Todd's mental condition had remained unchanged throughout the entire next day. After nearly three days Susannah knew this was it. His blood pressure was starting to drop and his heart rate was increasing, beyond normal. Neither was at a dangerous level, but his physical health was starting to become compromised. Viki was going to have to decide, now, if she would allow Susannah to start the Zyprexa. Susannah hated to force the issue and knew the torment she was putting Viki through. Susannah had promised Sam and Blair and Tea and most of all Viki that she would not give Todd the neuroleptic unless she had no choice. Unfortunately that time had come. Viki had to make the decision and make it now. Susannah asked Sam and Viki to come to her office with her. She saw the fear in their eyes, as they left Todd's room.

*****

Sam and Viki sat in the club chairs in front of Susannah's desk. Viki nervously rubbed the fingers of her left hand with the fingers of her right. Sam just gripped the arms of the chair. "I know you are both very upset right now. I hate to add to that," Susannah sighed. "I would really like to start Todd on the Zyprexa if we are going to do it. His pressure is lower than I would like and his heart rate is accelerating."

"Is he in danger?" Viki asked. She was terrified.

"No, but I don't like the way this is going. If his condition doesn't improve I'm going to have him transferred to the CCU."

Sam and Viki exchanged frightened looks. "Can this medication worsen his condition?" Sam inquired nervously.

"Paradoxically, there is a potential for this medication to cause hypotension and tachycardia. So, Todd will have to be monitored very closely. Right now his pressure is low and his heart rate up because of all his body is going through. I don't believe the Zyprexa will cause that to happen."

Viki and Sam looked at each other again. "Susannah, are you sure this medication is not as likely as some others to cause all those side effects?" Sam asked.

"It is usually better tolerated than the others, especially when it comes to the extrapyramidal symptoms," Susannah told them again.

"But Todd has had so many bad reactions to most of the antidepressants he's been on and some of the antianxiety medication. He even had problems with one of the vitamin supplements. The one that made him so sick to his stomach," Viki stated. She looked pleadingly at Susannah.

"Yes, I know. Todd is extremely sensitive to meds. That is a problem. Over the past few months I have tried so many different meds with him. That is why I sometimes even have to try some older meds, ones I usually don't prescribe anymore. Sometimes what may have caused problems for other patients can get a good result with one particular patient. Eventually we have to hit on the right combination. I don't like to take away of give more than one med at a time, because we need to know which one is causing the problem. Now again, this one has a low incidence or causing allergic reaction and stomach upset. In fact it has an antiemetic effect."

"In English please, Susannah," Sam remarked with a weak smile.

"It helps to prevent and relieve nausea and vomiting. So it actually can help his stomach feel better."

"And you said that the tremors and the spasms and the worst one the tardive dyskinesia and that, oh the malignant something . . ." Viki tried to remember the name.

"Neuroleptic malignant syndrome and that is rare, especially with this drug. I have to let both you know the worst scenario so you can make an informed decision, but you have to understand that the likelihood of these things happening is rare. The most common side effects, the ones that Todd is most likely to experience are sleepiness, dizziness, headache, possibly some fever, weight gain and an increased appetite, dry mouth, and constipation. The sleepiness and dizziness are usually transient and will ease up in time. We would have to watch for a rise in his SGPT and SGOT. Both are enzymes and an increase can indicate liver damage. I would monitor his renal function, but you know, we are already keeping a close eye on that and have been for months. Todd is on so much medication that he already has to be monitored very closely. I have spoken with a colleague of mine who works at Bellevue in New York City. He did say there have been some cases of elevated blood sugar. This is a new finding and is not yet in the literature for Zyprexa. As he has been all along, Todd is being monitored for that. All of the most common side effects are not serious and can be easily controlled. The main thing you may notice is that he will want to sleep a lot when the medication is started. Or it could have the opposite effect and cause insomnia and excitability. That is unpredictable. He may become restless, feel like pacing, and become anxious. He will still continue to receive the Paxil for depression and an antianxiety agent as needed, and his sleep med, although that may not be necessary during the initial phase of the Zyprexa. The Zyprexa alone may do the trick."

Susannah was hoping she was reassuring them. She knew that in her heart she wished she didn't have to try this drug with Todd.

"You don't think there is a chance that he will just pull out of this on his own?" Susannah could hear the desperation in Sam's voice.

"I think eventually this episode will pass. Unfortunately, I also think it will be followed by more of them. Even if Todd himself didn't experience anymore psychotic episodes, there are the alters who show schizoid symptomatology. Also, the Zyprexa may slow down the switching. I didn't want to risk it for that alone, but now I really don't see that there is much of a choice."

"When would you want to start it?" Viki asked.

"Tonight, I would prefer to give it to him at night because of the potential of making him sleepy. It has a long half-life. It only has to be given once a day. It will be crushed and put in his feeding tube. You do realize that it may take anywhere from a couple to several weeks before the full benefits are achieved. Unfortunately some of the more common and some of the more serious side effects, if there are any, can show up after the first dose of two."

"Susannah, there is something else I wanted to talk to you about," Viki began. "Terry said that Todd lost another pound. I don't understand. He is being fed so many times during the day with a high calorie supplement. Why isn't he gaining weight or at least not losing it?"

"Todd's body uses the calories as fast as we can get them into him. I am hoping that the appetite increasing side effect of this drug, if you choose to allow it, will help with that."

Viki was still undecided. She was terrified of doing something that could hurt Todd for the rest of his life. "Can we just have a little more time to think it over?" she asked Susannah.

"Yes, of course, but please, I would really like to start it as soon as possible if we are going to do it." Susannah's phone rang. It was Terry. Todd was coming out of the sedation sooner than expected and he was already screaming.

As soon as they walked out of Susannah's office they could hear Todd's screams echoing down the hallway. As they got closer to his room they became almost unbearable. He was, as before, screaming for the real Viki, Sam and Susannah. He was convinced his extremities did not belong to him. He was terrified that Starr was in danger and that his dog was lost and the he was lost in the woods and being rejected by Viki. He was fighting the restraints and short of breath. His blood pressure remained the same, but his heart rate had increased even further.

Viki could not bear it anymore. She could not just stand by and watch him suffer this way. She looked at Sam. "We have to do it. He can't go on like this." Sam didn't say anything. He looked at Viki and nodded. He hugged her and held her close.

"Susannah, bring me the papers. You can start him on the Zyprexa." Susannah patted Viki's shoulder and headed for the nurses station.

"Has Viki made up her mind yet?" Terry asked.

"Yeah, I'm starting him on 5 mg of Zyprexa tonight. I want it crushed and put in the NG tube and then do the 9pm feeding. I want the restraints left in place. Continue the Paxil as his antidepressant and with the lorazepam for anxiety. The Zyprexa and the other meds might be enough put him out for the night so hold off on the sleep med. I want his vitals checked every fifteen minutes, until further notice."

"Susannah," Terry asked, "do you think our boy is going to pull out of this?"

"Yes, I won't allow him not to," Susannah replied. She smiled at Terry as she patted her on the arm.

Viki and Sam watched nervously as Connie flushed Todd's feeding tube and then crushed his first dose of Zyprexa and mixed it with water and administered it. Todd was in a restless sleep despite being heavily sedated. The oxygen had been discontinued. The cardiac monitor was still in place. Susannah saw that Sam and Viki were looking at Todd as if he were going to explode the minute the medication went into him. She knew they were both terrified by the decision they had made.

"He's doing fine," Susannah assured them as she walked in-between Sam and Viki. She placed an arm around each of their shoulders. "I really hate this," Sam commented, "all those different medications working on different parts of his brain. I mean his brain for God's sake! That's what makes Todd, Todd. Sometimes I feel like we are trying to change who he is. Who the real Todd is? Sometimes I wonder if I even know the real Todd? If anyone does?"

"Sam, they are all Todd. Even Pete and Saber, but yes, you do know Todd. You know him and love him," Viki said, as she stroked her brother's hair.

"Sam we are not trying to change who Todd is. The medications are trying to normalize his brain not change it. Todd is severely depressed and that is not normal. He is highly agitated and anxious, that is not normal. He is psychotic and that is not normal. With the medications, we are trying to correct the abnormalities, not create them." Susannah really wanted Sam and Viki to understand. She knew how hard it was to see your child so heavily drugged and seemingly not getting any relief. She prayed that Todd would respond to the Zyprexa.

"Aladdin has a magic genie. I wish I had a magic genie." Sam was startled to hear Peep whispering. As the sedation lightened Todd had once again become restless. Restraints were put in place until he could be assessed. Peep quickly realized he couldn't raise his arms or legs. "The bad master tied me down. He tied me down," Peep cried.

Susannah was called to Todd's room. Sam asked Dave to please send someone to the lounge to get Viki. Connie checked Peep's vitals. "The giant's bad and the master's bad . . . send them away because I can't find the magic beans . . . I don't want the sheep to come . . . they bite and it hurts . . . because it's dark and they have too much wool . . . and I can't have a magic lamp . . . and Jack went up the beanstalk and I can't find him." Although he was crying, Sam noticed Peep's words were coming out slowly. His speech seemed sluggish.

Susannah came into the room with Viki not far behind. "Hello Peep. How do you feel?" Susannah asked, remembering to whisper.

"There's too much wool . . . I can't find the beanstalk . . . the master tied me down."

"No, Peep. You are in what's called restraints. That means that we don't want you to hurt yourself so we are helping you to stay safe. His crying slowed down. "Can you tell me if anything feels funny or different?"

"My head hurts cause the sheep bite it. The giant is bad. He's mean to Jack."

"Does your head hurt a lot?"

"A whole bunch. The sheep bite it."

Susannah didn't know if it was part of his hallucination or if he was already experiencing side effects from the Zyprexa. "Peep are you seeing sheep right now?" He nodded. Susannah could see his eyes were getting heavy. "Peep, are you feeling sleepy?"

"Uh huh, but I have to wait for the master to untie me cause then I can go find Jack."

Susannah thought for a moment. He seemed calm. "If I untie your wrists and ankles do you promise to stay safe and close your eyes and let yourself sleep?"

"Will you let the master tie me up again while I'm sleeping?"

"No, honey. I promise. We will not let the master near you. We'll watch over you and keep you safe while you're sleeping."

"That's good cause he's mean . . . and the giant is mean . . . and they hurt Jack cause he gave me the magic beans . . . the sheep ate them . . . see, they're eating the magic beans cause you won't let them bite me cause my head hurts . . . It's too dark to see the sheep . . . Mary had a lamb not sheep." His words were slurring as he fought sleep.

Susannah Connie and Dave released Peep's wrists and ankles from the restraints. Peep stayed calm and didn't try to get out of bed. He looked up at Sam and asked, "Will you keep the master from hurting the lady? Cause she untied me and he'll get mad"

"Sure I will Peep. Don't worry. I won't let the master anywhere near here."

"The giant too?"

"The giant too," Sam assured him in a whisper.

"It's okay to let the genie in cause he's good and he has to find his lamp. Okay?"

"Okay," Sam whispered.

"Why don't you close your eyes and try to rest for a while. It's bedtime," Susannah coaxed.

"My head hurts a lot," he murmured and fell asleep.

"Do you think his headache is a side effect of the medication?" Viki asked as soon as Peep went down.

"Possibly. It's difficult to tell at this point because he is on so much other medication and because he may have been feeling the sheep biting him. I don't know if Peep is prone to headaches. We'll give him some Tylenol just in case. Connie went to get it."

"He seemed a lot calmer do you think the Zyprexa could have kicked in already?" Sam inquired.

"No, one dose wouldn't alleviate the psychotic symptoms. It would make him sleepy and that may have kept him calmer."

"His speech seemed different, slower," Sam added.

"Yes, I noticed that too," Viki confirmed.

"That is probably the medication. It's usually a transient side effect. It kind of makes everything slow down and seem in slow motion. Some of the alters or Todd may be bothered by that feeling, at first." Susannah didn't add that this usually doesn't happen with just one dose. She was afraid, like with most other meds, Todd was extremely sensitive to this one.

"Perhaps he came out of the episode for good and no longer needs the new medication," Viki grasped at straws.

"Viki. I'm sorry. That is not likely. I do think the episode may have passed for now. I don't think anything has changed. Todd and the alters have come out of them before. I don't mean to sound discouraging, but you really have to give the medication a chance." Why don't you two go back to the lounge? I will stay here for a while and then stay in my office overnight, since it is the first time Todd has been exposed to the medication. Don't worry. I'll be here. The staff knows to call me immediately if there is even the slightest change."

Viki and Sam both nodded and kissed Peep goodnight. They headed for the lounge. Susannah stayed with Todd for two more hours. He was sleeping peacefully. She headed for her office and got some sleep. As Sam and Viki did, Susannah made several trips to Todd's room to check on him. "Todd may not have had any luck with the people who raised him, but he sure has people in his life who love him now," Connie commented to Marcia as she watched them come and go throughout the night.

Blair was nervous as she sat in the outer office waiting to see Matthew Allen. Blair had gotten his name from a lawyer referral group. He specialized in custody cases. "Mrs. Manning?" Blair looked up and saw a man in his fifties. He had curly, salt and pepper hair and lively blue eyes that made him seem younger than his age. He had a warm friendly smile. Blair liked that he personally came out into the waiting room instead of having the secretary show her in. Blair had decided to start calling herself Mrs. Manning again. She thought it appropriate under the circumstances.

"Now, let me get this straight," Matthew began, "you are seeking legal custody of your ex-husband? I have to tell you that my cases usually involve minors. I have never tired to get anyone custody of a mentally incapacitated adult before."

It upset Blair to hear Todd referred to that way. Matthew was sensitive to that. "Mrs. Manning, I know it is hard to see our loved ones sick. You do understand that we will have to show that your ex-husband cannot look after his own best interest and that those who are doing it for him are not doing right by him? I have to say going in to this that the fact that you and Mr. Manning are divorced will make this an almost impossible case to win."

"Almost? Then you think I have some kind of chance?" Blair asked, hopefully.

"Mrs. Manning, nothing is impossible. I have to be honest with you. Your chances are not good. Now why don't you fill me in on why Mr. Manning is your ex-husband and not your husband?"

Matthew was left a little stunned as Blair related the saga of Todd's supposed death in Ireland. She was upfront and honest about Todd seeing her with Patrick and about all the lost chances they had before they called it quits for good. She told him about Todd's marriage to Tea, emphasizing that it started with Tea being bought to help Todd win custody of Starr. She did, begrudgingly, admit that Todd cared for and might have even grown to love Tea before he got sick. She told him about the custody battle for Starr and that, legally, Todd had custody of their child. She told him what lead to Todd's breakdown. Of course, Blair did not have the whole story concerning Michelle. She explained that Todd's older sister was appointed his legal guardian and that she did not agree that she was getting the best care for him and that was why she wanted custody. She told him how she took care of her mother and "rescued" her from an institution.

Matthew listened and took notes. When Blair mentioned that Todd's sister was Victoria Carpenter, Matthew looked up. He was clearly surprised. "The publisher of the Banner?"

"Yes, does that make a difference? My husband is the founder and publisher of the Sun."

"I'm sorry. I didn't make the connection when I heard the your husband's name."

"I know Viki is a wonderful woman and I am not saying she doesn't want what's best for Todd. I am saying that what she thinks is best, isn't." Blair went on to tell him how long Todd had been in the hospital and how much worse he was now then when he was first admitted. She described Todd to him and told him about the pneumonia and the two cardiac arrests.

"So, you want Mr. Manning transferred to another hospital?" Matthew asked.

"No! I want him home."