Chapter 13
DR. BLAKE PUT THE POLICE report down on his desk. “I’m so sorry,” he said. “I know that Kaya was doing so well for so long. I’m sad to see that her symptoms are progressing.”
Mrs. Reed dabbed at her eyes with a handkerchief she had been carrying with her for the last three days since arriving in Palmetto. “Dr. Blake,” she said, “is there anything that you’ve discovered in the time that you’ve been meeting with Kaya that could be helpful? Something that we could share with the psychiatrist at Benson Hospital that could help them figure out the next steps?”
Dr. Blake sighed. “We’ve only met three times. We mostly talked about her history. She told me stories about things she had heard over the years, and her interpretation of what was happening at the time. We’re booked to have time with the fMRI in January, so we haven’t been able to get any data yet. But now I’m not so sure that’s a good idea.”
Graham’s head jerked upright. “Why not? I mean, not many people with psychosis have the opportunity to participate in this kind of research. I’d hate to see Kaya lose her opportunity to learn more about what’s going on with her brain just because she had a bad episode.”
Dr. Blake shook his head. “I’m not sure that I can ethically continue with this course of research, Reed,” he said. “We were going on the premise that Kaya had something going on that had not been seen before. I’m not so sure that’s the case now. It’s possible that she was just in the early stages of her illness, and now it’s starting to resemble something that has been through a lot of research.”
He gave Graham a warm smile.
“I’ll tell you what. I won’t cancel our time with the fMRI just yet. I’ll wait until Kaya gets fully assessed in the hospital and find out what the psychiatrist says. You said his name is Ernie Franklin? I’ve never heard that name before. But I’m not too familiar with the private, for-profit hospitals around here. I’ve mostly just worked with Palmetto.”
“Dr. Franklin’s the medical director and administrator of the place,” Mrs. Reed said. “He says he has years of experience working with young patients like Kaya. I’m really hopeful that he can find a medication that works for her, one that she won’t stop taking like she did last time. I really just want her to feel better, but I’m also concerned about her getting in trouble. The young man, Ted, has decided not to press charges against her due to the circumstances. I think that was the humane thing to do. He said he didn’t want to draw all that negative attention to her while she’s going through so much. I should probably send him a thank-you note or something.”
“That would be nice,” Dr. Blake said. “What can I do to help for now? Graham, I’d be willing to extend the due date of your final paper of the term if you need me to.”
Graham shook his head. “No, I’ve pretty much got it done.”
Dr. Blake shook his head. “Of course you do. It’s not due for a month. I would expect no less from a student like you. However, if you need to take some time, and miss class, you would be excused. I know you’ll make up any work you miss.”
“Thanks, Dr. Blake,” Graham said. “I might take you up on that.”
“I can’t believe I have to wait for visiting hours to see my own daughter,” Mrs. Reed said in the car on the way to the hospital. “I should be able to see her whenever I want to, or she wants me to.”
Graham pulled into the lot and looked around for a place to park. “I guess they have stuff they do during the day,” he said. “You know, like therapy, and groups, and meals. They have a schedule. For a lot of the patients, the structure’s really important.”
“Kaya doesn’t belong with those other people,” Mrs. Reed insisted. “She needs to be home, with her family. We can help her there.”
Graham pulled into a space, put the car in park, and looked at his mother. “I don’t know. Mom, maybe this is the right place for Kaya. She needs to be around people who can help her. People who are trained to help her. We just see her as the great person she is. You know, funny, cute, talented—just Kaya. All these years, we’ve encouraged her, but have we really been helping her?”
Mrs. Reed looked at her hands in her lap. “I don’t know, Graham.”
Tears came back to her eyes, and her handkerchief came back out of her pocket.
“Do you think . . . do you think it’s just gonna keep getting worse? Is Kaya going to have to leave college, and spend all of her time just trying to stay in reality? I can’t accept that! There’s too much life in that girl to just give up. But—but if she does give in to this illness, and we lose the person who she’s been . . . I think of all she could lose. Her education, her cheering, her boyfriend, her future . . .” She trailed off and then blew her nose.
Graham felt waves of despair go through him, settling in his stomach. He had seen some of the other patients when he visited Kaya in the hospital the day before. Some of them seemed like they might be okay, but others wore what had seemed like vacant stares, and when they walked, it wasn’t with grace and confidence like his sister. His sweet, enthusiastic sister, who had been sitting deflated on the holding room floor in the emergency department, and had been groggy and avoidant the day before when he tried to visit her at Benson Hospital. It killed him a little bit more inside every time he saw her.
“Let’s just go in and see how things are today,” he told his mother. “She has three days left on her hold, and hopefully she’ll be well enough by then that she can be discharged. She can take a leave of absence, maybe, and go back with you to Wisteria and get some outpatient treatment. And then it’s just a matter of waiting to see how she is.”
Mrs. Reed nodded. She shoved her handkerchief in her pocket and opened the door.
“Okay, let’s go,” she said, stepping out of the car. Graham followed her to the entrance. “We’re here for visiting hours,” she told the receptionist. “Kaya Reed.”
The receptionist had them sign in and sit in the lobby.
Five minutes later, a tech in blue scrubs came out to greet them. “I’ll take you to her room,” he said. “We tried to get her to come out to the day room, but she wouldn’t go. I’m not sure how long she’ll want you to stay. She really hasn’t engaged with anyone all day.” He left them at the door. “You have about an hour.”
Mrs. Reed rapped softly on the open door. “Kaya? Kaya, Graham and I are gonna come in and visit you now.”
She walked in and found Kaya sitting on the edge of the bed, her hands folded in her lap, her face blank.
“Kaya.” She took her daughter’s hand. “How are you?”
Kaya looked up slowly at her mother, her expression vacant. “You don’t have to be scared to talk to me, Mom,” she said dully. “It’s still just me. And no, I’m not gonna do anything crazy while you’re here.”
“Kaya,” Graham said, sitting on her other side. “No one’s afraid of you doing anything while we’re here.”
“Mom is,” Kaya said, looking at him. “She’s afraid. She thinks I’ve changed, and she doesn’t know me anymore. Do you feel the same way, Graham?”
Graham looked carefully at his sister. Her eyes had lost their shine. “I-I don’t know, Kaya. It sounds like you hear Mom’s voice telling you things about how she feels. But Kaya, isn’t it possible that you’re projecting your own feelings into her voice? Isn’t it possible that you’re feeling that you’ve changed, and you’re the one who’s scared?”
“I am scared, Graham,” Mrs. Reed said. She turned to Kaya. “It’s okay, Kaya. I don’t mind if you know. I’m terrified. Just as terrified as I’d be if they told me you’d been diagnosed with cancer or some other disease. And I feel helpless. I’m not sure what I can do to help you, and it does scare me.”
“You can believe me,” Kaya said. “You can believe that I’m not crazy. I’m not homicidal, and I’m not just imagining the things that I felt from that guy that day. I’m not wrong, Mom. Graham. I’m right, but if I keep telling them that, they’re gonna make me stay forever. But what can I do? No one believes me. So I have to wait until he hurts someone for everyone to believe me? No, just ignore the little schizo girl. She’s just nuts!” She lay back on her bed, letting her head hit the pillow. “If you want to do something for me, get me out of here.”
“Kaya,” Graham said. “The guy who let us in here said that you’re refusing to come out of your room. If you don’t come out and do what they want you to do, they’re not gonna think you’re doing better. You have to do what you have to do to get out of here.”
Kaya sat back up. “How on earth is an arts and crafts group gonna help me to not hear voices? Oh, and they had a group where everyone could process their emotions. What am I gonna do, tell them all that I was in a super good mood until the rapist knocked me down and told me scary things? How is that supposed to help?”
Mrs. Reed looked dangerously close to crying again. Graham made eye contact with her and hoped that his expression would tell her to try to hold it together.
“Kaya,” she said, “even if you don’t think it’s gonna help, you have to do what they tell you. Are you taking the medication?”
Kaya rolled her eyes. “Did you know that on the first day I was here, they restrained me? They said I was fighting them. They said that I was a danger to others, and I had to take my medication. They didn’t strap me down like they do in the movies, but they restrained me in a chair and gave me a shot.” She laughed. “The nurse who gave it to me was thinking about her boyfriend the whole time. They’d had a fight the night before, and she wasn’t sure if she was going to apologize, or wait for him to do it. There was a security guard, and he was trying to figure out where he was gonna go drinking with his friend after his shift. It was a great way to distract me while they shoved a needle in my ass. Man, at least they could have been thinking of something more entertaining.”
Graham closed his eyes. “Kaya—”
Kaya shook her head. “You really think I’ve gone over the deep end, don’t you?”
“Did you hear my voice say that?”
“No,” Kaya said. “But I didn’t need to. Your face says it all.”
Graham sat silently. All of them sat silently. Graham didn’t know what to say. He didn’t think his sister was off the deep end, but at the same time, she couldn’t be totally lucid.
“Kaya,” he said softly. “I’m sorry my face looks like it does. Blame it on Dad. He’s not here to defend himself.”
Kaya stared at him in horror. But soon, her face softened, and she smiled. Then she laughed. “Oh my God, Graham,” she said. “There’s a time and a place for everything. This is the looney bin. No laughter allowed!” She sighed. “Seriously, though. I have to figure out how to get out of here. I think the way to do it is to just shut up about that guy. I just need to keep it to myself. If I stop talking about it, they’ll think their stupid medications are working, and they’ll spring me.”
Mrs. Reed shook her head. “Kaya, no,” she said. “You need to talk to them. You need to tell them everything. Baby, if this guy really is dangerous, there’s no way to prove it anyway. But if he isn’t—if it really is just a voice that’s from your mind and not attached to him—then you really need help. Can you just consider that? It might be possible, even slightly, that your brain has started to manufacture voices that aren’t so benign like they were before. Most people don’t hear voices at all. You know that. It’s not mainstream. You hear voices. Granted, they’ve been different than most. But they’re still voices. It is, slightly, possible that your symptoms have gotten worse. It is possible that your mind is starting to believe them. It’s possible that you’re starting to fixate on them. Just, well, keep an open mind. Don’t shut out the help you’re being offered.”
Kaya squinted at her mother for a few seconds. Then she opened her eyes wide. “Then I guess you don’t want to hear about the voices I heard when I met the psychiatrist. What’s his name? Dr. Jefferson?”
Graham smirked. “Dr. Franklin,” he said. He was going to keep his mouth shut, but curiosity came over him. “What did his voice say?”
Mrs. Reed shot him a look. “Graham,” she said. “Don’t encourage it!”
Kaya laughed. “God, Mom. I’m not three, you know. I’m a grown woman.” She turned to Graham. “He was thinking about all the money he could make from me with my private insurance. I guess most of the patients here are from the town, and they have Medicaid. They don’t pay very much. But they can charge a lot more for private insurance and keep the patients longer. I guess he sees me as a money tree.”
Graham bit his bottom lip. What Kaya was saying was true. Private institutions were able to charge more from private insurance. They preferred working with patients who had employer-paid insurance rather than those on public assistance. He had learned about all of this in one of his practical psych classes. He had no idea how Kaya knew about it. She was taking Psych 101, but there was no way they talked about insurance and reimbursement in that class.
“So you think this guy is driven by the all-American dollar?”
Kaya nodded. “Yeah,” she said. “He said some other things, too, but I didn’t understand them. I asked him about it, and he said he had no idea what I was talking about. I told him what his voice said, and he said that my voices aren’t real. Then he decided to give me a higher dose of antipsychotics.”
Mrs. Reed lowered her head. “Kaya,” she whispered.
Kaya looked at her mother with concern and put her hand on her shoulder.
“Mom,” she said softly. “Mom. I swear, it’s gonna be all right. Okay? I just have to get through this. This isn’t the end for me.” She paused. “And I’m not gonna have to come live at home for the rest of my life, even if you want me to.”
She pulled her hand back and placed it on Graham’s arm.
“And you don’t have to worry either,” she said. “I won’t have to drop out of school. I’m not gonna do anything stupid to get myself locked up in here forever, and I’m not gonna do anything to get myself arrested. I know it was a close call the other day, but the whole thing caught me off guard. I’ll be more careful now, more discrete.”
There was a knock on the door, and they all looked up.
“Good afternoon, Kaya,” the man said, stepping into the room. He was wearing a long white lab coat over a shirt and tie. Graham noticed his expensive-looking shoes. “Hello everyone,” he went on. “I met you the other day. I’m Dr. Franklin. I’m treating Kaya.” He looked at Kaya and smiled. “Sorry to intrude upon your visit, but I was doing my rounds, and wanted to get a chance to check in on you. Kaya, I heard you haven’t left your room all day. What’s going on?”
Kaya shrugged. “I can’t see any reason to leave my room,” she said. “I’m happy here. This room has everything I need. There’s a bed, and a window, and a lovely K-Mart painting of a girl and flowers over the bed. I notice it’s bolted very strongly to the wall. And if I don’t leave, they bring me my meals in bed. It’s like being royalty.”
Dr. Franklin shook his head lightly. “I’m glad to see you have a healthy sense of humor, Kaya,” he said with a smile. “But I have to say, staying in your room all day is not going to help you get well. We’d like to see you get involved with our programming, interacting with staff and the other patients.”
“Or,” Kaya said, drawing out the word, “you could drop my hold and let me go home. I have classes to get to. And it’s almost Halloween. Grayson and I were trying to come up with costumes to wear. I think it would be therapeutic for me to be able to go to a Halloween party like a normal college freshman and have fun with my friends.”
Dr. Franklin’s smile was pasted to his face. “Kaya, we’ll talk more about this later.” He turned to Mrs. Reed. “I would like to talk to you in my office for a moment.” He turned to Graham. “You can join us as well. Kaya signed a waiver of confidentiality for both of you.”
Graham looked at Kaya.
“What? Sure, you should both go into a different room and talk about my future. Sure. Just make sure when you’re making plans to include me winning the lottery and moving to Los Angeles.”
Mrs. Reed shot her a look and then turned back to Dr. Franklin. “Will we be able to come back and see Kaya before we leave?”
Dr. Franklin nodded, and Mrs. Reed nodded back. She and Graham followed the doctor out of the room and into an office. Dr. Franklin closed the door.
“Kaya’s hold will be up in a couple of days,” he said. “I wanted to let you know that I’m going to recommend to the court investigator that she go to court for a commitment hearing.”
Graham’s body jerked so hard that he almost fell forward out of his seat. “What?” he exclaimed. “Commitment? Kaya? Why? She’s not a danger to herself or others. She had an episode, but it’s over. She seems fine! Why on earth would anyone want to commit her?”
Dr. Franklin folded his hands in front of him on this desk. “Graham, is it? Graham, I’ve been noticing that Kaya’s behavior adapts to who is with her at any time. When you or your mother are around, she is able to pull herself together and come across like she’s okay, and that all of this is a mistake. But that’s not the picture that we’re getting of her here. I’m not sure if you’re aware, but Kaya has made threats against the young man that she assaulted earlier this week. She has said that if released, she’ll find him, and he’ll regret his words. Need I remind you, the words she’s referring to are auditory hallucinations. Kaya’s been obsessed with the delusion that this man is dangerous, and she’ll go to any length to stop him.”
“Did she say anything specific as to what she’d do to him?” Graham asked.
Dr. Franklin shook his head. “Going to any length to stop him is close enough in my book. But there are other indicators that she’s slipping into a delusional world. She has also made statements about me to me and my staff. She’s convinced that I’m embedded in a conspiracy to defraud insurance companies, and that I’m cheating and billing for more than the services provided here. I can tell you quite clearly, that’s not happening here. I would know.” He chuckled. “And even if it was, how would an eighteen-year-old cheerleader from State find out? I don’t mean to make light of this, but these are serious accusations. And her source? Her voices. She claims that she heard my voice telling her that I’m corrupt. I can assure you that I am not corrupt.”
Mrs. Reed had her hand to her face. “So she’s really suffering from delusions,” she said. She shook her head. “She never had delusions before. Just the voices. The medication that you put her on, do you think it will help with the delusions?”
“That’s the hope,” Dr. Franklin said. “But I have to be truthful with you. There are different kinds of delusions. There’s the kind that comes and goes and can be eased by medication. Then, there are fixed delusions. These are the ones that become a system of belief for the person, that work their way into their psyche, and become their reality. Medications can help keep these patients calm, but they can’t take away the ideas.”
“But Kaya just started having delusions,” Mrs. Reed said. “It would seem that they would be the first kind, the kind that can be treated.”
“We just don’t know,” Dr. Franklin said. “Kaya has just been discovered to have delusions, that’s all. We have no idea how long she has been harboring similar delusions. Now that they are known, it’s likely that she will continue to talk about them, and they will continue to develop. Look at how she has already added me to her delusional system. It’s hard to say who will be next. We just have to hope that she can find some people, maybe some staff member here, or family or friends, that can support her and that she can trust. It’s important for her to have someone she can trust.”
“She can trust me,” Graham said firmly.
Dr. Franklin looked at him. “I certainly hope so.”
Graham folded his arms in front of him and shook his head. He grimaced.
“She doesn’t need to be committed,” he said. “I know about commitment. If she goes to court, the judge will throw the case away. She doesn’t meet the criteria. She doesn’t have a plan or means to ‘stop this guy by any means.’ She doesn’t even know his name. I know you’re gonna say it’s public record, but we’ll know if she tries to get access. I can tell you right now that if you release Kaya from the hospital, my mother will bring her back home, and I’ll come with her, and we won’t leave her alone for one minute. We know Kaya, and I know enough about mental illness to help her. I’m a psych major.”
Dr. Franklin gave Graham a smug smile.
“I see,” he said. “So you’ve been studying psych at State for a few years. When did you finish your medical degree, residency, and internship, and get twenty-two years of experience working as a psychiatrist? Once you’ve completed all of that, we can spend some time debating the merits of keeping a young girl with onset paranoid schizophrenia in the hospital for as long as it takes for her to become stable and be safe in the community. But for now, I’m going ahead with my recommendation. So if you’ll excuse me, I have some paperwork to complete, and visiting hours will be over soon. I suggest you get back to Kaya right now if you want to wrap up your visit.” He picked up his pen and started to write on a piece of paper.
Graham looked at his mother.
“I guess we’ve been dismissed,” he said, standing. He walked to the door. As he stepped out of the office, he heard his mother apologize to Dr. Franklin for his outburst, and then she followed him out.
“Graham,” she said, rushing to catch up with him. “Please. Don’t alienate your sister’s psychiatrist. This guy has the ability to help her get better and out of here sooner. Please. For me. Just chill out a bit, okay?”
Graham looked at his mother and then turned away and continued to Kaya’s room. He walked in and smiled at his sister.
“So that guy’s kind of a tool.”
Kaya laughed. “My point exactly.”
Graham looked at her intensely. “Kaya,” he said softly. “They’re gonna try to get you committed. Dr. Franklin’s gonna recommend it to the county. Please, please promise me that you’ll do everything they say. Please. You have to get out of here, and your attitude’s not helping you. You have to play their game. I know you’re not dangerous, Kaya. You have to stop telling them that you’re gonna go after that guy.”
Kaya looked confused. “What guy?”
Graham cocked his head. “The guy,” he said. “The one you attacked.”
Kaya shook her head. “I know what guy you’re talking about, but I never said I was going after him.”
Mrs. Reed pushed her way forward. “What?” she asked. “Dr. Franklin said that you told him that you’d do whatever it took to stop him.”
Kaya scrunched up her nose. “I never said that. I mean, I would never stoop to his level. It’s not in my nature to hurt people. Well, maybe when I feel like I’m unsafe, to protect myself, like I felt the other day, but I wouldn’t seek him out. What I would do would be to go to the police and have them take care of him.”
Graham and his mother looked at each other. “Kaya,” Mrs. Reed said. “Dr. Franklin said that it seems that you’re different around us than you are around everyone else. Maybe you want to protect us from how you really feel. Baby, I want you to be honest with us. If you’ve been telling people you want to get this guy, that’s okay. I don’t want you to hurt anyone, but I wouldn’t be mad at you if that’s how you felt.”
Kaya shook her head furiously. “Mom, this is nonsense! I have not once made a threat to anyone! As a matter of fact, I was planning on talking to that Sergeant Morris once I got out of here to see if maybe there have been any complaints about this guy. Yeah, I know it was a voice I heard, but it felt very real to me. I think it could have been something I saw in his face. Graham, you know all about that. We’ve talked about it. He scared me. I just don’t want to see him hurt anyone.”
Graham got down on his knees in front of his sister and put his hands on either side of her face.
“Kaya,” he said, looking right into her eyes. “Tell me right now that you’re telling us the truth. Tell me right now. I can tell if I’m looking in your eyes if you’re lying or not. Tell me. Now.”
Kaya’s eyes locked onto Graham, and she smiled. “Graham,” she said. “I’m telling you the truth.”
He kept his hands in place. “Kaya,” he said softly. “I’m thinking of a number between one and ten. What is it?”
Kaya looked at him, and a smile spread across her face. “Three and a half,” she answered confidently.
Graham’s hands dropped quickly from her face. He caught his breath.
“I believe you,” he said. “I have no idea why this guy is saying you said that stuff. Maybe he misunderstood. Maybe one of the staff got you mixed up with someone else. I don’t know. But whatever it takes, we’re gonna get you out of here, even if it means I have to testify at a commitment hearing.”
A tech appeared at the door. “Visiting hours are over,” she said. “I’m going to have to ask you to wrap it up.”
Graham nodded to the tech before turning back to Kaya. “We’ll be back tomorrow. We”ll talk to the court representative and tell him that we support you getting discharged. We’ll do what it takes.”
Kaya smiled and nodded. “I know you will.” She pulled him into a hug. “And by the way.” She pulled away. “I really like the idea of me and Grayson being Patrick and SpongeBob for Halloween. Thanks for the suggestion.”
She hugged her mother and said goodbye.
Graham and his mother walked to the exit and signed out.
Outside, the sky was growing dark in the mid-Autumn evening, and stray brown leaves were blowing around the parking lot in the soft wind. Graham opened his mother’s door and then started to walk around the car to the driver’s seat. He stopped short, Kaya’s comment about Halloween playing in his head. He closed his eyes. His feet went numb.
Graham had not said anything to Kaya about what to wear for Halloween. It had been a thought that popped into his mind while he was hugging her. He had thought that he would try to get Kaya out of the hospital before Halloween so she and Grayson could go to a party in a cute couple’s costume, like Patrick and SpongeBob. He had never said it out loud, but somehow, Kaya had known.
“Oh my God,” he said softly. He lowered himself until he was kneeling on the asphalt and pressed his head to his knees. “Oh my fucking God. Oh my God.”
The number that Kaya had jokingly guessed had been three and a half. And that was the exact number that Graham had been thinking.