My words speed up now that I’ve gotten to the major point. “Was Mason simply getting older, so his behaviors were interpreted differently and described more aggressively, or was he indeed getting more violent and aggressive? And if so, was it enough to hurt someone else?”
“So if I’m hearing you right in all of this, it sounds like he could’ve been?”
“It’s definitely possible that he could engage in violence, but it’s also equally possible that he’s not violent at all.” I shrug my shoulders with my hands up. “I’m sorry. I wish I had a more clear-cut answer for you.”
“But he definitely attacked those cops. He chucked rocks at the paramedics and bit his mom, which seems pretty aggressive and violent to me.” His lips are set in a straight line.
“That’s the first time he’s ever done anything like that. Believe me, if there’d been other instances like that, they would’ve been noted by his teachers or witnessed in at least one of the numerous testing sessions he’s had. Nobody describes him like that.” He takes in the information slowly like he does everything else, as if he’s always trying to decide whether to accept or reject an idea. “All that stuff down by the creek with everyone else? That was just a classic fight-or-flight response, and he was in fight mode. He had no idea who the enemy was, so he came at anyone that got close to him.”
It satisfies him for the moment. “What else do you have for me?” he asks.
I reach into my bag and pull out the copies of the psychiatric case notes, the single ones that don’t appear connected to a full report. I hand him his copies. “There’s other important stuff that might be helpful too.” I point to the papers I just gave him. “These aren’t connected to any of the other big reports in the file. I haven’t been able to find any place where they belong.”
I give him a few seconds to scan the content. His forehead wrinkles in thought while he reads. He looks up at me when he’s finished, immediately intrigued.
“I don’t know if you can tell, but these are progress notes from a psychiatric facility. One of them is from Children’s.” I point it out just in case he missed the letterhead. Children’s of Alabama is one of the few hospitals that provide inpatient psychiatric care to kids in Alabama. “He was admitted more than once, and one of the times it looks like he had ECT therapy.”
“Is that where they shock people? Like that guy in that movie? Dang, what’s that movie?”
“One Flew over the Cuckoo’s Nest?”
He snaps his fingers. “That’s it.”
“That’s the movie that always comes to mind when people think about shock treatment.” I roll my eyes, but I can’t help smiling at how proud he looks of himself. “Thankfully, the field has gotten a bit less barbaric since then, but yes, shock therapy induces a seizure. Even though it’s much more tamed down and not nearly as controversial as it used to be, it’s still an extremely invasive therapy that’s only used as a last resort in severe cases of depression.”
“So the kid’s been shocked . . .” He takes a minute to let that sink in. I’ve noticed he rarely uses Mason’s name. Must be a way for him to stay detached. “I just go back to being a family man myself over and over again in all this. And I can’t imagine the state one of my kids would have to be in for me to let them shock their brain and send them into a seizure.” He struggles to digest it like he’s eaten bad food. “Why would someone let people do that to their child? Even if it was a doctor?”
“You might consider it if your child was in a bad enough shape,” I offer. I haven’t stopped thinking about it, either, or reading up on the cases where it’s been used. “Mostly, it’s given when a child is catatonic and the period of catatonia has gone on to the point where they worry it might become permanent. Catatonia is like that. If your body shuts down for long enough, sometimes it doesn’t restart. They view it like an old car with a dead battery getting a jump start.”
“Wow, that’s some messed-up stuff right there,” he says, and coming from him, that’s impressive, given everything he sees in his line of work.
“It’s not the only piece.” I push that aside and slide the next hospital note over to him. “This is another one that looks like it’s part of an intake made on admission to the inpatient ward of White Memorial. At the top of it, someone writes in psychosis as a rule-out for the diagnosis. Less than five percent of kids have a psychotic episode. All of this stuff that I’m pointing out”—I motion to the papers splayed out in front of us on the table—“I’m doing it because none of it is anything that we’d typically see in a child with autism spectrum disorder.”
“Really?”
“Absolutely.” I nod my head determinedly. “That’s why it’s so alarming, especially when we only have a few of the pieces of the reports. Am I missing anything?”
“You’ve got everything that I do.”
“Where’d you get all this?”
“Genevieve. There’s no way we could get these kinds of medical records without a serious subpoena, and even then, we’d be pushing it. At least in this stage of the game. She brought in a folder filled with his stuff the first time we met. One of the ladies up front made copies.”
“Will you see if she has any missing parts?”
“Of course.”
“Then there’s the biggest red flag.”
“There’s more?” His eyes grow wide.
I nod. It’s a lot to take in, and I give him another moment before going on. “Mason has psychiatric issues and seizures that Genevieve’s never mentioned to you or listed in his medical history. That’s really odd.” I lean forward in my seat. “And on top of that, Mason has a severe intellectual disability too.”
“Okay, I know that’s important because you’re telling it to me, but you’re telling it to me like I’m supposed to know what it means, and I’m sorry, but I don’t.”
“A person is considered intellectually disabled if they have a reduced ability to understand information and learn new skills.”
“Still, what’s that mean? He has trouble reading? He can’t do math?” He looks like I’m speaking another language.
“It’s what we used to call mental retardation, but we don’t call it that anymore since people finally wised up to how offensive it was and stopped using it. We call it having an intellectual disability now, and they range from mild to profound. Most people are in the mild range.”
“But you said Mason is severe, didn’t you?”
“I did, and yes, he is.”
“On top of everything this kid’s dealing with, he’s also intellectually disabled? That’s what you’re telling me?” I nod. He takes a second to think about it before adding, “What a tough break.”
I can’t help agreeing, but it’s not the most important point in all of this. We haven’t even gotten there yet. I bring us back full circle. “Here’s the big thing about Mason’s intellectual disability that you need to understand—it puts his mental age at about four years old.”