it. “You took a lot of pills last night, Jason. I mean really a lot. You weren't kidding around this time.” She looked at him, he nodded, and then looked away. He was embarrassed now in the cold light of day.
“I was kind of drunk. I didn't know what I was doing,” he said, trying to brush it off.
“I think you did,” Maxine said quietly. “You took a lot more than last time. I think you need to take some time off now and think about it, work on it, do some groups. I think it's important that we deal with this, and I'm sure it's tough now with the holidays coming up, having lost your dad this year.” She had hit the nail on the head, and his mother stared at her with a look of panic. She looked as though she was about to jump out of her skin. Her own anxiety was sky high, and she was suffering the same things as her son, without the guilt. Jason being convinced he had killed his dad tipped the scale for him. Dangerously so. “I'd like you to go someplace where I've worked with kids before. It's pretty nice. The kids there are from fourteen to eighteen. Your mom can visit you every day. But I think we need to get a handle on what's happening now. I don't feel comfortable sending you home just yet.”
“How long?” he asked, sounding noncommittal and trying to be cool, but she could see the fear in his eyes. It was a scary thought for him. But his succeeding at his next suicide attempt frightened her even more. She had a lifetime commitment not to let that happen, if she could do anything about it. And often, she could. She wanted this to be one of those times, and to avert tragedy before it happened to them again. They'd had enough.
“Let's try it for a month. Then we'll talk, and see what you think and how you feel about it. I don't think you'll love it, but I think you might like it there.” And then she added, smiling, “It's coed.” He didn't smile in response. He was too depressed to care about girls right now.
“What if I hate it and don't want to stay?” He looked her in the eye.
“Then we'll talk.” If they had to, they could ask to have him committed by the courts, since he had just proven he was a danger to himself, but that would be traumatic for him and his mother. Maxine much preferred voluntary commitment, whenever possible. Jason's mother spoke up then.
“Doctor, do you really think…I was talking to my doctor this morning, and he was saying that we should give Jason another chance… he says he was drunk and didn't know what he was doing, and he just promised me that he won't do it again.” Maxine knew better than anyone that his promise wasn't worth a damn. And Jason knew it too. His mother wanted it to be something she could rely on, but she couldn't. Without question, her son's life was at risk.
“I don't think we can count on that,” Maxine said simply. “I'd like you to trust me on this,” she added quietly. She noticed that Jason wasn't arguing with her, his mother was. “I think your mom is upset that you won't be at home for Thanksgiving, Jason. I told her she can have Thanksgiving with you there. Visits are encouraged.”
“Thanksgiving's going to suck this year anyway, without my dad. I don't care.” He closed his eyes and laid his head back on his pillow, shutting them out. Maxine gestured to his mother to follow her outside, and as soon as they left the room, the private duty nurse went back in to sit with him. He would be closely watched at Silver Pines too. And at Silver Pines, the wards were locked, which was what Maxine knew Jason needed. Right now anyway, and maybe for a while.
“I think this is the right thing to do,” Maxine explained to her, as tears rolled down Helen's cheeks. “It's my strong recommendation. It's up to you, but I don't think you can protect him properly at home. You can't stop him from doing it again.”
“Do you really think he'll try?” His mother looked terrified.
“Yes, I do,” Maxine said clearly. “I'm almost certain of it. He's still convinced he killed his father. It's going to take time to get him past that idea. And in the meantime, he needs to be in a facility where he'll be safe. You won't get a moment's sleep if he's at home,” she added, and his mother nodded.
“My own doctor thought we could give him another chance. He said boys his age often do this for attention.” She was repeating herself, as though hoping to convince Maxine, who understood the situation far better than she.
“He meant it, Helen. He knew what he was doing. He took three times the fatal dose of your medication. Do you want to risk that again, or have him jump out the window? He could run past you and do it in a flash. You can't give him what he needs right now at home.” She wasn't pulling any punches, and slowly his mother nodded, and started crying harder. She couldn't bear the thought of losing her son.
“All right,” she said softly. “When does he have to go?”
“I'll see if they have a bed for him today or tomorrow. I'd like to get him out of here as soon as possible. They can't protect him properly here either. This isn't a psychiatric hospital. He needs to be at a place like Silver Pines. It's not as bad as you think, and it's the right place for him right now, at least until he's no longer in crisis, maybe after the holidays.”
“You mean Christmas too?” Helen Wexler looked panicked.
“We'll see. We'll discuss that later, when we see how he's doing. He needs some time to get his bearings.” His mother nodded and then went back into his room, while Maxine went to call Silver Pines. Five minutes later, everything was all set. Luckily, they had room for him. And Maxine arranged to have him transferred by ambulance at five o'clock that afternoon. His mother could go with him to help settle him in, but she couldn't spend the night.
Maxine explained everything to both of them, and said she would go to visit Jason there the next day. She would have to move some patients to do it, but it was a good day for that. She knew she had nothing crucial on her calendar in the afternoon, and her only two crisis cases were scheduled for the morning. He seemed peaceful about going there, and Maxine was still talking to them when a nurse came in and said there was a Dr. West on the phone for her.
“Dr. West?” Maxine looked blank. “Is he asking me to admit a patient for him?” Physicians did that all the time, but she didn't recognize his name. And then suddenly Jason's mother looked embarrassed.
“He's my doctor. I asked him to talk to you because he thought Jason should come home. But I understand…I guess… I'm sorry… do you mind talking to him anyway? I don't want him to feel I asked him to call for nothing. We'll send Jason to Silver Pines, maybe you could just tell Dr. West it's all arranged.” Helen looked awkward, and Maxine told her not to worry about it. She spoke to other physicians all the time. She asked if he was a psychiatrist, and Helen said he was her internist. Maxine left the room to take the call at the nurses' station. She didn't want to have the conversation within earshot of Jason. It was purely a formality now anyway. She picked up the line with a smile, expecting to talk to some friendly, naive doctor, who wasn't used to dealing with adolescent suicides on a daily basis, as she was.
“Dr. West?” Maxine said, sounding young, efficient, and pleasant. “I'm Dr. Williams, Jason's psychiatrist,” she explained.
“I know,” he said, sounding condescending with just those two words. “His mother asked me to call you.”
“So I understand. We've just finished making arrangements for him to be admitted to Silver Pines this afternoon. I think it's the right placement for him right now. He took a lethal dose of his mom's sleeping pills last night.”
“It's amazing what kids will do for attention, isn't it?” Maxine listened to him in disbelief. He was not only patronizing to her, he sounded like a total jerk.
“This is his second attempt. And I don't think three times the fatal dose is a ploy for attention. He's telling us loud and clear he wants out. We need to address that in a very serious way.”
“I really think the boy would do better at home with his mother,” Dr. West said as though talking to a child, or a very, very young nurse.
“I'm his psychiatrist,” Maxine said firmly, “and my professional opinion is that if he goes home with his mother, he'll be dead within a week, possibly twenty-four hours.” It was as blunt as she could get, and she wouldn't have said it to Jason's mother. But she wasn't going to pull any punches with the condescending, very arrogant Dr. West.
“That seems a little hysterical to me,” he said, sounding annoyed this time.
“His mother has agreed to admit him. I don't think we have any other choice. He needs to be in a locked ward, under careful watch. There's no way to set that up in a foolproof way at home.”
“Do you lock up all your patients, Dr. Williams?” He was downright insulting, and Maxine was starting to get mad. Who the hell did he think he was?
“Only the ones in danger of killing themselves, Dr. West, and I don't think your patient is going to be in great shape if she loses her son. What would your assessment be of that?”
“I think you need to leave the assessment of my patients to me,” he said, sounding huffy.
