Chapter Seven
HE AND RENATA HAD talked for a long time about getting out of the ward. Sooner or later, they would both be released to foster families. Gabriel sooner than Renata. But Renata whispered to him about escaping. Making a run for it instead of waiting until they were sent off to their foster families. Gabriel had listened to her various suggestions, wondering whether escape was really possible.
“I’ve done it before,” Renata said. “It’s not easy, but it’s possible. And it’s good if you’ve got somewhere to go. I didn’t have anyone on the outside. Nowhere to go.”
“Where did you go?” Gabriel prompted, curious.
“Just around,” she said with a shrug. “Once you’re out, you need to find some clothes. Too visible once you get out of the hospital, if you’re still in blues.”
Gabriel gazed at the window. “What floor are we on?”
“Seven. Too far to jump.”
He laughed. “I’m not thinking of jumping! I’m not trying to kill myself.”
“Probably wouldn’t kill you. Just cripple you. Then you’d be worse off than this.”
Gabriel knew his way around better on the lower floors. He’d had lots of hospital stays, so he knew where things were. If he could get down to the third floor, he knew places to hide. Where to get snacks. Where the children’s wards were where he might find clothes in rooms while the kids watched TV in the common area. That would be the best bet. Then he could go home to Keisha. They could find a place for him to hide if the police or social workers came looking for him. Get everything all arranged so that no one could find him. And he could go back to his old life again.
“How did you get out?”
“Which time?” Renata asked.
“How many times have you escaped?”
“Umm…” she rolled her eyes up toward the ceiling, thinking back. “I think… six. You can do it if you watch for opportunities. Doctors aren’t as careful making sure that doors lock behind them as the nurses are. There are all kinds of carts and bins that are pushed in and out of here. Laundry, lunch, gurneys, other equipment. Just keep your eyes open.”
“I don’t have very long.”
“You can always run away from your foster family. They won’t have security as good as here. Locks and alarms on the doors, maybe. But no orderlies.”
“So you think I should wait? Run away from the foster family?”
Renata considered, chewing on her lip. “Foegels… I haven’t been there before. There’s only so many families that take kids with major medical needs. Sometimes they move you out of the city, if they think you might run or cause trouble or if there’s no one who can take a medical case right now. That makes it a lot harder to run. You can’t just hop a bus with a sob story like you can inside the city.”
Gabriel’s stomach gurgled grumpily at the suggestion of moving farther away from his mother. “I could just call her to come and get me from there,” he suggested.
“No way. They’ll tap her phone. Put a GPS tracker on her car. She tries to take you out of the foster home, and she’s going to go straight to prison. I don’t think you want that, do you?”
Gabriel shook his head. Renata might be happy about her mother being in prison, but the last thing he wanted was for Keisha to be thrown in jail. Eventually, the court system would prove that Gabriel had been taken away without cause, and they would let him go home again. But that couldn’t happen if Keisha was in prison.
“She can’t be part of it,” Renata declared. “You’ve got to do it on your own.”
“Would they move me out of the city? When I’m supposed to be going to the mito clinic? Don’t they have to keep me here?”
“If it’s a family that already knows the protocol, then you’ve only got to go to the clinic once every week or two. So they can be a couple hours’ drive away and still keep you in the program.”
Gabriel watched for his opportunity. He couldn’t wait for the courts to straighten everything out. He wasn’t going to wait for them to put him into a new home, farther away from his mother, where he might be abused or even killed. He kept running through the stats that Renata and Skyler had quoted. Foster care was not safe. He’d be out of the frying pan and into the fire.
No one paid any attention to him while he was sitting in a wheelchair. Somehow people ceased to see him. He became a part of the furniture. So Gabriel sat and watched, occasionally wheeling himself a few feet down the hallway, hanging around the various entrance and exit doors and stairways to see where the best chances for escape would be.
“You can’t run,” Renata had reminded him. “So don’t try. Be stealthy. Just watch and wait.”
He was near one of the stairway doors when an orderly came up from a lower floor and strode into the ward, leaving the pneumatic door to swing shut behind him. Gabriel slipped his foot off of the wheelchair foot platform and jammed it into the closing door. The door stopped. Gabriel watched the orderly to see if he would notice that the door hadn’t clicked shut behind him. But the man just kept going, his mind obviously on something else. Gabriel waited there for a few long seconds, watching the man walk around the corner and out of sight. There were nurses and patients coming and going, but no one looked at Gabriel. No one noticed him with his foot in the door.
Trying to time his movements for when no one was looking his direction, Gabriel stood up, and as gracefully as possible, pushed through the door into the stairwell and let it click quietly shut.
He was out of the ward.
His heart was beating so hard and fast that he couldn’t catch his breath. He tried to calm himself down, but was so anxious that someone would look through the narrow security glass and see him standing there that he couldn’t force himself to relax. Slow, deep breathing did nothing for him.
Gabriel turned to dash down the stairs. It wasn’t until that point that he had to confront the reality of his physical limitations. Stairs? He was just going to run down the stairs to another floor in order to escape and blend in? He was still barely able to walk down the hallway with the handrail and IV pole. That was an accomplishment for him. How was he going to get down the stairs?
Gabriel grabbed the railing and forced himself to put his foot down the first step. He just about overbalance and pitched headfirst down the flight. Gabriel gripped the rail tightly, trying to keep himself upright, battling vertigo as he looked down, and down, and down each flight of stairs. How had he thought that he could just walk right out?
Gabriel’s legs were shaking. He sank down to sit on the top step. Was that it? He wasn’t even going to be able to get down one stair. Once sitting, he felt a bit stronger. The hypotonia was worst in his legs. Those big muscles that were supposed to take all his weight. His trunk and arms were not as weak.
He used his arms to boost himself down to sit on the next stair. Going down still meant supporting his weight mostly on his arms for a few seconds, but he was working with gravity by going down instead of up, and he could rest for a few seconds between each stair. Lifting himself down one stair at a time, Gabriel worked his way down the first flight of stairs. He started to grin to himself. Maybe he could do it. Maybe he could still escape. They wouldn’t be looking for him until supper time, and then no one would know where to look. Who was even going to remember him sitting in the wheelchair near the stairway? They wouldn’t know that he was gone until it was too late.
Two flights of stairs meant one floor. Gabriel saw the doorway to the sixth floor. He wasn’t sure what units were on the sixth floor; he’d never stayed there. But when he saw that the sixth-floor door also had a security swipe panel, he felt suddenly queasy.
He had assumed that only the locked wards like psych would have doors that needed security passes to get through. Was the sixth floor also a locked ward? Maybe a ward for dangerous offenders? Or were all of the stairway doors inaccessible without a security card?
Gabriel’s heart pounded, and he rested his head on the wall, closing his eyes. He was n
ot going to pass out. He was going to stay alert and focused and figure it out.
The door at the ground floor had to be able to be opened without a card, in case of fire. Hopefully, the doors below the fifth floor would not have security panels, and he could escape into the hospital and find a change of clothes. But if they were locked, the bottom door still had to open. Gabriel continued to bum his way down the stairs, one step at a time. His arms ached. They shook every time he put weight on them. How was he going to make it farther than the fifth floor if he had to? Could he make it all the way to the bottom?
He wasn’t even sure what he was going to do if the fifth-floor door was accessible. What ward did it open into? It wouldn’t help him much if it were maternity. He’d stick out like a sore thumb. And he’d have to walk or find a wheelchair. Probably both. ‘Watch for your opportunity’ hadn’t been the best escape plan.
Gabriel heard a door open somewhere below him and footsteps started to mount the stairs. Somehow he hadn’t thought about anyone else using the stairs while he was on them. He thought that it would be quiet. No one would use them. But the only way he had gotten into the stairwell was because someone had used them. People obviously didn’t rely solely on the elevators. Particularly the hospital staff. Gabriel tried to hurry. There was no telling how far away the intruder was. Or how high up he would come. Gabriel had to get to the fifth-floor door and get through it before anyone could see him. It would be obvious, with his gown and bracelet, that he was somewhere he wasn’t supposed to be.
He scraped his elbow on the edge of one of the concrete stairs and bit back a cry. It was nothing. A little scrape. Though at a hospital, even a little scrape could end up getting infected with an antibiotic-resistant staph, or worse. Gabriel had suffered through hospital infections before, and it wasn’t pleasant. Keisha always did everything she could to get him out of the hospital as quickly as possible, before he could pick up an infection or some other bug from another patient or a doctor who hadn’t washed his hands properly.
Gabriel wiped off the dirt and then spit on his hand to wipe his elbow, which he then wiped with the gown. That was the best first aid he could do under the circumstances. He continued on, the intruder’s steadily climbing footsteps getting closer and closer. Gabriel prayed that he would take another door, exiting the stairway, but he could hear every time the man walked through a flat landing and then started climbing up the next flight of stairs. Gabriel was frantic. He was going to be discovered. He finally made it to the fifth-floor landing and looked at the door. A security swipe pad with a red light glared at him.
Gabriel swore. The footsteps were now really close. There was no way to run or hide. He pulled himself to his feet, holding shakily to the handrail. Standing up was less suspicious than sitting on the stairs. If he smiled and said good morning in a confident way, like he was supposed to be there, then maybe the man would go on, not even registering his presence. Act like he was supposed to be there, and people would believe it. That was what they said on TV thrillers.
A man wearing a doctor’s lab jacket came around the corner and continued to mount the stairs at a steady pace. Gabriel wasn’t exactly sure how far the man had climbed, but it seemed like about three flights, and he wasn’t even breathing hard. What Gabriel wouldn’t give for an energy system like that. The doctor’s eyes went over Gabriel curiously. Gabriel tried to look like he wasn’t hanging onto the rail for dear life and forced a pleasant smile.
“Morning!”
“Good morning.” The doctor’s pace was slowing. He stopped a few stairs below Gabriel. “Are you all right?”
“Oh, yeah, fine.” Gabriel’s legs were shaking like jelly. He was sure that the doctor could see, considering they weren’t even covered by the blue hospital gown.
“Where did you come from?” The doctor looked up the stairs and at the closed fifth-floor door.
“I didn’t know it would lock,” Gabriel said. “I thought it was okay to use the stairs. It’s…” Gabriel was short of breath despite himself. “It’s good exercise, right? You should always take the stairs when you can.”
“Sure,” the doctor agreed with a friendly smile. He motioned to the locked door. “Do you want me to let you out?”
Gabriel continued to smile. “Yeah. That would be great.”
The doctor swiped his security card, and the light turned green. Gabriel staggered from the handrail to the doorknob for support. He turned it. As he opened the door, the doctor’s hand closed around Gabriel’s arm. Gabriel was too weak to try to twist away from him. The friendly doctor rotated Gabriel’s hospital bracelet to look at the details on it.
“Psychiatric,” he observed. “I think you’re on the wrong floor.”
Gabriel just looked at him. The doctor walked him through the door, but it became quickly obvious that Gabriel couldn’t go far under his own power, and the doctor grabbed a wheelchair from the unit they had walked into, which turned out to be nephrology. Gabriel expected the doctor to call security, but he looked at his watch and shrugged.
“I guess I’ll take you back up. Faster than waiting for someone to come pick you up.”
Gabriel didn’t say anything. The doctor didn’t make small talk, but wheeled him to the nearest elevator and headed up to the seventh floor, where he was required to swipe his card again to get off of the elevator. It caused quite a stir when he pushed Gabriel back to the nursing station. Gabriel hid his face behind his hands.
“I brought you an escapee,” the doctor said cheerfully.
“Gabriel!”
“Where did you find him?”
“In the stairway, a couple of floors down.”
The staff turned to look at the stairway door, which was now securely closed. One of the orderlies walked over and tested to make sure that it couldn’t be opened again.
“Well, thank you, doctor,” Nurse Barrett said, approaching and taking the wheelchair from him. “We’ll take it from here.”
“Keep an eye on that one!”
“Oh, we will.”
Gabriel swallowed. Barrett pushed him back to his room, and without a word, she helped him to stand up and to get into bed. Once he was lying down, she checked his pulse and his temperature. Gabriel was soaked in sweat from the effort of his escape, but she didn’t change him out of the damp gown; she just threw another blanket over him.
“I don’t understand why you would do something stupid like that,” Barrett said, putting the blood pressure cuff around his arm and starting to pump it up. “You’re getting out of here in a couple of days, why the sudden effort to escape?”
Gabriel waited while she released the valve and listened with her stethoscope.
“I just… want to go home.”
He was surprised when she pulled out a blood sugar monitor. He lay still while she lanced his finger and checked his glucose.
“You’re crashing,” she observed. “Why would you do something like that?”
“I want to see my mom. They’re going to take me somewhere else. Maybe out of the city.”
She shook her head. “If you are going to escape, you’re going to need some help. You can’t even walk out of here under your own power.”
Gabriel grimaced and nodded.
“Stay put. I’ll rustle you up something to eat.”
“Thanks.”
When she returned a few minutes later, she had a cheese string and a yogurt cup. Gabriel looked at the proffered snacks and then her face. “No dairy. I can’t eat that.”
“You need a snack. This is what we’ve got.”
“I can’t eat those.”
“What about the yogurt? It’s predigested. It’s not dairy anymore.”
“No,” Gabriel shook his head. “I can’t!”
“Honestly!” She rolled her eyes and stalked back out.
Gabriel didn’t know if that meant that she was going to look for another snack, or that he was screwed. He pulled the blankets around him. He was starting to shiver in spite of
the extra blanket, the hospital gown clammy against his skin.
He was beginning to think that Nurse Barrett had given up and was just going to let him crash, and then Nurse Lee came in.
“Sugar for you!” she announced. She put an applesauce cup and plastic spoon down on his rolling table and also pulled out a needle and vial. “Which arm?”
Gabriel pulled his left out from under the covers and held it out for her. Lee tapped his arm along the vein and didn’t bother with a tourniquet. She filled the needle and expertly slid it into his vein, hitting the bulls-eye the first time. Gabriel watched as she pushed the plunger in.
“There you go. That should help. Now eat. It’s a couple of hours until dinner and this is all I could find.”
“Thanks.”
She nodded and put a bandage on the injection site. Gabriel suddenly remembered his scraped elbow and held up his arm to show it to her.
“Can you clean that too?”
She held his arm still and took a closer look. “What did you do that for?”
He gave her an embarrassed smile. “I was injured in my daring escape attempt.”
Lee laughed. She got some alcohol wipes out of the side table drawer and cleaned the graze.
Gabriel gasped at the burn. “Oh! Ow! Oh, that hurts.”
“That’ll teach you not to go running away. Now, nap time. You eat your applesauce and stay in bed, or I’m going to get the doctor’s permission to sedate you. Then you can sleep until Friday.”
It was the first day that Renata was able to be up and around. Gabriel didn’t know where she got all her energy. Most people with a punctured lung would have been happy to stay in bed for a few days. But maybe it was because she was used to functioning with so little cellular energy, a little thing like traumatic injury couldn’t slow her down. She pushed a wheelchair into Gabriel’s room. Her oxygen tank was on the seat of the wheelchair and her IV hung on a pole attached to the back of the chair, and she was pushing it instead of sitting in it. She had a lot more stamina than Gabriel did. But then, from what he could tell, she was actually in psych for psychological issues, instead of for the amorphous ‘evaluation’ that Gabriel was there for, which seemed to mean taking him off of all of his meds to see how sick it would make him, and then putting him back on all of them, all for no particular reason.
“Ding, ding, trolley coming through,” Renata announced, in a mock-British accent.
“Hi!”
“Hi yourself. So, you enjoy your freedom yesterday?”
“No, not much.”
“Yeah.” Renata removed the oxygen canister from her wheelchair and sat herself down. “Getting out of the ward is one thing. Getting out of the hospital isn’t such a simple thing.”
“Why didn’t you mention that you can’t get back out of the stairwell without a security card?” Gabriel demanded.
“I dunno. You didn’t ask. I figured you knew.”
“I didn’t. Thought I’d be home free once I got out.”
“Nope. You gotta make sure you’ve got a swipe card too. Nurses leave them lying around all the time.”
“Well, I guess that’s it for my brilliant escape plans. I’m not going to get out again between now and when the social worker comes.”
“Yeah.” Renata reached for Gabriel’s table, which had been pushed to the side. “Hey. They left your chart here.”
Usually, the ubiquitous clipboard was carried in and out of the room by the nurse or doctor and kept at the nursing station between visits. This time, there had been a ruckus in the hallway, with an old man yelling and cursing. The nurse had left to see what was going on and had not returned.
Renata picked up the chart and started flipping through it.
“Hey, you can’t look at that,” Gabriel objected. “That’s private!”
“Well, you have a look, then. Usually, they won’t let you see it.”
She held it out to him. Gabriel hesitated. But why not? It was his chart; he had a right to see his own information. He took it from Renata, glancing at the door to make sure that no one was watching. He scanned the front page, but it was boring, mostly just vital signs and a few squiggles that he wasn’t sure of. He thought they might be shorthand for medications and dosages. He flipped back through the stack of papers, reading a few words in cramped handwriting wherever it was legible. Then he skipped straight to the back. The earliest records, from when he was first admitted. He looked over the chaotic, disorganized notes in several different hands.
“Munchhausen by Proxy?” he read aloud.
“Yeah, that makes sense,” Renata said. “Means they suspect your mom of trying to make you sick, to get attention and sympathy. It’s an easy way to get any medically fragile kid away from his parents.”
“Why would they think she was trying to make me sick?”
“They don’t. Not really. But that’s what they tell the social worker and the judge. Yes, this kid is dangerously ill, and we think that most or all the symptoms are being caused by the mother poisoning him. So he must be taken away immediately, for his own safety. Easy to keep mom out of the picture, too, because they need to have you by yourself to evaluate which symptoms are real and which ones are being caused by something she’s doing.”
“That’s crazy!”
“Hence the psych ward,” Renata laughed.
“No, I mean, it’s crazy that anyone would think that.”
“Think about it. Mito kids have a lot of bizarre, seemingly unrelated symptoms. There is no ‘usual’ course, they’re all different, and it can affect every system in the body.” She straightened up taller, trying to see what else was on the clipboard. “The other thing that they’ll say is that it’s psychosomatic. Does it say that?”
“Psychosomatic?” Gabriel searched the page. “Why would it say that? If she was poisoning me, then it wouldn’t be psychosomatic.”
“Why not? She could be making you sick by giving you something, but she could be making you more sick by suggesting things too. The body does what you tell it to.”
“She doesn’t do that! She’d never do that!”
“It could be very subtle,” Renata said. “You wouldn’t even realize she was doing it.”
“My mom is not trying to make me sick!”
Renata shrugged. “Maybe not,” she agreed cheerfully. “But could you prove it?”
Gabriel opened his mouth to argue, then closed it again. How could he prove that someone wasn’t telling him he was sicker than he was? It wasn’t like testing for arsenic. How could doctors even tell if a symptom was psychosomatic? And if it was, how could they tell where the thought came from? They couldn’t trace people’s thoughts.
He looked back down at the clipboard and skimmed through the words and phrases that he could read. “My mom isn’t making me sick. They think because she changed my diet and supplements that she’s making me sick? I was sick before that. She was helping me to feel better.”
“Munchhausen works every time. Kids with Munchhausen by Proxy parents get better and sicker all the time. Drives the doctors crazy, because they can’t sort out what’s going on. Every time the kid starts to get better, his health takes another nose dive. You fit the pattern, right? You get better, you get worse, you get new symptoms. You go to the hospital; you get better. You go home, you get sick and have to come back again…”
Gabriel shook his head. “No…”
She reached to take the clipboard from him, but Gabriel pulled it back. He didn’t want to share his private information with her. Renata leaned back again. She scratched at the bandaging under her gown, wincing and shifting her position.
“They’ve got her. She’s never going to be able to get you back. She wouldn’t put you in the mito clinic. She wouldn’t follow the protocol at the weight clinic. Your health keeps getting better and worse. Classic Munchhausen by Proxy, and that means they can never give you back to her.”
Gabriel pressed the button to call a nurse. Renata looked at him, frowni
ng. Gabriel rested the clipboard in his lap and put his head back, closing his eyes.
“Are you okay? You sick?”
Gabriel didn’t answer. One of the nurses came in after a few minutes. “You called? What do you need?”
Gabriel opened his eyes. “I want to go to sleep. I want to be alone.”
The nurse looked at Gabriel, then at Renata. She picked the clipboard up from Gabriel’s lap. “Let’s go, Miss Vega.”
Renata didn’t make a move, staring at Gabriel.
“I’m tired,” Gabriel repeated.
The nurse grasped the handles on Renata’s wheelchair and turned her around. Renata didn’t say good-bye.