Mayday, Part 2

The view from the passenger seat of the ambulance is commanding, but totally foreign. In the darkness of the night, I try to adjust to the perspective of my neighborhood from what feels like the top level of a two-story bus. Behind my left shoulder is a rectangular shaped portal through which warm yellow light glows. I lean over, crane my neck and twist my head to look inside.

I can only see the top of Alex’s helmeted head. He’s still strapped to the gurney. The EMT sits to his left, with what looks like a clipboard in his hand. Except for the jostling and bumps from the ride, Alex appears motionless.

The cab is loud from the roar of the diesel engine, so I can’t hear if Alex is crying, upset or what. It’s all very surreal to me, to be perched up here in a big emergency vehicle. And I always wondered who was “privileged” to sit up front. Some privilege.

We lumber towards the nearest hospital. There is little traffic because it’s late—about 8:45pm. We proceed unobtrusively; no sirens, no flashing lights. I take this as a good thing, since any issue Alex might be having doesn’t seem to have risen to the same level of urgency to the first responders as, say, a shooting victim.

Remembering the events of the last half hour, I suddenly realize that Kat is alone back at home with Drew and that no one else knows about what we’ve been dealing with except us. I fish my cellphone out of my pocket and thumb the button programmed to dial my mom and dad’s home. Unless my parents are someplace else, the phone rarely rings more than twice before they pick up. Especially this late in the evening, when nobody calls just to chat. Without fail, my mom answers before the end of the second ring.

“I’m in an ambulance headed to Northwest Community,” I tell my mom tersely. “Alex is having some sort of a psychotic episode. We don’t know if it’s because of one of his meds or what…but we can’t control him.” I sigh.

“I’ve never seen him this bad.”

“Oh God.” is all she says.

She promises to meet me in the emergency room. There’s not much more to say, and I don’t feel much like having a deep, personal conversation without a little bit more privacy. I hang up after instructing her to tell my dad to check on Kat and Drew.

The ambulance rumbles to a halt in the sheltered parking area outside the emergency room. I hop out of the cab and wait for Alex to be lowered to the ground. His eyes are wide open beneath the helmet but he seems remarkably calm considering the circumstances so far this night. Probably as dazed as me, I think. The EMT and a hospital staff member help wheel the stretcher inside the automatic double doors.

As I follow behind them into the slightly darkened main hallway of the ER, it’s pretty apparent that we’re catching the hospital staff on a slow night. Few of the triage areas are occupied. I notice the doctors, nurses and aides are looking up at us as we make our grand entrance. A few of the younger ladies smile as they see our little Alex, the boy with the sweet face—who also is wearing a helmet because he can hurt himself. It looks like pity to me. I’m kinda used to these reactions by members of the general public that are not familiar with him. Whatever. Even pity is better than apathy or denial.

Alex’s gurney is directed to a small alcove defined by two half walls and a retractable curtain. He surveys the area a little and with another atonal bleat worthy of a portable air horn, pronounces the accommodations wholly unsatisfactory. I can’t disagree, but it’s the best we can do right now.

Noting his wrist and ankle restraints functioning as advertised, I go to remove his helmet. He doesn’t fight me. A nurses’ aide stops in to check if we need anything. Given how much Alex has been screaming, drooling and sweating in the past hour or so, I ask for some ice chips, water or juice. Quickly procured, I offer them to Alex by holding them up to his mouth. He’s not interested. I sigh again.

More youthful-looking aides stop by with standard intake questions ranging from the banal (“Is he allergic to anything?”) to the specific (“How much Clonidine does he take at bedtime?”) to the downright bizarre (“When was the last time he had sexual relations?”) Yeah, no kidding. Alex just turned 9.

Finally a true medical doctor shows up. She introduces herself as one of the attending physicians for the E.R. tonight. She is calm and professional. Her facial expression shows warmth and care—much more so than the nurses’ aide. She has more questions about Alex, mostly the same ones I’ve already answered. I take a deep breath and repeat myself.

The doctor conducts a simple look-see of our son. He squirms a little when she touches him, but mostly holds it together. I’m still having trouble accepting the fact that he is literally bound to the bed so even if his nose itches he can’t do anything about it. He doesn’t have the ability to tell any of us, either.

After she’s done with the exam, she mulls things over for a bit. “You guys have been working with a psychiatrist, correct?” Yes, of course is my reply. “Okay. I’ll try to get a hold of her, let Alex relax for a little bit…and see how he does.”

All this sounds sensible, almost routine. Keep an eye on him for observation. He’s certainly safe here, though exactly why he flipped out so hard and so aggressively remains to be determined. And in his red Angry Birds pajama bottom and mismatched blue Cubs t-shirt, he’s not one for the fashion pages. He looks bedraggled.

So am I. I stand next to him and gently stroke his forehead. I whisper softly into his ear how much I love him and follow it with a kiss. It probably makes me feel better than it might to him, I don’t care.

A few minutes pass and my mom shows up. A nurse by training, she actually used to work at this hospital, but in the quality assurance department—not as a nurse. She’s been retired for many years. But her presence is greatly comforting to me. Other than Kat or Drew, there’s no one else I’d want to see more right now. I get a big hug. Nothing can deliver more comfort in those times of need than an embrace by the lady that brought you into this world.

She tells me my dad is on the way to our house so he can be with Drew while Kat heads this way. She also goes over to Alex’s bedside and tries to comfort him. Offering him her iPhone with the YouTube app playing Sesame Street songs offers a welcoming distraction. I’ve never enjoyed hearing Elmo sing more than right then, because Alex is transfixed. Maybe he’ll be able to ignore the fact that he’s just taken an ambulance ride to a sterile hospital room, and that he’s strapped to a bed. For a little while, maybe.

Kat shows up. I squeeze her in my arms and hold her for a long while. She shakes slightly and whimpers.

I catch her up on Alex, the doctor and our initial discussion about psychiatrists, medication histories and the short-term plan. “Hurry up and wait,” is the summation. Kat sighs in unison with me. Alex is still watching videos.

We have to have a pertinent logistical discussion next. As a recently certified Boeing 777 pilot, I was scheduled to finish my final qualification flight this next morning. In basic terms, it’s a very straightforward flight to Honolulu, flown with two extra crewmembers. This means that although the flight is about 9 hours long, I’ll actually be out of the cockpit for half of that time resting. The weather at our island destination is beautiful and the check airman pilot administering my flight is an old colleague of mine. In fact, I’ve been looking forward to this flight with him for months. Rescheduling it would throw many wrenches into my schedule and his. Delays like this would mess up the rest of my monthly flying schedule, the days off of which I’ve already tightly packed with every other obligation of my family life. I need to get this flight over and done with.

I broach all of this with Kat. Finally I ask her, “Do you want me to go?” She understands. And she leaves the decision up to me. In order for me to get adequate rest, I need to put myself to bed as soon as possible. It’s well past 10pm now. My show time at the airport is 8am tomorrow.

The doctor returns from her phone calls and research. “I spoke to Alex’s psychiatrist. We agreed on giving Alex a sedative to keep him mellow,” she continues. “If you agree, we’ll just give him the shot and keep him here to see how he does.”

Before we assent, Kat and I ask exactly what the sedative is and what the side effects might be. I follow up with the question of drug interaction with the other meds he is presently taking. “None, really. Alex might be a little groggy or loopy tomorrow, but he should be fine.” Satisfied, the medical staff prepares the syringe. I’m not one for needles, so I excuse myself. I motion for Kat to join me out in the hallway.

“Do you think you can handle Alex at home tomorrow?” I ask her. Obviously Alex will not be going to school tomorrow. Kat looks over to Alex while he gets his shot, then back at me. We have a trusted caregiver who is available on short notice if needed. I tell her I’ll make sure he can help her in the morning if she comes back home with Alex. She’s satisfied with this.

“I’ll be fine. Go.” Kat is supportive of me and brave. She’s also much stronger than she thinks she is sometimes. This is one more example.

I hug her again, then go back to check on Alex. He’s put down my mom’s phone, apparently no longer interested in videos, but I have noticed that they’ve removed his wrist restraints. I give him another kiss and hug.

“I’m gonna get going, buddy. I won’t see you for a couple of days…”

It’s always hard to say and do this with Alex because I have no idea whether or not he understands what I’m saying.

“I’ll see you on Sunday morning, I promise.” One more kiss on his forehead.

My mom tells me she’ll stick around for a little while longer until my dad picks her up at the hospital. I give her one more hug, then a final kiss to Kat.

“Have a good flight tomorrow.” She says. “That’s the plan,” is my canned response.

That’s always my plan. It will be different, for sure. Hopefully routine.

I arrive back home about 11pm to see my brother Lou and his wife Reen sitting on our sofa with Merrows, watching television. Merrows leaps to the doorway to greet me, tail wagging. She gives comfort to all of us. Not just Alex. She’s the best.

Lou tells me Drew has been asleep since about 10pm. He fell asleep in his own bed, a detail I find odd because lately, when he’s felt scared or otherwise troubled, he comes to our bed for comfort. I take it as a good thing that my brother made him feel safe. I tip-toe into his room and snuggle him up. One more kiss on the cheek, one more “I love you, goodnight” and I quietly close his door. He stays asleep.

I catch up my brother and sister-in-law about the past 3 hours. Frankly, it seems much longer ago than that. I thank them both profusely for coming over to help with Drew on such short notice. They’re compassionate and totally cool with all of it, scoffing at the notion that anything they did was the least bit inconvenient to them. “Anytime Dave, anytime.” Says Reen.

I’m exhausted. I brush my teeth and barely have the energy to take off my clothes. I’m asleep seconds after I hit the pillow.

The incoming text tone jars me awake. My bedside clock says 4am. Kat has texted me with news that Alex is free to leave the hospital and come home with her. She pulls into the garage a few minutes later. I scoop a fast-asleep Alex out from the back seat and gingerly carry him to his bedroom. Tucked in, bedroom door shut. Kat fills me in on the rest of the night spent in the E.R.

“It was laughable, actually,” Kat begins. “They gave him a second sedative and, after noting Alex was literally falling asleep, said we were free to leave at any time.” She punctuates the story with a harrumph. I ask her why the chagrin.

“Because, after you had left, someone from the mental health department came in to say that they were unable to find Alex any place else to go. Obviously he’s physically doing better…” Her voice trails off.

Thus opens up a whole new world of concern we have now for Alex—his mental well-being. Ambulances and emergency rooms are great and fine for stabilizing someone seriously afflicted with a physical ailment. But where does one go when the ailment is within ones’ head?

No solutions in this arena would be forthcoming at 4 o’clock in the morning, so Kat just brought Alex home. She left with some phone numbers of people to call to ask for assistance, presumably during “normal business hours.” What I’ve determined is that the term “normal” doesn’t apply much to our life at home. And it bums me out.

Kat and I share an exhausted sigh and crawl into bed. We powersleep until my alarm clock sounds at 6:30am.

Drew was already up and sitting on the sofa watching Spongebob Squarepants. I am glad to see him doing something he’s done hundreds of times before. I hope that the silly cartoon would help ease the stinging memory of last night for him.

“Hi daddy,” said Drew as I turn the corner from the hallway and walk into the room. “How are you?”

He’s got such an innocent voice, I think. And ever since Alex has been acting up with such severity, he’s picked up on the stress that it creates in our house. He’s always asking me how I am. Kat, too. It’s so sweet and heartbreaking at the same time. Sometimes I don’t think it’s fair Drew has to be a witness to Alex’s unsettling behaviors.

“I’m much better than last night, buddy. Thanks for asking.” I’m not lying now. It feels good to say this.

“Do you have to go flying today? I’m going to miss you so much…” He’s got that hound dog look on his face to go with the longing in his voice.

“Yeah, pal. I do. But when I’m done, I’ll be done for almost two weeks…maybe more.”

I’m not exaggerating here. Once I’m finished with my qualification flight, I’m scheduled for a bunch of time off. I can’t wait. This time looks like it will be well-needed and easily spent.

Drew thinks about what I’ve told him, considers it and responds, “Okay.” I promise him that things will be much calmer today and tomorrow at home. I’ve lined up assistance from our family caregiver and one of Alex’s at-home therapist to work extra for us today and tomorrow (Saturday). I will be home before sunrise on Sunday morning. That’s a pretty good plan, and Drew agrees with a soft smile. He wraps his thin arms around my neck.

My flight to Honolulu and back goes well. I have earned the full qualification to sit in the pilot seat of a Boeing 777 or, as an on-call pilot, in any seat at home waiting for my phone to ring.

I began this story with the concept of emergencies, of needing assistance, and when to ask for it. In the past, many pilots have gone to their graves denying the gravity of their predicament. They’ve made the mistake of thinking that their request for assistance is a sign of weakness, of poor planning or failure to do something.

What I’ve learned is there are many people that can help, are willing to help and that do help—if you only ask them to. By calling “mayday” for Alex, we were able to summon help right away. What we are coming to realize now is, once our immediate needs are met, more long-term sources of assistance are much more difficult to acquire. And there’s no catchy term like “mayday” for that.