Bipolar disorder can be an exhausting, nerve-wracking condition for patients and their families alike. In an excerpt from This Fragile Life, two parents learn of their son's illness. The book will be available in bookstores June 1.
Exactly one week later, returning home after dinner with friends, we found a voicemail message from my father in Washington, DC.
"Charlotte, where are you? I think Mark is in trouble," he said. "You need to call me." His voice sounded urgent. I called immediately. My father was not an alarmist; I knew he was worried. Mark had called my father when he could not reach us, and they had talked for almost an hour.
"I couldn't get him to stop talking," my father reported. "When I tried to ask him questions, he didn't seem to understand. I . . . I don't know, honey. He sounded really strange. He wanted to talk to you; he explicitly said, 'I do not want to talk to my father.' You need to call him. Here's the number."
I stopped shivering and calmed myself enough to dial. Houston sat nearby for support. Could Mark be in trouble? We had no idea what it all meant.
When Mark answered at the unfamiliar phone number, I asked immediately, "Mark, where are you? Why are you using this strange number?"
"It's a phone booth in Westwood Village," he told me.
I knew the area well since UCLA is in Westwood. "You're not near home at all. What's going on out there?" I prodded, trying to keep my voice steady.
When he answered instantly, "I don't know, Mom," I thought perhaps he had been in an automobile accident and someone was badly hurt. Perhaps the accident was his fault, and he was upset and confused. Mark continued, "They're watching me, Mom. I can't see them, but I know they're watching me. I don't know what to do. What should I do? Help me, Mom."
I was mystified and stunned into silence. I dared to ask, "Who's watching you, Mark?" He simply repeated, "I know they're watching, Mom. Help me. I don't know what to do." I heard his panic. It leapt the miles between us. The tone of his voice frightened me. I slid to the floor still holding the telephone. It was my lifeline to Mark. He began to gasp for breath, his words rushing one into another. Helplessly, I looked at Houston and wrote, He's crying!
I kept repeating slowly, "It's going to be all right. It's OK, Mark. Sh-sh-sh. We'll think of something. It's OK. We're here," like a lullaby. I had no idea what to do. If only I could touch him, I thought.
"Mark, why don't you go home? Isn't Lisa at home?" I asked.
My words startled him, and he shouted, "Oh no! I can't go home. It's not safe there. I can't trust her!" I heard the panic again. I decided I had to slow down the conversation. "Mark, I need to tell your father what's going on. I know he can help us," I tried to explain. "No, no, no!" he said emphatically. "Don't tell Dad. He doesn't understand these things."
"What things are you talking about, Mark?" I asked, puzzled.
"You know, the extraterrestrials," he said, waiting for my response.
I nearly dropped the telephone. Mark and I had always had fun talking about and debating the issue of life on other planets. We enjoyed television programs that featured people who claimed to have seen flying saucers. Houston would always say to us, jokingly, "I'm out of here. That's your stuff."
I recovered quickly and said, "It's OK, Mark. Your father has changed his mind about those things. It's safe to tell him now. I think you should talk to your Dad."
When Mark became quiet, I knew he had accepted my feeble explanation. Houston spoke to his son. "I'm here with you, Mark," he said. "What do you want me to do?" Houston and I frantically wrote notes as he talked to Mark. We tried to figure out what action to take and how to give Mark the support he needed. Whatever he was afraid of was real to him. Speeding through my mind were the words, Is this a nervous breakdown?
"Mark, do you want me to come get you?" Houston asked.
Mark sighed as he answered, "Yes . . . I want to come home. Please . . . I'm scared." Our son's life had tripped over itself. It was August 1996. Within hours, Houston was on a flight to Los Angeles.
Armed with his own brand of courage, an extra airline ticket, and a small bag with a change of clothes for our son, Houston rushed to L.A. with promises of love and safety. Houston left Philadelphia with a mask of bravado. He kissed me good-bye, assuring me he would bring Mark home. I knew he was frightened of what he would find.
We gave Mark the name of a university friend and colleague who lived in L.A. We would ask her to meet him in Westwood Village. Houston and I needed help urgently, and Vera Jackson's name came to both of us as someone reliable in a crisis. I assured Mark, "Vera is a safe person; she understands. You don't know her, but she knows all about you. We've talked so much about you over the years. She will keep you safe until your father gets to L.A." Mark responded positively to the word "safe."
When I called Vera in Los Angeles, she was surprised to hear my voice after such a long period without contact. I was not sure I could ask her for the extraordinary favor of watching our son until Houston got to L.A. We were professional colleagues, not friends with a history of growing up together. When I explained Mark's situation and our need, Vera never hesitated. I was touched by her willingness to help us.
"I'm just so glad I didn't go away this weekend," she said. She went on to explain, "I'd thought about going to a conference in Texas, but then, for no good reason, decided not to go. I guess I was supposed to be here."
After asking for Mark's physical description, she agreed to meet him at a Starbucks in Westwood Village and drive him to her home about an hour away. She ended the conversation with, "I'll just keep him comfortable until Houston gets here."
I remained home in Philadelphia. My task was to prepare for Mark's return. He would need a check-up with our family doctor, I guessed. He obviously needed rest and a change of pace. Mark had never been seriously ill growing up. I was sure his condition was a result of overwork and that he would respond to my care at home, a bit of pampering. I prepared his old room for his arrival and bought groceries. Houston called home when he landed in Los Angeles. I paced and waited for the next call telling me my son was OK. Houston did not call again until morning. The drive to Vera's house, in the dark with sketchy directions, had taken him more time than he had expected. Fearing the worst, I slept little.
Houston telephoned me the next day and described the situation. After arriving at Vera's, he knocked and shouted through the door, "It's Houston."
She called to him, "Come on in. The door's open."
Mark was awake, resting quietly in her arms. "She was holding him like a baby," Houston told me. I heard the strain of incredulity still caught in his voice. "Mark looked at me but didn't seem to really see me. He said, 'Hey, Dad,' but it was like he had just seen me the day before. And it really didn't sound like Mark. It was like someone else's voice calling me 'Dad.' It was really weird. Vera whispered hello."
During the hours it had taken Houston to fly from Philadelphia to Los Angeles and then drive the hour and a half to Vera's home, Mark had slowly deteriorated. He had been talking nonsense, and Vera had been agreeing with everything he said. Mark had shouted at the top of his lungs off and on during the night, so Vera had asked a male friend to come sit with her "just in case something happened that I couldn't handle." She had watched Mark's moods change over the hours.
"Once my friend arrived, Mark seemed to calm more easily," she explained. Vera told us later that she had been so relieved to see Houston arrive with the morning light. Within a half hour of Houston's arrival, Mark became extremely agitated. He began to scream obscenities directed only at his father. His volume increased, and neighbors began to peer from their doorways. Houston told me Mark frightened him.
"It was daunting," he reported. "It was like my son was not really there. He was shouting and baring his teeth. It was like one of those horror movies, only I was in the middle of it."
Houston told me that Mark paced shirtless and shoeless throughout the first floor of Vera's house, "like a caged animal." He hurled random threats at both of them, and, at one point, he gathered all the kitchen knives and began to swirl them in a threatening fashion.
He spat challenges at his father, "You think you're going to take me back, but you're not. We're going outside, and we're going to race up that hill. See that hill? And I'm going to win." He proceeded to knock objects off tables. Houston worried he would break something precious to Vera. Mark pulled books from bookcases and heaved them around the room and then made several piles with them. Houston and Vera became increasingly fearful.
"When I tried to touch him, he violently shoved me away," Houston said. "Mark seemed to move out of himself. I watched it happen! I was frightened for him, but I was really afraid for Vera and myself. I felt like Mark was holding us hostage."
As Mark became more viciously threatening with the knives, Houston gestured to Vera to call for help. "I really did not want to do that," he sighed. "But I didn't know what might happen next. I just knew Mark wasn't listening to anything we said."
When Vera called the local hospital, they told her to call 911. The second call brought a special unit of the Los Angeles Police Department (LAPD), the "psychiatric evaluation team." The special corps arrived within the hour, accompanied by uniformed officers with weapons drawn and eight cruisers. When Mark saw the swirling police lights, he seemed to sense danger for himself. He immediately ceased his threatening behavior and, clutching Vera's dog, fled to a nearby closet. Houston said, "It was amazing how fast he moved. It was as if he knew something bad was about to happen."
Mark hid in the closet until the police coerced him out. He remained confused and unclear about Houston's relationship to him. "I know you are not my father," he said at one point. "They sent you in his place, didn't they?"
Numbed by profound sadness, Houston recounted, "All I could do was put one foot in front of the other in order to keep going. I couldn't really think." He confessed that if he had stopped to process any of what he was seeing or hearing, he "would have been rendered helpless." Houston said to me, "You know, one of the most horrible times for me ever--one that tears at me whenever it comes to mind or wakes me in the night--is Mark being taken out of Vera's house in handcuffs. Like he was a criminal. He was bare-chested, barefooted, and had on sweatpants she had loaned him. I just wanted to put my arms around him, that's all. They wouldn't even let me ride with him to the hospital."
In his rental car, Houston followed the police cruiser. The usual destination for LAPD psychiatric emergencies was County Hospital, but another caring friend in L.A. enabled Houston to get Mark processed through emergency into the UCLA Neuropsychiatric Institute, a private facility. The private hospital was expensive. Houston held his breath and charged five thousand dollars on his credit card in order for Mark to receive care. It was financially difficult for us, but we wanted Mark to receive the best possible treatment. Before the close of Houston's second evening in Los Angeles, the UCLA Neuropsychiatric Institute admitted Mark as a patient. Mark was irate, verbally abusive, and uncooperative. He was held for seventy-two hours, the requisite time for emergency psychiatric evaluation, medication, and treatment. He spent a portion of those hours in four-point restraints.
The events of Houston's L.A. days played and replayed in his head. "On the way to the emergency room, I could see the back of Mark's head through the back window as I drove; he was sitting so straight. He never moved. I prayed he wasn't too scared," Houston told me.
He notified Lisa of Mark's whereabouts as soon as he reached the hospital. He was then fortunate to connect with another of our friends who cut short a business trip in Colorado to come to Los Angeles to lend a hand. When our friend, Craig, arrived, he and Houston met with Lisa. She recounted in detail Mark's previous few months. Lisa had been picking up the pieces of Mark's life as fast as they fell away. She provided excuses for his absences to his professors and university administrators. Since Mark could not focus sufficiently to read school assignments, she read pages aloud to him. She held his hand and rubbed his back whenever he became anxious or fearful. Sometimes she typed his papers into the night. "He just needs to stop smoking so much marijuana," she said. She refused to believe he was ill.
While Mark was in treatment at the UCLA psychiatric unit, his anger did not subside; he remained profoundly paranoid. He accused doctors and nurses of experimenting on him. He shouted that they were rough and unnecessarily hurtful. Doctors kept him restrained. Houston wanted to stay with Mark, to help pacify his raging son, but the hospital staff did not appreciate his presence. No one wanted Houston's account of the recent happenings. Brusquely, an intern told him to step outside the room. "You're making the patient anxious and irritable," he said. Mark told doctors that Houston was an enemy and not his father.
In spite of the signal to leave, Houston stayed on in L.A. He returned to the hospital the next day, hoping to speak with doctors about Mark's condition. He sat in the hallway near Mark's room, patiently waiting for a medical update. Doctors and staff passed him by without acknowledgment. He continued to sit. From time to time, he stepped into Mark's room to assure him that he was not alone. Finally, a resident assigned to Mark's case took Houston aside and said, "You need to leave. You need to go home to Philadelphia. Your son is bitterly angry with you. You continue to agitate him, and he says you abused him."
Houston reeled at the doctor's words: a "madman's lie," he told me softly. Based on Mark's stories, the doctor suggested that Houston seek a psychiatric evaluation. When Houston told me about Mark's accusation and the doctor's response, I was enraged. It took months for me to understand his eventual diagnosis of bipolar disorder and the impact it had on Mark's behavior. At that particular moment, I only knew that Houston needed me more than Mark.
Once Mark was able to recite his name, address, and other vital information, he was released from the neuropsychiatric institute at UCLA. The seventy-two-hour hold was at an end. Mark returned home to Lisa. He never filled his prescriptions for Depakote to curb his mood swings or his antipsychotic medication to stave off paranoia and delusion. He did not keep his appointments for psychotherapy. He returned to school at USC and found a job at a parking garage in Westwood Village. Years passed before Mark was well enough to apologize to his father for accusing him of abuse.