Chapter Ninety
"Lucky, we need to talk about your cigarette smoking," said Kevin.
Lucky was sitting in a wheelchair in Kevin's office, his sprained ankle propped up on a footrest, and his IV pole stationed next to his chair. His face was impassive and disinterested, and his eyes took on a distant quality. Occasionally, he'd focus on an object in Kevin's office, a Lucite paperweight on his desk or a framed medical diploma hanging on a far wall. Lucky moved his head up to glance at Kevin and looked back down at his hands lying on his lap. "I like to smoke," he said frankly. "They won't let me do it at the hospital, though. It's discrimination."
Kevin smiled at Lucky's answer, crossed his legs as he sat back in his chair and observed Lucky's body posture - his blank look, defeated slumped shoulders and head held down.
"We both know that cigarette smoking is bad for your physical health, so I won't belabor that point," commented Kevin. "As soon as you leave the hospital, you start smoking heavily. Why?"
Lucky shrugged. "I like to do it. It makes me feel good," he said vacantly.
"Can you be more specific as to what feeling good means to you?" questioned Kevin.
"Like I'm calmer for one," stated Lucky. "And I guess I feel more in control of things if I smoke."
"Do you see any connection between your cigarette smoking and other drug and alcohol use?" probed Kevin.
"Not really," replied Lucky. "What's one got to do with the other?"
Kevin leaned forward with his elbows on his desk, and he clasped his hands together. "Cigarettes contain a very powerful drug, for one. Nicotine is one of the most addictive substances a person can consume. Did you know that?"
Lucky shook his head, but remained silent.
Kevin continued. "Cigarettes may not be illegal for adults to consume, but they constitute drug use nevertheless. Alcohol is in the same category. Now you know that you are an alcoholic, so you've avoided drinking, even this last time you left the hospital."
Lucky nodded. His face took on a determined look. "I don't want to drink. I can't control it. I don't like being out of control." Lucky started furiously picking at the cuticle around this thumbnail.
Kevin tried to look Lucky in the eyes, but the boy wouldn't hold his gaze. "Lucky, I believe that cigarettes can act as a trigger to your other substance abuse. Once you start smoking, you easily graduate to drugs with stronger effects. And then, over time, you consume more and more of them to achieve the same feeling. Am I right?"
Lucky turned his head away and concentrated on following the swirled pattern in the commercial carpet. It soothed him to follow the endless lines curving and intersecting around and around. He blinked and jumped slightly in his chair. "Oh. Um, I guess so. I usually binge on whatever makes me feel better. Even candy. I always got sick on my Halloween candy when I was a kid." He laughed brittlely and started picking at one of his nails, tearing at it and then using his teeth to complete the job.
"I'm going to have you see a specialist, a substance abuse counselor that I know and respect," stated Kevin. "He can clarify some of the issues that you have with drugs and help you to learn better coping methods. Also, you need to attend a group therapy meeting once a week with other substance abusers."
"Why?" Lucky shot out. "I don't like talking about my problems in front of other people."
"Group therapy will help you to see that you're not the only one with your type of problem," Kevin patiently explained. "You can learn from one another's experiences. And, sometimes in the process of helping another person, you learn to how to help yourself."
Or you learn where to score some more drugs, thought Lucky.
~*~*~*~
His shoulders shook with his heavy breathing, and he was hunched over the toilet bowl, his fingers white from the exertion of holding himself up. Waves of nausea permeated his entire body from head to toe, as he vomited endlessly until there was nothing left. He felt weak all over, and he slid down to the cold floor, curled up on his side, and closed his eyes. Breakfast had been a disaster - he hadn't even made it to the bathroom. And now lunch was history. At least the psych tech had been there in time to help him roll his IV behind him. Lucky opened his eyes again, but the room was spinning in his vision, and he coughed and moaned dejectedly. His right hand gripped his stomach firmly, willing it to settle down and be quiet.
The psych tech poked his head around the corner. Lucky was still on suicide alert and couldn't even shut the door to the bathroom these days. John took in the sight of Lucky's misery. "Are you okay? Do you need some help?"
Lucky didn't answer, but he waved his right hand in the tech's direction and let it flop back down on his leg.
John grabbed Lucky's wheelchair and moved it over to the doorway. "Here we go," he said matter-of-factly, as he lifted Lucky from the floor and dragged him over to the wheelchair. He didn't like how unresponsive Lucky had become. John pulled the boy upright in the chair and tried to wheel both the chair and the IV stand to the bed. Finally, he positioned the IV and lifted Lucky up, then rolled him onto the bed. Lucky started crying quietly, and John asked gently, "Do you want me to get the doctor?" Lucky continued weeping, but nodded his head slightly.
Lucky was still crying when Jim Perkins came to his room about fifteen minutes later. "What's wrong, Lucky?" he asked as he patted the boy on the back. "John said you wanted to see me?"
Lucky blinked and wiped his eyes with his hand. "I'm so tired," he whispered. "And I feel so sick. I can't eat."
Jim looked concerned. "I'm adding an anti-emetic to your meds," he stated. "It will prevent you from vomiting so you can eat some food. We'll give you the medicine, then you can try to eat some bland food in a couple of hours. How's that sound?" Lucky rubbed his face again and looked distressed. "Why can't I eat? It makes me sick to think about it."
Jim pulled up a chair next to Lucky's bed. "Lucky, there's nothing wrong with you physically," he stated. "The drugs have had time to leave your system, so it's not that. And, you don't have any signs of infection or a flare-up of an ulcer. My guess is that you've got something that you're worried about, some kind of emotional upset that's affecting your nerves and your stomach. Does that make sense to you?"
Lucky nodded morosely. "Yeah," he whispered.
~*~*~*~
"Kevin. Hi, it's Jim." Dr. Perkins rested the phone between his shoulder and his ear as he flipped through some pages in Lucky's thick folder. "I just finished talking with Lucky Spencer. He's very distraught. He hasn't been able to keep down food since he was brought in here several days ago. Physically, he's fine - no more withdrawal symptoms, no ulcer or infection. In my opinion, he's under a lot of emotional stress. He was crying and on edge when I saw him a few minutes ago. He'd asked the psych tech if I could come to see him." Jim paused, laid down the folder and ran a hand through his hair. "Kevin, he needs some relief from whatever is bothering him. He wasn't eating in the time period before he left the hospital, probably not much on his own, and now this. He's going to become physically ill soon if this cycle isn't stopped. His body won't hold out for much longer. The IV helps, especially with hydration, but he needs to eat."
"I've decided to place Lucky on a benzodiazepine schedule while we proceed with his therapy," replied Kevin. "I believe that his dreams and flashbacks, lack of appetite and vomiting are symptoms of his struggle with issues that he has concerning his mother. We had started discussing the topic when he bolted from the hospital two weeks ago. At that time, he was having the same problems with nightmares and eating. A low, constant level of tranquilzer may calm his emotions enough for him to continue his therapy. Eventually, as he works through these issues, we can taper off the medication."
"That might be good for him at this time," agreed Jim. "Anything to relieve some of his anxiety. I prescribed an anti-emetic for him so that he can at least keep the food down that he manages to eat."
"Keep me informed if he continues to have problems with eating and vomiting," said Kevin. "I don't want him to become physically debilitated. If he continues this way for say, another week, we'll have to consider a feeding tube so he receives adequate nutrition."
"I sure hope not," stated Jim. "He's having a hard enough time as it is."
~*~*~*~
"Here's your medications," said the nurse as she handed Lucky a cup full of pills along with a cup of water. Lucky looked down into the pill cup. "That's more than I usually take," he said.
The nurse replied, "You have a new order for a pill to stop your vomiting and a sedative."
Lucky's face fell as he counted the pills. "Five in a row," he said quietly to himself. He shoved the pills into his mouth and swallowed them with the water.
"Let me see," the nurse instructed patiently.
Lucky stuck out his tongue, and replied, "What do you think I am - a hamster? Where am I going to hide five pills?" He patted both of his cheeks with his hands for emphasis. The nurse laughed and shook her head. "There's always a comedian," she chuckled.
~*~*~*~
Lucky was asleep when the psych tech brought his dinner into the room. He laid it on a table and pushed it towards Lucky's bed. He shook Lucky's shoulder. "Time to eat," he instructed. Lucky sat up quickly, but his face looked sick when he saw the food. "No," he said, turning his face back into his pillow.
The psych tech sighed. This wasn't going to be easy, he realized. He was under orders to try to get the kid to eat, no matter what. "Just try one spoonful of each item. Then, you can decide what you like," he said helpfully as he directed a spoon toward Lucky. Lucky shook his head and turned away. "What? What's wrong with this?" asked the tech. "I just had the exact same plate for my dinner. It wasn't bad. In fact, I liked it. Here, try some," he said again.
Lucky ignored him.
"Lucky," said the tech. "I'm not leaving here until you at least try a few bites. Either you can have them when they're good and warm or when they're cold and yucky. It's your choice."
Lucky turned toward the plate with an angry face, reaching for the spoon. He scooped up a spoonful of green beans and ate them distastefully like he had a bunch of worms in his mouth or a piece of rotten meat. His eyes filled with tears as he took a scoop of au gratin potatoes, and the tears rolled down his face when he took a small piece of sirloin burger. He ignored the apple cobbler dessert and inserted his face back into the pillow, crying silently. The tech shook his head, at a loss as to how to talk the kid into eating more.
~*~*~*~
Lucky scooted toward the edge of his bed and let his legs hang down the side. He watched his bruised feet as they dangled and kicked back and forth nervously. The effects of the sedation were working. His heart wasn't racing anymore, and his hands weren't shaking. But it did nothing to quiet the storm in his mind. He couldn't stop thinking about how bad things were, how he was right back where he had started. On some level, he knew he was better. He didn't fail to recognize people or scream bloody murder if he had to wash his hair. He knew he wasn't in Faison's compound and that he had survived that ordeal. But something was still there, gnawing at him constantly like a slow, insidious form of cancer that crept up on him and took him when he wasn't aware. The relentless pain curled around the edges of his mind and violated the depths of his heart.
Lucky stood up and swayed dizzily. He wasn't used to the effects of his new meds, and they made him feel funny. He gripped his IV pole for support, and after feeling sure that he could walk, headed for the bathroom. He wasn't supposed to go in there without calling someone for assistance, he knew that. But, he didn't care. The door to his room was open, and Rick, a psych tech, was stationed out there in the hall. However, he only checked inside the room every ten minutes or so. Lucky haltingly made his way to the door of the bathroom, pulling his IV pole with him and trying not to make any noise.
Once inside the bathroom, he futilely looked around the bare room. There was no bathtub in this room, only a shower, no breakables. And, they took away his utensils after every meal even if it was only a spoon or two. They were real careful about that. If he tried to break the mirror, it'd make a loud noise, and they'd descend upon him in a split second. Lucky looked down at the sink in front of him and at the stopper at the bottom of the white, porcelain bowl. He ran a stream of water and stopped up the sink, watching carefully as the stream at first only moistened the edges of the bowl, then plinked and splashed its way to several inches of water.
Rick didn't come right away. When the bowl was about half full, he entered the room and frowned when he saw Lucky. "What are you doing up?" he asked.
Lucky looked up at him with glassy, vacant eyes. "Washing up for bed," he stated emotionlessly.
"Ask next time you want to get up," said Rick. "We're supposed to help you get around."
Lucky smiled slightly. "I'll remember," he promised and then turned back to watch the water. Rick left the room, and Lucky continued to let the water flow. When the bowl was about two-thirds full, he turned off the water. He sunk his right hand into the pooled water and tested its warmth, idly twirling his fingers in the wet depths. It was lukewarm - just right. He wasn't sure how this would work. He'd tried holding his breath earlier in the day, even stuffing toilet paper up his nose, so he didn't have to manually cut off that one source of air. But he couldn't make himself not involuntarily gasp or frantically draw the air into his lungs. Even so, he supposed he'd pass out first and then wake up later.
Lucky plunged his face into the water, almost submerging his entire head. His eyes closed so he didn't have to stare at all that white. He slowly let the air out of his lungs as he idly counted. One…two…three…four…five. The gentle bubbles quietly burst onto the surface of the water and danced merrily around his head. On the count of ten, his lungs were empty, and he rapidly pulled in for more air, only this time it was water instead. The adrenaline raced in his veins as his body reacted in shock to the presence of the water as it invaded his nose and sinuses and continued on down to his lungs. He involuntarily expelled the water with a muffled gagging reflex, but he gripped the sink tightly and forced himself to keep his head under water.
He quickly pulled in a second round of water, and started feeling distant from the room and himself, like a gray cloud entered the room and covered the sun, hiding its warmth and clarity. Another minute or two went by. When he feebly pulled in for more water, he felt himself go, his knees buckling and his iron grip on the porcelain sink growing soft and loose. He heard the muffled metallic sound of an IV pole crashing. But before he hit the cold tile floor, he felt a pair of large hands - one around his chest and the other grabbing him by the back of his hair. His eyes were still closed when he vaguely felt the cold air rushing over his soaked face and hair, and the cold rivulets of water coursing over his neck and down his back and chest. Then, he didn't feel anything as the darkness consumed him.
When Rick poked his head in the doorway to check on Lucky, he immediately grabbed him and pulled his head out of the water. Water streamed down Lucky and gushed out of his mouth and nose. Lucky's full weight sank downward and caught Rick off balance. He inadvertently lunged to the side, still holding onto Lucky. Lucky wasn't breathing, and his lips took on a bluish hue. Rick quickly dragged him into the main room and positioned him on his back. Rick yelled loudly that there was a code here as he straddled Lucky's prone body.
Another psych tech and a nurse ran into the room and stared in shock at Rick giving a soaked Lucky mouth to mouth resuscitation. The nurse immediately assessed the situation and went to call the boy's psychiatrist. The other tech wheeled in a gurney to transport Lucky to the ER. After about 30 seconds of trying to resuscitate Lucky, the boy's body started jerking and trying to cough. More water began flowing out of his nose and mouth. Rick rolled Lucky over onto his side as the boy coughed and vomited up more water. Rick sighed with relief when he heard Lucky's strangled gasps for air. He grabbed a blanket from Lucky's bed and covered him with it, checking constantly to make sure he was breathing while the two techs lifted him and placed him on the gurney.
~*~*~*~
The nurse had already phoned the emergency down to the ER, and Chris Ramsey was waiting when Lucky was brought in. "He tried to drown himself in a sink full of water," explained Rick. "When I got to him, he was falling unconscious, and he'd stopped breathing, his lips were turning blue. I gave him mouth to mouth resuscitation, and he coughed and vomited up a lot of water. He's still having difficulty breathing. He's always had a pulse, though."
Chris flinched when he saw Lucky's wrist and heard Rick give him Lucky's name. He remembered being the ER physician on call the night that Lucky had slashed his wrist, and here he was back again with another suicide attempt. "Lucky," said Chris loudly.
Lucky didn't respond at all verbally, only flinching slightly and fluttering his eyelids when Chris applied painful pressure to one of his nailbeds. "GCS=E2M3V1=6," stated Chris. "Let's intubate and ventilate him. His airway looks clear, but he's apneic and hypotensive. Bring a portable chest x-ray in here, and I need an ABG, electrolytes, BUN, creatinine, CBC and glucose. Insert a Foley catheter and begin monitoring urinary output. Chris looked back to Rick. "Do you know how long he was in water?"
Rick shrugged. "Not exactly, but I'd guess maybe two or three minutes." Chris looked to the other nurse. "Start a central line IV - we need to start him on dopamine hydrochloride."
~*~*~*~
Two hours later...
Chris Ramsey stood outside of Lucky's ICU room, informing Kevin Collins of Lucky's condition. "He was fortunate that he was found soon. He suffered acute respiratory distress, but was quickly resuscitated. We'll keep him here for 24 hours to monitor him. He's off the ventilator now, but he'll require oxygen while he's here. He's hyperglycemic, and we have him on insulin, which should normalize his glucose levels. He managed to do a lot of damage to himself with only a small amount of water." Chris shook his head.
"Thanks, Chris," stated Kevin as he shook his hand. "I'll look in on him, then make some phone calls. I don't look forward to it." Kevin's face looked tense and concerned when he entered Lucky's room. Lucky's eyes were closed, and he wore an NG tube, oxygen mask as well as an assortment of IV's and monitors. His face was drawn and haggard, and the room filled with noises of his labored, raspy breathing.
Kevin pulled up a chair and sat down beside Lucky. Lucky's eyes fluttered open at the movement beside him. "Hey there," said Kevin gently. He picked up Lucky's hand and looked him in the eyes. "Your physician said that you should be alright. They're going to keep you here in the ICU for 24 hours to make sure you're fine." He lay Lucky's hand back down on the bed. "You went into respiratory arrest, so they had to help you breathe for awhile and gave you some medicine that you're still receiving." Kevin pointed to the IV's. "I'm going to let you rest for now," Kevin stated. "But if you need to talk to me, ask a nurse to page me, and I'll come see you. Okay? Otherwise, I'll stop by tomorrow morning." Lucky closed his eyes again. Kevin rose from his chair and walked over to the doorway, pausing to look back at his patient for a minute before leaving.
~*~*~*~
Bobbie was washing the dishes, and Tony was drying when the phone rang. Bobbie picked up the phone, and as she listened, her face fell and tears welled up in her eyes. "Oh, no!" she said in a distressed voice. "How could that happen?" Tony's face tensed as he sensed some bad news coming. "So he's going to be alright? You're sure? We'll be down there in a few minutes. Thanks for calling, Kevin."
Bobbie hung up the phone and looked over at Tony. "Lucky tried to kill himself again," she said softly. "Apparently, he filled a sink full of water and nearly drowned himself to death. He's in the ICU now. They expect he'll make a full recovery, but he has to stay there for 24 hours."
"I'll get the kids ready, and we can drop them off at Felicia's," stated Bobbie. "We'd better get down there quickly."
"How could this happen on a locked unit?" asked Tony incredulously. "And he was on suicide watch."
Bobbie shook her head and gave Tony a puzzled look. "I don't know," she said softly.
~*~*~*~
Tony and Bobbie met Kevin in the ICU waiting area. "What in the world is going on?" asked Tony tensely. "I thought we had this covered. That's why he was in a locked unit!"
Kevin's face was tight and tired looking. "He's an ingenious kid," he explained, sighing. "He told the psych tech that he was washing up for bed. Two minutes later, he's unconscious and nearly drowned. Normally, looking in on a patient once every few minutes is enough to protect them and give them some privacy. With Lucky, however, it's going to require continuous monitoring apparently. I'm very concerned that he was this determined to harm himself."
"Kevin, what's going on with him?" asked Bobbie. "I've noticed that his reactions are off, but what does that mean? Why is this happening?"
Kevin drummed his fingers on the wood part of his chair. "He's depressed," he stated simply. "His meds aren't up to a therapeutic level yet, but even before he left the hospital and while he was still on his meds, the depression was returning.
Tony shook his head and ran his fingers through his mussed hair. "What now?" he asked wearily.
"My recommendation is that we begin a maintenance course of ECT," stated Kevin. "It was very helpful in removing his previous depression, and sometimes patients require several follow-ups. Once the depression is under control, we can resume his therapy and work on his issues concerning his mother. It's my opinion that Lucky is going to continue a cycle of depression if that issue is not properly addressed. But he won't be able to handle therapy if he's severely depressed."
Tony nodded grimly. "Kevin, you know I'm no fan of ECT, but it did save Lucky when he was catatonic, and dammit, I don't want that kid to die!" Tony paused with one hand on his hip and took in a deep breath to regain his composure. "I agree with you. ECT might save his life again as much as I hate to say it. We've come too close to seeing him recover. There's no way I'm going to let him die like this. Set him up on a schedule, and I'll sign the papers as his legal guardian." Tony held out his hand to Bobbie, and the they walked toward Lucky's room.
~*~*~*~
Tony and Bobbie peeked in Lucky's room and found him asleep. "We probably shouldn't wake him up," said Bobbie. "Why don't we visit him one at a time for a few minutes, just to see that he's okay and be with him. You get yourself some coffee, and I'll go first. You look dead on your feet." Bobbie reached out her hand and stroked Tony on the cheek.
Bobbie entered the room and quietly sat by Lucky, watching him sleep and struggle to breathe. "Luke would die if you did, Lucky. Do you know that?" she whispered. "You're what's keeping him going. Only you. Sure he loves all of us, and we love him, but you're Lucas Lorenzo Spencer, Junior, his only son, the light of his life." Bobbie looked around the room at the monitors and equipment. Her thoughts shifted, and she made a disgusted face. I hate Laura more than I hate that Faison character. He was a madman, but what's her excuse? She is his mother. A lot of good that does her children.
Lucky coughed and shivered repeatedly, making a few noises and moving his arms slightly. Bobbie instinctively adjusted his protective warming blanket over his body, pulling it further up his chest. She gently pushed his right arm under the blanket, the one without an IV. She watched as an ICU nurse stepped into the room and quietly took Lucky's vitals, being careful not to disturb him.
The nurse turned to Bobbie on her way out. "Let me know when you leave," she whispered. "We'll send someone in to sit with him."
.