Elephant in the Sky (21 page)

And there, in that dark moment with just the two of us, Nate came back to me. I was real.

50

Nate

I'm going home today. Dr. Aldridge is sitting in my room, trying to talk to me. But I still don't want to talk to her.

We are by ourselves. Mom went to get a coffee. Dr. Aldridge came to talk to me about leaving the hospital. She said she thinks it is a good thing that I'm going home. I don't care where I am. I don't want to be at the hospital. But I don't want to be at home. I don't want to be anywhere.

I want her to leave.

I do not want to talk.

“Nate? I asked if you are looking forward to being at home, with your mom and dad and sister. And all of your things. You even get to sleep in your own bed tonight.”

If I talk, will it make Dr. Aldridge leave sooner? I try to answer her but I can't seem to speak. I don't know if it is my brain not working or my mouth. I try to think of the answer for a second and then realize I don't care. I do not want to speak to her.

“Is there anything about your house that you miss?” Dr. Aldridge asks.

No.

“Are there special breakfasts you like? Ones that you can't get here?”

No. I want you to go.

“Or maybe it's a special dinner you could have. I know you like spaghetti and meatballs. Would you like to have that for dinner tonight?”

No. I want you to get the
hell out of my room.

“What about family movie night. You'll be able to start having those again. Are you looking forward to that?”

No. Get the hell ou
t of my room, you dumb doctor.

“Nate, would you like to talk about Noah?”

Yes. Of course
I do. You just told me Noah doesn't exist, and no
w all you want to talk about are dumb things lik
e movie nights and my favour
ite dinners.

“Yes.”

“Okay. Let's do that, then. How do you feel about what we talked about yesterday?” Dr. Aldridge asks me.

I shrug. I don't know how to tell her.

“It's okay, Nate. You can tell me.” Dr. Aldridge waits for me to talk. When I don't, she says, “Why don't you think of just one word to use to describe how you are feeling about Noah. Can you do that?”

I nod. I know one word.

“That's great. I'd love to hear it.”

“Sad.”

“I can understand that,” Dr. Aldridge says. “It would be very sad to find out that someone you thought was real does not really exist.”

“I … I want to go back to how it was. When I knew Noah was … was real.” I start crying again. I'm mad that I'm crying. Because I don't want to. But I cannot help it.

“Nate, realizing that Noah isn't real is a big step to realizing what is real around you and what is not. It's a big step towards you being better. And we've talked a lot about why it's important that you get better.”

I nod. I wipe away my tears.

“You have parents who love you very much. And a sister who does too. And they'll help you continue to get better. Every day it will get a little bit easier.”

“But I don't like being awake in the days. I feel … kind of funny. Not like I've ever felt before.”

“Can you tell me more about it?” Dr. Aldridge asks.

“I feel tired all the time. But I can't sleep. And my mouth feels like I have wet cotton balls in it. So does my head. And my heart won't stop beating really, really fast. I don't like it.”

“Those are all side effects of the medication you are on. And I know they're very uncomfortable for you, but we're hoping they will get better soon. And the most important part is that they are making
you
better.”

“If the medication is making me feel like this, then I don't want to take it anymore. I want to stop.”

“You can't stop, Nate. You need to take your medication, just like we talked about. Every day. It is very, very important. It will keep you healthy.”

“I don't want to.”

“Look at how much progress we've made, Nate. When I first met you, we would not have been able to sit here like this, talking the way we are now. And you were very, very scared at that time. The medication is helping to make you less scared.”

“Will the medication make me forget Noah? I don't like that. I do not want to forget him.”

“I know you're sad about Noah. It's understandable. And it's okay to think of him still. It's also important to remember that he's not real. But if you need anything at all … something that you would have told Noah before or shared with him … then you can tell your mom or your dad. Or me. We are all here to help you.”

I look at Dr. Aldridge and tell her I know.

But really I don't.

Because I don't believe her.

All I know is that the medication is awful. It makes me feel sick. It makes me feel like I'm someone else. Not me. And if the stupid meds are making me feel sick, and making me forget Noah, I don't want to take them.

I just don't.

So I won't.

51

Ashley

“Are you comfortable, honey?” I asked Nate. It was his first night home from the hospital, and I was tucking him into bed.

He didn't answer me.

“I'm sorry you couldn't eat your spaghetti tonight,” I said, my voice filling the silent room. Pete had made homemade meatballs for Nate's first family dinner at home, but our son had hardly touched his meal. He claimed he wasn't hungry, and told us the meds were making him feel so sick that he couldn't eat. We hadn't pushed it, and settled instead for his agreement to take his meds, which had been the first exhausting battle when we got home.

The second had been Nate's silence. He'd been stone quiet since we got home. I had such high hopes for his return home, but his chronic silence was making everyone feel anxious and uncomfortable.

“Well, let me tell you, the sauce your dad made was pretty awesome. And the good news is there was a lot left over, so you can eat it whenever you're hungry. Maybe you could have some for lunch tomorrow.”

Nate gave me a look that suggested he wouldn't want it. I decided to drop the subject of eating. “Is there anything you'd like before you go to sleep? Some water maybe? Or I could stay with you. If you want, that is. Or I could sing you songs, or rub your back?”

Nate turned over in his bed, clearly telling me to leave him alone.

Dr. Aldridge had warned us of the highs and lows we'd experience. I knew Nate was far from being better. And for a long while, we'd never know what to expect from him.

“Okay, sweetie. I'll leave your door open so that I can hear you. Call me if you need anything at all.” I leaned over my son's back to kiss his cheek. It felt rigid, like he was clenching his teeth.

I left his door ajar and went downstairs. I found Pete waiting.

“Look what I found,” he said. He was holding two of Nate's pills.

“What? Where?”

“In Nate's napkin. I was cleaning up after dinner, and decided to do a little checking. Just in case.”

“Oh no. Really?” Our son not taking his meds was a nightmare. And I thought him taking them was the only thing that had gone right since Nate had come home.

“What do we do?” Pete asked. “Should we wake him up and make him take them?”

“I don't know … maybe?” With the mood our son was in, I had no idea what was best.

Pete started to walk up the stairs but I grabbed his arm. Something in my gut told me to wait until the next morning. “I don't know. Maybe we shouldn't. He's not doing well right now, and maybe the morning will bring a fresh perspective. Dr. Aldridge said it wasn't a huge deal if he missed one. We can sit him down in the morning and talk to him. After a full night's sleep.”

“I don't know if that's a good idea. I'm scared about him going back to what he was like before.”

“Me too. But I'm also scared to push him too hard. At least right now. He doesn't seem like he'd be able to take it.”

“Okay … I guess. But we need to talk to him as soon as Grace goes to school in the morning.”

“Agreed.”

“And I think I should sleep down here tonight. You know, just in case he gets up or something. He can't get outside because of the alarm, but I don't really want him walking around the house either. I'm sure he could do a lot of damage.”

“Yeah, I was thinking the same thing. I'll sleep with the door open so I can hear him, too. I doubt I'll sleep a wink tonight, to be honest.”

Pete drew me in for a hug and kissed my hair, filling me with comfort. Given the battle we were up against with our son, it was good that we had each other.

52

The next morning, after Grace had left for school, we sat Nate down on the couch so we could talk to him about what we'd found. He seemed uncomfortable, visibly twitching, and his face was ashen.

I sat a tall glass of chocolate milk down in front of our son, knowing it was his favourite. He hadn't eaten breakfast with our family, and I was desperate for him to take in something.

“Nate, your mother and I want to talk to you about something we found,” Pete began. He placed Nate's pills on the table in front of him. “Do you understand why it's important for you to take your meds?”

Nate immediately turned around in his seat so that he was facing the back of the couch. As he buried his face in the fabric, I could see that his hands were twitching and it looked like he was in spasms. It was one of the common side effects Dr. Aldridge had warned us about.

I clenched my fists and drew them to my mouth, biting my knuckles.
We
were doing this to him.
We
were making him take his meds.
We
were causing him to twitch. And feel nauseated. And not eat.

Pete drove the conversation forward.

“Bud, what happened to you when you first went into the hospital was the scariest moment of our lives. And this medication, even if it's making you feel sick … well, it's keeping you safe. It's making you better. You need it to be healthy.”

Nate whipped around, his eyes flashing with anger. “You don't get it, do you? You don't understand. It's making me feel like shit. It's making me feel like someone totally different. I don't even
want
to be healthy if it's going to make me feel like this. Because I'm not healthy. I'm sick. All of the time. I can't sleep. And I have this rash that's so itchy I scratch all night. And last night I puked three times, but there was nothing to throw up. Because I can't eat anything. I
hate this
. And I
hat
e you
for making me take it. And I won't. I won't take that stupid fucking medicine.”

I sucked in air, horrified to hear my little boy talking this way. I'd heard him swear on occasion, but never like that. And never to us.

“I'm so sorry to hear that,” Pete continued. “But none of us have a choice with this. You will be gone without it. You need it.”

Nate crossed his arms, and Pete stared back.

Before I could interject, Pete stood up and crossed the room. He grabbed hold of both of Nate's shoulders and lay him onto the couch, straddling our son's torso and arms, pinning him down so that he couldn't move. Nate struggled with as much force as he could exude, but Pete's strength and weight far surpassed our son's. Nate's head thrashed from side to side, in protest of what Pete was doing to him. He tried with all of his might to force Pete off him, but our son didn't have a chance.

“Pete!” I cried. I didn't even know I was going to speak. I pleaded with him to stop, but couldn't seem to find it in me to get out of my seat. I was frozen, watching the horror unfold in front of me.

Pete ignored my pleas and held Nate's head still, his firm lock stopping our son's head from thrashing about. He grabbed the medication and chocolate milk from the table, and pinched Nate's nose closed with one hand, forcing his mouth to open, then popping the pills into his mouth.

“Pete, no! Please. Stop!” I cried, finally finding movement in my legs. I leapt out of my seat and grabbed at my husband's arms, using all of my strength to try to get him to stop.

Pete didn't shrug me off like I knew he could have, but managed to find the strength to keep going, even with me on his back. He poured the chocolate milk into Nate's mouth, spilling it all over Nate and the couch, and forcing our son to swallow the pills and milk to avoid choking. When Pete was convinced the pills were down his throat, he got off our son, who was coughing and sputtering through his fear.

Kicking Pete off the couch, Nate curled into the fetal position on top of the milk-soaked cushions, and wailed through tears I'd never seen before. I shot Pete a look that I hoped expressed the true revulsion I felt towards him; I couldn't believe he would do something like that to our son when he knew how important it was for Nate to trust us.

Pete stood and left the room, running up the stairs and mirroring the sobs that were coming from both Nate and me. I'd been married to Pete for thirteen years, and I'd never seen him cry until that moment. Not even when Nate was missing or in the hospital.

I placed my hand on my son's back, gently, to let him know I was there and wouldn't hurt him. He responded, turning into me and showing the intensity of his fear by how tightly he hugged me. How powerfully he grabbed at my back. How tensely he gripped my clothes. How strongly he clenched his teeth. And, worst of all, how he couldn't stop his frail body from shaking in my arms.

53

“We need to change Nate's medication,” Dr. Aldridge said matter-of-factly, after hearing about the severity of Nate's side effects and his refusal to take his meds. Pete and I were sitting with Dr. Aldridge in her office at the hospital later that afternoon, while Nate was downstairs working on that day's art therapy with Payton. “Remember when we talked about this being a big game of trial and error? If Nate isn't responding well to the Risperidone, we'll try something new.”

I nodded, grateful to hear Dr. Aldridge's recommendation. I had been anxiously hoping she would say that, and had been prepared to beg her to switch Nate's meds if she wasn't instantly willing. The side effects and the hurricane of high-strung emotion and poor judgement that surrounded his refusal to take the drugs was tearing us apart. And it wasn't just Nate who was having a bad reaction.

“If Nate is struggling with the Risperidone, I think we should switch him to a drug called Aripiprazole. Like any medication, side effects can occur, but it's usually well tolerated. And if side effects do occur, in most cases they are minor and either require no treatment or can easily be treated.”

“What type of side effects?” Pete asked.

“The side effects that sometimes occur with Aripiprazole are similar to the ones that are associated with Risperidone. Most commonly, it's headache, drowsiness or insomnia, fatigue, nausea, and restlessness. But Nate's risk of getting any one of these side effects is less than thirty percent, and metabolically it's quite good. I think it's our next best bet.”

Pete and I nodded. We needed to get Nate away from the Risperidone.

“Now, how about you two?” Dr. Aldridge asked sympathetically. “How are you doing? Are you hanging in there?”

I didn't respond. I clutched the Kleenex I'd been holding since I'd walked into her office. Out of my peripheral vision, I could see that Pete was staring straight ahead with a blank look on his face. He didn't answer Dr. Aldridge's question either.

“Ashley? Pete? What's going on? It's important that you talk to me about how you're feeling and what's going on with your family. It's a crucial step in Nate's recovery.”

I waited for Pete to answer. I wanted
him
to tell Dr. Aldridge all that had happened when he tried to physically force our son to take his meds. It was his wrongdoing. It should be his confession.

“Did something happen?” Dr. Aldridge asked gently. She looked patiently at us over her smooth mahogany desk, which was bare except for a few perfectly organized piles of paper. Behind her sat a framed photo of her beautiful smiling family. She had two children of her own, who looked slightly younger than Nate.

“You could say that,” I answered, giving in to my need to talk. Pete and I hadn't spoken since the conflict that morning, and my need to confront the issue was overwhelming.

“I'd like to hear from both of you about this, but why don't you start, Ashley?” Dr. Aldridge suggested.

I told Dr. Aldridge everything. As I recounted the story, I became more heated in my gestures and concern, and knew that I was practically accusing Pete of abusing his son by the time I was finished. It was completely unfair of me, but the floodgates to my pent-up raw emotions had been opened and there was no stopping them.

I waited for Pete to jump in and defend himself, but he didn't. Instead, he sat still as stone beside me, and said nothing.

“Pete? Do you have anything to add? I'd like to hear your thoughts as well,” Dr. Aldridge coaxed gently.

“No. Ashley pretty much covered it. I did all that,” Pete said quietly, looking down. He looked so sad. “And I'm so sorry. I didn't mean to hurt Nate. I would never, ever hurt him. I was just so scared that he wasn't taking his medication. I
need
him to take his meds.”

Dr. Aldridge nodded compassionately. “I can understand that.”

“But I don't know what happened there. Ashley is right. I didn't handle it well at all. And I hate myself for it. I want my son to trust me, and now he won't.” Pete wouldn't look at me while he spoke, but I could see his face had turned white.

“Dealing with all of this is very complicated for everyone, I'm afraid.” Dr. Aldridge smiled warmly across her desk. “I know that your intentions were good this morning. And I understand that you want your son to take his meds so that he can be better. There's nothing wrong with that. You are both wonderful parents. I've seen that in you since the day I met you. But you're also human. And dealing with a complicated, emotionally charged situation.”

“But I … but I forced him to. Literally.”

“Did he take the medication?”

“Yes.”

“Then that part of the story is good. Because Nate
does
need to keep taking them to get better. Sometimes, as parents, we need to do things our children don't like. In a tough situation, we need to prioritize what's best for them. You knew Nate needed to take his meds, and you had run out of options. I'm not saying that what you did is the best way to get Nate to take his meds, but it was what you knew to do in that moment. Moving forward, we can work together on better strategies for getting him to keep taking his medication. Ashley is also right in that Nate will only get better in an environment that's filled with trust and security.”

Listening to Dr. Aldridge, Pete looked very small and frail. I could tell that he didn't want to be let off the hook so easily.

“Pete,” I began.

“No, please Ash, let me start.” For the first time since we'd entered Dr. Aldridge's office, my husband looked at me. “I feel horrible about what I did this morning. And I'm so sorry. I didn't know what else to do, and my fear took over.”

I reached for his hand and squeezed. “I know. And it's okay. I don't know what to do with all of this either.”

“Nate's just started to make so much progress lately. He can't go back there.
We
can't go back there. And all of the research I've looked at … all of the information Dr. Aldridge has given us to read, and anything else I can get my hands on … it all supports the fact that this disease is one that won't impact a person's ability to function normally in society —
as long as they take their meds
. It all comes down to that. And if he doesn't take them, I know it will destroy our family. So he needs to take them. For himself, and for all of us.”

I nodded, and was somewhat surprised to hear him talk about reading so much information on Nate's disease. I couldn't remember the last time Pete had read an article or book to help our children. It wasn't that he didn't care, but normally I was the big reader, the one constantly shoving articles at him on raising children. Pete's research showed me in a big way how much he cared about what was going on.

Dr. Aldridge jumped into the conversation. “You're right, Pete. Nate does need to take his meds. It will be easier once we've found the best ones for him, but you have to realize this could be a lifelong battle, even when he's taking the right drugs.

“I've seen so many reasons why people don't take their meds. In Nate's case, and in so many others, it's the side effects that make them want to stop. But then there will be other things as well. Like when he feels better, and is convinced he's ‘normal' and doesn't need them. Or when he becomes a teenager and struggles with his independence, and views his medication as a leash from you to him. A leash that he wants to rid himself of.”

Dr. Aldridge's words made sense, but they made me feel sick to my stomach. I hadn't gotten past the side effects to realize the umpteen dozen other reasons that Nate might want to stop taking his meds.

“We'll work on all of this together, and take it as it comes. We never stop with the ‘one day at a time' around here,” Dr. Aldridge said to us, her voice softening. “Nate's a great kid. And you are wonderful parents. I'll work with both of you on the different strategies for keeping him on track. So he sticks with his recovery plan. And so he takes his meds. Not only for him, as you said, but also for you and Grace.”

“What about today? What if he doesn't take them when we go home?” Pete asked. I could tell how anxious he was about living through another night of Nate refusing to take his pills.

“Why don't we all go and see Nate right now? He should be done his art therapy, and I'll spend some time with him to explain why the new meds will be better. Through all of our time together, I've gotten to know Nate quite well, and I'm confident I can get him to take his new meds before you leave here. Does that sound good?”

“Yes, definitely,” Pete answered, his voice mirroring the relief I felt.

As we followed Dr. Aldridge down the hall to the elevator, I took Pete's hand and gave it three small squeezes. It was something we had done at work earlier when we were newlyweds and wanted to communicate something between just the two of us, and others were in the room.

Pete turned to look into my eyes. His were warm and compassionate. Mine welled. When our gaze broke and he pulled me in to kiss my forehead, I knew he wasn't upset with me for what I had told Dr. Aldridge.

The elevator arrived, shaking us from our moment. We stepped onto it, still hand in hand, to go and start over with our son.