I walk through her door and sit down in a chair next to her desk. “What can I do for you today?” she asks me, her voice soft, caring, empathetic and concerned, as if she already knows. My hand moves to my pocket, as if it had a mind of its own. I start to finger the cool, heavy, rough metal in my pocket, wanting to grip it and use it, while at the same time wanting to chuck it as far away from myself as possible. “C’mon, Jack, you’ve got to talk to me. I can’t help you if you don’t.”
“Please just kill me now,” I whisper in a low mumble.
“I’m sorry, I didn’t quite catch that.”
“Please just kill me now,” I whisper again, this time more clearly.
“Why?” she inquires, matter-of-factly.
“Because if you don’t, then I will.” I grasp the rough grip in my pocket, my index finger falling to place on the trigger. This action, however, causes a clear outline through the pocket of my jeans, and I know that Mrs. Sosa sees it, but I don’t care. I doubt she could wrest it from me before I could use it.
“What’s in your pocket?” she asks, although it sounds more like a command. I hesitate. There’s a couple of different ways I could go about this. I could stay silent, make things as difficult as they could possibly be. I could tell her straight-out. Either way chaos is about to ensue. When a suicidal student comes in completely ready to die, controlled chaos always ensues. “What’s in your pocket?” she repeats, the command tone present. She must be mistaking my hesitancy for a refusal to speak.
“Take a wild guess,” I mutter darkly, uncomfortable telling her directly what it is.
“I think I know, but I want you to tell me.”
“I-I can’t,” I stutter out, shaking my head.
“Then just tell me yes or no-is it a gun?”
I hesitate a moment, then nod my head, tears welling in my eyes. “I need to hear you,” she commands gently, meaning she saw my head nod.
“Yes,” I choke out, tears now streaming down my face.
“Okay. I’d really like to talk to you about why you felt the need to bring a gun into school, but first I need to make sure you’re safe, and while you’re in possession of that gun, you, and everyone around you, are unsafe. Are you aware we always have a police officer in the building?” I nod my head yes, too consumed to be able to speak. “Are you okay with me calling him in here?” I shake my head no. I don’t want anybody else involved. “Well, unfortunately then, I have to bring him in. He’s the only one qualified to take the gun from you.” I continue shaking my head no. “Alright, you’re not going to be very happy with me, but I have to call him.” She reaches for her phone, keeping her eyes on me until she has to dial.
In that split second I pull the gun from my pocket, cock it, and put it to my temple. She looks back at me as she finishes dialing, and the look that crosses her face is a mix of fear, panic, and concern. “Officer Krupp? This is Bridget Sosa, from the guidance office. I need you in my office immediately. This is an emergency.”
“I’ll do it. I swear to god I’ll do it!” I cry out quietly, but still loud enough to be picked up by the phone. She puts the phone on the desk and immediately starts trying to talk me into putting the gun down.
“Jack, listen to me, please. You don’t have to do this.”
“Yes I do!” I cry through clenched teeth, my finger tense on the trigger.
“Well, you don’t have to do it right now. You can do it later. You can wait for a little bit before you do it,” she almost pleads.
“I’ve waited for long enough, put up with this for long enough. I have to do it now…” I trail off.
“Tell me why you have to do it now, why this can’t wait until later,” she commands pleadingly.
“You wouldn’t get it, you wouldn’t understand…”
“Then help me to understand. I want to understand.” There’s a soft urgent knock on the door, and my tense finger almost pulls the trigger as I startle. Mrs. Sosa looks past me to the window in her door, and what crosses her face could almost be a look of relief. She beckons for the person to come in as she replaces the phone receiver back on the phone, and the door quietly opens and closes beside me.
“Hey son, I’m Officer Krupp, but you can call me Kyle,” he introduces as he leans against the wall across from me. “What can I call you?”
“How about the world’s worst screw-up?” I retort, not really joking.
“You’re not a screw-up,” Mrs. Sosa interjects quietly, but is gently cut off by Officer Krupp:
“Okay, what’s your name, son?”
“Okay, Jack, I’m going to be up front and honest with you-I’m here to get that gun from you, and I will do it in whatever manner I have to. The easiest way is if you give me the gun, but I get a feeling that you don’t want to do that.”
My response is just a dead stare, almost a dare for him to try and take the gun away from me, to try to take away what will finally free me. Kyle must read the message on my face, because he picks up almost right where Mrs. Sosa left off.
“In order for me to help you out, Jack, I need to know what you’ve come to get help for.”
“Who said I came for help?” I practically snarl, renewed tears trailing down my face.
“Well, I would say you did,” Kyle responds quietly, “seeing as you came down her voluntarily.”
“Maybe I just wanted a witness.”
“I think we both know that that’s not one-hundred percent true.” I glare at him. I don’t want him to be right, but I know he is. If there wasn’t even the smallest part of me that wants help then I wouldn’t be here. I would have pulled that trigger long ago. It’s just that the part that wants help isn’t the dominant part.
I feel my arm start to relax and my grip slacken as I think about this. Kyle takes a step towards me and immediately I tighten my grip. Kyle sees this as well, and retreats.
“Alright, Jack, we need to come to some sort of agreement. If I stay against the wall, will you put the gun down so we can talk?”
With tears streaming down my face I shake my head. “I have to do this,” I choke out amongst the tears. My finger tightens again on the trigger, but I just can’t bring myself to pull it.
“Why do you have to do this? We want to understand, to help you, but we can’t if you don’t tell us,” Mrs. Sosa explains.
“I-I can’t. I don’t know what to say, what to tell you.”
“Why don’t we ask basic questions and you just tell us the answers,” suggests Kyle.
“I have a hard time answering questions…” I respond, trailing off.
“Why’s that?” Mrs. Sosa this time.
“I-I-I can’t-it-it’s hard to explain-”
“We’ve got as much time as you need,” encourages Mrs. Sosa.
“I-it-I-if I can write, maybe I can explain that way.” Immediately Mrs. Sosa pulls a pen and a medium sized pad of paper from one of her desk drawers. I eagerly take the pen and paper from her, grateful that I’m ambidextrous, so that I can continue holding the gun in my right hand and write with my left. As soon as I put the pen to paper the explanation pours out of me:
I’m terrible at saying things out loud. Even things that I want to say. It’s like there is this force inside my head that keeps me from saying anything, no matter how hard I fight it. Responses to questions circle continuously through my mind, but I can’t say it. It’s like a civil war breaks out in my mind between “say it” and “don’t,” and “don’t” always wins. People tell me to fight it, but I can’t, like as soon as the battle starts I’m paralyzed.
I stop writing and decide that that’s enough for now. I can write more later if I need to. I proffer the pad to Mrs. Sosa, and when she asks if she may read it aloud I give a curt nod.
After she finishes reading there’s a brief silence. Officer Krupp, or Kyle, rather, quietly breaks the silence: “If we let you write, can you answer questions, explain things to us, help us understand?” I hesitate for a moment, and then nod my head yes. Mrs. Sosa hands the pad of paper back to me, and I resituate it on my lap so I can write with my left hand.
“So why do you want to kill yourself?” Mrs. Sosa asks, although Kyle looks like he was about to ask the same question. I write nothing, but give Mrs. Sosa a look that says “really?” instead. “Okay, really broad question. What pushed you to want to do it now?”
I can’t wait any longer. I’ve waited too long, put this off longer than I should’ve. I should’ve done this ages ago…
“Why do you say that?” asks Mrs. Sosa, after reading my response.
I kept putting it off, hoping that things will get better, but they don’t, and they never will. I see that now, which is why I have to do this now. The words, the hate, the stress, it never goes away. None of it ever does, never will. The only way to get rid of it is to get rid of me. So I’m getting rid of me. Everyone else will be happier without me around anyways.
There’s a slight intake of breath from each of them after they read it, and then the pad makes its way back to me. I readjust my grip on the gun, making it tighter, firmer. As my fingers move Kyle and Mrs. Sosa both tense up, and this time I almost do pull the trigger, as I see their eyes locked on my fingers.
“How do you know it will never go away?” Mrs. Sosa prods.
“BECAUSE IT WON’T!” I burst out. “It never has, and because history just repeats itself, what’s happened before is doomed to happen again! It’s an endless cycle of torture and torment, and the only way for me to end that is to end me, so that’s what I’m doing!”
“History is only doomed to be repeated if circumstances don’t change,” whispers Kyle, interjecting his thoughts.
“THEN I’M CHANGING THE FUCKING CIRCUMSTANCES!! With me gone, the past will have nothing to revolve around, to repeat for, and therefore it will finally stop.” I try to pull the trigger, but I still can’t bring myself to put a bullet through my head. I pull the gun down from my head, knowing that I won’t be able to pull the trigger, no matter how much I want to. As I uncock the gun there is a collective sigh from both Kyle and Mrs. Sosa. I proffer the gun to Kyle by the muzzle, and as soon as he takes it I curl up in a ball, the pen and pad of paper falling to the floor.
“Jack…” they both murmur, almost simultaneously. I don’t move, don’t respond, but they both seem determined to say what they want to say.
“Thank you, Jack. You made the right choice.” Kyle’s words.
“Yes, Jack, you made the right choice,” echoes Mrs. Sosa. “I’d really like to talk with you about this, Jack. I feel like there’s a lot more you can share with me.”
I hear them talking, but I don’t really listen to what they’re saying. Instead, I’m thinking of what’s in my other pocket, and how to get away to use it.
“I need to go to the bathroom,” I quietly announce as I raise my head from my knees. A look passes between Kyle and Mrs. Sosa, and then Kyle says he’ll take me. “I don’t need an escort. I know how to get there,” I retort, almost offended.
“It’s not a matter of knowing how to get there, it’s a matter of knowing you’re safe,” Mrs. Sosa explains, and Kyle nods his head in agreement.
“Fine,” I grumble, and slowly unfold myself from the chair. I traipse out of the office, Kyle following close behind. He does afford me some privacy by waiting outside the bathroom at least. I traipse to the last stall, lock the door, and then sit down in the corner. I don’t actually have to go to the bathroom; I just wanted to get out of Mrs. Sosa’s office and to get some privacy.
I reach into my pocket that wasn’t holding the gun and pull out a small, plastic container. Carefully opening it, I remove the other piece of metal that I’ve been carrying with me. I slowly roll up the sleeves of my sweat-jacket, contemplating what pattern I’m going to draw this time. I settle on nothing in particular, just slow and deep. Something that may finally bring the end I seek.
I look for the vein in my left forearm, and, once I can see it clearly, I start to trace it slowly with the razor blade, using enough pressure to cut deeply, hopefully hitting close to the vein. As soon as I reach my elbow I hear Kyle’s voice calling out through the bathroom, followed by the sound of his footsteps as he enters the bathroom, looking for me. I say nothing, knowing he’ll find me anyways.
“Is everything okay?” he asks. “You’ve been in here for a while and I haven’t heard anything.” After a moment I see his head peering into the stall from over the door through my blurred vision. “Shit!” he mutters. His face disappears, and the lock starts to jiggle, but he can’t seem to unlock it from the outside. “Jack, can you unlock the door, please?” he asks, although it sounds more like a command.
“How about no?” I respond slowly, my words starting to slur. As my head drops to my chest, I feel too tired to hold it up anymore, I see that I have a pretty good sized pool of blood near my left leg, and the blood is steadily flowing from my left arm, which is resting on my left leg.
The lock jiggles again, and then falls silent. There’s a strange noise, almost like clattering, and I manage to lift my head to see Kyle crawling under the stall door. The noise is everything on his belt making contact with either the floor on the bottom of the door. I don’t see whether Kyle makes it all the way through or not. My head drops back to my chest and my vision slowly fades to black before I get a chance to.
Someone’s slowly shaking my shoulder, and there’s something squeezing my left arm. I open my eyes slowly, and though my vision is blurred, I can make out Kyle crouched in front of me, holding something on my left arm, which explains the pressure I feel, and his other hand stretched towards me, which is probably the one on my shoulder. I see his lips moving, and I hear sound coming out of his mouth, but I can’t process what he’s saying. As I stare at him, however, what he’s saying starts making sense:
“-you with me, jack? Can you hear me?” As I make sense of his questions I slowly nod my head, answering them. I hear a sigh of relief from Kyle before he asks me another question, “Can you hold this on your arm?” As he asks, he motions to a wad of toilet paper that he’s pressing to my arm.
“Why would I do that?” I slur back at him, still not one-hundred percent functional in my brain.
“Because we need to get the bleeding under control, or else you will lose consciousness again, and possibly bleed to death. I need to get help, but I need you to hold this to your arm so I can do that.”
“But that would be the opposite of what I want to do,” I respond slowly to his explanation, almost sneering at him.
“You don’t give up, do you?” he asks rhetorically. He stays silent after that for a moment, concentrating on my arm. Then, just as I start to slip back into the fringes of unconsciousness, “I hate to do this, but I have to. Jack, I would really like you to push down on your arm with this, but I can’t make you. I’m going to go get help. I can’t stop this by myself. You need medical attention. Where’s the blade you use?” I say nothing, make no motion to give it to him, either. “DAMN IT JACK!!! Just give me the blade! At this point, cutting yourself any more isn’t going to make a difference. If this one-” he motions to my left arm “-doesn’t stop bleeding then you will die. Please just give me the blade so I can have a tiny bit of peace of mind while I get some help.” His last sentence is pleading more than commanding. I open my right hand and let him take the razor blade from my palm.
He attempts to take my right hand and use it to take the place of his hand on my arm, but I refuse to hold my hand there. I would rather bleed to death than live this life any more. He leaves quickly without another word, and quickly I am submerged into blackness once again.
When I awake this time it feels different. There’s a constant pressure on the whole of my left forearm, and whatever it is I’m lying on is swaying slightly. And Kyle’s not crouched in front of me. That’s one of the big things I notice first. There’s a guy sitting on either side of me, and in front of me are a set of doors. I also feel something weird in my right arm, and when I look I see that a small tube has been taped to my arm, and it’s attached to a bag of fluid. Then I hear the wailing sirens above me and connect the dots to form the picture: I’m in an ambulance.
“Goddamn it,” I mutter, more to myself than anyone else, and the guy on my right takes notice that I’m conscious again.
“Hey, you’re awake. My name’s Mike, I’m a paramedic. You’re in my ambulance, on the way to the hospital. How’re you feeling?”
“Like I want to die…” I groan back, still completely serious about my desire.
“Yeah?” I nod my head. “Well, it’s our job to make sure that doesn’t happen, at least not while you’re under our care.”
“Greeeaaattt…” I mumble, trying, unsuccessfully, to keep it under my breath. Mike gives me a short chuckle, and then asks if he can ask me some questions. “Sure,” I respond slowly, nonchalantly.
“Alright, first I need to confirm your name and get your date of birth. Can you tell me your name?
“Okay, and now can you tell me your date of birth?”
“July thirty-first, nineteen-ninety-eight.”
“Do you know your social security number?”
“Not off the top of my head, no.”
“Okay, no worries, buddy. What’s your address?”
“Eleven thirty-five thirty-second street, northwest, Connorsville, West Virginia, 53957.”
“Moving on to the medical questions, do you have any allergies?”
“Are you on any medications?”
“Can you tell me how the injury happened to your arm?”
“Did they not tell you when they called?”
“They did, but I want to hear your side of it.”
“Fine,” I respond tersely. “I took a razor blade and cut myself.”
“That deep with just a razor blade?” He sounds slightly taken aback, as if he hasn’t encountered this type of situation before.
“You’d be surprised where determination can get you, especially when you have no desire to stick around…”
“Moving on,” he interjects, “why did you cut yourself? Were you trying to kill yourself?”
“Let’s see, I had just come from my guidance counselor’s office, where I was pointing a gun at my own fucking head, and I almost pulled the god damn trigger. Then you guys come to pick me up because I’m bleeding to death from a self-inflicted wound in my left arm. What do you think?”
“I would say that yes, you were. Is that correct?”
“No shit, Sherlock,” I retort.
“Alrighty, then. Do you have any previous psychiatric history?”
“What do you mean?” I ask, feigning confusion.
“Have you ever done, or tried to do anything like this in the past? Have you ever been diagnosed with any mental illness?”
“I’ve never been diagnosed with anything,” I mention, purposely trying to avoid answering his first question.
“What about the cutting? Is this a new behavior?”
I pause for a moment, contemplating how much to reveal. “No,” I finally state. “It’s been going on for about five years.” I expand, after a moment.
“And the suicidal thoughts? Are those recent, or have they been going on for a while?”
“It’s been going on for a while…”
“As long as the cutting?”
“No, only a couple of years.”
“Okay. Was there anything in particular that happened recently to make you try to do it today?”
“I just got tired. I’m tired of waiting for things to get better, I’m tired of putting it off, I got tired of trying to build up the nerve to do it. So, I decided that today was the day.”
He busies himself entering the information into a computer, and start rechecking my vitals. By the time he’s finished with that we’re stopping, and the driver of the ambulance is getting out. Mike has me sign something on his computer, and then the doors in front of me open, and I’m wheeled into the hospital. After they figure out what room I’m in, they have me move from the stretcher to a hospital bed. A nurse follows us in, and starts entering my information into another computer as she receives a report from Mike. After the EMTs and the first nurse leave, a second nurse enters the room and has me change into a hospital gown. About this time my parents show up, although I really don’t want to see them.
“Oh, Jack!” my mom cries out as she rushes over to the bed and tries to put her arms around me. I fend her off of me, and my father starts:
“Jack-” but I cut him off.
“Dad, I don’t need you reprimanding me.”
“Jack, please, just listen to me. I don’t want to reprimand you. I just want to know why. Why son? Why did you do it?”
As I stare at him I notice tears start leaking from his eyes. My father, the man who never cries in public, is crying over this. I have finally managed to do something that has brought out some form of emotion in my father.
“Why did I do this?” I croak back, fighting back tears of my own. “Why did I try to end the misery that is my life? Take a wild guess…”
“Jack, please. Don’t be like this. Just tell us what went wrong,” my father responds, half protesting, half pleading.
“What went wrong? Everything went wrong,” I retort, my voice starting to raise. “Everything screwed up, and I became the world’s biggest fuck up. I was so fucked up that I became nothing. Everything was so screwed up that it all became meaningless. Nothing means anything anymore. I’ve gone on far too long as nothing. It’s tie to end the nothingness.”
“Oh, Jack…” my mother sobs.
“Jack,” my father sighs, “why didn’t you say something before now?”
“Like you would have listened? Like you would have cared?” I throw back at him, my voice getting even louder as a feeling of rage overcomes me. “The only time you’ve ever paid any mind to me was when I did something wrong, when I screwed up, and even then, you were only ever disappointed. You never tried to help, you never tried to fix anything!” I’m shouting now, and even though I’m sitting in a bed, I’ve pushed my mother away from me. As I stare at my father and his shocked expression, the raging fury within me quells to a silent rage. “I gave up thinking you cared about me years ago,” I say in a low whisper that nevertheless carries across the room. My father’s shocked expression slides off his face and is replaced with a familiar one: disappointment. My mother’s expression however is one of dismay.
“I’ve always cared Jack-”
“That’s a load of bull!!!” I shout at my father as he tries to protest. “If you cared you would have been there! You would have noticed when this started five years ago!”
My father’s expression slowly changes to match my mother’s as what I’m saying sinks in. Before my father can say something else in protest, however, a doctor walks into the room. “Is everything okay?” He asks as he pushes a wheeled surgical tray in front of him.
“Everything’s fine,” I respond slowly, glaring at my father, as if daring him to say otherwise. As he walks to the side of my bed, the doctor looks from me to my parents and then back to me.
“Alright then. I’m Doctor Jim Johansson. I know what your chart says, but I want to hear from you why you’re here before I get started.”
“I have a big-ass cut on my arm,” I retort back in typical teenage fashion, proffering my gauze-wrapped left forearm.
“Okay, how did you get a big-ass cut on your arm?” I look away from Dr. Johansson and down at my feet, the frenzy of response starting in my brain and the paralysis that comes with it starting to set in.
“I did it,” I force out in a barely audible mumble.
“I’m sorry, did you say you did this?” I nod my head, the feeling of being unable to talk overtaking me. “Why did you do it?” he asks, sounding truly curious instead of like he was just trying to gather information, like he really cares. At first I don’t say anything, I can’t. But after Dr. Johansson prompts me, I respond:
“I want to die,” I say deadpan, staring him straight in the face as tears start trailing down my face again.
“Well, that is a reason…” he trails off, seeming slightly taken aback by my blunt response. Dr. Johansson pulls a wheeled stool over to the side of my bed and then uncovers the surgical tray, revealing a couple of pre-threaded suturing needles, a pair of scissors, and a syringe full of something. As he sits down on the stool, he picks up the syringe. “I’m going to inject a local anesthetic into your arm. Then I’m going to stitch the wound in your arm closed. Think you can handle that?”
I nod my head, and then he carefully unwraps the gauze from around my arm, taking care not to disturb the packing over the actual wound itself. He carefully sticks the needle into my arm near the cut, injecting the anesthetic.
After a few minutes, he gently palpates my arm around the packing. “Can you feel that?”
“Alrighty, then. Time to start stitchin’.” He flashes a smile at me with his last comment, but I don’t smile back. I can’t. My head is in complete chaos. I try not to think about the pair of scissors on the surgical tray next to me, easily within reach. As Dr. Johansson starts to gingerly remove the packing from the laceration on my left arm, I turn to the right, closing my eyes. Closing my eyes doesn’t help, though. If anything, it makes the chaos worse. Images flash before my eyes even more clearly with a black backdrop.
“I haven’t even started yet. You okay, bud?” Dr. Johansson asks me.
“Yeah, I’m doing just fine,” I lie through my teeth.
“The sight of the wound getting to you?”
“The sight of the thread being pulled through your skin freak you out a little bit?” I hesitate. The idea of watching my wound being stitched up actually sounds kind of cool.
“No, it’s not that,” I finally respond, turning to face Dr. Johansson. “It’s nothing, really.” I lock eyes with Dr. Johansson during this last statement, half hoping to convince him that, sans the gaping cut on my left arm, I’m okay, and half hoping that he sees through my mirage.
“Okay,” is all Dr. Johansson says, but the knowing look that flashes across his face towards me says that he knows it’s not nothing, but he’s not going to push the issue right now. He starts the tedious task of stitching closed the three inch gash in my arm.
After he finished sewing my arm and sets the last needle on the tray, he recovers the tray with the blue, paper-like material that was initially covering the tray, and bandages my arm over the stitches. “Now, based on the report from the EMTs, and based on my initial assessments, I would like for you to have a mental health evaluation.” I almost scream no. My parents both look stricken.
“Is that truly necessary?” my father intones, phrasing it as a question, but sounding patronizing more than curious.
“Yes,” Dr. Johansson responds confidently and assuredly. “Based on the nature of Jack’s wound, and a report to the EMTs from Officer Krupp that, prior to the infliction of this wound, Jack was pointing a gun at his own head, threatening to pull the trigger, I believe that a mental health evaluation is needed.”
“Can we discuss this outside, please?” my father asks in a commanding tone.
“Um, yes, we can,” Dr. Johansson responds, slightly startled by the sudden request. I watch my father walk briskly out of the bay, followed by the doctor, and my mother traipsing behind after a nod from me to follow them. Once I hear voices outside the closed curtain, I reach toward the surgical tray, slowly lifting the cover. I slowly grasp the scissors from the tray, almost as if trying to convince myself that I want to do this. I open the scissors, exposing the blades. I think about going after my right arm, but I can’t effectively control my left hand to dig the scissors into my right arm. The general anesthetic that was administered earlier is still in effect. I think briefly about my throat. Just cutting straight across. Not necessarily going for any major veins or arteries, just being symbolic more than anything. I decide to put that off until later. I want to actually bleed before I start leaving symbols.
My gaze falls to my thighs. The more I contemplate it, the better it seems. I slowly slide the gown up my right thigh until I see the bottom edge of my boxer-briefs. About half of my thigh is revealed. I gently drag the blade along my thigh, no pressure yet, just caressing, almost as if I were trying to shave my thigh. Then I actually turn the blade into my skin, poised to cut through the flesh. I push the blade into my leg, forcing it to go deep. I start pulling the scissors towards me, slowly lengthening the wound, and, despite trying not to, I give a soft cry of pain. The voices outside the curtain stop. Dr. Johansson’s head appears around the edge of the curtain.
“Shit!” he mutters as he rushes over to the side of my bed. His hand immediately grasps mine, trying to pull it up and away from my thigh. I fight him, trying to keep dragging the scissors towards me. The fight doesn’t last very long, though. Dr. Johansson forces my hand up and wrests the scissors from me. After moving to the other side of the bed, he pulls the tray away from my bed and puts the scissors back down on it. He walks over to a cabinet that’s off to the side, and then comes back to my right side, this time with a roll of gauze in his hand. He starts bandaging my thigh slowly, making sure to get pressure over the fresh wound. After he has a couple of layers of gauze down he picks up the pace a bit. After he finishes wrapping my thigh, he walks to the curtain and summons a nurse over. “I need another suture kit and a set of restraints,” I hear him inform her. He walks over to the computer near my bed, enters something into it, and then asks me a few questions. “Did you do this on purpose?” I look to Dr. Johansson with a face that says “really, you’re asking me that?” “I have to ask,” he counters, the look on his face almost sympathetic.
“Yes,” I finally sigh, giving up on being difficult, finally surrendering to the fact that I will be living today instead of dying.
“Were you trying to kill yourself?” I pause for a moment, thinking. I wasn’t necessarily trying to kill myself, but I wouldn’t have minded if I had bled out before they came back into the room.
“Potentially,” I finally respond, my response being naturally semi-cryptic.
“Can you elaborate on that?”
“The primary goal was not death, but if it occurred as a side effect I would not be all hot and bothered.”
“Ooookaaay…” Dr. Johansson mutters as he types a few things into the computer. “Now, you’re going to not like what I’m going to have to do next. Within the next few minutes a nurse is going to come in here with a set of restraints. Because of what you did, I now have to restrain you, for your safety as well as ours. She’s also bringing me a suture kit so that I can stitch up the wound in your thigh. You did a pretty good number there. I’m probably going to want to take an actual look at the wound before I stitch it up, make sure there’s no serious damage. What I would like to know now is whether you’re going to let me put the restraints on you nice and easy or am I going to have to call a couple of extra guys to help me put them on?”
“Well, as fun as it sounds to be forcibly restrained, I think I’m going to have to go the non-resistance route. I don’t feel much like fighting, and even if I did, I’m not in much of a position to do so.”
“So you’re going to let me put them on you nice and easy?”
“That’s not very reassuring.”
“Again, not in much of a position to fight,” I iterate, starting to feel fed up with the situation.
“Jack, just give him a yes or a no,” my father interjects. I glare at him. I want my parents as least involved as possible.
“You say you’re not in a position to fight,” Dr. Johansson comments, “but you resisted pretty well when I took the scissors from you. It would be nice to know ahead of time if you’re going to take a swing at me or something when I’m trying to put the restraints on you.”
“I don’t take a swing at somebody unless they really piss me off and punching them is deemed necessary,” I respond slowly. I notice that I’m starting to feel tired and sluggish. Despite the fact that it seems like all I do is sleep, I always feel tired. I also notice that my right hand, which has been resting on my thigh near the fresh wound, feels warm and wet. I glance down and see that the bandages on my thigh are bright red, apparently saturated with blood. Dr. Johansson notices me look down and follows my gaze.
“That’s not good,” he remarks as he walks briskly from the computer back over to my right side. Just then a nurse enters the bay, a handful of straps draped over one arm and pushing a tray almost identical to the one Dr. Johansson entered with earlier. “Good timing,” Dr. Johansson comments to the nurse as she proceeds towards him. “I need that suture kit over here. Can you start applying the restraints?” The nurse leaves the tray next to Dr. Johansson, who has already put on a pair of gloves and pulled out more gauze, and starts applying the restraints around my limbs and then connecting them to the bed so that my range of movement is terribly limited. I test just how far I can move by pulling against the restraints on my arms. I get about three inches before the straps are taught. Before I can test the straps around my ankles, I feel a sudden, constricting pressure on my thigh. I try to pull away from it as reflex kicks in, but my legs stops short, thanks to the restraints.
“Easy, Jack,” Dr. Johansson reassures me. “I’m just trying to control the bleeding at the moment. The only thing I’m doing is wrapping gauze and applying pressure.”
“It hurts,” I comment, feeling childish as I slowly relax the muscles in my leg.
“It’s going to hurt a little bit,” explains Dr. Johansson. “In order to stop the bleeding I have to apply a pretty significant amount of pressure.” I nod my head in understanding and sit back against the bed. As I feel the tight pressure around my thigh again, I fight the urge to pull away and try to relax my leg instead. I close my eyes as I continue to fight against pulling away.
After a few minutes the intermittent pressure dissipates and is overtaken by a constant squeezing. “I’m going to give that a few minutes and then check on it and hopefully get it stitched up, but in the mean time I’ve got a few things to take care of.” Dr. Johansson strips off his gloves and throws them away as he leaves the room. The silence that follows is so tense that a tightrope walker could walk across it. I can tell that my father is extremely displeased with something, and my mother just seems confused and concerned more than anything.
The tense silence continues until Dr. Johansson returns, pulling on another pair of gloves. “Let’s take another look at your leg, shall we?” I try to raise my knee up to make it easier for him to examine my thigh, but all that ends up happening is my ankle jerking in the restraint. “Easy there,” he comments, sounding reassuring. He sits on the wheeled stool next to my bed and pushes my hospital gown back to fully expose the bandaging. “The bleeding seems to be at least partially under control. It’s not bleeding through the bandage, which is good.” He slowly cuts through the gauze from the wound. After he carefully removes the gauze from the wound he pulls the suture kit closer to himself. He gently palpates around the wound, inspecting it, making sure there’s nothing in there that isn’t supposed to be. He swabs my thigh, wound and all, with an antiseptic soaked piece of gauze. I expect it to sting, but it doesn’t.
“Same drill as last time,” Dr. Johansson comments to me as he picks up the syringe from the tray. There’s a slight pinch as the needle enters my thigh, and a slight burning sensation as the anesthetic is injected. After a few moments, Dr. Johansson gently palpates my thigh again around the wound, but I feel nothing. After confirming this he starts to stitch the wound closed. Once he finishes sewing, he bandages over the stitches, just like he did on my arm. “That should do it,” he comments. “There should be someone here shortly to perform a mental health evaluation. They’re going to decide if you’re okay to be released or if they want to admit you to the psychiatric ward. If they chose to admit you they may admit you as inpatient or they may admit you as outpatient.”
“What’s the difference?” my father quickly interjects.
“Well, inpatient means that Jack will be staying in the hospital, on the ward. If he’s admitted as outpatient, then he would come to the hospital during the day and go home at night.”
“So it’s a difference in level of care?” my father asks, sounding accusatory.
“Kind of,” Dr. Johansson answers. “If Jack is admitted to inpatient, it means that we believe that he is an immediate threat to himself or someone else. To put it into layman’s terms a little bit, it basically means that his condition at this time is a little bit more severe. By having him admitted to the ward we know he’s going to a safe place where he can’t hurt himself or anyone else.” As Dr. Johansson says this my brain responds with a “challenge accepted.”
“And if he’s admitted to outpatient?”
“Well, it basically means that his condition is less severe; that we don’t think he poses an immediate risk to himself or to anyone else. If he’s admitted to outpatient, then we feel that he would be safe to go home, and would come to the hospital during the day, basically to receive treatment. There would be group and individual therapy sessions, much like inpatient. With either type of admission, our highly skilled and trained team of professionals will work with Jack to try to figure out why he’s doing what he’s doing, try to help him find some alternative things to do instead, maybe start him on some medication if it’s felt that it’s necessary, and help set up a long-term care plan for Jack, such as setting up appointments with outside therapists, and psychiatrists if we start him on any medications.”
“And there will be one person who determines whether he’s admitted inpatient or outpatient?” Now my father sounds skeptical, as if he doesn’t feel like this is a well-working system.
“One person does do the evaluation, but it’s not solely that person that makes the decision. The evaluator has a set of guidelines to follow during the evaluation, and then they consult with a couple of different people on the final decision, based on the findings from the evaluation.”
“Okay,” my father responds, sounding a little bit more comfortable with that information.
“Any other questions?” Dr. Johansson proffers. My parents shake their heads, and I remain still and silent, not trusting myself to say or do anything lest I give away my thoughts. “Okay. I will check back on you later, most likely after mental health comes down to do their evaluation.” He walks out of the bay, and again the room is overtaken with a tense silence.
“Jack,” my father starts, but I cut him off with a motion of my hand.
“I don’t want to hear anything you have to say. Everything is just an act now. I know you don’t really care about me. You care about what it means for you, how it’s going to reflect on you. You care about what people will think if they find out that you have a son who tried to kill himself, who cuts himself, who is a fuck-up in the eyes of society.” My voice fades away, no longer able to say anything.
“Oh, Jack…” my mother starts again.
“Rowena, please. Let me have a word with Jack. Then you can have your say with him.” My mother nods, agreeing. “Jack, I’m going to say what I have to say, and you’re not going to stop or interrupt me. I can’t make you listen, but I hope you will. I have always cared about you, Jack. I know I haven’t really showed it, but I have always cared about you, always wanted the best for you. I know I’ve pushed you to be good, because I always wanted you to be the best you could be. I’ve pushed you to do everything you possibly could because I want you to know that you’re capable of anything. I only ever was put down by my father, and had a mother who just went along with him instead of standing up for me. I never knew how much I was capable of because I was only ever put down. I didn’t want that to happen to you. I wanted to make sure you know exactly what you’re capable of. I’m sorry I haven’t shown this in a better way. I wish you could’ve brought it up to me before…before it go to this…” Tears are starting to trail down his cheeks again, and I’m almost touched by his words and show of emotion, but my anger overrides. Beneath all the anger I know he’s speaking the truth to me, but I don’t want to believe him. I can’t fully believe him right now.
Before I can formulate a coherent response, there’s another knock on the door as someone new pokes her head around the door. “Are you Jack?” she asks. I nod my head. “What’s your birthday?” After she asks me, she looks down at a clipboard in her hand to confirm my answer.
“July thirty-first, nineteen ninety-eight,” I tell her.
She looks up at me with a smile, and introduces herself. “My name is Emily. I’m from behavioral health, and I’m here to do your assessment. Would you mind talking with me for a few minutes?” I shake my head. “Great.” She looks at my parents in turn. “Would you mind if I talked to Jack alone?” My father looks slightly taken aback, and a questioning look starts to cross his face. My mother, while also looking slightly surprised, nods her head.
“Of course,” she answers Emily softly. She grabs my father’s wrist and pulls him out the door behind her, before he gets a chance to start questioning Emily.
Once the door closes behind them, Emily starts to explain, “Most people feel more comfortable answering these questions without other people in the room.” I nod my head in understanding. “I see from your chart that you were brought in after cutting your wrist in your school bathroom, which you did after holding a loaded gun to your head in your guidance counselor’s office. It also says that while Dr. Johansson was outside talking to your parents, you took the pair of scissors from the suture tray and started cutting into your leg. Is all that correct?” I turn my eyes away from her as I nod my head in affirmation. “Okay, Jack. I do need you to talk to me a little bit. I know it might be difficult, but I need you to try to use words. Can you tell me about why you did those things?”
I stare off into the floor in the corner of the room, not exactly sure how to respond yet. A couple of different thoughts race through my mind, each clamoring for attention, to be the one to leave first. My response depends on whether I want to be sarcastic, and an asshole, or genuine, and cooperative.
“Jack?” Emily prods after a moment of intense silence. I hold up a finger, asking her to give me a moment, and tap my temple a couple times, to let her know that I’m thinking about it.
I go back to my debate of how I want to answer her. The anger within me at the situation pushes me towards sarcasm, but there’s just something about Emily that feels calming, that pushes me towards being genuine. I struggle to find a phrasing that might satisfy both, but come up empty. As much as I want to be genuine, to just let myself break down here and let it all out, I can’t. Fear and anger override, closing any gates that may have started to open.
“I would think holding a gun to my head is pretty self-explanatory,” I finally mutter, still staring at the corner of the floor.
I don’t see how Emily reacts, but after a moment she responds with, “Holding a gun to your head may be self-explanatory, but not pulling the trigger when you threatened that you would isn’t.” So she’s willing to fight fire with fire, is she? Well, bring it on.
“So I chickened out on blowing my brains out. So what? I still tried to fucking kill myself by slitting my goddamn wrist.” I’m trying to hold it together, to keep the anger up front to hold up the bravado, but it’s not working. I can feel the tears starting to fill my eyes no matter how hard I try to blink them away. I glance in Emily’s direction, trying to gauge her reaction, how she’s taking what I say.
“Jack,” she says softly as she takes a couple steps closer to my bed. “I think you want to talk about this, but you’re letting your anger speak for you right now. Does that sound about right?” I look back at the corner of the floor, unable to meet her gaze. I know she’s right. I don’t want her to be, but I know she is. I nod my head. “May I sit here?” She motions to one of the chairs next to the bed. Another nod. “Let’s try going back a little bit,” she almost whispers. “How long have you been feeling suicidal?”
“I’m not really sure,” I reply after a pause.
“Is it something that’s been going on so long that you lost track of when it started, or is it more like something that came on gradually and has been building up?”
“I guess kinda both…” I almost mumble.
“So, like something that came on gradually a while ago, and has built up over a long period of time?”
I nod my head, feeling the tears starting to leak from my eyes as my breath catches in my throat, threatening to break loose in a sob.
“And the cutting. Is this a new behavior, or has it been ongoing?”
“It’s been happening on and off for about five years,” I choke out, trying to hold back sobs, already having given up on the tears, which flow freely down my face now. She makes some notes on her clipboard before continuing on with the questions.
“Now, in your chart, Dr. Johansson put the reason for the stunt you pulled with the scissors as ‘intent to harm self; possible suicide attempt’. Would this be correct?”
“I-I don’t know…I guess…”
“Were you or weren’t you trying to kill yourself?”
“I don’t know. I just wanted to hurt, to bleed…”
“Okay. Just a few more questions, Jack, then we’ll be done. Do you have a psychiatric care provider that you see on a regular basis? Like a psychiatrist or a therapist?” I shake my head no. “So you’re not on any medications, I take it then?” Another shake of my head. “If you were to be discharged to go home, would you be safe?” I think about it for a moment, then shrug my shoulders. “If you went home, would you try to kill yourself again?”
“Jack, I need you to be completely honest, not just with me, but with yourself, right now.”
“Maybe? I just, I really don’t know right now.” I close my eyes and turn my head away from Emily as the tears continue to fall down my face, fighting the sobs that want to rack my body.
“Okay Jack. Last question. Do you have access to any weapons at home, like firearms?” I nod my head. My dad has a gun safe, containing a couple different kinds of guns, and he doesn’t know that I know the combination. Hell, that’s where I got the gun that I tried to use this morning. I wouldn’t be surprised though if he still hasn’t noticed that I took it. He hardly opens it. He’ll go in there like three or four times a year, and it’s usually just to take them to a shooting range, or clean them. For all the guns he has, he hardly uses them. He’s more of a collector than anything else.
“Alrightey, Jack. Thank you for talking with me. I’ve got to meet with Dr. Johansson, and then I’ll be back to discuss your options.” I nod my head, letting her know I understand. She opens the door and walks out, and as soon as she leaves, my father immediately steps back in, followed momentarily afterwards by my mom.
“Jack, what did she ask you about?” My father asks, again in his commanding tone. I don’t answer him, tears still streaming down my cheeks. My mom reaches out her hand towards mine. I don’t take hers, but I don’t pull away either, and she rests hers gently on top of mine.
“Young man, I asked you a question,” my father pushes. Still, I don’t answer him. “Jack Brian Cavanaugh, what did she ask you about? What did you tell her?” He doesn’t raise his voice at me. Instead, he lowers it, speaks slower. I turn my hand over in my moms, gently gripping hers now.
“What did you say to me?” I snort.
“You don’t scare me anymore. You can’t do anything to me here.” My mom’s hand squeezes mine briefly. I can’t tell if she’s trying to warn me or comfort me.
“Watch your tone, young man.”
“Get. Out.” He gives me an incredulous look, like he can’t believe that I’m disrespecting him like this.
“Jack. Brian. Cavanaugh.”
“No. You’ve had your say. Now get out!” He continues to stare at me in disbelief, as if he can’t really be hearing what he’s hearing. He opens his mouth again to say something, but I cut him off. “GET THE FUCK OUT!” He looks at me for a few more seconds, then turns around, shaking his head, and storms out.
“Jack,” my mother whispers, “would you like me to leave too?” I shake my head. She leans over towards me to give me a hug, and I bury my face into her shoulder, letting loose everything I had been holding back. I’m not sure how long we stay like this, but after what feels like an eternity that ended too soon, Emily comes back into the room.
“Do you want to talk to Emily alone?” my mother asks me.
“No, it’s okay. You can stay for this,” I tell her. She nods her head and gives my hand another gentle squeeze.
“Hi Jack,” Emily opens with. “After meeting with Dr. Johansson and a few other members of the clinical staff, it was decided that inpatient care will best meet your needs right now.” I nod my head in understanding. I was hoping it wouldn’t come to this, but honestly, what else did I expect? I am actively suicidal. I tried to kill myself twice in less than a day. It’s probably past time for this to happen. “We don’t have a placement for you yet,” Emily continues, “because our unit has no more beds available, but we’ve started contacting other area facilities to check their availability. If none of them have space, then we’ll have to start searching further out, which will take more time, but we will find somewhere for you.” I nod my head again, and my mother murmurs a soft thanks to her before she leaves. I expect my father to step back into the room after she leaves, but after a tense moment, he doesn’t.
“Would you like me to tell your father?” I nod my head. “Okay, sweetheart, I’ll be right back.” I let her hand fall from mine as she walks away to go talk to my father. I hear the sounds of their hushed arguing outside for a few minutes, and then my mother comes back in, looking slightly exasperated. I raise an eyebrow to her, basically me asking her what happened without actually saying anything. She shakes her head. “Your father just being your father,” she answers. “Arguing against the doctor’s decision, saying you don’t need that, we can take care of this at home, etc. Going on about what he thinks is really the right choice, even if it’s not. So I sent him home to pack you a bag. That way, he can make himself useful while he stews, instead of just pacing back and forth outside the door.” I grunt amusedly, and accept my mother’s hand back into mine as she sits down into one of the chairs next to the bed, resting my head on her shoulder. She leans her head on top of mine, and places her free hand on the side of my head. After a few minutes I feel some wetness on the side of my head, and guess correctly that my mother is crying, and give her hand a slight squeeze.
“It’s gonna be okay, mom. We’ll get through this, okay. We’ll get through this.”
