Wednesday, November 13, 2013

No. 204 – Europa (Earth’s Cry Heaven’s Smile)

Performer: Santana
Songwriters: Tom Coster, Carlos Santana
Original Release: Amigos
Year: 1976
Definitive Version: Moonflower, 1977.

The guitar solo at the end of this song, particularly on the Moonflower version, is the musical equivalent of someone running to the edge of a great cliff and soaring off into the night sky. No song more embodies my blackest period than Europa—the time when Laurie was soaring on her own. It finally was time to go and get her.

I awoke Monday, June 9, 2008, much earlier than I wanted to the sounds of someone from Evanston Northwestern Hospital on my answering machine. The long slog that had been Laurie’s stay at the hospital—now a month—finally beat me down into a funk. All I wanted to do was stay in bed, but as soon as I heard Violet, I got up. When I heard what she had to say I was awake.

It seemed that Laurie’s insurance benefits were about to run out. Aside from the fact that we now would be on the hook for the untold thousands of dollars that her care was accumulating, Violet had worse news—the hospital was going to give Laurie the boot.

Wait … what?!

Violet quickly assured me that they weren’t going to let her go home—she was in no condition to go home—but, without insurance, the hospital had no choice but to send her to a state hospital, which was less expensive. OK, I’m getting dressed, and I’ll be right there. My depression was gone, snapped out of me by the realization that I didn’t have time for it. I head to get my head around what this all meant.

It was as bad as I thought when I arrived. Violet said the hospital already was starting the paperwork and that the transfer would take place within a couple of days. Violet assured me that where Laurie would go wouldn’t be anything like the institutions I saw in One Flew Over the Cuckoo’s Nest or 12 Monkeys. Laurie still would be cared for, but it definitely would be a step backward in terms of the quality of the care.

Violet also said the state hospital didn’t use ECT, so Laurie’s care would be drug therapy only. After a month of that and seeing no progress, it seemed clear what Laurie going to a state hospital meant … she might never come back. She might never get well. Violet remained confident that Laurie would get better … some day.

There was one option: If we could get Laurie to consent to ECT, the hospital could refile her as someone receiving necessary in-patient treatment. I had been afraid of ECT at first, but seeing no progress otherwise and faced with the alternative of the state hospital and an uncertain future, I was willing to try anything.

The salient question at hand: How do you get someone who isn’t in control of her mental faculties to consent to anything? Violet said she would draft a consent agreement and have it for me when I came to visit in the evening.

I stayed with Laurie through the afternoon, which the hospital staff allowed even though it violated visiting hours. She was visited by a neurologist. The hospital now was starting to wonder again whether something physical happened, even though all previous tests for things such as a stroke were negative. Maybe even Dr. Anderson was trying to find something, anything, that could keep Laurie there and not send her to the state hospital.

While I sat with Laurie, Violet brought me two forms—one to consent to ECT, the other to reapply for admission to the hospital. I couldn’t force Laurie to sign, so I sat down next to her and told her what each of these were and encouraged her to sign both. When I left, I placed the pen next to the two sheets and saw Laurie looking at both.

I arrived home to more bad news: The hospital was preparing a bill for Laurie’s latest care: $5,000. It didn’t even register. The money can wait till later.

That night, the visiting crew, coincidentally, was the same as the night Laurie entered Evanston Northwestern: Janet, Heidi and me. As I think I mentioned, I had sent daily emails to everyone in Laurie’s circle, updating friends and family on progress or lack thereof. So Janet and Heidi knew the direness of the situation. Laurie had made an illegible mark on the hospital readmission form but nothing more.

At one point, just before it was time to leave for the night, Janet—knowing Laurie the longest of anyone in Chicago—kicked me and Heidi out of the room. She said she would get Laurie to sign the ECT consent form. When she came out to the post-visit therapy session in the waiting room, she reported a lack of success.

I recalled something that happened earlier. One time when I wasn’t visiting, two friends—under the impression that we needed to be a bit more forceful with Laurie so she’d take charge of her own recovery—tried to get her to get up and walk around, when Laurie said a single word: “overstimulated.”

It occurred to me that Laurie’s condition, which I think a lot of people underestimated, was hindering her recovery. God only knows how many voices she was hearing in her head. She also was hearing too many in her ears. The giant size of the circle of people who loved her—a strength overall—actually was a weakness in this one situation.

The problem—my problem—was that out of respect to that circle, I deferred taking control of the situation. Well, that has to end. I lived with Laurie; I was the closest to her. It was time for me to pull rank, something I wished I had done from the beginning.

In no uncertain terms, I told Janet and Heidi that at this critical juncture, Laurie needed to hear one voice and one voice alone, and that voice had to be mine. All visitation would cease until further notice. They immediately agreed.

So it was up to me to get Laurie to sign to sign the ECT consent form. I had only a couple of days to accomplish that … or so I thought. I took another vacation day.

The next day, Violet again awakened me on the phone. It turns out that Evanston Northwestern was kicking out Laurie TODAY, this afternoon, unless she consented to ECT. I thought I had a few days. No, I had a few hours. Further, Violet informed that even had Laurie signed the consent form the night before, it wouldn’t be valid, because it had to be witnessed by a doctor. Dr. Anderson was available today at 11 and noon.

As you can imagine, I was in a pretty agitated state when I arrived at the hospital just before 11. I mean nothing was riding on me getting Laurie to sign the consent form … except everything. Laurie had to hear my voice now.

Dr. Anderson and I went into Laurie’s room and shut the door. Dr. Anderson sat in a chair to the side of Laurie’s bed. I rousted Laurie awake and propped her up with pillows, so she could see. She still was having the neck problem where she couldn’t lift her head, so I put the consent form on her lap and began to speak, slowly, quietly—desperately trying to mask my desperation. Dr. Anderson put the pen in Laurie’s hand.

I told Laurie that we had reached the end of the line. Her insurance coverage had run out and that she would have to leave the hospital unless she signed. I know you’re afraid, I said. So am I, but now I’m more afraid what might happen if you don’t sign. I know you’re hearing other voices. They’re lying to you. You need to hear me now, my love. I want you to come back to me. I miss you terribly. Please come back to me. Please sign.

This went on for minutes that felt like hours. Every second that passed was a lost opportunity. I kept at it, trembling in fear at the uncertain future if this went badly. Laurie showed no response, made no movement … nothing.

I had stayed positive the entire time I had been in the room, but I almost cracked. For a second, it didn’t seem like it was going to work. Dr. Anderson would have to leave soon and then we’d have only one more chance. Dear God, was this how it was going to end?

And then … and then … Laurie … began … to … sign.

I gasped and watched intently. It was a doodle unrecognizable to the untrained eye, but I knew, I KNEW, she was signing. I knew her signature, and I would swear on a stack of 1,000 Bibles, your honor, that I saw her hand move in just the way that it did when she signed the D of her middle initial and her distinctive L. Dr. Anderson grabbed the illegible form almost ecstatically and said she’d begin preparation for Laurie’s treatment right away. Laurie would stay put.

I vomited emotionally. I bawled tears of joy for the first time in my life. I told Laurie how proud I was of her, how brave she was, how she was doing the right thing. How I couldn’t wait for her to be back with me.

I laid her back down in her bed, so she could go back to sleep and then I RAN out of the ward, out of the hospital, out to the parking garage where I could whoop, cry, thrash about in emotional tumult. I couldn’t believe it. I felt as though I had just hit a walk-off grand slam to win the World Series, but better. I DID IT!!

I called John, Laurie’s brother. As soon as he answered, my emotions spilled out and I babbled uncontrollably: She signed! Laurie signed! Laurie signed the consent form! She’s starting tomorrow! And we both cried tears of joy together. I passed along as many details as I could and asked him to send an email to everyone in Laurie and my families.

Then I called Laurie’s Aunt, Ann. When I announced myself, Ann said she had been thinking that we should get a second opinion, and we should … She signed! She signed the consent form! Ann screamed in exultation.

I tried calling Janet, but she was unavailable, so I called Heidi to send the word to everyone in the posse. I still was jittery, the emotions of the past month rushing to the surface as I marched all around the outside of the parking structure in unbridled energy.

When I finished, I felt spent but energized. I finally went back to see Laurie, who was fast asleep. I left feeling better than I had in a long time. For the first time in a month, there was a light at the end of a black tunnel. Now, I just had to hope it wasn’t a freight train coming my way.

Don’t get me wrong, ECT still was a scary thing, regardless of how much I had been told about the procedure. But it was something different. ANYTHING was better than how it had been.

That night, during visiting hours, Laurie still was mostly uncommunicative, but she had more energy than usual. We walked around the hallway of the psych ward, a rare feat. That it was at Laurie’s specific request was even rarer, and it seemed as though Laurie could sense a change coming, too.

She was going to go into ECT at 6 a.m. the next morning, and I would be there—taking another vacation day—to help as much as I could. She was taking a huge step and needed a steady hand holding her. I wasn’t going to let go.

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