the girls by several inches, showed no signs of puberty, and devoured what was left of the pizza. And only minutes later, with mumbled excuses, they left. They had never made it as far as Daphne's room from the kitchen, and said they had to get home. They had been outnumbered by the girls three to one, but would have left early anyway. The scene was too much for them. The girls looked far more mature, and rushed back to Daphne's room to discuss it as soon as the boys had left. Maxine was smiling to herself, listening to them squeal and giggle, when the phone rang at eleven. She figured it was Sam wanting to come home, and she was still smiling when she answered, expecting to hear her youngest son's voice.
Instead, it was a nurse at Lenox Hill Hospital's emergency room, calling about one of her patients. Maxine frowned and instantly sat up in rapt attention, asking pertinent questions. Jason Wexler was sixteen, his father had died suddenly of a heart attack six months earlier, and his older sister had died in a car accident ten years before. He had taken a handful of his mother's sleeping pills. He suffered from depression, and had tried it before, though not since right after his father's death. He and his father had had a terrible argument the night he died, and Jason was convinced his father's heart attack and death were his fault.
The nurse said his mother was hysterical in the waiting room, Jason was conscious, and they were already pumping his stomach. They thought he was going to be okay, but it was close. His mother had found him and called 911, he had taken a lot of sleeping pills, and if she'd found him any later, he would have been dead. Maxine listened carefully. The hospital was only eight blocks away, and she could walk it at a good clip, in spite of the six inches of snow on the ground that had turned to slush late in the afternoon, and then frozen solid in brown icy patches by nightfall. It was treacherous when that happened.
“I'll be there in ten minutes,” she told the nurse efficiently. “Thank you for calling.” Maxine had given Jason's mother her home number and cell phone months before. Even when the call group covered for her most weekends, she wanted to be there herself for Jason and his mother if they ever needed her. She had been hoping they never would, and wasn't pleased to learn of his second suicide attempt. And she knew that his mother would be desperately upset. After losing her husband and her daughter, Jason was all she had left.
Maxine knocked on Zelda's door and saw that she was asleep. She wanted to let her know that she was going out to see a patient, and to listen for the girls, just in case. But she hated to wake her, so she closed the door softly without making a sound. It was her day off, after all. And then Maxine walked into Daphne's room as she pulled a heavy sweater over her head. She was already wearing jeans.
“I have to go out to see a patient,” she explained. Daphne knew, as they all did, that her mother went out to see special patients, even on the weekends, and she looked up and nodded. They were still watching DVDs and had gotten quieter as the night wore on. “Zelda's here, so if you need something, you can get her, but don't make too much noise in the kitchen, please, she's asleep.” Daphne nodded again, her eyes riveted to the screen. Two of her friends had fallen asleep on her bed, and one was doing her nails. The others were avidly watching the film. “I'll be back in a while.” Daphne knew it was probably an attempted suicide. Her mother never said much about it, but that was the reason she usually went out late at night. Her other patients could wait till the next day.
Maxine put on boots with rubber soles and a ski parka, picked up her purse, and hurried out the door. She was on the street minutes later, walking against a bitter-cold wind, moving south at a good clip down Park Avenue, toward Lenox Hill Hospital. Her face was stinging and raw and her eyes watering by the time she got there, and walked into the emergency room. She checked in at the desk, and they told her what cubicle Jason was in. They had decided he didn't need to go to the ICU. He was groggy but out of danger, and they were waiting for her to admit him for the night, and decide the rest. Helen Wexler pounced on her the minute she walked into the room, clung to her, and began to sob.
“He almost died…,” she said, hysterical in Maxine's arms, as Maxine led her gently from the room, with a glance at the nurse. Jason was dozing in the bed and hadn't stirred. He was still heavily sedated from the residue of what he'd taken, but he no longer had enough on board to risk his life. Just enough to help him sleep for a long time. His mother kept repeating that he had almost died. Maxine led her a fair distance down the hall, just in case her son woke up.
“But he didn't, Helen. He's going to be all right,” Maxine said calmly. “You were lucky you found him, and he's going to be fine.” Until the next time. That was Maxine's job to deal with, so that there wouldn't be a third time. Although once suicide was attempted, by any patient, the statistical risk of their trying again was infinitely higher, and the chance of success likelier each time. Maxine wasn't happy that he had tried it a second time.
Maxine got Jason's mother to sit in a chair, and take some deep breaths. And finally, she managed to speak calmly about it. Maxine said she thought Jason should be hospitalized for longer this time. She suggested a month, after which they could see how he was doing, and she recommended a facility she worked with frequently on Long Island. She assured Helen Wexler that they were very good with adolescents. Helen looked horrified.
“A
“I think that right now he needs the protection and the support. I don't want to bring him home too soon, and the holidays are going to be hard for him without his dad too. I seriously think he'll do better at Silver Pines. You can have Thanksgiving with him there.” Helen just cried harder.
Maxine was anxious to see her patient. She told Helen they would talk about it later, but they both agreed that he should spend the night at Lenox Hill. There was no other choice, he was in no shape to go home. Helen was in full agreement with that, just not the rest. She hated the idea of Silver Pines. She said it sounded like a cemetery to her.
Maxine checked Jason quietly while he was sleeping, read the chart, and was alarmed to see how much of the drug he'd taken. He had taken far more than a lethal dose, unlike last time when he had barely taken enough to kill himself. This time had been a far more serious attempt, and she wondered what had brought it on. She was going to spend time with Jason the next morning when he woke up. There was no hope of talking to him now.
She made some notes on Jason's chart of what she wanted. They were going to move him to a private room later that night, and her orders included a nurse with him, on suicide watch. There had to be someone there to observe him even before he woke up. She told the nurse she'd be back the next morning at nine o'clock, and if they needed her sooner, they should call. She left them her home and cell phone numbers, and then sat down again with Jason's mother outside. Helen seemed even more devastated than before, as reality began to hit her. She could easily have lost her son that night, and been alone in the world. The very thought of it nearly drove her over the edge. Maxine offered to call her physician, in case she wanted sleeping pills, or some mild sedation, which Maxine didn't want to prescribe herself. Helen wasn't her patient and Maxine didn't know her history or what other medications she might be on.
Helen said she had already called her doctor. He was supposed to call her back, but he was out. She said Jason had used all her sleeping pills, so she had no more at home. She started crying harder again as she said it, and she clearly didn't want to go home alone.
“I can ask them to put a cot in Jason's room for you if you like,” Maxine said gently, “unless that would be too upsetting for you.” If so, she'd have to go home.
“I'd like that,” Helen said softly, her eyes wide as she looked at Maxine. “Is he going to die?” she whispered then, terrified of knowing but trying to brace herself for the worst.
“This time? No,” Maxine said, shaking her head solemnly, “but we have to be as sure as we can be that there won't be a next time. This is serious business. He took a lot of pills. That's why I want him to stay at Silver Pines for a while.”
Maxine didn't want to tell the boy's mother now that she wanted him there for a lot longer than a month. She was thinking more like two or three months, and maybe an interim support facility after that, if she thought he needed it. Fortunately, they could afford it, but that wasn't the issue. She could see in Helen's eyes that she wanted Jason to come home, and she was going to fight Maxine on a longer hospital stay. It was a very foolish position for her to take, but Maxine had dealt with that before. If Jason was sent to a psychiatric hospital, they'd have to face that this wasn't just a “little mishap,” he was truly sick. Maxine had no doubt in her mind that he was suicidal and severely clinically depressed. He had been ever since his father's death. It was more than his mother wanted to
