Susannah looked at her watch. It was time for Todd's nighttime does of Dilantin. It was also time for him to have a dose of his neuroleptic and antidepressant. He was long overdue for a feeding and his vitamins. He was presenting calm. It was not essential that he get anything for anxiety right now.
Susannah sat down next to Todd and gently placed her hand on his shoulder. "Todd, it's time for you to take some of your medication now."
Todd jumped. As gentle as Susannah had been, she still startled him. She saw Todd squeeze his hands together. She knew he was holding onto Goodone's hand for dear life. Somehow, Todd did not associate Goodone with "one of those people running around in his head." Perhaps he didn't allow himself to think of Goodone that way because of his intense need for him.
"No drugs! You promised me! I'm not doing anything wrong. No drugs!"
"Todd, medication is not a punishment for bad behavior." Susannah had always hoped that the time would come when she would be able to have sessions with Todd about his medication. He had not been able or willing to participate in one, up till now. Susannah hoped that while this was not the time for a true session, covering all the medication issues, she could make some headway with Todd at this time. "We give you medication to help you feel better and to help you get healthier. One of the most important medications we give you helps you not to have seizures."
Todd didn't respond verbally. Susannah could see he was becoming more anxious. His hands were clasped together so tightly that his knuckles were white.
"Todd, do you remember my explaining to you that you have epilepsy?" Susannah took nothing for granted. Todd often buried, over and over again, what he couldn't face.
After a few seconds Todd nodded.
"We are giving you a medication called Dilantin. It helps keep your seizures under control. It is important that it be given around the same time every day. You are due for your next dose of it now. Will you take it willingly by mouth?"
"No drugs," Todd whispered.
"Can you tell me what about taking medication upsets you?" Todd seemed to be listening to Goodone. "Go ahead, Todd. Tell her. It's all right. I'm right here with you," Goodone encouraged.
"You want to control me with it. You give me drugs to take over my life. That's what's making me crazy."
"First, you are not crazy. Much of your illness has to do with the terrible abuse you suffered."
Todd started to tremble slightly. He hated to think of himself as having been abused. "I was disciplined. So what! I was bad all the time and my dad disciplined me." Then Todd remembered the memories of sexual abuse that had come to him. He was still struggling to make sense of them and could not discuss them right now. "I don't wanna talk about this anymore."
"Okay," Susannah took a different direction. "Some of your illnesses have to do with a chemical imbalance in your brain. The disorders the imbalances contribute to keep you from being in control the way you would like to be. They can take over your life and consume it. The medications help to normalize these imbalances and will help you gain control of yourself and your life. They do not place you in a position to allow someone to control you. Or take over your life."
"I don't like it when you hold me down or give me stuff to make me go to sleep. It's . . . it's . . . it's like you have all this power over me. Like you . . . y-y-ou can do whatever you want to me and I can't stop you. I hate that!"
Susannah was surprised that Todd was able to articulate his feelings to this extent. She guessed that Goodone was encouraging him. She was also very happy to see that Todd's thoughts were cohesive enough to express these feelings. She was very sure that both the antidepressant and the neuroleptic were starting to work for him.
"Honey, I know it can seem that way. The only time we need to control you, as you say, is when you are in danger of hurting yourself or someone else. It's our job to keep you safe and to keep everyone safe around you."
"You didn't keep Téa safe. You let me hurt her!" Tears formed in Todd's eyes. He hung his head. "I'd have let you given me enough drugs to kill me if it would've kept me from getting Delgado hurt."
"Todd, what happened to Téa was an accident. Accidents happen no matter how careful you are, but you are right. Téa did get hurt on our watch. For that I am sorry. We will learn to be even faster next time. You did nothing wrong. You asked Téa to let go of you. She didn't because she loves you and she didn't want to see you so upset." Susannah looked at her watch. "Todd, as I told you, it is our job to keep you safe and one of the ways we do that is to make sure you have medication to help to prevent seizures and it's time for you to take that medication."
Todd buried his head in his knees again.
Susannah did not want to restrain him and give him the medicine forcibly if she could help it. The time had come for Todd to start willingly taking his medication. If he only took it by force, he would never continue to take it as an outpatient, when that day came. In part, he would consider the medication as a test of wills. Learning about his medication and allaying his fears about it was the first step. While Todd's thought process was still altered, Susannah believed that right now he would be able grasp some information about his medications and the need for them.
"Todd. Honey, I want you to pick up your head and listen to me. Todd."
Todd lifted his head and turned in her direction.
"Thank you. Dilantin is not a sleep med. Its purpose is not to put you to sleep. Its purpose is to help control your seizure disorder. Zoloft, the antidepressant you're on, is also not a hypnotic. That means its purpose is not to put you to sleep either. Zoloft helps restore the normal balance of the chemical messengers in your brain so that your depression lifts and you don't feel so sad all the time. It also helps you to not get as many panic attacks. It helps you to think more clearly, like the way you are thinking now. One of the other medications you are on is called risperidone. It also helps you to think more clearly and may help with the noise you hear in your head. All of these medications have the potential to make you a little sleepy and groggy, but that side effect is usually transient. It doesn't last long. Once you've been on them for a while any sedating effect should diminish or go away completely."
Susannah saw Todd's eyes were starting to glaze over. She knew he could not digest any more information and most likely did not fully comprehend most of what she just told him, but it was a start. Slowly, if he were willing to listen, more and more information about his medications could be given to him.
"I'm not sad and I'm not depressed," Todd said adamantly, although his voice was strained.
Susannah saw denial was still a problem for him. She understood that names like DID, depression, schizophrenia, and other mental illnesses could be terrifying for patients to accept having. She knew that sometimes, when patients denied having a mental illness by name, they would admit to having symptoms of those illnesses. "Todd, do you feel sad most of the time?"
Todd nodded. Tears welled up in his eyes. "Yeah," he whispered.
"Is it difficult to keep yourself from crying?"
He nodded again.
"Do you think about dying a lot?"
Todd hugged himself even more tightly and responded with another nod.
"Do you think about killing yourself?"
Todd refused to answer that one. Susannah didn't push. She understood he was probably afraid to admit that, if it were true. His silence sent a warning signal to Susannah. For now she let it go.
"Do you feel confused a lot of the time?" Susannah went on.
"I hate feeling like that," Todd admitted.
"Do you remember having panic attacks?"
"When I can't breathe and my heart goes so fast and my fingers and face feel funny and my chest hurts?"
"Yes, those are panic attacks."
"They feel so horrible." Todd confirmed.
"Do you hear voices that you don't want to hear?"
"They make my head hurt. They're so loud. It's always been so loud and noisy in my head. I just want it to be quiet sometimes," Todd confessed in a whisper.
"Did you feel a lot of these things before you were brought to the hospital and before you were ever given any medication?" Susannah asked gently.
Todd thought about it for a minute. "Yeah," he admitted with a nod of his head. Tears slowly made their way down his cheeks.
"Then can you see that it's not the medication we are giving you that make you feel all those things?" Susannah pressed.
"I don't wanna be crazy," Todd cried. He buried his head in his knees and began to rock himself.
"You're not. Honey. You are not crazy. Some of the symptoms you have make you feel as if you are, but you are not. All the symptoms you mentioned are treatable. Epilepsy is treatable. Most of your symptoms can be treated with therapy and with medication. Both are important. The seizures can only be controlled with medication."
"If I don't take that stupid medicine I'm going to have a seizure?"
"There is a very good chance of that," Susannah confirmed.
'If I have a seizure they'll never let me see Delgado,' Todd thought to himself. Unfortunately, a part of him still thought of having seizures as "being bad." He was afraid if he were bad his punishment would be not being allowed to see Téa. He didn't understand that they were afraid to allow him to leave the unit under any circumstances. He thought if he could show them he was being good, they would relent.
"Okay, I'll take the medicine that will keep me from having a seizure, but I don't want none of that crazy people's medicine!" Todd announced firmly.
'One battle at a time,' Susannah said to herself. She and her staff exchanged glances. She knew they were thinking the same thing. "All right Todd. For now we will just bring you the Dilantin." Susannah was hoping she wasn't pressing her luck when she asked, "will you take a vitamin? It's a supplement. It's not medication for being crazy and will you drink another cup of juice? If you become too dehydrated, you can become sick and pass out."
Again, Todd wanted nothing to keep him from Téa. Todd sighed. "Okay," he grumbled. "Pushy broad," he muttered under his breath."
"Susannah and the staff exchanged wide grins. "I heard that, Todd. And most people who know me would agree with you." Susannah patted his knee. "Okay, Connie is going to bring you your medication and some juice. What kind would you like?"
"I don't care. I'm not thirsty. Anything!"
Susannah was hoping that Todd would show some interest in drink and then perhaps food. She figured she had been enough of a "pushy broad" for now. She didn't bring up Todd's anorexia. The alters had eaten well earlier in the day and if his feeding or actually eating something was postponed it would not be as critical to his health as not drinking enough or skipping his anticonvulsant would be. Susannah hoped he would fall asleep and allow for the feeding and the administration of his other meds to occur. Even though legally she could force medication because she had Viki's permission she knew that soon Todd needed to start learning how to make healthy choices for his own well-being. If things kept progressing, his thought processes would soon be in a place that would allow for medication sessions. Until now Todd was far too ill to comprehend any information on his meds. He was also far too ill to understand their importance and make decisions for himself.
Connie came back with some juice and a pill cup. "Todd, I have your Dilantin and vitamin pill. I brought you some orange juice. Would you like something to eat?"
Todd shook his head.
Connie shrugged. She figured it was worth a shot. "Hold out your hand, hon. I'm going to place the Dilantin in the palm of your hand and you can put it in your mouth."
Todd hesitated. Reluctantly, he held out his left hand. Connie placed the pill in it. Todd picked it up with his right hand. He hesitated again. He looked very anxious. "Are you sure this is only to make me not have seizures? What if you’re trying to trick me?"
They could see trust was still a huge issue for Todd. "Todd, I promise. It's the Dilantin," Susannah assured him.
"And it won't make me sleep or make me crazy?" Todd hated having to take their word for it. He was afraid they were trying to keep him from Téa. He was also uneasy knowing Kevin was around. Yet a part of him was happy there was someone who would tell him if he'd done something bad.
"No, it won't make you sleep or make you crazy. It will help control your seizures," Susannah promised.
Todd's hand was trembling as he brought it to his mouth. Susannah was very proud of him for taking this step in helping himself. She realized his fear of medication ran even deeper than she suspected. This made his choice to accept the meds an even braver act in her eyes and in the eyes of the staff. Todd put the pill in his mouth.
"Todd, here's your juice." Connie let the cup brush against his fingers. Todd took it and washed the pill down. "Okay, hon. Here's your vitamin. Hold open your hand again."
Todd's trembling increases as he placed the second pill in his mouth and washed it down with some more juice.
"You did a great job with those, Todd," Connie praised. "Now I need you to open your mouth so I can make sure you swallowed them."
"You think I'm lying to you!" Todd sounded angry. "I told you I'd take the damn pills and I did. I don't want to have a seizure!"
"I don't think you're lying to me. It's hospital rules. We have to make sure patients swallow any oral medication we give them."
Since Todd had never willingly taken any medication before, this rule came an annoying surprise to him.
"Okay!" Todd opened his mouth wide. "AAAH AAAHHH! There! Are you happy!" Todd snapped after exaggerating the sounds a patient would make when a doctor uses a tongue depressor.
Connie, hated to, but she said, "You have to lift your tongue so I can see under it."
"Jesus!" Todd exclaimed and lifted his tongue. "There! Now are you happy!"
"Yes, thank you, Todd. You did a great job," Connie commended him.
Todd folded his arms around each other and sat there steaming with anger for a few minutes. The staff exchanged looks, but said nothing to him.
After a while Todd asked them again what time it was. "It's been hours since Delgado got hurt. I want to go to her."
"Todd, I explained to you why that's not possible," Susannah gently reminded him.
"I've been good! I did everything you said. I even took the damn medicine! Kevin's been gone for so long! I wanna go see Delgado!"
They all knew Todd was functioning on pure adrenaline. It was late. He hadn’t slept or even lay down in hours. His body was not used to this. He was also beginning to shiver a little. He needed the warmth of some blankets. Susannah knew if they forcibly sedated him now the tiny bit of trust and progress they just made with him would be lost. They hoped his exhausted body would soon fall asleep on it's own.
"Hey buddy, would you like to listen to some music or hear the television?" Don asked.
"No!" Todd answered impatiently.
"Is there anything you'd like to do to help pass the time?" Susannah inquired.
"Yeah, I want to go to Delgado!" Todd answered bitterly.
"I'll make a deal with you," Susannah offered. "I'll call the ICU again and see how Téa's doing if you promise to lie down for a while . . ."
"I told you I'm not going to sleep! Are you deaf?"
"You don't have to go to sleep. I just want you off your feet and lying down. You can stay awake if you want to."
"I want to stay right here. This is where Delgado fell. I'm not leaving here till I know she's okay."
"You can lie down right here on the couch," Susannah pointed out.
"I wanna hear you talk to Téa's doctors," Todd insisted. He didn't trust them not to lie to him.
"I'll call from in here. You'll be able to hear all of my end of the conversation," Susannah gave in.
Todd thought about it for a few seconds. "Okay, but I'm not going to sleep!" He repeated firmly.
"No, you're just going to rest." Susannah went along with him.
"Todd, you look cold. Can I get you a blanket or two?" Marcia observed and asked.
"Yeah, okay. You never give enough heat in this overpriced loony bin," Todd complained.
Glances and smiles were exchanged as Marcia went to get Todd some blankets and a couple of pillows. It was obvious the staff adored Todd. They found him to be a bright, caring and a sometimes funny young man. They all desperately wanted to see him well enough to have a good life. Everyone hoped once Todd was comfortable he would not be able to fight sleep. They also hoped the news about Téa would be good. Not only for Todd's sake, but because they had all come to like and care about Téa.
"So, what are you waiting for? You said you were gonna call about Téa," Todd impatiently reminded Susannah.
"I'm going to the phone right now," Susannah let him know.
Todd heard Susannah ask for Doctor Marahbee. "She is! Fantastic!" Todd heard Susannah exclaim. Susannah was careful not to use any medical jargon that Todd would not understand. "Does she seem to be regaining consciousness? . . . Great! So you don't think she'll need surgery? . . . When do you plan on weaning her off the vent . . . off the breathing machine?" Susannah phrased it that way for Todd's benefit. "Are Viki, Sam and Kevin still with her? . . . Good. Her husband has been extremely worried about her . . . I will. Thank you. Please let me know immediately if any problems occur." Susannah hung up the phone.
Todd had been holding his arms tightly wrapped around himself and rocking back and forth in an attempt to hold himself together and self-sooth all during Susannah's phone call.
Susannah approached Todd. "Téa is doing better. The blood clot seems to be going away on its own and they don't think she'll need surgery. Her heart rate and blood pressure are getting better and so is her breathing."
"Is she awake?" Todd asked nervously.
"Not yet, but what they call her level of consciousness has increased. She is getting closer to waking up."
"How come Kevin didn't come back to tell me?" Todd asked suspiciously.
"They are running some tests on her and he is waiting for the results. Viki and Carlotta are with her."
"What about Sam?" Todd wanted to know.
"The doctor didn't mention Sam. Maybe he left to get coffee or something," Susannah guessed.
"Is this doctor a good doctor? I got lots of money. I want Delgado to have the best doctor in the world. You can get my jet and fly someone in from anywhere."
Susannah smiled. "Thank you Todd. I know you want the best for Téa. I promise you that Doctor Marahbee is a very good doctor. Téa is in good hands."
Marcia had been back for a few minutes. She waited until Todd got his information from Susannah. "Todd, here you go, honey. I have a couple of nice warm blankets for you. I also have a couple of pillows to help you get comfortable."
Marcia placed the pillows against the armrest of the couch. So Todd would not be lying flat. "Would you like some help lying down?" she asked.
"They know to call here if she gets worse, right?" Todd was still uneasy about resting.
"Yes, the phone in here will ring," Susannah promised.
"And Kevin knows to come to this room if he has any news about Delgado?"
"Yes, he knows. He came directly here before. Do you remember that?" Susannah asked.
"Yeah," Todd answered softly. "Delgado's really gonna be okay?" Todd asked in a childlike tone.
"The doctor thinks she'll be fine," Susannah responded.
Todd felt for the pillows and slowly rested his head against them. He sighed deeply. As they had hoped, Todd's exhausted and still frail body fell asleep within ten minutes.
If any of them needed to speak, they whispered or stepped out of the room. The ringer on the phone was turned down to very low. Kevin showed up about thirty minutes after Todd had fallen asleep. Dave was posted outside the room waiting for him. He filled him in on what had transpired since he left. Kevin was so relieved to hear it and to hear that Todd had gone down. "Wow! He took his medication willingly?" Kevin was shocked to hear that.
"Only the anticonvulsant and the vitamin. But hey, that's still amazing progress," Dave confirmed.
"Mom and Sam will be very happy and relieved to hear that too. At least I think Sam will be. He went for coffee hours ago and didn't come back. Mom sent me to look for him. I found him in the family lounge. He was just staring out the window. I'm really worried about him and even more worried about my mom and Todd now that Sam has legal rights to Todd," Kevin admitted.
"I know how hard this has been on all of you," Dave confirmed.
Kevin nodded. "I'd better get back and give mom the good news. She's been feeling so torn about being away from Todd for so long, but she knows he doesn't want her to leave Téa's side."
*****
"Téa! Téa open your eyes!" Doctor Marahbee tried again.
"Téa. Come on wake up. I came all the way from New York to see you open those eyes." Del stroked Téa's head. "Mi hermosa hermana. You need to come back to us now."
"Téa. Es su abuela. Es hora ahora de despertar. Despierte para su abuela. Wake up for me, Téa . . . Mi preciosa niña." Téa's grandmother stoked her head lovingly.
Téa's brother and grandmother had arrived shortly after Téa had begun showing signs of progress. The doctors had them try to get her to wake up. Téa was still sedated, but it had been lightened. Every hour she was brought out of it and while her reaction to pain and noxious stimuli had increased, she was still not responding to verbal commands or opening her eyes. Téa's pupils were now equal and reactive. Her reflexes were still normal. They were reasonably sure the subdural hematoma was resolving on its own. They were turning the settings down on the ventilator to wean Téa off of it. She was doing well. They were concerned because she wasn't waking up.
Since they were there now, Del and Téa's grandmother both insisted Bo drive Carlotta home so she could get some sleep. Kevin insisted Viki go to the lounge. He told her Sam was already there. Viki was surprised he hadn't come back to see how Téa was or that he hadn't at least gone to see how Todd was. She wanted to go to Todd. Kevin told her they had finally gotten Todd to sleep and she might wake him. Viki was dead on her feet and finally gave in and headed for the lounge. Sam was lying in one of the beds when he heard her come in. He pretended to be asleep. It was only after he was sure Viki was asleep that he quietly got up and continued to stare out the window.
Todd did not awaken when they gave him a feeding and administered the Zoloft and the risperidone. He continued to sleep through the night. Susannah went to her office to get some sleep. Several staff members stayed in the dayroom with Todd.
Del and Téa's grandmother kept watch over her through most of the night. Del, who worked a night shift, had no trouble staying awake. Téa's grandmother, after refusing to go lie down, would nod on and off in a chair outside the ICU. Then every thirty minutes she would go in and talk to her much loved granddaughter.
Finally, near dawn, Sam lay down and fell asleep. Shortly after that Viki woke up. She assumed he had slept through the night. She looked at him closely. Like Todd, even in sleep Sam wore a pained expression. Viki quickly showered and changed and headed to the dayroom. Carl, who was posted outside the door, told her Todd was still sleeping soundly. After all that had happened his body was exhausted. He let Viki know that Todd had received another feeding at four thirty in the morning and had slept through that one too. He told her they hoped Todd's worn out body would sleep right through his eight o'clock feeding and medications. Viki headed for the ICU. She knew Kevin was keeping watch and he would have alerted her if Téa or Todd had taken a turn for the worse.
Viki saw Kevin sitting outside the ICU drinking a cup of coffee. She headed for him. "Sweetheart, have you gotten any sleep?" Viki asked her eldest son.
"I got some right here in this chair. I'm fine mom. How are you and Sam holding up?"
"I'm okay. The rest did me good. Sam was asleep when I got to the lounge and he's still sleeping. I didn't want to disturb him."
"I think Sam needs all the rest he can get," Kevin stated a little sharply. Kevin saw Viki's worried eyes. "Mom, I'm sorry. All I meant was Sam is taking everything very hard. I think he needs some down time."
Viki changed the subject. "Are Del and Téa's grandmother still here?"
"Yes. They're in with her now. Mom, she's really starting to wake up," Kevin smiled happily. "I was in with her for a while. I was telling her about Todd and how's he's holding it together for her. Every time I mentioned his name her eyelids fluttered a little. She can't make any sounds because of the breathing tube in her throat, but I think she was trying to say something. They still have her prettily heavily sedated because of the ventilator. I told the nurse to talk about Todd to her when they let the sedation lift to run the neuro checks on her. The nurse said Téa moves around a little and acts like she's trying to open her eyes."
"Oh honey! That is such good news. I can hardly wait to tell Todd. Actually you'd better tell him. He may not believe it from anyone but you."
"I still can't believe Todd is needing me for something," Kevin laughed. "Even if that something is my past hatred of him."
Viki hugged Kevin. They saw Doctor Marahbee approaching them.
"Okay, Téa is breathing well on her own. We are going to allow her to come out of sedation and then extubate her. I believe once the sedation lifts completely, she will be awake. She opened her eyes on command for a couple of seconds on her last neuro exam."
"Was she frightened or in pain?" Viki asked anxiously.
"No, she really wasn't aware of much. She didn't look around. She'll be going down for another CT scan once she's extubated. I'm reasonably sure it will show the subdural is much smaller. Relax. She's doing great! I'm going to catch a short nap while I have the chance. I'll see you both in a little while." Doctor Marahbee turned to leave and then turned back and faced Kevin. "I almost forgot. Telling us to talk about Téa's husband to her was a great suggestion. All we have to do is mention him and we get a great response from her. She's really fighting to get back to him."
"He's fighting to get to her too. He begged them to let him visit her," Kevin informed the doctor.
"It would be great if he could, but I'm sure Doctor Hanen knows what's best for her patient. Anyway, if all continues to go well Téa should be out of here in a couple of days." This time Doctor Marahbee headed for his nap.
*****
It was seven fifteen in the morning. Kevin had gone to get everyone something to eat, some coffee and juice. Del had placed a chair in front of the one Téa's grandmother sat in so she could elevate her legs for a while. He sat with her.
Viki sat next to Téa's bed holding her hand. They had stopped the sedation at six. "Téa, do you know I had a daughter? Her name was Megan. She would have been a little older than you are now. I missed out on getting to do so many mother daughter things with her. With Jessie living her own life out in Arizona, I'm really missing having a daughter. Honey. I love you, not just as Todd's wife. I love you for you. I know I can never take your mother's place . . . Do you think maybe sometimes we can do some mother and daughter things together, maybe go shopping for clothes . . . get makeovers at a department store? Honey, do you know the one thing I would love to do with you more than anything? I would love to look at wedding dresses with you. Maybe someday when Todd is well you and he can get married again. This time you can have a huge wedding with your grandmother and brothers there. Carlotta, Christian, Eli, Antonio and Andy can come. Tina, C.J. and Sara can come up from Baltimore. Starr can be a flower girl. Rachel can be your maid of honor. Maybe we can even get Bo and Susannah to gag and hog tie Nora and she can come."
Despite the breathing tube, Viki noticed what looked like a small smile on Téa's lips. "Téa. Todd loves you so much. He even willingly took medication so he wouldn't have a seizure and not be there for you. He wants to be here with you. He's holding on and staying Todd like a drowning man holding on to a life preserver. He wants to be there if you need him. Sweetie, there isn't much he can do for you right now, other than love you. He does you know. He loves you so much. He wants to be able to help you when you need help too and he hates that right now he can't. It's not because he doesn't want to. You have to stay strong for him. Téa, he needs you so desperately. You have to wake up all the way. You have to do it for Todd."
Téa's eyes opened. She had been hearing Viki in a dreamlike way. The meaning behind Viki's words, more than the words themselves, had gotten through to Téa. Viki called the nurse over. Téa's doctor was called. Téa eyes were unfocused. 'Why does everything look so strange? What's going on?' Téa wondered anxiously.
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