Elephant in the Sky (20 page)

48

Nate

“I'm feeling okay, I guess.” But I am annoyed. Dr. Aldridge always asks how I feel. I want to tell her that I feel like shit, but I don't want Mommy to be mad at me for swearing.

“What do you mean by ‘okay'?”

“Tired. Like I'm going to puke. And I can't think properly. Even though I want to, and I try really hard to think. I just can't.”

Dr. Aldridge nods and writes something down in the book she brought with her. “And what about your mood? How are you feeling?”

“Okay, I guess. My sister and my best friend came to visit me today. That was good. I was happy to see them.”

Dr. Aldridge nods again. She writes more words down in her book. There is a pad of paper inside it. “Can you tell me about your sister, Nate?”

I shrug my shoulders. “I don't know. She's okay.”

“Is she older or younger than you?” I give the doctor a funny look. Because it's a funny question. I know she knows how old Grace is.

“Older. Grace is twelve.”

“Do you get along with Grace?”

“I guess.”

“Is she nice to you?”

“Sometimes she's nice. Sometimes she's not. Mostly she just ignores me.”

“And what about Noah? Can you tell me about him?”

“He's my best friend. He's always nice to me.”

“What do you do together?” Dr. Aldridge asks. She finishes writing more stuff down in her book.

“I don't know.”

“Are you in the same class?”

“No, but I see him sometimes at school. Mostly we just hang out at home. He lives on my street.”

“What types of things do you do with Noah?”

“I don't know.” I am getting bored by my conversation with Dr. Aldridge.

“Well, how about we start with today. What did you do when Noah was here visiting you?”

“We watched a movie. And played some video games.”

“I see. Do you do anything else with Noah? When you're not in the hospital?”

“Yeah. We play outside. We go swimming. And ride bikes. And we play hockey. We are on the same team, but sometimes he's not there.”

“How come?”

“He only plays when we need the help.”

“Makes sense.” Dr. Aldridge scribbles on her paper again. When she finishes, she looks up. “The nurses told me you had quite the scare today, Nate. Can you tell me about that?”

I stop and wait. I watch Dr. Aldridge for clues to see if she's been sent by the nurses who wear the bad clothes.

“Nate?” Dr. Aldridge asks again. She keeps smiling. I decide it is okay, so I tell her all about what Spider-Man told me. What I needed to be careful of. Why I couldn't take the pills from the nurse wearing navy blue because it would have killed me.

“That sounds pretty scary.” Dr. Aldridge stops for a minute and then asks, “How do you feel when you think about dying, Nate?”

I don't say anything. I don't want to talk about this.

“Do you want to die? Or do you ever think about hurting yourself?”

“No. Of course not. Why would I want to do that?” I shake my head. Sometimes doctors are so strange. They are supposed to be smart, but then they go and ask stupid questions like that.

“I'm happy to hear that. I wouldn't want you to hurt yourself.” Dr. Aldridge stops talking. It's like she's waiting for me to say something. But I have nothing to tell her.

“How about school? Can you tell me about that? Do you like it?” Dr. Aldridge asks.

“I guess so.”

“Do you like your teacher?”

“Yes.”

“What's her name?”

“Mrs. Brock.”

“What do you like about Mrs. Brock?”

“I don't know. She teaches me stuff. And she's nice to me, I guess.”

“Do you have a favourite subject?”

“No.”

This is a dumb conversation.

“What about the kids in your class? Do you like them?”

I shrug again. I don't want to talk to her about Tyson or any of the other mean kids in my class.

“Who are your friends in your class, Nate?”

“Can I play a video game now?”

“No. Not yet. I'd like to talk about your friends at school first. What are their names?”

“I only have one friend.”

“Okay, what is your one friend's name?”

“Noah.”

More writing. “But Noah isn't in your class, Nate. Do you have friends in your classroom?”

“But I told you … I still see him at school sometimes, even though he isn't in my class. I don't need any more friends.”

Dr. Aldridge smiles at me. “Okay, then, why don't you tell me more about Noah? What is the best time you've spent together? Any favourites?”

“Yeah. Definitely. This summer, he came with us to the cottage. It was fun. I liked swimming with him. And fishing, too.”

“Anything else?”

I shrug. “I'm tired. Can we stop, please?”

“If you'd like. But I do have a few more questions for you. Do you think we could keep going? Just for a little bit?”

I look down at my hands. “I guess so.”

“Okay, Nate. That's good. We'll talk about a few more things, and then we'll stop. If you feel too tired, let me know and we'll wait for another day.”

I wait for her next question.

“Can you tell me about any of the kids in your class who might not be so nice to you?”

“No.”

“Why not?”

“Because I don't want to talk about them.”

“Okay. I understand that.”

Dr. Aldridge waits. She says nothing. I stare at her and cross my arms.

“Nate, I want you to know that if you ever want to talk to someone, I'm always here to listen. No matter what. And don't forget what I told you last time. Everything you tell me will stay just between the two of us. I won't tell anyone. Not even your mom and dad. Not unless you want me to.”

I think about this for a moment. I wonder if I really can trust her.

“Do you remember how you told me the last time we met that you sometimes don't eat your lunch? That you throw it out when your dad isn't looking?”

I nod my head. I feel scared. I'm going to get into trouble for doing that.

“Well, I didn't tell anyone about that. Not one person.”

“You didn't?”

“No, I didn't.” Dr. Aldridge looks me straight in the eyes when she says it. It makes me believe her.

We sit quietly.

It feels like a really long time.

If I tell her about Tyson, will she let me go to sleep sooner? Or play video games?

“His name is Tyson. But there are others too. They are mean to me like the kids at my last school”

“Tyson? Who is that?”

“The kid in my class who is always mean to me.”

“What does he do, Nate? Can you tell me about it?”

“I don't know. Stuff, I guess. He calls me names all the time. Like weirdo and cuckoo. And he tells me I'm ugly.”

“That isn't very nice. It must be very hurtful.”

“Yeah, I guess. And sometimes he steals my snacks, when he likes what I bring for my recess snack. Especially if it's Fruit Gushers. Those are his favourite. And a few times he punched me when I wouldn't give them to him.”

“He punched you? Where?”

“In the cheek. Or in the stomach. One time it really hurt. He did it so hard. I felt like I couldn't breathe, and I fell to the ground. Then he took my apple juice and Fruit Gushers and ran off.”

Tears fall down my cheeks and I am surprised. I didn't think I was going to cry. “But the worst part was that he didn't even eat it. Even though I know he loves Fruit Gushers. He threw them in the garbage and screamed at everyone in the playground to never eat a snack from a weirdo. That I probably do weird things to my food.”

“That must have been very hard. Did you tell anyone?”

“Yes.”

“Who did you tell?”

“Noah.”

“Anyone else?”

I shake my head. I never tell anyone things like that, except for Noah.

“Why not?”

“I don't want them to know, I guess.”

“Thank you for telling
me
, Nate. I know that must have been hard to do. And I'm here to help you, if you want me to. With Tyson or anything else that's going on in your life. You now that, right?”

“Yeah. I do.” I scratch my head. It feels itchy. “Dr. Aldridge?”

“Yes, Nate?”

“Are you going to tell anyone about Tyson stealing my snacks and punching me?”

“No, Nate. Not unless you want me to.”

“Okay, good. I don't want you to.” I look down at my arms. They look funny for some reason. And I'm starting to feel like I'm going to throw up.

“Dr. Aldridge? Can I ask you something?”

“Yes, Nate. Anything you'd like.”

“Can we stop now? I don't feel good.”

Dr. Aldridge snaps her book shut and puts her pen in her bag before smiling at me and giving me a hug. “Of course, Nate. We'll start again the next time we meet, okay?”

I nod and crawl into bed. I don't remember falling asleep.

49

Ashley

“I think Nate's ready to go home,” Dr. Aldridge said to Pete and me from across her desk.

“Really?” I asked cautiously. Nate had been in the hospital for just over two weeks and although I was desperate for him to return home to our family, I was also nervous to be without the constant support of the medical team at the hospital.

“I will still treat him, as an outpatient. And I should see him regularly. Twice a week to start, and then less frequently as Nate gets better. You should all continue to go to your support groups. But Nate's delusions have really started to diminish. He isn't showing signs of paranoia. And he's certainly not agitated like he was when he first came in. He's stable. I think he can handle it.”

“What about school?” I asked hesitantly, my protective instincts kicking into high gear. I knew Nate would need to return to school at some point, but I was dreading the moment he would go back to the bullying.

“I have a suggestion for you about school. It's fairly new, but there's a solution that I think will work well for Nate. A new type of school has recently opened not far from here, called the Henry Lewis School Hospital. Basically, it's a child and adolescent day program that also offers schooling. It's a really great transitional program for kids like Nate who no longer need to be a part of the inpatient unit but still require more intensive treatment and would have a tough time being integrated back into a regular classroom. Nate would spend the day involved in individual and group therapeutic activities. There are teachers on site, and he would attend school at the hospital, and then return home each afternoon.”

“Are there doctors on site as well?” Pete asked.

“Yes. Including me. There are three psychiatrists who work out of the day hospital. I could continue to work with Nate there.”

“It sounds too good to be true!” I replied with a sense of relief. “It really sounds wonderful.”

“It is. I strongly believe in this program. It focuses on combining things like individual therapy, family therapy, behavioural interventions, and medication management to facilitate keeping the child at home, in school, and in regular outpatient treatment. Nate's a perfect candidate.”

“When would he start?”

“I've looked into availability, and we can get Nate in the week after next, if you'd like. Starting on Monday.”

Pete and I both nodded eagerly.

“If Nate is to go home, there's one big thing we need to all be aware of,” Dr. Aldridge continued. “The Risperidone has started to work, and is doing a good job of shifting his brain from an unbalanced world of mania and psychosis to reality. As we talked about before, though, every patient is different and it could take weeks before Nate sees the world for what it truly is. Nate doesn't need to be in the hospital anymore, but he
is
straddling the fence between the delusions he's experienced and what's actually happening around him. He's on middle ground right now, and while the psychosis has really been minimized, Nate still believes some of the things that are not true.”

I nodded. I knew exactly what she was talking about. Beside me, Pete took my hand.

“We have no way of knowing when that will change,” Dr. Aldridge continued. “It would be better if I were with him when he starts to realize everything for what it is. Because when he does … when he realizes things aren't as he's thought, it will be a very tough adjustment period. And he will likely mourn them, like a real-life loss.”

“Is that why you asked us to bring in the pictures? To help get him to realize all of this?” Pete asked. Dr. Aldridge had sent us both an email the night before asking us to bring in family pictures from the past year.

Dr. Aldridge nodded, pursing her lips. “If you've got them, let's go to Nate's room. There's no time like the present to see if my idea helps …” Dr. Aldridge stood from her chair and we followed her into the elevator.

When we got to the room, Nate greeted us with a big smile. He was just finishing his session with Payton, the art therapist whom he had been working with for the past two weeks. He loved it, and Dr. Aldridge felt it was one of the treatments that was helping him the most. During her daily visits, Payton used various materials to get Nate to express his inner images, feelings, and needs.

“I was just leaving,” Payton said. “I'll see you tomorrow, okay Nate? You can finish your clay project when you have some more time today. Sound good?”

“Okay!” Nate responded.

Once Payton had left, Dr. Aldridge pulled up a chair. “Your parents brought in some of your photo albums from the past year for me to take a look at. I loved seeing them. You've grown so much taller over the past few months …”

“I know, right?” Nate grinned. He looked proud.

“Want to see?” Dr. Aldridge opened the first album to a section about halfway through. The pages revealed pictures of our street pool party from over a year before. All the kids were in the pool, and Nate was jumping off the diving board, hamming it up for the crowd.

“Look what a great jumper you are!” Dr. Aldridge said, pointing to another picture of Nate. I remembered him jumping off the diving board and doing an impersonation of a frog like it was yesterday. “And here you are with your hockey team that fall. Lots of pictures of you scoring goals … you must be a very good hockey player.”

“The best — right, Nate?” I said, smiling proudly. “He's the leading scorer on his team.”

“That's great,” said Dr. Aldridge. She slowly flipped through the photos.

“And here you are this past summer, Nate, riding your bike.” Dr. Aldridge grinned, pointing to the pictures of Nate racing up and down the street.

Nate nodded his head, examining the photos. Dr. Aldridge continued to flip the pages, until Nate took over. He stared intently at the pictures, as though he was seeing them for the first time.

“Ah. Your trip up north from this past summer!” Dr. Aldridge said, pointing to a picture of our family sitting in front of the cottage we had rented. “You look like you're all having so much fun.”

“Yeah. I guess.” Nate's voice was very quiet. When Dr. Aldridge didn't respond, the room fell still.

“Nate?” Dr. Aldridge asked quietly. Pete and I remained silent. We did not move an inch. “Is there something you're noticing in these pictures?”

Nate shrugged, looking very sad.

“Anything you want to talk about?” Dr. Aldridge asked in a voice barely above a whisper.

“It's Noah,” Nate said almost inaudibly. Tears formed in his eyes. “He's not in any of these photos.”

Dr. Aldridge waited for our son to continue.

“He's … he's not real, is he? My best friend Noah … he doesn't exist in real life. That's why he's not in the photos. Even though he was there with us. On my hockey team, at the cottage … he was there with me. I remember him standing beside me when we took the group picture in front of the cottage. But now … he's not in the photo.”

“That is right, Nate. He isn't in the photos,” Dr. Aldridge said quietly. She sat down on the side of Nate's bed, and looked my son straight in the eyes. Her voice was calm and clear. “I know Noah has been very real to you for a very long time. And this is likely difficult for you. But you need to know that your mom and dad and Grace …
they
are all very real. They
do
exist in real life. And they all love you very, very much.”

Hearing Dr. Aldridge's words, Nate started to cry openly. I was desperate to go to him, but didn't want to interrupt the doctor's progress. Instead, I watched from the sidelines, my heart breaking a little bit more with each tear that fell down Nate's cheeks. I took Pete's hand, and he squeezed it tight.

“But … if Noah isn't real, then how do I know that? How do I know Mommy and Daddy and Grace are real? What if I find out tomorrow that they aren't real either? And I'm all alone?”

I couldn't take it any longer. I rushed to his bed, and pulled my son into my arms. Tears were coursing down both of our cheeks. “Sweetie … oh honey. Mommy and Daddy, we're right here. Feel my face. Give me a hug. I'm so very real, and I will never leave you. I promise you. We all love you so much, and we will always, always be here for you.”

“Nate,” Dr. Aldridge said softly. “You knew that Noah wasn't real because he wasn't in the pictures. Is that right?”

Nate sniffed loudly and wiped his wet cheeks with his hand. “Yes.”

“But who was in the pictures with you? Who has always been in the pictures with you?” Dr. Aldridge asked.

“Mommy. And Daddy,” Nate responded. “And Grace too.”

“That's right. So you know that
they are real
. It isn't like Noah.”

“But … but I'll miss Noah. He was my best friend in the whole world.”

“I know, sweetie. And whenever we aren't with people we care about, it's very sad,” I said, squeezing my son more tightly.

“Do you know what the good thing is, Nate?” Dr. Aldridge asked, gently interrupting me. “You've told me exactly what you like about Noah. Right? You like that he's fun. And that he likes hockey. And that he keeps your secrets. Well, the next time you make a new friend, and I know you will, you can use all of those things to help you figure out exactly who you want to be your absolute best friend. Does that make sense to you?”

Nate nodded but didn't stop crying.

“Why don't I give you some time?” Dr. Aldridge asked Pete and me quietly. “I know one of you will need to get back to Grace at some point, but I'd suggest you stay as long as you can with Nate tonight. We can plan on discharging him in the morning, after he's had a good night's sleep and I talk to him one last time. Does that work?”

I nodded. I was so grateful that between her and the medication, she had finally been able to get through to Nate and convince him that Noah wasn't real. He'd been talking about his made-up best friend for months.

When Nate's obsession first started, Pete and I had thought Noah was just an imaginary friend. Grace had had two of them when she was slightly younger than Nate, and always insisted on bringing her two best friends, Chippia and Mippia, along for the ride. But Nate's fixation on Noah had lasted longer and was far more intense. And by the time the real psychosis kicked in, it was apparent what was actually going on.

With the doctor gone, I crawled into bed with my son and pulled him close. He had stopped crying, and was staring into nothingness. Any remaining sparkle that he'd had in his eyes over the past few months had completely vanished.

Lying there, Nate remained unresponsive. I pulled him tight, hoping for a squeeze, or even a shift in position. But I received nothing in return. Not even a twitch.

Nate's eyes were open but he lay still, barely breathing. It was as if his spirit had vanished along with Noah.

“Sweetie? Do you want to talk about it?” I whispered in my son's ear. Pete was sitting in the chair in the corner, quietly waiting. Watching. Wanting to help, but unsure of what to say. Unsure of what to do.

“It's okay, Bean. You can talk to me. I love you, and I'm here for you,” I whispered. I said a silent prayer, asking for God to return my son to me.

Nate said nothing, but I didn't get out of the bed. If he wouldn't talk to me — if he
couldn't
talk to me in that moment — well, then, I would wait with him until he could. I was not going to leave my son.

Someone knocked gently on the door. Dinner. Pete quietly ushered them out of the room, signalling that we'd come and get it when we were ready. The attendant quickly left, taking the food tray with him.

The room grew darker. I didn't know if Nate was awake or asleep, although I sensed his eyes were open. I squeezed him tight to let him know I was there. To let him know that I wouldn't leave him. I knew what it felt like to be abandoned by a parent, and I would not do that to my son, particularly when he'd just found out the person he was closest to did not really exist. I couldn't imagine the horror of learning that someone so important to you wasn't just gone but, worse, had never even existed in the first place.

None of us moved from our positions in the room. Under the covers, I took Nate's little hand, still soft like a baby's, and gently squeezed. But I got nothing in return. Just the lifeless, silky hand of my broken-hearted little boy.

Pete eventually left the room, quietly and without saying a word to us. He wanted to get home to Grace.

Somewhere in the middle of the night, a delicate, hushed voice entered the room. “Mommy?” Nate whispered. His breath was hot against my ear.

I hugged him tighter to let him know I was listening.

“How do I know what is real?” He asked the question so quietly I had to lean in to hear him. “How do I really know that you are real?”

Squeezed beside my son in the dark hospital room, my heart broke. A sane adult with a logical approach to life would have difficulty processing such a complicated, life-altering devastation. I couldn't even imagine what it would be like for the fragile mind of an innocent little boy.

In the darkness, I took Nate's hand and guided it to my tear-coursed cheek. I kissed his palm. “Sweetie, I am real. And I am here for you. Feel my cheeks. Hear my voice. Take hold of what you are feeling right now … just for a moment, sweetie, and try to feel with your heart. Don't think with your brain. And you will know, down deep in your soul that I am real. That I have
always
been here for you. I always will be. Nothing will ever change that, my dear, precious Nate. No matter what.”

I pressed my eyes shut and waited for his response. At first nothing came, and I wondered if I had gotten through to him.

But then, finally, Nate nestled in closer to me. He took my hand. Returned my squeeze.