"By the light of the moon, she rubs her eyes, sits down on the bed and starts to cry. And there's something less about her. And I don't know what I'm supposed to do, so I sit down and I cry too, but don't let her see."
Her Diamonds, Rob Thomas
Let me walk you through the last couple days. *Self harm is discussed below, so if this may be upsetting or triggering to you, please skip this post.* Some background info is that Hope began cutting about six weeks ago. Cutting itself isn't a reason for hospitalization; it's a very poor coping skill, but not considered life threatening unless the person is also suicidal. Hope was in the hospital for a few days last month because she was suicidal, but she seemed to level out, and they felt safe enough to let her come home. She has continued to cut, though we thought it was getting better. It wasn't. Read on to see where we are now. I'll take you through the last two days, starting with Monday afternoon. I'm really stretching myself here, because I'm going to walk you through the facts (plain font) and also my thoughts and emotions (italicized) as we walk through a crisis.
It's Monday afternoon. We're walking out of the therapist's office. Hope told him that she's been cutting places on her body we can't see, and that she has the blade from a pencil sharpener hidden somewhere. She agrees to give me the blade, to show me the places she's cut so I can make sure nothing looks infected or needs attention, and we again go over plans for how to deal with the desire to cut. As we get to the car, I ask her to show me her wounds. She lifts her shirt...
Oh, nonono. Don't react, mama. Don't react. She can't handle her own pain, she doesn't need to feel responsible for yours. Take a breath. You can do this. If there is still air left in the world, find a way to get some into your lungs.
"Okay," I say. "We need to go back in." We walk into the therapist's office and ask to talk to him again. She's sobbing. She lifts her shirt and shows him what I've just seen. Hundreds of cuts. Literally hundreds. They start just below her bra and end somewhere past the waistband of her low-rise shorts. Most of them are an inch or two in length, and organized in rows. The ones on the sides of her hips are longer and deeper. And then, worst of all, there are words.
Oh, my sweet girl. My heart. How? How is there such pain inside that you could cover your body in these wounds? Words... cut into skin... cutting into my heart... "Kill Me." "I Hate Myself." Baby girl, how? How do you live with pain this deep, and how do you hide it so well? How will I ever close my eyes again without seeing this image? Wait... are you kidding me? How am I thinking of myself, of my pain, when she is hurting this way. Breathe. Focus.
We're driving to the hospital. Therapist and I agree that's the only move we can make from here. Hope stares out the window. I reach over and pat her leg or rub her arm occasionally, but she doesn't speak. I don't trouble her with either inane chatter or deep conversation. I know she doesn't want either right now, and I'm thankful that I don't have to try to make my voice sound steady.
Don't let her see you cry. She can't bear feeling like she hurt you on top of the load she's already carrying. Thank goodness for sunglasses. Thank goodness she's tuned out enough to not notice when I reach up to wipe tears away before they slide out of my sunglass fortress. I must keep my body still and stoic; the thousands of emotions breaking me apart from the inside will just have to infuse these tears and slide quietly out. It's all I can afford right now.
We check in to the ER at the psychiatric hospital. I give an overview of the problem, fill out some papers, and sit in the waiting room. Meanwhile, they've taken her from me. They'll search her, take her clothes, put her into scrubs, and put her into a locked, secure waiting area.
Right now they're making her take her clothes off. Someone will stare at her and write down every mark on her body. I hate this. I mean, I get it. They have to be sure she doesn't have anything she could use to harm herself or anyone else, and they have to document any injuries she had when she got to the hospital. She's been through this many times, and accepts it as part of the process. I know she's feeling ashamed this time, though. The cutting makes her feel deep shame, and right now, strangers are staring at her wounded body.
The nurse takes me to a room to get a more complete report of what's going on. I'm thankful that she's someone we know. Repeated visits have made us familiar with some of the staff. Hope's sweetness (it shines through her no matter the situation) and my habit of talking to everyone I see (I do it even when I'm hurting, because I feel like it's my job to make sure I use every moment to spread kindness because you never know how someone's day has been) has endeared us to the staff, and at least the ones we know are good to us. I'm so thankful for those little things. The nurse, "S," has also spoken to Hope, and I'm glad she had a familiar face on her side of things.
Now that we've both spoken to a nurse, they let me join Hope in the locked part of the building. They pull her from the small waiting room where she's been sitting with a dozen other kids and a couple of psych techs. There are some chairs in the hall outside the room, and that's where they usually put parents when they come in, but right now there is no one in one of the tiny day rooms on the hall, and our nurse let us sit in there instead.
Thank you, S. I'm glad you were here today. The sea is stormy and the night is dark, and I'm being tossed around, unable to get my bearings. I needed a familiar face to ground me.
We wait. Hospital time passes excruciatingly slowly. There's no clock in the room, just three chairs that fold out into beds when necessary, and just enough room for all three to be folded out at once. Hope doesn't have much to say, so mostly we just sit. Occasionally, someone familiar breaks up our endless waiting. A nurse we know brings water for me and apple juice for Hope, and spends fifteen minutes or so catching up. Later, psych tech "E" brings a snack basket around. She stops in our room before continuing on to where the other kids are next door. Tonight, the snack basket choices are peanut butter crackers, small bags of chips, half turkey sandwiches, and juice. E says "I brought you an apple," and reaches into her pocket, retrieving a shiny red delicious, wrapped in plastic. Another small, kind gesture for the girl everyone loves. Later, a psych tech strolling down the hall stops in the doorway and bellows "Hoooope!" She smiles, bounces out of her chair and over to the doorway. "Hey, Mr. C."
How nice to see a real smile for a moment. But how messed up is our life that we're familiar to this many people at the psych hospital? She greets this man like you might greet a favorite teacher. How is this our life?
It's late Monday evening. It's been four hours. Finally, a doctor. She's not someone we know, but she is kind and thorough. She says that they don't admit for cutting, but that she's very worried about the rapid escalation and the voiced desire to be dead, and that Hope does need to stay.
That's disappointing. That's a relief. Did I really just have those two thoughts simultaneously? I hate when she's away, and I know she hates being in the hospital, but at least they can keep her safe while we figure out what to do. What the hell are we going to do?
I have to go. The decision has been made, and it's not visiting hours, so it's time for me to leave. Without her. While they've decided to keep her, they don't actually have any beds available on the unit, so she'll wait in observation. Sort of. Even the observation unit is full right now, so for now she'll be on the ER side. The observation unit is brightly painted, carpeted, has a chalkboard wall, a tv, board games, water and ice that the kids can get themselves, board games, art supplies, etc. The ER observation area is a narrow room with chairs lining each side, a tv at one end, and the internal wall is mostly window, so you can watch staff walk by but not much else. Two techs sit at the end of the room, and around a dozen kids sit in the chairs. (Regular chairs. The ones in observation are the kind that turn into beds, so they're pretty comfy. Not here in the ER.) They have a game cabinet as well, but there are just a few games with missing pieces, and a single new-and-still-intact game of Uno. The kids who don't behave well stay in this area for as long as they're waiting. Hope is appropriate for the other observation unit, and is put on the list for it, but it could be a couple days before she even moves over there, let alone get into the actual unit upstairs. At least for tonight, she's in the ER. There are a few small rooms on that hall that have chairs that fold into beds. Some kids will sleep there, but there are currently more kids than space, so some will sleep on mattresses on the floor in the hallway. They turn off the lights in the little rooms, but they have to leave hallway lights on. If she's stuck on a hallway mattress, there will be lights and movement all night long.
How is this my life? How is it that I'm driving away, leaving my child in a psych hospital with cuts all over her body, hoping she'll make it through this battle alive, and hoping that she'll at least not sleep on a floor under fluorescent lights tonight? This is not what I dreamed her life would be.
I'm driving home. Finally, I cry. I weep from the depths of my soul, for her pain, for mine, for all who love her and hurt along with her.
Okay, mama. Pity party over. You're almost home, and baby boy needs you. Find a reassuring smile to give him. We'll process emotions later. We'll remind him later that it's okay to cry, that it's okay to feel your feelings, that of course we're sad that Hope is in the hospital. It's okay to let him see that you have feelings, but not in this moment. When you hit the door, you've got to have a reassuring smile for him.
Tuesday morning. Before my eyes are open, it hits me like a punch in the gut. Hope is in the hospital again. She wants to die. The image of her wounded body hits me again.
This is too much. I can't bear it. I know, I know, it's not about me. It's crappy of my to think of my feelings, but I'm so tired. I can't do this. Not again.
I keep the day looking as normal as possible, especially for the little guy. Psych hospitalization is not like a hospital stay for any physical reason. I can't spend my day sitting by her side. I can visit for an hour and a half this evening. A social worker will call me at some point today to let me know how today's evaluation with the doctor goes, but there's not much else I can do on my end. Some days there are phone calls with the hospital, phone calls to the insurance company, meetings at the hospital, but today there is just surviving until I can see her. I make a dinner that the guys can put in the oven later, because visiting and the commute on both sides will take me out for most of the evening. I go through the motions of cooking, cleaning, and pretending to be a functional human.
I can't move, because I'm paralyzed by the weight of the entire world. I can't be still, because I'm churning with all the emotions there ever were. I am pain and numbness. Is this what she feels like? No, I can't even imagine what she feels like. At my very worst, I've never experienced what she lives with. I ache with her pain.
It's Tuesday evening. Finally, I see her. She cries through half of the visit. She tells me what she thought of the doctor she saw that day, what she ate at meal times, what type of group therapy they did that afternoon. I tell her what I talked about when I spoke to the social worker, what med changes the doctor suggested, and that I agreed with those proposed changes. We exchange small talk when she feels like talking, and I hold her when she can only cry.
My sweet girl. I'm so sorry you're hurting. I know you want to go home. I want to take you home. They won't discharge you right now, but even if they would, I'd be so scared to take you. I don't know how to keep you safe. I'm so, so scared about how I'll keep you safe.
"It's Mental Health Awareness Month, you know. I'm thinking I should update my blog at least once this month. Are you okay with me writing about where you are right now, and why?" She says that's okay with her. I ask if there's anything she would like to tell anyone who reads my blog. She thinks and finally says that the only thing she wishes is that people understood how it feels to be her. "But," she practically whispers, "no one can understand that."
I wish I could, my baby. I wish I could walk in your shoes, so you could have mine. And if you can't have mine, I wish I could at least spend a few moments in yours so that I could understand. Maybe then you wouldn't feel so alone.
Now it is Wednesday. The day has passed much like yesterday. The days blur together in these times. There is hospital and not hospital. I fake it for my girl's sake at the hospital, and I fake it for my boy's sake at home. But, man, does my car see the worst of me. I sob, I scream, I rage.
We don't know what to do. We're making a couple small changes to Hope's meds, but they're not really expected to fix things. There are no med changes at this point that will fix what's going on. And she doesn't just need to work through something -- a trauma or tragedy or event -- and then she'll be able to move on. And she doesn't just need to learn some coping skills. She could teach a class on them. She knows a ton of other things she could or should do when she feels like cutting or feels suicidal, but in the moment she can't do any of them. There's nothing they can do that's going to make her significantly better or safer in the coming days or weeks. We believe that eventually she'll begin to feel better. Whatever we do, she'll probably start to come out of this eventually. I don't have anything to base that belief on, really, except that she hasn't always felt that way, and surely she won't always, right? Some of her symptoms are constant, but every major crisis we've faced has eventually passed. So I guess I hope that if nothing else, keeping her safe in the hospital while some amount of time passes will get her closer to being on the other side of this.
We're scared. We're very, very scared. I wish I had better news, or some positive, encouraging words. Not today, friends. Today, I'm just a terrified mama, desperately hoping to hold on to my baby girl.
Hold on, my precious one. Please stay. I know it hurts, but I promise we'll be right here beside you. I'm so afraid that you're slipping away, and I don't know how to keep you safe. I know it's not easy. I know it's not fair. I won't tell you lies, and I won't promise that it will ever be easy for you, but there is still so much beauty in living. There is so much beauty in you. How can I make you understand either of those truths? I need you. The world needs you. Please stay.
