Chapter Thirty-Three
The walls of the VIP wing wore a soft yellow paint with an off-white trim. Picture windows on the outside wall allowed the sun to shine onto blue flecked terrazzo tile. The effect was like walking across a summer sky. Cai would have been inspired to paint it, no doubt. For Riley, on this dismal day with a forecast of more misery, the sunshine felt like an insult.
Ahead of him, past two opened automatic doors, Peter squared off like a gladiator facing the lion’s cage.
Riley wasn’t ready for this battle. He stopped halfway to catch his breath, out of the warmth of the sun. The bottom half of his jeans cooked from the part of the window he couldn’t escape.
“I’m here.” Jeremy touched his elbow.
Several doors with brass nameplates lined the walls opposite the windows. Dr. Kate Sherman walked out of the one closest to the elevator. Her silver ponytail swung with the force of her stride. “Agent Cordova?” She held out her hand, then retracted it when she noticed he held a cane. “Good to see you again.”
“It’s just Riley. This is Father Wolff,” he said with a tilt of his head. “My support priest.”
“Call me Jeremy.” He took her outstretched hand. She used the other one to wave Peter and Austin over.
“This isn’t where I normally practice, so I’m borrowing an office for our meeting.” She again glanced at the cane. “We can sit out here, if you prefer, but there are some sensitive topics to discuss.”
“I can walk,” Riley assured her. “Peter. Austin.” He reached out his hand as they approached, receiving a handshake from Austin and a glare from Peter.
“You look like shit,” Austin said. “We could have met in your room.”
“I’m going to see Cai after this,” Riley said.
Peter’s hands clenched into fists. His cheeks turned a dark shade of pink. The usual stoicism was gone, replaced by anger and something else Riley couldn’t place. His tone was its usual ice. “I’d like to see him. Please.” The words came out like they’d been rehearsed.
“And? Why are you telling me?” Riley asked, nonplussed. “I have no objection to you seeing him. And if I did, I suspect you’d ignore it.”
“You don’t know?” Austin asked. He wrapped his fingers around Peter’s wrist.
“Know what?” Riley waved off the answer. “Answer that in a minute. I need to sit.”
“Of course.” Dr. Sherman led the way back to her borrowed office where she turned to Peter and Austin. “You’ll need to wait out here. I’m sorry, Peter. I know this is hard.”
Had Cai been so angry at Peter that he’d barred him from visiting?
“Unless,” she continued, looking at Riley, “you’d allow them to come in?”
“Allow them? Of course, they can come in.” What the hell was going on?
“You understand that you have been designated power of attorney?” she asked.
Riley stared at her for a full thirty seconds before asking, “Dr. Sherman, why would I understand that?”
“I see. In we go. I will have to explain everything.” She opened the office door and motioned everyone inside.
Peter stopped him before he could follow her. “Thank you,” he spat out like it hurt to say it.
“We’ll figure it out, Peter.” When Jeremy moved in close to help him sit down, Riley whispered, “Did you know about the power of attorney?”
“She just left a card and said for you to call her when you were better. I assumed we’d find out in a week. Not days after you were in the ICU.” Jeremy leaned against a wall of books beside the chair.
“You’re so melodramatic. I haven’t died in four whole days.” Riley motioned a lost-looking Peter into the chair beside him.
Austin stood next to Jeremy.
“Okay,” Dr. Sherman began. “I assumed, wrongly of course, that Cai had already told you about the power of attorney, Riley. Let me start with this. I hadn’t seen Cai in two years until he woke me up in the middle of the night a little more than a week ago to have me, and my husband, witness a document naming Riley Cordova as power of attorney. In the event you refuse the power of attorney, or are incapacitated, it goes to me.”
“Why would he do that?” Peter asked. “How could he do that?”
“As for how, Colorado doesn’t require his signature until he accepts. As for the why? Cai was convinced he was about to sink into a depressive state. He felt you would devote too much of yourself to him, Peter. He also believed that the difficult decisions ahead would weigh too heavily on you.”
“He’s my brother. Would you do different? Would any of you do different?”
“May I be blunt, Peter?” she asked.
“Never stopped you before.”
“The saying, ‘They’d let him get away with murder’, I feel you took this too literally.”
“Hah!” Austin’s laugh shot out like he’d held it in for years. “Finally, someone else says it.”
“I have control over everything right now?” Riley asked before Peter’s obvious simmering could explode.
“That’s correct,” she answered.
“Then he can see Cai whenever he wants.”
Peter’s jaw shuddered like his teeth were about to chatter and then relaxed. “Thanks,” he whispered.
“Now that we have that out of the way,” Dr. Sherman said. “Would you mind if I speak frankly to you as well, Agent Cordova?”
“Please do. And it’s just Riley. I’m no longer with the FBI.” He ignored the stares that whipped his way.
Dr. Sherman, taking his cue to not beleaguer the subject, didn’t address it at all. She leaned over and pulled a file out of what he presumed was a purse or bag. “I’ve been to see Julian Thompson and, from the pills he described to me, Cai had been self-medicating with lithium for quite a while. His Lithium levels were within therapeutic range, but there's been kidney damage. Lithium needs constant monitoring of thyroid and kidneys for that specific reason. This means I've had to taper him off the Lithium and am unable to administer an anti-psychotic, yet. All of which is unfortunate, since I deliberately chose not to prescribe lithium to him, despite it being the best medication for his bipolar diagnosis. Lithium has a one percent higher chance of causing tremors in the hand. And the ironic part of all of this is that I will put him back on his original medication, Depakote, because it is the best option for patients with kidney strain and acute mania.”
Mania.
The small windowless office held the silence with a suffocating grip.
No doubt everyone in the room immediately pictured the rivers of scars from Cai’s wrist to his ears, some that passed within a hair of his jugular. All were courtesy of his mania.
Reagan slipped into Riley's thoughts. Pain and fear brought memories of the night he died. If his mind wandered farther down that path, he’d be worthless, but he couldn’t stop the feelings of helplessness. Jeremy, as if reading he needed it, crouched next to him and took his hand.
Peter’s nose twitched uncontrollably, and he cleared his throat enough that his esophagus was probably raw. Not even Austin’s embrace seemed to calm him.
Dr. Sherman’s eyes softened. “Cai is lucky to have this much love and support in his life. I’m afraid this is going to get much worse before it gets better. But we’ll get through it.”
She waited for breaths in the room to ease out and shoulders to grow slightly relaxed before she continued. “For now, Cai is secured to a bed. He is having religious delusions in which he thinks he’s a God, or the God—impervious to pain and invincible. I don’t need to tell any of you how dangerous that is, do I? Do not loosen his straps. His rapid speech is part nonsense, part either Albanian or Russian. So, you may or may not understand it. Do not reinforce the delusional speech. But do not confront him about the delusions, either. Listen to what he’s telling you. The underlying message may be that he feels unsafe, that he’s scared. Encourage any honesty and try to be honest without, again, confronting or reinforcing the delusions. We are all used to Cai’s logic, but if you try to logic him out of the delusion, you will make him distrust you. I cannot reiterate this enough. Cai is not rational right now. He cannot be reasoned with. It would be like trying to reason with cancer. When you find yourself feeling frustrated, sad, angry, and you absolutely will, leave the room. Most importantly, let him know you’re there for him and that you love him. You cannot and do not need to do more than that.”
Riley had felt loss. Reagan’s death had had such a profound effect on him and his family that they had forever been altered. They’d been able to grieve together. Support each other. How could he grieve someone he could see and touch but couldn’t reach?
“Now the good news!” She took a deep inhale through her nose and her smile took on a confidence he didn’t buy. “He hasn’t hurt himself irreparably. His kidneys should return to normal in a few months. And, with treatment, manic phases are three to eight weeks. The longest I’ve seen is eleven weeks. In Cai’s case, we have a vague roadmap. This is his third manic episode. A depressive cycle followed two of them. But this one has likely been triggered by stress and improper dosages. Those are factors in our favor because they do not follow the typical cycle. He might not enter a depressive state. If he does, it could take months to find the right medication and dosages. Are you prepared to keep him in a private room that whole time, Austin?”
“Yup.” Austin cleared his throat. It didn’t help. They could all hear the emotion cracking his voice. “Yes. Whatever he needs.”
“Good. Then let me ask you all to read up on some therapies I’d like to try. Cai has always been interested in unconventional therapy. However, we will start with a typical protocol. Meanwhile, I would like all of you to read up on ketamine treatments and ECT. Both have had positive results with Bipolar Depression. If you have any qu—”
“No fucking way!” Peter stood up.
“I’ll send you all the literature,” she said, ignoring Peter’s outburst, then turned to him. “And remind you that these are the hard choices Cai was afraid you’d have to make.”
Riley had heard of ketamine used in treatment, mainly from cases where doctors sold it illegally. “ECT?” Riley asked. “Is that shock therapy? Isn’t there a risk of brain damage?”
“Not with the modern treatment. I hope you’ll read the articles and studies, in case we need to discuss that option. If you have any questions, I’ll follow up. We have several other treatments before we consider anything outside the box.”
“Dr. Sherman, you wouldn’t have brought it up this early unless you expected difficulties,” Riley said. Would his heart ever beat at a normal pace again?
“Call me Kate.” She leaned back in the chair, folding her hands on her stomach. “Bipolar patients, especially young ones, are very difficult to treat. Luckily, Cai has reached adulthood, and I might not have the issues of the past. If he doesn’t respond to typical protocols, we’ll have this discussion again, and you will be more prepared. Yes? Great. Now,” she said, standing up.“Let’s get you in to see him.”