[3]

Kim was sitting cross-legged in her bed when I arrived. She looked at me like she hardly recognized me, barely lifting her gaze when I entered through the single-wide doorway.

I rushed to her and took her between my arms at the shoulders, trying to squeeze to tightly, not to do anything drastic that might send her back over the edge.
“How are you?” I tried.

She shrugged, classic Kim, but her lips didn’t move. Her eyes pulled away from me slowly, as if absent mindedly, and she focused straight ahead at the bare eggshell wall. Only it wasn’t focused. She wasn’t gazing at the wall at all, but through the wall, as if she could watch the cars pull out of the tree-spotted parking lot into the street.

When I looked over my shoulder, I noticed Dr. Le had disappeared into the hallway. I pulled up a chair - another hard plastic one - resting in the corner up to Kim’s bedside and lifted an elbow onto the edge her bed. I tried to meet her gaze over the next two hours, but it was fruitless. She wouldn’t utter a word. From her low-rising, twin-sized bed she only stared while I asked questions, told stories.
At the end of our visit, I bent down to brush her dark brown hair behind her ear and kiss her forehead, her clammy skin sending a chill down my spine.

I noticed Dr. Le standing at the nurse’s desk outside Kim’s room in the patient lounge area when I left Kim’s room. The tiny patient rooms surrounded the sprawling lounge area on three sides with the circular nursing station plastered at the far end of the room. In the center of the common area, a set of four wood-backed sofas circled a TV, and a double sided bookshelf some twenty feet away held only doctor-approved reading material.

I tapped Dr. Le on the shoulder and thanked him for his time. Did I not enjoy the visit, he wanted to know, I looked slightly upset. I was always welcome and Kim would enjoy my visits even if she didn’t seem to, he assured me.

I nodded and walked briskly towards the end of the common room without a word, my eyes down the whole way, avoiding the glossy-eyed stares, mindless whispers, and laughs from worlds completely unknown outside the patient’s own minds.

When I reached the half door at the end of the room, a foot shot out in front of me, blocking my path. I raised my eyes to meet the intent gaze of a young man about my age with died yellow-orange hair and a wrinkled blue Nirvana t-shirt. I gawked a little, raising an arm up to say, what the hell, let me through.

He shifted his weight between his two socked feet, his eyes refusing to leave mine. “Kim’s going to be fine, you know.” His hands dug deeper into his pockets.

Oh great, she’s already got some ex-crack addict as a crazy stalker, I thought. “Yeah. I know,” I said, although I didn’t. “If you’ll excuse me.” I made a motion to the door, but the rocker punk stopped me.

“I’m Ben.” He extended a scrawny tattooed arm in my direction, completely ignoring my desire to leave.

“Great, thanks.” Did I even need to introduce myself to this crazy? “Madeline.” I cautiously took his hand in mine, making a mental note of the hand sanitizer dispenser at the nurses station.

Ben’s eyelids lowered a bit, tenderly, and I couldn’t help but smile when he attempted some kind of clumsy bow. “Thanks for the update, Ben,” I emphasized his name so I wouldn’t forget it. “I’ll be seeing you.”

The temperature outside was still chilly, and I pulled my button-up sweater tighter across my chest to block the steady spring wind. Did I really park this far out, I whispered, trudging through the visitor’s spaces at the back entrance of the hospital. I saw my dirty black Toyota on the far end of the lot and made a beeline over grassy medians. The sky was beginning to darken already, and the visitor’s lot had emptied quite a bit from earlier that afternoon as broken families headed home for Saturday night dinners while their loved ones sat isolated on the third floor, eating sticky, smelly hospital food.

Dr. Le told me I couldn’t bring outside food for Kim when I asked him earlier. We have to be very careful about what we allow in, he reminded me. Some patients were recovering drug abusers; you never knew what people would hide chemicals in. I could, however, bring something calming to Kim, an old stuffed animal or her favorite book, he said, dependent on it being approved by the staff first. No, this wasn’t a prison, he assured me, but patients were not always in the right state of mind. It’s safety, he said.

I unlocked my car as I approached, two clicks and a ring of lights responding to the remote. I pulled the driver’s side door open and launched my purse across to the passenger’s seat. As I let my weight fall into the driver’s seat, I began thinking back upon that strange guy that met me on my way out. I had been quick to dismiss him at first glance, but maybe he had talked to Kim. Maybe she had told him something she hadn’t told me. I clicked the seat belt across my chest, angrily. How could she dare open up to a complete stranger, some psychotic nutball, and she wouldn’t say word to me, wouldn’t even look me in the eye.

I swerved out of the Tucker’s lot onto the pavement that would wrap me back around to the hospital’s main entrance. Just as I was pulling up to the stop sign near the emergency room entrance, I noticed a small slip of paper stuck to my windshield between the wiper and the glass. “A ticket?” I growled. Really? Hoping it was only some cheap advertisement for lawn services or low-end legal advise, I pulled off to the side of the road and hopped out to the grab the slip of paper.

“Dr. Montague, Adult and Child Psychology,” the text at the top of the slip read. At the bottom, some pseudo-religious quote about wings and hope invited me “let my true self fly,” and the middle held only a phone number with a local area code. I chuckled and shoved the crumpled piece of paper into the console cup holder. What kinds of people actually believe this bogus? What kind of business does not give you an address when they’re trying to sell you their services? At least their marketing strategy was good, tackling the parking lot of the psychiatric ward.

It was 6:18pm when I pulled up to Kim’s apartment building in Church Hill. She lived in a 1920’s revival, a three story mansion that had been converted into three separate apartments during the eighties then updated just a few years ago to add such luxuries like stainless steel appliances and recessed lighting. That was one thing Kim and I both enjoyed. Maybe it was our obsession with HGTV or the fact that we grew up in the old South, but when it came to living spaces, history was key. I remembered when Kim moved into this apartment two years ago, how we lied with our backs on the wide wood floor, planks rescued from the original construction and refinished to shine like new, how we stared up at the ceiling, making up stories about the people who lived here originally.

The key turned easily in her apartment door. I was glad she made this emergency copy even though I told her I’d never need it. When I pushed the door back, I hit the light switch closest to the door and the overhead light fixture in her living room illuminated a tan leather sofa, a green and tan color block rug, a suede loveseat and two Wasili chairs around a non-functional fireplace topped with a flat screen.

Quietly, I wandered the living room, running my hands over the sofa, the chairs, spinning my feet on the rug, a strange dance to music only I could hear. The mantel above the fireplace held thirteen photos: six of me and Kim, chronicling our years from diapers to engagements and the awkward spaces in between, four of my parents, three of Kim with various friends from elementary school to her current job as a high school teacher. I blew the dust off one of Kim and me at the Biltmore sometime when I was in middle school. In the preserved color shot, we were holding each other in a full arm embrace, our smiles sincere and our childish giggles completely oblivious to the giant mansion in the background.

My feet lead me to the other side of the living room, past the kitchen in the back. I hit the kitchen light as I passed and let only the overflowing light guide me down the dark hallway while my fingertips ran over the smooth cream-colored sheet rock walls. I regretted then, not spending enough time here with Kim in the last few months. She had called me for dinner countless times, only a few in which I partook and each of those had been only routine. At the end, I would always rush out to meet my friends for drinks or catch the end of a TV show I just had to watch. At the time, I reassured myself that Kim had her own life, that she’d be okay without me, but each time I wound up with a pit of deserved guilt eating my stomach.

When I entered Kim’s bedroom, the familiar scent of her perfume tickled the underside of my nose. The light above her bed shone on her neatly tucked sheets and immaculately stacked pillows. I remembered then that my mom had been here a few days ago when Kim was still at the hospital. Like my typical mother, she had come with an arm-full of cleaning supplies to dust, scrub, and disinfect the entire house, and specifically the bathroom. With a heavy stomach, I imagined the blood that must have filled the shallow tub water, the rink of dark red crusting the hard plastic after the water dried. Kim had left the mess like a confirmation of her struggle, her cry for help encoded in the blood stained towels. Then my mother had come to clean up as usual, as if scrubbing away the evidence might scrub away the memory as well.

I sat down on the wooden trunk at the edge of Kim’s bed, an heirloom from the grandmother that passed away just last year. The cedar-lined oak trunk had always been a favorite of Kim’s as a child, and I could recall more than one game of hide-and-seek at my grandparents house that ended in Kim’s laughter erupting from amongst the spare sheets and blankets inside the four foot long box.

I ran my hands along the underside of the top, my fingers searching for the latch. I knew there was a trick to this old thing. When my thumb finally found the brass fixture near the middle, I pushed in hard and stood up so I could pull the heavy top open. A few blankets were folded neatly and stacked next to two spare pillows and sheet sets. Kim loved Pottery Barn. I was surprised the trunk wasn’t bursting with sheets in every color and pattern. I pushed the lid back down with a thud, pulling up just once to check the latch.

I looked around Kim’s room, not knowing what exactly I was looking for. When I turned onto E Grace St earlier that evening, I told myself that I was just going to stop by, to pick something up that I could bring my sister in the hospital. But somewhere darker, somewhere truer, I was just looking for some evidence. A blood stain, a note. A reason, an explanation. Anything to connect the our safe, quiet past with this startling, thunderous present.

From inside my pocket, my phone began ringing. My mother. “Maddie? Dad and I are just getting to the restaurant. Are you still meeting us?” Shit. I glanced at the clock hanging above Kim’s desk. It was already seven o’clock.

Sure, yes, get me an iced tea. I’ll be there soon. What? The back of the restaurant. Sure sure, I knew how to get there. I began rambling off something to buy me time, but I had already lost track of the words escaping my mouth. Something glossy and thin was peeking out from the modern, silver-framed clock in Kim’s room.

I shoved my phone back into my jacket pocket and hurried to the clock. I wasn’t sure what I expected to find, but I knew whatever it may be, Kim was trying to hide it. When I reached up to grab the clock, I ended up pulling the whole thing off its nail on the wall. It clattered to the ground to with a bang, a piece of aged paper and two photographs fluttering behind it like ash.

I didn’t move right away. Suddenly, I wasn’t sure if I wanted to see the pictures. I had stumbled into this place of privacy and now I was barging through, my own needs the bull in the china shop. But my curiosity won. I knelt to the floor and lifted the first photograph, careful to keep my fingerprints from smudging the surface. The picture was old. It was yellowed around the corner and square in shape. The three sepia toned figures posed in the center were dressed more conservatively that seen nowadays and the counter in front of which they stood – was it grocery? butcher? – held an expansive vintage register with large steel keys.

I studied their faces for a moment. Did they look vaguely familiar to me? I caught a glimpse of the clock. 7:12. My parents would be anxious by now. I grabbed the second photo and mystery paper, and hurried out the door, careful to replace the clock and turn out the lights as I left.

[2]

Kim and I are playing in the cul-de-sac at the end of our street. Between us, we have a bucket of chalk and four Barbies. We use the chalk to draw a neighborhood for the dolls on the pavement, meticulously etching each street corner while the mid-summer sun toasts our untainted skin.

“Over here”, I tell Kim and she hurries to my side to see the Barbie-sized bakery I have drawn. It is complete with an awkward two-dimensional awning and red-striped curtains. She draws the baker outside. “You forgot the most important part”, she says.

We play for hours, her thoughts completing my ideas, her rationalism solidifying my unsteady notions. I draw houses, she adds the entryways. I draw chimneys, she adds the smoke.

The sun begins to set and my belly is growling. I know that Mom is making tacos for dinner. Kim grabs my hand and pulls me to my feet so we can walk home. We walk a few yards, our tiny fingers entwined, then I pull away at a sprint. “Race you!” I yell over my shoulder, but I’m already ahead. When I get to our gravel driveway, I look back. Kim struggles to catch me, but she falls, her knees scraping the rough asphalt, her glasses careening ahead of her down the street.

_____________________________________________________________________________

The beige plastic chair in the visitor’s lobby of Tucker’s Psychiatric Ward was digging into the sides of my hips. I readjusted myself in the chair much better suited for a kindergarten classroom, and glanced around at the other inhabitants, the tired-looking woman in her thirties rocking a crying baby, the slovenly man hunched in the back with his knees up to his chest.

In the past three days, Kim had physically recovered at MCV, received a full psychiatric evaluation, and been transferred in an ambulance to the painted cinderblock walled psychiatric ward at a nearby Richmond hospital. She had made a fast recovery physically, Dr. Andrews said, but we were all holding our breaths that she would make the same progress mentally.

My parents had reserved a room for a week at the Marriot Hotel on 5th street. They wanted to be as close to the hospital as they could, and they spent the first two days living the stiff hospital room chairs, taking shifts to get coffee, food, or sleep.
My father had come over to my house for dinner just last night while my mother remained hovering over Kim’s bedside. He wandered my small rental house in awe. “It’s beautiful, Maddie. I’m really sorry we don’t get to come up enough,” he said looking around to take in the sea foam walls and leather sofa. His eyes latched onto a photo collage over the living room sofa, and he leaned in to get a better view. “You and Kim were so tiny here,” he whispered to the black and white print of two babies covered in sand at the beach. “Did you ever think we’d end up like this?”

I hadn’t been able to visit Kim once at MCV, and not because I didn’t have the time. I just couldn’t stand the thought of seeing her in what might have been her death bed, the tubing digging into her flesh, the mummy-like gauze wrapped around her sewn wrists, the irritating clicking, humming, and gurgling of the machines sustaining her life. Dr. Andrews had described the process of her blood repletion to me that night of the suicide - I had only just begun saying the word to myself, but I still could not bear to let it leave my lips – how they hooked her into the IV machine and began pumping her full of fake blood, other people’s blood, anything they could to fill her vessels and move oxygen through her body once more.

Her wrists were healing nicely, now, my parents had informed me on the phone. The sliced fresh was sewn easily back together. The holes on the underside of her elbows where the IV lines had bitten through were simply covered with a piece of cotton and taped as if it never happen, as if it had all been a child’s game. But I knew the part that really mattered, her mind, was split into a million pieces and every piece of eating herself from the inside out.

The elevator door opened to my right. An Asian man with only a few inches on my 5’4” frame smiled when he small me. He walked briskly over to my side, thrusting a thick white hand at me as he approached. “You must be Madeline, right? I’m Dr. Le, the head psychiatrist at Tuckers.” He did not wait for my reply before hurrying back to the elevator, excitedly commanding, “Come, come!”

The elevator doors closed in front of us when Dr. Le pressed the button for floor 3. “The elevator here is the only one that goes to the psych floors. The other elevators in the hospital,” he gestured behind him with a stubby arm, “don’t have access to these units.” He chortled and added, “for obvious reasons.”

The elevator door opened to a floor divided into three visible sections, two separated by long glass walls from the middle, where the nurses station connected the glass sides via a series of locked doors. I could see people behind the glass in my periphery, but I refused to look, instead keeping my eyes focused on Dr. Le’s pin striped shirt moving in front of me.

Dr. Le pulled a keychain from his pocket and used a short gold key to open the gated half door into the nurse’s station. I followed him past three nurses urgently writing in maroon three-ringed binders, through the back of the square nurses station, and down a short hall with four doors. He opened the last one on the right, extending his left arm to prop the door opened while I entered.

“Welcome. Have a seat,” he gestured to two narrow suede armchairs in front of a towering mahogany desk.

The room was painted a warm tan, the color of just-right biscuits from the over, a stark change from the sterile beige walls that filled the rest of the hospital. A small window to my left captured the parking lot outside. I found myself wishing to be out there, to feel the cleansing spring air as I sped away in my car. On the wall above Dr. Le’s head, three framed diplomas hung proudly honoring his credentials.

“Now,” he began, “where shall we begin?”

Were we here to discuss my psychological state? I could not help but wonder. “How is Kim?” I insisted instead.

“She is doing well. I’m sure you’ve heard her diagnosis. What do you know about bipolar disorder?”

I shook my head, dumb. I remembered a lady in our neighborhood growing up whom they called bipolar, and I pictured the day we found all those dead cats behind her house. I shuttered at the thought.

“Well, like any other psychological diagnosis, it affects every patient differently, but we usually differentiate the disorder into two separate diagnosis based on a patient’s symptoms. We call those bipolar one, your classic cases, and bipolar two, a much more common phenomenon. Both disorders are characterized by two distinct phases of mental instability: mania and depression.” He gently tossed each hand to the side as separated the phases verbally. “Still with me so far?” He asked.

You could tell by his patience and gentility that Dr. Le had children. Guessing from his age and his career training, I’d imagine they were just toddlers at this point

“Now I’m sure you are aware of some depressive symptoms. Again, each patient is different, but we usually look for signs like a generally down mood, huge weight gain or loss, excessive sleep, and a general apathetic attitude towards life - that is to say, one might lose interest in the things he or she used to enjoy.”

I remembered dinner with Kim last month around her 26 birthday. We were halfway through our salad when I asked about the sprint triathalon she trained for every spring. “Oh, I’m not doing it this year. I’ve just been too tired,” she told me, starring blankly at the lettuce on her fork.

Dr. Le continued. “Now, for the mania, you really just have to imagine symptoms that are pretty much the opposite of what we just discussed. A manic person usually takes excessive risks, has a grandiose image of him or herself, takes on too much all at once. After talking extensively with your parents, I do believe that Kim is not just depressed, but bipolar. Her manic symptoms are less pronounced, so at this point I would classify her as bipolar two. It’s nothing to be scared about, and I assure you that it is a disorder than can be controlled.”

“How?” I found Dr. Le’s straight-forward explanations were comforting.

“Drug therapy, mainly. Then we supplement pharmacotherapy with cognitive-behavioral therapy. Counseling, essentially. If those don’t work together, we look towards other options, for instance, electroconvulsive therapy.

I imagined Kim strapped to a hard wooden table, her arms and legs flailing as two a spider-web of electrodes sent electricity soaring through her body. God, I hope the drugs work, I thought.

“With Kim, since her major problem seems to manifest itself in depression, we’ve chosen to start her on a mood stabilizer called lamotrigine. Drug therapy is completely individualized on a patient-by-patient basis, so if what we’ve chosen for Kim doesn’t work, we’ll switch. There are a number of different drugs and combination available. Since she presented in such an extreme state of depression, we are also going to start her on an antidepressant called sertraline. In combination, I think this regimen will work really well for her.

I have to warn you though, these things will take weeks to work. The antidepressant, in particular, usually takes weeks to see full benefit, and we can’t make a lot of changes until we hit that point.”

This was turning slowly into a nightmare. “How many weeks are we talking?” I propped my elbows onto the smooth wood desk.

“Four to six. We’ll probably know by four if we can switch or not, but I’d really like Kim to remain here with us until we get her over that first hurdle.” He made the motion of leaping over a hurdle with this right arm. “After that, she can probably manage on outpatient visits and regular therapy sessions.”

I began to melt into my chair once more. The image of Kim in the fetal position on a old wood-frame sofa surrounded by slovenly old men shouting obscenities began to suffocate my normal thoughts, and I squeezed my eyelids tightly to keep from crying. How could my sister end up here, in this place, with a bunch of lunatics for Christ’s sake?

Dr. Le graciously gave me a moment to compose my thoughts. Then leaned across the wide, flat desk, momentarily bridging the gap between the medical and human, to squeeze my hands in a way that made me think he knew his patients as more than just a diagnosis, more than just a list of progress notes and medications.

“Now,” he finally spoke. “How about that visit?”

[1]

I was dreaming about the Trojan Horse the night my sister attempted suicide. It was a cool dark night in April, and I was lost in a dream as a warrior dressed in a pink chiffon dress. My comrades and I were going into battle against a city of Indians who dressed only in loincloths, and we devised a plan to arrive in a Trojan Horse, only it was shaped like an old wood house. And when we finally arrived and opened the door, I woke up to the sound of the telephone ringing.

Back in my lilac bedroom on W Grove St, the windows were open for the mild spring air that had drifted in from the West earlier that week. Exactly four lights were on in my tiny 1930’s bungalow – the light under the microwave, two lamps in the living room, and a nightlight just outside the bathroom door. The ceiling fan hummed on low just above my head, and I breathed in the fresh air, the scent of early oak leaves and late-night pizza.

What time was it, I wondered, irked to be losing sleep after pulling 12 hours at the office again that day. My computer buzzed softly across the room, it’s power light pulsing in rhythm to the ringing phone on the bedside table. I watched the light dance for just a few musing seconds, then pulled a pillow over my head harder and tried to lull myself back into the dream with the cool underside of the pillowslip against my face.

The phone began screaming again.

“Who the fuck,” I snapped aloud into the darkness as I shot up from under the covers, blue and white pillows flying everywhere. I grabbed the receiver with indignation and shot into it nastily. “Hello?!”

There was a long pause on the other end, and I glanced at the sleek digital alarm clock on to my right. The square green numbers read 4:36am. I had received that clock from my parents for Christmas three years ago after I received my first real job as a marketing assistant at Philip Morris in Richmond. More excited for themselves I believe, than they were for me, they drove up with me from Charlotte, NC six days after I received my final hiring agreement to look at apartments in the city. I had been out of college for a six months at that point, and we were all tired of my weekends away, the endless rejection letters, and a dismal economy better suited for homelessness than success. That Christmas, I received two gifts: a job, finally, and a sleek, digital alarm clock to “help me start every day on the right foot,” according to my parents.

I hit the alarm button on the clock with my right hand. No use in going back to bed now, I thought. “Hello?” I asked again, this time more exhausted than angry.

“Madeline?” My mothers voice sounded drained, a song without a melody. “Madeline, it’s your mother.” As if she had to remind me.

“Mom? What are you doing calling me so early? It’s 4:30 in the morning.” I lightly tapped my feet under the white down comforter. My fingers drummed against the receiver, waiting for her permission to succumb once more to sleep.

“I’m sorry, honey. I just –“ She breathed so deeply, I could almost feel the air being sucked in the earpiece of telephone receiver. She began again, her voice trembling. “I just need you to come to the hospital. It’s – it’s your sister.”

I had already begun throwing the comforter off my legs. I hurried to the dresser, frantically throwing open drawers, the receiver still at my ear. “Where are you?” I almost screamed, my hands shaking uncontrollably as a fished through clothes to find the first things my fingers could grab.

“MCV. Downtown. Please.”

“Mom, I’ll be there soon.” I hit the off button and threw the phone backwards onto the bed without waiting for a reply. A million thoughts were already careening through my mind. Was it a car accident, an armed robbery? Kim never lived in the nicer areas of Richmond. But she was at the hospital. That meant she was at least alive. I threw on a pair of ragged leggings and a large grey hoodie over my underwear and sports bra. The fan continued to whirl quietly above, completely unaware of disaster, but my heart was pounding faster than cars in the street outside. In one fluid motion, I grabbed my purse, keys, cell phone, and sped out the door to my car.

By the time I rounded the corner to the hospital, my hands were so sweaty, I was having to use the sleeves of my sweatshirt to grip the steering wheel. “God dammit!” I yelled at the car in front of me, slamming my palms down on the steering wheel. “Move!” The Volvo in front of me pulled towards the right without a signal. I cursed again loudly, throwing a finger just to make a point, then swerved into the dark garage with a yellow sign marked, “Visitors Only.”

The winding deck was narrow on all sides, and I sat up straighter in my seat to keep from taking out any vehicles. That would be the last thing I needed. At this hour, I only had to rise three levels before a few parking spots appeared amongst the rows of dirty Hondas and sparkling Mercedes. I spun into spot next to a revamped El Camino, and took off running at full speed to the information desk.

“I need to find my sister.” I snapped at the woman at the counter. She was plump, about 40, with graying brown hair and a pen tucked behind ear.

She didn’t even bother to raise more than an eyebrow when I approached. “Her name?” she squawked, lifting a pair of peacock-rimmed glasses to meet her eyes.
“Elders. Kimberly Elders.” My right knee bounced up and down on the other side of the counter.

“Now….” She plucked a few keys on the computer in front of her. “Ah ha. Found her. ICU. Second floor.”

She looked up to meet my gaze, but I was already hurrying towards the stairs, taking them two at a time, and the receptionist’s voice only chased me fruitlessly from a distance. “To the right! Turn right at the top of the stairs! And slow down!”

I saw my parents as soon as I sped through the doors of the ICU waiting room. My mother was crumpled like a wet dollar bill into my fathers lap, her left hand holding a wad of tissues near her cheek. My father looked surprising aged, as if his body only just now remembered his 61st birthday last month. His eyes found mine, expressionless as I approached.

“Maddie,” he whispered, taking my hand in his and gently guiding me to the empty seat on his right.

I couldn’t take my eyes off his. I couldn’t bear to open my mouth, to ask what had happened to his older daughter.

“Kim is alive. She breathing on her own again, and the doctor says she’s almost stable.” He answered my silent question, and relief of an answer took pounds of my chest. I was suddenly able to breath again, and breath I did. I breathed fast and deep, allowing the knowledge of her safety wash over me until I was choking and sobbing from both fear and relief.

My mom, waking at the sound of my tears, rose from her chair to kneel before me and take me in her arms. “Madeline, Madeline, Madeline.” She whispered into my hair. I buried my face into her green wool sweater, drank in the slightly dull scent of her Chanel No. 9.

“Mom? What happened?” I finally asked as I peeled my wet face back from her sleeve.
But no sooner had I spoken than a taller man with glasses, tussled brown hair, and white coat appeared at her side. He stood patiently in front of us, making brief eye contact with me while she rose from her knees to face him. “Mrs. Elders, Kim is going fine. We’re going to keep her overnight in the ICU, but then we’ll step her down to a regular room for the remainder of her recovery,” he gestured to the hallway, which led back in the direction of the Med/Surge Unit.

“What I wanted to talk to you about are her options after her stay here.” His eyes softened a bit around the edges as he said this; I could tell he was comfortable with the basics, the vitals, the life or death of a situation. What he was about to approach was the gray area, the area that took a little piece of his heart explain.

“We can, of course, send her home.”

My mothers eyed widen in hope.

“But what I’d suggest is to have her stay some place for a couple weeks. We can do a pysch consult sometime in the next few days, once we get her physically healthy again.” He inadvertently touched his wrist as he said this.

“We have some of the best psychiatrists on staff, and they do consults like this more often than you would imagine. Of course, this is all up to you.” He looked at my mother and then my father, taking in their eyes, their wrinkles, trying to read their thoughts through their expressions.

When they both looked away, he turned towards me. “You must be Madeline.” He extended a long white forearm in my direction. “Kyle Andrews.”

I nodded and shook his hand. It was slender, but strong. “Nice to meet you,” I stated automatically, wishing in reality that I was anywhere but here. I was just beginning to place the details together, to understand that whatever happened to my sister wasn’t an accident. It wasn’t a faux pas, a slippery mix-up, the consequence of being at the wrong place at the wrong time. It wasn’t a gun-fueled robbery gone wrong or a ruthless rampage from some hood rat on the East End. No, I thought to myself, the only vicious killer was herself.

__________________________________________________________

I am five years old, Kim is 6. We climb off the bus together, my very first day of kindergarten. My mother is waiting for us, her arms spread like wings in front of the accordion-folded glass door, and in her hands I see two stuffed dolls, wrapped around the neck with cranberry colored bows.

We spring from the doors like slinkys, our bodies folding into her arms and our laughter contagious. She hands us each a doll: The stuffed lion for Kim and the droopy bean-filled bear for me. We hug them like our own, our fairy fingers squeezing their plush flesh, and Mom kisses each of our foreheads before taking our hands.

I’m silent the entire walk home. Kim chatters nonstop, to the point where I lose track of her conversation, but I watch her fingers twitch at her sides when she Mom asks about her new friends.
_____________________________________________________________

“What do you think, Madeline?” All eyes were on me. Dr. Andrews had pulled up a chair in front of my parents now. He was holding a few pamphlets like a deck of cards spread between his fingers.

“What I-“ I was caught off guard as usual. My parents were nodding silently as he spoke, both taking in every word as if it were his last.

“Maddie,” my father started, “We were talking about the options for Kim. We think we might want her to stay somewhere for a while where she would have 24 hour coverage. People to watch over her for the time being.”

Dr. Andrews was nodding behind him. “Family is the best support a patient can get, but we never ask a family member to become a nurse overnight. Some of the facilities in the area are top notch in the field of psychiatric care, and I know Kim’s health would flourish there.”

Fuck, psychiatric care, I thought. I did not want my sister shut up in some fucking loony bin with a bunch of psychos. What she needed was her friends, her family, people she could trust. I knew Kim best of all.

“What about me? Why can’t she stay with me?” I looked Andrews straight in the eye.

“Madeline, I understand your concerns, but care-taking is a responsibility that can’t help but become a burden. In the medical world, we are taught to constantly weigh risks versus benefits. Staying with you might be okay for Kim, but we must also consider your own quality of life as well. And what if, god forbid, something happened while on your watch?”

Good damn, the medical population. How did they know what was best for me? I kicked a trashcan lying innocently near my foot, and the paper inside trickled out onto the floor, defeated. “What are my options?”

“Well, that’s what I’ve been discussing with your parents. There’s a facility here at MCV I’m fast to recommend. There are also a few other facilities in the area that we can look into. Either way family is still an integral part of the healing process.”

God damn, talking head, I thought.

My mother spoke up. “That’s where you come in. Your father and I are considering staying in town for a bit while this whole thing pans out, but we’d like your help too. We know how close you two are.”

Dr. Andrews was nodding again. “Visiting hours are the facilities are immense and very flexible. I understand you have a promising career, but even a weeknight or weekend drop by do wonders.”

“How long?” I snapped.

“Well, again, we haven’t had the full psychiatric consult, but depending on the diagnoses it could be a couple days to a couple months. My initial impression is uncomplicated major depression, but that is nowhere near the official word. The drugs for such a condition can take up to four to six weeks to see the full effect, but I’d doubt if she’d need to stay that long.”

“What the – four to six weeks? Weeks? She’s not even that sick. She can’t be!” My feet tapped the ground, livid. I could feel the adrenaline pulsing through my veins.

“Now, again, I don’t know the full diagnosis. If there are any signs of mania, the course of treatment may be shorter or longer, depending, of course, on a number of factors.”

He turned back towards my parents. “Mr. and Mrs. Elders, I’m going to get you in touch with the psychiatrist here to keep you up to date on Kim’s process.”
I had already begun falling. I let my back slide down the back of my chair, my feet slipping across the white linoleum floor and eating the tiny gray specks in the tile as they moved.

My palms lay open beside me on the floor where I landed as if to call out in surrender. I give up, I give up, you win. I lost my sister long ago.