Eyes Wide Open

Anna Aquino’s almond eyes grew wide. “ Oh…” She jumped up, came around the desk, and took my hand. “I am so, so sorry about what happened. I’ve run this facility for eight years. We’ve never had anything like that happen here before.”

“These are Evan’s parents…”

Instead of being defensive, Anna Aquino took Gabriella’s hands warmly in hers and gave her a compassionate hug. “I spoke with you the night he disappeared. When he didn’t come back, I was so worried. He seemed like such a good kid, your son. If I knew he was in such a state, I never ever would have allowed him to be admitted.”

Gabriella pulled away. “What do you mean, if you knew he was in such a state? You let our boy just walk out of here. We trusted you to take care of him and now…” She glared at the woman with reproach.

Over the years, I’ve seen my share of indifference when it came to caregivers. Nurses just going through the motions, care facilities doing the minimum, bilking the insurance companies. But Anna Aquino wasn’t like that at all.

“Ms. Erlich,” she said, “I know how you must feel, but look around

… This is an open facility. We don’t keep people here against their will. We’re not set up for that sort of thing here. We can’t even force our patients to keep on their medications. It’s strictly voluntary.

“That first day, your son was like a zombie here. He was totally snowed on so much Seroquel he could barely talk. He wouldn’t even eat. But by the afternoon of the next day, he seemed so much better. I know he called you-”

“Yes,” Gabriella said, “he said he wanted to make the best of it here, but…”

“That afternoon, he came up to me and told me he was going to go for a walk. I was actually excited to hear it. I thought he was coming back to life. He said he was just going to walk around the town. When he didn’t come back, of course, we were worried, and that’s when we called…”

“I think what my brother and sister-in-law would like to know,” I asked plainly, “is just how a violent, bipolar kid on suicide watch just a couple of days before could simply be allowed to walk out the door.”

Anna looked into my eyes and shook her head. “Because no one ever informed us of that, Dr. Erlich.”

I squinted, not sure I’d heard her properly. “ What? ”

“No one told us your nephew had been suicidal. Or about any of his behavioral history. I had no record on him at all, other than he was bipolar and had spent time at County and was placed on a high dosage of Seroquel. Believe me, if I thought he was a danger to anyone-or to himself-there’s no way I would have ever admitted him here. You can see for yourself we’re not equipped for that sort of thing.”

“You’re telling me you received no patient history?”

“No.” Anna shook her head. “Zero. They just drop them here. Like baggage. With a two-line diagnosis and a medication chart. When they saw I had an open bed, they brought him here. I’m a state-funded facility, Mr. and Mrs. Erlich, so I can’t simply refuse. This is my biggest frustration. They never give me any history. You see my patients here… We specialize in dementia and Alzheimer’s care. Believe me, if I knew your son was schizophrenic-not to mention suicidal! -I would never have let him stay here even for a night. Poor kid, I’m heartbroken over this…”

My anger was increasing. No history. Not even a medical report from the hospital. They might as well have pushed him off that ledge themselves. What was the hospital hiding? “Do you mind if I see his charts?”

“Not at all,” Anna Aquino said. “I have them right here.” She went around the back of her desk and came back with Evan’s file.

A two-page transfer form from the Central Coast Medical Center read, “History of bipolar behavior.” It listed his medication, Seroquel, and the dosage, two hundred milligrams. A hundred milligrams was normally the prescribed dose. A drop-dead maniac would be turned into a zombie on that! The form said the patient had been released from care and was being transferred to the Harbor View Recuperation Center on a strictly voluntary basis.

It was signed Brian Smith, Social Worker. And cosigned Mitchell Derosa, MD.

My blood stiffened. I saw that Evan had signed it too.

I had to restrain myself from crumpling it into a ball and hurling it against the wall.

There was no history of his previous psychological behavior. Not a single word about the nature of his treatment in the hospital. Nothing on the violent actions he had manifested when the cops took him away. Or his attempt to purchase a firearm.

Not even a mention of his urge to kill himself.

They had basically just thrown him here! As soon as a bed opened up. Like Anna Aquino said- baggage.

What had happened to the restrictive facility they had promised Charlie and Gabriella? Where their son would receive monitoring and attention? They were right-everything just fell between the cracks because no one felt they mattered.

“Can I have a copy of this?” I asked, handing Anna back the forms.

She shrugged. “I don’t see why not.”