Saving Max
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“This is my son, Jonas.” Hearing his name, the boy shakes his head and blinks rapidly. His hands never stop moving. Fingernails scrape at scarred welts on his arms. Danielle instinctively pulls her own sleeves down. Jonas rocks back and forth, testing the chair’s rubber stoppers as they squeak against the floor. All the while, he makes soft, grunting noises, a perpetual-motion-and-sound machine.
“If I have to say something about myself, I suppose it would be that I’m from Texas and was a pediatric nurse for many years.” This does not surprise Danielle. What Marianne says next, however, surprises her deeply.
“I actually finished medical school, but never practice.” She inclines her head toward her son. “I decided to stay home and take care of my boy. In fact, that is the most important thing about me.” She clasps her hands and then flashes what Danielle believes must be one of the most beautiful smiles she’s ever seen. Her attitude is infectious. The parents all smile and nod, like a bobble-head dog in the back of a ‘55 Chevy.
“Jonas’s diagnosis is retardation and autism, and he doesn’t speak, not really.” Marianne pats the boy’s knee. He does not acknowledge her. His eyes roam the room as he taps and scratches. The reddening on his arms deepens to a frozen cranberry. “He’s been this way since he was a little boy,” she says. “It’s hard, you know, to deal with the challenges our children have, but I do the best I can with what the good Lord gave me.” As sympathetic glances pass from the parents to her, Marianne brightens like a rainbow after rain. “His father … well, he’s gone, bless his heart.” She averts her eyes. “Recently, Jonas started getting violent and self-destructive. I want him to have the very best, and that’s why we’re here.”
After she finishes, everyone applauds, but not too much. It’s like being at the symphony. Once or twice—that’s polite. Anything more would be disrespectful. Marianne then whispers to Jonas in some kind of gibberish. In response, he whirls around and slaps her face so hard with a flat, open hand that it almost hurls her from her chair.
“Jonas!” Marianne cries. She covers her scarlet cheek as if to ward off further blows. A male attendant appears; yanks Jonas to his feet; and pins both arms behind his back.
“Nomomah! Aaahhnomomah!” The attendant pushes him roughly into his chair, gripping his hands until he quiets. Everyone sits, stunned. As soon as he is released, Jonas bites the knuckles of his right hand so hard that Danielle winces.
Marianne seems inconsolable; her veneer of optimism shattered. Danielle leans over and embraces her awkwardly as the woman sobs in her arms. Normal mothers are oblivious to their enormous, impossible blessings, she thinks. To have a child who has friends, goes to school, has a future—these are the dreams of a race of people to whom she and this woman no longer belong. They are mere truncations, sliced to so basic a level of need that their earlier expectations for their children seem greedy to them now—small, mercenary—almost evil. Their one hope is sanity. Some dare dream of peace. As Danielle tightens her arm around this destroyed woman, she knows that the communion between her and this stranger is deeper than sacrament. She feels the holiness of the exchange, however alienated and bereft it leaves them. It is all they have.
Danielle stares up at the forbidding sign posted on the thick glass doors. Secure unit. No unauthorized persons. No exit without pass. The black, merciless eyes of one of the 24-hour security cameras glare down at her from a corner of the room. They learned at orientation that they are installed in each patient’s room and in the common areas. This is supposed to make them feel safe.
It is late afternoon. Danielle stands at the reception desk, but Max hangs back. He is terrified. Danielle can tell. The more afraid a teenager is, the more he acts like he doesn’t care. Max looks bored shitless.
Danielle doesn’t blame him. By the time the group session was over, she was ready to slit her throat.
“Ms. Parkman?” The nurse waves her over with a big smile. “Ready?”
Oh, sure. Like mothers in the Holocaust about to separate from their newborns. She squares her shoulders. “I’m at the hotel across the street—Room 630. Can you tell me when visiting hours are?”
The nurse’s smile fades. “You’re not leaving tomorrow?”
“No, I’m staying until I can take my son home.”
The smile dies. “Parents are not encouraged to visit during assessment. Most go home and leave us to our work.”
“Well,” says Danielle, “I suppose I’ll be the exception.”
The nurse shrugs. “We have all the pertinent data, so you can go back with Dwayne to the Fountainview unit.” The enormous attendant who came to Marianne’s aid with Jonas appears. Dressed in blinding white, his chest is so big that it strains against the unforgiving fabric of his shirt. As he comes toward them, Danielle thinks of football players, heavyweight wrestlers—men with abnormal levels of testosterone. She looks at her pale boy, who weighs no more than two damp beach towels, and imagines this man pinning him to the ground. If Max bolts, this guy will snap him up in his jowls like a newborn puppy and carry him down the hall by the scruff of his neck.
“Hi, I’m Dwayne.” The wingspan of his outstretched hand is larger than Danielle’s thigh.
“Hello.” She manages the smallest of smiles. Dwayne grasps her hand, and she watches it disappear. In a moment, he returns it.
He turns to Max. “Let’s do it, buddy.”
Danielle moves forward to embrace him, but Max charges her—fist raised, face enraged. “I’m not going in there!”
Dwayne steps in. With one elegant motion, he yanks Max’s arms in front of him; slips behind him; and envelops Max’s entire upper body in his massive arms. The ropy muscles don’t even strain. Winded and trapped, Max flails and twists. “Get your fucking hands off me!”
“Give it up, son,” growls Dwayne.
Max shoots Danielle a look of pure hatred. “This is what you want? To have some asshole put me in a straightjacket and lock me away?”
“No, of c-course not,” she stammers. “Please, Max—”
“Fuck you!”
Danielle is rooted to the floor as Dwayne drags Max down the hall. They come to a menacing red door that buzzes them through. Her last glimpse of Max’s contorted face is seared into her mind. He stares at her with the betrayed eyes of an old horse at the glue-factory gate. He is gone before she can utter the words that strangle in her throat.
At the far end of what appears to be a TV room are four women dressed in jeans and T-shirts—undercover nurses in casual disguise. A large whiteboard hangs on the wall. It unnerves her that Max’s name is already there with ominous acronyms scribbled next to it—“AA, SIA, SA, EA, DA.” The black letters hang final, immutable. She sneaks a look at the typewritten sheet pasted on the board. “AA—Assault Awareness; SIA—Self-Infliction Awareness; SA—Suicide Awareness; EA—Escape Awareness; DA—Depression Awareness.” The words slice her heart.
Danielle glances around the room and notices Marianne chatting with an older doctor. She smiles warmly at Danielle. Jonas plucks at his clothes and twitches his feet in an odd, disturbed way, as if he’s doing the flamenco sitting down. Then she sees Carla and her son go into one of the bedrooms. Her heart sinks. She would do anything to prevent Max from being on the same unit with a boy who would break his own mother’s arm and purple her eye.
An older woman with a shock of short, white hair enters the room and walks up to Danielle. She exudes a calm authority. A conservative, navy suit matches feet shod in dark, sensible flats. Behind small, gold-rimmed glasses are very, very green eyes. Her doctor’s coat is Amway white. Red embroidery on her lapel says Associate Director—Pediatric Psychiatry, Maitland Hospital. She holds out her hand with a smile. “Ms. Parkman?”
“Yes?”
“Dr. Amelia Reyes-Moreno,” she says. “I’ll be Max’s primary doctor while he’s here.”
“Nice to meet you.” Danielle stares as she shakes the woman’s hand. Her long, fine fingers are cool to the touch. Intensity and intelligence are evident in her gaze. Danielle’s research of Maitland revealed that Reyes-Moreno is one of Maitland’s most valued psychiatrists, nationally renowned in her field. She glances at the old doctor with Marianne, his veined hands folded as he listens. Both are smiling. Danielle wants him. Someone who looks as old as Freud and who’ll take one look at Max and say, “Of course! I see what they’ve all missed. Max is fine, just fine.” Then he’ll nod his head wisely and go on to his next miraculous cure.
Dr. Reyes-Moreno catches the arm of a young, dark-eyed man who looks like a pen-and-ink rendering of Ichabod Crane. “Dr. Fastow,” she says, “would you mind my introducing you to Ms. Parkman? She is the mother of one of our new patients, Max.”
He nods curtly and fixes Danielle with a milky stare. “Ms. Parkman.”
“Dr. Fastow is our new psychopharmacologist,” says Reyes-Moreno. “He has just returned from Vienna, where he spent the last two years conducting exciting clinical trials of various psychotropic medications. We are honored to have him.”
Danielle takes the hand he offers. It is cold and dry. “Dr. Fastow, are you planning to significantly change Max’s medication protocol?”
His gray eyes are limpid. “I have reviewed Max’s chart and ordered extensive blood work. I plan to take him off of his current medications and put him on those I believe will better serve him.”
“What meds are those?”
“We will provide you with that information once we are more familiar with Max and his symptoms.” He gives her another cold stare and takes his leave.
Put off by his antiseptic manner, Danielle turns to Reyes-Moreno, who nods reassuringly. “Don’t worry, we’ll take good care of him.” Danielle panics as she watches Reyes-Moreno disappear through the malefic doors of Alcatraz. Only the dominating truth—that Max wants to kill himself—prevents her from breaking down those doors and fleeing with him back to New York. She takes a deep breath. There is nothing to do but go back to the hotel and work. She turns to go.
“Who are you?” A muscular girl with thick, oily hair stands before her with clenched fists.
Danielle tries to walk around her, but she blocks her path like a defensive back. “I’m a … mother.”
“I’m Naomi.” Her eyes snap like a bird whose nest has been threatened. “You that new kid’s mom?”
“Yes.”
“He’s a real brat, that one. I can tell.” She swaggers her hips back and forth and smirks. “He just better stay out of my way, that’s all. I’m dangerous.”
Danielle blinks, rooted where she stands. “What do you—”
“I cut people.”
“What?”
Naomi lifts up a greasy lock of hair and reveals a ruby keloid the size of a fat caterpillar on the side of her neck. “I practice on myself first.” Her fingers let the fatty strands fall back into place. Coal-pot smudges under her eyes look like permanent bruises and are an odd contrast to her light eyes and gray skin. Danielle has one thought: this ghoul is going to be with Max every day.
“Boundaries, Naomi.” It is big Dwayne. He inserts himself between Danielle and Naomi and points a large finger down the hall. “Move it.”
“Yeah, right, Duh-wayne.” Her eyes glitter like a raccoon holding a silver spoon in the dark. “Why don’t you get your sorry fucking face out of my boundaries, okay?”
“Get to your room. You know the drill.” Dwayne has the hardest soft voice Danielle has ever heard.
“Fuck you.”
“An hour. Solitary.”
Naomi skulks down the hall.
Dwayne turns to Danielle with a big grin. “Welcome to Fountainview, Mom.”
CHAPTER FOUR
Danielle spends an exhausting morning at the hospital giving Reyes-Moreno Max’s life history. It so debilitates her that she goes back to the hotel, takes off all her clothes and sneaks between the cheap sheets like a downtown hooker on a lunch break. Marianne, who is staying at the same hotel, rousts her after only twenty minutes and hustles her off to the Olive Garden on Main Street.
Danielle settles into the fake leather booth, which exhales as she sits. The Olive Garden may be the only restaurant in Plano that actually serves wine with names on it, not just colors. Danielle is relieved to find that they have real knives and forks—not the antisuicide plastic of Maitland. The waitress takes their drink order and disappears.
Danielle sneaks a sidelong glance at Marianne’s ensemble. She wears a crisp, navy pantsuit with a cream-colored blouse. A diaphanous scarf with paisley butterflies is wound loosely around her neck and is held in place by a simple gold pin. Her blond hair is freshly coiffed. Her short nails are painted a demure beige that matches her bag, which brims with needlepoint and vivid yarns. Marianne appears supremely calm and composed in her femininity. Danielle glances down at her own pantsuit. Is everything she owns black?
They have been discussing their sons’ disabilities and disorders, their medications and Maitland. Danielle learns that Jonas has pervasive developmental delay (PDD), oppositional defiance disorder (ODD), and is profoundly autistic. The prospect of a premature exchange of private information about her son—anathema to any New Yorker—keeps Danielle closemouthed. She does disclose that Max has Asperger’s, but does not reveal that Dr. Reyes-Moreno did her level best to persuade Danielle to go back to New York until the assessment is concluded. She cited the needs of the “process”—observation, transference, medication, testing—all of which apparently cannot take place effectively with her in the wings. Danielle had smiled politely, but has no intention of leaving.
As Marianne goes on with the litany of medical minutiae only mothers of these children find remotely interesting, Danielle hears something that catches her attention. “What did you say?”
Marianne snaps open a starched red napkin and fans it on her lap. “I was talking about a new drug Dr. Fastow, the über-psychopharmacologist, has prescribed for Jonas. I’m very excited about it, even though the potential side effects are disturbing.”
“What are they?”
Marianne shrugs. “Liver damage, heart problems, tardive dyskinesia.”
Danielle is alarmed. Long-term use of some antipsychotics—even the newer atypicals—can result in permanent physical problems, like irreversible rigidity of the extremities. Danielle imagines Max with his tongue stuck out in a frozen sneer or his arm jutted at a permanent right angle to his body. “Aren’t you scared?”
Marianne runs her finger down to a menu selection and holds it there. “Not really. It’s more important to be willing to take risks when you’re at this level.”
Danielle isn’t sure what she means. Maybe Max isn’t at the same level—whatever that is.
“So, tell me,” says Marianne. “Has Max ever been violent? I know that’s an issue for so many special-needs boys.”
Danielle feels her face flush. “No, not really. A few incidents at school.” And tearing at her arms.
Marianne squeezes her hand. “It’s okay. Jonas has been violent, too, but more in the nature of self-infliction. You know. Clawing at his arms, biting his knuckles— all perseverative behaviors.” She shrugs. “Besides, Jonas has had such severe problems since the time he was born that it’s a miracle we’ve made it this far. He was cyanotic as an infant—turned blue, you know. I had to sleep next to him night and day. One minute he’d be fine, and the next he’d be purple and cold as ice. I can’t tell you how many nights we spent in the emergency room.” She looks up. “Not exactly lunch conversation—sorry.”
“Not at all. How often do you see him? I get short visits in the morning and afternoon.”
Marianne’s eyes widen. “You’re joking, right?”
Danielle frowns. “No, Max’s psychiatrist says that anything more will interfere with his assessment.”
“Well, Dr. Hauptmann gives me unlimited access.”
“Dr. Hauptmann?”
“You saw him with me the other day.” Marianne gives her a surprised look. “He’s the foremost child psychiatrist in the country. I’m sure you researched all the doctors here, as I have.” Marianne accepts a white wine from the waitress with a big smile. “Dr. Hauptmann and I have been in contact for some time, and he agrees on the nature of my involvement in the assessment.” She shrugs. “I think it’s because I’m a doctor. We talk about things he can’t discuss with just any parent. If it were up to the staff—especially that Nurse Kreng—I’d never see Jonas.”
Danielle feels the effects of the wine. She sits back, finally unwinding. “Where are you from, Marianne?”
“I was born in a little Texas town called Harper—way up in the hill country. My daddy was a rancher.” Marianne laughs at Danielle’s raised eyebrows. “He said I was just like his cattle. I matured early, with a high carcass yield and nicely marbled meat. So I wouldn’t end up in a hayloft with one of those Harper boys, he shipped me off to the University of Texas.” She shrugs. “When I graduated, I applied to medical school and got in.”
“Where?” Danielle can’t help it. Pedigree means a lot to her.
“Johns Hopkins.”
“That’s very impressive.”
Marianne gives her an amused look. “Southern girls do have brains, you know.”
Danielle blushes. “What happened to your plans to practice medicine?”
“A month before I had Jonas, my husband, Raymond, had a massive coronary and passed away.”
Danielle grasps her hand. “How awful for you.”
Marianne gives Danielle’s hand a squeeze. “Thank you. It was difficult, but I have Jonas. He’s such a blessing.” Danielle nods, but can’t help thinking how blessed she would feel if her husband had died right before she gave birth to such a damaged, fractured child.
“So,” she says, “once I began to appreciate the extent of Jonas’s challenges, it became clear that I had to give up my dream of becoming a doctor. I couldn’t justify that path if it meant turning over my son’s care to a stranger, no matter how qualified.” She smiles at the waitress as she serves the entrées. After she leaves, she looks at Danielle with her beautiful blue eyes. “So I took on part-time jobs as a pediatric nurse. It hasn’t been easy, but it gives me the flexibility I need.”
Danielle tries to think of something meaningful to say. Her respect for Marianne has grown commensurate with her quiet, dignified tale of self-sacrifice and love. She feels a stab of guilt. Would Max have had all these problems if she had stayed home? She looks at Marianne. No matter what her difficulties with Max, they are child’s play compared to this poor woman’s lot.
Her face must reflect her dismay. Now it is Marianne who reaches over to pat Danielle’s hand. “It’s not so bad. We all have our trials and joys.”
“I just want you to know how much I admire you,” says Danielle. “You seem so strong and … balanced.”
“You’re stronger than you think.” She flashes her brilliant smile. “And we’re going to be great friends—I can tell.”
Danielle smiles back. Maybe she’s right. Maybe she does need a friend.
CHAPTER FIVE
Danielle looks up. Marianne catches her eye and smiles. They sit in companionable silence in a secluded area of the Fountainview unit called the “family room”—a misnomer if Danielle’s ever heard one. It is, however, the only place where they have any privacy and can avoid the daily traffic of nurses and patients going to and from their rooms. It is the only hideaway where they can pretend that everything is normal. Danielle closes her laptop for a moment. She is seriously behind in e-mailing a draft brief to E. Bartlett Monahan, her senior partner and the bane of her existence. He is the head litigation partner and a member of the management committee—one of the firm’s five powerhouses who rule them all. “King Prick,” as he is referred to by the associates, is forty-eight, a bachelor and a not-so-secret misogynist. E. Bartlett, as he insists on being called, doesn’t believe that women have the balls to be litigators, much less partners. Women are secretaries, mothers, other men’s wives and—when the urge strikes—to be slept with and discarded.
He has not taken kindly to her absence—not that she expected a whit of understanding from him. He has no experience with kids—and he certainly has no clue about special-needs children.
She rubs her eyes and takes in the scene. Marianne sits across from her, knitting what appears to be something complicated, while Jonas holds a ball of yarn, which he bounces in his hands. He mutters and shakes his head in that odd, rhythmic way that Danielle has come to recognize as his attempt to communicate. Marianne, dressed in a perfectly creased white pantsuit and silk scarf, appears not to notice Jonas’s machinations as she calmly knits and purls. Danielle has always avoided engaging in the domestic arts. Her experience has been that professional women cannot risk being perceived as weak or too feminine in any way—at least not litigators. Danielle has always secretly looked down upon women who stayed home as inferior in both position and choice. As she watches Marianne and Jonas and sees the love and devotion that binds them, she feels herself color and repents.
She certainly can’t claim that she has been the best parent in the world if Marianne is the benchmark. Unlike her, Danielle never contemplated quitting her career to take care of Max—not that she had the choice. The money had to come from somewhere. Still. She turns and takes in the sight of Max, pale and sprawled across the sofa next to her, sound asleep. Anyone looking at the two of them would probably only see the distance between them. Seeing him this way tears at her heart and gives way to the crushing panic she has felt since they came here. What is wrong with her child?
Her cell phone vibrates. Maitland does not permit the use of cell phones—probably to keep the schizophrenics from believing they’re on the line with God, she thinks. Sighing, she takes her phone, laptop and purse and walks out of the unit. She plops down on a white cement bench far enough out of sight so that Max can’t see her through the window as she shakes a cigarette from the pack. She lights it; inhales deliciously; and touches the iPhone’s various Apple icons to access her recent calls. Shit. E. Bartlett’s secretary. Another touch of the screen. A nasal voice announces that her brief is expected no later than tomorrow morning. She groans. Another late night downing hotel-coffee dregs.
She takes in the brilliant sunshine and vibrant blue sky. She relaxes body and mind, letting the warmth spill over her in golden waves. The last puff of her cigarette is a reluctant one. She has to go back into that sterile, unnatural place. It is agony to sit and not be able to do anything. She sighs and goes back to the unit, where one of the young nurses buzzes her in. As she walks down the hallway toward the family room, she hears shouting and wailing. Her heart slams in her chest as she breaks into a run. The sight that greets her is complete bedlam.
Dwayne, the gigantic orderly, has Max in a Mandt hold. He sits on the floor behind him with his burly arms cinched tightly around Max’s chest, his tree-stump legs preventing Max from moving. “Get off me, you son of a bitch!” He writhes, kicks and screams. “Motherfucker!” Dwayne holds him easily, his face impassive, as if he cradles a wild animal every day.
Naomi, her greasy, black hair flying, faces a young orderly who is trying to capture her. She lands a flying kick at his groin. He crumples to the ground, moaning. Another orderly, this one older and bigger, comes up behind her and twists her arms behind her back. Naomi breaks free and circles around him, her hands making swift slicing motions. Her voice is a crow screech. “You want what he got? Bring it on, dickhead!” Her Goth-black nails bite into her palms. She turns around and lands a powerful high kick on the orderly’s shoulder. He, too, is implacable as he hauls her kicking and screaming down the hall.