Dear Emergency Room Staff,
I wish I didn’t know you quite as well as I do. My son’s body is healthy and strong, so imagine my surprise when I found myself spending so much time in your bleak rooms. I know there are some of you who roll your eyes and wish it wasn’t us again when you see his name show up on your patient board.
Believe me, I wish it wasn’t us again too.
My son is 17 and this year alone we’ve found ourselves as patients of yours four times. That’s still a couple times less than years past, even if it is four times more than I wish it was.
You see, my son with the strong and healthy body has a mind that isn’t always in good health. Sometimes he’s in a dark place and we’ve exhausted all the resources within our reach. There are times we’re able to get him to you in our own vehicle, praying he doesn’t try to open the door and jump while we’re driving down the street. Other times, the ambulance brings him, unable to calm him down despite the best efforts of the police and firemen and paramedics that lined our otherwise quiet, suburban street.
When we make our way to you, we are often exhausted, completely at the end of our rope. The decision to walk through your doorway is not one we ever make on a whim. It follows hours — sometimes days — of emotionally taxing meltdowns for him, sometimes threats and fears for his safety and every once in a while, ours too.
This last summer we brought him to you because he hadn’t been himself for a couple weeks. One night at bedtime he came to me and told me he didn’t feel safe. We called his therapist, called the Mobile Crisis Line too, and they all told us to take him in. He wasn’t sure he could make it through the night without ending his life.
Imagine that. Your child: so deeply sad that he wasn’t sure if he could live until the morning and so out of desperation, he came to you to help keep him safe.
We waited in the lobby for such a long time; his mental state not as critical as others presenting with physical symptoms, I suppose. He looked scared and unsure he had made the right decision coming here, so I tried to stay as calm as possible.
The hospital is not a place he always feels safe. He was just 6 years old the first time we had to make the decision to hospitalize him for mental health issues. It was the hardest thing I’d done up to that point and I wish it was the last. We went several years before the next time, but then it was three times in just six months that the ER staff deemed him unstable enough to send to pediatric acute care once again. One of those times he was in a place high up on a top floor of the hospital, no access to the outside. They called me at home one night while he screamed in the background and told me they didn’t know what to do with him and asked if I had any suggestions on how to calm him down before they resorted to a sedative shot. Through his sobs and my sobs, they couldn’t figure it out and so when we went to see him the next day, he was awake but not all the way and he didn’t even notice that he’d wet his pants.
He was 10 years old.
That night, 17 and as low as he’d been in a long while, he wasn’t angry and out of control. He was so deeply sad he was almost catatonic at points. It was a big deal to him (and us) that he’d finally reached a point where he could identify when he was headed for a spiral before we were already deep into it. Although it was scary and sad to know he felt so hopeless that suicide seemed like a viable option, it was somehow hopeful for us too. I’d hoped that would mean something to you as well.
When you finally called him back, his eyes changed and his limbs started to twitch just a little bit. He was scared, that much was apparent. I was worried what that meant and urged you to remember he was here this time because he was suicidal. You rushed through the basic protocol, slapped a hospital bracelet on his wrist just a little bit too tight and then you told him to get undressed and put on the paper jumpsuit.
I saw the shift happen then.
“No,” he said.
Simple and clear at first, I wish you’d listened to him then. I understand you worry about his shoelaces and the tie around the elastic waist of his basketball shorts, but you could have given him some time to process what was going on.
Instead, you sighed with impatience and called in more nurses and two security guards who crossed their arms and spoke in harsher tones than necessary. My son was cornered then. I was feeling panic rise and trying my best to stand between him and the suddenly full room of people all speaking to him at once, but I couldn’t contain his fear.
“I don’t want to take my clothes off!” he yelled, less in control of his pitch and volume this time.
Before I could put my arms around him or talk him down, there were two grown men on top of him, pinning his arms behind his back, bumping his head against the metal rail of the bed so hard an immediate red lump began to form. You ripped his shirt as you forced it over his head. You threatened to call the police and make a report for property damage for the hole his flailing foot put in the wall as he fought to stay upright.
You got him changed, all right. In a jumpsuit more suited for a prisoner. You made me sit outside his room in a hallway cut off from the rest of the ER. There was a tiny window and nothing else. You covered it so I couldn’t see in while he stayed inside and screamed. The echoes of his pleading voice tinged with fear and confusion in symphony with screams of the grown man detoxing from heroin in the room directly next to him.
We took him home that night, after all. By time we got to him he was drugged, his wrists were bruised where the guards had grabbed him during the dressing process and he was so sedated his words slurred but the tears still came freely from the corner of his eyes.
“Please Mommy, take me home. I don’t feel safe. I will be good. I won’t hurt myself. I just want to go home.”
We came to you for help. And in your frustration and rush you forgot my son was still a boy. That because his body was strong and robust it didn’t mean he wasn’t still just as sick as the patients with the fevers and open wounds. Perhaps you saw the pile of paperwork and phone calls required to secure him a bed in the overcrowded adolescent psych wards looming before you, or maybe it was close to the end of your shift and you just didn’t want to deal with it. You forgot, perhaps, that we are human too. That in our exhaustion and moment of crisis we were scared and overwhelmed and needed just a couple of passive moments for him to process your demands.
I know your job is hard and you are tired, I do. But please, can you just try to remember to slow down sometimes? I’d like for you to consider how incredibly hard my job is too, and how very tired my son is of carrying his illness every.single.day. He never asked to be a regular.