Chapter Fifty-Four
Kevin was concentrating intently, his hand moving rapidly, making notations on Lucky's Spencer's chart. There was a knock at his office door. Tony appeared in the doorway, holding a World Wide Wrestling doll in one hand and looking anxious.
Kevin waved Tony over. "Come on in," he said good-naturedly, motioning to a chair in front of his desk. "I was just placing some notes on Lucky's chart. I examined him a few minutes ago." Kevin quickly finished up, closed the folder, rested his black Mont Blanc pen on top of it and looked intensely at Tony. "You want to know what is happening with Lucky," he stated.
"That's why I'm here," Tony said wearily, running a hand through his hair and straightening up in his seat in preparation for a bombshell.
Kevin dug in. "My examination of Lucky confirmed my earlier suspicions. He is definitely in a catatonic state, and his condition has worsened from the prior evening. He is now showing rigidity in his limbs, facial tics, and is in a stupor, completely unresponsive to various stimuli."
Kevin paused and played with the folder for a moment before continuing. "What this means is that Lucky is suffering from two serious conditions in addition to his Post Traumatic Stress Disorder. All of these conditions are interrelated and make his prognosis more problematic."
Kevin leaned back in his chair and laced his fingers behind his head. "I've now narrowed my diagnosis to Complex Post Traumatic Stress Disorder with attending depression, self-inflicted violence and catatonia. Lucky has a history of subjection to totalitarian control over a prolonged period, which is his imprisonment with Faison. His reaction to this long-term trauma has resulted in alterations in affect, consciousness, self-perception, systems of meaning, and relations with other persons. Roughly translated, this means he is exhibits a constellation of symptoms including a sense of hopelessness and despair, isolation and withdrawal, shame, guilt and self-blame, amnesia for traumatic events, transient dissociative episodes, depersonalization/derealization, chronic suicidal preoccupation, and self-injury."
Tony swallowed hard several times, but it didn't alleviate the dryness in his mouth. "That's a lot of symptoms," he said almost in disbelief.
"Lucky has suffered repeated trauma over a prolonged period of time," explained Kevin. "He needs time to process that trauma and to heal. A patient moves through various stages in that process. The first stage is stabilization, where patient and therapist establish trust and rapport. The patient should feel able to cope with daily life at the end of this stage. Next, the real work of therapy begins. We had achieved that stabilization and moved on to focus on his current symptoms and how to handle them when Lucky was re-victimized, thereby causing him to regress."
"What does this mean in terms of treatment?" Tony asked.
Kevin continued. "My recommendation is that we establish Lucky on a schedule of sedative anticonvulsant drugs, that is, benzodiazepines and electroconvulsive therapy or ECT over a period of two to three weeks, depending on its rate of effectiveness. I've already ordered the benzodiazepine, and we can set him up for his first ECT session within two days. I'll need your signature to authorize the treatment."
"Whoa, whoa," said Tony skeptically, raising his hand to stop Kevin. "Hold on a minute. I'm a neurologist here, remember? You're talking about administering ECT to my nephew? Isn't that a bit extreme? What about potential side effects?"
"Tony, it is not extreme in light of the fact that Lucky is suffering from a terminal illness. He is experiencing a major depression and has attempted suicide twice in the span of five months. The next time he tries, he'll succeed. I have no doubt about that. My first responsibility as a physician is to save his life. He has not responded to conventional cognitive and pharmaceutical therapies and now is catatonic as well. ECT is a recognized and recommended therapy for treating catatonia. General Hospital has state of the art equipment, and I've used it successfully with patients under similar circumstances. ECT can be very helpful in treating both the depression and the catatonia at the same time. If we can get Lucky to the point where he is responsive and able to listen and take direction, then we can begin work on his therapy again. One other consideration is that Lucky is still underweight. He will not maintain well on an IV, and the catatonic state is not good for his body and the healing of his physical injuries. We need to break him out of that state as soon as possible for his general welfare."
Tony stood up, sighed and cracked his neck. "My head feels scrambled," he complained. Kevin rose from his seat and suggested, "Would you like to take a break? I have some coffee brewing over here. Hawaiian coffee, not that generic GH slop." Tony yawned and stretched. "Just what the doctor ordered, huh?" Kevin chuckled as he retrieved two cobalt blue mugs from his credenza. "What would JuanValdez say?" quipped Tony. "Bypassing his Colombian coffee for that tropical brew?" Kevin filled a mug and handed it to Tony. "I fell in love with this stuff when I vacationed in Maui. I order it by the pound over the Internet."
"Oh, man," said Tony with twinkling eyes. "What I wouldn't give to be lying on some sandy beach with the palm trees waving over my head, a beautiful redheaded babe to one side of me and a tray of tropical drinks on the other side."
Kevin nodded. "My fantasy as well. Except that there's a brunette in my dream." Tony sipped his coffee and stared at his mug appreciatively. "Hey, this is really good stuff, my friend." Kevin nodded. "I know."
The two men walked back to Kevin's desk. "Let's get this hammered out," said Tony with resignation. "I want my nephew to make a full and complete recovery. He deserves every happiness this world has to offer."
"Yes, he certainly does," agreed Kevin. "By the way," he said, pointing toward Tony's lap. "Did Santa Claus bring you a present? You seem loathe to part with your Mr. Wrestling Man there."
Tony looked up sharply "Why, I do believe our analytical psychiatrist has a sense of humor. Go figure." Tony picked the doll off of his lap and smacked it on his knee several times. "This was a gift to my son, Lucas. He wanted to make sure that Lucky had a Christmas present, so he gave it to me to give to his cousin."
"Nice boy," Kevin said with approval.
"His mother is a very special lady," said Tony. "She's done an excellent job raising our son. I give her all the credit."
~*~*~*~
Tony stood in the doorway of Lucky's room, watching the nurse attend to the boy's needs. His heart was heavy as Lucky lay there insensibly, not making a sound or moving. The nurse changed his bandage over his cuts, took his vitals and adjusted his pillows under his head. Afterward, Tony came in and sat next to Lucky. He picked up his right hand and held it while he talked to him.
"I don't know if you can hear me, Lucky, but I want you to know your Uncle Tony is here, and you can always count on me to be here for you. Your Aunt Bobbie, too."
Lucky continued to stare at one point on the ceiling, his gaze never altering or showing focus or recognition.
Tony placed Lucky's hand back down on the bed and laid Lucas' wrestling doll underneath his palm. "Lucas wanted to wish you a Merry Christmas, Lucky. This is a present from him. He told me to tell you to get better soon so you two can wrestle like the guys on the TV program. I don't know about that," laughed Tony. "Please don't break the furniture, but we want to you to get better and come home." Tony shifted in his seat and coughed away a few tears. "I've gotten used to having you around, buddy. It's going to be lonely without you." He patted Lucky on the hand, and rose from his seat, leaning over to kiss him on the forehead and smooth his hair to the side. "I love you, kid. Don't disappoint us. Get better soon."
~*~*~*~
Bobbie picked up the phone and dialed the number for the Quartermaine mansion. "Monica Quartermaine, please,"she stated. "This is Bobbie Spencer calling."
Monica answered the phone. "Bobbie, Merry Christmas! It's so nice to hear your voice. You saved me from another Quartermaine marathon holiday battle." She laughed. "What's up?"
"Oh, Monica, I have some sad news. I wanted to tell you first, so you could talk to Emily. She's going to be very upset I think."
"Please tell me it's not Lucky. Emily adores that boy."
Bobbie sighed. "Yes, it's Lucky. He had a breakdown of a sort at the GH Christmas Party last night. He tried to kill himself, and he's in the psychiatric wing. Monica, he's catatonic, he doesn't respond or recognize anyone. It's bad."
"Bobbie, I'm so sorry. You and Tony must be devastated. I don't know how I'm going to approach Emily. This is going to be so hard on her. She talks about Lucky constantly, and she's been so happy with him.
"He's a good kid, Monica. I hope you don't hold this against him. He's had some awful breaks, and he received a rather bad emotional shock yesterday. It's Laura again. She sent him a note basically telling him to go kill himself and that he'd never see his sister Lulu again. Can you believe that woman? She's poison."
"Yes, she is," agreed Monica. "I used to think she was a good mother, she seemed so devoted, at least in public around other people. I guess you never know what goes on behind closed doors. Bobbie, Lucky has never been anything but respectful and attentive to Emily, and even Edward fancies the boy. No, I won't hold this against him. I want him to recover and have a normal life. But how is this going to affect his job and his schooling?"
Bobbie took in a deep breath and let it out raggedly. "I spoke with Tony on the phone awhile ago, and he's going to speak to Lucky's boss about the situation and ask him for a leave of absence. They're very happy with Lucky's work, so hopefully that won't be a problem. His classes at PCU don't start for another three weeks, and that buys us a little time. Kevin thinks that Lucky will need to be hospitalized for at least a month, and that could interfere with his classes. Tony is going to contact the school and see if they can arrange for him to take one course online. He'll probably have to drop out of several classes, though. But as long as he starts PCU, that's a step forward."
Bobbie changed the subject. "Monica? Do you know much about electroconvulsive therapy? Kevin is recommending it for Lucky, and I'm concerned. I'm a surgical nurse, so it's outside of my expertise. As a neurologist, Tony is concerned about potential side effects."
"They've made great improvements in the therapy," stated Monica. "In the past, it was sometimes misapplied, so people cling to that concern. But, there are risks with any treatment, especially pharmaceuticals. I'm thinking he should be fine, but I'd be happy to consult on his case as a cardiologist."
"That would be great, Monica.".
"I'm so glad you phoned me, Bobbie. Even if it is bad news. Emily was about to call Lucky, and it will help me to talk to her first. Is there anything I can do for you, hon?"
"No, Monica, thanks. I think we're holding our own."
"Keep me in the loop about his progress.".
"Sure thing.".
~*~*~*~
The older, grandmotherly nurse talked to Lucky the whole time she spent bathing him. She lifted his arm and sponged it. "Unfortunately for you, you're not speaking because you have to listen to me, and believe me, I can talk. Can't shut me up." She laughed lightly, pausing to wring out the sponge. She placed his arm back into his gown and gently laid it down on the bed. "A nice looking young man like you must have to beat the girls off with a stick. Am I going to have to break up the fights between all your girlfriends when they come around to call? Yes, I thought so."
She rolled Lucky over on his side, and started washing his back. "You're the most compliant patient I've had today," she exclaimed. "But I would prefer it if you'd talk to me. I bet we could have an interesting conversation. That's a funny doll you have there. Looks like someone gave you a present today. Wasn't that nice of them? Is that Hulk Hogan? I don't know any of those wrestler's names. I'm too old, it's not my thing. But, my grandsons like wrestling. They tear up the house when they watch it." She toweled Lucky off and moved him onto his back again. Moving his gown aside, she ran the sponge over his stomach, careful to avoid the bandaged, stitched wound. "And how did you do that?" she asked. "It looks like it hurts. I don't know if it hurts you now, but I'll be careful around it just in case, okay?"
After the nurse finished bathing Lucky, she ran a soft hand over his hair. "Get better soon, sweetie. Then we can have that conversation."
~*~*~*~
There was a rare break in activity at the nurse's station. "Hey Deb," said one nurse to another. "What's up with the patient in Room 2B?" Deb turned around leaned against the countertop. "Oh, that's the kid who is catatonic. Poor guy. He's certainly easy to deal with since he doesn't move or talk. But, it's so sad."
Another nurse named Jill joined in the conversation. "I remember him before he was admitted here. He's a computer guy. He completely fixed all the problems we had transferring files to the outpatient mental health clinic. Remember that nightmare we had for a month?"
A third nurse shook her head, "How could I forget," she said sarcastically. "What was he like, before this I mean?"
Jill replied, "He was really sweet. And talk about smart. He fixed that problem in no time, and it's worked ever since. He was a nice kid. Certainly doesn't deserve this."
Deb nodded and sighed. "It's sad.
I'm going to include him in my prayers. He can use all the help he can get."
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