November 12, 2011
Dr. Duncan and Dr. Southland had conferred and decided Gabriela was suffering from psychosis, with no known cause.
Dr. Duncan deferred to Neurology regarding the possibility that the AED’s Gabriela had been taking may in some way be responsible for the psychosis. Dr. Southland had decided, based on one clean thirty minute EEG, that Gabriela did not have intractable epilepsy. And, therefore, decided against taking Gabriela on as a patient.
So we had come to Huntington Hospital, where Dr. Southland’s partner had assured me days earlier that Neurology would work hand in hand with Psychiatry to determine if the medication had caused Gabriela’s psychosis. Yet, Neurology completely dismissed themselves from Gabriela’s case within the first forty–eight hours, and after one thirty–minute EEG. So, despite my best efforts to get a new neurologist to help, Gabriela was left to be treated as just another behavioral health case.
Visiting hours allowed for one and a half hours each weekday evening, but on weekends I could visit for six hours each day. Saturday, I arrived at the waiting area by noon.
I pushed the intercom button next to Ward 400. It took some time before a voice asked how they could help me.
“I’m here to see Gabriela Shufani, I’m her Mother.”
A loud buzzer sounded and I hurried to open the double doors. I couldn’t remember which direction to go once I was inside, but after looking around I found Ward 400. There was another intercom at that set of doors and I was buzzed in directly.
When I opened the door I saw Gabriela at the far end of the hallway; she hadn’t noticed that I had entered.
The hallway was quite long, with deep blue patterned carpeting. Six bedrooms were lined up on the right and each was furnished with two simple beds and a small dresser. Each room had a private bathroom. Only the occupants of a room or staff members were allowed in the bedrooms.
In the center of these semi-private bedrooms was the “quiet room.” This room was used only when patients needed to be confined to protect themselves or the other patients on this ward. Typically, admittance to this room was preceded by an injectable anti-psychotic that rendered the patient hopelessly out of it for some time.
Mounted on the wall next to the quiet room was a whiteboard. Each resident was listed along with which room they had been assigned to, as well as their assigned medical doctor and psychiatrist. There were twelve slots; Gabriela Shufani’s name was written in the upper right corner.
Directly across from the whiteboard and quiet room was the nurses’ station, which had a medication dispensary window; another window the patients used if they needed to talk with a nurse; and a Dutch door whose top half was always open, with bottom half closed and locked. The nurses’ station also had a large window that looked into the day room, with a computer sitting to the side of the window.
Between the nurses’ station and the main doors were two conference rooms. The psychiatrist used one for daily talks with patients, and the other the social workers used.
On the opposite side of the nurses’ station was the day room, which was where all meals were served, group sessions conducted, TV watched, games played, and visitors met.
Situated outside the day room door was the client assistant (CA). This staff member was seated at a portable blood pressure machine and computer, and was charged with keeping order among the resident patients.
Gabriela stood in the hall by herself. I approached her slowly and smiled.
“Hi,” I said.
I watched her face, searching for clues to how she was doing. It appeared there had been no improvement from the evening before.
Day two and she still wore the same clothes she had been admitted in. Her arms were still clasped under her breasts, as though they hadn’t moved at all since yesterday morning.
She shuffled backwards and forwards facing the hallway walls, and had very slight responses to me being there. She obviously knew me, even though she still hadn’t spoken.
Someone brought a chair so I could sit in the hallway. They offered one to Gabriela, as well, but she pushed it away.
I sat next to her as she stood, and talked to her. I told her how much I loved her and missed her.
I asked how her visit with Kiki went? Did she have a roommate? How was the food? She wouldn’t speak; the most she offered was a flicker of a smile.
The CA in the hallway had been listening to me try to engage Gabriela in a conversation. She offered that Gabriela had not eaten any breakfast, nor had anything to drink. And that Gabriela had spat out her blood pressure medication earlier in the morning.
Gabriela was incensed by these comments and grabbed my sweatshirt, pulling me down the hall away from the CA, who cautioned Gabriela not to pass the nurses’ station. Gabriela was considered a high AWOL risk after her attempted escape, so she was not allowed past the nurses’ station, toward the exit doors. Gabriela gave the CA a suspicious look over her shoulder.
My daughter looked completely different than I had ever seen her before, like someone had put makeup on her. Angelina Jolie in “Girl interrupted” … that was the look! Wild, uncombed, unclean brown hair; tiny, five–feet–two–inch, frail build; pale, chalky coloring to her face with a massive covering of acne and deep, purple–rimmed, sunken hazel eyes that looked past and through everyone and everything.
Gabriela had medication stains down the front of her jacket. She had not brushed her teeth or washed her face for months, and because the ward had been kept on the warm side, I could see a buildup of sweat and oil on her face…. She flat-out looked horrifying, and smelled worse.
I tried, unsuccessfully, to ignore her smell and look. I wanted to concentrate only on letting her know I was there. I wanted Gabriela to know I wasn’t going to be scared off, not by epilepsy and not by this.
I sat with her that day until 6 PM.
I tried to get her to eat, to drink, to sit, to talk.
I was not successful.