Chevy Stevens - Always Watching

I gave him an encouraging nod.

He continued. “She’d just gone through a breakup—her ex was a real jerk. But we started hiking and doing yoga together. It seemed to cheer her up.”

It had been a good idea on his part. Exercise is one of the best natural aids for depression.

“So you noticed some signs of depression before you got married?”

“I guess…. She’s the kind of person who’s always trying to take care of everyone else, so it’s hard to tell sometimes. She’d get really quiet or start crying, but she wouldn’t want to worry me, so I wouldn’t know what she was upset about. But when she got pregnant, she was really happy about the baby, picking out names, buying toys….” His voice wavered. “I don’t know what to do about the baby’s room or all the clothes she bought.”

My mind flashed to Paul painting Lisa’s nursery strawberry red with apple green stripes because our child would be different, would skip to her own beat. Which she had, always—a trait I’d admired, until she danced away from me.

“Let’s take it one day at a time,” I said, as much to myself as to him. “You can work all that out later.”

“When can Heather come home?”

“She’s been involuntarily admitted into the hospital so we can keep an eye on her. We can’t release her until she’s no longer a danger to herself.”

“What if she tries… you know.” He swallowed hard. “What if she tries to do it again?”

“We won’t let her here. And we won’t send her home until she’s stable and has a good support system in place.”

“Can I see her? I brought some of her things.”

Normally, we’re strict about visiting hours—they’re only from four to nine in PIC, where everyone has to be buzzed in and out. We don’t allow visitors before noon, so patients can attend programs, and we can make our rounds. But he looked desperate, and I thought seeing him might help Heather settle in.

“She’s resting right now, but you can say a quick hello.”

We didn’t talk as we rode up the elevator to Psychiatric Intensive Care on the next floor. Daniel seemed lost in thought, and I was busy counting my heartbeats while focusing on my breathing. I’ve suffered from claustrophobia for years, a fact that would probably shock my patients. Various coping techniques help, from mental imagery to breathing exercises, but when I first heard the elevator seal shut, I had to restrain myself from hitting the panic button.

We were buzzed into the unit. In PIC, the nurses’ station is behind glass, and a security guard is always at hand. One side of the unit is for high-risk patients like Heather, and the other is the step down unit, where they go when they don’t need the same level of monitoring. If they continue to improve, they are moved down to the next floor, where they have more freedom.

The nurse searched the bag Daniel had brought for Heather to make sure there wasn’t anything she could hurt herself with—the frame was removed from their wedding photograph, same with the tie from her robe. When the nurse was finished, I showed Daniel to an alcove in the lounge area, where they could have some privacy but still be in view, then went to get Heather.

As I entered the seclusion room, I gave her a quick visual. She was still curled in a ball, her pale arms wrapped around her torso with both small hands on her shoulders, as if she were trying to hold herself together.

“Heather, do you feel up to a visit with Daniel now?”

Heather twitched at the sound, then slowly rolled over. Her voice was pleading, and her eyes flooded with tears, as she said, “I need to see him.”

“Okay, but you’ll have to come out with me because we don’t allow visitors in the seclusion rooms. Are you feeling strong enough to stand?”

She was already pulling herself up into a sitting position.

When we entered the lounge area, Daniel jumped to his feet—and froze as he took in the sight of his wife slowly shuffling beside me, the bandages on her wrists, the hospital blue pajamas, the blanket she’d wrapped around her shoulders like an old woman’s shawl.

“Daniel!” she cried out.

“Oh, sweetie,” he said as he gathered her into her arms. “You can’t scare me like that again.”

Once a patient has been in for a few days we leave them alone with their visitors, but I wanted to see how Daniel and Heather interacted—in case Daniel was part of the problem. I sat in one of the chairs a little to the side.

Daniel gently helped Heather lower herself before taking a seat. Heather rested her head against his shoulder, and he wrapped his arm around her back, supporting her.

“I’m sorry, Daniel.” Heather’s voice was raw with emotion. “I hate what I’m doing to you. You shouldn’t have to take care of me all the time.”

A red flag. Suicidal patients try to convince themselves that people would be better off without them.

Daniel said, “Don’t talk like that. I love you. I’m not going anywhere. I’m going to take care of you forever.” As though to prove his point, he pulled the blanket up around her shoulders, tucking it around her neck where the hospital pajamas had drifted down, revealing the hollow of her thin collarbone.

She clearly wasn’t frightened of Daniel, so I decided to leave and finish my rounds. Then Heather, speaking slightly under her breath, said something that caught my attention.

“I told the doctor about how they keep calling.”

“What did you say?” Daniel didn’t sound upset, just a little worried.

“Not much, I don’t think…. I’m confused, and my head feels funny. Are you mad at me?”

“I’m not mad, sweetie. But maybe you shouldn’t think about any of that right now, just think about getting better. We can talk about everything else another day.” His face was earnest, making sure she understood.

“Do you think Emily knows… what I did?”

“No, they probably wouldn’t have told her at the center.”

Heather nodded, then glanced up at the camera in the corner. She’d also glanced at it when she first sat down, and I wondered if she’d been at a treatment center where patients were monitored.

“Is there someone you’d like me to contact for you?” I said.

Heather looked at Daniel. He shook his head, just a slight movement, but she nodded back, acquiescing to whatever he’d just silenced.

I said, “It would help my treatment plan for Heather if you told me what program you were attending.”

Heather rested her hand on Daniel’s leg, her eyes pleading with him. Daniel’s were focused on her bandages, then he turned to me.

“We used to live at a spiritual center. It’s out in Jordan River. We left when Heather got pregnant because she didn’t want to have the baby there. Some of the members have been calling to make sure we’re okay. They’re nice people.”

I’d heard that there was a center out in Jordan River, a spiritual retreat of sorts that was well respected, but I didn’t know much else about them.

Heather had started to cry again, her shoulders shaking.

“They made me feel like it was my fault I lost the baby.”

“They don’t really believe it’s your fault—no one thinks that,” Daniel said. “They’re just trying to help, sweetie. You were doing so well.”

Heather was crying harder now, her face twisted.

“I didn’t like how they’re always telling us what to do. They—”

“Heather, stop—you don’t know what you’re saying.” Daniel’s eyes shot to my face, his voice concerned and his expression helpless. “They have rules, Dr. Lavoie, but they’re so we can stay focused on the workshops.”

Heather and Daniel clearly weren’t on the same page about the center, but she didn’t want to contradict Daniel in front of me. She kept glancing at him. Is it okay that I’m saying this? Do you still love me?