Page 68 of For Her Own Good

Lowry

It’s generallya cause for celebration when one of my patients seems to be doing better. Perhaps they’ve had some sort of breakthrough in therapy, maybe the medication or drug cocktail they’ve been taking is working well, or they tried a new treatment like TMS or ECT and it’s precisely the right tool.

I love that feeling. It’s why I do this job. Helping people live better, fuller lives is why I spend hours poring over medical journals, going to continuing ed classes and conferences, why I mine my colleagues’ knowledge and experience. That’s all I’ve ever wanted to do: help people. There is nothing so satisfying as watching the expertise you’ve accumulated over most of your lifetime be used in the service of giving someone their life back. Or giving a family their loved one back.

There was one case I had when I first got to Chicago where an elderly woman who’d dealt with chronic low-level depression for as long as she could remember was thrown into a near-catatonic state after her husband passed away. I was one of her team at the hospital and we tried everything. Elderly patients can be challenging in very different ways from kids and I felt out of my depth. Felt terrible every time I saw her children and grandchildren come to visit her because I knew they were looking at me and wondering why I couldn’t do more. And why couldn’t I?

I spent hours upon hours in the library making lists of medications and therapies and drug cocktails and everything I could think of to try because there was something about her—she still had so much life in her, so much love to give, and I felt as though if I could only find the right combination, I could crack her out of the locked safe of her grief.

Eventually we got her sign-off—and her daughter’s approval—to try ECT, and it was… It’s not always a miracle. But for this woman it was. After her first course of treatments, I went to check on her and she was with her daughter and some of her grandkids. Looking at photo albums, smiling, laughing after she’d barely looked at her loved ones for months. Warmed my heart. I’d been about to leave when there was a tug at my lab coat and I looked down to see a little girl. Five, maybe six. I’d squatted down because she clearly had something to say.

“Are you my grandma’s doctor?”

“Aye, one of them.”

“You made her better?”

“I like to think I helped. There’s a lot of people here who’ve been trying to take the best care of her we can and help her feel better.”

“I felt like she went away even though she was still here.”

“That’s a good way of putting it. She probably felt that way inside too.”

“She’s back now, though. You found her.”

And then she hugged me, her small arms around my neck, nearly making me fall on my arse with the strength of her embrace. My throat had gotten thick and my sinuses burned as I patted her back.

That’s one of the memories I dredge up when I’m having a shite day, when nothing seems to be going right or I’m dealing with new computer systems or red tape and paperwork, which aren’t the reason I got into psychiatry at all. Or when I’m dealing with a difficult patient and I can’t seem to find the combination to their safe, can’t figure out how to help them.

Some of my colleagues have become hardened to it, are convinced there are some people who simply can’t be saved. Perhaps that’s smarter or at least easier, but I’ve never been able to feel that in my bones. And I don’t feel it now while sitting across the coffee table from Tony.

He’s…calm today. Not angry, not frustrated, not desolate. Which could be good, but I’m almost certain it’s not. There’s a thing that happens sometimes with severely depressed patients who are suicidal. You’d expect them to keep tumbling down the hill of their disease until they reach the pit of despair and appear to be at rock bottom before they end it all. That’s how it was with Starla.

Things got worse and worse and worse, and the last appointment we had before she slit her wrists in the bathtub, it had seemed like it was painful for her to be alive. Everything hurt. Sitting hurt, standing hurt, walking hurt, breathing hurt, talking hurt; anything and everything was a misery.

But sometimes they seem at peace. They’ve made a decision, they’ve made—or are making—a plan. All the misery they’re feeling, all the hurt they believe they’re causing other people, all the wasted space they’re taking up, it’s going to be over soon. They give things away, they make arrangements, they write letters, they donate money. One of the benefits, I suppose, of orchestrating your own death.

Tony’s not wearing one of his Bruins shirts today, and I have to wonder if it’s because he’s already passed it on for someone to enjoy when he’s gone. He may be at peace, but I am very much not. And I’m irrationally angry at the Bruins for losing the Stanley Cup and at the NHL for being in the off-season right now so I can’t talk to him about hockey, perhaps remind him in a sneaky way that there’s something he’d like to live for, even if it’s seeing the next face-off. I don’t care what gets the job done, so long as it’s done.

“Tony, I’m very concerned about you.”

“What for? I’m feeling pretty good.”

“If that’s true, I’m glad for it, but I’m having trouble understanding what’s changed over the past few weeks. We haven’t tinkered with your meds, you haven’t tried anything new in terms of therapy. Maybe you took up yoga and you forgot to mention it? Or…”

I don’t want to say it out loud. Perhaps if I keep my suspicions to myself, they won’t manifest. That is the worst kind of superstition and I won’t allow it to overtake my professional acumen. Also if I don’t do everything in my power to stop him from taking his own life, I’ll regret it. No matter what, I’m sure I’ll come up with something I could’ve done differently, better, because why couldn’t I have done more?

“Or maybe your suicidal ideation has become rather active and you’ve been making plans. Suicide is never the answer. We still have things we can try, and you have a family. Emily and Portia and Clara. You’re a good man, and I know you wouldn’t abandon them.”

His brows gather for a split second before he smiles at me. It’s creepy as hell. “Don’t worry, doc. Everything’s going to be fine.”

“You’re not giving me reason to believe that’s true.”

Tony looks up at the clock and pushes out of the chair. “Time’s up, I gotta go.”

I want to block the door, prevent him from leaving, call up inpatient care and get the process started on committing him, but I can’t. He’s given me no concrete reason to believe he’s going to take his own life, and my hands are tied without it.

In desperation, I stand in front of the door. Not so close he can’t leave, but close enough that it’s going to be uncomfortable for him to get by. I don’t like it, but my panic has reached stomach-twisting levels.

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