Dr. Sam Campbell (![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png)
breakablehearts) wrote in ![[community profile]](https://www.dreamwidth.org/img/silk/identity/community.png)
dreamlikenewyork2023-11-19 01:54 am
breakablehearts) wrote in dreamlikenewyork2023-11-19 01:54 am
"Looking out for love in a little bit of darkness."
Who: Sam Campbell and Alexis Harrington (with Justin Campbell)
What: Treading Water
Where: Sydney, Australia
When: After this
Sam murmured a thank you to the nurse who admitted him into the secured acute mental health unit and followed her down the long corridor she was leading him to the wing she said Justin had been admitted to. It didn’t have the overbearing bleakness people might assume was stereotypical of a ‘closed’ or locked mental health ward. It looked just like the other units in this hospital, which was state of the art in every sense. It just didn’t have the same hustle and bustle as other inpatient units. Visitation would be limited to likely only a couple of people at a time and shorter visiting hours. This was outwith those hours, so that would be contributing to comings and goings in the corridor to staff and patients. Even then, patients would likely be restricted to where they could go. They had been given an exception because technically, it wasn’t a normal visit because Justin was sedated and his room would be locked until he was awake and they could assess the risk of harm to himself and others. The visiting leeway to a handful of authorised family members was there today because they were waiting to see if Justin had caused himself damage while he was psychotic and re-injured himself physically or internally, potentially setting back the progress he had made with his rehabilitation.
Spotting Alexis leaning into the wall outside the room the nurse guided him to, he came up beside her, putting his hand softly on her back so he didn’t startle her. “How are you holding up, sweetheart?” he asked, following her gaze through the large observation window to where Justin was unconscious, unmoving in the bed by the window. The depressing and dreary view was a grey wall of the neighbouring building and the room seemed cold and bare. It was never easy to see the poor kid like this. It would never get easier either.
Alexis blinked out of the numb haze she had been lost in, taking Sam’s hand. “Wait, why are you here, darling? How’s Mark? You should be with him.” She shook her head. “I… I don’t know how I am. I don’t know how I’m supposed to be. I thought I was prepared to face this whenever it happened, but I wasn’t. This is horrible. It’s like he’s a criminal.”
Sam laced his fingers with Alexis’ and gave her a gentle kiss. “Mark’s sleeping, his body is overtaxed. Gen’s with him. I just had to come up to see how you were because it’s the first time you’ve seen Jus in a psych unit. I know it’s confronting, sweetheart, but it’s for his own safety. Seclusion and restraint tactics are never easy to witness, especially with your own child. They’ll only do what’s absolutely vital to keep him safe.”
“Did he say if he drank? Did it cause a heart attack? How are you feeling? I’ve been worried, you should be resting now the chemo side effects have set in.” Alexis closed her eyes briefly, taking in a deep breath to keep herself braced for whatever the hell could possibly hit next. For now, she could breathe a little knowing Justin would be kept asleep until morning and the hope was that the heavy cocktail of meds they hit him with would have worked and neutralised the psychosis. They hoped he would be stable when he woke but of course, there was no guarantee and he actually could be severely mentally unwell in the days or weeks to come following a psychotic episode. “They took the straps from his hands and feet but there’s still a belt around his waist. In my head, I guess I knew what this could be but seeing him in there like that, I feel sick. There’s nothing I can do to help him…”
Rubbing his forehead, with a small shrug, Sam shook his head. “To be honest, I don’t know if what I’m feeling is side effects or raging twinsense. Don’t worry about me, though, love. I’ve been worse. He was too unwell to talk to, he had to be intubated to sustain oxygen intake, but thankfully not a heart attack. It was close, though. It’s all pointing to a severe Antabuse reaction, even the ECG results, so he’s going to have to stop taking it. He’s on an infusion of a cocktail of meds to counteract the reaction, but figuring out what actually happened will have to wait until he can tell us. I know Sparky, though, he wouldn’t have had booze knowing he was coming to the hospital for Justin’s physio session. Mark’s drinking, it… it’s difficult to explain but there’s a pattern to how he drinks when he’s off the wagon. It’s not destructive until he pushes too far, so he tolerates a lot but that means he can mask it well and actually function effectively more than most would. It’s a lot easier for him to carry the habit, which can be dangerous. When substance use is easy, it’s harder to abstain because you can justify it to yourself. That’s why he wanted the Antabuse. He wouldn’t have drank. He just wouldn’t have. But that tiny niggle of doubt won’t go until I can talk to him.” He rubbed Alexis’ back, looking Justin over via the window. “You’re here, that’s something, sweetheart. He just has a complex relationship with self-harm. He may purposefully re-injure as a way to self-harm so until they can ascertain he’s comprehending medical advice to restrict movement, they have to keep him restrained.”
Alexis softly brushed Sam’s hair back from his face to check him over. “I can’t not worry about you. You don’t look okay. Considering what Mark just went through, I’d say you’re probably feeling both. Here, you’d be telling everyone else how important keeping the electrolytes up is.” She took a bottle of Gatorade from her bag to give to him. Since his cancer diagnosis and the commencement of his oral chemo treatment, she had taken to carrying a few supplies with her but he had been resting and taking it easy most of the week. This sudden burst of stress and being on his feet might leave him feeling worse for wear. “So, he doesn’t know what’s happened to Justin? They said Justin was screaming that Mark was dead and I just… feel like I can’t breathe when I think about it, the terror he must’ve been feeling to push him into psychosis like that. What about Shea? Is he okay?”
Despite the fact pretty much every member of his family warned they would be making sure he was taken care of while he was going through chemo, Sam looked at the bottle of Gatorade with a bewildered sigh. “Just focus on Jus, sweetheart. It’s okay to do that, you’re his mum. I’ll tell you if I’m feeling like I’m not holding up, I promise.” He twisted the cap off the Gatorade and had a little of it to reassure Alexis, if nothing else. “He doesn’t. He was in and out of consciousness when they had the crash team working on him. The moment Justin’s trauma response is triggered, he’s in danger of escalating rapidly. This was literally a worst case scenario that played out. It could’ve only been worse if Mark did actually die and in Justin’s fight or flight-triggered brain, that’s what he would’ve thought he was seeing. You can’t reason with him, that’s why he has to be chemically restrained. Shea’s wrist is broken from how he fell on the hard ground and he’s got a concussion. He blames himself, poor kid. They’ve given him something to calm him down, so he’s sleeping now. He couldn’t have known Justin would react like that. It’s hard for anyone to fathom until they’ve witnessed it.”
Alexis rested her head against the glass with a sigh, almost like if she kept her eyes on her son, it could somehow take all this pain away for him. “This doesn’t ever get easier, does it? It physically hurts thinking if I’d just… been okay and not lost him, I could’ve prevented this. I could’ve protected him. I would’ve protected him with my life.”
“No, Lex, sweetheart, you can’t do this. It’ll eat you alive. I’ve seen it eat Mark alive. That’s part of why we’re here. You nearly lost your life bringing him into this world and that’s why you couldn’t stop what happened. You need to be stronger than the force of that guilt, my love. You can’t escape it, so you have to conquer it. Especially when I know how much love he needs to anchor to coming out of these episodes.” Sam wrapped his arms around Alexis, kissing her forehead and pulling her close. “I want to tell you it gets easier but you made me promise to not censor anything when it comes to Justin. This part? Is the worst of the worst. You just have to try to catch your breath and keep going.”
“I don’t know how to do this, Sam. I thought I did, I thought I was prepared, b—but I can’t do it. I’m not as strong as Mark is. I still have all that… that…” Alexis put her shaking hand to her head, struggling to explain what she meant. “The memories of when he was taken from me, suddenly they feel like they just happened yesterday. All the promises I’ve made him that I can handle everything, they were lies! I’ve been lying to my son and reassured him I wasn’t. I should never—”
Sam softly put his fingers to Alexis’ lips. “I can’t let you say it, love. Because you don’t mean it, you’re just scared and it’s okay to be scared. You think Mark wasn’t scared when he was trying to figure it all out in the early days? He fucked it all up so many times when he couldn’t cope with the pain and Justin forgave him every single time. You never lied to him. You’re here, where you should be. I hate that this is reigniting your past trauma but that’s being a mum, sweetie. They don’t say being a parent is the hardest job in the world for nothing. It’s even harder when your kid is seriously unwell. I’d offer to get Al to come chat with you about some of this but unfortunately, he’s got a fierce hangover and impeccably poor timing. I may have tore him a bit of a new one down in Cas when I was stressed.”
“A hangover? Alec? Is he okay? Why are you tearing him a new one?” Alexis looked Sam over and she could see how drained and exhausted he was trying to deal with everything. In that sense, she was glad Alec was there for backup because them both being doctors had always been invaluable but that didn’t mean they wouldn’t fall apart when things got as scary as they possibly could. Mere hours ago, she had seen that Sam had been terrified Mark was about to die from a heart attack and there was nothing that would have kept him back at the house resting through his chemo side effects. That didn’t mean he was well enough to be up and around but he would be damned if that would stop him when it came to his twin and his twin’s child. That was a huge part of Sam she fell in love with from the start, though she also knew she had to make sure he was taken care of while he was busy trying to care for others. She brushed his hair from his face and gave him a kiss. “Let’s sit down, honey. I think we both need it. Tell me where everything is up to. Jus definitely can’t just wake up on his own? He’s okay in there?”
Sam didn’t object to sitting down because he was feeling the side effects right through his body but it was nothing compared to what Mark and Justin were going through. “It’s okay, sweetheart. He’s safe. He can’t wake up with how he’s been sedated. It gives his brain a chance to rest and reset. That’s the hope, anyway. I won’t sugarcoat it, it doesn’t always work that way. His psychotic episodes are infrequent but there’s no pattern to them. The extreme stress he’s been under, it might be harder for him to come through it. Which is why they made the safest choice for him, to admit him here. I know it’s awful to see him like this but it’s what’s best for him until we know his psychosis has been addressed. But you can ask me anything you need. If I don’t know the answer, I’ll liaise with the staff here.” There was a small nook of chairs just down the hall and once they were seated, he rubbed his knees, which were aching the most today. “Al had a catchup with some old RAAF mates. He doesn’t see them often, so it was good for him to take the time for it. He’s only really a social drinker and he’ll have to wait out the self-inflicted misery but that’s not why I was angry at him. It was his tension with Kade. We need to be united and we don’t have the emotional space for tension amongst us, so I basically told them to piss off and get their act together either way. Jus relies on Alec to understand why his C-PTSD makes him respond the way it does, so his head needs to be in the game. Don’t get me wrong, I think he and Kade are perfect for each other but they need to figure it out either way. I feel bad for losing my shit. It’s been a day. I… never do too well when Sparky’s in a bad way. If it seems like I am, it’s just because I’m good at faking it. Anything with Mark’s heart, it’s a danger zone. I should’ve done more to talk him out of the Antabuse.”
Alexis began softly massaging Sam’s neck, feeling the stress in the tightly wound muscles. “I’m sure he won’t hold it against you, darling. Siblings are supposed to call each other out on their shit, right? If it helps them with a reality check that if there’s a time that highlights they should be fighting for each other, it’s now. Can’t say a hangover would make it an easy situation to navigate, though.” She shook her head. “Mark would’ve still made the decision to start that medication, even if you had. He wanted to do all he could to show Justin he was doing all he could to stay on the wagon. What heart condition does Mark have? I know he was left with a weakness from the serious cardiac infection he had that caused the heart attack but I feel like it’s something he’s never spoken of himself. It’s always been a difficult subject for Jus to talk about too. He kind of chokes up when he skirts it so I never wanted to push. How much danger is he in with this severe reaction to having some sort of alcohol in his system. Is it… he wouldn’t have drank, would he? Not knowing what Jus was facing today. Sorry, I feel awful for asking that. Mark’s always seemed almost invincible, save for when he was sick in Vermont shortly after I met him.”
Sam closed his eyes, rubbing his forehead with his fingertips with a sigh he couldn’t stifle because he knew exactly where Alexis’ head and heart would go with this particular subject matter. It was always inevitably going to come up again but there was a reason Mark purposefully didn’t dwell on it or make an issue of it. “Mark has a mild form of cardiomyopathy, which was caused by myopericarditis, a serious infection that occurs in two different parts of the heart. Mark’s basically a walking domino-effect, for want of a better analogy. Dad had a heart attack when we were all in high school and his grandfather died of one, so we’ve got a genetic predisposition to cardiac issues, but many families do. That doesn’t mean we’ll all end up with heart problems, we just have a higher risk of cardiac events because of our genetic makeup. Mark’s alcohol addiction and dependence put him at even higher risk of not just heart attack but things like cardiac infection or heart disease. That’s almost certainly what led to the infection, and the infection caused the cardiomyopathy. But we were able to get him on treatment early for it, so it prevented long-lasting damage and was able to reverse the effects to a degree, but the condition is still there and he’ll be on medication for it for the rest of his life. And I know what you’re going to think, sweetheart. Yes, Justin also has those higher risks from not just his genes but his substance abuse. The fortunate part is, he is extremely fit and healthy physically, and there’s never been any sign his heart is anything but in peak condition. Mark only started prioritising taking care of himself once he became a dad.”
Alexis hung her head but after a moment or two, she buried her face in her hands, taking some deep breaths in a struggle to keep herself from crying again. She had already cried almost hysterically when the psych nurses came to tell her Justin was settled in his room if she wanted to see him. She hadn’t meant to break down and she had tried so damn hard to keep it together but it was too much of a shock to herself to see the reality she knew existed play out. Up until then, she realised now she must’ve been in denial or at least held onto false hope Justin might not get this ill again. Until she saw it for herself, it had been hard to fathom how in danger Justin’s mental illness was. “I don’t know if I feel better or worse hearing that. I don’t even know what I’m supposed to be feeling, it’s all just… it hurts.”
“It does,” Sam agreed softly with a nod, combing his fingers through her hair. “But knowledge about predisposed health concerns isn’t a bad thing. It means there’s the chance to get a jump on things and we know warning signs to look for. For all the medical intervention Justin has needed, he’s only had cardiac symptoms when he’s having systemic reactions to external sources. Which have been pretty harrowing with some of the resuscitations, so if there were any potential issues with his heart, that’s likely when we would’ve seen the signs. That’s always been the really difficult part. Physically, Justin is as healthy as he can be and he tends to bounce back from physical ailments because he will hyper-focus on his fitness when he’s recovering. But mentally, it’s the opposite. Even if he hyper-focused on mental fitness, no amount of work he does will cure bipolar or C-PTSD. It’s what us Aussies call trying to push shit up a hill. Doing something really difficult with little chance of success.”
“So, he stops trying? Is that where some of his suicidal thoughts come from, knowing that no matter what happens, he can’t escape it? I’ve seen him work, it’s like he has everything in the world to live for but I still know there’s always that little tiny voice in his head telling him the opposite. Or not so tiny on the bad days. Now he thinks he’s losing Sash. Is he going to have the fight left in him to get through this?” Alexis took her hands from her face and rubbed her palms on her knees, wishing she could stop this snowballing sensation of inner panic building inside her. She always felt the most ill-equipped to be his mother when he was seriously sick, like she could never make up for all the time she was absent in his life. “Okay. Um… say the drugs do what we hope they do and he wakes up tomorrow with the psychosis under control, how is he going to be? What happens in the wake of a psychotic episode? Do I try to talk to him or will that trigger him again? I just… can’t… I can’t fuck this up. I have to keep the promises to him I’ve made.”
As much as Sam wished he could sugarcoat some of this for Alexis so she wasn’t hurting with almost two decades worth of pain swallowing her, that wasn’t how they both promised each other they would navigate their relationship. With Justin in particular, she had made Sam swear he would always be a straight-shooter about what she needed to know. It was just really difficult when there were no clear, straight answers for most of this. “I don’t think he will have the fight, no. I don’t think he will give up on Sash but he might not be able to keep holding up the pretence if he’s really unwell. Best case scenario, there will be a period he’s withdrawn and doesn’t have much capacity to engage. He won’t eat or drink, so usually that means handling his fluid and nutrition intake for a little while. All these circumstances, though, are nothing we’ve ever had to deal with before so it’s hard to know and I think it will depend on how Mark’s feeling. Justin won’t believe he’s alive without seeing for himself. You can try to talk to him but don’t be hurt if he doesn’t engage. It’s never a bad thing to remind him we’re here for him and love him, no matter what.”
Once again, Alexis was trying to calm her emotions by focusing on her breathing and taking in every word Sam was saying. “How do I comfort him? Can I even comfort him? If words won’t work and… he won’t want to be touched, will he? That’s part of what triggered him, Shea trying to make sure he didn’t try to stand to get to Mark. How do I do this, Sam? Isn’t it just easier and safer for him for me to step back and let you, Mark, and Gen do it all in a way that keeps him safest?”
“It would be the same for any of us. I really mean that. We usually just wait for Jus to reinitiate touch when he’s ready. Which he will. When he’s well, he’s always been touchy-feely. He didn’t earn the nickname ‘Smooshie’ by accident. All you need to do is be there and keep being there, showing him you mean everything you’ve promised him. Because it’s these times when he’s at his worst, at rock bottom, that he doesn’t feel like he deserves any of it and he doubts our affection for him. His head is in a really dark place and it takes a little time for him to resurface through it. This is the time that it’s more important than any other to show him you’ll be there to catch him when he falls. That’s all you need to do. Medicine will do the rest. You’ll know when he starts to come out of it and you just need to let him go through the motions, listen when he’s ready to talk,” Sam guided her gently, really wishing there was more he could offer but they all flew blindly through Justin’s storms.
“Mhari said Sash keeps asking why Justin isn’t there, so she thinks he was definitely what Sash has been anchoring to. Jus really made a lot of progress with him, even when he was struggling. She asked me how we wanted to navigate this. She doesn’t want to feed Sash more lies. It’s not sitting right with her that they’ve had to lie to him about Andi and Justin as it is. I didn’t know what to tell her because I don’t know what Justin would want us to say.” Alexis shook her head, feeling a suffocating sense of uselessness on every front but it was comforting in a very strange way to know that sounded like a parent thing and Mhari was in the same boat with her own son. They were all trying to do what was best for both boys. “How has he been in the wake of these sorts of episodes in the past? If the medication is helping, I mean. Is he just completely disconnected? Does he talk? Is he angry or agitated? Does he know what’s happened? I feel like I’ll just go into this better if I have an idea what to expect. I’m sorry if I’m asking too many questions, honey. You don’t have to do this. You have to be there for Mark. Are you… this twinsense thing, is it making you feel what he’s feeling? I should’ve asked. I’m sorry.”
Sam took both her hands with a shake of his head, and kissed the backs of both of them. “Hey, hey, hey. You don’t need to keep apologising, sweetheart. You don’t. Talking is how we deal with this and try to make sense of things. You should ask any questions you need to and I don’t mind how many there are, I’ll try to answer if I can. Something like this, you can’t just know and thank fuck this is something none of us deal with frequently to know better ourselves. We know some, but everything with Jus is a learning curve because his condition changes all the time. We still don’t know how much he still disassociates or has lost in his trauma memories. We don’t know if there is even more he does remember and is yet to disclose to anyone. There may even be things he has disclosed to Sash and not us. Whenever he has any sort of severe episode, it’s always an emotional minefield. If Mhari can hold off a little longer until we know how Jus is tomorrow, it might be better for everyone but if not, we’ll navigate with whatever she and Martin thinks is best for Sash.”
He had to pause briefly to go over in his head how things played out with Justin’s previous psychotic episodes, all of which had external factors that impacted on the management of his condition. “He never has memory of having been psychotic. He once likened it to waking up after he hit his head badly. People tell him what happened but even that’s a juggling act because too much can overwhelm and agitate him but too little and the poor kid has no idea what the hell happened or why he is where he is. He absolutely hates being in a psych unit but not because of reasons we would probably think. Being restrained triggers memories of when his attackers would hold him down or tie him up and drugging him to calm him down makes him feel completely disconnected from his mind, which scares him because he associates drugs with losing control. The only way Jus has ever been able to cope with his illnesses is if he can maintain a little autonomy over himself, which is what his attackers always robbed him of. I know how painful that is for you to hear, my love, and I’m sorry. But bearing that in mind, in the immediate downward spike after the psychosis, he’ll be someone you feel like you don’t know. He won’t make eye contact and he might say things that make no sense or are even hurtful, because they could be coming to him in fragmented memories. If he’s still mildly psychotic, he might be agitated or aggressive but it’s usually only as a protective mechanism if he can’t handle touch or he’s not understanding what someone is saying. If he talks, it’s usually devoid of emotion and monotone, very short answers. We take little steps with him and engage with him how he needs to be engaged, usually by keeping things we say short and simple, not bombarding him. Gradually, he will come out of that and be more like himself.” He deflated a little shoulders slumping when he allowed himself to give into what he was feeling physically. “Yeah, I’m channelling Sparky a little. But we always just see it as sharing each other’s pain.”
Alexis looked over at the door to Justin’s room again, rubbing her hand up and down Sam’s arm. “I think I already knew everything you just said. Maybe not exactly but I think I know my son well enough now to understand how his trauma impacts every part of his life. Whenever he’s just trying he’s damn hardest to get a leg up, the trauma knocks him back down again. But he keeps getting back up. Somehow. I don’t know how, but I’m so proud of him for even just trying. I just doubt myself as a mother so much. Everytime he gets knocked down, I start panicking that I can’t help him with the pain or I’ll do or say something that will make it worse for him. I don’t even know why because nothing he’s ever said to me indicates that’s how he feels with me coming into his life. Now that I think about it, though, I think it’s because one small mistake as his mom could put his life on the line. I don’t know how to deal with that. But I somehow have to figure it out between now and tomorrow morning or everything I’ve promised him will have been a lie.” She covered her face with her hand, shaking her head.
“Lex, honey, you can’t make it worse for him. You being there for him can only make it better, even in the smallest of ways. And I know I’m speaking for him saying this but I also know he’ll tell you that in his own way when he’s feeling better. You absolutely know more about your son than you realise. This is your own traumatised mind making you doubt yourself because you might spend the rest of your life blaming yourself for losing him. I’m Sparky’s identical twin and I honestly and truly think it will be the same for him. It will be a long, difficult battle to keep conquering those feelings to keep parenting Justin the way a seriously sick and mentally disabled young person needs. That is truly okay because I’m not letting either of you go it alone and Gen’s our partner in crime too. It’s not possible for Justin to have too much parental or family love.” Sam’s heart was aching for everyone in this equation and it was hard to see his fiancee doubting her validity as a mother. It wasn’t unfamiliar, though, as he had been helping Mark with the same since the moment Justin showed up on his doorstep wasted and promptly vomited all over him after calling him ‘Dad’. “Mental illness puts his life on the line. As a parent, you just have to be there to catch him when he falls. For now, we just need to trust in medicine to settle and regulate him again and then wait for him to guide what he needs. It’s going to get harder the longer Sash takes to make progress with his recovery and looks more likely he will have a permanent traumatic brain injury. Just keep talking and try not to internalise as much as you can. We can get you more help if you need it, beautiful. What you’re feeling is so normal for parenting a sick kid. It doesn’t invalidate you as a mum. Let me talk to the staff allocated to monitoring him tonight. I’ll see if they can let you have a little time in there with him while he’s safe and sedated.”
Alexis took Sam’s hand before he stood up to track down Justin’s nurses. “Wait, wait, wait. You should be resting. Take the breather while you can. It’s okay. I know he’s safe and being well cared for. You need to let me look after you too. I can’t just ignore that you’re getting treatment for cancer, even though I know you would have to be on your deathbed not to be here for Mark and Justin. I’m so scared you’re going to do too much.”
Sam kissed the backs of both of Alexis’ hands and then hugged them to his chest. “I’m holding up okay for now. The drugs are holding off the worst of the symptoms. I’ll come in with you while you just sit with him for a little while. If they’re okay to authorise it, you should really take it up, sweetheart. I promise, you’re going to know if I start tanking in how I feel. It’s much harder to conceal it than I hoped it might be. Only because I don’t want everyone getting upset about it. Treatment is a good thing. We’re so lucky to have so much access to it. One thing I have the utmost confidence in to get through these difficult things is medicine. I love you. I’ve got you,” he murmured and gave her a gentle kiss.
Nodded, Alexis watched Sam head over to the staff station and rose herself, moving back over to the door to Justin’s room. Looking in at her son again, he hugged herself, rubbing her hands up and down her arms to try to get some warmth but it was pointless when she felt so chilled inside. ‘Complex’ and ‘complicated’ just weren’t strong enough concepts to explain her feelings anymore. Later, she was going to have to video call with her parents back in the US to tell them what happened and now Justin’s condition had taken a really bad turn for the worst. She knew it was going to make them get on a plane and fly over here to support her and she wouldn’t try to stop them. She remembered Justin saying to her once in their early days of bonding and forging a connection that he knew the day would come when she and the new chapter of his family would see him at his worst, when he was having a really bad episode and it scared him. But he could specifically verbalise why and he didn’t have to. She understood what he was telling her and when she tried to reassure him, he intercepted and said, ‘It’s okay to be scared of monsters, Mom. We’re supposed to be.’ Such a simple thing to say but told her so much of how he viewed his mental illnesses. He wished the people who loved him didn’t have to see the monster too.
It was a little while before Sam returned accompanied by a staff member wearing the same colour scrubs as Ava wore. “Darling, this is Sigrid. She’s the Nurse Manager of the Acute Adolescent Mental Health Unit this shift. She’s overseeing Justin’s care due to the special circumstance. Sigrid, this is my fiancee, Alexis, Justin’s biological mum. Sigrid said she’s happy for us to sit in the room with Justin until the handover to the nightshift staff happens a bit later. Staff will be popping in and out regularly for the half-hourly obs and to administer meds. Sigrid’s a close friend of Ava.”
Alexis shook hands with Sigrid, giving her a passing grateful smile. “Thank you. Is there anything I need to know? Am I allowed to touch him or will that disrupt anything? I don’t want to get in the way or do anything wrong.”
“We do have to keep the door to the room locked for everyone’s safety but no, sitting with him and holding his hand won’t disrupt anything or get in the way of the continuity of his care. He can’t wake from the medication he’s under. We just ask not to interfere with any of the medical restraints. His Orthopaedic specialist has asked us to keep his back and pelvis immobilised until they receive the results of his scans to ascertain if he’s re-injured anything. If there’s any issues or you need assistance, please just hit the yellow Assist button or if there’s any urgent change in his condition, the red Emergency button.” Sigrid swiped her security card over the reader by the glass doors, which beeped before they opened. “There’s only the secured benches to sit on, I’m afraid. We don’t have anything in these rooms that can be used for harm.”
After following Alexis into Justin’s room, Sam shook Sigrid’s hand with a tired smile. “Thanks for letting me call on our connections for this. We really appreciate it. Please just let us know if you need us to leave sooner than the shift changeover.”
“No need to thank me. I have a son who is Justin’s age. I can’t begin to fathom how difficult this is for all of you. I’m just up the hall if you have any questions. Call for the staff if you need any help.” Sigrid left them alone and the door swung closed and locked behind her with a click.
Going over to Justin, Alexis put her hand over his that was resting at his side and felt so cold to the touch. The chill to his skin and the colour of his complexion, she was glad she could see the even rises and falls of his chest to reassure her he was alive. There was an imposing blue restraint belt around his waist and loosened restraints around his forearms, probably so they could be re-secured if he woke still agitated and combative. Brushing her hand over Justin’s hair, she leaned over and kissed his forehead. “It was nice Sigrid let you pull strings like this. It helps and makes it feel worse simultaneously. How did Mark… deal with this the first time he went through it?”
Sam stood at the foot of the bed with a soft sigh as he had to take in his nephew this unwell again. The poor kid tried so hard to just make it through each day and at every turn, his own brain kept knocking him down. He smoothed the blankets over Justin’s feet for want of any other way to help him. “The first psychotic episode we knew he had or his first acute psych admission? They were separate events. Though, the former was somewhat the writing on the wall for the latter.”
“The psychosis. Is Shea the first person he’s inadvertently hurt during a psychotic episode? I think I do know my son well enough now to know even just the mere thought that he physically harmed someone would crush him. We’re going to have to go over with him what happened, how it happened. Do we even tell him about Shea? He’s going to blame himself. I just want to have some sort of… of… perspective on what might go through his head in the wake of this. Is that even possible?” Even if Justin wasn’t conscious, Alexis was still stroking his hair softly in some desperate attempt to comfort or soothe him. The fixed benches lining the wall beneath the window were too far away. She would stand at his side with him as long as she could. But Sam was another story. “You should sit down, darling. You looked wrecked. I don’t want you keeling over too. Sit and rest, please?”
“Oh, Mark really didn’t play his cards the best way the first time because he didn’t know it was psychosis he was facing. Justin was severely agitated and aggressive, completely unlike himself and didn’t want Mark near him. It was only after he was admitted to hospital for treatment and he had a psych assessment that they determined it was psychosis and even though it was the first we were seeing it in him, it was unlikely the first time it happened.” Sam didn’t protest and stepped back to perch on the closest end of the bench so Alexis wasn’t worrying he would be another Campbell to bite the dust and land in a hospital bed that night. That’s the last thing anyone needed and he’d be no help to his family if it happened. “We can’t keep things like that from him, love. We really can’t. This is one of those times he has desperately made us all promise we won’t keep him in the dark about, that we keep it real with him. You’re right, he’ll be crushed but it will be worse if he discovers we weren’t honest with him. There’s no way we can know what might go through his head at any given time but because he doesn’t remember being psychotic, there’s always a disconnect for him trying to process and understand what he’s being told he did. I’d imagine that’s terrifying and confronting for him. Shea’s not the first person he’s injured during a psychotic episode. He seriously injured Sash when he was hallucinating that he was someone else — likely one of his abusers — trying to murder him. Justin was in the ICU after a serious drug reaction, when he had the serotonin toxicity. He regained consciousness abruptly without warning and was psychotic from the drug interactions and highgrade fever. He ripped out all the equipment attached to him and threw a chair at Sash, screaming at him to get away and not touch him. The chair smashed the glass door, it was thrown with such force and left Sash with a severe concussion and a fractured skull. That’s why there’s been so much concern about his brain injury this time. It’s not the first serious head injury he’s had.”
After gaping at Sam in shock for what felt like much longer than a few moments, Alexis closed her eyes and slowly crouched down beside Justin’s bed, though still holding his hand like a lifeline to him. What Sam just outlined took her breath away and choked her up yet again. “This is why he once told me he deserves to be locked up when he’s psychotic. I thought it was just… I don’t know, his self-deprecating dark humour he sometimes bends to. To think the person he loves in this world more than anything is someone trying to murder him?” When she pulled herself up again, using the bed rail to stop herself falling, she was roughly wiping tears away from her eyes because that burning anger from deep within that place inside her she had to lock her maternal instincts up in for so many years was igniting like fuel to a flame and she couldn’t even keep speaking. She gripped both hands around the bedrail and was shaking from trying to keep herself together, nearly failing to keep those horrible thoughts about what those evil monsters had done to her beautiful boy to scar his mind so much and forcing him to have to battle himself for the rest of his life. “I’m never going to stop being so fucking angry.”
Sam watched Alexis sadly but she didn’t need to spell out what she was thinking and feeling. He knew. He knew as soon as the topic of conversation turned there, she would have to be pulled back into that awful headspace again. It wasn’t for him to try to avert. He might be Justin’s nephew and his twin brother might be Justin’s father, but he would never be one of the people who created him and brought him into this world. Alexis and Mark would have to shoulder knowing their absence in Justin’s life as a child was why he was abused, even if neither of them made that choice or was to blame that it happened. Days like this, it would just be as painful as it could be, like re-opening old impossible to heal wounds again and again. “You asked me how Mark deals with this, sweetheart. That’s how he’s had to do it, by learning to not let the anger consume him so he’s incapable of being present when Justin needs him the most. That’s not to say he always succeeds. He once likened those hardest days to feeling like he had someone screaming in his face with his hands tied behind his back so he couldn’t push them away. Like a sleep paralysis demon you can’t wake up from. But he also said that Jus can’t escape the fact he was repeatedly harmed in the worst way possible, so Mark doesn’t really want to escape the anger. Feeling the pain with his kid is, I think, one of the ways Mark coached himself to keep going. I can’t profess to know what that feels like first-hand, even if we’re identical twins. Thoughts and feelings around those sorts of traumatic life experiences are felt differently by everyone. You just need to find a way to not let it drown, my love. If it does, you won’t be able to be the mum to him I know you want to be.”
“Can I ask something that I’ve always been scared to say out loud?” Alexis’ gaze remained on her son, immobile in the bed save for chest rising with each even breath. She tucked her hand in under Justin’s again, watching his limp fingers settle into her palm. “Has he ever named or identified any of the abusers, other than the cunt who paraded as his mother? If I ever knew…”
Sam shook his head, leaning over with one elbow resting on his knee while he rubbed the aching muscles in his shoulder and neck. “Not consciously. One of the times he was staying at the Vermont lakehouse with his friends, he had a horrific nightmare and was screaming in his sleep for someone to stop and leave him alone. By the account from Sash and the other kids, there was no doubt it was a nightmare about being sexually abused. It was confronting for them and left them all shaken. It’s one thing to know that’s happened to someone you care about, but to witness it almost like it’s happened in front of you? He was screaming a name and Mark asked Clint to look into it, and it was almost certainly the pastor from the church his grandparents were dedicated to, who was dead by the time Clint had a return on his leads in Chicago. Jus has only ever stated it happened to him for a prolonged period and by multiple people, and has only really spoken of it in a detached and clinical way, though I’d say he has gone over it in therapy because he’s had therapy sessions that had him being physically sick or passing out from a trauma response. You’ve seen on and off how he has an almost immediate uncontrollable systemic response when his trauma is triggered. Just a few steps too far and this is what can happen, it triggers a psychotic episode.”
Closing her eyes again briefly, Alexis focused on taking some deep and slow breaths so her emotions didn’t spiral. Although she knew some of this with surface-level details, she needed to hear more. It was like she was trying to prepare for some sort of battle, that if she had more information, it would make it easier to get through. It wouldn’t but maybe it could keep her grounded while trying to stay strong for her son. “Am I a terrible mom for being glad he has dissociative amnesia? Like some small mercy that his brain chemistry is blocking some of the things that cause him so much pain. I just wish he could forget it all.”
Sam got up and went back over to the bedside so he could wrap his arms around Alexis and hold her. “You’re not a terrible mum. Not wanting your child to be in pain or distress is the very essence of being a wonderful parent. It’s just also one of the hardest parts. Alec says that a lot of Justin’s memories are still dissociated and it’s likely Jus doesn’t know all the abusers. He just knows what they did to him. James said it's a hallmark that the perpetrators ensure the victims can’t ID them. It’s how they get away with it. I think that if he knows or has any memories that could identify the abusers, he wouldn’t say anyway. He’s too scared Mark would do something stupid and then he’d lose him. But it’s also too traumatic for him to talk about. The worst of the disclosures happened when he was really unwell cycling with mixed episodes or after a psychotic episode. Sash said when it happened with him, it was like Jus was on some sort of disconnected autopilot. He does come through it, though, sweetheart. He comes back to us. It’s just a rough road getting there.” They shared a brief kiss and he started rubbing little circles to her lower back, reminding her she wasn’t going this alone.
“But with everything else happening, without Sash there, does he have the strength to fight?” Alexis murmured, resting her head on Sam’s shoulder.
“Probably not,” Sam reluctantly had to admit. “But somehow, he always still does.”
LOG, COMPLETE
What: Treading Water
Where: Sydney, Australia
When: After this
Sam murmured a thank you to the nurse who admitted him into the secured acute mental health unit and followed her down the long corridor she was leading him to the wing she said Justin had been admitted to. It didn’t have the overbearing bleakness people might assume was stereotypical of a ‘closed’ or locked mental health ward. It looked just like the other units in this hospital, which was state of the art in every sense. It just didn’t have the same hustle and bustle as other inpatient units. Visitation would be limited to likely only a couple of people at a time and shorter visiting hours. This was outwith those hours, so that would be contributing to comings and goings in the corridor to staff and patients. Even then, patients would likely be restricted to where they could go. They had been given an exception because technically, it wasn’t a normal visit because Justin was sedated and his room would be locked until he was awake and they could assess the risk of harm to himself and others. The visiting leeway to a handful of authorised family members was there today because they were waiting to see if Justin had caused himself damage while he was psychotic and re-injured himself physically or internally, potentially setting back the progress he had made with his rehabilitation.
Spotting Alexis leaning into the wall outside the room the nurse guided him to, he came up beside her, putting his hand softly on her back so he didn’t startle her. “How are you holding up, sweetheart?” he asked, following her gaze through the large observation window to where Justin was unconscious, unmoving in the bed by the window. The depressing and dreary view was a grey wall of the neighbouring building and the room seemed cold and bare. It was never easy to see the poor kid like this. It would never get easier either.
Alexis blinked out of the numb haze she had been lost in, taking Sam’s hand. “Wait, why are you here, darling? How’s Mark? You should be with him.” She shook her head. “I… I don’t know how I am. I don’t know how I’m supposed to be. I thought I was prepared to face this whenever it happened, but I wasn’t. This is horrible. It’s like he’s a criminal.”
Sam laced his fingers with Alexis’ and gave her a gentle kiss. “Mark’s sleeping, his body is overtaxed. Gen’s with him. I just had to come up to see how you were because it’s the first time you’ve seen Jus in a psych unit. I know it’s confronting, sweetheart, but it’s for his own safety. Seclusion and restraint tactics are never easy to witness, especially with your own child. They’ll only do what’s absolutely vital to keep him safe.”
“Did he say if he drank? Did it cause a heart attack? How are you feeling? I’ve been worried, you should be resting now the chemo side effects have set in.” Alexis closed her eyes briefly, taking in a deep breath to keep herself braced for whatever the hell could possibly hit next. For now, she could breathe a little knowing Justin would be kept asleep until morning and the hope was that the heavy cocktail of meds they hit him with would have worked and neutralised the psychosis. They hoped he would be stable when he woke but of course, there was no guarantee and he actually could be severely mentally unwell in the days or weeks to come following a psychotic episode. “They took the straps from his hands and feet but there’s still a belt around his waist. In my head, I guess I knew what this could be but seeing him in there like that, I feel sick. There’s nothing I can do to help him…”
Rubbing his forehead, with a small shrug, Sam shook his head. “To be honest, I don’t know if what I’m feeling is side effects or raging twinsense. Don’t worry about me, though, love. I’ve been worse. He was too unwell to talk to, he had to be intubated to sustain oxygen intake, but thankfully not a heart attack. It was close, though. It’s all pointing to a severe Antabuse reaction, even the ECG results, so he’s going to have to stop taking it. He’s on an infusion of a cocktail of meds to counteract the reaction, but figuring out what actually happened will have to wait until he can tell us. I know Sparky, though, he wouldn’t have had booze knowing he was coming to the hospital for Justin’s physio session. Mark’s drinking, it… it’s difficult to explain but there’s a pattern to how he drinks when he’s off the wagon. It’s not destructive until he pushes too far, so he tolerates a lot but that means he can mask it well and actually function effectively more than most would. It’s a lot easier for him to carry the habit, which can be dangerous. When substance use is easy, it’s harder to abstain because you can justify it to yourself. That’s why he wanted the Antabuse. He wouldn’t have drank. He just wouldn’t have. But that tiny niggle of doubt won’t go until I can talk to him.” He rubbed Alexis’ back, looking Justin over via the window. “You’re here, that’s something, sweetheart. He just has a complex relationship with self-harm. He may purposefully re-injure as a way to self-harm so until they can ascertain he’s comprehending medical advice to restrict movement, they have to keep him restrained.”
Alexis softly brushed Sam’s hair back from his face to check him over. “I can’t not worry about you. You don’t look okay. Considering what Mark just went through, I’d say you’re probably feeling both. Here, you’d be telling everyone else how important keeping the electrolytes up is.” She took a bottle of Gatorade from her bag to give to him. Since his cancer diagnosis and the commencement of his oral chemo treatment, she had taken to carrying a few supplies with her but he had been resting and taking it easy most of the week. This sudden burst of stress and being on his feet might leave him feeling worse for wear. “So, he doesn’t know what’s happened to Justin? They said Justin was screaming that Mark was dead and I just… feel like I can’t breathe when I think about it, the terror he must’ve been feeling to push him into psychosis like that. What about Shea? Is he okay?”
Despite the fact pretty much every member of his family warned they would be making sure he was taken care of while he was going through chemo, Sam looked at the bottle of Gatorade with a bewildered sigh. “Just focus on Jus, sweetheart. It’s okay to do that, you’re his mum. I’ll tell you if I’m feeling like I’m not holding up, I promise.” He twisted the cap off the Gatorade and had a little of it to reassure Alexis, if nothing else. “He doesn’t. He was in and out of consciousness when they had the crash team working on him. The moment Justin’s trauma response is triggered, he’s in danger of escalating rapidly. This was literally a worst case scenario that played out. It could’ve only been worse if Mark did actually die and in Justin’s fight or flight-triggered brain, that’s what he would’ve thought he was seeing. You can’t reason with him, that’s why he has to be chemically restrained. Shea’s wrist is broken from how he fell on the hard ground and he’s got a concussion. He blames himself, poor kid. They’ve given him something to calm him down, so he’s sleeping now. He couldn’t have known Justin would react like that. It’s hard for anyone to fathom until they’ve witnessed it.”
Alexis rested her head against the glass with a sigh, almost like if she kept her eyes on her son, it could somehow take all this pain away for him. “This doesn’t ever get easier, does it? It physically hurts thinking if I’d just… been okay and not lost him, I could’ve prevented this. I could’ve protected him. I would’ve protected him with my life.”
“No, Lex, sweetheart, you can’t do this. It’ll eat you alive. I’ve seen it eat Mark alive. That’s part of why we’re here. You nearly lost your life bringing him into this world and that’s why you couldn’t stop what happened. You need to be stronger than the force of that guilt, my love. You can’t escape it, so you have to conquer it. Especially when I know how much love he needs to anchor to coming out of these episodes.” Sam wrapped his arms around Alexis, kissing her forehead and pulling her close. “I want to tell you it gets easier but you made me promise to not censor anything when it comes to Justin. This part? Is the worst of the worst. You just have to try to catch your breath and keep going.”
“I don’t know how to do this, Sam. I thought I did, I thought I was prepared, b—but I can’t do it. I’m not as strong as Mark is. I still have all that… that…” Alexis put her shaking hand to her head, struggling to explain what she meant. “The memories of when he was taken from me, suddenly they feel like they just happened yesterday. All the promises I’ve made him that I can handle everything, they were lies! I’ve been lying to my son and reassured him I wasn’t. I should never—”
Sam softly put his fingers to Alexis’ lips. “I can’t let you say it, love. Because you don’t mean it, you’re just scared and it’s okay to be scared. You think Mark wasn’t scared when he was trying to figure it all out in the early days? He fucked it all up so many times when he couldn’t cope with the pain and Justin forgave him every single time. You never lied to him. You’re here, where you should be. I hate that this is reigniting your past trauma but that’s being a mum, sweetie. They don’t say being a parent is the hardest job in the world for nothing. It’s even harder when your kid is seriously unwell. I’d offer to get Al to come chat with you about some of this but unfortunately, he’s got a fierce hangover and impeccably poor timing. I may have tore him a bit of a new one down in Cas when I was stressed.”
“A hangover? Alec? Is he okay? Why are you tearing him a new one?” Alexis looked Sam over and she could see how drained and exhausted he was trying to deal with everything. In that sense, she was glad Alec was there for backup because them both being doctors had always been invaluable but that didn’t mean they wouldn’t fall apart when things got as scary as they possibly could. Mere hours ago, she had seen that Sam had been terrified Mark was about to die from a heart attack and there was nothing that would have kept him back at the house resting through his chemo side effects. That didn’t mean he was well enough to be up and around but he would be damned if that would stop him when it came to his twin and his twin’s child. That was a huge part of Sam she fell in love with from the start, though she also knew she had to make sure he was taken care of while he was busy trying to care for others. She brushed his hair from his face and gave him a kiss. “Let’s sit down, honey. I think we both need it. Tell me where everything is up to. Jus definitely can’t just wake up on his own? He’s okay in there?”
Sam didn’t object to sitting down because he was feeling the side effects right through his body but it was nothing compared to what Mark and Justin were going through. “It’s okay, sweetheart. He’s safe. He can’t wake up with how he’s been sedated. It gives his brain a chance to rest and reset. That’s the hope, anyway. I won’t sugarcoat it, it doesn’t always work that way. His psychotic episodes are infrequent but there’s no pattern to them. The extreme stress he’s been under, it might be harder for him to come through it. Which is why they made the safest choice for him, to admit him here. I know it’s awful to see him like this but it’s what’s best for him until we know his psychosis has been addressed. But you can ask me anything you need. If I don’t know the answer, I’ll liaise with the staff here.” There was a small nook of chairs just down the hall and once they were seated, he rubbed his knees, which were aching the most today. “Al had a catchup with some old RAAF mates. He doesn’t see them often, so it was good for him to take the time for it. He’s only really a social drinker and he’ll have to wait out the self-inflicted misery but that’s not why I was angry at him. It was his tension with Kade. We need to be united and we don’t have the emotional space for tension amongst us, so I basically told them to piss off and get their act together either way. Jus relies on Alec to understand why his C-PTSD makes him respond the way it does, so his head needs to be in the game. Don’t get me wrong, I think he and Kade are perfect for each other but they need to figure it out either way. I feel bad for losing my shit. It’s been a day. I… never do too well when Sparky’s in a bad way. If it seems like I am, it’s just because I’m good at faking it. Anything with Mark’s heart, it’s a danger zone. I should’ve done more to talk him out of the Antabuse.”
Alexis began softly massaging Sam’s neck, feeling the stress in the tightly wound muscles. “I’m sure he won’t hold it against you, darling. Siblings are supposed to call each other out on their shit, right? If it helps them with a reality check that if there’s a time that highlights they should be fighting for each other, it’s now. Can’t say a hangover would make it an easy situation to navigate, though.” She shook her head. “Mark would’ve still made the decision to start that medication, even if you had. He wanted to do all he could to show Justin he was doing all he could to stay on the wagon. What heart condition does Mark have? I know he was left with a weakness from the serious cardiac infection he had that caused the heart attack but I feel like it’s something he’s never spoken of himself. It’s always been a difficult subject for Jus to talk about too. He kind of chokes up when he skirts it so I never wanted to push. How much danger is he in with this severe reaction to having some sort of alcohol in his system. Is it… he wouldn’t have drank, would he? Not knowing what Jus was facing today. Sorry, I feel awful for asking that. Mark’s always seemed almost invincible, save for when he was sick in Vermont shortly after I met him.”
Sam closed his eyes, rubbing his forehead with his fingertips with a sigh he couldn’t stifle because he knew exactly where Alexis’ head and heart would go with this particular subject matter. It was always inevitably going to come up again but there was a reason Mark purposefully didn’t dwell on it or make an issue of it. “Mark has a mild form of cardiomyopathy, which was caused by myopericarditis, a serious infection that occurs in two different parts of the heart. Mark’s basically a walking domino-effect, for want of a better analogy. Dad had a heart attack when we were all in high school and his grandfather died of one, so we’ve got a genetic predisposition to cardiac issues, but many families do. That doesn’t mean we’ll all end up with heart problems, we just have a higher risk of cardiac events because of our genetic makeup. Mark’s alcohol addiction and dependence put him at even higher risk of not just heart attack but things like cardiac infection or heart disease. That’s almost certainly what led to the infection, and the infection caused the cardiomyopathy. But we were able to get him on treatment early for it, so it prevented long-lasting damage and was able to reverse the effects to a degree, but the condition is still there and he’ll be on medication for it for the rest of his life. And I know what you’re going to think, sweetheart. Yes, Justin also has those higher risks from not just his genes but his substance abuse. The fortunate part is, he is extremely fit and healthy physically, and there’s never been any sign his heart is anything but in peak condition. Mark only started prioritising taking care of himself once he became a dad.”
Alexis hung her head but after a moment or two, she buried her face in her hands, taking some deep breaths in a struggle to keep herself from crying again. She had already cried almost hysterically when the psych nurses came to tell her Justin was settled in his room if she wanted to see him. She hadn’t meant to break down and she had tried so damn hard to keep it together but it was too much of a shock to herself to see the reality she knew existed play out. Up until then, she realised now she must’ve been in denial or at least held onto false hope Justin might not get this ill again. Until she saw it for herself, it had been hard to fathom how in danger Justin’s mental illness was. “I don’t know if I feel better or worse hearing that. I don’t even know what I’m supposed to be feeling, it’s all just… it hurts.”
“It does,” Sam agreed softly with a nod, combing his fingers through her hair. “But knowledge about predisposed health concerns isn’t a bad thing. It means there’s the chance to get a jump on things and we know warning signs to look for. For all the medical intervention Justin has needed, he’s only had cardiac symptoms when he’s having systemic reactions to external sources. Which have been pretty harrowing with some of the resuscitations, so if there were any potential issues with his heart, that’s likely when we would’ve seen the signs. That’s always been the really difficult part. Physically, Justin is as healthy as he can be and he tends to bounce back from physical ailments because he will hyper-focus on his fitness when he’s recovering. But mentally, it’s the opposite. Even if he hyper-focused on mental fitness, no amount of work he does will cure bipolar or C-PTSD. It’s what us Aussies call trying to push shit up a hill. Doing something really difficult with little chance of success.”
“So, he stops trying? Is that where some of his suicidal thoughts come from, knowing that no matter what happens, he can’t escape it? I’ve seen him work, it’s like he has everything in the world to live for but I still know there’s always that little tiny voice in his head telling him the opposite. Or not so tiny on the bad days. Now he thinks he’s losing Sash. Is he going to have the fight left in him to get through this?” Alexis took her hands from her face and rubbed her palms on her knees, wishing she could stop this snowballing sensation of inner panic building inside her. She always felt the most ill-equipped to be his mother when he was seriously sick, like she could never make up for all the time she was absent in his life. “Okay. Um… say the drugs do what we hope they do and he wakes up tomorrow with the psychosis under control, how is he going to be? What happens in the wake of a psychotic episode? Do I try to talk to him or will that trigger him again? I just… can’t… I can’t fuck this up. I have to keep the promises to him I’ve made.”
As much as Sam wished he could sugarcoat some of this for Alexis so she wasn’t hurting with almost two decades worth of pain swallowing her, that wasn’t how they both promised each other they would navigate their relationship. With Justin in particular, she had made Sam swear he would always be a straight-shooter about what she needed to know. It was just really difficult when there were no clear, straight answers for most of this. “I don’t think he will have the fight, no. I don’t think he will give up on Sash but he might not be able to keep holding up the pretence if he’s really unwell. Best case scenario, there will be a period he’s withdrawn and doesn’t have much capacity to engage. He won’t eat or drink, so usually that means handling his fluid and nutrition intake for a little while. All these circumstances, though, are nothing we’ve ever had to deal with before so it’s hard to know and I think it will depend on how Mark’s feeling. Justin won’t believe he’s alive without seeing for himself. You can try to talk to him but don’t be hurt if he doesn’t engage. It’s never a bad thing to remind him we’re here for him and love him, no matter what.”
Once again, Alexis was trying to calm her emotions by focusing on her breathing and taking in every word Sam was saying. “How do I comfort him? Can I even comfort him? If words won’t work and… he won’t want to be touched, will he? That’s part of what triggered him, Shea trying to make sure he didn’t try to stand to get to Mark. How do I do this, Sam? Isn’t it just easier and safer for him for me to step back and let you, Mark, and Gen do it all in a way that keeps him safest?”
“It would be the same for any of us. I really mean that. We usually just wait for Jus to reinitiate touch when he’s ready. Which he will. When he’s well, he’s always been touchy-feely. He didn’t earn the nickname ‘Smooshie’ by accident. All you need to do is be there and keep being there, showing him you mean everything you’ve promised him. Because it’s these times when he’s at his worst, at rock bottom, that he doesn’t feel like he deserves any of it and he doubts our affection for him. His head is in a really dark place and it takes a little time for him to resurface through it. This is the time that it’s more important than any other to show him you’ll be there to catch him when he falls. That’s all you need to do. Medicine will do the rest. You’ll know when he starts to come out of it and you just need to let him go through the motions, listen when he’s ready to talk,” Sam guided her gently, really wishing there was more he could offer but they all flew blindly through Justin’s storms.
“Mhari said Sash keeps asking why Justin isn’t there, so she thinks he was definitely what Sash has been anchoring to. Jus really made a lot of progress with him, even when he was struggling. She asked me how we wanted to navigate this. She doesn’t want to feed Sash more lies. It’s not sitting right with her that they’ve had to lie to him about Andi and Justin as it is. I didn’t know what to tell her because I don’t know what Justin would want us to say.” Alexis shook her head, feeling a suffocating sense of uselessness on every front but it was comforting in a very strange way to know that sounded like a parent thing and Mhari was in the same boat with her own son. They were all trying to do what was best for both boys. “How has he been in the wake of these sorts of episodes in the past? If the medication is helping, I mean. Is he just completely disconnected? Does he talk? Is he angry or agitated? Does he know what’s happened? I feel like I’ll just go into this better if I have an idea what to expect. I’m sorry if I’m asking too many questions, honey. You don’t have to do this. You have to be there for Mark. Are you… this twinsense thing, is it making you feel what he’s feeling? I should’ve asked. I’m sorry.”
Sam took both her hands with a shake of his head, and kissed the backs of both of them. “Hey, hey, hey. You don’t need to keep apologising, sweetheart. You don’t. Talking is how we deal with this and try to make sense of things. You should ask any questions you need to and I don’t mind how many there are, I’ll try to answer if I can. Something like this, you can’t just know and thank fuck this is something none of us deal with frequently to know better ourselves. We know some, but everything with Jus is a learning curve because his condition changes all the time. We still don’t know how much he still disassociates or has lost in his trauma memories. We don’t know if there is even more he does remember and is yet to disclose to anyone. There may even be things he has disclosed to Sash and not us. Whenever he has any sort of severe episode, it’s always an emotional minefield. If Mhari can hold off a little longer until we know how Jus is tomorrow, it might be better for everyone but if not, we’ll navigate with whatever she and Martin thinks is best for Sash.”
He had to pause briefly to go over in his head how things played out with Justin’s previous psychotic episodes, all of which had external factors that impacted on the management of his condition. “He never has memory of having been psychotic. He once likened it to waking up after he hit his head badly. People tell him what happened but even that’s a juggling act because too much can overwhelm and agitate him but too little and the poor kid has no idea what the hell happened or why he is where he is. He absolutely hates being in a psych unit but not because of reasons we would probably think. Being restrained triggers memories of when his attackers would hold him down or tie him up and drugging him to calm him down makes him feel completely disconnected from his mind, which scares him because he associates drugs with losing control. The only way Jus has ever been able to cope with his illnesses is if he can maintain a little autonomy over himself, which is what his attackers always robbed him of. I know how painful that is for you to hear, my love, and I’m sorry. But bearing that in mind, in the immediate downward spike after the psychosis, he’ll be someone you feel like you don’t know. He won’t make eye contact and he might say things that make no sense or are even hurtful, because they could be coming to him in fragmented memories. If he’s still mildly psychotic, he might be agitated or aggressive but it’s usually only as a protective mechanism if he can’t handle touch or he’s not understanding what someone is saying. If he talks, it’s usually devoid of emotion and monotone, very short answers. We take little steps with him and engage with him how he needs to be engaged, usually by keeping things we say short and simple, not bombarding him. Gradually, he will come out of that and be more like himself.” He deflated a little shoulders slumping when he allowed himself to give into what he was feeling physically. “Yeah, I’m channelling Sparky a little. But we always just see it as sharing each other’s pain.”
Alexis looked over at the door to Justin’s room again, rubbing her hand up and down Sam’s arm. “I think I already knew everything you just said. Maybe not exactly but I think I know my son well enough now to understand how his trauma impacts every part of his life. Whenever he’s just trying he’s damn hardest to get a leg up, the trauma knocks him back down again. But he keeps getting back up. Somehow. I don’t know how, but I’m so proud of him for even just trying. I just doubt myself as a mother so much. Everytime he gets knocked down, I start panicking that I can’t help him with the pain or I’ll do or say something that will make it worse for him. I don’t even know why because nothing he’s ever said to me indicates that’s how he feels with me coming into his life. Now that I think about it, though, I think it’s because one small mistake as his mom could put his life on the line. I don’t know how to deal with that. But I somehow have to figure it out between now and tomorrow morning or everything I’ve promised him will have been a lie.” She covered her face with her hand, shaking her head.
“Lex, honey, you can’t make it worse for him. You being there for him can only make it better, even in the smallest of ways. And I know I’m speaking for him saying this but I also know he’ll tell you that in his own way when he’s feeling better. You absolutely know more about your son than you realise. This is your own traumatised mind making you doubt yourself because you might spend the rest of your life blaming yourself for losing him. I’m Sparky’s identical twin and I honestly and truly think it will be the same for him. It will be a long, difficult battle to keep conquering those feelings to keep parenting Justin the way a seriously sick and mentally disabled young person needs. That is truly okay because I’m not letting either of you go it alone and Gen’s our partner in crime too. It’s not possible for Justin to have too much parental or family love.” Sam’s heart was aching for everyone in this equation and it was hard to see his fiancee doubting her validity as a mother. It wasn’t unfamiliar, though, as he had been helping Mark with the same since the moment Justin showed up on his doorstep wasted and promptly vomited all over him after calling him ‘Dad’. “Mental illness puts his life on the line. As a parent, you just have to be there to catch him when he falls. For now, we just need to trust in medicine to settle and regulate him again and then wait for him to guide what he needs. It’s going to get harder the longer Sash takes to make progress with his recovery and looks more likely he will have a permanent traumatic brain injury. Just keep talking and try not to internalise as much as you can. We can get you more help if you need it, beautiful. What you’re feeling is so normal for parenting a sick kid. It doesn’t invalidate you as a mum. Let me talk to the staff allocated to monitoring him tonight. I’ll see if they can let you have a little time in there with him while he’s safe and sedated.”
Alexis took Sam’s hand before he stood up to track down Justin’s nurses. “Wait, wait, wait. You should be resting. Take the breather while you can. It’s okay. I know he’s safe and being well cared for. You need to let me look after you too. I can’t just ignore that you’re getting treatment for cancer, even though I know you would have to be on your deathbed not to be here for Mark and Justin. I’m so scared you’re going to do too much.”
Sam kissed the backs of both of Alexis’ hands and then hugged them to his chest. “I’m holding up okay for now. The drugs are holding off the worst of the symptoms. I’ll come in with you while you just sit with him for a little while. If they’re okay to authorise it, you should really take it up, sweetheart. I promise, you’re going to know if I start tanking in how I feel. It’s much harder to conceal it than I hoped it might be. Only because I don’t want everyone getting upset about it. Treatment is a good thing. We’re so lucky to have so much access to it. One thing I have the utmost confidence in to get through these difficult things is medicine. I love you. I’ve got you,” he murmured and gave her a gentle kiss.
Nodded, Alexis watched Sam head over to the staff station and rose herself, moving back over to the door to Justin’s room. Looking in at her son again, he hugged herself, rubbing her hands up and down her arms to try to get some warmth but it was pointless when she felt so chilled inside. ‘Complex’ and ‘complicated’ just weren’t strong enough concepts to explain her feelings anymore. Later, she was going to have to video call with her parents back in the US to tell them what happened and now Justin’s condition had taken a really bad turn for the worst. She knew it was going to make them get on a plane and fly over here to support her and she wouldn’t try to stop them. She remembered Justin saying to her once in their early days of bonding and forging a connection that he knew the day would come when she and the new chapter of his family would see him at his worst, when he was having a really bad episode and it scared him. But he could specifically verbalise why and he didn’t have to. She understood what he was telling her and when she tried to reassure him, he intercepted and said, ‘It’s okay to be scared of monsters, Mom. We’re supposed to be.’ Such a simple thing to say but told her so much of how he viewed his mental illnesses. He wished the people who loved him didn’t have to see the monster too.
It was a little while before Sam returned accompanied by a staff member wearing the same colour scrubs as Ava wore. “Darling, this is Sigrid. She’s the Nurse Manager of the Acute Adolescent Mental Health Unit this shift. She’s overseeing Justin’s care due to the special circumstance. Sigrid, this is my fiancee, Alexis, Justin’s biological mum. Sigrid said she’s happy for us to sit in the room with Justin until the handover to the nightshift staff happens a bit later. Staff will be popping in and out regularly for the half-hourly obs and to administer meds. Sigrid’s a close friend of Ava.”
Alexis shook hands with Sigrid, giving her a passing grateful smile. “Thank you. Is there anything I need to know? Am I allowed to touch him or will that disrupt anything? I don’t want to get in the way or do anything wrong.”
“We do have to keep the door to the room locked for everyone’s safety but no, sitting with him and holding his hand won’t disrupt anything or get in the way of the continuity of his care. He can’t wake from the medication he’s under. We just ask not to interfere with any of the medical restraints. His Orthopaedic specialist has asked us to keep his back and pelvis immobilised until they receive the results of his scans to ascertain if he’s re-injured anything. If there’s any issues or you need assistance, please just hit the yellow Assist button or if there’s any urgent change in his condition, the red Emergency button.” Sigrid swiped her security card over the reader by the glass doors, which beeped before they opened. “There’s only the secured benches to sit on, I’m afraid. We don’t have anything in these rooms that can be used for harm.”
After following Alexis into Justin’s room, Sam shook Sigrid’s hand with a tired smile. “Thanks for letting me call on our connections for this. We really appreciate it. Please just let us know if you need us to leave sooner than the shift changeover.”
“No need to thank me. I have a son who is Justin’s age. I can’t begin to fathom how difficult this is for all of you. I’m just up the hall if you have any questions. Call for the staff if you need any help.” Sigrid left them alone and the door swung closed and locked behind her with a click.
Going over to Justin, Alexis put her hand over his that was resting at his side and felt so cold to the touch. The chill to his skin and the colour of his complexion, she was glad she could see the even rises and falls of his chest to reassure her he was alive. There was an imposing blue restraint belt around his waist and loosened restraints around his forearms, probably so they could be re-secured if he woke still agitated and combative. Brushing her hand over Justin’s hair, she leaned over and kissed his forehead. “It was nice Sigrid let you pull strings like this. It helps and makes it feel worse simultaneously. How did Mark… deal with this the first time he went through it?”
Sam stood at the foot of the bed with a soft sigh as he had to take in his nephew this unwell again. The poor kid tried so hard to just make it through each day and at every turn, his own brain kept knocking him down. He smoothed the blankets over Justin’s feet for want of any other way to help him. “The first psychotic episode we knew he had or his first acute psych admission? They were separate events. Though, the former was somewhat the writing on the wall for the latter.”
“The psychosis. Is Shea the first person he’s inadvertently hurt during a psychotic episode? I think I do know my son well enough now to know even just the mere thought that he physically harmed someone would crush him. We’re going to have to go over with him what happened, how it happened. Do we even tell him about Shea? He’s going to blame himself. I just want to have some sort of… of… perspective on what might go through his head in the wake of this. Is that even possible?” Even if Justin wasn’t conscious, Alexis was still stroking his hair softly in some desperate attempt to comfort or soothe him. The fixed benches lining the wall beneath the window were too far away. She would stand at his side with him as long as she could. But Sam was another story. “You should sit down, darling. You looked wrecked. I don’t want you keeling over too. Sit and rest, please?”
“Oh, Mark really didn’t play his cards the best way the first time because he didn’t know it was psychosis he was facing. Justin was severely agitated and aggressive, completely unlike himself and didn’t want Mark near him. It was only after he was admitted to hospital for treatment and he had a psych assessment that they determined it was psychosis and even though it was the first we were seeing it in him, it was unlikely the first time it happened.” Sam didn’t protest and stepped back to perch on the closest end of the bench so Alexis wasn’t worrying he would be another Campbell to bite the dust and land in a hospital bed that night. That’s the last thing anyone needed and he’d be no help to his family if it happened. “We can’t keep things like that from him, love. We really can’t. This is one of those times he has desperately made us all promise we won’t keep him in the dark about, that we keep it real with him. You’re right, he’ll be crushed but it will be worse if he discovers we weren’t honest with him. There’s no way we can know what might go through his head at any given time but because he doesn’t remember being psychotic, there’s always a disconnect for him trying to process and understand what he’s being told he did. I’d imagine that’s terrifying and confronting for him. Shea’s not the first person he’s injured during a psychotic episode. He seriously injured Sash when he was hallucinating that he was someone else — likely one of his abusers — trying to murder him. Justin was in the ICU after a serious drug reaction, when he had the serotonin toxicity. He regained consciousness abruptly without warning and was psychotic from the drug interactions and highgrade fever. He ripped out all the equipment attached to him and threw a chair at Sash, screaming at him to get away and not touch him. The chair smashed the glass door, it was thrown with such force and left Sash with a severe concussion and a fractured skull. That’s why there’s been so much concern about his brain injury this time. It’s not the first serious head injury he’s had.”
After gaping at Sam in shock for what felt like much longer than a few moments, Alexis closed her eyes and slowly crouched down beside Justin’s bed, though still holding his hand like a lifeline to him. What Sam just outlined took her breath away and choked her up yet again. “This is why he once told me he deserves to be locked up when he’s psychotic. I thought it was just… I don’t know, his self-deprecating dark humour he sometimes bends to. To think the person he loves in this world more than anything is someone trying to murder him?” When she pulled herself up again, using the bed rail to stop herself falling, she was roughly wiping tears away from her eyes because that burning anger from deep within that place inside her she had to lock her maternal instincts up in for so many years was igniting like fuel to a flame and she couldn’t even keep speaking. She gripped both hands around the bedrail and was shaking from trying to keep herself together, nearly failing to keep those horrible thoughts about what those evil monsters had done to her beautiful boy to scar his mind so much and forcing him to have to battle himself for the rest of his life. “I’m never going to stop being so fucking angry.”
Sam watched Alexis sadly but she didn’t need to spell out what she was thinking and feeling. He knew. He knew as soon as the topic of conversation turned there, she would have to be pulled back into that awful headspace again. It wasn’t for him to try to avert. He might be Justin’s nephew and his twin brother might be Justin’s father, but he would never be one of the people who created him and brought him into this world. Alexis and Mark would have to shoulder knowing their absence in Justin’s life as a child was why he was abused, even if neither of them made that choice or was to blame that it happened. Days like this, it would just be as painful as it could be, like re-opening old impossible to heal wounds again and again. “You asked me how Mark deals with this, sweetheart. That’s how he’s had to do it, by learning to not let the anger consume him so he’s incapable of being present when Justin needs him the most. That’s not to say he always succeeds. He once likened those hardest days to feeling like he had someone screaming in his face with his hands tied behind his back so he couldn’t push them away. Like a sleep paralysis demon you can’t wake up from. But he also said that Jus can’t escape the fact he was repeatedly harmed in the worst way possible, so Mark doesn’t really want to escape the anger. Feeling the pain with his kid is, I think, one of the ways Mark coached himself to keep going. I can’t profess to know what that feels like first-hand, even if we’re identical twins. Thoughts and feelings around those sorts of traumatic life experiences are felt differently by everyone. You just need to find a way to not let it drown, my love. If it does, you won’t be able to be the mum to him I know you want to be.”
“Can I ask something that I’ve always been scared to say out loud?” Alexis’ gaze remained on her son, immobile in the bed save for chest rising with each even breath. She tucked her hand in under Justin’s again, watching his limp fingers settle into her palm. “Has he ever named or identified any of the abusers, other than the cunt who paraded as his mother? If I ever knew…”
Sam shook his head, leaning over with one elbow resting on his knee while he rubbed the aching muscles in his shoulder and neck. “Not consciously. One of the times he was staying at the Vermont lakehouse with his friends, he had a horrific nightmare and was screaming in his sleep for someone to stop and leave him alone. By the account from Sash and the other kids, there was no doubt it was a nightmare about being sexually abused. It was confronting for them and left them all shaken. It’s one thing to know that’s happened to someone you care about, but to witness it almost like it’s happened in front of you? He was screaming a name and Mark asked Clint to look into it, and it was almost certainly the pastor from the church his grandparents were dedicated to, who was dead by the time Clint had a return on his leads in Chicago. Jus has only ever stated it happened to him for a prolonged period and by multiple people, and has only really spoken of it in a detached and clinical way, though I’d say he has gone over it in therapy because he’s had therapy sessions that had him being physically sick or passing out from a trauma response. You’ve seen on and off how he has an almost immediate uncontrollable systemic response when his trauma is triggered. Just a few steps too far and this is what can happen, it triggers a psychotic episode.”
Closing her eyes again briefly, Alexis focused on taking some deep and slow breaths so her emotions didn’t spiral. Although she knew some of this with surface-level details, she needed to hear more. It was like she was trying to prepare for some sort of battle, that if she had more information, it would make it easier to get through. It wouldn’t but maybe it could keep her grounded while trying to stay strong for her son. “Am I a terrible mom for being glad he has dissociative amnesia? Like some small mercy that his brain chemistry is blocking some of the things that cause him so much pain. I just wish he could forget it all.”
Sam got up and went back over to the bedside so he could wrap his arms around Alexis and hold her. “You’re not a terrible mum. Not wanting your child to be in pain or distress is the very essence of being a wonderful parent. It’s just also one of the hardest parts. Alec says that a lot of Justin’s memories are still dissociated and it’s likely Jus doesn’t know all the abusers. He just knows what they did to him. James said it's a hallmark that the perpetrators ensure the victims can’t ID them. It’s how they get away with it. I think that if he knows or has any memories that could identify the abusers, he wouldn’t say anyway. He’s too scared Mark would do something stupid and then he’d lose him. But it’s also too traumatic for him to talk about. The worst of the disclosures happened when he was really unwell cycling with mixed episodes or after a psychotic episode. Sash said when it happened with him, it was like Jus was on some sort of disconnected autopilot. He does come through it, though, sweetheart. He comes back to us. It’s just a rough road getting there.” They shared a brief kiss and he started rubbing little circles to her lower back, reminding her she wasn’t going this alone.
“But with everything else happening, without Sash there, does he have the strength to fight?” Alexis murmured, resting her head on Sam’s shoulder.
“Probably not,” Sam reluctantly had to admit. “But somehow, he always still does.”
LOG, COMPLETE