Issues
Five Months Later
Standing in the garden, Jack held Ianto in what had become known as 'the position.'
Ianto his arms clamped around Jack's waist, standing as close as he could get, his head buried in Jack's shoulder. Jack held him and ran one hand down his back, the other massaging and stroking the back of his neck. Ianto was having a bad day; he had woken in a grump and things had gone downhill from there.
The last five months had been very difficult. It was clear Ianto saw Jack as his security blanket. Ianto would do nothing unless Jack was right there with him every moment of every day which made doing seemingly simple things like going to the toilet a challenge. It made leaving impossible as Ianto would not let him out of his sight and the furthest allowance for separation appeared to be the reach of his arm.
Jack didn't care. He was determined to prove to everyone here that he could look after Ianto, and secondly Ianto needed this. He needed Jack like a drowning man needed air. He could still be triggered into a flashback. However with Jack's presence, attention and their new sleeping arrangements these had begun to lessen. As a consequence, the brain damage was now becoming more evident.
Geoff Green had explained that for Ianto it was like he had multiple complex competing parts of himself; one was the part that was hyper-vigilance PTSD and the other was dictated by the degree of regression. On top of all this was the brain damage.
His brain damage was significant, affecting his memory in a jumble of confusion. It was clear from his first moments at the unit that he needed help to do the simplest tasks, like feeding himself and using the toilet. All indications as Jack suggested that he may have had an eidetic memory were gone. The few tests they had managed to give him showed that all and any instructions had to be endlessly repeated before Ianto fully understood. However even after all this hard work Ianto would appear to have only the bare basics. How much he actually knew was open to question. He remained in his blank state unless directed to do something within the confines of the routine. Geoff explained that at the beginning Ianto was like a living moving doll; it had taken weeks before he'd started to do the simplest things for himself. The day he lifted a spoon from a bowl to his mouth was a noted breakthrough. It was heartening to see how he responded to Jack but he had a long way to go.
Jack asked if this might be Ianto resisting their efforts because it was possible Ianto saw himself still a captive. Geoff agreed it was a possibility; on the other hand Ianto was showing classic symptoms of someone with brain damage, which was evident in his physical co-ordination for example. The scans he had had at the UNIT facility showed that memory areas of his brain had been severely disrupted. His brain had taken a severe knock not just from the torture but he had been assaulted chemically, and the side effects of whatever had been used on him meant as it was a combination that left Ianto fighting to retain and recall anything.
In light of his memory loss the staff told him the names of objects around him including colours because Ianto could not speak and tell them what he knew. They worked from the premise that he needed to know everything. Geoff told Jack that after they had begun this they had noted a small improvement in Ianto's behaviour and he was observed picking up objects and moving his lips as if repeating what the object was over and over again as to not forget. From the beginning they had always interacted in a way that allowed Ianto to name parts of himself and those objects around him; 'I'm putting your jumper over your head' types of conversation like you would anyone who had forgotten the basics. Geoff smiled, noting that Jack had continued with this almost without comment and every interaction was interspersed with telling Ianto as much as they could about what they were doing in an attempt to get him to interact with the world around him.
Also difficult had been just observing Ianto without him flicking immediately into his blank state. To do so the staff had used a whole range of tactics to observe him. What appeared to work best was to ignore him and just pretend to be doing something. Geoff added that he had started to sit in the dayroom working on reports, trying to gain some insight to how to help him further. It had given him an understanding that Ianto felt direct focused attention was the equivalent of someone pointing at him shouting 'You!' This behaviour of remaining or trying to blend into the background was a way of avoiding being picked for torture; as a consequence they never put him on the spot if it could be avoided. Until the breakthrough with Jack the only interactions they had managed with him was in direct relation to his schedule. All other actions he did only if he was seemingly unobserved.
What was disappointing was it appeared he had no recollection of anyone he had known up until that point. Tosh and Gwen had visited and they had shown him some of the photographs of his parents, Lisa, and all of them. However it was not certain Ianto even recognised himself let alone anyone else. Once they had left and he was alone in his room he had only glanced at each photograph and not paid them any attention since.
On the other hand he had retained aspects of his personality and as far as they could tell his intelligence was unaffected, especially his mathematical ability and love of anything mechanical. To say he was confused as he tried to make sense of the world around him would be an understatement. His link to sanity was the routine and now Jack.
The emotional overload and frustration was overwhelming. Ianto felt intense emotion but with no words or any other outlet to express it, it came out like a tantrum. If he got into a major strop things tended to escalate until the staff were forced to intervene. Today Ianto had gotten upset because lunch was late. Once it had arrived he had refused to eat it, and had thrown it and the table across the room. Another resident had then started to act out so Jack had led Ianto outside in an effort to calm him down. He looked at his watch and saw it was their time for being outside so hopefully they could get him back on track for the rest of the afternoon. He knew once he was through this Ianto would continue as if nothing had happened.
Jack took a deep breath as he saw Dr Green coming to speak to him. They had decided that any discussion about Ianto's future would be discussed in front of him. It was an open policy because, despite his confusion, he had the right to be part of the process towards his recovery. Jack had insisted on this. Ianto was an adult; this was his body, his mind, his life. For him to move forward there had to be 100% transparency with no surprises.
"There you are," Dr Green said as he saw Jack and Ianto under what he called the comfort tree. It was where Jack brought him every time he got out of control, being the first place Jack had taken him when he had rescued him from the room.
"Ianto is feeling much better," Jack told him as he joined them and felt Ianto give a tiny almost imperceptible nod.
"I have joined you today because there are two things which need to be arranged before Ianto can leave." Jack felt Ianto stiffen, because despite appearances Jack knew he was paying attention to every word. How much he understood was one thing but the one word that always got his attention was the word 'leave'. "When Ianto was brought in here he had two ongoing issues that needed attention, both of them serious and with his departure it is now essential they be dealt with," the doctor explained.
"Basically Ianto needs his teeth fixed and he needs some surgery to fix the damage to his lower bowel," he told him. Jack nodded in agreement. He knew Ianto's teeth were causing him pain, several needed repair and at least one needed to be removed. The other was the damage caused by the rapes; whatever they had used had caused a pocket to form in his lower bowel, called the sigmoid colon. The interior sphincter which had also been ruptured at some point also needed some repair, and all this led to abscesses. They were affecting his general health, were painful and caused a certain amount of leakage which Ianto was acutely embarrassed by.
Jack and Geoff looked at each other, knowing what was in Ianto's best interest was one thing. Getting him to understand and cooperate was another.
"I see he needs fixing both ends. How many days involved?" Jack queried as Ianto shifted his head to Jack's other shoulder.
"Teeth can be done in one day; we have a dental unit on site. He will need an oral surgeon. I suggest he be fully anesthetised. We do it late afternoon, bring him back here, and he will wake up in the unit. Once he wakes up and realises his mouth feels better then all well and good."
"The other?" Jack asked.
"Minimum three days in hospital, approximately one month after care, means sticking lots of creams and enemas up his bum, which will be messy but soothing. I don't need to tell you that this scenario and particulars of this surgery is the most likely to trigger an episode."
"I know this is going to sound odd but what do they do when a child needs serious surgery?" Jack asked.
"We use medical play. Set up a doll or something and we walk them through every step," Geoff told him as he saw where Jack was going.
"I think that's what we need to do. I can arrange for the surgery to be done privately. He needs to know every face, the buildings, the works. We explain exactly what we doing every step of the way, every medical wipe, every injection," Jack told him.
"At the same time we can also address his anaemia and get him a transfusion," Geoff added. Jack nodded as he pulled out his mobile.