Sunday, March 21, 2010

Finally Writing About Gem (part 2)

Part 2

Part of me—a large part—doesn't want to tell this story. It is a hard thing to reflect on, but apart from that I don't want to put a troubled and troubling image of Gem into the heads of people who remember him as a healthy, vibrant young man, a quick-thinking child with beautiful eyes... I don't want to alter or tinge those existing memories with the cloud-cover of his last years. But I feel that I must, because his last years are a crucial part of who he was whether we like it or not. A life is a whole thing. And also because I believe we can learn something important and grow in our own lives and relationships from pondering Gem's experience. And maybe from my experience as his mother.

But, if you knew Gem personally, please—before you read beyond this paragraph—stop, disconnect, take a moment or more to think, recall, and lock in for yourself a typical or simple memory moment about Gem. Live there in your memory for a bit and maybe write about it, record your memory in some way—the "before" image. I just don't want you to lose that. I'd love it if you'd share it also, but mostly I hope that you will be able to keep that for yourself. Then DO return, if you are inclined, and follow on.

Another hesitation I have in writing about Gem is that I am all too aware of how one-sided my story is, how non-objective. It is just my story of what I shared with him, my viewpoint, and nothing more than that—not a definitive chronicle, not a case study, and there are parts of his life about which I know little or nothing—please just take this for what it's worth. (And share your story also, if you will!)

There were four particular areas of mental disorder I noted in Gem: a semi-catatonia that came during the most acute phases; non sequitur thinking and speech that I began to notice before any other symptoms, but didn't give much attention to at the time; psychotic delusions that sometimes overwhelmed his consciousness; and a gradual, complete loss of all positive emotions and good feelings.

In the Spring of 2005, after several days of hallucinatory experience and not eating around the UCB campus and in his Berkeley apartment, he left his home, wearing only light clothes, heading south from Berkeley along the railroad tracks. Four days and 60 miles later, having eaten only a lemon he found along the way, and during which he slept very little, hiding in weeds, he reached a point of complete exhaustion and pain. This culminated in his lying down on the tracks to await a train and death. He was just DONE as he told me later; he had no life energy left.

But he wasn't done, as it turned out. Here is the account of that episode that I wrote to some friends at the time:

My 24 year-old son, nearing the end of his years as a student of Art at UC Berkeley, has been living on his own for 5 years, and all OK... until this occurred. He apparently had several delusional experiences over a few days in mid-March, stopped eating, began to believe he couldn't use money or drive. He left his apt walking along the RR tracks south through the worst sections of the east bay cities... walked for 4 days and nights, no supplies, food or shelter--just sleeping in the weeds by the "river" all the way into San Jose (60+ miles), where he was so weakened--now 7 days with no food except a lemon he found, and only a little water from the filthy river along the tracks--and at that point he didn't want to spend another night out in the cold--so he resignedly laid down ON THE TRACKS! He did not move when a RR official hollered at him, so the police were called, and they picked him up and took him to the county hospital. Severe dehydration, starvation (he was thin before, but now he's just skin and bones) and a rare physical condition of air in the chest cavity and spinal column ("subcutaneous emphysema") were the diagnoses. He was put on a 3-day hold for mental evaluation because of his clearly self-destructive behavior, and because he refused a procedure to try to diagnose the cause of the air in his chest. They had to force that procedure on him, since a perforation in the lungs or trachea is a life threatening condition. They thought he might have swallowed glass or sharp rocks. (No perforation was found--the condition is rare anyway, and even rarer to have no apparent cause--though it is known to occur spontaneously sometimes in "very thin men".)

Through all this, he didn't give the hospital my phone number--he was there 3 nights before I had any clue. He was still in an abnormal state of mind, mumbling about good and evil. I found out he was missing because his boss at the campus library where he's worked for 5 years began asking other students where he was when he didn't show up for work or call in. This was totally out of character for him. His friends then starting calling each other. When no one could reach him, and he hadn't told anyone of a planned trip or anything like that, one of his friends called me, and finally I called the campus police. They had received a query about him 2 days before from the doctor who was treating him. Somehow they had learned he was a Berkeley student, maybe from ID he had on him. But the university had only a defunct phone number for his dad who had since moved to Hawaii, and no phone number for me.

I got down to San Jose as soon as I heard all of this, and spent the next 3 days at his bedside, where he initially made little sense and was so weak he could hardly talk at all. But he began to respond to me quite quickly. He was talking more like himself by the end of that first day, steadily ate the fruit I brought him, and was transferred late the next day to the emergency psychiatric clinic for the required evaluation. He was in that center for 8 hours, witnessing all kinds of scary things. I wasn't allowed to be with him there, and was quite concerned, not only about his mental state, but also I fretted that he wouldn't eat in that environment--and he SO needed to continue getting nutrients. At this point, *I* was really struggling. I broke into tears several times in that stark, lonely waiting room. I was so overwhelmed with uncertainty of how to help. The ER doc who treated the medical conditions had told me this was probably the onset of schizophrenia, and that he would probably require ongoing medication to control the condition. I made calls to my husband, and a friend, and just waited, wondering and worrying.

Two psychiatrists evaluated him, and diagnosed the incident as a "single manic episode". They did not believe he was experiencing schizophrenia, or that any medications are required at this point. They recommended regular follow up visits with the health clinic at the university, lots of strength-building foods, and watchful attention from his friends and family as he resumes his normal life. Apparently, a single episode like this is not all that uncommon.

He is now back at his apartment and picking up the pieces. He's still quite emaciated, but is eating normally, using money, has driven his car, gotten in touch with his boss and his professors, and has a first appt. at the health center this week. I am calling or emailing every day and he responds well.

So that was the beginning of the end of Gem's life. There is more to the story—I will continue later.

Sunday, March 14, 2010

OK, I will finally start to write about Gem

It is a lovely, sunny, warming, late-winter day. I have been rambling about outside, here at my Moody Ridge home, less than 3 miles from where Gem was born, puttering at tasks, just generally loving this place, loving life, loving Gem, missing him. I have been realizing how deep and wide my bound-up, postponed expressions of that love are — I'm bursting with it this morning. So I will let loose a little and see what happens.

Where do I start? Sometimes I think that the story starts at the ending. I don't always dislike knowing the ending of a tale first, (or is it maybe, a middle after all? or even a beginning?) — that would imply that a subsequent reading of a book could never be as right, as satisfying, as a first reading. Simply not true. Maybe I can get more out of recounting Gem's story starting from his death and working back. That's what I'm inclined to do.

Gem Emilio Wiseman. On July 5th, 2009, he leaped off the 700+ foot high Foresthill Bridge near Auburn, CA to his death. He was 28 years old. He was my first-born son.

He had struggled mightily and painfully for the four years just prior with psychotic episodes, swirls and swamps of mind disorder, interspersed with relatively normal periods of productivity and self-sufficiency. Ins and outs. I can't give a formal diagnostic label to what ailed him. Largely because of the cyclic (or rather, the increasingly wide extremes of a sine wave pattern) nature of the thing, one of the first diagnoses we got was bipolar disorder. I read a lot about that, and I don't think the patterns match very well, but what do I know? We never got a confident diagnosis from any of the psychiatric medical people who interacted with him. Gem himself did not participate willingly in their efforts to label him with a mental disorder. He said he was fine. "I am not sick, I do not need help," as in the title of the insightful and helpful book by Xavier Amador.

But something was not "normal"—he would become so neglectful of the needs of life that he would be at risk sometimes of dying in one way or another—several incidents happened. He would get dysfunctional, or he would act in a way that scared other people, and then security, police and/or medical people and/or family/friends would step in and corral him into a forced treatment regimen—until he again met expectations. The forced treatments included locked-door, prison-like shelter, forced psychotropic and other drugs, frequent group counseling sessions with seriously disturbed, dysfunctional people, behavior modification reward-punishment systems, isolation from exposure to healthy people and environments, and huge mega-thousand dollar billings, followed by bill collectors, loss of home, car, etc.

I can't diagnose, but I can describe the symptoms I observed. I'll get into that in my next post.