Cracked

Cracked

by Telaina Eriksen

Photo by Ruan Richard Rodrigues

I haven’t quite had a panic attack on the way here, but I’ve had to breathe deeply and talk to myself a lot. It’s okay. You’re okay. She’s okay. We’re going to be okay. She is still alive and that means things are okay.
        “Mom, are you almost here? Or are you stuck in traffic?”
        “I’m here, honey. I’ve been in the parking lot since 11:30.”
        “Oh, I thought you were going to call.”
        “I didn’t know I was supposed to call when I got here.”
        “I’ll be out in just a second. A nurse has to walk me out.”
        “I’m parked right out in front of door C1.”
        “Okay. See you in a minute.”
        I get out of my Toyota Highlander but don’t close the driver’s door all the way. I’m unreasonably concerned the door will lock behind me and we won’t be able to get back in the SUV. I stare at the windshield crack that has been slowly growing all day. It is creeping across the windshield and will soon breech the passenger’s side as well. It happened at the start of this (well, at the start of my knowledge of this)—my husband and I were caravanning to take our daughter’s car back to her apartment building’s parking garage, when a stone kicked up from a semi in front of me and hit the windshield with such force that I flinched on its impact. The crack appeared the next day and could not be fixed. My husband ordered another windshield, but it won’t be in for weeks.
        My daughter slowly walks out of the psychiatric hospital’s automatic door. Her tall, slender body towers over the nurse who is walking next to her. Her head is shaved like a Marine’s, and she’s lost weight that she couldn’t really afford to lose. She and the nurse carry five bags between them—four brown grocery style bags and the Barnes and Noble “This Side of Paradise” reusable bag that I brought her clothes and books in a few days after her admittance. I couldn’t go in and see her and had handed her belongings to a nurse wordlessly. My daughter had said to be sure to bring her volume of Rumi’s poetry. After that conversation, I had put my head in my arms at our dining room table and wept.
        I take the bags the nurse has been carrying and force a smile and nod at her masked face. I open the Highlander’s hatch, and my daughter and I shove all the bags in the back.
        “Thank God,” she says, as she slides into the passenger seat and closes the door. “Thank God, I’m outside again. I know, I know, I needed help, but that place…”
        “I’m sorry,” I whisper, my eyes tearing. “I got you a bottle of water and a strawberry Frappuccino. I think you’ll like it. I think it tastes like a smoothie?”
        She takes a sip of it and nods. “It’s good. The cold feels good.”
        “Lunch now, or when we get back to Lansing? There’s a Qdoba close.”
        “Now, please. Qdoba sounds good. The food was awful. Reconstituted eggs. Dry gluten-free pasta.”
        She has celiac disease and autism spectrum disorder. Food is hard under the best of circumstances. These are far from the best of circumstances. She likes Qdoba and it has never made her sick. These are our criteria. I turn the Highlander on and head out of the facility’s parking lot. The sun is bright, hot—July in Michigan. The light bounces off the broken windshield. It’s getting worse, but I can still see.
        “Mom, did you see if my medicine was in the bags?”
        “I don’t know, honey. I didn’t look inside.”
        “Stop the car. I need to make sure it’s there.”
        I pull the car over in a strange parking lot just off the facility’s road. Is it an abandoned apartment building? An abandoned office complex? A meth lab? I don’t know. My daughter gets out of the car and opens the hatch and searches through the bags. She exhales in relief.
        “It’s all there,” she says. She closes the hatch and climbs back in the passenger seat. “I’m very motivated to take my medicine. I don’t ever want to go back there again.”
        I know from my fevered reading and research that what she’s expressing is good “insight” into her illness and that I should applaud this statement. But since my heart has felt like it has been repeatedly impaled by a sharp metal object these last 12 days, I try and fail to find an appropriate response.

*

        

I work every day with words but still don’t understand etymology. But evidently the word schizophrenia comes from both Latin and Greek and it means “to split the mind.”

*

        

As we walk into Qdoba, I am struck by both the strangeness of this, and its naturalness. After all, I have been picking my daughter up from places since she was six weeks old and in daycare for the first time. I’ve picked her up from preschool, school, friends’ houses, camps, practices, sporting events, tutors, appointments, and even for weekends home while she was in college. If you had asked me at any point in the last quarter of a century whether I would ever pick my child up from a psychiatric hospital, I would have said “God willing, no.” But inside I would have been sure that this would never happen to us. I’d been a good parent! I’d encouraged therapy! I affirmed her decision to go on medication for her anxiety and depression! I communicated! We’d never yelled! We’d never spanked! She graduated from college! She studied abroad!
        There are only three people working at Qdoba and it is the lunch rush. We are in the second summer of Covid and every restaurant is understaffed. The Delta variant is surging and both my daughter and I are vaccinated and we’re not wearing masks. It feels as though the amount of effort to find the box of masks in the car and then place masks on our faces is insurmountable in this moment. She wants to eat outside since she has not really been outside except for the hospital’s small, enclosed courtyard.
        In line at Qdoba, we talk over each other in our eagerness to have an actual conversation rather than the strained phone calls of the last week and a half. She tells me about the people she met in the hospital, how strange the place was, how Christian it was–“we could choose songs to listen to in the art room but they couldn’t have profanity.” We are both baffled by this because it was an adult unit and everyone was over 18.
        I thank her again for calling me that Saturday night. “I didn’t know where you were for 30 hours,” I tell her. I start to cry. “I’m sorry, I know this isn’t about me…” I trail off, thinking of the 30 hours my husband and I had spent wondering what psychiatric hospital in the state of Michigan had room to take our beloved oldest child.
        We finally get our food and take it outside to the sidewalk, where Qdoba has set up several tables for “outdoor dining.” The sun is hot, but my daughter smiles and digs into her chicken and cheese nachos. She’s told me she is still having some auditory hallucinations, but her rational brain is “back online,” and she is able to recognize them as hallucinations. She hears Pokémon music and New Age music, those aren’t bad, she says. It’s the whistling. Like a creepy man is bending close to her ear and whistling right in it. Over and over and over again.
        The Seroquel makes her fatigued and dizzy. But it is not an overstatement to say it has saved her life.

*

        

From a January 2020 Washington Post article by Abigail Jones about schizophrenia, ‘“The onset is so cruel,” says Steven Hyman, director of the Stanley Center for Psychiatric Research at the Broad Institute of MIT and Harvard. He’s referring to the fact that schizophrenia typically strikes in the teens and 20s. “Family and society are just finishing their incredible fiscal, emotional, cognitive investment in the production of a wonderful person, and that person is snatched away.”’
        I don’t know much yet. This is all too new and raw. But I know for sure that my daughter hasn’t been taken from me. She’s sitting right across from me, eating nachos.

*

        

There is still so much stigma and discrimination around mental illness, as you can tell from Steven Hyman’s quote, which implies that someone’s innate worth has been taken from them because of a horrible, debilitating illness that can be detected on a brain scan. We “invest” in and “produce” people and when we don’t have our expected return on investment, well, that’s a goddamn tragedy. The tragedy isn’t that my daughter wanted to kill herself, or no longer trusted me or her father, or that she was in agony for months, believing and feeling like she was being poisoned. The tragedy is also not that she went to the police and the emergency room and no one helped her. No. The tragedy in our society is that she may not offer us and American capitalism an appropriate ROI.
        Depression and anxiety, both of which my daughter also experiences, have become more normalized. Even bipolar disorder has come slowly into the light and there is some understanding. But schizophrenia. Oh no. Dangerous, intractable, aggressive, violent, homeless, jail, prison, group homes… the words fly past me. I read stories of families who are exhausted, at their wits’ end, searching for resources that may or may not exist. Their loved ones are in the criminal “justice” system, or homeless, or wards of the state, or in and out of mental hospitals in a never-ending cycle. Bright articles on the internet say that 40 to 50 percent of people with schizophrenia can live independently!
        Like the ACT and the SAT which I was actually concerned about less than a decade ago, I don’t know what percentile we’re dealing with yet. The possibility of my daughter deteriorating—her brain losing more and more mass with each psychotic episode—makes me so physically sick to my stomach that I cannot eat. But imagine how horrified she must feel, reading these same things about her illness.

*

        

Who do I tell? And when do I tell them? Am I protecting my daughter’s privacy or am I silenced by the stigma? Both?
        An acquaintance asks how my daughter is doing. How do I respond?

*

        

How many times in my life have I used the words psycho and psychotic flippantly? I’m ashamed. Even with throwing those words around throughout the first 50 years of my life, I didn’t recognize real psychosis when it was right in front of me.
        As we’re finishing our lunch, I broach things tentatively. The psychotic episode has torn into our relationship. My brain knows that she hasn’t been responsible for her words and actions for months. My heart is still suffering from the things she believed and said. We talk about finances, touch on the future. Nothing has to be decided now. She is alive.

*

        

Less than two weeks ago, I walked into her apartment to get her some clothes and books, take out the trash and run the dishwasher, as she requested in a phone call from the hospital. There were so many locks and door jams. On the refrigerator alone there were three buckle locks—one with a key, one with a combination. Inside the fridge, coins were centered on all the food so she could tell if it had been moved or touched. Survival gear spilled out of plastic grocery store bags. Lice treatment products littered the counters of her bathroom and kitchen. The kitchen counters were filled with empty bottles and dishes with dried on food. Trash piled on her kitchen floor, even though the trash chute was just around the corner from her apartment. Receipts from urgent cares and the emergency room were scattered in the apartment. She’d been looking for help and no one had helped her.
        I sat down on her couch and took deep breaths. Tears clouded my eyes and the sharp pain in my chest ran the length of my sternum. How had I not known?

*

        

Looking back, I see all the signs of what is called “schizophrenia prodome.” I justify my ignorance with the pandemic lockdown, her introverted nature, her anxiety and depression, my growing frustration at her seeming unwillingness to plan or execute anything, her hating every job she worked. According to an October 2017 article in the Indian Journal of Psychiatry, the schizophrenia prodome includes, “Cognitive deficits including memory, attention, and concentration are the most commonly documented clinical findings. This may incorporate relative disturbance in speed and verbal memory, social reasoning, and emotional processing. Various mood changes such as anxiety, depression, mood swings, sleep disturbances, irritability, anger, and suicidal ideas are reported as part of prodromal symptoms.” The article argues for early interventions, before full-blown psychosis occurs. “According to recent developments, a prodromal state may be identified based on the current symptoms with reliability and predictive validity. Appreciation is growing that these patients and their families experience substantial current distress.” Yes, folks, our distress level has been substantial for some time.
        I remember my daughter’s paleness. Her expressionless face. Her jerky movements as she played beanbag toss at the Memorial Day cookout.
        I try not to think of the brain mass she lost because I didn’t want to hover, because I just wanted her to be okay. I try not to think about it. But it’s hard not to.

*

        

I wanted her out of the house. Her anger and her negativity toward my husband and me had rolled off of her in waves. I thought she needed physical space. That the pandemic had just taken its toll with so much togetherness and her working a job she hated had stressed her out. I imagined an empty nest where the house was quiet. I imagined writing and reading for hours, uninterrupted, not worrying about her emotional state, not having to “be there for her” after a long day at work. I imagined cooking things she didn’t like for dinner. I did my time, I thought self-righteously. She’s 25 years old.

*

        

According to a paper in the July 2015 Journal of Indian Psychiatry, written by R. Thara and Shantha Kamath, women with schizophrenia tend to have better “outcomes” than men. The paper says, “The Australian Study of Low Prevalence (Psychotic) Disorders looked at gender differences among 1090 cases of psychosis (schizophrenia, schizoaffective disorder, affective psychoses, and other psychoses). Results within diagnostic groupings confirmed differences in how men and women experience and express their illness. Within each diagnostic group, women reported better premorbid functioning, a more benign illness course, lower levels of disability and better integration into the community than men.” But I already realize that “better” where schizophrenia is concerned does not mean anything close to the life I had imagined for my daughter, or the life she had imagined for herself.

*

        

We get back in the Highlander to drive toward Lansing. We continue to talk about hard things. I-96 is heavy with traffic from vacationing Midwesterners—the freeway leads to and from Lake Michigan. At some points, I-96 is down to one lane. Our governor is still trying to fix the damn roads even in the midst of a pandemic. I know it probably isn’t safe to talk about psychosis and schizophrenia while driving but we’re communicating, and I don’t want to stop. Maybe it is easier like this. We don’t have to look each other in eye.

*

        

Eugen Bleuler, a late 19th/early 20th century Swiss psychiatrist, was the first to use the word schizophrenia. One of his beliefs was that delusions expressed the emotional life of the person with schizophrenia. In a 2018 scholarly article in Front Psychiatry, “Bleuler’s Psychopathological Perspective on Schizophrenia Delusions: Toward New Tools in Psychotherapy Treatment,” the authors Filipe Arantes-Goncalves, Joao Gama Marques, and Diogo Telles-Coreria argue that (and I am grossly simplifying here) pills are great and a life-saving tool, but also the type of delusions a person has indicates something that needs to be explored, as Bleuler first said a century ago. Delusions may be tied to unexpressed emotions that have been unable to be processed as the brain becomes overwhelmed and begins to malfunction. The person with schizophrenia still wants the same things they have always wanted—a job, relationships, or whatever else their goals might be. But they cannot achieve these goals because of their disorganized thinking, and in some cases, strange behavior, or in other words, they can’t achieve their goals because of the schizophrenia. The brain doesn’t know what to do with this contradictory information, and the emotions that frustration creates, and so the schizophrenia projects all that confusion, guilt, shame, and anger outward to rest on others in the form of persecutory delusions.
        In my daughter’s case, those others were myself and my husband, her parents.

*

        

When my daughter was saying awful things about me and my husband, when I finally realized she’d had a psychotic break, I wanted to argue with her. I wanted to be right. I wanted to explain, justify, rationalize, prove, provide evidence. I felt angry, heartbroken, in shock. I felt like you feel after you’ve been in a bad car accident, where you know you’re alive, but you don’t know how badly you’re injured yet.
        But schizophrenia doesn’t care about facts or evidence. It doesn’t care about feelings, and it’s not interested in debates. It doesn’t care about the person it inhabits, or the people playing the starring roles in the delusions. It simply is. And everyone involved needs to accept that, whether they want to or not.

*

        

We exit off the freeway and as I make the turn toward her apartment, I see a young mother walking with her two children. The older child, dressed in a sundress and sandals, is four or five. The other child I cannot see—they are in a stroller. The mom is smiling down at the preschooler who is holding her hand. I feel so much envy. I was that mother once. I want to roll down my window and tell the mother to watch out. I want to shout to her that she needs to stop smiling, because life is coming for her, and her kids. I want to scream at her, “Don’t you realize you’re on borrowed time? That anything can happen?”

*

        

“Do you want me to run to the store?” I ask, pulling into the parking garage at the apartment complex. The crack in my windshield has surprised me on the way home. Rather than snaking towards the passenger side, it has turned and began creeping up, up, up toward the top of the car.
        “I think I’m going to do a grocery delivery order and sleep.” Her roommate in the hospital had snored. The caregivers at the hospital shined flashlights on them every few hours in the overnight hours to make sure the patients hadn’t hurt themselves. Even with the soporific effects of the Seroquel, she is running an extreme sleep deficit.
        “You’ll text or call if you need anything?” I am holding three of the brown paper bags as my daughter grapples with her two bags and tries to find her keys in her purse.
        “I will. And I’ll see you at the movie on Friday,” she says, opening the first door into her apartment building with her key. Movie theaters might be dangerous again with Covid, but we have already decided she cannot stay isolated in her apartment.
        I put the bags down on the counter and hug her. Am I doing the right thing leaving her? I don’t know. But she wants to be left. And since I am the one who took her to be locked up, don’t I owe her this leaving?
        We end our embrace and she looks around her apartment. “Oh my god, it feels so good to be free. And not be paranoid. I felt like I was being tortured.” I follow her eyes around her apartment, wondering if she is seeing what I am seeing, or do we see different things now? I asked her on a phone call earlier this week if she wanted me to put any of the locks or survival gear away, and she very clearly expressed that she wanted to keep those things.
        Will we ever find our way back to each other? I’ve scheduled our first family therapy session for next week. Does her good insight mean we might be spared the endless cycles of psychosis, hospitalization, brain damage, and worsening hallucinations that I’ve read about online? And how will I fall asleep at night now, knowing her brain might fail her? How do I let go of her to manage her illness as the adult she is, but also be there for her when she needs me?
        God, what have we done to deserve this? I think. I feel guilty immediately. Parents lose children every day. People starve and suffer and live in misery, and then die. We are one small story in the midst of all of that.
        I look at her shaved head, her blue eyes. I am ill-equipped to deal with what is being asked of me. I sense already her illness will require me to retire my need to be right, and instead to have humility, patience, acceptance, and most of all, an expansive love that is not dependent on being well-regarded by her in return. I don’t know if I am capable of it.
        But for her I will try.