October 29 to November 3, 2011
Gabriela talked to me that weekend about wanting everything to be fixed and just wanting to get back to normal.
We both knew that UCLA had great neurology and psychiatry departments. She asked my opinion about her self-admitting into the psych ward there. I agreed that it would be a great place and that they should be able to figure it all out with her.
We packed a small overnight bag and headed toward the UCLA hospital.
It is a beautiful hospital, well taken care of and upscale. Gabriela and I waited patiently in the ER for the head of their psych clinic to talk with her.
When the doctor arrived she talked with Gabriela about what was going on. She was very compassionate and attentive, but at the end of the day she didn’t feel there was a substantial enough reason for Gabriela to be admitted into their acute psych ward.
What was most amazing was that my daughter shared with her that she wanted to kill herself, but that wasn’t enough. Apparently you need more than just the desire to kill yourself; they would like you to have a solid plan. And they will decide if it’s a solid plan or not.
As a result of this rejected attempt for help, Gabriela and I had a very serious conversation about the “what if’s.” What if the situation that had led to her first hold started to happen again?
We decided we would be ready, or as ready as anyone could be. We made a short list of “to do’s” and triggering events:
Complete a Durable Power of Attorney, both health care and assets.
I was to take her to the hospital if she was: ruminating like she had prior to the Holy water, hallucinating, hearing voices or isolated.
The hospital she wanted to go to was UCLA but because of the rejection she had just experienced she picked Huntington Hospital.
That was it.
Gabriela’s ruminating had started to become more frequent. It wasn’t nearly as bad as it had been prior to Henry Mayo, but it was definitely coming back.
We were just a few days away from her follow up appointment with Dr. Wreck. Gabriela was scheduled for Thursday November 3 at 8:30 AM, we were most likely the first appointment that morning.
While we waited in the exam room for Dr. Wreck, Gabriela was clearly fading in and out of our world.
A quick single knock to the exam room door and it swung open without so much as a glance or greeting. Dr. Wreck seated herself at the computer in front of Gabriela and me.
Her opening line was, “It has become apparent that you would be happier with another neurologist … would you like me to recommend someone?”
Inside my head I screamed, “Are you fucking kidding me?! I wouldn’t want your recommendation! I fucking hate you! The only reason we are here today is because we couldn’t find anyone else willing to take this case on!”
But what I said was, “No, you are very familiar with my daughter’s case.”
Gabriela asked Dr. Wreck to now acknowledge that the medications she was on needed to be adjusted. The doctor’s response slapped both of us, as Dr. Wreck sat cross-legged, leaning forward to make sure we were listening as she clearly enunciated every word. “I will not change your medications in the least.”
Gabriela responded, “At some point Dr. Wreck, you are going to have to listen to me, I am the patient.”
Dr. Wreck responded speaking slowly and deliberately “No … I … do not. There isn’t anything you will ever be able to say to me that will make me change my mind.”
That was it, Gabriela was gone, staring up, head tilted.
I was on my own.
I had copies of the studies on Zonisamide for Dr. Wreck. I handed them to her, and she waved them off.
I kept my hand extended. “Please pretend that you give a shit and take these.”
Without even so much as a glance she folded them and put them on the chart. She was done with this appointment.
I looked at her and said, “So if you are unwilling to change the medications as you have been directed, what are you willing to do to help my daughter?”
She shrugged her shoulders.
I glared at her, my eyes were full of tears. “Look at her, how you can sit there and do nothing?”
With an exasperated sigh, she said, “Well, I guess we can try Diamox.”
I hated this doctor like I had never hated any other. I knew in my heart that everything that had happened and was happening to Gabriela was completely her fault, not because she could have predicted that the Zonisamite would have had such a bad effect on Gabriela; but because, despite the fact that we continued to bring it to her attention at every appointment for nearly a year, her only response was irritation with a “noncompliant” patient and parent. Apparently, her perfect patient is one that doesn’t take much thought on her part, and follows the doctor’s directions sheepishly. Gabriela fits neither of those descriptions.
What makes Dr. Wreck even more horrific in my view is that at this appointment an outside doctor had advised her that IT’S THE MEDICATION STUPID! and I’d brought three medical studies that support IT’S THE MEDICATION STUPID! Despite all that, Dr. Wreck still refused to adjust the medications. Why? I’m convinced that, despite the fact that Dr. Wreck now absolutely knew the Zonisamide needed to be changed, she didn’t change it because in her selfish mind it could have made her somehow, in some way professionally liable for what happened to Gabriela. The fact that her professional standing was more important than her patient, my daughter, a beautiful young woman, and another human being, wasn’t just shocking; it was disgusting.
I never filled that prescription. I just had a bad feeling that turned out to be right.