you just might find you get what you need

It definitely wasn't love at first sight. You know those hokey ads of two people running towards each other in a field of daisies, arms extended, ending in an embrace? Well, we would have missed, turned around to try again, and smashed heads together, knocking out a tooth in one and inflicting a black eye on the other. It was really that bad.

When I found out that Elizabeth was being shipped back to Butner, I emailed E, our wonderful social worker from the last time there. She had a full caseload and didn't think we would end up with her this time. We didn't. I didn't hear anything after a day or so and emailed her again. Finally I got a phone call from Mr. G, our new social worker. He was obviously multi-tasking and apologized for being too busy to call. I said the best way to get ahold of me was to email. He said he didn't email. When I started talking about something I felt it was important for him to know, he cut me off and said he'd see me when I got there that afternoon.

By the time I did get there, I was in a fury. I was early enough that I figured a supervisor would be around and I planned to ask to be switched to a more compatible social worker. I was madder and meaner than the last time we'd been in Butner, and I was in no mood to be messed with. I waited in the lobby for him to come get me to take me to the unit. He arrived and started talking immediately about Elizabeth as we made the five minute walk to the lower level. E and I used to make small talk on that same walk. She made me feel like Elizabeth was the only patient she had and she had all the time in the world to listen. I felt like I was in the presence of another human and that made it easier to focus on the difficult work we had to do.

I don't do well with what I hear. Like Elizabeth, I have my own auditory processing problems. I got through college by writing down every word of every lecture and then going back to the dorm and rewriting the important parts. I can't walk and listen at the same time. I need to see it, and pictures help too. And I communicate best by writing, so that I have time to think about every word and whether it conveys what I want it to say.

Every encounter Mr. G and I had seemed to be a negative one. He talked fast; I listened slow. He strode; I moseyed. I was an idealist; he was a realist and impatient with my impatience with the system. He was interested in facts; I told stories. He interrupted constantly; so did I. We seemed doomed.

Before Elizabeth came in to the visiting room, Mr. G and I sat and talked, mostly at each other. "Why won't you do email?" I asked. "I need you to do email." He said that HIPAA regulations made it so that an email with identifying information in it could cost him an outrageous fine and he wasn't taking the chance. "Okay," I said. "But I don't do well on the phone, so it will have to be in person. And you can't do something else while you are talking to me." I could feel his irritation growing. "And you can't interrupt," I added, "Or I'll have to bring a talking stick and you can only talk while you are holding it." He looked at me in semi-amazement and then laughed.

When I left that day I hadn't talked to a supervisor yet. But Mr. G seemed reasonably competent and fairly personable. I asked Elizabeth what she thought. "I like him," she said. "Some of the kids don't because he's strict. But I think he's nice." That was important. After all, she was his patient, not me. I didn't have to like him. He sure was hard to talk to though.

As a southerner, it's hard for me to trust someone if I don't know their people. Have you ever noticed that when southerners meet for the first time, they start playing the Who Do You Know Game? It's an easy way to find out if someone is good or trustworthy or maybe not so nice. You can't play that game in hospitals, especially psych wards. In Baptist we lucked out and there WERE people who knew my people, and they were people I trusted. But this guy was the HIPAA king and I didn't know his people or his stories, and he had my kid.

The next time I came, Elizabeth said, "Mr. G knows Louise." Well, THAT was unexpected. Louise is a bona fide wise woman who knows both of my children well. I emailed her as soon as I got home. "He is one of the best people I know," she said. Oh. My friend Janice, herself a social worker and a member of my Child and Family Team weighed in. "He seems to know what he's doing." That was high praise from her. When we next met, I told him that Louise and Janice had vouched for him and I was willing to keep working with him. "But please don't just dive in. Ask me about the weather or something."

And he did. He really tried and I appreciate that. He made small talk, obviously itching to get on with it. As time went on, our relationship became easier. When I'm talking about Elizabeth, I have stories I tell, stories that I think say far more than a straight narrative does. He started listening to my stories and in the process discovered that it's easier to do that than to calm me down when I can't get my point across. He took time to hear what was being said in between the lines. He learned to laugh at me when I pounded the table and said I wanted to control everything. Then he helped me find what I could control and get on with it.

Claire and I visited Elizabeth last night. I was incensed about a decision the hospital had made, and this time I was the one who started in on him as soon as he came down. "How come I have to obey your rules but the hospital doesn't have to obey their own rules?" I fired at him. "What are you, an idealist?" he countered. We went on like that, yet somehow managing to accomplish what I had wanted to before we ever got to the unit. While he was out of the room getting Elizabeth, Claire asked if we were going to have the conversation I had talked about having all the way to Butner. "Oh we got that straightened out," I answered. She narrowed her eyes in confusion. "You two were each carrying on a conversation, but it wasn't the same one," she said. "How could you have accomplished anything?" But somehow, we did.

As I signed reams of paperwork tonight in preparation for Elizabeth's leaving Friday, I stopped between forms. "You are a good person and I appreciate everything you have done for us," I began. "You said that yesterday," he said, "Here, you didn't sign this one."

When my kids were little, I used to infuriate them by countering their complaints with singing the Rolling Stones' song, "You can't always get what you want . . . " I still miss the easy relationship I had with E at Butner. She was just what Elizabeth and I needed our first trip to Central Regional, kind, patient, knowledgeable, pastoral. But Mr. G kept me from getting too comfortable. This was just a temporary resting place on our way to better things. He wasn't about bonding, he was about getting her what she needed and sending her on her way. He, jarring yet compassionate, was the right person for this part of our trip. Because, you know, if you try sometime, you just might find you get what you need.

Where we're headed

. . . . and all I do is miss you and the way we used to be . . .

It's looking like the Butner chapter of this journey may be coming to a close. Since Elizabeth has been back there, the push has been to get her out quickly before she gets too comfortable. She likes Butner and she feels safe there. Hell, I feel safe there too. It's hard for both of us to leave. Again.

We have been looking at PRTFs, psychiatric residential treatment facilities for those lucky enough not to need that particular acronym. There aren't enough anyhow, and the situation is complicated by the fact that a Virginia PRTF that had 113 NC kids lost their NC funding, and so those kids bounced back into the already overcrowded NC system. Some PRTFs have turned her down, based on her high level of need. I have the world's best Child and Family Team (CFT) and they, along with our Butner social worker, work long hours calling, submitting applications, and calling some more. Finally two accept her, both in eastern NC.

Yesterday I drove down to visit the one in Kinston. It's a haul, over two hours or three Dire Straits albums away. My heart remains in the mountains even though I've lived in central NC for 23 years, and so this flat dusty land feels especially alien and alienating. Why are there so many RV sales lots on this road? I pass Cleo's Concrete Creations, Chosen Vessel Ministries, and lots of Christian academies. Yellow signs with red spray painted words sprout like weeds all over the roadside: peaches, tomatoes, yorkies. Yorkies? I check again. Yep, yorkies. Do I really want her in a town that boasts the 2nd AMEN ment Gun Shop? I'm suddenly very homesick for Chapel Hill.

I continue along Hwy 70, cut off on 268 and find my way to the facility. Road construction debris fills a vacant lot next to it. The place itself looks like a prison, with a fence around it and several low buildings. I stop and sit in the car for a couple of moments, my mood matched by the heartrending strains of a Mark Knopfler guitar solo, the notes echoing the words of the last verse: rockaway, rockaway. In my mind it sounds a lot like walk away, walk away, but I resist. The song ends and I get out.

A staff member is walking with a obviously upset and indignant girl, who cries and tells her side of the story. The staff member listens and makes sympathetic sounds. The girl calms down and I can no longer hear her voice. That's positive. I am directed to the administration building. Kim is perky and upbeat, obviously excited about this new unit. She points out that a new unit is different from a new program. They already have 24 beds for kids ages 7 to 17. This new unit will house 18 more kids. Elizabeth is being offered a bed in a pod for six girls, most of them 12 and 13.

We go to the new building which is in that final stage that all teachers know from the week before school starts. Floors are shiny new, bedspreads are on the bed, but the computer lab is empty. Boxes are stacked in the hall. The building is light-filled and attractive. She would be in a three girl living area, with three bedrooms, a kitchenette, one bathroom and a sitting area. As I look around, I suddenly see all the things that I didn't know to look for in the last PRTF, signs that tell me that perhaps this place can handle someone with her level of need. The TV is behind glass. There are no visible projectiles. There is one seclusion room for every three kids. Kim tells me that even when they are asleep, there are four people assigned to a six bed unit. Okay, that's good.

We find an empty office and sit, and I fire questions at her. I'm going to tell her just how bad my kid is, making sure she knows what they are in for. I thought I had told the last PRTF that, but somehow they didn't get it. I'd rather tell them now than have THEM tell me later. "Are you sure you can handle her?" I demand. Kim smiles. "That's what we do here," she says. "I could tell you stories about kids that make your child look easy. They deserve to be helped too. We can handle her." I ask how many kids they have kicked out in the four years they have been open. None, she tells me. My kid can get kicked out of just about anything, I brag. She's been kicked out of schools, camps for mentally ill kids, PRTFs, and psych wards. There's a first for everything. "Are you scared yet?" I ask. "No," she says. "That is what we do," she says again.

I tell her I'll let her know something on Tuesday and head back home. I call members of my CFT team. We talk about good points and bad. I realize most of what I object to is due to my snobbishness: eastern North Carolina, the gun shop, the fact that Kim mispronounces words. But I'm mostly stuck because I no longer trust my gut, a real handicap for someone who makes most decisions by what feels right. I loved the last PRTF; I loved that it was a working farm on 400 acres. They had a cat, for God's sake. There is no cat here. It was in the mountains. I liked the people at the old PRTF. But bucolic and nice didn't work so well. I need competent more than I need lovely.

At our treatment team meeting today, the social worker and psychiatrist sit and listen as I babble, even though they are pushed for time. They are in their best therapeutic mode, patiently asking hard questions to help me clarify what I want to do. Finally Mr. G, our social worker, asks, "What do you need from us?" "Tell me what to do," I say. They hesitate and look at each other, knowing they aren't supposed to impose their views or wishes, and then turn back. "Take it," they say in unison. Finally—certainty from someone! They talk about why they like it and their reasons are good. They point out that she is in far better shape than the last time she left Butner. And we've learned from the mistakes that we made in her last discharge plan.

We make a plan: Mr. G will have her decide what she needs to do to say goodbye. They'll make a list and check things off. Butner will transport her down there; I won't go. She isn't allowed visitors for 30 days, but I can call. It won't be easy; she refuses to come to this treatment team meeting and hangs up on me twice when I try to tell her about the place. If I'm having trouble trusting, how much harder for her? On June 3, she and the other five girls will arrive at the facility together. That's not much time.

One bright point: our seminarian (a student priest to those not liturgically inclined) will be assigned to a church in Kinston. The Holy Family diaspora, which served us so well in Baptist, comes to the rescue yet again. Tom agrees to visit her and I feel better knowing another pair of eyes are on her.

If they do what they say they can do, she will spend the next one to two years there. They will do medication management, therapy and something they call ART—aggression replacement therapy. She'll get schooling and she can earn trips into town, and eventually even home visits. The assumption is that she will leave there and come home because our system naively assumes that a few months of services will cure mental illness.

I would like that but I no longer count on it. It's a long, winding road our family is traveling. This part is dusty and flat. I hope for a more scenic route someday, but that might not be where we're heading. When the things that you hold /Can fall and be shattered/Or run through your fingers like dust. . . I turn up the volume, hoping it will cover the conversation in my head. Right now my job is to get to this next turnoff and hope it's one that leads somewhere good.

garbage strikes, punk rockers and dandelion wine

After I survived the Aran Islands part of my British Isles expedition in the summer of 1987, I hitchhiked across the country to Dublin. It was a novel feeling to hitchhike the width of an entire country in one day. Hell, it was a novel feeling to hitchhike, something I had never been brave (or stupid) enough to try in the States. There was always a bit of anxiety interspersed with the excitement of getting a bit further along the way, but there were enough people happy to give an American a ride that I made fairly good time.

I arrived in Dublin in the midst of a rainstorm and a garbage strike. I finally found a youth hostel where I shared a room with two teenage punk rockers from Chicago. It worked out well; they stayed out all night and slept all day while I did the reverse. None of us had much money, but they had enough drama for all three of us. I listened to their early morning tales and offered advice that they neither asked for nor followed, advice that usually fell into one of three categories: see a doctor, call the police, don't do that again. I likewise disregarded their advice, which generally consisted of foregoing stuffy cathedrals and trying one of the many pubs or discos. We bumped along in genial disharmony, each bemused by the others' choices as how to best experience Ireland.

While they slept, I played the virtuous sightseer. I slogged along in ankle-deep floating garbage as I hiked to the post office that was the headquarters of the 1916 Easter Rising. My very distant relative Thomas McDonagh was executed for his part in that rebellion and was memorialized by Yeats in poem and by a plaque in the PO. I saw the Book of Kells at Trinity College and went to St. Patrick's Cathedral, where Jonathan Swift was Dean. I had planned to hitchhike up to Belfast, but by then my achilles tendons were so sore and inflamed that I knew I couldn't. After dithering for a day or two, I decided to splurge on the train and so arrived in Belfast relatively though not completely painfree. I took the bus across town to the ferry and watched as soldiers poked our luggage with their rifles and questioned us as to our destinations. It was my first experience in a war zone and I was happy to get on the ferry and head to Scotland.

My destination was the small town of Strenraer for two reasons. One was that was where the ferry went. But it was also the home of a family my boyfriend had met the previous year when he was in Scotland, and they had invited me to stay. I arrived in Strenraer without incident and called the family. The wife answered the phone. After we had exchanged greetings, I told them where I was, and she said she would send her husband to get me. I described what I was wearing: "I'll be the one in the white shirt and black pants." "Hmm," she said thoughtfully, "I think I'll come along as well."

When they pulled up, she jumped out of the car and burst into laughter. "Next time," she said, "You might want to call them trousers. I had visions of you standing here in black underwear."

I had thus established myself as a green traveler rather than the urbane American I had hoped to pass myself off as, but that worked to my benefit. I was obviously in pain, so the mom hustled me off to the doctor. He invited the whole staff to meet me; they all had friends in America that they wanted to ask me about, friends in Montana and New York and Massachusetts, and they were disappointed when I didn't know them. He looked at my inflamed achilles tendons for just a moment, asking, "You've been hitchhiking, haven't you?" I was surprised, but I admitted that I had been. He explained it was a very common injury. I was wearing a heavy pack, and when a car stopped, I ran to get in, my body at an awkward angle which stressed my tendons. He put me in an ankle brace and on an anti-inflammatory, apologizing profusely for the one pound cost, and sent me on my way. I tried to pay but he wouldn't let me. This was my first, wonderful exposure to government sponsored health care.

I filled my prescription, put on my ankle braces and felt like a new woman. So when the teens of the family invited me to a local disco that night, I was ready to try it. The three of us entered the dimly lit, cheesy nightclub with its grimy floor and glittering ball and headed up to the bar. I knew that it wasn't a good idea to drink alcohol while taking medication, so I decided to stick to apple cider. The room was hot, I was thirsty, and the cider was cold and cheap. After the third one, I discovered I liked to dance, something I had never enjoyed much in the U.S. After the fourth one, my dancing had improved so much that I was attracting spectators, who obviously were watching in envy. After the fifth, the crowd had gotten large enough that I started wondering if something was amiss. I found one of my hosts, who offered me a beer. I explained that I couldn't drink alcohol and was sticking to cider. She stared at me for a moment before she and her friends dissolved in giggles. "And what do you think the cider is?" she asked.

Oops. I decided to take my chagrined and intoxicated self home to bed, but she wasn't ready to go and her brother was nowhere to be found. "It's easy enough," she said. "Just cross the square and keep to the left. You'll see our flat." I found my way home and fell into bed fully clothed. The next morning at breakfast, as I cautiously eyed my fried tomatoes and eggs, I looked up to find her brother watching me with amusement. "I see you got home all right," he said. "I wasn't sure you would. You looked like a bloody sailboat, tacking from one side of the street to the other. We followed you part way to make sure you got here. I thought you said you didn't drink?"

There were further adventures involving the whole family, the World Cup on the telly and homemade dandelion wine that it would have been rude to refuse, but for some reason those memories aren't clear. I'm sure they still have their family stories about the American who came to visit and stayed accidentally drunk the whole time. Is it any wonder I can't remember their names?