The sullen young blonde sat in front of me as I read her chart. She was a beautiful young teen with pale sky blue eyes and golden blonde hair. Her complexion was a little pale but it suited her. She reminded me of Snow White only the Snow White that sat in front of me was still strung out on the witch’s spiked apple.
“Cool shoes! Are you gonna be my doctor?”
“I’m Dr. Manaois and I am working with Dr. Gerald. How did you end up here, Suzy?” I was in my second year of residency training the first time I met Suzy. I was training to be Psychiatrist. I was doing my rotation in Child psychiatry. I loved working with children. It’s the parents that drained me, enraged me to no end.
Suzy nonchalantly told me her story. The whole thing was no big deal she explained. She and her friend were just “playing” and that she just cut herself “as a joke”.
“Well, I guess we did party a little bit” she laughed when I confronted her about her drug screen.
Suzy was the older of two siblings. Her sister was twelve. They lived with their mother and her current boyfriend of the moment. He was twenty two. Her mother was thirty. They had been together for about two months. Her mother didn’t work but was almost never home. Her father she was told was in jail.
Suzy was still in high school with mediocre grades. She wanted to go to beauty school. “I just love fixing my hair and make-up! I’m a girly girl”
Message 2: “Jeannie, tell Suzy to call me. I know she’s there. Tell her I love her and she needs to come home”
Jeannie, the social worker burst into staffing, “Dr. Manaois, guess who called me twice this morning?” She announced in a sing songy voice. “Joe Dealer. He’s wanting to talk to Suzy but she won’t sign consent for us to talk to him”
Joe Dealer was Suzy’s boyfriend/fiancée/husband. She would interchange the terms depending on how the relationship was going. He was the father of her three kids and provided her with drugs.
They met when she was 15. Joe was 28 back then. He was a friend of her mother’s boyfriend at the time. Suzy was abused and neglected all her life. Joe gave her the only kind of nurturing she knew. Sex and drugs.
“How is Suzy doing on the unit” I asked.
“She slept all day yesterday. She says she not suicidal, not homicidal and not psychotic and wants to go home AMA today. She says she’s done detoxing and she can keep herself safe when she leaves here” the nurse reported.
“She went to my group this morning” the therapist chirped in. “Quiet and sat next to that guy whose wife left him”
“She just came in yesterday. Whatever. She knows the drill”
Leaving against medical advice usually meant no prescriptions and we would not make any follow up appointments. Jeannie always referred Suzy back to Dr. Cecil. She had dropped out of their clinic several times and they always took her back.
“Are you sure this is what you want to do? You know we still want you to stay”. Suzy was quiet but her hair was combed and she was a little more put together.
“Yes. I wanna go home today. I know you always try to help me, you and Dr. Cecil and I wanna thank you both but I have to do this on my own” Suzy went home that day with the guy whose wife left him.
7 Years Later
“This is Dr. Manaois”
“Dr. Manaois, Suzy Crackhead”
“I want her medically cleared and then I’ll take her. Routine labs, detox protocol including taper”
“You got it”
“22 y/o Caucasian female with a history of Schizophrenia, Bipolar Disorder and Polysubstance abuse admitted after a suicide attempt by overdosing on Xanax and Lortab. Patient has a history of multiple overdose attempts and a history of self mutilating behavior as a teen. Numerous psych admissions. Last admission was in this facility 3 months ago”
My staff knows I will always take Suzy. She’s been here several times. We know each other pretty well. I know the names of all her three kids and she knows my second ex-husband. He is her out patient psychiatrist.
Schizophrenia? Definitely not. Bipolar? Maybe. Probably. Drugs? It always is. She wasn’t her perky self this time. She was disheveled. Her once golden locks now look like something that would clog one’s sink. Her pale sky blue eyes were stormy. Sunken from all the years of abuse.
“I left him, Dr. Manaois. I left him. I had to and I can’t go back. They took my kids. I have nothing. I can’t go to my mother. She’s just as bad as I am. My sister is in college and wants nothing to do with me. She’s clean. I have nothing, Dr. Manaois, nothing. I really want help, for real this time. I can’t go back to Joe. Not this time. Not ever”
She says this all the time but every time she leaves here, he is the one who picks her up.
Everyone does stupid stuff when they’re young but young, dumb and stupid is allowable up until 23 years old. Suzy’s birthday is in a few weeks.