Her words assault me like punches, and there’s nowhere to hide. I grip the banister behind me as my brain struggles to make sense of what she just said. Pieces of the report pass through my mind in quick snippets. I thought they referred to a male patient. How could it have been Savannah?
As if she’s reading my mind, she explains, “John and I did everything to protect her and keep her struggles private. We always held on to the hope that she’d grow out of it, and we didn’t want how screwed up she was as a kid to affect her as an adult. That’s not fair to anyone, you know?” Pleasure fills her features. She’s getting off on this. “Her middle name is Stevie, so we made sure to use that name and my maiden name whenever she was admitted somewhere so nothing could ever be traced back to her. You think your health information is private, but you never know. We took every precaution we could to keep her safe.” She looks and sounds every part the concerned parent. It’s hard not to be fooled.
“Were her reports in with the ones you gave us on Mason?” Dread creeps up the back of my throat.
“Did I accidentally toss one of those in?” she asks, and I can’t tell if it’s feigned innocence or real. “I didn’t mean to, but maybe it’s a good thing that I did.” She opens the door wide. “Would you like to come inside and go through more? I have plenty of full reports on Savannah. You could study her until your little psychologist heart is content. She’s a fascinating creature. So smart but just can’t seem to get her head screwed on straight. Those hormones hit, and wow—different kid. Just wait until Harper hits puberty.”
I stumble backward to the stairs behind me. The trauma of the day catching up with me all at once, making me dizzy and nauseous. The coffee sours in my gut. “I’m sorry. I’m just going to go. I need to think.”
“This a bit too much for you? Not what you expected?” She sneers at me. “What did you think was going to happen when you went sticking your nose into places it didn’t belong, Casey?”
TWENTY-EIGHT
CASEY WALKER
I stare at the phone in my hand. Savannah’s number sits on my screen, but I can’t bring myself to hit call. It’s been like that since I left Genevieve’s and got home to my empty house. I’ve taken my phone out to call her and put it away more than ten times. I don’t know what to believe. Does it change Savannah’s story if everything Genevieve said about her is true?
The psychiatric reports in Mason’s file were hers. Genevieve wanted to make sure there was no mistaking her daughter had been locked up multiple times. She must’ve sent the reports to Detective Layne as soon as I left, because they were waiting in my inbox when I got home. He forwarded them to me with a note that said:
She also called. Said she wanted to be completely transparent about everything in her family. Didn’t want there to be any secrets between us.
He ended it with an emoji shrug.
We’ve got a call scheduled first thing in the morning, and I’ve been frantically trying to get through as much of it as I can before our talk. It’s a welcome distraction with Harper being gone. I’ve been digging through all Savannah’s files in the same way I did Mason’s. All the missing pieces from the reports that had me so baffled before are there, and everything fits perfectly in place. Her file isn’t as big as Mason’s, but it’s impressive.
Genevieve wasn’t lying about her being hospitalized at twelve. The psychiatric admission note for psychosis is hers too. She was transferred to the inpatient unit after release from the emergency room, where her stomach had been pumped after an intentional overdose of Tylenol. Her intake is a pretty standard medical-status exam:
Patient appeared stated age. Patient hostile and uncooperative. Labile mood. Thought processes were disorganized and tangential. Auditory hallucinations present. Delusional persecutions also present. Patient repeatedly states, “My mom’s trying to kill me. You have to help me.” Concentration poor. Start lithium 300 mg at night. Increase trazodone 10 mg.
Her descriptions are much more violent and aggressive in comparison to Mason’s. She was continually oppositional, refusing to do as she was told or follow the ward’s schedule. She got combative with the nurses and staff members, hitting and kicking them. She even bit one.
And Genevieve was there through it all. That’s in Savannah’s chart too. Mother present for family therapy written every Wednesday morning. Mother visited noted every weeknight from five to seven during visiting hours and in the four-hour time chunks on the weekend. She never missed an opportunity to visit or be on the unit. She attended every family therapy session and educational seminar on the schedule. She was the model parent despite Savannah being the most unruly and uncooperative patient. The nurses and doctors showered her with praise. Mother motivated and committed to therapy and mother forming parent support group online. It never stopped. Genevieve maintained her diligence and devotion to Savannah throughout the entire twenty-three days that she was there.
By the end of her stay, Savannah was a different girl, as devoted to her mother as she was to her recovery. Her main psychiatrist sang her praises in her descriptions as she neared discharge:
Patient states she is doing well. Auditory hallucinations have improved. Patient reports she no longer hears voices. Persecutory delusions in relation to mother have improved. Patient reports “I know my mom loves me” and “my mom would never do anything to hurt me.” Mood stable. Thought process logical and coherent. Reports still feeling down at times but “getting better every day.” No medication side effects. Continue medication management.
The overdosing on Tylenol isn’t as alarming as the psychosis that happened to her afterward. It’s common for kids to impulsively take Tylenol because it’s such an easily accessible drug. Sometimes kids do it as a genuine attempt at suicide, but more often than not, they do it as a suicidal gesture rather than truly wanting to end their lives because they think Tylenol is harmless. Most people don’t know that Tylenol is a lethal killer. Too much of it causes liver failure, and it’s not long before all your organs start shutting down.
Maybe she was suicidal—maybe she wasn’t—but there’s no question she was psychotic. Was it happening before her overdose or as a result of it? The notes aren’t clear.
Unfortunately, Savannah’s progress was short lived. She ended up in the emergency room two months after her discharge. Genevieve ran into the hospital screaming for someone to help her and that her daughter was trying to kill herself again. She created a huge scene, and half the security team came outside to help her. It’s all very detailed in the nurse’s note.
The emergency room physician recommended inpatient hospitalization again because this patient’s condition requires 24-hour monitoring due to potential danger to self and severe deterioration in level of functioning. Prior suicide attempts. She stayed for eleven days.
Her next intake note from White Memorial doesn’t get any better.
Patient not oriented to place and time. Affect lethargic. Largely unresponsive. Oppositional when pressed. Speech slurred. Tangential. Rule out psychosis.
She was the one who received electric shock therapy almost exactly eighteen months from the date of her first hospitalization. Her diagnosis traveled all over the place, from major depressive disorder to bipolar 1 to oppositional defiant disorder, then back again, before settling on major depressive disorder with psychotic features, where it stayed. No matter where she went, though, Genevieve never left her side. She remained her biggest support even when Savannah fired ridiculous accusations at her like that she was trying to poison her food or that someone else was controlling her mom’s behavior. For a girl who looked really good on paper throughout her adolescence, she was a train wreck on the inside.