“So, you think Mia just needed more Seroquel, and she wouldn’t have had the relapse?” I asked, hopeful that he might have solved our problem.
“Seroquel is in a group of medications called atypical antipsychotics. You don’t really need to know that, but what you do need to know is that these drugs work by balancing the levels of neurotransmitters in the brain, increasing the amount of serotonin while dampening the amount of dopamine.” He could tell that I was still waiting for an answer. “I’m not sure if we could have prevented a relapse, as you say, but I do believe that with an increased level of Seroquel your wife’s thinking will return to normal.”
“Great,” I said, but something was still troubling me. “Dr. Martinez, the psychiatrist we saw in the emergency room, he thought she was suffering from brief reactive psychosis. That’s a onetime event. Bipolar sounds more serious.”
“We don’t know what we’re dealing with here,” he responded. “Let’s not worry about that right now. Let’s get the psychosis under control. It could be a lot of things.”
“And how long do you think that will take, to get it under control?” I asked, thinking of the last twenty-four hours and wondering how much more I could handle.
“With medication, almost all cases of psychosis resolve in four to eight days.”
I contemplated another week. It was difficult to imagine, but I didn’t have a choice.
“Okay.” I nodded. “Okay, we can do that.”
“Good.” He handed me a prescription. “I can’t take her up to six hundred milligrams immediately. We’ll scale it up over the next few days. See my directions. And let’s keep your appointment for Monday. Hopefully, things will have improved by then.”
He said it so optimistically, and he seemed so knowledgeable, that it gave me confidence.
I only had to survive the weekend.
7.
The Plan
Beastie Boys and Miho Hatori
“I Don’t Know”
1:49–2:17
Mia never gave up on helping me find the cause of my illness. “We need to keep looking,” she would say as we’d bundle up to make yet another trip to the research library at the University of Chicago.
I had been sick for two years when I started having additional aches in my joints. Mia suggested seeing a specialist in rheumatoid arthritis. “It causes the kind of joint problems that you’re describing. I’ve never heard of it being associated with abdominal pain, but I guess it’s possible.”
When we saw the specialist, he disagreed with her. “No, you don’t have rheumatism,” he told us, “but it could be autoimmune related, maybe linked to some type of bowel disease.” This was the break we needed.
A few months later, a colonoscopy showed clear signs of Crohn’s disease. Neither Mia nor I knew much about it, but we quickly became experts. The disease had no known cause or cure. It was an autoimmune disorder in which the body attacked the small and large intestines, causing inflammation and pain. Another common indication was severe diarrhea, which fortunately I did not have. My abnormal presentation of symptoms was the reason it took so long to find the correct diagnosis.
I was relieved to finally have an answer, but it was a devastating one. The doctor delivered a crushing prognosis: “Pat, you must learn to live with pain. We might be able to help things with medication, but you have a chronic disease. It isn’t going away.”
Thankfully, Mia kept me from losing hope. Several months later, we stumbled across a little-known book called Breaking the Vicious Cycle by Elaine Gottschall. The author outlines her thesis that Crohn’s disease is caused by an imbalance of the bacterial colonies lining the intestines. She also introduces a diet designed to reestablish balance, eradicate the pain, and restore health.
The diet is unbelievably strict: no gluten, lactose, or refined sugar. You aren’t supposed to eat anything that you haven’t prepared yourself; you have to be certain of the ingredients. It is a difficult regimen to follow and would require huge investments of time.
Fortunately, I had Mia’s support. She helped me start the diet and stick to it. We embraced all the cooking that had to be done. Back then, you couldn’t find gluten-free options like you can today. We spent our weekends buying whole almonds and grinding them into flour or making shaved zucchini into pizza dough. Some of the recipes were really wacky.
But the diet worked! Slowly but surely, my intestines began to heal, and the pain subsided. Within five years, I was completely healthy again. It was truly a miracle, and it wouldn’t have been possible without Mia’s encouragement and hands-on help.
When you are sick, and the experts don’t have any answers, you need an advocate. You need someone who believes in you, who will stick by your side and never give up.
I shudder to think what would have happened to me without Mia’s support.
***
On the way home from the appointment, we stopped at the pharmacy to pick up the new prescription. Mia was moving from twenty-five-milligram tablets of Seroquel to one-hundred-milligram pills. Stronger doses made me nervous, but I was reassured by Dr. Martinez’s promise that higher levels of the psychotropic drug would address her psychosis.
We started increasing the medication on Friday afternoon, but that evening was similar to the previous night. Mia did her best to stay quiet during dinner, and I did my best to have patience with her while we were holed up in our bedroom. It wasn’t ideal, but it was tolerable.
When Mia fell asleep, I spoke with her cousin Alex again, interested in his view as a psychiatrist. He agreed with Dr. Martinez’s recommendation to increase the Seroquel dosage. When I told him that she would be taking six hundred milligrams of Seroquel daily along with the Ativan and Restoril, his response was memorable: “Pat, that amount of medication would make a three-hundred-pound man sleep for three days.”
Laughing, I made a comment about not minding if Mia slept that long, but the humor masked a grave concern. How severe was her brain imbalance that even with all that medication she was only sleeping six hours a night? “Alex, I’m really worried,” I confided. “This has to work. All I want is for her to get better, but I don’t know what to do.”
“You’re doing everything you can,” he assured me. “Let the medicine do its job. Even though Mia’s sick now, she knows you’re with her. Trust me, that means everything, even if she can’t express it.”
The following morning, I sensed a change in her behavior. Mia was becoming less fixated on the details of the past week and more concerned with the broader picture. At times, she had moments of self-awareness. “Oh my God, Pat, what is happening to me?” she asked repeatedly, her eyebrows pulled together in worry. But then, moments later, she was lost again.
We now had a calendar with detailed notes scrawled across every day in September. We also had my small notebook, in which I had logged comments from Mark, Dr. Patel, and Alex, along with the recent addition of Dr. Martinez’s instructions. Periodically, Mia would review them with determined concentration, as if attempting to solve a crossword puzzle without any clues.
“Something is going on, Pat, what is it?” she would ask every ten minutes or so.
“You and I are spending time together,” I began replying, stripping all emotion from my response. “Dr. Martinez gave us a plan, and we are following the plan.” Then, I would pull out my notebook. While we were in his office, I had scribbled:
The Plan:
600 milligrams Seroquel
Ativan the same
Restoril the same
4-8 days
Each time this happened, Mia grabbed the notebook and recited “The Plan” out loud to herself. She must have read it thirty times that morning. “I’m glad we have the plan,” she would say, sighing, and then revert to her psychotic behavior.
Around midday, she became fixated on going back in time again, much like she
had in Celia’s garage.
“Pat, we need to start going backward,” she demanded continuously, as if her survival depended on it. “We need to play it back. If we play it backward, everything will be okay.”
She acted as if I could make it happen. Feeling helpless, I kept refocusing her attention on Dr. Martinez’s instructions. “No, that isn’t the plan,” I would respond, flat toned. “Dr. Martinez gave us a plan, and we are sticking to the plan.”
“Right, right, the plan,” she would repeat, taking the notebook from me.
As the day drew on, more paranoia began to creep into her deliberations. At various points, she became convinced that our room was being bugged or secretly videotaped. She also started talking about the devil again, like she had in Mark’s truck. She was working through a theory that Satan could travel between people when they looked at each other, jumping from one brain to the other through direct line of sight.
Surprising, Mia’s behavior wasn’t obviously deranged. If you had a machine that could analyze body language and vocal intonations, without focusing on her words or the meaning of her sentences, you probably wouldn’t have noticed anything wrong. She looked normal; her voice sounded normal. And this made our interactions that much more disturbing, especially all the talk about Satan. She described her theory regarding the devil like she would any other scientific hypothesis.
She never once questioned staying in the bedroom. It was as if she knew that isolation was better than being around other people.
When we finally emerged for dinner on Saturday night, I was physically and mentally exhausted. I hadn’t slept much in a week, using the time that Mia was asleep to update the family and catch up on work. My patience was wearing thin, too. Being around a psychotic person nonstop was becoming unbearable.
Additionally, I was concerned about the kids; we hadn’t spent much time together in a week. On Sunday morning, I decided to escape the house with them. We needed a break, and Mia’s parents could watch her while I was gone.
After a few hours of visiting parks, smiles had replaced the serious faces that had started the day. When we were back in the car to return home, I took the opportunity to ask how they were doing. Will seemed fine, but Jamie was quiet, which was rare for her. I sensed that something was wrong, so I pressed harder.
She looked at me uneasily. “I know you’re busy, and this isn’t that important,” she said, “but I’m just sad that I missed my tea party yesterday.”
Her sentence hit me like a shock. For months, she had been looking forward to that party. Her Girl Scouts troop was holding it at a high-end British restaurant, complete with crumpets and jam.
“Oh, Jamie,” I said, with a guilt-racked conscience, “I wish you would have reminded me! I feel terrible!”
“I don’t want you to feel terrible, Daddy,” she said. “I wasn’t going to tell you, but you kept asking. I was just being honest.”
“I’m glad you told me,” I said, “but I’m so mad at myself. I should have taken you.”
“No, it’s okay, it’s not that important,” she repeated, and for some reason that made me feel even worse. I heard it like, “It’s okay, I’m not that important.”
“No,” I said, “it’s not okay, Jamie. You are just as important as everyone else in this family. I will make it up to you. We’ll go to tea together, okay? We’ll do it this week. I promise.”
Of course, I had no idea how I would find time to take Jamie to tea. I hadn’t really been to the office in a week, and Mia required so much of my attention. Even so, the kids needed my support, too. I was painfully aware that the situation could cause serious harm to their emotional development, and I was determined not to let it. I knew that Mia would want me to prioritize the kids, too.
Walking back into the house, any thought of the kids quickly evaporated. I was appalled to see Mia sitting on the couch across from Marcos, instructing him on some kind of experiment. He was holding his hand over his left eye.
“Right, now look straight into my right eye,” Mia commanded. “No, you have to cover your left eye completely, or the results will not be accurate. Any obstacle could interfere with the transfer of thought.”
“Oh, sorry,” he said, moving his hand higher in deep concentration. They were seated about two feet away from each other. Mia had a pad of paper beside her, acting like a scientist conducting research.
Maybe it was my lack of sleep, but I found the entire scene incredibly upsetting. I couldn’t believe that he was playing along with her delusions, although I shouldn’t have been surprised. From experience, I knew how difficult it was to interact with Mia in her current state. You didn’t know if you should try to talk sense into her, ignore her, or pretend that she was acting normally.
Playing along seemed the worst approach to me. I thought it would encourage her psychosis, egging her on to wilder ideas. I rushed over to the couch, breaking them up, and quickly ushered Mia back into our room.
She was going on about her new theory. It was something about the power of the eyes and how ideas could be transferred from one person to another through vision. It was eerily similar to her devil-speak from the previous day, only her arguments were becoming more and more spirited, like she was sliding deeper into psychosis.
I became increasingly distraught, blaming myself for leaving her with her parents, but that didn’t have anything to do with it. Her behavior was changing because the Seroquel levels in her body were steadily rising. Still, I decided not to ask Marcos and Lucia to watch her again.
I called my mom to see if she and my stepdad could visit for a while. She immediately agreed, although they couldn’t make it to our house until Tuesday. Fortunately, Celia had recently texted, wanting to know if she could help. I responded to her message and asked if she could come until my mom arrived. Not only would Celia provide backup support if needed, but her visit would be good for the kids. She could be loud, but she was funny. And at that point, we all needed a laugh.
Celia pulled into the driveway a few hours later, right as we were sitting down for dinner. After greeting everyone, she pulled me aside. “Oh my God, Pat!” she cried. “You look terrible. Have you slept at all?”
“Not really,” I admitted. “I’m averaging about four hours a night.”
“It’s not enough. You need to get sleep. What good will it do Mia or the kids if you get yourself sick? I can stay with her tonight.”
“Celia, it’s pretty tough. You spent time with her last Sunday. Remember how uncomfortable you were? I have more experience with it now.”
“I can do it, Pat,” she assured me. “You need to rest.”
The thought of a full night’s sleep was mesmerizing, but I already felt guilty for having left Mia that morning. Still, I knew Celia was right. I reluctantly acquiesced and gave her the night shift.
Will and Jamie were thrilled when they heard that I would be spending the rest of the night with them. “You can sleep in my bed tonight, Daddy,” Jamie offered. “You’re so tired, and you’ll sleep better that way.”
“Yeah,” chimed in Will, “and I’ll give you my extra pillow!”
“Right, and my stuffed animals!” echoed Jamie.
“And we’ll read to you for a change,” added Will.
They had fun going back and forth, coming up with ways to pamper me. It turned into a memorable event, and I relished every second. It was such a relaxing change from the unrelenting stress of being around Mia. They treated me like the child, tucking me in, hugging me good night, and turning out the lights as they snuck out of the room. I fell asleep as soon as they left.
I woke feeling rejuvenated from my first full night’s sleep in over a week. Celia was frazzled, informing me that she and Mia had been up early. I offered to take over. Mia and I were scheduled to see Dr. Martinez later that day, and I wanted to get a sense of her condition.
It became
immediately clear that Mia was not responding to the medication. Her anxiety levels were even higher than the day before. She was raving about Mensa, an organization for people with high IQs. She was convinced that some of our relatives were members, and she wanted to know what secrets they were keeping from us.
Mia was also still obsessing over her theory concerning eyesight, having remembered Satan’s role in her hypothesis. She broached the idea that the devil had been in her dad’s brain while they were conducting their experiments the prior day. She was trying to figure out if Satan had escaped during their experiments and might be lurking in close proximity. This last detail was alarming. Mia had been talking about the devil off and on for a week, but this was the first time she mentioned him being in the house.
Even though I had pledged not to respond to her outlandish ideas, I felt compelled to quash these thoughts immediately. “No, Mia,” I stated firmly, “the devil is not in our house.” She abruptly stopped talking and gave me a suspicious look like, How can you be so sure about that, Pat? I ignored her, hoping that would be the end of it.
About midmorning, we started preparing for the doctor’s appointment. I was in the shower, and as the water rained down from the showerhead, I thought about Dr. Martinez’s plan. As I walked back into the bedroom, I was wondering what more he might recommend.
“Pat, we need to kill the dog,” Mia said in a calm voice. She was standing by the foot of the bed, our old miniature dachshund cradled in her arms.
“What are you talking about?” I gasped. Chica was like our firstborn child. We had adopted her as a puppy right after our wedding, and Mia loved her as much as I did.
“It’s the devil,” she lamented. “He got inside her.” I started to look down, but she cut me off. “Don’t look into her eyes!” she shouted.
Oh right, I thought to myself, because if I look into her eyes, Satan might jump into me.
Safe, Wanted, and Loved: A Family Memoir of Mental Illness, Heartbreak, and Hope Page 8
