Revenge of the Needle Fairy

Dec. 5, 2016

Hold Me Tight and Fear Not, or The Revenge of the Needle Fairy

“For they may turn me in your arms

To a fearsome dragon snake

But hold me tight and fear not

All for your child’s sake” - Tam Lin, traditional English ballad

“When Sweeney heard the shouts of the soldiers and the big noise of the army, he rose out of the tree towards the dark clouds and ranged far over mountains and territories. A long time he went faring all through Ireland, poking his way into hard rocky clefts, shouldering through ivy bushes, unsettling falls of pebbles in narrow defiles, wading estuaries, breasting summits, trekking through glens, until he found the pleasures of Glen Bolcain.” - from “The Madness of Sweeney, trans. Seamus Heaney

I knew my day was about to get more complicated than it was already when I drove up to my patient’s house and saw two ambulances and two state trooper cars parked there, askew at the end of the steep driveway, lights flashing.

The morning had already gotten more complicated than it needed to be when Hank, my oldest son, asked if he could ride around with me in my car while I made my rounds. Hank is 31 and is prone to seeing visions and hearing voices, and since the recent upset in the national elections, the voices had been louder and more insistent, at least judging by the way Hank was behaving, acting out and drinking heavily and declaiming that the end of the world was at hand, polishing and cleaning his shotgun.

This morning he had calmed down enough to pass as normal, after hiking down from his mountain top campsite, where a heavy frost had fallen the night before. Seeking human company, something to distract him from the incessant and furious dialog plaguing his inner ear, he purchased a couple of 40 oz. bottles of malt liquor and asked if he could ride with me as I made my visiting nurse rounds. He’d done it before, when he could not bear to be alone. I told him he would have to stay in the car and keep quiet.

I parked down on the road, away from the house where the woman, suffering from the daily advance of the cancer in her body and brain, had so alarmed her young caregivers that they had called 911. They had called me earlier, but without expressing to me how worried and frightened they were, or how the grandmother had changed overnight. So I didn’t get there soon enough to reassure them, with the result that there were now about a dozen emergency responders in and around the house, fussing with their electronic tablets and trying to get the pulse oximeter to work properly. I knocked on the door and went in.

The family lived in a well loved, crowded old two story home in the village, with a flock of teenagers, young Moms with diapered toddlers, hound dogs, grizzled Chihuahuas, cats, parakeets, guys with tattoos. The house smelt of cigarette smoke and coffee. The police officers and EMTs moved from room to room asking questions. I identified myself as the Hospice nurse and went into the bedroom where the woman lay, unresponsive and breathing heavily. “She wasn’t like this last night!” the granddaughter explained, wide-eyed, tearful. We discussed options. Of course she could be taken to the hospital to be evaluated, but what then? One of her daughters, bleary eyed and disheveled from spending the night at the bedside, began to cry. We were waiting for the oldest daughter, who had the decision making capacity, to arrive. I spoke to the patient and stroked her arm. Her eyes were open but stared unfocused. Her bald head turned on the pillow.

“It’s OK to keep her home,” I said. “In the ER she’ll be poked with needles and tested and all that. She was just there last week so you know what it’ll be like.”

“Why is she like this? She was out of bed last night and ate dinner and asked for water…”

“She’s dying.” I hoped I sounded gentle. “Her body is trying, but it can’t fight any more. I’m sorry.”

Louder sobs. At this point one of the teenage girls came in and said, “There’s a drunk guy down at the bottom of the driveway.”

Damn. That would be Hank. I told them that it was just my son and that he was harmless. The daughter in charge had arrived and was talking to the officers. “Mom didn’t want to go back to the hospital. She was furious when we took her there the other day. She said ‘No more’. She wants to be home.”

The emergency team accepted this verdict and started to pack up and leave. I spoke to the daughter and the other women about caring for the mother. She would just stay in bed now. They nodded, tucking the blankets around her. I gave them some supplies: swabs to sooth her mouth, disposable pads for the bed. I went over the medications: morphine, haldol, ativan, to calm her, to soothe the pain.

Then the blonde daughter who had been weeping came back into the room, angry now. “There’s some drunk asshole down on the road spouting off and using the N-word! “ She hugged her brown skinned toddler to her side. “I do not need this today! My husband and kids are African American…I’m about to go down there and kick his ass!”

I was already out the door, apologizing. “My son…he’s not in his right mind….” Furious, I charged down the hill. As soon as the cops and ambulances - entities with which Hank was extremely familiar and which he had respected by remaining silent as long as they were in the vicinity- were gone, he had burst forth with an unleashed spewing of psychotic relief. He was standing bedside my car, beer in hand, and I was yelling profanities at him in a decidedly unprofessional manner.

“Get in the FUCKING car you FUCKING asshole! You are going to get me FUCKING fired!”

Shaken and seething, I drove him away. The only two things that saved the situation, in my mind at least, from almost certain disaster, were [1] that we were in the village where Hank often travels on foot, so I could claim he had seen my car and stopped to plague me rather than admit to the admittedly poor judgment of letting him ride shotgun with me while I’m on duty. And [2] the fact that earlier on, I had managed to doctor up one of his beers with a hefty dose of antipsychotic medicine, which was about due to go into effect, and if I was lucky, drop him in his tracks.

“Goddamn it, Hank, you are going to go to sleep for a LONG TIME!”, I thought to myself as I drove him back up the hill towards his camp site. That family would undoubtedly call my manager - as they should; I would have done the same- and I would have to explain myself, with perhaps serious consequences to my job, which was my meal ticket. A job I needed, a job I liked, a job I could not well afford to lose any time soon.

Up the steep hill. Brown late autumn leaves drooping on the trees. The neighbor’s billy goat, tame and untethered, eyed us quizzically. Hank, quiet now, grabbed his pack, his phone, his coat, his beer. Dropped the phone in the leaves, fumbled for his knife, his wallet. I was out of the car beside him, bundling up his tattered and campworn possessions, hurrying him along. “Can you drive me up to the top?” “NO!” It was a step and slippery dirt track up a perpendicular hillside, which I swore I would never drive up again each time I drove up it. “I have to work. You may have lost me my job.” I fished for his phone in the leaves, considered keeping it so he wouldn’t lose it along the way, but then handed it to him, jumped back in the car and started to drive off.

“Take me to the Pub tonight?” he called after me. It was Pub night and I had said I would take him and his friend there the day before, when things had been a little less chaotic.” Call me”

“I’ll call you.”

You’ll be asleep, I thought to myself, leaving him standing at the foot of the mountain track, tall and blond and ruddy, strong and broad shouldered. A handsome figure of a man, my young son. He whose cry had woken me from my first exhausted sleep on the night after he was born, stirring against my side like an otter pup.

He did call me later that afternoon, but then the phone fell silent and as the shadows lengthened over the valley I began to worry about him. At night fall, and despite my promise to myself not to do so, once again I drove up the winding hand hewed track, all the way up through the darkness to where his tent was pitched. The campsite looked deserted in the twilight, his sometime companions not around. Tarps were strung up between the trees and plastic jugs and beer cans scattered around. I approached his tent from which emanated a gentle snoring. Called to him, unzipped the tent to see that he was covered up, with a thin blanket at least, not freezing. I shook his leg and called to him again but he didn’t stir or wake. So I went down the hill and went to the Pub myself, where in the dim glow of the bar light and to the clink of glasses and sound of mandolin strings I could tell a few people the story of the day, or at least part of it, and make what I hoped was a tragicomic tale of it, the martyred mother’s tale.

He must have slept right through until the afternoon of the next day, never remarking or wondering why he had slept so long, either unsuspecting or not wanting to lose face, or both. The next night it rained heavily and he called me, a mix of frantic and demanding. “Can you come pick me and my shit up? I’ve got to get out of here.” No dry firewood, no food, alone, my refugee from “My Side of the Mountain.” I drove up the steep steep hill- never again!-and in the pitch black helped him load a summer’s worth of necessities and detritus into my long-suffering SUV. A wet, mildewy old leaf smell pervaded the car as various rucksacks, duffels, rolled up tarps and assorted pots and pans, rakes, saws and axes were heaped in.

We left most of it in the car when we arrived back at the haven of my tiny, stuffy apartment above the former post office in the little postapocalyptic ghost of an upstate town square. He was raving again, demanded beer, berated me for calling the cops on him years ago and telling the psych ER nurse that he had a submachine gun buried in the yard- a thing I regret doing, but then it is the only reason they kept him in the hospital that day and gave him any kind of medical treatment- a recurring theme with him when feeling stressed and oppressed. I palmed more haldol into his beer, hoping he’d sleep.

That night I woke up after sleeping for an hour. He had fallen asleep on the futon in the room next to mine, tossing and sweating in the blankets, after downing large quantities of alchohol- eleven beers out of the 12-pack- heavily laced with the medication. I lay awake, listening to his breathing.

I’m thankful that we are living in the era of antipsychotic medications, although he hates them and will resist the idea, the mention, or any hint of a suggestion that they do him any good. According to his philosophy, they are poisons. They cause impotence, sterility. They are devised by evil sadistic doctors who want to keep him weak so they can have all the women to themselves. These evil old white men are the cause of the world’s agony, and of Hank’s agony, and as such they must be destroyed. This is Hank's philosophy and creed, which he preaches to anyone who will listen or to the empty air.

And his father had given him back his shotgun. Albeit when Hank had been in a much more docile and rational frame of mind. Back in the summer. Back just after I had gotten that last shot of long acting meds into him.

Now the shotgun and shells were placed on a low shelf beside him, within easy reach. In easy reach of my hand was a syringe full of his medication. I could not let this opportunity pass.

Whenever the Needle Fairy, as I like to call my alter ego, performs this bizarre and heartbreaking act of motherly love, much caution is required. Hank must not catch me in the act. Once or twice I was almost sure he knew that something had happened to him in the night. He even came up with the term “Needle Fairy” himself , growling, “Huh…. I guess the Needle Fairy was here last night,” as he examined his sore arm. But other times he seems to have forgotten all this, and just rolls with the new turn of events: the sudden smoothing out of relationships, the calm, the surprising way he will fall asleep after drinking only three or four beers. Last time I filled the prescription almost came to disaster when the pharmacy innocently called him to tell him his medication was ready and he confronted me in a rage, after going into the pharmacy and causing a scene, screaming at poor Mohammed, the mild and benevolent Pakistani pharmacist and telling him never to fill any such prescription again.

I later got the drug from Mohammed, but I had to pay cash for it, and I promised him that this type of incident would not occur again. “But this prescription should last him for a year or two,” I explained. It was nominally a 2 ½ month supply.

“So he doesn’t take it very often?”

“No, but when he takes it he REALLY needs it.”

He really needed it tonight. I was about to leave town for a ten day trip, Hank had nowhere to stay except at my apartment, and if he acted out too badly we would both be evicted. My fellow tenants had complained in the past, when he was really loud and obnoxious, and the landlady had warned me. He now had, for the first time in many years since we had confiscated it when he first became ill, a loaded gun. He was heavily sedated. I hoped it was heavily enough. It had to be tonight.

I turned on the bathroom light so as to be able to see what I was doing without the light possibly waking him. Luckily he had managed to undress, and was sweating under a down sleeping bag. I tried lifting it aside and he stirred as the cold air hit his skin. The bedding seemed wet. Damn, he had spilled beer on himself and was lying in it. I felt a pang of guilt at putting him in such a pitiful circumstance with my stealth therapy method. He stirred again. Carpe diem. The needle jabbed in, and I had to take a few long seconds to slowly push the plunger and deliver the clear, viscous fluid into the muscle where it would slowly, over the next weeks and months, disperse into his system.

Just as I was removing the needle he turned and woke up, growling “What are you doing?” I scooted the syringe aside, clicking the safety cover over the needle, and tried to speak calmly, something I am usually good at, screaming at him the previous morning being the exception.

“Let me help you, Hank. The bed's all wet.”

He took this stoicly, still half asleep, and stumbled trancelike into the bathroom to wash. I stripped the bed, threw the soiled bedding aside and laid down towels and a quilt. He went back to sleep. I went back to sleep. The Needle Fairy’s instrument of mercy, sheathed and empty, lay hidden on my dresser behind a small brocaded eyeglass case.

Postscript

For ten years the Needle Fairy managed to perform her task, with subterfuge, patience and not a little risk. On January 30, 2021, Hank died from suicide, while the Needle Fairy waited helplessly in the wings.