Chapter 19

CHAPTER 19

Maddy, her mother, and Emily are in Dr. Weaver’s office, Maddy in her usual seat, her hip pressed against the left-side arm of the sofa, her mother at the other end, Emily between them. It’s been three weeks since her mother told Dr. Weaver about the cutting and Maddy was put on a higher dose of quetiapine. This office visit is a scheduled appointment, just a check-in. Maddy doesn’t expect Dr. Weaver will change anything about her medications, but she is hoping Dr. Weaver will give her the green light to move back to New York City and live with her sister. Anticipating their mother’s brick-wall, over-my-dead-body resistance to this plan, Emily offered to be there, a soldier ready to do battle, on her sister’s side, and Maddy gratefully accepted. Emily took an early train in this morning and the entire day off from work.

“I think it’s a terrible idea,” says her mother.

“What about it do you feel is terrible?” asks Dr. Weaver

“For one, Emily works, so Maddy would be alone all day.”

“I don’t need a babysitter.”

“I’m home by midafternoon,” says Emily. “I’ll look out for her.”

“And I won’t be ‘alone all day.’ I’m going to get a job at Starbucks.”

“You can do that here,” her mother says, ready with her smart return, sitting tall as if she’s won the point.

“I don’t want to do that here. Sofia and all the other summer people are away at school. I’ll feel like a loser if I go back there now.”

“Tim can’t want his fiancé’s little sister sleeping on the couch every night,” says her mother.

“He’s fine with it,” Emily says. “Honestly, he works so late most nights, he’ll barely notice she’s there, and I’d love the company.”

Emily looks over at Maddy and smiles. Her mother bristles. She’s not used to Emily taking anyone’s side but hers.

“It’s only for one semester,” says Maddy. “I’ll come home for the summer, before the wedding, and go back to school in the fall.”

“But she has to get enough sleep,” says her mother, addressing Dr. Weaver, ignoring her daughters. “You said that’s critical for her stability. How is she going to do that sleeping on a couch in a small apartment?”

“At least I’ll have a bathroom door.”

Arms crossed, Maddy leans forward, looking past Emily at her mother, accusation in her eyes. The room goes silent.

“What does that mean?” asks Dr. Weaver.

“It means they took away my bathroom door,” says Maddy, hoping for an ally.

“We were just re-creating how you have the rooms set up here,” her mother says. “For her safety.”

They wait for Dr. Weaver’s response. She taps her index finger on the pen she’s holding, nodding slightly but not to them, as if she’s rehearsing what she’s about to say in her head and approves.

“Amy, that’s not necessary. When Maddy was an inpatient here, she was in a potentially dangerous state of mind. It was an acute crisis that called for certain measures and extreme precaution. She is no longer in that crisis state. If you look at her now, and really take the time to see her, you’ll see she’s actually doing quite well.”

Point for Maddy. She replays Dr. Weaver’s last sentence again in her mind, and the words feel good.

“I understand there are a lot of emotions to deal with in the aftermath of this kind of trauma. But it’s important for Maddy’s recovery and continued stability that she’s treated with dignity.”

“She treats me like I’m a mental patient,” says Maddy, emboldened.

“I do not!” her mother says, her voice vaulting high. If she were wearing pearls, she’d be clutching them. Maddy wonders whether she’s objecting to the accusation or to the use of those two deplorable words.

“What about the cutting?” her mother asks.

“I haven’t cut at all, not since we upped the dose of the quetiapine.”

Dr. Weaver nods, pleased.

“How do we know if she’s telling us the truth?” asks her mother.

“I believe her,” says Emily.

“I believe her, too,” says Dr. Weaver. “And I understand that the cutting and her behavior when she was manic has broken your trust in her, Amy. It takes time and repeated evidence of trustworthy behavior for repair. Try to be open to it.”

“But New York City with no routine or structure, that can’t be safe for her. You can’t be recommending—”

“Mom, I told you, I’m getting a job. There’s a Starbucks on every corner.”

“And I go to bed early,” Emily says. “Asleep by ten, up at six. Eight hours every night. We can be on the same schedule.”

“What happens if—” Her mother pauses, working to choose her words. “If something happens?”

“I know it feels safer to keep her at home. But you removed her bathroom door, and she still managed to cut herself repeatedly without you knowing. At some point, and I think we’re there, we have to let Maddy get back to living her life.”

Maddy and Emily turn to each other, celebration on their faces.

“Within reasonable bounds,” says Dr. Weaver. “I wouldn’t recommend working fifty hours a week or getting a job as a flight attendant, flying red-eyes and switching time zones. But Starbucks sounds doable.”

“That’s totally fair,” says Maddy.

“You can keep your appointments with me via telehealth, and I’ll also refer you to a therapist in the city.”

“Okay.”

“And I’d like you to check in every evening on a mood app. You’ll answer questions about how much sleep you got, your stress levels, mood. We’ll customize it with questions about cutting, spending money, Taylor Swift. This way, we can track what’s going on with you, see if you’re beginning to disregulate at all in either direction, and we can then hopefully address it before it becomes an issue.”

“So she’s supposed to be able to catch any changes herself?” asks her mother, as if she’s found the fatal flaw in this cockamamie plan.

“No. If Maddy agrees, I’d like you, Emily, and I to all have access to her mood app account.”

Dr. Weaver’s eyebrows lift, creasing her forehead into a series of lines. Maddy imagines the mood app to be like the Find My app on her phone, but instead of sharing her physical location, it would reveal the whereabouts of her mental state. It feels invasive, like she’s being asked to let a committee read and judge her journal.

Maddy nods.

“But what if she doesn’t answer the questions accurately?” asks her mother.

“You mean honestly,” says Maddy, offended. “She thinks I’m a liar.”

“Maddy—”

“Hold on, let’s take a breath. It’s a good question. First, we all lie to ourselves at times. Maddy’s not a bad person if she reports that she’s feeling fine when she’s actually feeling a little down. But if she starts to swing, especially toward hypomania and mania, she’ll lose the ability to accurately self-reflect.”

Her mother nods, arms folded. “Exactly—”

“That’s why we’re not going to rely on it alone. Think of the app as a tool in our toolbox. Another tool will be your interactions with her. Is she talking too fast? Is she sleeping a lot less or a lot more? Is she texting you too much and all through the night? Is she wearing expensive new clothes or talking about knowing Taylor Swift? These are our alarm bells. If you see any of these, you raise your hand immediately and let me know, okay?”

“Okay,” says Emily.

“Okay,” says Maddy.

Her mother stays tight-lipped. Her arms are crossed, and she’s looking out the window behind Dr. Weaver, her head pointed away from her daughters.

“I want to add ‘no drinking and no drugs,’?” says Dr. Weaver. “You have to commit to that. I can’t treat you properly if you’re taking stimulants or depressants. Can you agree to this?”

“Yes.”

“And if we do spot anything alarming or detrimental to your stability that we can’t address with adjustments in medication or behavior, then you come back to Connecticut. How does that sound? Do we have a plan?”

“Yes,” says Maddy.

“Yes,” says Emily.

Breath held, Maddy waits for her mother’s answer. Her mother is outnumbered, three to one. Maddy’s plan was just approved, with conditions, by a doctor. That has to hold a lot of sway. But her mother’s vote has always outweighed everyone’s, and Maddy fears that a no from her would be enough to veto the whole thing.

Feeling better also means she’s feeling desperate to resume some semblance of a normal life for a twenty-year-old. She knows she can’t return to NYU yet, but living with her sister in New York City beats living in nowhere Connecticut with her mother by a million miles. She looks across the sofa at her mother. Her mother’s arms and legs are crossed. Her jaw is set. It’s going to be a no. Maddy’s seized with fear and desire, both energies expanding throughout her body, twisting into a knot at the base of her throat. Getting out of her childhood bedroom suddenly feels like oxygen, this decision life-and-death. If she’s forced to stay home with her mother for the next five months, she might be safe, but she will lose the will to live.

“Okay,” her mother says. “But if something happens, she’s coming home.”