The Back Building (21 page)

I often went to Jenna’s school open houses, to her chorale concerts and teacher conferences, so I felt I had a say in her upbringing. Next week was the spring concert at school and I was beginning to dread it. I feared Jenna would act out and embarrass us all, but Camille didn’t fret one bit. When the day arrived, Jenna came downstairs wearing black eye make-up and red lipstick. She was only twelve years old and was far too young for make-up.

“Oh, Jenna, go take that off right now.” I said knowing the kids were supposed to dress in spring attire.

“Mom, she is just experimenting. Gosh,” my daughter said in front of Jenna, undermining me.

“So, you are okay with her looking like that?” I asked my daughter.

“Well, no, but what can I do?” She asked me in front of Jenna as if she had no authority over her child, giving Jenna all the power.

I was fearful of going to the concert and bearing witness to Jenna’s strange behaviors. I didn’t want to be embarrassed but I felt I needed to be present for my daughter.

When the seventh grade took the stage, Jenna was front and center. Her smaller size, when compared to her peers, landed her in the front row. Her black attire stood out among the bright pinks, purples, and blues the other students wore to celebrate the season. When the group sang, Jenna looked far off in the distance, her mouth unmoving. I followed her eyes and noted she was staring at the clock, perhaps she just felt uncomfortable on stage and found the overhead lights to daunting.

Thankfully, when the fourth and final song was complete the seventh graders were led off stage. No outbursts or odd behaviors took place and I was grateful. When we arrived home Jenna seemed a tad confused, and sullen. We watched television for an hour or so and before bedtime Jenna looked utterly confused.

“When is my concert, Grandma?” She asked in front of her mother.

“Darling, your spring concert was tonight.” We were alarmed she forgot the past several hours and knew she was not okay.

“What? Why didn’t you take me? I am so mad at you. I hate you!!! You forced me into this horrible black outfit and why do I have eyeliner on?” Again, Jenna spewed made up words that were confusing and strange.

I looked at my daughter as tears streamed down her face. It wasn’t just the licking and smelling anymore, or the short temper, now it was as if Jenna were divided.

Chapter Eighteen

Genetics

My grandmother, Iona, was insane. She spent time in an insane asylum as a young woman for being demented. I had fond memories of Iona, however, because she was always a pleasure to be around. Iona was simply an odd duck with imaginary friends that she spoke to. As a child I used to laugh out loud when my grandmother had a running dialog going with an invisible person, until my mother told me it wasn’t kind to make fun.

“But, Mama, no one is there. It’s so funny.” I would retort.

“It might seem that no one is there to you, Shirley, but to Grandma, her friends are very real.” My mother said.

This was my first experience with mental illness and as a result it made me more observant of the people around me and how they interacted.

I saw Grandma Iona in Jenna at times, that distant, confused look that Jenna got worried me and took me back to my youth. Sometimes my grandmother would look lost and afraid, and her condition worsened as she aged, especially after my grandfather, James, died.

But Jenna was only twelve years old, true she didn’t seem to have any aberrations or people she spoke to, but her other behaviors pointed to something disturbing.

Camille made the appointment with her pediatrician, who after observing Jenna, phoned the psychiatric center at Syracuse’s premier Hutchings facility. It was a facility that took care of children as well as adults. It had beds for those that needed round the clock care, or offered day treatment options for those less dire.

Our first appointment was with Dr. Saul who would be giving Jenna her psychiatric evaluation. He was very curious upon observing Jenna’s behaviors. She licked the walls in his office, sniffed the air like a pup, and then licked her hands. When she sat before him she took off her shoes and socks, then licked her feet. She had no sense that this was odd or inappropriate. It was as if her sense of right and wrong, along with appropriate manners, were lost.

“Jenna, my name is Dr. Saul. Tell me, what does my office smell like then?” He asked.

“It smells like spices and someplace far away. I don’t recognize it, but that’s okay.” Then she mumbled to herself putting vowels and consonants together making clicking, nonsensical words and sounds.

My daughter and I sat back and listened as the doctor conversed with Jenna about everyday things, such as the concert that she claimed to have missed. After a half an hour of conversing, the doctor sent Jenna and I into the waiting room while he spoke to Camille alone. I gathered from the ghastly expression on Camille’s face when she stepped out of the office that the news was not good. It was my turn to meet with the doctor, although I was not a parent, I was a guardian and primary care-giver. I was her grandmother.

“Your daughter will need support. I fear she is in a state of shock at the moment, Shirley,” the doctor said when I sat down across from him.

“Yes, Camille is already under a lot of stress with her demanding work schedule and honestly, this came on very suddenly.” I confided.

“As it often does in these cases.”

“May I ask you something? My grandmother was insane, she spent a stretch of time at Willard Hospital as a young woman. Can this be hereditary?”

“Certainly it can. It would be most helpful to me if I could obtain her medical records, do you have access to them?” he asked.

“I don’t, but that’s not to say I can’t try to obtain them for you. I have memories that may be helpful and am more than willing to share any information I can remember if it helps my granddaughter.”

“Yes, she will need all the help she can get. I am sending her home because she is not harming anyone right now. She may seem confused at times which is normal for what she is experiencing. You may notice swift mood swings, or changing sleep patterns and I ask you to jot down what you observe. We will meet regularly from now on and keep a sharp eye on her progression.”

“Dr. Saul, what is the diagnosis?”

“It appears she has a psychotic disorder of some kind. It is even possible she may be having a psychotic break. However, until we have her tested for epilepsy, brain tumors, or encephalitis, we can’t confirm this. We need to rule out any other medical conditions, or neurological disorders that involve the central nervous system.”

“Oh my.” I gulped in air, closed my eyes and felt the expansion of my lungs.

“Shirley, are you alright?” the doctor asked.

“Yes, I’m fine. Please go on.” I answered.

“Once this testing is complete and we have more concrete information, we can go forward with a diagnosis. Psychotic disorders are most often diagnosed in teenagers or young adults, but it’s not entirely uncommon to have an adolescent child present with these symptoms. Unfortunately, we have found that the younger a child is when they present with the classic symptoms, the more severe the case is.”

The tears welled up in my eyes, as I listened to the doctor.

“What can we do, Doctor?” I said clutching the tissue he handed me.

“Be patient, be strong for your daughter, and we will meet again next week to discuss Jenna’s CAT scan results.”

“Thank you, Dr. Saul.”

“You are welcome, and if anything else unusual comes up, don’t hesitate to call me.” He handed me his card, with his personal cell phone penciled in the corner.

His office made the necessary appointments for Jenna and now all we could do was wait. My daughter took the week off from work, which would drastically affect her income but it was imperative she be present for Jenna’s testing.

***

The CAT scan was imposing and while we didn’t tell Jenna precisely what kind of test she was getting, she grew uncomfortable when our car turned into the hospital parking lot. After checking Jenna in, she was told to undress and put on a hospital gown that opened in the back. She seemed suspicious of the nurse that took her vitals and attempted to run an intravenous line in her arm. Jenna started talking quickly in gibberish: the nurse looked at my daughter and me questioningly but didn’t say a word. The nurse found a vein and rubbed the spot with an alcohol swab. Jenna clicked her tongue and grew irritable but remained still while the needle was inserted. I wondered what she was thinking when she stared at the ceiling so intently.

Once the line was placed, she was transferred into an adjoining room and laid on a narrow table. Jenna shielded her eyes from the bright lights and looked uncomfortably at the sterile equipment surrounding us. While we waited for the head technician to arrive, Jenna grew restless and fidgety. She began tugging at her tape and tried ripping out the IV needle. She stood up to leave, claiming everyone in the room was out to get her. Her monologue became panicked and she started sweating on her brow.

“Jenna, everyone here is trying to help you. They just have to run some tests to determine your condition,” I said calmly to my granddaughter. I placed a gentle hand on her shoulder, trying to force her back down to the cot. My daughter stood uncomfortably in the corner watching everything unfold.

“They put something in my brain, Grandma, through the needle in my arm and now they want it back. Don’t let them hurt me, they want to kill me!” Jenna was sweating more profusely now and continued her attempts to try to flee. A large black man blocked the doorway and two nurses escorted her back to the cot, where her arms and legs were put in restraints.

Jenna screamed and clicked her tongue, her language strange and confusing to all of us who were around her. I tried to console her but her eyes were wide with fear. When the technician finally entered the room, he had a doctor with him. Jenna was administered a sedative via the IV to calm her so that the testing could take place. Everyone in the room was on edge, but my daughter was mortified.

The blood work and urine culture came back negative. Similarly, the results from the x-rays and CAT scans were normal, Jenna had no problems with her endocrine or metabolic systems. This pointed to the fact she did indeed have a neurological or mental disorder. Dr. Saul phoned my daughter at home and scheduled an appointment for us with a pediatric neurologist the following day. This doctor was a close colleague of Dr. Saul's and he was able to make room for us in his schedule.

Jenna was reluctant to get out of bed the following morning. Camille and I had to drag her into a steaming hot shower to wake her up. Neither of us could get her to use soap or to wash her hair, Jenna feared the substances were poisoned. She dressed with great apprehension and tried lying back in bed, but we urged her to get ready for the day and promised her pizza for lunch. I felt like she was unraveling before my eyes.

The neurologist had a thick foreign accent that was hard to decipher and it made Jenna wary. She warmed up to his nurse, however, during her hearing and vision testing and the remainder of the tests ran smoothly. The exam was straight-forward and the doctor was able to assess Jenna’s motor and sensory skills, along with her speech and balance. He used a reflex hammer to check her nerves and a flashlight to study her eye movement. The exam only took half an hour and when we finished we went straight to Dr. Saul’s office. The neurologist told us he would call Dr. Saul with his results immediately.

The doctor’s door was ajar when we arrived at his office, thankfully this meant we didn’t have to wait. We entered together and took seats as the doctor stood to greet us before closing the door. Jenna squeezed her eyes tightly shut when the door latched shut, her body tensed.

“I understand, Jenna, that you were uncomfortable with yesterday’s testing?” Jenna just shrugged, fearful this doctor was out to get her as well.

“Well, the testing came back negative as you know. Jenna does not have any medical basis for her behaviors. I just spoke with the neurologist as well, and those tests were also negative. In other words, Jenna doesn’t have any diseases that might present with speech deficiencies or mood swings. Having this information allows us to move forward with therapy to arrive at a diagnosis.”

“Doctor, what are you looking for exactly?” I asked while my daughter sat by, unusually quiet, holding Jenna’s hands.

“This diagnosis will be tricky. I have ruled out Post Traumatic Stress disorders, because she hasn’t had any traumatic events or accidents.”

Suddenly Jenna stood up. “You don’t know me, you are just like the rest of them!” She yelled as she stormed from the room, slamming her fist against the wall on her way out. My daughter followed her outside and the doctor motioned that I allow them to retreat.

“She is displaying delusions of persecution. As you have just witnessed, she thinks people are out to get her. This is a common occurrence in schizophrenic patients, Jenna may even accuse you of being against her.”

“Okay. Are you saying that my granddaughter has multiple personalities? The Jenna I know would never act like that. She has never had a violent bone in her body.”