Hospital, January 2005

Getting back to n., and his latest stay in the hospital, here’s the rest of the story of the days between the start of his breakdown and his discharge from the psychiatric unit.


On Thursday morning, January 20, I had a call from n’s social worker at CFS, whose name is Mark. He said he hadn’t heard directly from Lyle at the TRY program, but he had received a message from n., who said Lyle had told him to ask for Assisted Living. He said this would involve discharging n. from CFS care, and applying for Welfare. He said Assisted Living was a Welfare program. He said that Welfare would feel that n. was being dumped on them and it might take a couple of months for n. to be approved. He asked if I would pay for n. to be in a rooming house if CFS discharged him. I asked him to explain the Assisted Living program and he couldn’t. He said he would have someone call me, and I didn’t hear from anyone. I said that giving n. his own place now, when he was using drugs heavily, would just be enabling his drug use by giving him a better to place to hang out with his buddies, without making him any safer.
I talked to Lyle and Lyle’s colleague Cindi about this later. They were not advising anyone to give n. his own place, but they were encouraging emancipating n.(their word) from CFS care. I am still not clear on their vision of this process. They seem to be agreeing that n. should stay at the Salvation Army for now, cut down on his drug use, and start a job placement as the first steps on his path to self-sufficiency.
When I went downstairs at noon on Thursday to get my car, n. was still in the donut shop. We drove to the Canadian Tire store on Isabel and got batteries for his discman. He wanted to use my cell phone to call Danielle. Her roommate took the call and told n. she was sleeping. N. was trying to tell her to keep Danielle at the hotel until he could get there. He told her to try to keep Danielle away from a person called Mike.
The trips to Canadian Tire and to my appointment, and back downtown were strange, even by the standards of talking to n. when he has been upset or under the influence. He talked constantly, almost in a stream of consciousness. He talked about things that he usually concealed or lied about. He talked about his fear that Danielle was getting drugs from a dealer and was breaking up with him. He complained that she was using too much and said that she went through and 8 ball in a few hours while he could make it last for a week. On the way back, he said he had heard people talking about him but had not been able to see them or find them. I dropped him outside the bus depot, so that he could visit Lyle. The TRY program is based in the office block beside the bus depot.
Thursday night, the shelter on Mayfair called me twice. First they notified me that n. had checked in. Then they said he was paranoid and talking strangely and that they were sending him to the Health Sciences Center for a psychiatric evaluation. When I hadn’t heard anything else by Friday afternoon, I called the hospital. The psychiatric nurse in Children’s Emergency Unit said he had not been in that unit on Thursday night. I checked with the shelter, and they said their cab had taken n. to the Adult Emergency Unit, and that n. had seen a doctor. N. had not talked about his paranoid thinking and the doctor had let him go.
After supper on Friday, n. called me. By this time, the weather had become very ugly. It was snowing, and there were high winds. I think it was a true blizzard. N. said he was in Winnipeg Square, a mall at Portage and Main. He said he had been to Mayfair this evening and could not get in because they had a problem with his behaviour. He told me he was still blacklisted at Nidinaway. I asked him to give me a few minutes to think. I called the shelter at Mayfair and they confirmed that he was barred because of his strange behaviour. They said they could not call the Crisis intervention team and they had sent him away with bus tickets and change for payphones. When n. called me again, he was crying and asked me to take him to the hospital for a psychiatric evaluation. I picked him up and took him to Children’s Emergency. We stopped at a fast food restaurant. He was generally lucid but he had an edge, and he was having mood swings. He was upset about his girlfriend.
When we got to the emergency unit, he went into a waiting room and used the PlayStation and TV in that room, and then asked for a blanket and went to sleep. I talked to the Psyschiatric Nurse – the same person I had talked to on the phone in the afternoon. She said n. would be seen by an intern or medical resident and then by a psychiatric resident before he could be admitted. I left him in her care and he was admitted sometime that night.
N. called me in the afternoon on Saturday and I agreed to visit him. I called on Sunday after I had skied and made sure I could visit. I spent some time with the nurses, giving them information and phone numbers. I called his CFS worker Mark on Monday. He was not aware of the hospital admission and I briefed him.
N. called me on Monday and asked me to bring his PlayStation. The ward had a Nintendo system and he wanted his own games. However he had not discussed his plans with the nurses, and I took the thing home. He had run out of tobacco and wanted cigarettes, to help him control his craving for other drugs and I bought a pack and dropped it off on Tuesday morning. We didn’t have much to say to each other on my first few visits. He told me that Danielle kept promising to visit, but had not actually visited. He seemed to have been able to call her room, and he had talked to her roommate quite a bit.
I called Lyle during the week and let him know where n. was. He told me that n. had done some work, but had missed appointments and that he was not finished with the remedial work. He decided to visit n. in the hospital. He agreed that n. had been very upset about Danielle and about his friends’ being in jail. He said that n’s use of crystal meth was pretty obvious to him.
When I considered the last three months, I saw the collapse of n’s social supports and his escalating amphetamine use as part of the same process. His drug use – and that of his friends Mark and Don – was leading to anti-social behaviour and crime. Mark and Don got arrested, and n. was kicked out of his comfortable placements. N. was unhappy with Danielle and himself. More drugs, more craziness, less happiness.
N. and I had longer talks on Tuesday and Wednesday evening. He had calmed down, and his skin was clearing up. He was getting used to the idea that Danielle did not want to see him and he decided to write a letter telling her that he was dumping her. He was thinking about drug treatment but not happy with the idea. He talked at length and with some feeling about how enjoyable it had been to sit with his friends and play video games and smoke dope and to go out for good times. He was unhappy at the idea of having to go and work every day to have shelter and food and possessions. He thought that was a boring and hopeless situation. I talked to him about giving himself simple goals each day, staying busy, and living his life one day at a time.
He said that he would go for drug treatment but he began to say that he needed to do it with his friends. Since they are adults, their treatment would probably be at the Behavioural Health Foundation in St. Norbert – if the Foundation takes them and the Court releases them. N. is a minor had his residential program would have to be through AFM (the Addictions Foundation of Manitoba) at Southport (a facility near Portage la Prairie). Since n. has avoided contact with them since last winter, he will have to spend a time in their intake and assessment process before he goes anywhere.
He has made some progress. He is being honest about his amphetamine use. He seems to see that crystal meth cannot be managed safely and he now seems open to the idea that he needs help to change. He is getting scared of the power of his addiction, which is not necessarily a good thing. He is scared at times, but at other times he thinks it’s a hopeless situation and he might as well give in.
I have learned more about the signs and symptoms of crystal use, and I have been growing away thinking that I am responsible for his addiction and his rejection of work, school and home life. It is possible that if he was a happier kid with more interests, he might not have become involved with drugs or not found them so engaging when he started to use them 3 years ago.
I’m also getting away from the idea that I have to walk on eggshells around n. to avoid triggering more drug use. He will do what he wants. He may tell himself that it’s a reaction to me, but it’s his own craving that drives his choices.

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