Cracked: Putting Broken Lives Together Again - Drew Pinsky, Todd Gold (2004)

Chapter 24

IT IS TWO days later, and I am listening to the crackly rattling in Esther’s lungs. They sound like metal garbage cans rolling around an alley. Her bruises aren’t healing. She’s still drowsy from the Librium, and so I cut that back and switch her to Serax, a similar drug that is metabolized differently. It should enable her to wake up, but I can’t provide anything that will allow her to tolerate treatment any better.

I can see she is fed up. She shuddered away from me as I tried examining her. She doesn’t want to cooperate.

“I’d like you to start attending groups more regularly,” I say.

“Oh no, I can’t listen to those stories,” she says. “There’s no one my age, and I’ll tell you something. Those young people in there are disgusting. Their language is horrible. You can’t imagine the kind of words they use. I can’t tolerate that. It makes me too upset. I can’t even say those words.”

“You don’t have to,” I say. “Just sit there.”

“Why? To hear those stories? The things those women talk about. The men are so violent. It’s frightening.”

I understand. She doesn’t identify with any of the other, mostly younger patients. But I really don’t know what to do.

I don’t have many options. I can’t threaten her with a discharge, since that’s what she wants. So over the next week I make it a point to try to develop a warm connection with her, and hope she stays long enough for her daughter to take a more active interest in her treatment. At the same time, she emerges from her Librium cocoon and provides enjoyable company, even if it is irascible. Esther wins over a lot of the staff with her no-nonsense talk. She seems to have a comment on almost any subject, especially the younger people.

“I think a lot of the kids you got here just needed a good paddling when they were young,” she says.

“A lot of them did get hit,” I reply.

“They didn’t get hit in the right places,” she cracks.

The last time I see Esther, she’s talking about politics. She doesn’t know much about current events, which is surprising for the amount of television she watches—her set is on 24-7—but “the old lady,” as she has lately taken to calling herself, definitely has her opinions. She thought JFK was sexy. His brother Bobby, too. “But not Teddy,” she adds. “The rest of those Kennedys are from nothing.” She has no liking for Nixon or Ford. “I liked Carter and his mother, Miss Lillian. She was a kick in the ass.”

“What’d you think of Reagan?” I ask.

“Handsome.”

“How about Clinton?”

“He was a honey.”

“Bush?”

“I want to live long enough to see a regime change,” she says, borrowing a phrase from the latest war, and showing me she might be more with-it than I suspect.

Esther is much improved from the time she was admitted. No question. Having regular meals, decent sleep, and no booze has made her stronger and healthier. I see potential for a few good years, even if she doesn’t. Yet I don’t know what to do with her. Then she solves that problem late in the afternoon. It’s about four-thirty, and I’m helping Alexi prepare for the next team meeting when I look up from a stack of folders and see Esther teetering down the hall, holding a tiny bag with her belongings, like a little old lady heading toward her train.

In her case, it’s a cab.

“I’ve called a taxi,” she says.

I’d wondered if this would happen. It typically does with the more able elderly patients. At a certain point, they reach their limit and go.

I look at Alexi, who has her hand on the stack of files. If she has strong feelings about a patient, she usually shares them. This time she remains silent. I make a few comments to Esther about staying, but they’re halfhearted. Both of us know it. I really can’t think of anything more to do for this patient, but she has a parting comment that’s intended to help me.

“This place isn’t for me,” she says. “But you keep up the work. You’ve got to help these kids.”

“I will,” I say. “Take care of yourself.”

Alexi and I make sure Esther gets to the taxi.

“That was interesting,” she says after it drives off.

“What was?” I ask.

“Before, you would’ve fought and threatened her. You wouldn’t have given in so easily.”

I shrug.

“Maybe I’m changing.”

A while later I check on the patient in 419. Brianna is a nineteen-year-old competitive gymnast who came in addicted to speed a few hours before Amber died. She was placed in the room next to Amber’s. After Amber died, Brianna freaked out, complaining she’d never been that close to a dead body. She stood in the hallway, warning us she didn’t want to see the body, and going on and on about it until someone stepped away from the commotion long enough to say, “Then get in your room.”

She has struggled the past three days with boundary issues. She has shown up late to her groups. She has taken over the television set in the lounge, fixating on certain sexy programs that feed her need for a thrill. We have had to curtail that habit. Now, since the previous evening, she has convinced herself that her chronically ill grandfather back east is going to die at any moment, and so she wants out. She’s still harping on it when I check on her.

“No one here understands how close we are and how much he means to me,” she says.

“Yes, we do,” I say. “We also understand what you’re feeling, and why, and you need to start showing up in group on time and talking about it.”

She turns toward the window, and with one finger delicately parts the drapes a sliver so she can see outside.

“But I could’ve been that girl who died,” she says. “It freaks me out. I can see the same thing happening to me.”

“That’s right,” I say. “That’s your disease. She had it, too, and it killed her. It kills lots of people. I don’t want that to happen to you.”

“It wasn’t supposed to happen to her, either,” she says. “I mean, this is a hospital, for crying out loud.”

“Yes, it’s a hospital. People die at hospitals. They also get better—the way you will if you share this, get a sponsor, work on your first step, and get this process going. It’s painful. All these feelings you have now are the ones you’ve been covering up with all this behavior. It’s time to feel the feelings.”

It’s also time to contain Brianna better. We limit her TV, take away her cell phone, and make sure she gets to group on time. Basically we close down all of her escape hatches, hoping she learns to calm down. It doesn’t work immediately. For a day and a half, she gets profoundly depressed. She also suffers two panic attacks.

Somehow, though, amid all this drama, Brianna connects with another patient, Azura. In her mid-twenties, Azura looks completely unapproachable. Her arms, neck, and back are totally covered with tattoos. She is pierced on her tongue, nostril, and cheek. She looks like a tribal desperado from a Mad Max movie. The two women couldn’t look more different on the outside—and yet Brianna and Azura have soon found a common ground for sharing in a way that makes them see how similar they are on the inside.

Still, I couldn’t be more pleased. For Brianna, this is an important step that could be the start of real healing. She is connecting with another person. And vice versa. That’s exactly how it happens. It can’t happen any other way. If both women are going to make it in recovery, they need to be involved with something other than themselves. A genuine self can only develop in relation to someone else. In the past, people turned to loved ones, neighbors, or religion to heal their problems. That doesn’t happen anymore. Nowadays the culture is all about arousal and quick fixes. But they don’t work.

The way these two women click has the potential to be different, to be the real thing. I can’t predict if it will turn out well for them. It is a long process, much longer than the twenty-eight days (max) that most patients spend in the unit. It is a process that will take the rest of their lives. Yet I hope I am witnessing a vital step in what could be their chance at a new, more fulfilling life. This is how it begins.

Apparently something else is beginning, too. I don’t notice it, but Alexi comments on my mood, my reaction.

I take a step back from myself and agree.

“I think hope has returned.”