She swallows. “She has bipolar.”
“What type?”
“Type I.” She runs a hand over her face. “She was diagnosed after Piper was born.” She keeps her eyes fixed on my shirt button as she rattles off facts with the precision of a head nurse. “She’s had four major hospitalizations in my lifetime. Two depressive, two manic. This is the worst manic break since I was twenty-five.”
That’s detailed. It’s the language of someone who’s been in too many exam rooms and hospital corridors to count.
She quickly gives me the rundown of her mother’s medication. “The doses were adjusted last year after a depressive episode. She’s been stable for a while.”
“When did she stop taking them?”
Madison’s jaw tightens. “Weeks ago. Maybe longer. I’m not exactly sure. She hid them.”
“She didn’t tell anyone?”
“No.”
“Does she know she stopped?”
“Yes and no,” Madison says quietly. “She thinks she doesn’t need them anymore. She says she feels good. That she’s having good days.”
I process the data. Bipolar I with psychotic features. Off-meds. The brain is basically on fire at this point.
“Is she aggressive?” I ask.
“Frantic,” Madison clarifies. “She’s pulling at us. She’s trying to scrub the skin off her hands.”
I look past Madison and see a man I assume is her father standing in the shadows of the hallway. He looks between Madison and me before stepping forward to shake my hand.
“Beckett, I assume?”
I dip my chin.
“Thanks for coming. I’m Arthur. Madi’s father. Donna is in the bedroom. She’s trying to fold the same sheet over and over. She won’t stop. She’s… she’s talking to people who aren’t there.”
“Madison tells me she’s been off her medication.”
“I promised her, after the last time, I promised I’d never send her back. It broke her. It broke her spirit.” He closes his eyes, a single tear escaping. “I can’t be the one to put her back in a cage. I love her too much.”
I look at Madison. She’s watching her father with a mixture of pity and weary frustration. She’s been the one holding the line while her father held the heart.
“Arthur,” I say gently. “This isn’t my primary specialty. I can assess her, and I can try to get her to take a sedative to break the cycle of sleeplessness, but if she’s a danger to herself or if her vitals are compromised, we have to consider hospitalization. The brain can’t sustain this level of activity indefinitely.”
He exhales and nods once, while Madison gives me a small look of thanks.
“She’s in the bedroom,” she repeats. “She won’t take anything. She thinks we’re trying to ‘poison the light.’ She’s terrified of being sedated.”
I either forget or just don’t care when I reach out and wipe a tear away from her cheek with my thumb. She sighs into my touch.
God, I want to pick her up and run away with her.
Arthur mumbles another thanks before he disappears into the kitchen.
“If I go up there alone, do you think she’ll remember me?”
Madison huffs a sad laugh. “We’re married with a dog, remember?”
“A Golden Retriever?”
