A Bitter Pill to Swallow- chapter 4
The four of them were silent on the drive back to Jonathan's dorm. Tony was hyper focused on the road ahead, knowing if he looked over at Angela, his heart would break all over again. Angela had her hand pressed to her forehead, trying to will away the intense headache that had formed from the moment she heard the words 'I hate you Mom' come out of Jonathan's mouth.
Samantha and Mona were also lost in their own thoughts in the backseat. Samantha knew the state of Jonathan's dorm room and knew finding anything in there would be a monumental task. She hoped they would get in and out quickly and head back to the hotel. Mona couldn't help the flood of memories of her sister that invaded her mind- childhood memories of them playing in their garden, later in life as teenagers spending time with friends, the first time Margaret met Angela and held her in her arms, to the final time she saw her before she died.
They finally pulled up to the dorm and headed inside. Angela and Tony spoke to the resident advisor again and were given the keys to get into his room. Everyone, with the exception of Samantha, was taken aback at the state of his room.
"Tony… how did he let it get this bad? It's disgusting in here! He's never once let his room ever get to this level of… of…" she started.
"Of a pigsty Angela! This place is disgusting! I don't even know where to start!" shouted Tony.
"I think we need to come back here in the morning and tackle this room. There's no point in getting anything right now with the state of this room. We can come here early and start cleaning before we go back to see him" said Mona.
"Yes you're right Mother. Nothing is getting done in here tonight. We should head back to the hotel and try and get some rest. We can come back tomorrow morning" she said as she started to walk towards the door. A photo not covered in clutter and garbage caught her eye as she passed his dresser. It was the photo of the five of them taken at their wedding. They all looked so happy, so on top of the world. She picked up the framed photo and held it close to her chest.
"Tony… did we… did we miss this back then? Have we been so focused on us these past few years that we missed this? Or earlier? When he was a teenager and so socially awkward at times? When he was little…" started Angela before she broke down into a new round of tears. Tony came over to her and wrapped his arms around her, slowly rubbing her back.
"Eh oh, oh eh… this is no one's fault! Yes we have been enjoying finally being together but it's not like we've neglected him Angela! I don't know why this is happening now or whatever we could've done to make things different now. Hindsight is always 20/20. We have to stay in the here and now to focus on how to get him the help he needs now" said Tony as he helped her to the door. Mona and Samantha took one final look around, their hearts breaking again as they headed out the door.
A short while later, they arrived at the hotel. Mona and Samantha opted to share a room and headed in that direction, while Tony led Angela to their room. Once inside, they both collapsed on the bed. They curled into one another and held each other tightly. After a few moments, Tony pulled back a bit.
"Angela, I think you need to call Michael and let him know what's going on" said Tony.
"Yes I know you are right. Let me see if I have his number in my bag" she said as she reluctantly got up off the bed and grabbed her purse. After digging for a while, she pulled out a small green address book and found Michael's number. She took a few deep breaths and then dialed the number on the hotel phone.
"Hello Heather? This is Angela… hi… yes… is Michael there? It's really urgent that I speak to him… thank you… hi Michael. I… I don't know where to begin. It's Jonathan, he's… he's in the hospital, a psychiatric hospital. They think he's in the beginning of a Bipolar Disorder manic episode… I know… Samantha came up to visit him today and he was acting all hyper and irrational. His dorm room was a disaster and he hadn't slept in over twenty four hours. We all came back up and he was even worse. He… he cut his arm badly when he tried to pick up a large lamp and attacked the EMTs when they tried to help him. When he got to the hospital, he had to be sedated so he could be treated. We met with the doctors and they think it's a mental health problem" said Angela.
"I know Michael… yes and it was negative it's not drugs or alcohol… he was fine before he left for school… the week before Michael… yes he seemed fine, maybe a little homesick but nothing like this… he's committed Michael I didn't have a choice!" she started to shout. By this time, Tony was up and off the bed, standing next to her, trying to calm her down. He ended up taking the phone from Angela to speak to Michael.
"Hi Michael it's Tony. Look, I think it's best if you can see about taking a flight out here tomorrow or the next day. I've never seen him like this and he's going to need all of us to be on the same page. He's really in a bad place… I wouldn't have believed it if I hadn't seen him with my own eyes… okay good. Call back this hotel number tomorrow when you know your plans… okay good… good night Michael" he said as he hung up the phone.
"How dare he accuse me of leaving him there! Like I had a choice! What was I supposed to do? Fight the doctors and take him out of there in the condition he is in?" she continued to shout.
"Angela! Angela… you need to calm down! He was totally out of line saying that but Angela remember… Michael has been absent for most of Jonathan's life. He hasn't seen him since his graduation from high school over a year and a half ago. They talk what? Maybe once a month if that… he doesn't know him like we do. Heck… I don't even blame him for being in denial about it. If I hadn't seen him with my own eyes, I never would have believed it either…" said Tony.
"I swear if Michael gets in the way of his treatment…" said Angela.
"We won't let him Angela! He just has to take one look at him to know something is not right. The doctors need to talk to Michael and explain what's going on like they did for us. That on top of seeing him in this state will convince him that he is where he needs to be right now to keep himself and others safe" said Tony.
"You're right Tony. I would have probably reacted the same way if I hadn't seen him myself. I hope he can get here sometime tomorrow. We should probably turn in for the night… not that I think I'm going to get much sleep…" she said.
"Good idea. I'm hoping Hank can come up tomorrow and take Samantha and Mona home. You know, once we have a handle on how things are going" said Tony.
"Yes I hope so too. She's been through a lot today, finding Jonathan like this not once, but twice. And even though Mother doesn't show emotions often, I know this is impacting her after hearing about Aunt Margaret. Hopefully he can take the both of them home" said Angela.
"Let's get ready for bed… tomorrow is going to be another long day" said Tony as they got their suitcase out and began to get ready for bed. It didn't take long for them to find themselves curled up in bed, finding comfort in one another's embrace. A restless sleep soon followed for both of them, both having nightmares they knew would be there to greet them when they awoke.
The next morning, after getting ready after barely enough sleep to function for the day, the four of them headed back to Jonathan's dorm. Angela had called the hospital earlier in the morning for an update. There was no additional news other than his manic state remained. They stopped to get a quick breakfast and managed to get to the dorm by nine. The resident advisor provided them with garbage bags. Tony had given Jonathan a cleaning supply college starter kit at the beginning of his semester. Tony was not surprised to see all the products unopened at the bottom of his closet.
"Okay everyone… pick a corner and get to work! I'm hoping we can get this done in time to get over to the hospital before lunchtime" said Angela as she picked up a garbage bag and began picking up the trash off his floor.
"Eww gross! I'm half expecting an animal to pop out from this mess! This pizza box has half eaten pizza from at least a month ago!" screamed Samantha.
"Eh oh, oh eh! He's lucky he doesn't have ants or bugs or worse!" chuckled Tony.
They spent the next two hours putting Jonathan's room back into some semblance of order. By the time they were done, they had filled eight garbage bags full of trash and demolished the cleaning products. Angela set off to pack him some clothes, things to do that would be allowed on a psychiatric ward and some toiletries. They finished their work and took inventory of the newly cleaned room. A sadness fell over all of them as they each wondered if he would get a chance to live back here again or even continue on with college. They pushed those thoughts out of their minds and headed out the door.
Once they arrived back at the hospital, they were directed to the fourth floor where they met the admissions receptionist. Angela was given more paperwork to complete. Tony gave them the clothing and belongings to be checked in and labeled with his information. Once the forms were completed, they were taken onto the unit and brought to one of the social worker's offices.
"Hello my name is Jessica and I am Jonathan's social worker. I'd like to ask you some questions so we can figure out how to best help Jonathan. The doctor will be in shortly to review his most recent treatment regimen. The good thing is he is still very young. With the right course of medications and treatments, he really has a very good chance of recovery" said Jessica.
"So… so there's a chance he won't recover?" said Angela, the lump in her throat making it hard to breathe, let alone speak.
"Let's focus on the present moment and getting him the help he needs. You all made the right decision bringing him here yesterday. I can only imagine how difficult that was leaving him here but you made the right decision" said Jessica. She began asking them some basic demographic information as well as a comprehensive history, ranging from his school academic records to his medical history to his social life. She explained the questions were to help complete a psychosocial evaluation as part of his intake paperwork.
"Thank you for giving me the information I needed for the evaluation. We tried to get it from Jonathan last night and then this morning, but we were pretty unsuccessful" she said as she pulled out more consent forms for Angela to sign. Angela had a fleeting thought that the amount of paperwork she'd already signed or would in the future killed a small forest.
"Will we be able to see him?" asked Mona.
"Yes, depending on his condition. He's been irritable at times and has had to have a one on one aide to ensure his safety and those around him. It's very common when a patient is in a manic state to exhibit these types of symptoms. We hope that once we start the medications, they will begin to take effect and the Jonathan you know will be ready and able to start his path to recovery" she said. Just then, Dr. Friedman came in with a nurse, followed by Jonathan and an aide.
"Mom! Tony!" Jonathan shouted as he ran over to them, practically knocking Angela off her feet as he embraced her tightly. Thankfully Tony was there to steady them both. Jonathan gave hugs to Tony, Samantha and Mona before being offered a chair to sit in by the doctor.
"Are we here to talk about me going home? My arm feels fine so I think I should go back to school. They have a nurse on campus I can go to if it bothers me. My friend Alex went there last spring when he fell coming back from a frat party and torn open his knee. He was so drunk it was hilarious! He could barely stand up! Here let me show you what he looked like…" he shouted, his speech very rapid and pressured, as he stood up and started to walk across the room. All the family could do was watch him in silence, trying to hide their horror and pain.
"Jonathan, how about you take a seat so we can all talk alright?" said the doctor. The aide helped him take a seat at the table.
"So Jonathan, I know you want to go back to school, but right now we have to focus on getting you more help and support. I want us all to discuss how best we can help you. I know this might be hard for you and your family to hear, but we believe you are in the onset of Bipolar Disorder and in a manic state. The best way to treat you right now is to try out some medications to hopefully help stabilize your mood. It's safest for you to be here on the unit until we know the medications are working. If you…" said Dr. Friedman when Jonathan shot up, knocking the chair to the floor, causing everyone in the room to jump.
"No! I'm not staying here! You can't make me! I want to go home! You can't keep me here! Mom! Tony! Do something!" he screamed as the aide tried to calm him down. He grabbed him by the arms in what looked to the family like a bear hug from behind, causing Jonathan to fight even more.
"Jonathan please calm down!" pleaded Angela.
"C'mon buddy take it easy!" said Tony as he stood up and tried to help calm him down. He got within arms length of him when all of a sudden Jonathan broke free of the aide's grip. He fell forward right into Tony, his arm swinging and punching Tony square in the face, the momentum knocking them both to the ground.
"Call a code white! Get additional staff in here now!" shouted Dr. Friedman.
"Tony! Jonathan!" Angela screamed as she ran to them lying on the floor. Tony was moaning on the floor, holding onto his bad shoulder. The aide was able to grab Jonathan and pull him to his feet. By this time, two more aides came running into the room to restrain Jonathan.
"Tony I'm sorry! Let me go! Let me go! You can't do this to me! Mom! Grandma! Sam! Help me!" he screamed over and over again until the aides were able to get a hold of him and take him out of the room.
"Tony are you okay?" cried Angela as she knelt down next to Tony. Sam and Mona also came around and knelt down next to him. They helped him sit up, Tony in visible pain as he was still holding his shoulder.
"I'm fine. Just let me get up" he said as he stood up, wincing in pain as he sat down in the chair.
"Are you okay Mr. Micelli? We can have our nurse check you out" said Dr. Friedman.
"No I'm fine. This… this is not our son! He's never been aggressive, not even when he was little!" shouted Tony.
"I know you are still thinking of him as the Jonathan you've always known, and to some extent he still is, but right now while he is in a manic state, he's not the same Jonathan. I'm recommending starting him on Lithium as well as Divalproex to combat the manic state. Be prepared, once he does come down from the manic state, he will most likely enter a depression. We will look to alter his medication if and when this happens. This is going to be a rough couple of days for you all. I recommend coming back later on today or even tomorrow for a visit. We will call if there are any updates" said Dr. Friedman as he stood up and headed out of the room. They were escorted off the unit and headed back to the car, all four too stunned and saddened to say anything.
"Here Dad, let me drive. You still look like you are in pain" said Samantha as she took the keys from Tony.
"I think you should get that shoulder checked out Tony" said Mona as she got into the passenger side, leaving Tony and Angela to get into the back of the jeep. Angela helped him get his seatbelt on as he wasn't able to lift his shoulder.
"Sam head to the ER side of the hospital and drop us off. Then head back to the hotel and see if Hank can drive up to get you and Mother to take you all home. You've got work tomorrow and there's nothing more you guys can do right now" said Angela as she was holding back the tears in her eyes that were threatening to fall.
"Angela I'm fine…" started Tony until Angela interrupted him with a look that he knew all too well. He decided it was better to just go along with her than to try and fight her. Sam drove around to the emergency department entrance and dropped them off. They watched Angela help Tony through the electric doors, until they were both out of sight.
"Mona… this is a nightmare! I can't believe this is happening!" she cried.
"I know Sam… and I have a horrible feeling it's only going to get worse when Michael gets here…" said Mona as they headed back to the hotel.