TODAY

Table Talk
How do you do it all? Work, kids, spouse?

Mental Hell
By Lori Leibovich
Teen suicide in a psychiatric hospital

An Excerpt
"A Wrongful Death,"
By León Bing

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As thanksgiving neared, it was decided that it would be easier for everyone if the Schecks did not insist on a family visit. Merry and Bob were delighted when Ed Dueñez called and asked if he could make a holiday visit to Christy at the hospital. Dueñez retains an acute recollection of the day. "We sat at a table with two other kids, in the cafeteria. Another girl, and a boy, both about Christy's age." He pauses. "Well, all three of those kids began to tell horror stories about their lives at home. They sat there, one-upping each other, performing for my benefit, talking about absentee parents, wild parties, drugs at home, gangs, all of it.

"That really got to me. Christy had always been real polite, and highly articulate. Not in the least a street kid, and no way a bullshitter. Well, she was a different person that afternoon. We sat at that table and she talked the talk. And what she was doing was one-upping the other two kids."

Dueñez sighs deeply. "The other two were talking the same way, but to tell you the truth, they didn't seem to be emotionally disturbed at all, to me. They were just opposed to authority. Maybe they were a little out-of-control about it, but they weren't nuts. They were angry kids who had roamed the streets.

"But I saw right away that the hospital was where Christy had learned street-gang talk. Merry had already told me what Christy was saying about being in a gang, and getting kidnapped and raped, and now here she was, saying all that in front of me in the exact same manner as those other two kids. With the same kind of hand gestures you see on rap videos. It really was like she was another person. And she was just too fierce, and too tough for it to be real."

After the meal, Christy took Dueñez to see her room. "The instant we got to her room, Christy reverted back to being herself. Everything about her changed: her voice, her mannerisms, everything. She was real proud of her room. She showed me how, if she stood on a chair, she could see the Coronado Bridge out the window. Showed me a little gift her sister had made for her. She was Christy again." While Dueñez and Christy were talking, a young woman stuck her head in the doorway and reminded Christy that a group meeting was scheduled. Christy invited Dueñez to attend with her.

"The meeting was held in the cafeteria, about twenty tables with four or five people to a table. There were some adults sprinkled around ..." He pauses, thinking. "I guess some of them could have been visitors. But as far as I could tell, there was absolutely no adult supervision during that meeting. The kids vented without restraint, ragging about everything from the food to the kind of music they were allowed to listen to. Christy and I sat with the two kids I'd met earlier, and the three of them repeated and embellished all that stuff they said at lunch." He falls silent again.

"I really don't know how many staff members were in that room. All I know is nobody said a word except the kids. And the only thing out of the kids was horror stories. Maybe I should have intervened at some point, maybe I should have said something like, 'This is inappropriate.'" Dueñez's tone is shot through with the dark shadings of a long-harbored remorse. "But I was only a visitor.

"Before I left the hospital that day, I went and found the young woman who had come to Christy's room earlier. She was one of the mental-health counselors, probably twenty-two years old. I introduced myself, told her I was Christy's school counselor, and then I confronted her. I talked about Christy's lies about being kidnapped and raped, and being in a gang, and all the rest of it. I said, 'When are you people going to do some reality therapy here?' Know what her answer was?" He does not alter his voice, does not attempt to diminish by imitation: "'Ed, I know what you're saying. But if I cut Christy off, she's going to think I don't believe her.'"

As Dueñez relives the moment for me, anger causes his voice to lift and resonate. "And I said, 'So you're allowing her to tell all these stories, and you pretend that you believe them so that Christy gets her own credibility, and then you're going to yank all that away from her? Is that the treatment plan?' Well, this young woman, this so-called counselor, floundered. There was no intelligent answer she could give me, so she just kept trying to convince me that she knew what she was doing. In those words: 'We know what we're doing.' And I kept hitting that one point: 'You're putting Christy up against the wall by acting as if you believe these off-the-wall stories. You keep on acting like that, and she's going to believe them herself. And that's what's so crazy.' I told her that what Christy and every other kid in that group meeting needed was to be confronted with their real lives."

When Christy had been hospitalized for approximately three weeks, Merry Scheck received a call from Dr. Quinn. He informed her that Christy was "stuck" and that in order "to get her unstuck" he felt it was necessary to medicate her with antidepressants. Reluctantly, Merry agreed. "I could see Christy getting worse, so I said okay. And at the back of my mind I was still considering that it just might be a biological problem. I thought maybe this would help."

I ask if medication had ever been prescribed for Christy before. Merry's eyes turn away for an instant, then she looks at me again. "During the first week or so that Christy was on the locked unit, she got angry about something and slammed her fist into a wall. The staff considered that kind of behavior as being 'out of control,' and so they did a takedown on her."

I remembered the term and the procedure. It is widely used in psychiatric facilities. In a takedown, the patient is pinned to the floor by as many as four, even five staff members, then lifted and carried into a room reserved for this purpose. These rooms, usually referred to as "quiet rooms," are without furniture with the exception of a bare mattress, upon which the patient is placed. "When they did the takedown on Christy," Merry continues, "she was given Thorazine."

Thorazine is a narcoleptic, a powerful tranquilizer that has been described as a pharmacological substitute for lobotomy. It is most often used to control behavior, and I have heard it described, by psychiatric workers, as one of the "droolers," because patients often drool after the drug has been administered. (The trade names of other narcoleptics are Haldol, Melleril, and Stelazine.)

Suddenly, surprisingly, Merry smiles. "At one point they were going to put Christy in four-point restraints, and she told me later, 'Mom, the bed in that room smelled. So I calmed right down.'" The smile fades, extinguished by a surge of anger. "Now there's a reason to calm down: The bed smelled." Christy was started on a daily dose of twenty-five milligrams of imipramine, a tricyclic antidepressant. When she complained of sleeplessness (a common side effect of the drug), Restoril, a mild sedative, was prescribed. Tricyclic antidepressants have been the subject of many studies. They are lethal in overdose and, while proving to be not particularly effective against depression, they have a dulling effect on the mind. The prescribed maximum dosage of imipramine for an adolescent is 100 milligrams. By her third month at Southwood, Christy was being given 150 milligrams of imipramine a day. Shortly after Christy was begun on daily medication, Merry commented to Gary Juleen that since all of Christy's attention-gaining accusations and outbursts had failed to deliver what Christy wanted, she expected that the next escalation would be a big one. "The next thing Christy does will be to accuse Bob of sexually molesting her." Speaking about it now, Merry explains her reasoning. "It was just a gut feeling. But I could see it coming. "

B A C K To interview with León Bing