Against Medical Advice (5 page)
Read Against Medical Advice Online
Authors: James Patterson
“ ’Night”
I LOVE MY SISTER — she’s my best friend — but sometimes it’s so hard for us, unbelievably hard and unfair. I can cause her a lot of trouble and pain, and every now and then she starts to get even.
I don’t know why she picked tonight to try to trick me. It’s bad enough that a new tic is making me twist my shoulders so hard that the bed creaks. Add this to all my other nightly thrashing around, and my bedposts are getting wobbly enough to collapse.
But just as the clonidine and Benadryl are finally beginning to work, I hear Jessie from her bedroom, which is right next to mine.
“ ’Night, Cory,” she sings out a little too happily, and my eyes pop open.
There are certain phrases people say to me that I
always
have to respond to. Saying
good night
is one of them, and Jessie knows it.
“ ’Night, Jessie,” I say as quickly as I can, trying to make it sound as if it’s the last time we’ll be doing this.
I’m about to drift off when she does it again.
“ ’Night, Cory.”
“Stop doing that, Jessie!” I yell back, and quickly follow it up with another “ ’Night, Jessie.”
This isn’t like her. Jessie is almost always on my side, but lately things are changing. She used to let me join in when her friends came over to play, but now she takes them right to her room and locks the door. I guess it’s hard for her to have a brother like me when she’s trying to be regular.
Yesterday she deliberately got me in trouble. When my mother wasn’t around, she told me that it was okay to pee in the bathroom sink. And when I did, she told on me.
It’s easy for Jessie to trick me, just like she’s doing tonight. She’s smart and plans ahead much better than I do. A while back, she made up a rule that whoever yells
Front seat
first gets it when we go for a ride. I agreed because I thought I’d always remember, but so far she’s won about a hundred times in a row. Occasionally she remembers to call
Front seat
when we’re still in the house. And every time she wins, she laughs in triumph.
I stay awake for a long time, waiting for Jessie to say it again, which is just as bad as her doing it, but finally, when nothing more happens, the medicine takes over and I drift off into . . .
“ ’Night, Cory.”
The gleeful little call splits open the darkness, and I sit up in bed and yell for my mother, who shows up fast.
“What’s the matter, Cory? Are you all right?”
“Jessie won’t stop saying ‘ ’Night, Cory.’ She’s doing it on purpose.”
Mom ducks into Jessie’s room and scolds her until she promises to stop.
Finally, sleep arrives, and with it my best dream. I’m riding a motorcycle on a highway that goes on forever. I’m traveling faster and faster, bent down over the handlebars, passing everyone else. I’m not thinking about anything as the cars and trees fly past — except the thrill that’s rippling through my body.
Eventually I’m going so fast that my motorcycle races ahead of the sound of its roaring engine, and I’m moving in a state of blissful quiet, as if I’m the only one at the very tip of a spaceship. A wonderful voice talks to me, telling me that this is how happy I will be someday.
This blessed freedom will be mine.
And then comes another voice, from another place and time, a softer one, just loud enough for me to hear.
“ ’Night, Cory.”
I STARE UP at the two-hundred-year-old tree in my backyard, almost out of breath from the excitement. It’s more than a hundred feet tall. I wonder how many storms it must have survived to still be here, waiting for a barefoot kid with an unusual urge to climb.
The tree trunk has to be at least twenty feet around and looks like a huge elephant’s foot. I wonder if I’m really crazy to be doing this, but I don’t think so.
Crazy
is someone who kills people because his dog tells him to.
I have to climb because there’s no other way to get rid of the urge that’s building up inside me. It’s as if I have wires in my brain that light up at the thought of it, but they’re wired to the wrong places and don’t allow the electricity to turn off.
So this isn’t about being crazy. This is about bad wiring.
Right now I should be at school with the other fifth graders, but today I can’t sit still long enough to make it through the whole day.
So this afternoon, while the other kids are learning English, geography, and math, my assignment is climbing.
Lucky for me, the kids who lived here before left a homemade rope ladder that’s still attached to the first branch. I stand on the rope step and can tell it’s strong enough to hold me.
I hook my foot around the next rung, but right away my leg shoots straight out and slams into the tree. This is what I’m most afraid of, the excitement making my body spark more than usual. A wrong move a hundred feet in the air will make the trip down a lot faster than the climb up.
On the next try, my leg is okay, and I keep going until I run out of ladder and can grab hold of the first branch and pull myself into the tree.
The next few branches line up one above the other, and I climb them quickly. Then a large gap stops me.
My bending tic hits all at once, and my stomach clenches so hard that for a few seconds I can hardly breathe. The thrust forward shifts my weight so much it throws me off balance, and
suddenly I’m falling.
My whole body jerks to a stop when my legs get tangled in a thick bunch of branches and end my fall. It all happened so fast that I didn’t have time to be scared, but I am now that it’s over.
I stay very still and suck in a few gallons of air.
I look down and see just how bad an idea this whole thing was. Below, there’s a pattern of small light and dark rectangles, and I realize they’re the roof shingles on my house.
I’m much higher up than I thought, and I wonder how I’m going to get down.
That thought makes me
need
to test the danger of a fall. I let go of the limb I’m holding on to for just a second until I start to lose my balance. Then I grab it again at the last moment. I test again by letting go for a longer time and almost don’t get my grip back before it’s too late.
But I still need to climb. I wrap both arms around an overhead branch and hook one leg around it, then the other, and in a moment I’m hanging upside down.
All at once a big muscle in my left leg contracts, making it straighten out. Now only one leg is attached to the tree, and
I’m still hanging upside down.
I dangle there, high off the ground, not knowing if I’m going to fall. I wait for the spasm to stop, then I wrap my leg back around the branch and haul myself right side up.
I don’t know how long I’ve been climbing. My shirt is soaked with sweat.
The muscles in my arms are tingling from the strain of holding on for so long, but being this close to the top elates me.
I push apart a final thick clump of leaves, and a small space opens up. Now I can see where some of the highest branches end. The branches here are thinner, and I don’t know if the last one will hold my weight, but I’m not going back down until I find out.
I take a deep breath and go for it. It bends but doesn’t break.
And I’m there!
I actually begin to relax. The breeze is like a silk scarf on my skin. Far below, the earth looks like it’s moving back and forth, but it’s only the treetop swaying.
I’m like a bird in the canopy of a great forest — one that’s washing stillness over my body. Up here, I’m part of another world — a zone without time or stress. I needed to get here because of the thrill but also because, up here, there’s something I can never find on the ground.
A place where no one can see me tic.
I don’t see any reason to come down.
No reason in the world.
What I don’t know, and won’t for many years, is that the act of climbing this tree is the key to something wonderful.
This is it.
I just don’t know it yet.
Resource Room
YOU’D HAVE TO BE unconscious not to realize that something is about to break loose in the Resource Room at my school. It’s obvious to all the kids that Phillip is getting more hyper by the minute, but Mr. Jansen is still sitting behind his desk, reading today’s
New York Times.
He seems concerned with what’s going on only when it gets so loud that you can hear us in the halls or when someone starts to freak out. Then he yells, “Be quiet and sit down! Now!”
The Resource Room is a classroom set up as a quiet space for special-needs kids like me who require a break in order to get through the school day or need a place to go when they get to be too much to handle in a regular classroom. The teachers have started sending me here for time-outs a lot, ever since my behavior in class got out of control.
Everything about middle school has made me worse. Just changing classes puts me under unbelievable pressure. I can’t work the combination on my locker very well, so I’m always late for my next period. When I finally do get the door open, I usually forget to lock it again. Already I’ve had my jacket, books, and several lunches stolen. Feeling anxious between classes makes me worry all the time, and that’s made my tics go off the charts.
This is the main reason one of my teachers sent me to the Resource Room again today.
There aren’t that many of us in the school who come here, and everybody knows who we are. I’m not the only sixth grader, but I’m the only one who comes because his body is like a Mexican jumping bean.
The trouble with the Resource Room is that it isn’t what it’s supposed to be — a rest. It’s not really Mr. Jansen’s fault. He can’t do much to keep kids like us under control. We’re already on medicines for that, and he probably figures that we come to this room when our medicines aren’t working. What chance does he have?
So I’m not surprised when, without any warning, Phillip bursts out of his chair and begins to run around the room, screaming his lungs out and knocking things off other kids’ desks and the blackboard railing. Phillip is the most out-of-control kid in the entire school. He never stops moving and can’t be quieted down no matter what people say to him. So Phillip and I have a lot in common.
On his second lap around the classroom, Phillip suddenly cuts into a row of desks and slides to a stop within a few inches of a boy named Danny. You never know what Danny is going to do either. He can be as still as a rock, just staring into space, or he can get as wild and crazy as Phillip.
Phillip approaches Danny and reaches for his head, grabbing a fistful of curly red hair. Before Danny knows what’s happening, he’s being dragged out of his chair headfirst. Even though he’s way off balance, he manages to get to his feet and kick Phillip in the leg. He follows that by grabbing Phillip’s arm and sinking his teeth into Phillip’s wrist.
Phillip retaliates with a kick of his own that misses Danny and makes a desk go flying. Both kids are about the same size, so this fight could go on for a while, unless the teacher gets them to stop.
“Hey, you two!” Mr. Jansen yells, making his way into the fight. He reaches Danny just in time to stop him from pushing his hand into Phillip’s face. The teacher separates them by grabbing their shirt collars.
“Knock it off right now or you’re going to Mr. Arno’s office.”
The threat of being sent to see Mr. Arno scares just about everybody in the school. Mr. Arno is the vice principal and is in charge of discipline. He’s a big man with a floppy mustache and an expression like that of a snarling wolf. When he talks, he sounds like he’s barking at you.
Phillip doesn’t tune in to what Mr. Jansen is saying, so he continues to fight until his shirt is almost torn off his back.
Danny is more in touch with reality. He stops fighting, which calms Phillip down. In a few seconds, Phillip stomps back to his seat.
Mr. Jansen shakes a finger at both of them. “Don’t make me talk to you again. This is a rest period.
All you have to do is be quiet!
”
For a while things are peaceful, but Danny is still upset. Phillip has really hurt him this time, and he’s angry.
All of a sudden, Danny lets out a howl and launches himself like a missile at Phillip. He knocks both Phillip and his desk backward.
“That’s it!”
Mr. Jansen hollers, charging out of his seat again.
I want to help calm things down, mainly for Danny’s sake — he didn’t do anything to deserve being attacked. But the last time I tried to help in a situation like this, I was told to stay in my seat, and I don’t want to make Mr. Jansen angry at me.
The fight ends before the teacher gets to them. Danny has satisfied his urge for revenge and is moving back to his seat. Phillip is also tired of the fight — the last push knocked him out of his chair and sent him sprawling to the floor.
For the first time since I came into the Resource Room today, there’s no noise. The quiet feels good, but it’s already too late for me. I’m more anxious now than I was when I got here.
The silence lasts about another twenty seconds. Without warning, Phillip leaps out of his desk and heads full force for Danny, waving his arms and offering up an earsplitting scream.
Mr. Jansen bolts out of his chair again, but before he gets to them, the fight spills over to where two other kids are sitting. One is the only girl in the room, and she starts crying and puts her head down on her desk.
I put my head down, too, to try to block out what’s going on. I make a few throat-clearing sounds and do a few shoulder lurches that have been building up. Poor Mr. Jansen doesn’t know what to do or who to talk to first, so he ends up standing there, checking the clock on the wall. He still has ten minutes left with us.
My mom has to come early to pick me up,
but at least she’s first in the car line.
Med Menu
WHAT’S SO TERRIBLY WRONG with me that so many smart people can’t help me figure a way out of it? It’s been
more than six years
since my body started jerking, shaking, quivering, twitching, and exploding on its own. I’m more out of control than ever, and I wonder why anyone thinks another drug is going to help after we’ve tried so many. I’m already eleven years old. My so-called childhood is almost gone.
Lately I’ve heard Dr. Pressler describe some of the things I do as
compulsions.
That’s why she’s prescribed Celexa, the first antidepressant I’ve ever taken. Everyone thinks it could be a breakthrough for me, since antidepressants work on compulsions, but in my case, the medicine seems to make everything worse. Celexa hypes up the need to jerk my body to one side so violently that I hurt a nerve or something, and it takes days for me to stop jerking and hurting myself.
After Celexa comes Paxil, another antidepressant. My doctor says it’s worth trying because different medicines can do different things, even if they’re in the same general category.
For a while Paxil really helps my mood. I become much happier than before, and being happy calms my tics down. But then my mood gets so good that it doesn’t feel real. I actually tell my mother, “I don’t want to grow up. I don’t want things to change.”
How weird is that?
The good time doesn’t last for very long, anyway. By the end of a week of nirvana, I start getting into trouble at school again, falling off chairs and being disruptive. So my mother begins to take me off Paxil right away.
Against medical advice,
I guess. A short while later, the school calls her and says I had a great day, and she thinks that my getting off Paxil is the reason. But I think,
If things are better when I’m
off
Paxil, then why weren’t they better when I wasn’t
on
it to begin with?
Maybe it’s only that I’m still coming off the drug, which is like being on a lower dose. So we go up and down on Paxil a few more times, but we can’t see that it helps, and I finally get off it altogether.
When I have good and then bad days on the same medicine, it’s hard to know what’s going on. Is the medicine wearing off? Is it the different doses I’m trying? Dr. Pressler says maybe my mind eventually figures out how to beat each medicine so that it can go back to the way it was.
Fluvoxamine is one of the worst drugs I try because its side effects are so extreme. At first it calms me down quickly. My dose is increased, and I have another great day at school. Right after that I can’t stop laughing in art class and am asked to leave.
From there I become depressed, and the dose goes up again. Three more calm days in school are followed by a sudden burst of more tics and cursing in front of friends. I begin clenching and unclenching my right hand so hard that after a while it becomes impossible to open and close it at all.
Even worse, my body is jerking almost continuously, and for the first time it keeps doing it in my sleep, the only period when my body gets a rest. That’s a real problem. I can’t sleep, and it’s making me crazy, seriously crazy.
When we finally lower the dose of fluvoxamine, my twitching goes down pretty fast; the cursing, too. My food and germ phobias go away. Then we add clonidine, which I have taken since first grade, and everything is okay until I start throwing things and having to touch boiling pots of water on the stove. I get in trouble at school by talking, laughing uncontrollably, and saying nasty things, so there goes fluvoxamine.
It kills me that there are so many unsolved mysteries about my medicines. Once in a while one starts to work, then something changes and the side effects get worse. I never know if it’s the medicine itself, the combination of medicines, the doses, or the usual ups and downs that happen with Tourette’s. This is the most complicated puzzle I can imagine for my doctors and parents to try to figure out — which probably explains why they haven’t so far.
But we have no choice except to keep trying. Our new plan is to start on BuSpar in a few days, because Dr. Pressler now believes anxiety is causing everything else to be worse. She’s also talking about trying a new drug called Risperdal, an antipsychotic used for schizophrenia and to control violent behavior. This is a very big decision for my parents. Risperdal hasn’t typically been used for Tourette’s, and I’ll be one of the first Tourette’s kids in America to try it. I’ll also be part of a new study, like a lab rat.
Risperdal worries me for another reason. People who take it gain, on average, thirty-five to forty pounds. So instead of being just a kid who can’t stop moving, I’ll become a
fat
kid who can’t stop moving.