ANOTHER BOTTLE OF PILLS         

Another bottle of pills, another phone call from my mother telling me that my sister has overdosed. It has been almost one year to the day since the last time. A year ago, I drove four hundred miles, stood by her hospital bed and mourned the wasted potential inside her lifeless body. That night, when I walked out of the hospital and into the blowing snow, I believed that I had seen Debbie alive for the last time. I believed that I had talked to her, argued with her for the last time. I had watched her self-destruct into the abyss of addiction for thirty years during which I learned the difference between crack and crank, which drugs she snorted and which she injected, and, perhaps worst of all, the degrading things she did to obtain them. She spoke of running drugs for a motorcycle gang, and I shivered in horror as I watched her eyes dance, thrilled at the edge of danger. Motionless and frail, machines keeping her alive, she looked as though she’d taken her last joyride.

            At my mother’s place, ten minutes from the hospital, while I wrote in my journal about saying my final farewell to Debbie, my mother made phone calls and procured the cemetery plot next to my maternal grandmother. We’d had thirty years to prepare ourselves for Debbie’s death; neither of us was shocked.

The next morning, I went back to the hospital alone to speak to Deb’s doctors. I needed to know the process of terminating life support. My family had experienced death – my father’s sudden heart attack at age sixty-four; his mother’s subsequent year-long deterioration and death; three years later, my grandfather’s pneumonia and death three days later, after a stroke; a sister-in-law’s terminal brain cancer in her twenties, leaving behind two toddlers and my dad’s grief-broken brother; my mother’s brother, of heart failure in his fifties, after years of alcohol abuse – but, none had been on life support. Was Deb’s husband, Garry, who was at the hospital for a few hours in the evenings after work, the only one who could legally discuss the situation with the doctors? He seemed to be moving in a daze, and I needed to know what to expect, what to do when the time came. Garry said that according to the quantities and fill dates on the pill bottles laying on the floor around the sofa where he’d found her unconscious, Deb had taken about three hundred pills over the course of three days. Overdose deaths have made news headlines for years, but I’d never heard of anyone ingesting that many pills. Her prescriptions were for Xanax, Valium, Vicodin, muscle relaxers and various over-the-counter pain relievers and cold medications.

            “I’m her sister,” I said to the nurse at the desk in the critical care unit, “and I’ve been told that she took about three hundred pills over the last few days. Can you tell me her prognosis? We need to make preparations, and her husband hasn’t talked to the doctors.”

            “She took three hundred pills that day,” the nurse said. “The EMTs gave her NARCAN and charcoal just in time. Another thirty minutes, maybe fifteen, and it would have been too late. She told us that she didn’t intend to wake up. But, she’s awake now if you want to see her.”

 I didn’t recognize the nurse from the night before, and I thought that we must be talking about different patients. I verified that she was talking about my sister. “She was very agitated earlier, so we sedated her somewhat, but she’s sitting up talking”. The nurse turned toward Deb’s room in the semi-circular unit.

 “I’m not sure that I should go in there,” I said. “I might upset her. We haven’t talked in a long time.”

            “I’ll ask if she wants to see you,” the nurse said, nodding. Having no idea what I’d see or what Deb would say, I fought the urge to run out the door. The nurse returned in a moment and motioned for me to follow her. She said, “Do you know if she and her husband are having problems? She said he’s divorcing her, and it upset her.”

“No,” I said. “He was here last night. The Valentine’s Day songs on the radio seemed very painful to him.” I walked to the door of Deb’s room, donned my best poker face and looked in.

            “At least I’m skinny,” she said, the hospital gown hanging off one shoulder, revealing purple letters of a tattoo on her shoulder. Her hair stuck to her head, matted and greasy, and purplish black circles encased her eyes. I passed her bed as I walked to the only chair in the room. She reached for my hand and fingered my bracelets.

            “Pretty jewelry. You’re so lucky. Jim is so good to you.”

            “I’m the luckiest woman in the world.” I slid into the hardback chair and kicked my handbag underneath with the heel of my boot. I cleared my throat and searched for something, anything to say. “I’m glad you lived” didn’t seem appropriate, especially since she apparently wasn’t. I definitely couldn’t tell her that she looked good, bones jutting out, hair matted, face blemished and unwashed.

            “Where did you find those jeans?” she said. “I’m still wearing Levi’s. You’re awful dressed up for a hospital.”

            “I threw on some jeans and a jacket. Have you seen all the snow outside? I could open the blinds if you’d like.”

            “You don’t have to avoid looking at me,” she said, and then she snorted that sardonic laugh that told me she thought I was clueless.  “I know I look like hell. You don’t attempt suicide and come out of it looking like a fashion model. You could ask me what I’ve been doing for the last two years besides swallowing pills. Or, maybe you don’t want to know.”

            “Debbie, I don’t know what to say to you. The nurse said that you told them you didn’t want to wake up. I don’t understand that. Why would you want to die? What in your life is so bad that you’d rather die than face another day?”

            “You’re such a snob,” she said. “Why did you come here? You can’t understand problems if you’ve never had one. You have your perfect husband and your perfect marriage and your perfect little life, lucky you. News flash, we aren’t all as lucky as you. Garry’s divorcing me.”

            “Debbie, I don’t know what’s going on with you, but that isn’t true. He was sobbing in the waiting room last night. He’s broken hearted thinking you’re in here dying.”

            “Oh, no,” she said. “He’s divorcing me, just you wait and see.” After ten minutes of fruitless arguing, I changed the subject. The nurse who had shown me to the door came to check her vital signs. I left the room and called my mother and my niece to tell them that Debbie was awake. I hadn’t the heart to tell them that she brought along her tiresome, surly attitude. My niece showed up at the hospital first, armed with comb, brush, dry shampoo, hair detangler, face cleanser, perfume, deodorant, makeup. She set her loot on the bed table and started to work on Debbie, a job far too familiar to her at twenty years old. I watched her gentle hands work at the knots in Deb’s hair, and I thought , There’s no wonder she wants to be a nurse; she’s already had years of training.

            The first two or three knots that my niece attempted to untangle drew annoyed grunts from Deb as she sat on the side of the bed, complaining that Garry wasn’t at the hospital. I explained that he was working as many hours as he could, since no one knew how long she might be in the hospital; he didn’t know when necessity would require him to take time off work later. She remarked upon another piece of my jewelry and reminded me again how lucky I was to have such a thoughtful husband. I choked back the urge to respond that my husband didn’t wonder every day whether he’d find me conscious when he came home.

            Within an hour, Debbie said, “It was nothing. I took an extra Cymbalta. It’s no big deal. I’ll be out of here tomorrow.” My niece hit another snag in the tangled mass of Debbie’s hair. Debbie reached up and slapped her hand. “Ouch,” she snapped. “Stop hurting me.” I walked to the door and motioned for the nurse and told her that my niece and I were leaving, that I thought that my sister needed to rest. I asked her what would happen next. She said that due to the extreme amount of drugs in her system and the fact that she came so close to death, Deb no doubt had suffered heart, lung, liver, kidney and brain damage, the extent of which would be determined by a barrage of tests administered in the progressive care unit, when Deb was stable enough to be moved. After treatment for her physical trauma, she would be transferred to the psychiatric ward for evaluation and treatment. The psychiatrists would work with my brother-in-law to place her in a rehab facility to address the addiction issues.

I told Deb that she should rest and that my niece and I were going to lunch. Deb told my niece to come back to the hospital to visit later; she told her to go out to the house and spend the night, because her stepdad needed her.

            “No, Debbie,” I said. “She’s going back to her own apartment. And, she’s going to work tomorrow. You’re out of the woods now, and she has a life of her own.” I pushed my niece out the door, my hand on her back. Deb continued, “Go on out to the house and spend the night; Garry really needs you now,” as we walked away.

            Safely in the hallway, I said, “Your dad is not your responsibility. You have a life, and so does Mom, and I’m staying until you both get back to them. Your mother is exactly where she needs to be.”

I called Mom and told her about Deb’s hitting my niece. I told her that Deb decided that one too many anti-depressant pills had caused the overdose. I told her that we were going to lunch, after which I was sending my niece home.

Like an actor prepared for a role, Debbie knows how to play the rehab and psychiatric systems. Two days after she woke up, while Garry worked to find a long-term rehab facility, a nurse called and said, “Your wife has signed herself out; you need to come and get her.” And, she came home.

            In the past year, she has overdosed, and she has attempted suicide. Last fall, while my husband and I were out of the country for several weeks, she spent several days in psychiatric evaluation and was diagnosed as bipolar. For awhile, she made monthly visits to a psychiatrist and weekly visits to a psychologist. I called and encouraged her; I bought every highly recommended book on bipolar disorder I could find in triplicate – one each for Debbie, Mom and me. My hopes were buoyed that maybe her addiction was based in a mental illness that could be treated, and if she got treatment for the underlying illness, she could stay sober. I worried when, a month into treatment, she complained about gaining weight on Lithium.

One afternoon in January, Deb called, and I felt as much as heard the stick-and-slide slur in her voice. For months, I’d heard it off and on, but I hadn’t wanted to throw away our hopes of her recovery. I was almost expecting my mother’s phone call a few weeks later. Another February, another bottle of pills, another night of wondering if she will wake up this time.