Under Her Care(15)
“Got it.”
“Everything shifts right when he hits ten. In early reports, everyone says things like He engaged in self-stimulating behavior for twenty minutes to decrease anxiety, or Client twists hair when agitated to self-soothe. All those behaviors are just ways he’s managing his anxiety and trying to juggle his internal state. They’re all super common, too, especially in kids that age. Nobody’s threatened by those behaviors, but all that changes as he gets older. An agitated teenager, especially one who looks like a grown man, doesn’t look as harmless and innocent as an agitated little boy. You see the change happen in how they describe his similar behavior.” I pull up another part of the report and scroll to the highlighted section. “Like right here when he’s thirteen: Patient became agitated and aggressive when unable to complete tasks. My guess is he probably engaged in the same self-stimulating behavior that he did when he was ten, but they interpret it differently.” I keep going through the section. “And here’s another one—Mason pulled his hair out when frustrated. In both cases, he was twisting his hair, but you form a very different opinion of him based on the words the examiner uses to describe him.” I pause for a second. “Is this too much?”
“No, no, this is great. It’s exactly why we brought you on. These are the things we need to help us. Fascinating stuff.” His face is so hard to read sometimes. This is one of them.
My words speed up now that I’ve gotten to the major point. “Was Mason simply getting older, so his behaviors were interpreted differently and described more aggressively, or was he indeed getting more violent and aggressive? And if so, was it enough to hurt someone else?”
“So if I’m hearing you right in all of this, it sounds like he could’ve been?”
“It’s definitely possible that he could engage in violence, but it’s also equally possible that he’s not violent at all.” I shrug my shoulders with my hands up. “I’m sorry. I wish I had a more clear-cut answer for you.”
“But he definitely attacked those cops. He chucked rocks at the paramedics and bit his mom, which seems pretty aggressive and violent to me.” His lips are set in a straight line.
“That’s the first time he’s ever done anything like that. Believe me, if there’d been other instances like that, they would’ve been noted by his teachers or witnessed in at least one of the numerous testing sessions he’s had. Nobody describes him like that.” He takes in the information slowly like he does everything else, as if he’s always trying to decide whether to accept or reject an idea. “All that stuff down by the creek with everyone else? That was just a classic fight-or-flight response, and he was in fight mode. He had no idea who the enemy was, so he came at anyone that got close to him.”
It satisfies him for the moment. “What else do you have for me?” he asks.
I reach into my bag and pull out the copies of the psychiatric case notes, the single ones that don’t appear connected to a full report. I hand him his copies. “There’s other important stuff that might be helpful too.” I point to the papers I just gave him. “These aren’t connected to any of the other big reports in the file. I haven’t been able to find any place where they belong.”
I give him a few seconds to scan the content. His forehead wrinkles in thought while he reads. He looks up at me when he’s finished, immediately intrigued.
“I don’t know if you can tell, but these are progress notes from a psychiatric facility. One of them is from Children’s.” I point it out just in case he missed the letterhead. Children’s of Alabama is one of the few hospitals that provide inpatient psychiatric care to kids in Alabama. “He was admitted more than once, and one of the times it looks like he had ECT therapy.”
“Is that where they shock people? Like that guy in that movie? Dang, what’s that movie?”
“One Flew over the Cuckoo’s Nest?”
He snaps his fingers. “That’s it.”
“That’s the movie that always comes to mind when people think about shock treatment.” I roll my eyes, but I can’t help smiling at how proud he looks of himself. “Thankfully, the field has gotten a bit less barbaric since then, but yes, shock therapy induces a seizure. Even though it’s much more tamed down and not nearly as controversial as it used to be, it’s still an extremely invasive therapy that’s only used as a last resort in severe cases of depression.”
“So the kid’s been shocked . . .” He takes a minute to let that sink in. I’ve noticed he rarely uses Mason’s name. Must be a way for him to stay detached. “I just go back to being a family man myself over and over again in all this. And I can’t imagine the state one of my kids would have to be in for me to let them shock their brain and send them into a seizure.” He struggles to digest it like he’s eaten bad food. “Why would someone let people do that to their child? Even if it was a doctor?”
“You might consider it if your child was in a bad enough shape,” I offer. I haven’t stopped thinking about it, either, or reading up on the cases where it’s been used. “Mostly, it’s given when a child is catatonic and the period of catatonia has gone on to the point where they worry it might become permanent. Catatonia is like that. If your body shuts down for long enough, sometimes it doesn’t restart. They view it like an old car with a dead battery getting a jump start.”