"Let's go home," he says. "Please let's go home."
"We're almost there, dude." I keep driving. I am relieved he doesn't try to open the car door as we drive.
He walks in on his own this time. No running or yelling, no threats. He walks up to the guard, whom he recognises, and asks if Clarence still works here. It turns out he does, but he is not on duty tonight. Clarence once drew my son a picture of Pikachu while he was asleep on a gurney in the emergency room hallway. He placed it by my son's side with a goodbye note: Keep shining, origami master. My son kept it for months, until one day he shredded it in anguish, throwing the pieces at my feet.
We are both disappointed to miss Clarence. My son remembers that Clarence is going to art school part-time after his shifts and wonders aloud if he is in art class at this moment. I remember that my son gave Clarence an elaborate origami dragon, and Clarence's eyes were bright as he carefully, delicately held it up to the light.
"Your son is different than anyone I ever met," he whispered to me as he said goodbye that night. "He'll be OK."
Tonight there is no Clarence, and this security guard does not tell us his name or draw pictures for my son. But he quickly takes us out of the main waiting area to the psychiatric check-in. Through two locked doors, past the adult triage area, and into another locked hallway with a desk near the door. They are expecting us. Five minutes later we are in one of the three empty rooms reserved for children. Bright lights, that familiar thin mattress with the see-through sheet, the flat, paper-covered pillow. There is a reclining chair next to the gurney, and I squint against the urge to angry-cry.
A nurse comes in almost immediately to ask the standard questions and tell us that there are no children's psychiatric beds available. In all likelihood it will be weeks before one opens up, so she will call around. The bed might be far away. My son might have to be transported by a police car because insurance does not cover ambulance trips that are two or more hours in one direction. If that occurs, I will not be able to accompany him, of course.
"He's 8," I say.
"Yes," she says.
She continues. There are two hospitals with children's beds in Maryland, but they will not take Virginia Medicaid, so she won't bother calling them. It would cost thousands of dollars a day, out of pocket, to send my son out of state. There probably aren't beds anyway, she says. There are so few places that take kids younger than 12.
My son has medical issues in addition to bipolar disorder, and he needs a psychiatric unit that is attached to an actual hospital. This makes it even harder to find a bed for him. So they search. We spend three days in this room waiting.
Finally he has a bed, but it is in a hospital many hours from our house. To my great relief, they decide he is safe enough that I can drive him there in my car. A friend's son was not so lucky and had to be transported in handcuffs by a sheriff's deputy to a hospital six hours away. She texted me a photo of her heavily sedated 11-year-old being thrust headfirst into the back of that police car.
I go to the ladies room to wash my face before taking my son back to our van, pushing my fists into my eyes to wake up.
At the hospital they reset his medications, restarting the complicated process of observation and side-effect management. He refuses to eat or drink, throwing his Lithium levels into dangerous territory until they eventually allow me to bring him a peanut butter and jelly sandwich, an apple and a bag of chips, when I visit. On the third day he is physically assaulted by his roommate. On the fourth day he begins to call me every night as bedtime approaches, sobbing and begging to come home. The phone is taken from him by an angry nurse, and I throw up in the kitchen sink as my cellphone blinks "call ended."
On day five he meets an occupational therapist who teaches him how to make slime, distracting his nervous, seeking hands. She shows the nurses how to help him avoid meltdowns with meaningful work instead of endless television and coloring pages. He starts to feel better as he organises their cotton swabs and bandages, passes out snacks and teaches the other kids how to make origami foxes and frogs. He charms the nursing assistants with poetry he composes on the spot. He goes two full days without threatening to kill himself, and the psychiatrist thinks he can probably continue treatment on an outpatient basis.
Eight days after he arrived, I bring him home. There is no step-down support because our city is so far away from the hospital. No connection to outpatient services, nobody working with his school, nobody checking his progress. His teachers do not talk about his hospitalisation. They are jumpy, panicked. The principal questions whether this is the right school for my son. His classmates whisper and stare.
The walls between him and his friends are shoulder height, requiring time to knock down. But the walls set in place by the adults in his life are so high he cannot even see the top. The same adults have barricaded me inside with him: I have failed him.
But under his thin, delicate skin, he is sunshine. As he heals, I see his friends and teachers begin to peek over the walls and through the cracks, pushing through inch by inch, first hesitantly and then enthusiastically. Even the school librarian, once so irritated by his constant chatter and requests, finds him in the hallway and gently places a hand on his shoulder.
"I saved the new illustrated 'Harry Potter' for you," she says, blushing as he holds it to his chest and recites poetry in her honor.
"You're different than anyone they ever met," I think. "You will be OK."
Hannah Grieco is an educational advocate and writer.
