Memoir

How to Get Your Paranoid Mother Into the Poisonous Ambulance

When your mom is bipolar and believes everything is trying to kill her, the simple act of getting to the hospital becomes a battle of epic proportions.

How to Get Your Paranoid Mother Into the Poisonous Ambulance

“She’s been difficult,” the nurse says. “Refusing the ambulance. Something about diesel fumes. Make any sense to you?”

“Let me guess,” I reply. “Poisoned again?”

When Mom first arrived in the emergency room, she told the staff about a propane leak inside her home, and she wanted several expensive tests to prove she was being poisoned. Every time I hear the word “propane” or “poison,” it instantly reminds me of when Mom thought Dad was trying to blow up the house. She imagined that she could smell gas billowing — an insidious and lethal cloud. The murder plot unraveled in her mind as if she was the main character in an Alfred Hitchcock movie. Once she sparked her BIC lighter to smoke a Marlboro Red, the house would explode: a suburban slaughterhouse.

The nurse stops in front of Mom’s room and explains my mother is on a seventy-two-hour hold, which means we have that much time to get her to another hospital for the more long-term treatment she needs.

I was in Los Angeles when I received the phone call that she was missing, but finding a flight to Massachusetts had been complicated by the fact that earlier that morning, a man walked into the Delta terminal at LAX and opened fire with an assault rifle. The gunman, Paul Anthony Ciancia, killed a Transportation Security Administration screener and shot two other TSA officials. He had a note in his duffle bag that said he wanted to “instill fear into their traitorous minds.”

“She taking her medicine?” my brother Jason asks.

“Not here. She did have a few Ziploc bags filled with pills. So it’s hard to know,” the nurse says.

Jason is younger by almost seven years. Our parents never mentioned he was their attempt at saving the marriage, but I’ve always had my suspicions. Looking back on the room my parents designed for him in the blue colonial on Walden Terrace, it was the perfect cover: the white crib, the nifty turquoise-painted walls and the novelty baby-bottle piggy bank by the door. If Jason was the panacea to their crumbling relationship, then he failed miserably. By the time Jason was three years old, Dad was living in an apartment off Route 9 in Shrewsbury which resembled the cartoon motel from the episode of “The Simpsons” in which Mayor Quimby schtupped his bimbos.

It’s been awhile since I’ve seen Jason. He’s a senior at St. John’s University now, with a thick orange beard. He’s wearing a denim bomber jacket with white stuffing around the collar.

Behind the glass door, Mom is sitting in a chair staring at the wall. Three different police departments searched for her after her psychiatrist issued the Section 12, a law that allows mental health specialists to forcibly hospitalize, through the authorization of restraint, an individual in danger of causing harm to themselves or others. The Section 12 was issued several hours before the Leominster police found her in a CVS off Route 2. She had our dog Buddy in the backseat and his food and seizure medicine in the trunk. She also had a bar of soap, several empty cartons of chocolate milk and a plastic bag filled with her trash.

Jason and I enter the room like we are trying to avoid stepping on the cracks in the tiles. She looks defeated, as if she is a sculpture built from granite and given life only to have been turned back into stone. She turns away from the wall when she notices we are in the room.

“Forget what I looked like?” Mom asks.

She has a habit of despising what she really wants — like attention. If someone compliments her on her looks, she passes off the admiration as an insult. But it is help that she dreads the most. No matter how hard we tried to convince her to participate in support groups, she refused, believing that bipolar disorder was unfairly slapped upon her like a scarlet “A” in colonial New England. So she kept her illness a secret and demanded that we keep it, too.

Mom is wearing a sweatshirt from Jason’s university. She looks older, like a family portrait that has been forgotten in the attic. Her voice sounds dry and harsh, perhaps a result of the Marlboro Reds she’s been smoking for decades.

Ironically, she blames the hoarseness on the fact that the hospital isn’t allowing her to smoke. It’s never productive to call her out on her bullshit. If she decided that cigarettes are actually providing health benefits, then that is her unbendable truth. There is always something wrong physically — a problem with her heartbeat or another phantom malignancy that a doctor will swiftly diagnose as psychosomatic. It almost seems like a ritual she has to undergo before she can accept what is wrong mentally.

“Where the hell is that nurse?” she asks.

She has a carton of yogurt on a dining cart in front of her. She picks it up and starts to spoon yogurt into her mouth. It ends up all over her face.

“How about treating them with respect?” I ask.

“I’ve been inhaling poison. How about respect for my life?”

I am tempted to ask, but I know exactly who she thinks is trying to poison her. It’s Dad: the symbol of her hatred, the most villainous and corrupt man in the world. But Dad is a sixty-seven-year-old from Philadelphia who dreams about being an usher at Fenway Park after he retires. He has a particular proclivity toward pimple ball, a type of backyard baseball played with the end of a broom handle and a rubbery pink ball. His identity isn’t an elaborate disguise; he’s not a criminal.

“Ahhhhhh.” She moves closer and opens her mouth wide. “Can you see the lumps?”

Nothing but her tonsils and tongue covered in yogurt. I decide to go with the truth, often a dangerous proposition: The doctor saw nothing wrong physically, and there are no signs of poison.

“Shut up,” she says fast, like staccato notes. She keeps saying “shut up” over and over until that train of thought spills over into a narrative about being mistreated and abused. Over the years, I’ve heard different forms of this trauma, and sometimes a gun pops into the picture, but the man holding the piece is never revealed. Other times my imagination creates something more sinister, an unshakable notion that I am missing an important piece to this puzzle. It’s impossible to know what is true and what is a delusion.

“This is why you need help,” Jason says.

“You’re out of your mind if you think anyone will listen to me. It’s been twenty years…” She picks her purse off the hospital bed and turns it upside down, dumping out the contents. Scattered across the bed are receipts, candy wrappers, tissues. “I need cigarettes.”

“The ambulance is on the way,” I say, which I immediately regret.

She stops rifling through the contents of her purse and looks at me again as if I have just revealed that aliens have landed in Florida and are kidnapping all children under the age of seven. “They’re diesel trucks. No more fumes, Joseph.”

I can already see the ambulance scene: The EMTs will have to strap her down to the bed. She will gasp for oxygen, convincing herself that she can’t breathe as the ambulance spews invisible death. Over the years, Mom has been thrown into many different police cars, handcuffed and treated like a prisoner. She’s been strapped down to hospital beds and forced medication. She needs the pattern to end. She needs, at least, the appearance of choice.

Leaving the room, I see the EMTs are already walking through the automatic doors. The first EMT is named Jared, and he is tall with a shaved head. He is wearing thin-framed glasses that rest on a crooked nose. He must have been hit many times. The other EMT, Drew, is shorter, and he looks like no matter how hard he tries, he will always appear like he just graduated from high school. He sports a spotty shadow on his chin.

I quickly explain the situation with Mom and the ambulance. They suggest restraints, and I implore them to find another option.

“Joseph!” That’s when Mom came barreling around the corner. “Joseph Alan Lapin.” Then she witnesses me talking to the two EMTs, and I can tell she wants to yell something dramatic like, “Et tu, Brute?”

The EMTs stare back at each other and, without saying a word, nod to signal they understand.

Mom fixates on Jared suddenly. She points her finger at him and starts to shake her head: “I know you.” She is staring at him suspiciously. It’s as if she is about to rip off his mask and reveal that he is actually Dad in an elaborate disguise.

Poor Jared. He didn’t know what he was walking into, just like so many other strangers that have become a projection of one of her internal battles. I can imagine her gaze is causing Jared a considerable discomfort, but he stands stoically. Perhaps Jared is considering strapping her to a gurney. She is in the middle of a rant about the diesel from the ambulance and how it will make her sick when he says, “We actually have gas trucks.”

Jared understands our situation. The ambulance they currently have runs on diesel, he explains, and they will need to ask about switching trucks with another driver. Jared and Drew scurry outside to inquire.

“I don’t trust that guy,” Mom says. She is whispering as though the hospital is bugged with microphones so microscopic they can be implanted within cells.

The nurse comes back into the room, holding the paper cup with Mom’s medicine, which she claims is too high a dose. Eventually every dose becomes too high. She will swear off the pills like she is abstaining from chocolate for Lent. Jason grills her further about the medicine, but she ignores him and sorts through the contents of her purse with her phone in the other hand. She hangs up the phone and starts dialing again. Then she points toward the nurse. “This idiot took my pills away from me.”

When I watch her interact with the nurses, I can’t believe she is the same woman who would hold Jason to her chest when he was a baby and lean forward, turning him upside down so he would giggle; who taught her two sons how to read music and sing in harmony at the old upright piano.

I walk out to check for an ambulance when I see the two EMTs wheeling a gurney into the emergency room. There is a strap on the gurney, and I begin to protest. Jared and Drew say the gurney is mandatory, but there will be no restraints. I go back into the room and find Mom sitting on the bed, still on the phone.

She had determined that she needs to be sent to The Arbour, a hospital in Brookline, because she had a somewhat positive experience there before. She looks at her things scattered across the bed. She closes her flip phone and picks up the remnants of her yogurt and scoops the rest into her mouth quickly, as if she is about to embark on a journey across the commonwealth. Jason tries to help, moving closer to the bed and putting the paper and trash into her pocketbook, but Mom throws down the yogurt and rips the purse out of Jason’s hands.

The nurse knocks on the door. “Time,” she says, with such enjoyment I think I saw her smile.

Jason and I move into the hallway so Mom can collect her things in private. Jason is standing there with his hands in his pockets, peering down toward the end of the hallway. Perhaps he is asking himself the same question I usually do: Do we have the right to shape her waking dream?

We know the next steps quite well. She will stay in the hospital until the psychiatrists hit on the correct balance of medication. During her stay, we will receive endless phone calls from the pay phone in the unit. When we bring up her treatment or medication, she will hand the phone to other patients, saying that we must talk with so-and-so. This woman is an artist. This man is writing a novel. Such wonderful people.

It is almost twenty minutes before we see her turn the corner of the hallway. She is coming around the bend full-steam, and each step she takes on the white tile echoes through the hospital like an elephant stomping down a flight of metal stairs. She stops short of the gurney.

“No way, no how,” Mom says.

“No restraints,” Jason says. “Just a seat belt.”

She looks at the bed and puts her hand on it, as if testing the temperature of a pool before jumping in. She looks at Jared again with that same expression that suggests she is looking into his nervous system as a way to verify his identity. With one final attempt to instigate a distraction, she asks: “Don’t I know you? Ever attend St. John’s Church?”

“Just get in the ambulance,” I say under my breath. “Please just get in the ambulance.”

“We haven’t had the pleasure until today,” Jared says.

With that she sits down on the edge of the gurney. I can suddenly notice the exhaustion in her body. Jared and Drew lift her feet off the floor and snap together the seat belt. They roll her through the emergency room. Her hands are folded on her chest and her eyes are closed.

I hear a buzzing sound and Jared and Drew wheel Mom through a set of automatic doors which lead to the ambulance. Jared opens the back door and they prop up the bed, lifting her inside. Jason climbs into the back of the ambulance while I watch Drew secure the gurney.

Once in the ambulance, she wants Jared to shut the doors. She points to the left, where there are several ambulances running, and they are, in fact, diesel trucks. Jared smiles at us in the ambulance and shuts the doors. It feels like we are being enclosed in a tank.

At any moment, I imagine these two men will lose their patience. In the grand scheme of their day, we are only one family. In all the years that we have tried to help Mom with her illness, we have never met anyone who is this understanding.

“When this is all over,” I say to Drew, who is filling out paperwork, “I want to email your company.” I know that I sound like an octogenarian handing out a quarter to a bell hop, thinking that it is enough to grab himself a soda pop down at the country market. But I value their time and effort, and if there were more healthcare providers who approached individuals with mental illness in a similar way, then the prospect of healing would be higher.

“I want the contact information, too,” Mom says. “Make sure.”

Everyone in the ambulance laughs for the first time.

That’s when Jared sits down in the front seat and puts the key in the ignition. Finally, we have Mom in the ambulance on the way to the inpatient psych unit. I wait for the roar of the engine, but nothing happens. I wait a few more seconds for the sweet sound of combustion, but still…nothing.

I already know what is wrong. After spending hours convincing Mom to enter the ambulance voluntarily, the very vehicle we need to bring her to safety has shit the bed. Mom is suddenly unable to sit still, and Jared and Drew beg her to relax. Mom unbuckles her seat belt and starts to slide out of the gurney.

“You can’t leave the gurney once you’re on the ambulance,” Drew says.

Mom starts to hyperventilate and hold her throat. Jared and Drew recognize this performance, and Jared says, perhaps untruthfully, that if she were to leave the gurney, then they will be required by law to bring her back inside, and she will have to find a different crew.

Mom has her hand on the seatbelt and I can see that she is wrestling with the consequences — a positive sign. Then I watch her lay back on the gurney, fold her hands on her chest and close her eyes. It seems she has finally surrendered.

After the second ambulance arrives, we start our journey toward The Arbour with me following behind in Jason’s Subaru. In order to elude traffic, we have to drive down Route 2. I open the windows a crack to feel the cold air and slap myself in the face to avoid falling asleep. I can see the Massachusetts Correctional Institute at Concord emerging near the roundabout. At the first red light after the roundabout, Mom starts to wave at me as if we are in separate cars on the way to a vacation. She expects me to wave back. I give her a quick acknowledgment, and I notice she is smiling. Strangely, there is happiness in her face. Yes, it is mania, but still.

That’s when I see something bouncing on the road. It goes underneath the ambulance and pops out the other side. I hear a smack and swerve the Subaru out of the way of the metal object skipping on the highway. The ambulance slows down and pulls over into the breakdown lane. I sit in the car for a moment, staring at the flat tire in disbelief. Jared comes out on the driver’s side and he just throws his hands up in the air, admitting that all of this was out of his control. Mom is laughing from the gurney. At what exactly, I’m not sure, but it is probably the knowledge that we will always have breakdowns to remind us we are family.