bag of pill containers.

  He poured at least twenty vials onto his desk and looked at Steve in surprise. “Why do you keep the empty ones?” he asked. “Most of these are expired.”

  The doctor had a deep voice and straight black hair, shiny as coal, that kept flopping across his forehead. Steve thought of Hitler. He was glad the doctor didn’t have a moustache. He was wiry—maybe a runner? And he wore a dark blue and yellow striped bow tie—Michigan’s colors—that moved with his Adam’s apple when he talked. His tortoise-shell glasses made him look intellectual.

  “I can’t throw them out!” Steve retorted.

  “Why not?” the doctor asked lightheartedly.

  This doctor must be stupid, Steve thought. “How will I know what I’m supposed to take?” Steve was exasperated and got up and paced the room. “I can’t sit anymore. What am I doing here? I never had a man doctor before.”

  “Does it make you uncomfortable that I’m a man?”

  Now what am I supposed to say? Steve looked at Dr. Nora for an answer. She just nodded at him as if it was okay to tell the truth. He felt the sweat rolling down his face. His hands were shaking. When did that start? He wondered if he could smoke in here. Probably not. He studied his hands and shoved them in his pockets and stared at his shoes. I should’ve worn my tassel loafers. Tennis shoes look stupid, like I’m trying to look like an athlete. Not anymore. Not with this gut.

  “Steve?”

  “What?”

  “Would you like me to help you with your meds?” the doctor asked.

  “But y
ou’re not my doctor.”

  “That’s true. I know your doctor is Dr. Pandi, and she’s out of town. I should’ve explained this to you earlier, but before you arrived today, I got in touch with Dr. Pandi and explained the situation. She agreed for me to act as your doctor for now.”

  Steve narrowed his eyes in suspicion. Situation? “Sometimes I can’t understand Dr. Pandi.”

  “Can you understand me?” the doctor asked.

  “Yes, but you go too fast.” Steve sat back down next to Dr. Nora. His eyes narrowed, and he looked at her suspiciously.

  “Then I’ll slow down,” he said. “With your permission, I’d like to help you get back on track with your meds. You’d only be in the hospital four or five days. What do you say?”

  Steve stared at the doctor, trying to decide if he was joking about the “permission” part and noticed he was very thin, maybe a runner, and wore a bow tie that moved up and down with his Adam’s apple when he talked. It was funny. Steve had to look down to stifle a laugh. “I always take my meds.” He stood up again and turned to Dr. Nora. “Do you think I should?”

  “Yes,” Dr. Nora said. “Dr. Varga and I often worked together with patients. I trust his opinion.”

  Dr. Varga. Dr. Varga. Dr. Varga.

  “I think Dr. Varga is an excellent doctor. He can help you,” she said.

  It was going all wrong. Dr. Nora was agreeing with this guy that thought a few days in the hospital was a good idea! “Another psych unit? What did I do wrong?” Steve asked in disbelief.

  “You did nothing wrong, Steve,” Dr. Varga said. “It’s so we can adjust your medication to stabilize you again.”

  Steve started to laugh, mumbling to himself. That’s funny. I’ve never been stable. I’m not even a man. How could I be? I never graduated from college, got married, or had children. I hate children. I don’t even have a job. I’m a male, but not a man. He tried to stop laughing but couldn’t. It was all such a joke. Why were they so serious?

  “Steve?” Dr. Nora asked.

  Both doctors stared up at him like a couple of frogs. Blinking at him. Just waiting to jump. Dr. Nora’s eyes were bugging out of her head. She started talking. A frog that talks. He never heard of such a thing. He laughed even harder.

  “You’ll feel better after a few days, and then you can go home,” Dr. Nora said.

  “I want to call Sylvia,” Steve demanded. “I want to talk to my sister.”

  “Of course. Let’s call her right now,” Dr. Nora said.

  Steve spoke to Sylvia first. Then Dr. Nora spoke to her. Then Dr. Varga. Then Steve spoke to her again. She promised she’d fly out right away. Scott was coming, too, but a few days later. She said she’d visit him every day in the hospital. The psych unit. And she promised she’d bring him back to his home herself. He stared at the floor. “Okay, I’ll go,” he said despondently. “I need a cigarette.” He got up, hiked up his pants, and, without a glance back, left the room.

  16

  It was day. It was night. Breakfast, lunch, and dinner came on trays to his room. He ate. He slept. The days blurred, and he couldn’t keep track. Nurses came and went with pills in tiny paper cups. Steve didn’t know what they were, but he had to take them while the nurse waited or he’d be in trouble. But wasn’t he already in trouble? Why else would he be locked in here? Doctor’s orders. Dr. Pandi? Dr. Varga? Dr. Nora? Who is my doctor? He tried to remember the nurses’ names, but it was never the same person. Someone was using his bathroom. The toilet flushed. Water was running. A strange man came out and without a word crawled into the bed next to Steve’s. I’m sharing a room? No one was familiar.

  “How long have I been here?” he asked out loud. Silence echoed back, and he asked again. A grunt came from under the covers of the neighboring bed. Steve eased himself upright and glanced at the window. The heavy curtains were pulled shut, but it wasn’t dark inside the room. He couldn’t make out the clock on the far wall. He noticed his glasses on the nightstand and put them on. He looked at the clock again—seven o’clock. Morning or evening? He slowly stood, looking down at himself, not remembering when he got dressed. His feet were bare and cold. He shuffled to the window, pulling the curtain back just enough to peek outside. No way to tell if it’s morning or evening. What difference does it make anyway? He found his soiled socks in the corner. He was putting them on when he heard clattering from the hall. The door opened, and a black man with a food tray walked in.

  “Nice to see you up, Steve. Maybe you’d like to eat your breakfast in the cafeteria today?”

  So it’s morning. Kinda rude—he could at least introduce himself. “What’s your name?” Steve asked. “Have you been here before?”

  The guy smiled big. “I’m Terry. I’ve been bringing your breakfast every day.”

  “How long have I been here?”

  “Two days now. Why don’t you put your shoes on, and we’ll go down to the cafeteria to join the others.”

  “Others? You mean patients?”

  “Sure. C’mon with me, I’ll show you.”

  “I don’t know if I can be ready in time. I have to put on my shoes and . . “ Steve felt his tongue thickening as he spoke, making it hard to form the words. I can’t tell him I have to go to the bathroom, and bad! “My food will get cold.”

  “No problem. You won’t need this tray of food. You can go through the line and order what you want.”

  Steve thought that sounded pretty good. “Like pancakes?”

  “I think they are serving pancakes today, as a matter of fact. I’ll leave this tray here for Brian in case he wants to eat.”

  “Brian?” Steve asked.

  “Your roommate. He just got here yesterday. Take your time to get ready while I deliver a few more trays. I’ll be right back.”

  Steve moved toward the bathroom, waiting for Terry to leave the room, then he rushed to the toilet. He had diarrhea.

  Terry returned, and they walked down the hall together. A few nurses they passed greeted Steve directly, saying how nice it was to see that he was feeling better. He didn’t recognize them, but he nodded and smiled back, just to be polite. There was a low hum of conversation as they entered the cafeteria where men and women sat at tables either alone or in small groups of three or four. Windows extended across two walls and a glass door led to a small patio, where some people were smoking.

  “Am I allowed to smoke?”

  “Anytime you want, but only outside on the patio,” Terry said.

  Steve couldn’t decide what he wanted more, a cigarette or breakfast, but he didn’t know where his cigarettes were. Maybe in his room. He hoped nobody had stolen them.

  Terry steered him to the food line, grabbed a tray, and told him to order what he wanted. Steve’s hunger took over: hashed browns, sausage and bacon, scrambled eggs, and pancakes with syrup. Not coffee, iced tea. Terry was guiding Steve toward a table where two guys were eating, but Steve cut him off at the pass, saying he wanted to eat by himself. Terry left, and Steve huddled over his food, gobbling it down without looking up. When he was done, he surveyed the room to see what he was supposed to do with his tray. He waited until someone else got up with a tray and turned to watch where he was going. On the wall by the food area, he spotted a sign marked Trash. A red arrow pointed down to a large black bin with trays and plates stacked on top. Steve followed, deposited his dirty dishes, then wandered out to the patio.

  Buildings in the distance, on the other side of a highway bridge, looked familiar. It was downtown Akron, not far from home. From this vantage point, Steve realized he must be in St. Thomas Hospital, not some mental institution in the middle of nowhere. He didn’t know what that meant for him exactly, probably a shorter stay, which made him feel much more at ease. A clean-cut looking man dressed in pale blue, loose-fitting shirt and pants sat smoking right in front of him. Maybe an orderly. Nurse? Not a doctor. Doctors don’t smoke. He nodded to Steve and held out his Marlboros. “I’m Jim. Wanna smoke?”

  “Don’t
mind if I do,” he said, pulling a cigarette out of the pack. “Thanks, I’m Steve.”

  Jim lit his cigarette, and Steve took a seat in the plastic chair next to him. The sky was blue, the sun felt good on his face, and, like waking up from a bad dream, he relaxed. Maybe he wasn’t in trouble after all.

  17

  OCTOBER 1999

  The evening Sylvia arrived in Ohio seemed unseasonably warm. She had her heart set on brisk, invigorating fall weather, forgetting that Indian summer was typical for mid-October. After seven years in Los Angeles, she still missed “real” seasons, which, she’d discovered, gave her a tangible sense of the passing of time. Seventy- to eighty-degree temperatures and clear blue skies throughout most of the year made it seem like time stood still. Without the seasonal calendar, November and December came as a surprise—Thanksgiving turkeys and Christmas trees didn’t belong.

  Had she been able to come in November, the original plan, cold weather would’ve been a sure thing, with the possibility of snow. Can’t forget to cancel that flight, Sylvia thought—yet another thing to add to her list. The thousands of minor, practical details she had to track cluttered her mind to distraction. She had a whole notebook tabbed by category for Steve’s life: doctors, community services, mental health support groups, car and health insurance, bank/stock accounts, and home maintenance.

  With Trevor recently clean and sober and working as a waiter, she had set his notebook aside some months back. Her son was on his way to managing his own life, which had opened a space for Sylvia to breathe again. Until Steve’s hospital admission. The emotional toll of her son’s tenuous struggle with sobriety and her brother’s helplessness wrapped around her like a blanket of heavy fog that wouldn’t lift. Even with brief moments of reprieve, she kept groping to find her way, praying for a path to clear so she could enjoy life again.

  To arrive in Ohio and not to be greeted by her dad or mom was still disconcerting. Missing them wasn’t getting easier; she thought about them more with each passing month. In Los Angeles, she had seen a man in a grocery store, who resembled her dad so much she burst into tears and dashed down an empty aisle. In her dreams, she’d be with her mom and vividly hear her voice, only to wake up and face the harsh reality that she was gone. Sylvia hated that nothing ever stayed the same in life. Nancy living in their parent’s bedroom didn’t feel right either, and Sylvia scolded herself for finding the change so hard to accept, when she should feel fortunate that Nancy was willing to live with Steve. If Sylvia was still adjusting, she could only imagine how hard it must be for Steve.